The role of a simple Nomogram model in evaluating the severity of mycoplasma pneumonia pneumonia in adults / 中国基层医药

Objective:To investigate the role of a simple Nomogram model in evaluating the severity of mycoplasma pneumoniae pneumonia (MPP) in adults.Methods:The clinical data of 162 patients with MPP who received treatment in Wenzhou Central Hospital from March 2015 to October 2022 were retrospectively analyzed. These patients were divided into a severe group ( n = 67) and a common group ( n = 95) according to whether they were diagnosed with severe MPP. The clinical data of patients were recorded. Fourteen clinical variables were screened, including age, sex, onset season, fever, heat peak, fever duration, cough duration, white blood cell count, percentage of neutrophils, percentage of lymphocytes, hemoglobin, platelet count, C-reactive protein, and procalcitonin. Multivariate logistic regression analysis of statistically significant variables in univariate analysis was performed. The Nomogram model was constructed with the R language software package (version 3.6.2). The model was verified with a calibration curve and receiver operating characteristic curve. Results:Univariate analysis results showed that in the severe group, the fever peak ( Z = 5.03, P < 0.001) was higher, fever duration ( χ2 = 27.55, P < 0.001), and cough duration ( χ2 = 28.72, P < 0.001) were longer, white cell count ( t = 2.93, P = 0.004), percentage of neutrophils ( t = 9.08, P < 0.001), C-reactive protein ( t = 35.05, P < 0.001), and procalcitonin level ( t = 15.09, P < 0.001) were greater compared with the common group. The percentage of lymphocytes ( t = 1.16, P < 0.001), hemoglobin level ( t = 1.22, P < 0.001), and platelet count ( t = 2.82, P < 0.001) in the severe group were significantly lower than those in the common group. Multivariate logistic regression analysis results showed that heat peak, cough duration, and C-reactive protein were positively correlated with the severity of MPP (all P < 0.05). The percentage of lymphocytes, hemoglobin concentration, and platelet count were negatively correlated with the severity of MPP (all P < 0.05). The establishment and validation results of the Nomogram model showed that the accuracy of the model was good, with a sensitivity of 88.73%, a specificity of 77.61%, and a C-index of 0.904. Conclusion:Heat peak, cough duration, percentage of lymphocytes, platelet count, and C-reactive protein are closely related to the severity of early MPP. A simple Nomogram model can be one of the tools for early assessment of the severity of MPP.

Effects of daily mean temperature on the incidence of other infectious diarrhea in Hebei Province / 中华传染病杂志

Objective:To explore the lag effect and correlation between daily average temperature and the incidence of other infectious diarrhea in Hebei Province.Methods:The data of meteorological factors (including temperature and average daily temperature) and the daily incidence of other infectious diarrhea in Zhangjiakou City, Chengde City, Tangshan City, Qinhuangdao City, Baoding City, Langfang City, Cangzhou City, Shijiazhuang City, Hengshui City, Xingtai City, and Handan City in Hebei Province from 2017 to 2020 were collected. Eleven prefecture-level cities were divided into four regions, including east, north, middle and south regions. Distributed lag non-linear model was applied to examine the non-linear associations and the lag effect of daily mean temperature on daily incidence of other infectious diarrhea. Meanwhile, the cold and hot effects were used to estinuate the lag-response relationship on the incidence of other infectious diarrhea.Results:A total of 231 008 cases of other infectious diarrhea were reported in Hebei Province. The seasonal distribution was obvious, showing a bimodal distribution of large peaks in summer and small peaks in winter. An inverse S-shaped association between average daily temperature and cumulative risk ratio ( RR) of other infectious diarrhea was observed in Hebei Province. Both high temperature (higher than 27.50 ℃) and low temperature (less than 13.67 ℃) could increase the risk of other infectious diarrhea. When the temperature was lower than 13.00 ℃, the lag time and RR had a U-shaped association (lag four to seven days, 23 to 30 days). Meanwhile, when it was higher than 13.00 ℃, it had an inverted U-shaped association (lag 5 to 21 days). A comparison of four regions of Hebei Province showed that the lag time from south to north was extended from six days to 30 days at low temperature effects with temperature P5=-7.24 ℃. When the temperature getting hot ( P95=28.25 ℃), the risk occurred at lag 0 days, and the lag time gradually got short from north to south. Thus, the high temperature effect reached maximum quickly with a relative short duration. Conclusions:The inverse S-shaped non-linear association between daily average temperature and the incidence of other infectious diarrhea in Hebei Province is observed. Both low temperature and high temperature are associated with increased risk of other infectious diarrhea. But the impact of low temperature is more notable, which has a relative long duration.

The value of circulating microRNA-1 in the early diagnosis of coronary atherosclerotic plaque rupture in patients with stable coronary heart disease / 中华危重病急救医学

Objective:To evaluate the diagnostic value of circulating microRNA-1 (miR-1) in early coronary artery plaque rupture in patients with stable coronary artery disease (SCAD).Methods:A prospective cohort study was conducted. Sixty-seven patients with SCAD admitted to the department of cardiology of the Third Affiliated Hospital of Soochow University from January to June in 2019 were enrolled. All patients had completed coronary angiography (CAG), percutaneous coronary intervention (PCI) single stent implantation or only CAG was performed according to the CAG results. Blood samples were collected before (0 hour) and 3 hours after the procedure. The expression of plasma miR-1 was detected by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR), and electrocardiogram was used to detect cardiac troponin I (cTnI) levels. The difference of miR-1 and cTnI levels in PCI or CAG patients before and after procedure were compared, and the value for early diagnosis of coronary artery plaque rupture in SCAD patients was evaluated. The diagnostic efficacy was evaluated by the receiver operating characteristic curve (ROC curve).Results:There were 38 CAG patients and 29 PCI patients. There were no significant differences in gender, age, previous history (without hypertension history) and baseline data of cardiac function between the two groups. The expression of miR-1 after PCI was significantly higher than that before PCI [2 -ΔΔCt: 2.11 (1.56, 2.73) vs. 1.26 (1.07, 1.92), P < 0.01], and there was no significant difference in cTnI level before and after PCI [μg/L: 0.00 (0.00, 0.02) vs. 0.00 (0.00, 0.02), P > 0.05]. There were no significant differences in miR-1 and cTnI levels before and after procedure in the CAG group [miR-1 (2 -ΔΔCt): 1.09 (1.00, 1.40) vs. 1.21 (1.00, 1.71), cTnI (μg/L): 0.00 (0.00, 0.02) vs. 0.00 (0.00, 0.02), both P > 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) and 95% confidence interval (95% CI) of miR-1 in the diagnosis of coronary plaque rupture were 0.794 (0.687-0.900), P < 0.01, the sensitivity was 82.8%, the specificity was 68.4%, and the optimal cut-off value was 1.51. The AUC and 95% CI of the difference of miR-1 before and after operation (ΔmiR-1) were 0.704 (0.567-0.842), P = 0.004, the sensitivity was 62.1%, the specificity was 84.2%, and the optimal cut-off value was 0.39. The efficancy of miR-1 and ΔmiR-1 after procedure to diagnose coronary plaque rupture in patients with SCAD was similar ( Z = 1.287, P = 0.198). However, baseline miR-1 might not predict whether patients with SCAD need PCI or not (AUC = 0.630, P > 0.05). Multivariate binary Logistic regression analysis showed that increased postoperative miR-1 expression was an independent risk factor for coronary plaque rupture in SCAD patients [odds ratios ( OR) = 2.887, 95% CI was 1.044-7.978, P = 0.041]. Conclusion:Circulating miR-1 might have the value for early diagnosis of coronary artery plaque rupture in SCAD patients.

On the differences and reasons of online courses demand for military medical students at different educational levels: taking an example of a military medical university / 中华医学教育探索杂志

Objective:To explore the distinctions between different educational levels: stability of learning state, views on and demand for online courses, and further investigate the influencing factors.Methods:A self-designed questionnaire with good reliability and validity was conducted, and all the students in a military medical university were selected by cluster sampling method, and the data were collected by issuing a network questionnaire. SPSS 26.0 was used for data processing.Results:Undergraduates were different from graduates and doctoral students in stability of learning state, the period of home study: doctoral students (2.41±1.30) h < graduates (2.10±1.17) h and undergraduates (2.15±0.99) h; the frequency of using online courses: undergraduates (4.18±1.10) times > graduates (3.29±1.16) times and doctoral students (3.29±0.98) times. In terms of views on online courses, necessity: undergraduates (4.14± 1.01) > graduates (3.93±1.05) and doctoral students (3.78±1.03); familiarity: undergraduates (3.42 ± 0.91) > graduates (3.27±0.97); adaptability: undergraduates (3.79±0.91) > graduates (3.58±0.94) and doctoral students (3.63±0.97); likability: undergraduates (3.36±1.04) > undergraduates (3.25±0.96) and doctoral students (3.17 ± 1.01); teaching effect: undergraduates (2.80±1.04) > graduates (2.67±1.01) and doctoral students (2.61±1.03). In terms of demand for online courses, ideal number: undergraduates (2.52±1.27) > graduates (2.11±1.21) and doctoral students (2.01±1.25); class style: undergraduates (1.77±0.94) > graduates (2.00±0.92) and doctoral students (2.04±1.83). There were statistically significant differences between undergraduates and postgraduates in all dimensions ( P<0.01 or P<0.05). Conclusion:Undergraduates may be more susceptible to academic environment than graduates and doctoral students, showing that the learning stability of undergraduates is the relatively the worst. Undergraduates most recognize online courses, and different educational levels have different demands for online courses.

Nursing of patients with traumatic aortic dissection / 中国实用护理杂志

Objective:To summarize the nursing experience of patients with traumatic aortic dissection.Methods:The clinical data of 72 patients with traumatic aortic dissection treated in our department from January 2009 to August 2020 were retrospectively analyzed. Maintain hemodynamic stability and prevent shock, accurate judgment and effective analgesia, safe transportation and avoid secondary damage, careful skin care during bed confinement, prevention of deep vein thrombosis, lung nursing after thoracic injury are included.Results:Totally 69 patients survived, the survival rate was 95.83%. 1 patient was critically ill before the operation and was treated with invasive ventilator at admission. After the above nursing, he could not maintain effective vital signs and died. 1 patient died of aortic dissection rupture before operation. 1 patient died of disseminated intravascular coagulation after stent implantation. 1 patient suffered from skin pressure injury during hospitalization. No aortic rupture or fracture site displacement occurred in tran sit. Among the 5 patients with atelectasis, 1 died of using invasive ventilator before operation, and the other 4 patients recovered well after treatment with noninvasive positive pressure ventilation. No DVT occurred in all patients during hospitalization, 1 patient was diagnosed as deep vein thrombosis and pulmonary embolism at admission. After treatment, the symptoms of pulmonary embolism improved.Conclusions:Pay attention to hemodynamic monitoring and maintenance of stability, accurate analgesia, safe transport, skin care, anticoagulation prevention of deep vein thrombosis and intraoperative bleeding, lung care after chest injury, can effectively reduce complications and promote the rehabilitation of patients.

Biological functions of CREB/ATF bZIP transcription factor in metabolism and cell growth / 生理学报

Nutrient overload-caused deregulation of glucose and lipid metabolism leads to insulin resistance and metabolic disorders, which increases the risk of several types of cancers. CREB/ATF bZIP transcription factor (CREBZF), a novel transcription factor of the ATF/CREB family, has emerged as a critical mechanism bridging the gap between metabolism and cell growth. CREBZF forms a heterodimer with other proteins and functions as a coregulator for gene expression. CREBZF deficiency in the liver attenuates hepatic steatosis in high fat diet-induced insulin-resistant mice, while the expression levels of CREBZF are increased in the livers of obese mice and humans with hepatic steatosis. Intriguingly, CREBZF also regulates cell proliferation and apoptosis via interaction with several transcription factors including STAT3, p53 and HCF-1. Knockout of CREBZF in hepatocytes results in enhanced cell cycle progression and proliferation capacity in mice. Here we highlight how the CREBZF signaling network contributes to the deregulation of metabolism and cell growth, and discuss the potential of targeting these molecules for the treatment of insulin resistance, diabetes, fatty liver disease and cancer.

Study on transformation rules of terrestrosin D in course of Tribuli Fructus stir-frying based on simulated processing technology / 中国中药杂志

The contents of terrestrosin D and hecogenin from Tribuli Fructus were determined before and after stir-frying. The results showed that the content of terrestrosin D was decreased significantly,and the content of hecogenin was increased significantly after such processing. In order to verify the inference that terrestrosin D was converted to hecogenin by stir-frying,the quantitative variation rules of terrestrosin D and hecogenin were studied by simulated processing technology,and the simulated processing product of terrestrosin D was qualitatively characterized by ultra performance liquid chromatography/time of flight mass spectrometry( UPLC-TOF/MS) to clarify its transformation process during stir-frying. The results showed that the content of terrestrosin D was decreased significantly at first and then a platform stage appeared with the prolongation of processing time at a certain temperature. Raising the stir-frying temperature could further decrease the content of terrestrosin D and delay the time that the platform stage appeared. When the processing was simulated at higher temperatures( 220 ℃ and 240 ℃),the content of hecogenin was increased gradually with the increase of processing temperature and the prolongation of processing time. In the process of stir-frying,the deglycosylation reaction of terrestrosin D to hecogenin was not completed in one step. The deglycosylation reaction occurred first at the end of the sugar chain,and then other glycosyl units in the sugar chain were sequentially removed from the outside to the inside to finally form the hecogenin. This study provides a basis for further revealing the detoxification mechanism of stir-fried Tribuli Fructus.

Analysis of Solubilization of Fatty Oil from Euphorbiae Semen on Four Euphorbia Factors Based on Thinking of Self-assembled Micelles in vivo / 中国实验方剂学杂志

Objective: The solubilization of 4 compounds(Euphorbia factor L1,L2,L3 and L8),caused by mixed micelles self-assembled from fatty oil of Euphorbiae Semen and bile salt of intestinal juice,was researched in the simulated human intestinal environment. Method: The mixed micelles were prepared with different amounts of fatty oil of Euphorbiae Semen.The transmission electron microscope(TEM) was used to observe the morphology of the micelles.Particle size detector was used to determine the particle size and Zeta potential.HPLC was used to assay the solubility of these 4 compounds.The variation tendency of the total dissolution of these 4 compounds with the change of standing time was observed. Result: Particle size of the mixed micelles was uniform and its morphology was spherical.The absolute values of Zeta potential were less than 20 mV.When the amount of sodium deoxycholate was fixed 4.96 g·L-1,the solubility of these 4 compounds with the concentration of fatty oil at 0.1-4 g·L-1 were significantly greater than that at the dosage of 0 g·L-1.The solubility of these 4 compounds in the micelles formed by fatty oil was 1.3 to 4 times as much as the micelles without fatty oil.The micelles was stable for 36 h. Conclusion: The micelles self-assembled from fatty oil of Euphorbiae Semen and bile salt of intestinal juice,have significant solubilization effect on Euphorbia factor L1,L2,L3 and L8.This research can lay the foundation for clarifying the detoxification mechanism of removing fatty oil and making frostlike powder from the perspective of pharmaceutics.

Epidemiologic characteristics and pathogen surveillance of hand, foot and mouth disease in Hebei province from 2008 to 2017 / 中华疾病控制杂志

Objective To analyze the epidemiological and pathogenic characteristics of hand-foot-mouth disease (HFMD) in Hebei Province from 2008 to 2017, so as to provide scientific evidence for prevention and control of HFMD. Methods The epidemic data and laboratory detection data of HFMD from 2008 to 2017 were collected and analyzed by descriptive epidemiology. Results From 2008 to 2017,a total of 690 368 cases of hand, foot and mouth disease, including 4 939 severe cases and 208 deaths were reported in Hebei Province, with an average annual incidence of 95.53/100 000. The largest number of reported light cases were 2009, while severe cases and deaths were in 2010. The number of reported cases increased every other year but decreased in general. In 2008, 2009 and 2012, the main peak of the onset of spring and summer was formed from April to June. In 2010, 2011 and 2013-2017, the main peak of the onset of spring and summer was from May to July. Main peak value in spring and summer showed a backward delayed trend. The sex ratio between men and women was 1.59:1.The majority of deaths case were scattered children and preschool case. Other enteroviruses, human enterovirus 71,(EV-A71) and coxasckievirus A16,(CV-A16) alternately became the main pathogens of common cases. The pathogenic composition of different cases was different and the difference was statistically significant ( 2=2274.17, P<0.001). Conclusion The number of reported deaths and severe cases has decreased significantly. It is necessary to adjust the focus of prevention and control, pay more attention to the mild cases of FHMD, and further strengthen the monitoring of other enteroviruses pathogenic spectrum.

Analysis of the epidemiological characteristics of severe and deceased cases of hand, foot and mouth disease in Hebei province between 2010 and 2016 / 中华实验和临床病毒学杂志

Objective@#To analyze the epidemiological characteristics of severe and deceased cases of hand, foot and mouth disease (HFMD) in Hebei province, so as to provide reference for prevention and control of the disease.@*Methods@#Severe and deceased HFMD cases reported from the National Disease Surveillance Information Management System and the laboratory testing result in Hebei province from 2010 to 2016 were analyzed. Descriptive epidemiological method involving the distribution of population, area, time and pathogeny were used for the analysis.@*Results@#From 2010 to 2016, 3 803 severe HFMD cases and 162 deceased cases were reported in Hebei province, and the ratio of severe cases among all HFMD patients was 0.75%. A chi-square test showed that the incidence of severe HFMD between males and females was significantly different (χ2=239.37, P<0.001), and scattered children were the main patient. Infants less than six months of age had the highest ratio of severe HFMD cases, the group of one-year-old and younger children had the highest proportion of severe HFMD cases. The severe ratio and severe incidence of Xingtai, Langfang and Hengshui were the top three prefectures having the highest proportions of severe cases. The number of severe cases fluctuated over the past 7years, but showed a downward trend. The constituent ratios of EV-A71 in severe cases and deaths were 79.25% and 92.66%, respectively.@*Conclusions@#Severe HFMD epidemics showed a declining trend in Hebei province. EV-A71 is still the main pathogen of both severe and fatal cases. It is necessary to strengthen the prophylactic and therapeutic measures for the young children (< 2 years).

Influence of students' autonomous learning ability on problem-based learning — taking medical psychology course as an example / 中华医学教育探索杂志

Objective Studies have shown that problem based learning (PBL) can improve the students' ability of autonomous learning.However,it is unclear whether students' autonomous learning ability will affect students' evaluation in PBL teaching.This study took medical psychology course as an example to explore the influence of medical students' autonomous learning ability on PBL teaching effect.Methods 43 8-year program medical students of Grade 2010 and 2011 were enrolled in this study.Scale was used to assess medical students' autonomous learning ability before the start of the PBL teaching.Self made questionnaire was used to survey the students' evaluation in PBL teaching.Linear correlation analysis was used to detect the relationship between medical students' autonomous learning ability and students' evaluation in PBL teaching and their examination results.Results Medical students' autonomous leaming ability is significantly positively correlated to the students' evaluation of PBL teaching (P＜0.05).The correlation coefficient between learning motivation and "PBL enhanced learning interest" or "PBL enhanced information utilization ability" was high (r=0.507 and 0.536,respectively).It showed that students with stronger autonomous learning ability had more positive evaluation of PBL teaching.The students' learning motivation was also positively correlated to the test score (r=0.416,P=0.006).Students with stronger learning motivation had higher test score in the final exam.Conclusion These results indicate that the relationship between the students' autonomous learning ability and PBL teaching is bidirectional.The students with more powerful ability of autonomous learning will be more active in the process of PBL teaching,and the positive experience will promote their autonomous learning ability in turn.

Related factors and interaction on HIV/HCV co-infection of patients access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT).Methods A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region.The questionnaires information included demographic characteristics,HIV and HCV infection status,history of drug abuse,urine test for morphine,high risk sex behaviors,needle sharing,dropped out etc.Methods of x2 test one-way,multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection.Results The study subjects included 750 participants,18.31％ (127/691) of patients were co-infected with HIV and HCV.The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84％ (81/226) and 19.88％ (64/322) respectively,which were higher than those who have never shared needles or dropped out (9.89％,46/465 and 17.07％,63/369).Logistic regression analysis results showed that after adjusted for confounding factors,patients who shared needles (OR=4.50,95％CI:2.72-7.43) and dropped out of treatment (OR=1.71,95％CI:1.04-2.80) were more likely to be infected with HIV/HCV.Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21,AP=0.44,SI=1.95).Conclusions Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection.Health education,psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.

Related factors and interaction on HIV/HCV co-infection of patients access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT).Methods A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region.The questionnaires information included demographic characteristics,HIV and HCV infection status,history of drug abuse,urine test for morphine,high risk sex behaviors,needle sharing,dropped out etc.Methods of x2 test one-way,multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection.Results The study subjects included 750 participants,18.31％ (127/691) of patients were co-infected with HIV and HCV.The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84％ (81/226) and 19.88％ (64/322) respectively,which were higher than those who have never shared needles or dropped out (9.89％,46/465 and 17.07％,63/369).Logistic regression analysis results showed that after adjusted for confounding factors,patients who shared needles (OR=4.50,95％CI:2.72-7.43) and dropped out of treatment (OR=1.71,95％CI:1.04-2.80) were more likely to be infected with HIV/HCV.Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21,AP=0.44,SI=1.95).Conclusions Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection.Health education,psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.

Analysis of molecular characteristics of aggregation epidemic induced by norovirus infection in Hebei province, 2015-2016 / 中华实验和临床病毒学杂志

Objective@#To understand epidemiological characteristics of the pathogens and evolution of the genotype associated with infectious diarrhea epidemic caused by norovirus in Hebei Province.@*Methods@#A total of 8 infectious diarrhea outbreaks caused by norovirus were reported from Jan 2015 to Dec 2016, of which epidemic treatment materials and specimens were collected at the same time. Norovirus nucleic acid was detected by using real-time PCR, and the partial ORF2 of the all positive specimens were amplified by RT-PCR and sequenced. Phylogenetic tree was constructed by using Mega5.2 based on partial ORF2 sequences of norovirus to perform phylogenetic analysis.@*Results@#A total of 8 norovirus outbreaks, involving 265 cases who were mainly for residential inhabitents, children and students, were reported during this period, and the overall attack rate ranged from 0.70% to 8.13%. The overall positive detection rate of norovirus was 66.25%. The PCR products were sequenced, and sequencing result were obtained for 28 samples, which included GⅠ.3, GⅡ.2, GⅡ.4, GⅡ.13 and GⅡ.17.@*Conclusions@#Multiple genotypes of infectious diarrhea outbreaks caused by norovirus were found in Hebei province.

Inhibiting miR-29 on growth, invasion and metastasis of PANC1 cells / 中华胰腺病杂志

Objective To investigate the effects of inhibiting miR-29 on growth,invasion and metastasis of pancreatic cancer PANC1 cells,and explore the potential mechanism.Methods Oligonucleotides inhibiting miR-29 (anti miR-29) and control oligonucleotides (miR NC) were used to transfect PANC1 cells to establish anti miR-29 PANC1 cells and miR NC PANC1 cells.Transient transfection of PUMA siRNA,E-cadherin siRNA or NC siRNA was used to construct cotransfected anti miR29 + PUMA-siRNA-PANC1 cells and anti-miR-29 + E-cadherin-siRNA-PANC1 cells.Number of colony formations was observed,cell survival was detected by MTT,cell apoptosis was measured by flow cytometry,cell invasion was detected by transwell chamber assay,and cell migration was detected by wound healing assay.Subcutaneous injection of anti miR-29 PANC1 cells was used to establish xenograft nude mice model,and venous injection of anti miR-29 PANC1 cells was used to establish lung metastasis nude mice model,and the subcutaneous and venous injection of PANC1 cells served as control.The growth of xenograft and the number of lung metastatic nodules were observed.TUNEL method was used to detect cell apoptosis in xenograft and immunohistochemical analysis was used to detect PUMA and E-cadherin in xenograft.Results The survival rate of PANC1,miR-NC-PANC1 and anti-miR-29-PANC1 cells was 100％,(96.8 ± 2.8) ％ and (24.4 ± 3.2) ％.The number of colony formation was (213 ± 36),(196 ± 28) and (37 ± 6) per 100 high power field.The number of transmembrane cells was (56.3 ± 9.6),(49.8-± 7.3) and (11.2 ± 3.4) per 400 high power field.The distance of cell migration was (260 ± 48),(247 ± 46) and (53 ± 7) μm.Cell apoptosis rate was (1.5 +0.9) ％,(2.6 + 0.9) ％ and (22.4 + 2.8) ％.There was statistically significant difference between anti miR 29 PANC1 cells and other PANC1 cells (P ＜0.05).The survival rate,apoptosis rate,transmembrane cells and migration distance of anti-miR-29 + PUMA-siRNA-PANC1 cells was (84.7 ± 10.9) ％,(1.3 ± 0.8) ％,(49.7 ± 6.4) per 400 high power field and (182 ± 36) μm,indicating that the effects of miR 29 inhibition on PANC1 cells were abolished (all P ＜0.05).The volume of the xenograft of PANC1 and anti-miR-29-PANC1 cells was (3 800 ±270) and (1 890 ± 160)mm3,the cell apoptosis rate was 0.93 ±0.14 and 8.26 ± 1.15,the number of metastatic lung lesions was (26.4 ± 6.5) and (8.6 ± 2.7),the PUMA positivity was (7.2 ±1.6) ％ and (43.8 ± 7.6) ％,E-cadherin positivity was (8.3 ± 3.6) ％ and (47.4 ± 5.7) ％,respectively.The xenograft volume and the number of metastatic lung nodules of anti miR29 PANC1 cells was obviously decreased or decreased,but cell apoptosis rate,PUMA positivity and E cadherin positivity were obviously increased,and the differences were all statistically significant (P ＜ 0.05).Conclusions Inhibiting miR-29 expression can decrease cell proliferation,migration and metastasis of PANC1 cells,and the potential mechanism may be associated with the upregulation of PUMA and E-cadherin.

Correlation between insufficient methadone dosage and morphine positive urine on drop out of treatment in patients with access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.

Correlation between insufficient methadone dosage and morphine positive urine on drop out of treatment in patients with access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.

Correlation Between Brain Activation Changes and Cognitive Improvement Following Cognitive Remediation Therapy in Schizophrenia: An Activation Likelihood Estimation Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several studies using functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have indicated that cognitive remediation therapy (CRT) might improve cognitive function by changing brain activations in patients with schizophrenia. However, the results were not consistent in these changed brain areas in different studies. The present activation likelihood estimation (ALE) meta-analysis was conducted to investigate whether cognitive function change was accompanied by the brain activation changes, and where the main areas most related to these changes were in schizophrenia patients after CRT. Analyses of whole-brain studies and whole-brain + region of interest (ROI) studies were compared to explore the effect of the different methodologies on the results.</p><p><b>METHODS</b>A computerized systematic search was conducted to collect fMRI and PET studies on brain activation changes in schizophrenia patients from pre- to post-CRT. Nine studies using fMRI techniques were included in the meta-analysis. Ginger ALE 2.3.1 was used to perform meta-analysis across these imaging studies.</p><p><b>RESULTS</b>The main areas with increased brain activation were in frontal and parietal lobe, including left medial frontal gyrus, left inferior frontal gyrus, right middle frontal gyrus, right postcentral gyrus, and inferior parietal lobule in patients after CRT, yet no decreased brain activation was found. Although similar increased activation brain areas were identified in ALE with or without ROI studies, analysis including ROI studies had a higher ALE value.</p><p><b>CONCLUSIONS</b>The current findings suggest that CRT might improve the cognition of schizophrenia patients by increasing activations of the frontal and parietal lobe. In addition, it might provide more evidence to confirm results by including ROI studies in ALE meta-analysis.</p>

PBL teaching practice in medical psychology——taking somatoform disorders as an example / 中华医学教育探索杂志

According to the course characteristics and teaching outline of medical psychology,problem-based learning (PBL) case about somatoform disorders was compiled based on a typical clinical real case.The PBL case covered a wide range of topics such as basic medicine,clinical medicine and medical psychology.Just as clinical treatment process,teachers gave information and put forward the corresponding questions in successive steps.By self-study and group discussion,students learned knowledge about anxiety,somatoform disorders,therapeutic relationship,sociocultural factors and individual personality.The course survey showed that PBL teaching was appreciated by medical students.The PBL model can improve learning interest and self-study ability,promote the connection of different subjects and combine theory and practice.The PBL model is useful for improving the quality of medical psychology teaching.

Early diagnostic value of circulating microRNA-1 on acute myocardial infarction in patients with chest pain / 中华危重病急救医学

Objective To evaluate the early diagnostic value of circulating microRNA-1 (miR-1) on acute myocardial infarction (AMI). Methods A prospective cohort study was conducted. The patients with chest pain admitted to the Second People's Hospital of Wuxi from November 2012 to June 2015 were enrolled. According to AMI diagnostic criteria, the patients were divided into AMI group and non-AMI group, and healthy individuals during the same period were served as heath controls. The venous samples of the onset patients were collected within 3 hours after admission. The plasma miR-1 was determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the levels of plasma cardiac troponin I (cTnI) and MB isoenzyme of creatine kinase (CK-MB) were measured by electrochemiluminescence. The correlation between plasma miR-1 and cTnI as well as CK-MB was performed by Spearman analysis. The early diagnostic performance of plasma miR-1, cTnI, and CK-MB for AMI was estimated by receiver operating characteristic (ROC) curve analysis. Results There were 127 patients in AMI group, and 107 in non-AMI group, including 82 patients with angina pectoris, 2 with pulmonary embolism, 3 with aortic dissection, 2 with acute pericarditis, 3 with myocarditis, 13 with acute heart failure, and 2 with peptic ulcer. Ninety volunteers were served as healthy controls. There was no difference in clinical characteristics including gender and hyperlipidemia between AMI group and non-AMI group. The expressions of plasma miR-1, cTnI and CK-MB were significantly increased in AMI patients as compared with those of the healthy controls [miR-1 (2-ΔΔCt): 4.32±2.60 vs. 1.44±0.75 and 0.98±0.18, cTnI (μg/L): 3.23 (0.63, 10.70) vs. 0.02 (0.00, 0.17) and 0.00 (0.00, 0.00), CK-MB (U/L): 32.40 (14.20, 95.40) vs. 14.40 (11.20, 17.10) and 8.90 (8.28, 9.50), all P < 0.01]. The expression of plasma miR-1 had a significantly positive correlation with cTnI and CK-MB in AMI patients (r1 = 0.395, r2 = 0.490, both P < 0.000). It was demonstrated by ROC curve analysis that the area under ROC curve (AUC) for the diagnostic value of miR-1 on AMI was 0.905 [95% confidence interval (95%CI) = 0.860-0.950, P = 0.000], the sensitivity was 86.6%, and the specificity was 95.4%; the AUC for cTnI was 0.908 (95%CI = 0.870-0.946, P = 0.000), the sensitivity was 81.9%, and the specificity was 95.9%; the AUC for CK-MB was 0.795 (95%CI = 0.736-0.854, P = 0.000), the sensitivity was 63.0%, and the specificity was 92.9%. Conclusions Plasma miR-1 has the capacity in early diagnosis of AMI, superior to CK-MB, and equal to cTnI. It can provide additional diagnostic information beyond cTnI. The diagnostic accuracy for early AMI can be improved with the combination of plasma miR-1 and cTnI.