Epidemiological characteristics and risk factors of bronchiectasis in patients with chronic obstructive pulmonary disease in Suining area / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics and risk factors of bronchiectasis in patients with chronic obstructive pulmonary disease (COPD) in Suining area, and to provide theoretical basis for COPD prevention and treatment of bronchiectasis. Methods A total of 582 patients with ACUTE exacerbation of COPD (AECOPD) admitted to grade A Hospitals in Suining area from 2019 to 2020 were selected as the investigation objects. According to whether the patients had bronchiectasis, they were divided into control group (without bronchiectasis, n=485) and observation group (with bronchiectasis, n=97). The risk factors of bronchiectasis in COPD patients were analyzed by univariate analysis and logistic regression. The clinical data of the two groups were compared, including age, sex, whether there were other diseases, respiratory tract infection, proportion of purpuric sputum, colonization rate of Pseudomonas aeruginosa. Results Of 16.84% (49/291) AECOPD patients occurred Bronchiectasis. The colonization rate of Pseudomonas aeruginosa in observation group was significantly higher than that in control group (P<0.05). The values of FVC and FEV1/FVC in observation group were significantly lower than those in control group (P<0.05). The levels of serum CRP and PCT in the observation group were significantly higher than those in the control group (P<0.05). Male (OR=2.515), high proportion of GOLD grade III/IV (OR=3.654), smoking (OR=3.472), diabetes (OR=3.829) and bacterial infection (OR=4.159) were independent risk factors for bronchiectasis in COPD patients (P<0.05). Conclusion COPD patients in Suining area have a high risk of bronchiectasis.The lung function was declined significantly.It has a high colonization rate of Pseudomonas aeruginosa. Patients who are male, have a high proportion of GOLD class III/IV, smoke, have diabetes, and have bacterial infections should be given interventions that can reduce the risk of bronchiectasis in COPD patients.

CHESS endoscopic ruler in objective measurement of diameter of esophageal varices in liver cirrhosis and portal hypertension: a prospective multicenter study / 中华消化杂志

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.

Analysis of drug resistance of Helicobacter pylori in different age groups in Ningxia / 中华消化杂志

Objective:To investigate the antibiotics resistance of patients with Helicobacter pylori ( H. pylori) infection of different age in Ningxia. Methods:From July to December 2021, a total of 1 040 patients with H. pylori infection confirmed by 14C-urea breath test who had no history of H. pylori treatment and underwent gastroscopy were selected from the H. pylori special outpatient clinics from Ningxia Hui Autonomous Region People′s Hospital, Ningxia Hospital of Integrated Traditional Chinese and Western Medicine, Yuanzhou District People′s Hospital of Guyuan, Wuzhong People′s Hospital, the Second People′s Hospital of Shizuishan, People′s Hospital of Zhongwei, Yinchuan First People′s Hospital. Gastric mucosa specimens were obtained under gastroscopy and cultured for H. pylori in vitro. Harvested H. pylori were detected for H. pylori drug resistance phenotype. Kirby-Bauer disk diffusion method was used to detect antibiotic sensitivity. Previous use of antibiotics of patients were recorded. The characteristics of primary drug resistance of people≤44, 45 to 59, and ≥60 years old were analyzed. Chi-square test was used for statistical analysis. Results:A total of 538 H. pylori strains were obtained from 1 040 gastric mucosa specimens cultured in vitro, with a positive rate of 51.7%. A total of 187 patients could provide information on history of antibiotics usage. The primary drug resistance rates of metronidazole, clarithromycin and levofloxacin were high, which were 95.5% (514/538), 44.6% (240/538) and 45.4% (244/538), respectively; however drug resistance of amoxicillin, furazolidone and tetracycline were not found. The double drug resistance rate was 36.4% (196/538), mainly resistant to metronidazole and clarithromycin or metronidazole and levofloxacin, the drug resistance rates were 17.8% (96/538), 18.2% (98/538), respecitively. The triple drug resistance rate was 25.5% (137/538), all of the strains were metronidazole, clarithromycin and levofloxacin resistant strains. The primary drug resistance rates to levofloxacin and clarithromycin in patients with H. pylori infection who had previous history of quinolones and macrolides were 60.9% (28/46) and 63.4% (83/131), respectively; which were higher than those of patients who had not used corresponding drugs (41.8%, 59/141 and 39.3%, 22/56), and the differences were statistically significant ( χ2=5.05 and 9.23, P=0.023, 0.002). The drug resistance rates of metronidazole of ≤44, 45 to 59, and ≥60 years old group were 94.2% (163/173), 95.5% (231/242) and 97.6% (120/123), respectively, and the differences were not significant ( P>0.05). The single drug resistance rates of levofloxacin of ≤44, 45 to 59, and ≥60 years old group were 34.7% (60/173), 48.3% (117/242) and 54.5% (67/123), respectively, and the differences were statistically significant ( χ2=12.95, P=0.002). The levofloxacin resistance rate of ≤44 years old group was lower than that of 45 to 59, and ≥60 years old group, and the differences were statistically significant ( χ2=7.70 and 11.49, P=0.006, 0.001). The single drug resistance rates of clarithromycin of ≤44, 45 to 59, and ≥60 years old group were 36.4% (63/173), 50.4% (122/242) and 44.7% (55/123), respectively, and the differences were statistically significant ( χ2=8.00, P=0.018). The clarithromycin resistance rate of ≤44 years old group was lower than 45 to 59 years old group, and the difference was statistically significant ( χ2=8.00, P=0.005). Dual drug resistance rates of levofloxacin and clarithromycin of ≤44, 45 to 59 and ≥60 years old group were 49.7%(86/173), 70.2%(170/242), 45.5%(56/123), and the difference was statistically significant( χ2=27.63, P<0.001). The resistance rate of clarithromycin and levofloxacin in 45 to 59 years old group was higher than that in ≤44 and ≥60 years old group, and the difference was statistically significant ( χ2=18.00 and 21.13, both P<0.001). Conclusions:Primary drug resistance rates to metronidazole, levofloxacin and clarithromycin are high in patients with H. pylori infection of different ages in Ningxia. Individualized eradication therapy guided by drug resistance test is recommended.

Current status of prevention and treatment of esophagogastric variceal bleeding in cirrhotic portal hypertension patients in Ningxia region: a multicenter study / 中华消化外科杂志

Objective:To investigate the current status of prevention and treatment of esophagogastric variceal bleeding (EVB) in cirrhotic portal hypertension patients in Ningxia region.Methods:The retrospective and descriptive study was conducted. The clinical data of 820 cirrhotic portal hypertension patients who were admitted to 21 medical centers in Niangxia region from January 2018 to December 2020 were collected, including 85 cases in Ningxia Hui Autonomous Region People′s Hospital, 73 cases in the Fifth People′s Hospital of Ningxia Hui Autonomous Region, 59 cases in the Wuzhong People′s Hospital, 52 cases in the Qingtongxia People′s Hospital, 50 cases in the Guyuan People′s Hospital, 47 cases in the Yuanzhou District People′s Hospital of Guyuan City, 47 cases in the Yinchuan Second People′s Hospital, 40 cases in the General Hospital of Ningxia Medical University, 40 cases in the Tongxin People′s Hospital, 35 cases in the Yinchuan First People′s Hospital, 34 cases in the Third People′s Hospital of Ningxia Hui Autonomous Region, 32 cases in the Zhongwei People′s Hospital, 30 cases in the Lingwu People′s Hospital, 30 cases in the Wuzhong New District Hospital, 30 cases in the Yanchi People′s Hospital, 29 cases in the Ningxia Hui Autonomous Region Academy of Traditional Chinese Medicine, 28 cases in the Shizuishan Second People′s Hospital, 25 cases in the Shizuishan First People′s Hospital, 21 cases in the Haiyuan People′s Hospital, 20 cases in the Pengyang People′s Hospital, 13 cases in the Longde People′s Hospital. There were 538 males and 282 females, aged (56±13)years. Observation indicators: (1) clinical charac-teristics of cirrhotic portal hypertension patients; (2) overall prevention and treatment of EVB in cirrhotic portal hypertension patients; (3) prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Results:(1) Clinical characteristics of cirrhotic portal hypertension patients: of 820 cirrhotic portal hypertension patients, 271 cases were in compensated stage and 549 cases were in decompensated stage. Of the 271 cases in compensated stage, there were 183 maels and 88 females, aged (53±12)years. There were 185 Han people, 85 Hui people and 1 case of other ethic group. The etiological data of liver cirrhosis showed 211 cases of viral hepatitis B, 4 cases of alcoholic liver disease, 8 cases of viral hepatitis C, and 48 cases of other etiology. There were 235 cases of Child-Pugh grade A and 36 cases lack of data. Of the 549 cases in decompensated stage, there were 355 males and 194 females, aged (57±14) years. There were 373 Han people, 174 Hui people and 2 cases of other ethic group. The etiological data of liver cirrhosis showed 392 cases of viral hepatitis B, 33 cases of alcoholic liver disease, 10 cases of viral hepatitis C, and 114 cases of other etiology. There were 80 cases of Child-Pugh grade A, 289 cases of grade B, 170 cases of grade C and 10 cases lack of data. (2) Overall prevention and treatment of EVB in cirrhotic portal hypertension patients: of 271 patients in compensated stage, 38 cases received non-selective β-blocker (NSBB) therapy, 16 cases received endoscopic treatment, 6 cases received interventional therapy. Of 549 patients in decompensated stage, 68 cases received NSBB therapy, 46 cases received endoscopic treatment, 28 cases received interventional therapy. (3) Prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals: of 271 patients in compensated stage, 181 cases came from tertiary hospitals, of which 28 cases received NSBB therapy, 15 cases received endoscopic treatment, 6 cases received interventional therapy. Ninety cases came from secondary hospitals, of which 10 cases received NSBB therapy, 1 cases received endoscopic treatment. There was no significant difference in NSBB for prevention of EVB between tertiary and secondary hospitals ( χ2=0.947, P>0.05), while there was a significant difference in endoscopic treatment for prevention of EVB between tertiary and secondary hospitals ( χ2=5.572, P<0.05). Of 549 patients in decompensated stage, 309 cases came from tertiary hospitals, of which 22 cases received NSBB therapy, 29 cases received endoscopic treatment, 22 cases received interventional therapy. Two hundreds and fourty cases came from secondary hospitals, of which 46 cases received NSBB therapy, 17 cases received endoscopic treatment, 6 cases received interven-tional therapy. There were significant differences in NSBB and interventional therapy for prevention of EVB between tertiary and secondary hospitals ( χ2=18.065, 5.956, P<0.05). Conclusions:The proportion of receiving EUB prevention in cirrhotic portal hypertension in Ningxia is relatively low. For patients with compensated liver cirrhosis, the proportion of NSBB therapy and endoscopic treatment in the secondary hospitals was lower than that in tertiary hospitals. For patients with decompensated liver cirrhosis, the proportion of interventional treatment in secondary hospitals is lower than that of tertiary hospitals, but the proportion of NSBB in secondary hospitals taking is higher than that of tertiary hospitals.

Clinical experience in choledochoscopy for the treatment of intrahepatic bile duct stones complicated by biliary stricture: a clinical analysis of 230 cases / 临床肝胆病杂志

Objective To investigate the value of choledochoscopy in the treatment of intrahepatic bile duct stones complicated by biliary stricture,treatment methods,and related complications.Methods A retrospective analysis was performed for the clinical data of 230 patients with intrahepatic bile duct stones complicated by biliary stricture who underwent choledochoscopy in Jiangning Hospital Affiliated to Nanjing Medical University from June 2015 to May 2017.The treatment timing and duration of choledochoscopy,number of times of stone removal,and intraoperative complications were observed,and the patients were followed up for 1-3 months to observe residual stones,T tube detachment,and postoperative gastrointestinal reactions.Results Of all patients,229 had benign biliary stricture and 1 had malignant biliary stricture found by choledochoscopy.A total of 692 person-times of choledochoscopy were performed,and the patients underwent 2-7 times of choledochoscopy (mean 3.9 ± 1.1).Each time of choledochoscopy lasted for 25-60 minutes (mean 40.9 ± 11.5 minutes).Choledochoscopy was performed during 90-120 days after surgery (mean 105.0-± 9.5 days).Eight patients experienced T tube detachment,and six of them underwent successful T tube replacement.Of all patients,4 had residual stones after choledochoscopy,resulting in a residual stone rate of 1.73％.There were 83 person-times of postoperative complications including pyrexia,nausea,and diarrhea,which were relieved after symptomatic treatment.Conclusion Choledochoscopy is an important supplemental therapy for the surgical treatment of intrahepatic bile duct stones complicated by biliary stricture and has the features of high efficiency,small trauma,and rapid recovery.Therefore,it holds promise for clinical application.

Molecular simulation study on the recognition between hydroxy isoindolin ketone derivatives and HIV-1 integrase / 中国药科大学学报

@#To discuss the conformational change and the recognition mechanism of hydroxy isoindol ketone derivatives with HIV-1 integrase, fifty-eight hydroxy isoindol ketone derivatives were docked to the integrase using AutoDock program. Molecular dynamics simulation with 16 ns was carried out for the two complex modes, respectively, in which the corresponding small molecules exhibited strong inhibition ability. Main force acting on the association of small molecules with integrase was explored based on the docking complex model. After analyzing the hydrogen-bond and conformational changes, it was found that the hydrogen-bond between N155 and D64 was the key factor maintaining the DDE motif stability. Furthermore, the hydrophobic interactions between the loop region where Y143 located and the hydroxy isoindol ketone derivatives were found to play an important role for their recognition.

Molecular recognition mechanism and motion of HCV NS3/4A protease with Faldaprevir analogue / 生物工程学报

Faldaprevir analogue molecule (FAM) has been reported to effectively inhibit the catalytic activity of HCV NS3/4A protease, making it a potential lead compound against HCV. A series of HCV NS3/4A protease crystal structures were analyzed by bioinformatics methods, and the FAM-HCV NS3/4A protease crystal structure was chosen for this study. A 20.4 ns molecular dynamics simulation of the complex consists of HCV NS3/4A protease and FAM was conducted. The key amino acid residues for interaction and the binding driving force for the molecular recognition between the protease and FAM were identified from the hydrogen bonds and binding free energy analyses. With the driving force of hydrogen bonds and van der Waals, FAM specifically bind to the active pocket of HCV NS3/4A protease, including V130-S137, F152-D166, D77-D79 and V55, which agreed with the experimental data. The effect of R155K, D168E/V and V170T site-directed mutagenesis on FAM molecular recognition was analyzed for their effect on drug resistance, which provided the possible molecular explanation of FAM resistance. Finally, the system conformational change was explored by using free energy landscape and conformational cluster. The result showed four kinds of dominant conformation, which provides theoretical basis for subsequent design of Faldaprevir analogue inhibitors based on the structure of HCV NS3/4A protease.

Modulation of endothelial progenitor cells by tumor necrosis factor-α in multiple organ dysfunction ;syndrome in swine / 中华危重病急救医学

Objective To study the modulation in number and function of endothelial progenitor cell ( EPC ) in multiple organ dysfunction syndrome ( MODS ) after trauma in swine, and to investigate its pathogenesis. Methods Forty pigs were divided into sham group and MODS group ( each, n = 20 ). The model of MODS of two-hit injury, namely hemorrhagic shock and endotoxemia, was reproduced. The peripheral blood was collected before hemorrhage ( T1 ) and endotoxin injection ( T2 ), and 1 hour ( T3 ), 24 hours ( T4 ), 48 hours ( T5 ) after endotoxin injection. Phosphorylation of p38 mitogen-activated protein kinase ( p-p38MAPK ) in mononuclear cell was determined by Western Blot, the content of tumor necrosis factor-α ( TNF-α) was determined with enzyme linked immunosorbent assay ( ELISA ), and the number of EPC was determined with flow cytometry. Results Model of MODS was successfully reproduced in 17 pigs. In model group, the expression of p-p38MAPK ( A value ) peaked at T3 ( 4.83±0.52 ), and gradually declined at T4 and T5 ( 4.36±0.43, 1.93±0.33 ), and the expression of p-p38MAPK at T3-T5 was significantly higher than that at T1 ( 1.00±0.22, all P<0.01 ). The plasma concentration of TNF-α( ng/L ) at T3 in MODS group was obviously elevated compared with that of sham group ( 532.43±52.17 vs. 129.03±20.45, t=31.163, P<0.001 ), and it peaked at T3, it then gradually lowered, and it was significantly higher at T4 and T5 than that in sham group ( T4: 398.93±35.75 vs. 131.12±29.53, t = 26.562, P < 0.001; T5: 287.48±27.26 vs. 126.44±26.96, t=17.861, P<0.001 ). The number of EPC ( ×107/L ) was apparently increased in MODS group at T3 compared with sham group ( 4.832±0.624 vs. 3.545±0.363, t=9.542, P<0.001 ), and it peaked at T3, then gradually decreased, and the number of EPC at T4 and T5 was significantly lower than that in sham group ( T4:2.628±0.627 vs. 3.442±0.325, t=5.043, P<0.001;T5:2.203±0.711 vs. 3.471±0.323, t=2.972, P<0.001 ). Conclusion Phosphorylation of p38MAPK could increase the plasma concentration of TNF-αand decrease the quantity of EPC in MODS,which may be one of the mechanisms of MODS.

Electronic data quality control strategy in clinical research / 中华医学科研管理杂志

Objective To establish a method for data quality control of clinical research data based on electronic data capture (EDC) system.Methods After analyzed the specific characteristics of EDC's workflow process,and also referred to international data management guideline,we established the data quality control strategy by summarizing actual data quality control experience of data management department in Peking University Clinical Research Institute.Results Application of EDC has changed traditional clinical research process,therefore EDC data quality control strategy should be built according to its own process flow,namely,selecting the appropriate EDC system,reasonable design and build electronic case report form (eCRF),standardization research center / user management processes,timely and accurate on line eCRF filling up,accurately capturing/docking ex ternal electronic data,planned data monitor and auditing,timely and efficient query management,strictly data locking and unlocking operation process,and strict electronic record life cycle monitoring.Conclusions At present time,clinical research in China is still in the earlier stage of the transition from traditional paper-based data collection (PDC) to EDC.Establishing and applying particular quality control strategy will optimize the process and results of data quality control.

Nationwide Investigation and Analysis of Present Status of Independent Clinical Laboratories in China / 现代检验医学杂志

Objective To build a supervision mechanism for independent clinical labs (ICL),surveyed the current situation of such novel institutions in China.Methods By way of the nationwide network of clinical labs,ICL in China were surveyed by written questionnaires and spot inspection.Results In the surveyed 38 ICLs,the maximum registered capital was 44 900 thousands,the minimum was 2 000 thousands.The maximum number of employee was 1 105,the minimum was 19.6 labs passed ISO15189 ratification,4 labs passed CAP ratification.17 labs participated in local external quality control,29 labs par-ticipated in national external quality control.Conclusion Although ICL in our country have developed well in the past dec-ade,such vulnerabilities as unbalanced staff ratio,full-range quality control bugs,cutthroat competition,asymmetrical infor-mation disclosure and bio-safety have loomed in the meantime.It is time to formulate a stricter industry access system and appropriate regulatory modes.

The structure and technical research of medical information interaction and sharing among regions / 生物医学工程学杂志

The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional clinical data repository (CDR).

Performance evaluation of paramagnetic particles chemiluminescence micro-particle immunoassay for determination of serum vitamin B12 / 中国免疫学杂志

Objective:To evaluate the performance of paramagnetic particles chemiluminescence microparticle immunoassay ( CMIA) for detection of serum Vitamin B12 ( VitB12 ).Methods: Analysed CMIA system precision, accuracy, anti-interference, analytical measuring range( AMR) ,clinical reportable range ( CRR) and biological reference interval were evaluated,according to the clinical and laboratory standards institude ( CLSI) EP5-A2,EP15-A2,EP7-A2,EP6-A,C28-A3c guidelines.To assess the accuracy,we used the reference material SRM 1955 from national institute of standards and technology ( NIST ) and external quality assessment ( EQA) samples ( LN5-B and K-C) from CAP.Results:The precisions of within-run and between-run were less than standard of manu-facturer when the concentration of VitB12 was 108.84-874.43 pmol/L.The results of SRM1955 met the allowable range of the target val-ue.The results of EQA samples( K-C and LN5-B) also up to the CAP calibration and validation/linear evaluation error limits stipulated standards,and the results through linear verification when the concentration of VitB12 was 89-1 057 pmol/L.The 95% verification interval contains the specified value also.The relative deviation was less than external quality assessment standard from national center for clinical laboratory ( TEa:target value ±25%).Anti-interference evaluation showed without significant interferenc when TG ≤20 mmol/L,Bil ≤300 μmol/L VitC≤1.5 g/L to the VitB12 detection system ( CMIA).AMR validation showed determines the best fit equation was linear equation polynomial.There was the linear relationship when the concentration of VitB12 was 0-1 107 pmol/L.The upper limit of CRR was 110 700 pmol/L,the maximum dilution was 100 times.Biological reference interval validation showed that the overall level of VitB12 in this study reference individuals conform to the standard of manufacturer statement for the population,the overall level of VitB12 in female little higher than male,but no significant differences.Conclusion:Performance of CMIA for detection of serum VitB12 basically met needs of laboratory,which can provide reliable results of VitB12 for laboratory,provide information for the VitB12 status of population in the laboratory evaluation.

The observation on the effect of recombinant human interleukin-11 inhalation for preventing and curing radioactive laryngitis / 中国实用护理杂志

Objective To conduct prospective randomized controlled clinical observation on patients with nasopharyngeal carcinoma under chemotherapy and radiotherapy using inhaling therapy with recombinant human interleukin 11,and the preventing and curing effect of recombinant human interleukin 11 on radiation-induced pharyngitis is evaluated.Methods 161 cases of newly diagnosed patients with head and neck cancer were selected under the principle of informed consent and these 161 cases were divided into the observation group (87 cases) and the control group (74 cases) based on randomization principle.In the observation group,when the dose reached 20Gy,then recombinant human interleukin-11 inhaling therapy was applied `ll the end of radiotherapy,for the control group,conventional treatment was applied in the event of radioactive throat.RTOG criteria were used during the observation in patients with the occurrence and treatment of radioactive pharyngitis.Results When compared with the control group,the average time for radioactivity to appear was prolonged,the severity decreased and the healing time was shortened in the observation group,those data were statistically significant.Conclusions Recombinant human interleukin-11 inhaling therapy can prevent and cure inhalation of radioactive pharyngitis and this therapy is better than conventional treatment.It's worthy of further study and clinical application.

Investigation of self-perceived burden among continuous ambulatory peritoneal dialysis patients / 中国实用护理杂志

Objective To investigate the level of self-perceived burden(SPB) and analyze the influencing factors in continuous ambulatory peritoneal dialysis(CAPD) patients.Methods One hundred and ten CAPD patients were investigated by a self-designed demographic questionnaire and Self-Perceived Burden Scale (SPBS).Results The total score of SPBS was (30.27±7.88) points,being in a middle level,and 85.45％ of the patients showed different levels of burden.Single factor analysis showed the influencing factors of self-perceived burden were marital status,family per capita income,the main caregivers and selfcare ability.Conclusions Most CAPD patients have obvious self-perceived burden,nursing staff should use the relevant nursing measures to reduce the SPB with CAPD patients and improve their quality of life.

A preliminary study of test reliabilty in quantitative proprioception measurement / 中华物理医学与康复杂志

Objective To study the test-retest reliability in quantitative measurement of proprioception using Tecnobody rehabilitation system.Methods Nine healthy volunteers [4 males,5 females,averaged age (22.8 ±0.68) years] participated in three consecutive measurements on both feet by using Tecnobody rehabilitation system for computerized proprioceptive assessment.Standard error of measurement(SEM),correlation coefficient and intraclass correlation coefficient(ICC) obtained from the three consecutive measurements were used to analyze the Timeused in each measuring session,and the average track error (ATE) of the measurements.ResultsSEM values of Time in left foot and right foot were 3.07 ～ 3.83 and 6.65 ～ 8.44 respectively.ATE values in left foot and right foot were 1.33 ～ 1.97 and 1.39 ～ 1.91 respectively.The Time and ATE correlation coefficients of left foot / right foot were 0.919/0.6 and 0.808/0.831,respectively.The Time ICC values were 0.893/0.639 for left foot / right foot,respectively ; and the ATE ICC values were 0.716/0.734 for left foot / right foot,respectively. Conclusion The Tecnobody rehabilitation system provided a fairly good reliability in both relative andabsolute values in quantitative evaluation of proprioception in the feet.These data in a larger amount may be useful for setting up variables and the standard values of the local population for reference in proprioceptive rehabilitation.

The Development of Clinical Document Standards for Semantic Interoperability in China / 대한의료정보학회지

OBJECTIVES: This study is aimed at developing a set of data groups (DGs) to be employed as reusable building blocks for the construction of the eight most common clinical documents used in China's general hospitals in order to achieve their structural and semantic standardization. METHODS: The Diagnostics knowledge framework, the related approaches taken from the Health Level Seven (HL7), the Integrating the Healthcare Enterprise (IHE), and the Healthcare Information Technology Standards Panel (HITSP) and 1,487 original clinical records were considered together to form the DG architecture and data sets. The internal structure, content, and semantics of each DG were then defined by mapping each DG data set to a corresponding Clinical Document Architecture data element and matching each DG data set to the metadata in the Chinese National Health Data Dictionary. By using the DGs as reusable building blocks, standardized structures and semantics regarding the clinical documents for semantic interoperability were able to be constructed. RESULTS: Altogether, 5 header DGs, 48 section DGs, and 17 entry DGs were developed. Several issues regarding the DGs, including their internal structure, identifiers, data set names, definitions, length and format, data types, and value sets, were further defined. Standardized structures and semantics regarding the eight clinical documents were structured by the DGs. CONCLUSIONS: This approach of constructing clinical document standards using DGs is a feasible standard-driven solution useful in preparing documents possessing semantic interoperability among the disparate information systems in China. These standards need to be validated and refined through further study.

Combined surgical treatment for the patients with Hepatocellular Carcinoma complicated with Portal Hypertension / 中国综合临床

ObjectiveTo explore the practicability of combined surgical treatment for the patients with Hepatocellular Carcinoma(HCC) complicated with Portal Hypertension(PH).MethodsThe clinical data of 43 patients withHCCcomplicatedwithsignificantesophagealvaricesandhyperspleniawereanalyzed retrospectively.All patients were diagnosed with esophageal varices and hypersplenia of different degrees, 14 of them had severe esophageal varices, the other 29 patients had moderate esophageal varices.Firstly all patients underwent splenectomy, 18 of them had selective portoazygous devascularization in addition.After that the patients received hepatectomys ,with local excision or segmentectomy as the major operation methods.Results All patients received hepatectomy combined with splenectomy treatment.There was no perioperative mortality, but 12 patients had complications after the surgery.Over seventy percents patients(33/43)accepted regular followup.Among these 33 patients,the 1-year and 3-year survival rates were 90.9％ (30/33) and 63.6％ (21/33)respectively.Eleven patients died of tumor recurrence.Four patients had upper postoperatively gastrointestinal hemorrhage.ConclusionHepatectomy combined with splenectomy didn't increase the mortality in the patients with HCC complicated with PH.The combined surgery might reduce the incidence of severe complications, such as postoperative bleeding.We believe the combined surgical treatment is feasible for this group of the patients.

The clinical value of using a four-point method to measure joint angles / 中华物理医学与康复杂志

Objective To study the clinical value of using a four-point method (FP) in measuring joint angles.Method Methods Twenty-five subjects without knee dysfunction were studied.Every knee joint was tested in extension,below 90° of flexion and above 90° of flexion with the traditional three-point method (TP) and the new four-point method.X-rays were taken as a gold standard measurement.The reliability and validity were analyzed using Bland-Altman plots,which can yield 95% limits of agreement (LOA).Results (1) The joint axis centers moved with changes in joint angle.(2) The 95% LOA of inter-tester reliability was (-5.0,2.7) with the FP and (-6.5,4.4) with the TP.The 95% LOAs of intra-tester reliability were (-3.6,4.0) for tester A and (-4.1,4.8) for tester B with the FP,while (-5.0,6.4) for tester A and (-6.1,5.8) for tester B with the TP.(3) The 95% LOAs in the three positions were (3.5,2.6) in extension,(-3.3,3.6) in mild flexion and (-1.9,5.7) in greater flexion with the FP,and ( 6.8,1.1),(-4.0,7.1) and (0,8.5) with the TP.Conclusions The FP gives better reliability and validity than the TP in joint angle measurement.

Influence of Different Extraction and Purification Methods on Astragalus Polysaccharides and Pharmacological Evaluation / 中草药·英文版

Objective To clarify the influence on component and pharmacological action of Astragalus polysaccharides (APS) as complementary therapeutic agents prepared by different extraction and purification techniques. Methods Components of APS prepared by different extraction and purification techniques were analyzed, and these APS were used for synergy and attenuation of chemotherapy, radiotherapy treatment with H22 liver cancer and Lewis lung cancer of tumor-bearing mice, and also used for the regulation of immune function to immunosuppression mice. Results Experimental data were analyzed by means of statistical method to get pharmaco-result: A3 (extracted by microwave assistance and purified by membrane separation) > A4 (extracted by refluxing and purified by membrane separation) > A1 (extracted by refluxing and no purification)≈ A2 (extracted by microwave assistance and no purification). There were no significant differences on pharmacodynamic action between A1 and A2. However, compared with A1 and A2,it was worth noting that A3 and A4 exhibited good pharmacodynamic action. Then A3-in and A4-in, the samples in dialyzer after dialysis, were separated and purified to get homogeneous APS, which were the principal constituents of APS in dialyzer, with the molecular weight (Mw) of 7669 and 14 142 determined by HPGPC, respectively. The average Mw of APS outside of the dialyzer, A3-out was 3102 and A4-out 3256, which were the main compositions of A3 and A4, accounted for 79.63% and 53.92%, respectively. Conclusion APS with Mw about 5000 Da exhibit better antitumor effect and immunological activity. Refluxing, microwave assistance extractions, and membrane enrichment techniques bring different cases on Mw distribution, components and pharmacodynamic action, and obviously exhibit relationship among component, Mw distribution, and pharmacological action.

Preliminary study of 1.5 T MR guided radio-frequency ablation for hepatic malignant tumors / 中华放射学杂志

Objective To explore the technique and feasibility of using 1.5 T MR guided radiofrequency ablation (RFA) of hepatic malignant tumor. Methods Twenty three patients with 44 malignant lesions in liver confirmed by pathology were treated with 1.5 T MR guided RFA using MR compatible multipolar RF electrode. Only patients refusing open surgery or suffering from unresectable lesions were included. Of these, 11 patients had primary hepatic carcinoma and 12 patients had hepatic metastases. The mean maximal diameter of lesions was (3.3 ± 1.8)cm. Postoperative MR was performed; the ablation zone covered and exceeded 0.5 to 1.0 cm to the margin of initial tumor was considered successful. Results All ablations were successful and lesions created by radio frequency were large enough to cover the initial tumor volume in all cases. No severe complications such as biliary fistula, perforation of diaphragmatic muscle,postoperative jaundice and pneumothorax were encountered. The mean operative time was (93 ± 33 ) min.The RF electrodes appeared in MRI as low signal structure. The ablation lesions were well-defined hyperintensity in T1 WI and hypo-intensity with a thin rim of high signal intensity on T2WI and DWI. Conclusion 1.5 T MR guided RFA of hepatic malignant tumor is an effective and safe technique.