Current Status and Challenges of Biological Sample Management in Clinical Trials / 中国医学伦理学

With the rapid development of clinical trials, the relevant medical research and molecular detection based on biological samples are closely related to the progress of clinical trials, making the role of biological samples in clinical trials increasingly obvious. The standardized supervision mode of biological samples is an important prerequisite for carrying out high-quality clinical trials. Although the laws and regulations related to clinical trials are becoming more and more perfect, there are still a large number of adverse events related to biological samples, which seriously affects the progress and results of clinical trials, and is one of the important challenges currently facing. Therefore, it is urgent to enhance the supervision of biological samples and improve the management methods of biological samples in clinical trials at this stage. Through in-depth discussion of the current status of biological sample management in clinical trials at home and abroad, this paper analyzed the issues existed during the supervision of biological samples, and supplemented the biological sample management methods by further combing the existing relevant laws and regulations and the Guidelines for the Ethical Management of Biological Samples in Clinical Trials, with a view to providing suggestions and ideas for optimizing the management mode of biological samples in clinical trials.

Research progress of radiation carcinogenic effect and its interference factors for survivors of the atomic bomb disaster in Japan / 中国辐射卫生

Based on the study of solid cancer incidence in survivors of the atomic bomb disaster (atomic bomb survivors) from 1958 to 1998, the Radiation Effects Research Foundation (RERF) performed an additional 11-year follow-up (1999—2009) to further investigate the 50-year solid cancer incidence of atomic bomb survivors from 1958 to 2009. Considering influencing factors such as gender, smoking, drinking, body mass index, and medical exposure, we updated the radiation risk estimate for solid cancer and found a new problem of the relationship between gender-specific dose response, exposure age and cancer incidence during the study, which provides guidance for future research.

Diagnostic value of Copenhagen index in premenopausal and postmenopausal ovarian cancer / 肿瘤研究与临床

Objective:To compare the diagnostic value of Copenhagen index (CPH-I), serum carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), and risk of ovarian malignancy algorithm (ROMA) for diagnosis of ovarian cancer in premenopausal and postmenopausal women.Methods:The clinical data of 239 patients with ovarian tumor treated in People's Hospital of Rizhao in Shandong Province from January 2017 to January 2020 were retrospectively analyzed. The patients were divided into ovarian benign disease group (152 cases) and ovarian cancer group (87 cases) according to postoperative pathology. The receiver-operating characteristic curve (ROC) was drawn with surgical pathology as the gold standard; the area under the curve (AUC) and the sensitivity and specificity of CPH-I, CA125, HE4, ROMA were calculated. The diagnostic performance of CA125, HE4, ROMA and CPH-I for diagnosis of ovarian cancer was compared in overall, premenopausal and postmenopausal patients.Results:The CA125 level, HE4 level, ROMA index, and CPH-I predicted probability (PP) values of ovarian cancer group were higher than those of ovarian benign disease group, and the differences were statistically significant (all P < 0.01). The AUC of CA125, HE4, ROMA, and CPH-I in the overall patients was 0.935 (95% CI 0.896-0.963), 0.940 (95% CI 0.901-0.966), 0.964 (95% CI0.932-0.984), 0.964 (95% CI 0.932-0.984); the AUC differences of CA125 and ROMA, CA125 and CPH-I (PP values), HE4 and ROMA, HE4 and CPH-I PP values were statistically significant (P values were 0.036, 0.009, 0.018, 0.019). The AUC of HE4, ROMA, and CPH-I in the premenopausal patients was 0.947 (95% CI 0.896-0.978), 0.949 (95% CI 0.898-0.979), 0.944 (95% CI 0.893-0.976), which were all larger than AUC of CA125 (0.921) (95% CI 0.863-0.960), the differences were statistically significant (P values were 0.036, 0.036, 0.026); AUC of CA125, ROMA, CPH-I PP values in postmenopausal patients was 0.953 (95% CI 0.891-0.986), 0.947 (95% CI 0.882-0.982), 0.943 (95% CI 0.877-0.980), all of which were larger than AUC of HE4 (0.889) (95% CI 0.810-0.944), and the differences were statistically significant (P values were 0.029, 0.014, 0.015). Conclusions:The diagnostic efficacy of CPH-I and ROMA for ovarian cancer is comparable, and regardless of menopause or not, the diagnostic efficacy of CPH-I and ROMA is higher. The diagnostic efficacy of CPH-I and ROMA for ovarian cancer is better than that of CA125 and HE4 in overall patients, the diagnostic efficacy of CA125 is the lowest in premenopausal patients, and the diagnostic efficacy of HE4 is the lowest in postmenopausal patients.

Practice and thinking of electronic data capture application in clinical research management / 中华医院管理杂志

Electronic data capture(EDC) plays an important role in improving the quality of clinical research.The authors introduced the main functions of EDC and the use flow, then from its core function, analyzed the role of EDC in improving the quality of clinical research and scientific research management. Then they proposed the thinking of finding and solving problems from EDC " big data".Their efforts aim at enabling research administrators in extending clinical research management scope and management quality.

Discussion on Ethical Supervision and Informed Consent of Biobank / 中国医学伦理学

With the constant deepening of medical research and the need of translational medicine,it is neces-sary to normalize the construction of biobank with high - standard. However,there are no issued ethical guideline and standard for biobank in China at present. Based on this,this paper expounded the related ethical guidelines for biological samples and the review and supervision of ethics committee,and deeply expounded the issues of informed consent related to biobank,that is,the informed information of informed consent,the need to get explicit consent from the donor when collect,preserve and use the biological samples and the mode of informed consent,in order to lay the foundation for the future development of standards and norms.

Application of radiochemical separation and a-spectrometry in individual dose monitoring for occupational plutonium internal exposure / 中华放射医学与防护杂志

Objective To explore the applicable conditions for using urine plutonium monitoring data to assess personal internal doses,in order to provide references for the occupational health management and the urine plutonium monitoring in nuclear sector.Methods Using some plutonium mixtures from DOE nuclear facilities,as an example,the urine plutonium levels were estimated through simulation calculation at 1 mSv effective dose arising from either acute or chronic inhalation of plutonium compounds,respectively.The results were compared with the typical detection limit of radiochemical separation and α-spectrometry.The feasibility of urine plutonium monitoring for dose assessment of internal radiation exposure was discussed.Results Only for type M plutonium compunds,1 mSv detection limit can be achieved using radiochemical separation and α-spectrometry within 10 d after inhalation.Conclusions Before the monitoring plan of urine plutonium is made,detection limits of monitoring method should be considered.Internal dose could be accessed using workplace air monitoring and working hours when necessary.

The changes in optic disc parameters of Vogt-Koyanagi-Harada syndrome and optic neuritis with optic disc edema using three-dimensional optical coherence tomography / 中华眼底病杂志

Objective To compare the differences of optic disc morphology and optic nerve head parameters between Vogt-Koyanagi-Harada (VKH) syndrome and optic neuritis (ON) with optic disc edema. Methods This is a retrospective study including 21 first-onset VKH patients (35 eyes) as VKH group and 22 first-onset ON patients with optic disc edema (27 eyes) as ON group. The differences of age (t=-1.11) and gender (χ2=0.20) between two groups were not significant (P>0.05). Sixty-two eyes of 43 age and gender-matched healthy subjects were enrolled in this study as control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examinations. The difference of optic disc morphology between two groups was observed. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The disc retinal pigment epithelium (RPE) angle was observed too. Results Among 35 eyes in VKH group, 31 eyes (88.57%) had retinal detachment next to the disc, 3 eyes (8.57%) had serrated inner limiting membranes of the disc. Twenty eyes (64.52%) had highly reflective points, lines, or membrane-like structures in the retinal detachment areas. No such signs appeared in ON patients. Compared with ON group, the optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were bigger, the thickness of mean CP-RNFL and the superior, inferior quadrants of CP-RNFL were thinner, disc RPE angles was smaller in VKH group (P<0.05). Compared with control group, the disc area, optic cup area, rim area were bigger, C/D vertical diameter ratio was smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was smaller in VKH group (P<0.05); the disc area, optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was bigger in VKH group (P<0.05). Conclusions VKH patients have smaller disc RPE angles and more chance to develop retinal detachment next to disc than ON patients. The C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio are bigger, the mean CP-RNFL and the superior, inferior quadrants of CP-RNFL are thinner in VKH eyes.

The changes in optic disc parameters and thickness of circumpapillary retinal nerve fiber layer in acute uveitis of Vogt-Koyanagi-Harada syndrome with different degrees of optic disc edema / 中华眼底病杂志

Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=-2.17, P<0.05). The differences of gender, diseased time (t=-1.67) and corrected visual acuity (t=-0.76) between 2 groups were not significant (P>0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively.All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P<0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P<0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P<0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.

The changes in optic disc parameters of Vogt-Koyanagi-Harada syndrome and optic neuritis with optic disc edema using three-dimensional optical coherence tomography / 中华眼底病杂志

Objective To compare the differences of optic disc morphology and optic nerve head parameters between Vogt-Koyanagi-Harada (VKH) syndrome and optic neuritis (ON) with optic disc edema. Methods This is a retrospective study including 21 first-onset VKH patients (35 eyes) as VKH group and 22 first-onset ON patients with optic disc edema (27 eyes) as ON group. The differences of age (t=-1.11) and gender (χ2=0.20) between two groups were not significant (P>0.05). Sixty-two eyes of 43 age and gender-matched healthy subjects were enrolled in this study as control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examinations. The difference of optic disc morphology between two groups was observed. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The disc retinal pigment epithelium (RPE) angle was observed too. Results Among 35 eyes in VKH group, 31 eyes (88.57%) had retinal detachment next to the disc, 3 eyes (8.57%) had serrated inner limiting membranes of the disc. Twenty eyes (64.52%) had highly reflective points, lines, or membrane-like structures in the retinal detachment areas. No such signs appeared in ON patients. Compared with ON group, the optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were bigger, the thickness of mean CP-RNFL and the superior, inferior quadrants of CP-RNFL were thinner, disc RPE angles was smaller in VKH group (P<0.05). Compared with control group, the disc area, optic cup area, rim area were bigger, C/D vertical diameter ratio was smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was smaller in VKH group (P<0.05); the disc area, optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was bigger in VKH group (P<0.05). Conclusions VKH patients have smaller disc RPE angles and more chance to develop retinal detachment next to disc than ON patients. The C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio are bigger, the mean CP-RNFL and the superior, inferior quadrants of CP-RNFL are thinner in VKH eyes.

The changes in optic disc parameters and thickness of circumpapillary retinal nerve fiber layer in acute uveitis of Vogt-Koyanagi-Harada syndrome with different degrees of optic disc edema / 中华眼底病杂志

Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=-2.17, P<0.05). The differences of gender, diseased time (t=-1.67) and corrected visual acuity (t=-0.76) between 2 groups were not significant (P>0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively.All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P<0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P<0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P<0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.

Clinical analysis of continuous monitoring of intracranial pressure in old patients with hypertensive cerebral hemorrhage / 中国综合临床

Objective To evaluate the clinical value of continuous monitoring of intracranial pressure in old patients with hypertensive cerebral hemorrhage?Methods The clinical data of 217 cases of old patients with hypertensive cerebral hemorrhage, including 105 patients underwent continuous monitoring of intracranial pressure(monitoring group) and 112 patients without monitoring of intracranial pressure(control group),were retrospectively analyzed?The times and the total dosage of mannitol, the complications and prognosis of two groups were compared?Results The times and the total dosage of mannitol of monitoring group was respectively (42?1±5?4) times and ( 820?1±114?8) g,significantly less than that of control group((59?5±8?2) times, (1187?7±241?5) g;P=0?032,0?011)?The rate of pulmonary infection and stress ulcer showed no significant difference between two groups ( P = 0?608, 0?471 )?The rate of acute renal insufficiency and electrolyte disturbances was significantly lower in the monitoring group than that in the control group ( 11?4%( 12/104 ) vs?29?6%( 33/112 ) , 28?6%( 30/105 ) vs?41?9%( 47/112 );P = 0?004, 0?036 )?The prognosis of the monitoring group was better than that of the control group(72% vs?48%;χ2=13?02,P<0?01)?Conclusion Intracranial pressure monitoring has an important value for the treatment of old patients with hypertensive cerebral hemorrhage.

A biocompatibility study on Allomax mesh implanted in different planes of abdominal wall in a rat model / 中华普通外科杂志

Objective To evaluate biocompatibility of Allomax mesh implanted in different planes of abdominal wall in a rats model.Methods SD rats were randomly assigned to the profacial group (Onlay group),the retro-rectus group (Sublay group) versus the intraperitoneal group(IPOM group) according to different abdominal wall planes the mesh implanted,Adhesion and shrinkage of the mesh were observed,and quantitative measurements were conducted in fibroblast ingrowth,scaffold degradation,extracellular matrix deposition and numbers of vascular ingrowth after 1,3 and 6 months mesh was implanted.Results Macroscopic observation showed both Onlay and Sublay groups was superior to IPOM group in abdominal wall integration,which included shrinkage,relocation and adhesion of the mesh at all the time points,and most or whole of the mesh had incorporated with host abdominal wall at 6 months.Most of the mesh had not incorporated with host abdominal wall and shrinkage and relocation of the mesh were found in IPOM group at 6 months.Microscopic investigation showed lipocytes appeared in the mesh in Sublay group at 3 months,and numbers of ingrowth of fibroblast and neovascularization in Sublay group were significantly less than in Onlay and IPOM group at 6 months.Scaffold degradation and extracellular matrix deposition were remarkably less in Sublay group in comparison with Onlay group and IPOM group after 1,3 and 6 months.Conclusions Biocompatibility of AlloMax mesh implanted in profacial plane of abdominal wall was superior to implanted in retro-rectus plane and intraperitoneal plane as showed in a rat model.

Application of urine uranium monitoring in internal dose assessment / 中华放射医学与防护杂志

Objective To explore the applicable conditions for using urine uranium monitoring data to assess personal internal doses with a view to providing references for the occupational health management and the urine uranium monitoring in nuclear industry sector.Methods The urine uranium levels were calculated, through simulation calculation set at 1 mSv effective dose arising from either acute or chronic ingestion of uranium compounds.The results were compared with the monitoring values of workers without occupational exposure history.The feasibility of urine uranium monitoring for dose assessment of internal radiation exposure was discussed.Results For special monitoring of acute ingestion, liquid fluorimetry can meet monitoring requirements of Type F uranium compound, Type M low enriched uranium and Type S naturally occurring uranium.For routine monitoring, only Type F low enriched uranium and Type M naturally occurring uranium can be detected at shorter monitoring intervals, But it was not suitable for Type S uranium compounds.Conclusions Background levels and detection limits should be considered when urine uranium is measured for the purpose of assessment or control of exposure to uranium and the interpretation of the results.

Importance and Challenge of Non-Affiliated Scientific Member in Ethics Review Committee / 中国医学伦理学

After discussing the reason for insufficiency of committee member in current ethical review , and considering the requirement for improving the function of Ethics Review Committee , this paper proposes that Ethics Review Committee should appoint more non -affiliated scientific members to ensure the independence of ethical re-view , thus protecting the rights and beneficence of subjects , and to secure the justice in ethical review of protocols , the paper also discussed the resolutions to address the challenge brought by appointing non -affiliated members .

Discussion on occupational exposure limits of Type F uranium compounds in workplaces / 中华放射医学与防护杂志

Objective Derived air concentration of Type F uranium compounds are calculated respectively in order to provide reference for the management and evaluation of occupational hazard factors in workplace.Methods The air concentrations in the workplace of Type F uranium compounds were derived respectively through numerical simulationn,from individual dose limits,acute poisoning and chronic chemical damage threshold.Results Under normal operation conditions,the concentration of 5 μg /m3 for Type F uranium compounds in air of workplace can meet the requirements of radiation and chemical hazard control.Open inhalation of 1.1 mg/m3 is acceptable in a short time.Conclusions It is feasible to establish a permissible concentration limit in workplace for Type F uranium compounds.

PPARγexpression in rat lung tissue after ventilator-induced lung injury / 局解手术学杂志

Objective To observe the changes of PPARγ expression in ventilator-induced lung injury rats and explore the role of PPARγ in the pathogenesis of ventilator-induced lung injury. Methods Sixty male Sprague-Dawley rats were randomly divided into 3 groups ( n=21 each ):group N received large tidal volume with mechanical ventilation ( Vt=12 mL/kg);group C received lower tidal volume with mechanical ventilation ( Vt=6 mL/kg);group R received room air without mechanical ventilation. Rats in every group were randomly divided into 3 subgroups respectively by 1,4 and 8 h. The samples of lung were collected at 1,4 and 8 h after ventilation. Lung pathological examina-tion, total protein and white blood cells in bronchoalveolar fluid and wet-to-dry weight were detected. The exoressions of PPARγmRNA were detected by RTPCR;PPARγ protein in lung tissues was detected by western bolt. Result After 4 and 8 h ventilation in group N,total pro-tein and WBC in bronchoalvelor fluid,W/D were markedly higher than those of group C and R (P 0. 05). Conclusion PPARγmRNA and protein expressions in the rats lung tissue of ventilator-induced lung injury were decreased and as-sociated with inflammation and damage of lung tissue.

The application and evaluation of school-based teaching material of pathology in higher vocational colleges / 中华医学教育探索杂志

Objective To write the school-based teaching material of pathology,and apply it to the students in higher vocational colleges to evaluate the application effect.Methods Two classes of clinical medical students of Grade 201 1were divided into two groups:the experimental group(Class1,58 students) and the control group(Class2,60 students).Both of the two groups take the integration of theory and practice teaching method.The traditional teaching material was applied in the control group while the school-based teaching materials were adopted in the experimental group.Statistical analysis software SPSS 13.0 and two samples t test were used to compare the preparing effect before the class,case study effect and the final examination of the two groups.After the end of the course,students' teaching satisfaction questionnaire was conducted,and the results of the survey for the rank sum test were analyzed.Results The scores of preparing effect before class were higher in experimental group(84.4 ±6.2) than those in the control group(78.2 ±5.8),t=5.61,P=0.001; the case study effect in experimental group(78.6 ± 6.6) was higher than that of the control group(72.8 ± 5.3),t=5.27,P=0.002; there was no significant differences in the final examination between the two class [experimental group (83.5 ± 6.8),control group (81.6 ± 6.9)],t=1.51,P=0.183.The questionnaire shows,in the aspect of the difficulty of teaching material,the degree of satisfaction in the experimental group(satisfied:28,general:30,unsatisfied:0) was higher than the control group(satisfied:18,general:37,unsatisfied:5),Z=-2.43,P=0.015; in the aspect of reading interest,the degree of satisfaction in the experimental group(satisfied:32,general:25,unsatisfied:1) was higher than the control group(satisfied:22,general:35,unsatisfied:3),Z=-2.09,P=0.036; in the aspect of emphasizing on the key point,the degree of satisfaction in the experimental group(satisfied:20,general:38,unsatisfied:0) was higher than the control group(satisfied:12,general:39,unsatisfied:9),Z=-2.72,P=0.007; in the aspect of self-study effect,the degree of satisfaction in the experimental group(satisfied:20,general:38,unsatisfied:0) was higher than the control group(satisfied:16,general:39,unsatisfied:5),Z=-3.13,P=0.002; but there was no significant differences in classroomlearning effect(experimental group:satisfied,38,general,20,unsatisfied,0; control group:satisfied,36,general,23,unsatisfied,1),Z=-0.68,P=0.497.Conclusions The school-based teaching material can contribute to the students' self-learning,enhancing the students' interest of learning and knowledge-application ability.

The study on the influencing factors of rheumatism's treatment / 中华风湿病学杂志

Objective To study influencing factors in patients with rheumatic diseases.Methods One hundred and twenty patients with rheumatic diseases were selected from November 2013 to February 2014 in our hospital for the study.The influencing factors in patients with rheumatic diseases were obtained by proposed questionnaires,and then the univariate and multivariate Logistic regression analysis were performed to study factors affecting the treatment.Results Patients older than 50 of the observation group accounted for 38％ (18/48),the proportion of farmer,patients with primary school education level or below,and monthly income ＜3 000 RMB was 35％(17/48),60％(29/48),and 46％ (22/48) respectively.Compared with the control group,they were significantly higher than the control group,which were 64％(46/72),58％ (42/72),79％(57/72),65％(47/72) (x2=8.058,P=0.005; x2=6.025,P=0.014; x2=4.986,P=0.226; x2=4.456,P=0.035) respectively.Using the treatment as the dependent variable,age ≥50 years of age,farmer,primary school and lower education level,and monthly income ＜3 000 RMB as the independent variable,we carried out the regression analysis.Age (OR=1.124,95％CI:1.084-7.236),occupation (OR=1.871,95％CI:1.054-7.243),education level (OR=1.982,95％CI:1.157-6.256),monthly income (OR=1.363,95％CI:1.012-8.227) are the influencing factors of rheumatism's treatment.Conclusion The treatment of rheumatic diseases are influenced by many factors,and more societal support should be provided to help patients with rheumatic disease receive professional treatment and better control of the disease.

Clinical analysis of 56 cases with secondary fungal infection with chronic obstructive pulmonary disease / 中国综合临床

Objective To figure out clinical characteristics and risk factors of secondary fungal infection in patients with chronic obstructive pulmonary disease(COPD).Methods Two hundred and ninetysix patients with COPD were enrolled in our study who were treated in the People's Hospital of Liaocheng.Of whom,56 cases with secondary fungal infection were served as infection group and other 240 cases were non infection group.The clinical data including sorts of antibiotics,the therapy periods of antibiotic,hormones,hypoalbuminemia,invasive operation and death cases were recorded.Sort of fungal were determined by sputum culture.Results Mortality of infection group was 16.1％ (9/56),obviously higher than that of the noninfected group (6.2％ (15/240)) and the difference was significant(x2 =6.436,P ＜0.05).The average sorts of antibiotic,the therapy periods of antibiotic,rate of hormones,the rate of hypoalbuminemia,rate of were invasive operation in infection group were (2.6 ±0.8),(15.4 ±2.6) d,41.1％ (23/56),57.5％ (32/56),35.7％ (20/56),higher than those in non infection group(1.6 ±0.6,(9.6 ±2.2) d,8.3％ (20/240),12.1％ (29/240),5.4％ (13/240) ; P ＜ 0.05).The total efficacy rate in non infection group was 90.4％ (217/240),higher than that in infection group (78.6％ (44/56)),and the difference was significant (x2 =4.248,P ＜ 0.05).The majority sort of fungal in infection group was monilia albicans.Conclusion The main risk factors of secondary fungal infection in patients with COPD include long-term using high-end application antibiotics,hormones,hypealbuminemia and invasive operation.The therapy on fungi is focused on pathogen treatment such as anti-fungal drug therapy.

Comparative study of intravenous medication and pelvic perfusion on patients with gynecological pelvic inflammatory disease / 中国基层医药

Objective To investigate the effects of intravenous medication and pelvic perfusion in the treatment of gynecological acute and chronic pelvic inflammatory disease.Methods 120 cases with pelvic inflammatory disease were randomly divided into two groups.The control group(60 cases) received intravenous drugs.The observation group(60 cases) were given pelvic infusion therapy.The treatment efficacy of the two groups was compared after treatment for 14 days.Results The obvious effective rate of the observation group was 80.00％,which was significantly higher than 50.00％ in the control group(x2 =11.58,P ＜ 0.05).The total effective rate in the observation group was 90.00％,which was significantly higher than 68.33％ in the the control group(x2 =13.72,P ＜ 0.05).The incidence rate of adverse reactions in the control group was 38.33％,that in the observation group was 20.00％,the difference between the two groups was significant(x2 =4.18,P ＜ 0.05).Conclusion Pelvic perfusion therapy can improve the clinical efficacy of pelvic inflammatory disease,improve the symptoms of patients,reduce side effects,which is worthy of clinical application.