Study of government responsibility on village clinics construction / 中华医院管理杂志

As the " bottom" of the rural three-level medical and health network, the village clinic is the closest medical and health institution to the villagers. Through field research on H District of Beijing, the author found that the government implemented the management responsibility of village clinics by issuing health policies to carry out the standardization construction, strengthened the practice management of village doctors, and stabilized the income source of rural doctors, so that village doctors could better assume the functions of village level public health and prevention and treatment of common diseases. However, the unclear ownership relationship of village clinics and the labor relationship of village doctors, the differences in hardware configuration and the convergence of post responsibilities under different management systems affected the government′s implementation of the management responsibility of village clinics. Therefore, it could be necessary to pay attention to the change of policy environment, timely reform and mechanism integration of village clinics, and establish a career development mechanism connecting counties and villages. The bottleneck in the construction of village clinics will be broken, and the goal of " quality medical and health services nearby" for rural residents will be realized.

Theory and Practice of Policy Change: Current Situation and Countermeasures of Village-level Health Human Resource Distribution in Field Research in H District of Beijing / 中国医学伦理学

【Objective:】 To explore the current situation and problems of village-level health human resource allocation based on the theory of policy change, and to help rural revitalization and healthy rural construction from the perspective of "consolidating the basic level foundation as fundamental policy". 【Methods:】 a) Information census method. A round-the-box survey on the distribution of health human resources at village-level in 14 rural towns and villages in H district was conducted. b) In-depth interview method. Based on the principle of information saturation, three township and villages clinics and community stations were selected for field observation, and in-depth personal interviews were conducted with key insiders. 【Results:】 The health policy environment changed significantly with the spatiotemporal changes. "Hollow village" and "inverted village" coexisted. The change of registered population and permanent resident population accelerated, old village doctors and new village doctors continued on the same hand, village clinics and community station were in "double track" of management progress. With the change of internal and external environment of the above-mentioned policies, the allocation of health human resources at village level needs to be studied urgently. 【Discussion:】 Under the dual function of external and internal environment, the policy change is inevitable. The health human resource distribution at village-level should be integrated with the system in terms of policy. The career development mechanism is connected up and down. Team construction revolves around suitable and applicable for batch training.

Allocation of village-level health resources in Huairou District of Beijing from the perspective of health geography / 中华医院管理杂志

Objective:To analyze the physical geography and social and economic geography of Huairou District, Beijing, from the perspective of health geography and based on the science of health policy, and study the implementation effects and existing problems of village-level health resource allocation policy based on household registration system and population number, then put forward relevant countermeasures.Methods:From December 2020 to May 2021, 14 rural townships in Huairou district of Beijing were investigated on the basis of literature review, on the basis of information saturation, through typical case analysis, semi-structured interview and other methods. According to the distribution of physical geography and social economic geography, 15 administrative villages of 3 townships were selected to carry out field observation and in-depth interviews with key insiders on the basic information of village clinics and rural doctors, basic medical and health services, management system and operation mechanism.Results:The characteristics of geographical environment, population change and population density of village-level health institutions in Huairou district made the current situation of village-level health resources allocation highlight the current situation of insufficient policy coordination and supervision, and showed the reality of unbalanced distribution of village-level health institutions. There was a big gap between the geographical distribution of villager health institutions and the allocation of health human resources and the health needs of villagers, and the current situation was worrying. The lack of analysis of health geographical factors in the policy formulation and implementation was an important factor.Conclusions:To realize village-level health allocation, it is necessary to fully consider health geographic factors, break institutional boundaries through policy coordination and differentiation, and gradually optimize village-level health resource allocation starting from optimizing the layout of village-level health institutions.

Association of blood lipids and albumin-bilirubin index with disease progression in patients with chronic hepatitis B virus infection / 临床肝胆病杂志

ObjectiveTo investigate the value of blood lipid indices and albumin-bilirubin index (ALBI) in evaluating the progression of chronic hepatitis B virus (HBV) infection. MethodsA total of 184 patients with chronic HBV infection who visited The Second Affiliated Hospital of Anhui Medical University from June 2016 to June 2017 were enrolled, and according to the stage of the disease, they were divided into ASC group (74 HBV carriers), CHB group (70 patients with chronic hepatitis B), and LC group (40 patients with compensated cirrhosis). A total of 50 healthy individuals were enrolled as health control (HC) group. Blood lipid indices and liver function parameters were measured, and the changes in blood lipid indices and ALBI during the progression of chronic HBV infection were analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett method was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups; Pearson correlation analysis was used to investigate correlation. Results There were significant differences between the ASC, CHB, LC, and HC groups in blood lipid indices of cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (APOA), and apolipoprotein B (F=12.075, 19.559, 6.554, 9.392, and 5.458, all P＜0.001), and the LC group had significantly greater reductions in the above indices compared with the other three groups (all P＜0.05). There was a significant difference in ALBI between the four groups (F=49.225, P＜0.001); the LC group had a significantly higher ALBI than the other three groups (all P＜005), and the ASC and CHB groups had a significantly higher ALBI than the HC group (both P＜0.05). CHO, HDL-C, LDL-C, and APOA were negatively correlated with ALBI (all P＜0.05), among which CHO and HDL-C had the strongest correlation with ALBI (r=-0.310 and -0.266, both P＜0.001). ConclusionIn patients with chronic HBV infection, blood lipid indices and ALBI can reflect the degree of liver function damage, especially in patients with liver cirrhosis.

Association of blood lipids and albumin-bilirubin index with disease progression in patients with chronic hepatitis B virus infection / 临床肝胆病杂志

ObjectiveTo investigate the value of blood lipid indices and albumin-bilirubin index (ALBI) in evaluating the progression of chronic hepatitis B virus (HBV) infection. MethodsA total of 184 patients with chronic HBV infection who visited The Second Affiliated Hospital of Anhui Medical University from June 2016 to June 2017 were enrolled, and according to the stage of the disease, they were divided into ASC group (74 HBV carriers), CHB group (70 patients with chronic hepatitis B), and LC group (40 patients with compensated cirrhosis). A total of 50 healthy individuals were enrolled as health control (HC) group. Blood lipid indices and liver function parameters were measured, and the changes in blood lipid indices and ALBI during the progression of chronic HBV infection were analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett method was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups; Pearson correlation analysis was used to investigate correlation. Results There were significant differences between the ASC, CHB, LC, and HC groups in blood lipid indices of cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (APOA), and apolipoprotein B (F=12.075, 19.559, 6.554, 9.392, and 5.458, all P＜0.001), and the LC group had significantly greater reductions in the above indices compared with the other three groups (all P＜0.05). There was a significant difference in ALBI between the four groups (F=49.225, P＜0.001); the LC group had a significantly higher ALBI than the other three groups (all P＜005), and the ASC and CHB groups had a significantly higher ALBI than the HC group (both P＜0.05). CHO, HDL-C, LDL-C, and APOA were negatively correlated with ALBI (all P＜0.05), among which CHO and HDL-C had the strongest correlation with ALBI (r=-0.310 and -0.266, both P＜0.001). ConclusionIn patients with chronic HBV infection, blood lipid indices and ALBI can reflect the degree of liver function damage, especially in patients with liver cirrhosis.

The clinical and imaging characteristics of sellar regionlesions in children / 实用放射学杂志

Objective To evaluate the clinical and imaging features of the sellar region lesions in children.Methods The clinical and imaging features of 112 cases with sellar region lesions were analyzed retrospectively,which were confirmed by pathology.Results 37 cases were craniopharyngiomas, which had two main symptoms of intracranial hypertension(57%)and diabetes insipidus(11%).On imaging it demonstrated as a calcified cystic tumor(81%).18 cases were gliomas, the main clinical feature of which was decreased visual acuity,13 of them were pilocytic astrocytoma, which manifested as a solid tumor with significantly enhancement(94%).16 cases were germ cell tumors,the main complaint was diabetes insipidus (75%),13 of them were germinoma, which showed iso-high density on CT and moderate enhancement after administration of contrast.And it showed high signal intensity on DWI.7 cases were hamartoma,86% patients of which showed gelasmus epilepsy,the imaging showed iso-signal masses with no enhacement in the hypothalamic papillary region.5 cases were LCH,80% of which had the complaint of diabetes insipidus,imaging findings manifested as thinkened pituitary stalk and loss of hyperintensity of posterior pituitary on T1WI.3 cases were pituitary tumors.23 cases were Rathke's cleft cysts,3 cases were arachnoid cyst.Most of the patients presented with headache.Conclusion The clinical and imaging features shows some specific features, which is helpful to improve the correct rate of diagnosis and provide the basis for further treatment.

Association between serum level and exon gene polymorphism of complement C3 and primary open angle glaucoma / 中华检验医学杂志

Objective In order to explore the association between complement C3 and primary open angle glaucoma (POAG),the serum complement C3 level was detected and the polymorphism of the C3 exon gene was analyzed in patients with POAG.Methods A prospective case-control study was designed.A total of 45 patients with POAG visiting Eye &ENT hospital of Fudan University were collected from December 2014 to December 2015,and 45 age-/gender-matched healthy subjects from yearly health screening were collected as normal controls.Serum C3 concentration was detected by immunoturbidimetric assay.Meanwhile,genomic DNA was extracted from peripheral blood leukocytes,and sequencing for C3 exons was followed with PCR to analyze the gene polymorphism.Statistical analysis was performed by use of SPSS 20.0 software.Student's t test was used to evaluate the difference of serum C3 level between two groups.Chisquare test was used to analyze the difference in the distribution of C3 exon gene polymorphism between two groups.The one-way ANOVA was utilized to analyze the difference of serum C3 level among different genotypes of C3 exon.Results The serum level of C3 in POAG (104.81 ± 29.15)mg/dl was significantly lower (t =-3.162,P =0.002) compared to controls (121.06 ± 18.39) mg/dl.There were a total of seven single nucleotide polymorphisms (SNPs) (rs2230201,rs2230204,rs2230205,rs428453,rs423490rs7951,rs539822147) within the C3 exon gene region,but no mutation was detected.There was no difference in the frequency and distribution of these SNPs between POAG and controls,as well as,there was also no significant difference in serum C3 level among these SNPs genotypes.Conclusions Decreased serum C3 level in POAG patients indicated that complement C3 might be involved in the pathomechanism of glaucoma.No significant abnormality of C3 exon gene was detected,so the gene polymorphism having an impact on serum C3 level could be excluded as a reason probably.

Association between blood lipid level and primary open angle glaucoma / 中华检验医学杂志

Objective To explore the relationship between blood lipid level and primary open angle glaucoma(POAG)and intraocular pressure(IOP).Methods A retrospective case-control study was designed.80 POAG patients from EYE & ENT hospital of FUDAN university were collected as a case group from January 2015 to May 2016.Meanwhile 80 age and gender matched healthy people were collected as a control group.The differences of gender in men subgroup (POAG:44,Control:39) and female subgroup (POAG:36,Control:41) showed no statistic significance.Serum total cholesterol(TC),total triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A(Apo A) and apolipoprotein B(Apo B) were measured using Roche automatic biochemical analyzer.The analysis of the above mentioned lipid levels between POAG group and control group was conducted by independent student′s T test and multivariate logistic regression.The relationship between lipid level and IOP was analysied using Pearson correlation test.Results The TG level was (1.40±0.71)mmol/L in the POAG group,(1.00±0.37)mmol/L in the control group.The difference had statistic significance (t=4.467,P<0.001).The HDL-C level in the POAG group was (1.22±0.36)mmol/L,(1.38±0.25)mmol/L in the control group.The difference also had statistic significance (t=-3.228,P=0.002).Comparison between the men subgroup and female subgroup found that the TG level in the POAG group of men was (1.47±0.71)mmol/L,(1.01±0.36) mmol/L in the control group and the HDL-C level were (1.14±0.31) mmol/L,(1.32±0.20)mmol/L in two groups.Both the level of TG and HDL-C had statistic significance in men (t=3.717,P<0.001;t=-3.240,P=0.002).The TC,TG level in the POAG group and control group of women respectively were (4.59±0.81)mmol/L,(1.33±0.72)mmol/L and (4.21±0.64)mmol/L,(0.99±0.38)mmol/L.Both blood level were significantly higher than the control group in women (t=2.278,P=0.026;t=2.503,P=0.016).Logistic regression analysis showed that the TG level correlated with POAG (P=0.004,OR=2.831,95% CI=1.392-5.759)and both POAG in the men and women (P=0.025,OR=3.223,95% CI=1.156-8.989;P=0.045,OR=2.554,95% CI=1.020-6.395).Pearson test showed that the TG level of POAG patients was positively associated with IOP in spite of gender(P<0.05).Conclusion The peripheral blood level of TG was significantly increased in the POAG patients and significantly correlated with IOP,which indicated that the increased peripheral blood level of TG may be the independent risk factor for the POAG..

The correlation analysis between clinical biochemical indexes and cataract of middle aged and senior / 中华检验医学杂志

Objective A large sample of multi-factor Logistic analysis of clinical biochemical indicators from elderly cataract patients were done to find the characteristics of possible changes in potential factors for cataract-related indicators and explore the pathogenesis of cataract from the perspective of laboratory diagnosis.Methods A retrospective case control study was conducted .Cataract patients from Eye-Ear Nose Throat Hospital of Fudan University were collected during June 2011 to July 2015 and routinely tested for 14 clinical biochemistry indicators including ALB , GLU, TP, GLB, BUN, URCA, Cr, LDH, ALP, Ca, Na, K, Cl, and P.The mean age of the 3 527 cataract patients (1 804 males, 1 723 females) was (64.47 ±11.29) years.Those data were reserved by LIS (Laboratory Information System) system and were retrieved for large data analysis . The control group was filtered from hospitalized patients besides cataract patients during January 2014 to July 2015.The mean age of the 3 333 control subjects ( 1 770 males, 1 563 females ) was ( 64.04 ±9.03 ) years.Biochemical indicators between cataract group and control group were analyzed by independent student′s t-test and Logistic regression .Meanwhile , the objects were divided into 3 groups according to the age (40-59 years,60-79 years,≥80 years) for independent student′s t-test with the control group respectively .Results There are no statistical difference in age ( t=1.663,P=0.096) and gender ( t=2.63,P=0.105 0) between cataract group and control group ( P>0.05).The results of Logistic regression between cataract group and control group were as follow : ALB (OR=1.053,95%CI=1.019-1.088),BUN(OR=1.113,95% CI=1.076-1.152),Cr(OR=1.007, 95%CI=1.003-1.010),GLB(OR=1.049,95% CI=1.018 -1.081),GLU(OR=1.175,95% CI=1.139-1.211),Cl(OR=1.059,1.032 -1.088),Na(OR=1.180,95% CI =1.150 -1.212).Those might be enrolled as risk factors for cataract (P<0.05).The level of ALB, GLU, Na and Cl in cataract group according to different age groups were significantly higher ( t=8.780,t=4.670, t=9.695, t=6.415, P<0.05) than that of control in 40-59 age group;the level of ALB, BUN, Cr, GLU, Na and Cl in cataract group was significantly higher ( t=4.974, t=9.414, t=4.123, t=6.906, t=14.741, t=9.212, P<0.05) than control in 60 -79 age group; the level of BUN, Cr, GLU, Na and Cl in cataract group was significantly higher (t=6.077, t=4.906, t=2.626, t=5.459, t=3.424, P<0.05) than control in 80-age group.Conclusions The level of ALB, BUN, GLB, Cr, GLU, Na and Cl in peripheral blood of cataract patients was significantly increased which suggested that those change might associated with the pathogenesis of cataract .

Construction of CYP1B1 gene haplotypes predisposing to primary congenital glaucoma through allele-specific PCR/restriction fragment length polymorphism analysis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To develop an allele-specific PCR (AS-PCR)/restriction fragment length polymorphism (RFLP) assay for CYP1B1 gene haplotypes predisposing to primary congenital glaucoma (PCG).</p><p><b>METHODS</b>Twenty Chinese PCG patients and 20 healthy controls were recruited. Peripheral blood sample was subjected to direct sequencing for common single nucleotide polymorphisms (SNPs) of the CYP1B1 gene. Based on the results, CYP1B1 gene haplotypes were constructed by PCR-RFLP and AS-PCR combined with RFLP.</p><p><b>RESULTS</b>Four SNPs loci were identified by sequencing, which included rs10012 G>C (S1 in exon 2), rs1056827 T/G (S2 in exon 2), rs1056836 C/G (S3 in exon 3) and rs1056837T>C (S4 in exon 3). The distribution of such loci showed different characteristics between the two groups. 50% of the PCG patients had rs10012 G>C and rs1056827 T>G, while 25% of PCG patients had rs1056836 C>G and rs1056837T>C. As for the controls, 25% had rs10012 G>C and rs1056827 T>G, 10% had rs1056836 C>G and rs1056837T>C. None of the SNP loci has presented alone. PCR-RFLP was carried out to confirm the results of SNPs typing, but could not confirm the linkage between the SNP loci. By contrast, AS-PCR combined with RFLP has achieved specific amplification for rs10012 G>C and thorough differentiation of 1056827 T>G polymorphism. Similar results have been obtained by the same method for rs1056836 C>G and rs1056837T>C typing and linkage disequilibrium analysis.</p><p><b>CONCLUSION</b>The AS-PCR/RFLP assay has successfully constructed the haplotypes of the CYP1B1 gene. For its accuracy, efficiency and specificity, the method may be used for constructing haplotypes for hereditary disease studies.</p>

The impact of autophagy on proliferation of HEL cells and hematopoietic cells of polycythemia vera patients with JAK2 V617F mutation / 中华血液学杂志

<p><b>OBJECTIVE</b>To detect the activity of autophagy and explore the impact on survival and proliferation of HEL cells and hematopoietic cells of polycythemia vera （PV） patients with JAK2 V617F mutation.</p><p><b>METHODS</b>Flow cytometry, AO staining and Western blot methods were used to detect the autophagy activity and the expression of LC3-Ⅱ protein of JAK2 V617F+ HEL cells and hematopoietic cells of 12 newly diagnosed PV patients with JAK2 V617F mutation. HEL cells and bone marrow cells of 3 PV patients were treated with rapamycin or 3-MA to induce and inhibit autophagy, respectively. CellTiter Glo(R) method was used to detect the proliferation activity of cells.</p><p><b>RESULTS</b>There was higher level of mean LC3-Ⅱ fluorescence intensity in HEL cells (159 389 ± 29 001) than that in K562 cells (96 047 ± 24 134) (P=0.044). The formation of autophagosome in HEL cells is more than that in K562 cells detected by microscope. What's more, the level of mean LC3-Ⅱ fluorescence intensity in 12 PV patients' myeloid cells (92 842 ± 4 250) was higher than that of 15 healthy volunteers (86 633 ± 2 504) (P=0.001). The expression of LC3-Ⅱ protein was higher in PV patients' peripheral blood cells than that in healthy volunteers detected by Western blot. After treated with rapamycin 12, 24, 48 h, the activity of autophagy in HEL cells and bone marrow cells of 3 PV patients were increased and the proliferation activity was higher than the control group, the proliferation activity at 48 h were (101 413 ± 3 720), (18 744 ± 1 015), respectively. However, after treated with 3-MA 12, 24, 48 h, the activity of autophagy was decreased and the proliferation activity was lower than the control group, the proliferation activity at 48 h were (5 732 ± 166), (5 371 ± 56), respectively.</p><p><b>CONCLUSION</b>There is high basical activity of autophagy in JAK2 V617F+ HEL cells and hematopoietic cells of PV patients with JAK2 V617F mutation. Up-regulated autophagy promotes proliferation of JAK2 V617F⁺ HEL cells and bone marrow cells of PV patients with JAK2 V617F mutation. Decreased autophagy inhibits proliferation of JAK2 V617F+ HEL cells and bone marrow cells of PV patients with JAK2 V617F mutation.</p>

Low-dose temporal bone CT in children: feasibility and image quality / 中华放射学杂志

Objective To analyze the feasibility of low dose temporal bone CT scans in children.Methods We obtained an optimized low-dose protocol in pre-experiment.The optimized protocol was used to examine 27 consecutive children.And then we retrospectively analyzed 27 examinations underwent a standard temporal bone CT scan acquired with 120 kV and 250 mAs.The interobserveragreement (Kappa value) for the 2 reviewers was calculated.The children were then divided into 4 subgroups according to age-specific effective dose conversion coefficient.The effective dose and image quality between the two protocols at the same age were compared by t test.Results The result of pre-experiment showed that radiation dose was significantly reduced when the parameters were 100 kV and 70 mAs.The interobserver agreement(Kappa value)was high (0.784).The interobserver agreement for both low-dose (0.641) and high-dose (0.815) groups were high.The effective doses of low-dose group were (0.707 5±0.029 1)(0,1.0 year old),(0.431 6±0.051 3)(1.1 to 5.0 years old); (0.309 5±0.138 4) mSv (5.1 to 10.0 years old) respectively.The effective doses of high-dose group were (3.166 2±0.462 5),(2.048 6±0.224 7),(1.492 0±0.422 1) mSv respectively.The difference between low and high dose groupswas significant in all of the subgroups (t=-10.612,-26.22,-79.84,P＜0.05).The image quality of low-dose group was75.5±0.6,75.6±3.5,75.4± 2.4 respectively.The image quality of high-dose group was78.8± 1.0,79.8± 2.2,79.5± 1.0 respectively.The effective dose for the forth subgroup (10.1 to 18.0 years old) wasl.194 9 and 0.228 1 mSv respectively.Though the image quality of low-dose group was significantly lower than that of high-dose group (t=-3.667,-26.220,-6.315,P＜0.05).All the images of low-dose scan were diagnostic.The image quality of both groups was 80.The radiation dose was 5 to 6 times lower thanstandard protocol used in daily work.The effective dose for infants is higher than the older children underwent the same protocol.Conclusion Low-dose temporal bone CT scan allows an accurate evaluation of middle and inner ear structures and is feasible in children.

Functional evaluation of auditory cortex by functional magnetic resonance before cochlear implantation: a pilot study / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the functional evaluation of auditory cortex by functional magnetic resonance imaging (fMRI) before cochlear implantation (CI).</p><p><b>METHODS</b>Twenty-one children with severe to profound sensorineural hearing loss (SNHL) (7 cases with normal inner ear structure, 3 cases with large vestibular aqueduct syndrome, 1 case with cochlear nerve hypoplasia) and 7 children with normal hearing were examined by fMRI under sedation. The subjects received acoustic stimuli at four random frequencies (500, 1 000, 2 000, 4 000 Hz) during fMRI examination. Tones were interleaved with silence in a block-periodic fMRI design with 16-second on-off intervals.Each stimulus repeated twice and the total acquisition time was 4 minutes and 28 seconds.</p><p><b>RESULTS</b>Activation was identified in the auditory cortex of the 28 subjects in response to monaural and binaural acoustic stimulation, which was shown in the transverse temporal gyrus (Heschl gyrus), the thalamus and both.Of the 21 patients with SNHL, contralateral dominance was shown in six cases, ipsilateral dominance in five cases and bilateral equilibrium in 10 cases when one ear was exposed to the stimuli. Of the seven children with normal hearing, contralateral dominance was shown in three cases, ipsilateral dominance in two cases and bilateral equilibrium in two cases.No significant difference of the activation intensity in auditory cortex was shown between children with SNHL and normal hearing (P > 0.05). Good hearing recovery was obtained in the 21 patients after CI. No significant difference in the level of hearing and speech rehabilitation was shown between children with LVAS and with normal inner ear structure.Listening behavior response threshold was 55 dBHL in the case with cochlear nerve hypoplasia 10 months after CI.</p><p><b>CONCLUSIONS</b>fMRI would be a feasible means of evaluating the function of the auditory cortex, which can be used for assessing the function of the entire auditory system prior to CI combined with ABR and imaging.</p>

Association between change of health care providers and pregnancy exposure to FDA category C, D and X drugs / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Changing health care providers frequently breaks the continuity of care, which is associated with many health care problems. The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C, D and X drugs.</p><p><b>METHODS</b>A 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 were chosen for this study. The association between the number of changes in health care providers and with pregnancy exposure to category C, D, and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression, with adjusted odds ratios (ORs) and its 95% confidence intervals (CIs) as the association measures.</p><p><b>RESULTS</b>A total of 18 568 women were included in this study. Rates of FDA C, D, and X drug uses were 14.35%, 17.07%, 21.72%, and 31.14%, in women with no change of provider, 1-2 changes, 3-5 changes, and more than 5 changes of health care providers. An association between the number of changes of health care providers and pregnancy exposure to FDA C, D, and X drugs existed in women without chronic diseases but not in women with chronic disease.</p><p><b>CONCLUSION</b>Change of health care providers is associated with pregnancy exposure to FDA category C, D and X drugs in women without chronic diseases.</p>

Evaluation with functional magnetic resonance imaging in 1 case of cochleovestibular nerve malformation in children before cochlear implantation and review of the literature / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the feasibility of cochlear implantation by functional magnetic resonance imaging (fMRI) in a patient with cochleovestibular nerve hypoplasia.@*METHOD@#Audiometry, radiological examination and fMRI of the auditory cortex were performed to a 15-year-old boy with bilateral hearing loss before cochlear implantation.@*RESULT@#Results of pure tone audiometry and auditory brainstem responses showed profound sensorineural hearing loss (SNHL). Transiently evoked otoacoustic emission was absent on both sides. High resolution computed tomography revealed the inner ear malformation (incomplete partition I) on both side. Oblique sagittal reconstruction in magnetic resonance imaging (MRI) showed the malformation of cochleovestibular nerve, fMRI demonstrated the activation of the right primary auditory cortex during 1-kHz monaural stimulation on the left side. No cortical activation appeared during the monaural right acoustic stimulation using the same sound pressure level. The child had subjective auditory response 1 month after cochlear implantation on his left side.@*CONCLUSION@#fMRI would be an effective measure in the assessments for the cochlear implantation candidates, combining with audiometry and radiological examination, especially when MRI shows cochleovestibular nerve malformation in these patients.

Comparative Evaluation of Gene-set Analysis Methods / 中国卫生统计

Objective To compare the efficiency of χ~2-Fisher's exact test which is one of the competitive null hypothesis approaches with SAM-GS which belongs toself-contained null hypothesis approaches. Methods The two methods were used to analyze a simulation experiment which contained five different scenarios. The results were compared with the simulated initialization,and assessing indexes were calculated to compare the efficiency. Results Under the same conditions,SAM-GS always have higher power than that of χ~2-fisher's exact test. However, the final inference is equivalent, namely if the difference between the two groups are smaller than 0.30,the two methods can not be better to identify differences between them. By contrary, when the differences between the two phenotypes are larger than 0.30, the two ways can both identify differences. Conclusion SAM-GS tends to have slightly higher power thanχ~2-Fisher' s exact test. The two methods can be used for screening enrichment gene sets of gene expression profile.χ~2-Fisher's exact test has the important advantage of being able to analyze multi-class phenotype.

Pathological study of dilated cardiomyopathy / 中国病理生理杂志

AIM: To study the pathological features of the dilated cardiomyopathy and the mechanisms involved. METHODS: The left ventricular myocardium specimens were obtained from 8 patients with dilated cardiomyopathy by BATISTA. The morphological changes was examined macropathologically and histopathologically. RESULTS: The dilated cardiomyopathy from 8 patients can be classified into two types macropathology. One of them showed hypertrophy of left ventricular wall and the other showed fatty infiltration on myocardium of the left ventricular. In the first type, swelling of the endothelial cells as well as luminal stenosis even occlusive of small arteries and arterioles were observed in the study. Electronical microscopical examination showed that there were a lot of homogeneous secretory granules in the endothelial cells. CONCLUSION: These results suggested that the secretory granules might be from the damaged myocardial cells and entered into the adjacent endothelial cells. The pathological changes mentioned above could aggravate the ischemia of myocardium. At the same time, the vicious cycle make the pathological changes more serious. Further study should be made to confirm the nature of the secretory granules.

Development of Acute Promyelocytic Leukemia in PML-RARalpha Transgenic Mice / 中国实验血液学杂志

To investigate the leukemogenic potential of PML-RARalpha fusion protein in vivo, hCG-PML-RARalpha transgene was constructed using molecular cloning technique and hCG-PML-RARalpha transgenic mice were generated. The genotype and phenotype of hCG-PML-RARalpha transgenic mice were analyzed by PCR, RT-PCR, morphology of peripheral blood and bone marrow cells, and pathological examination of spleen, liver and bone marrow. As a result, acute promyelocytic leukemia was developed in 3 hCG-PML-RARalpha transgenic mice in 1 - 5 months. The results demonstrated that PML-RARalpha fusion protein plays a crucial role in leukemogenesis.

Evaluation of genome degradation of plasma hepatitis C virus during methylene blue photochemistry treatment / 中国输血杂志

Objective To study the degradation of hepatitis C virus(HCV) genome before and after methylene blue photochemistry(MB-P) treatment of the plasma.Methods MB was added to HCV positive plasma to a final concentration of 1.0?mol/L.The plasma was then exposed to 30000 Lux fluorescence.Plasma samples were then collected at different times of exposure.Real-time PCR was used to quantitatively study the course of the HCV-RNA degradation.The whole genome was screened for integrity by RT-PCR with 8 pairs of specific primers which targeted sequential overlapping sections of HCV genome.Results Results of real-time PCR showed that the copy number of HCV-RNA was continuously decreasing during MB-P treatment.RT-PCR results showed that the reactivity of different sections of the HCV genome to MB-P was significantly different and indicated that the 5' end and 3' end were more stable. Conclusion MB-P treatment could degrade HCV RNA with various sensitivities to different sections of the genome.RNA degradation may play an important role in plasma virus inactivation.Detection of HCV genomic RNA might be clinically useful to monitor the process and efficiency of virus inactivation.