Mutational Signatures Analysis of Micropapillary Components and Exploration of ZNF469 Gene in Early-stage Lung Adenocarcinoma with Ground-glass Opacities / 中国肺癌杂志

BACKGROUND@#In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration.@*METHODS@#A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases.@*RESULTS@#MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05).@*CONCLUSIONS@#The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.

Risk factors of urinary incontinence in Chinese women based on random forest / 中华妇产科杂志

Objective:To explore the risk factors of urinary incontinence (UI) in China by using random forest algorithm, and to evaluate the predictive effect of each risk factor on UI.Methods:A baseline survey with a multistage stratified cluster sampling design was conducted between February 2014 and January 2016, and followed up by telephone from June to December 2018. A total of 55 477 adult women from six provinces of China participated the survey. According to the ratio of 1:1, under sampling method was used to randomly select the same number of women as UI from the non UI women. The data were randomly divided into training set and verification set according to 7:3. The training set was used to establish the random forest model, which including the candidate variables with P<0.2 in univariate analysis, and the verification set was used to verify the predictive effects. Results:A total of 30 658 patients (55.26%, 30 658/55 477) completed the follow-up, the median follow-up time was 3.7 years. Among the 24 985 women without UI at baseline, 1 757 (7.03%, 1 757/24 985) had UI at followed up, including 1 117 (4.47%, 1 117/24 985) with stress UI, 243 (0.97%, 243/24 985) with urgency UI and 397 (1.59%, 397/24 985) with mixed UI. When fixed the number of features as 2 and the number of random trees as 300 in the random forest model, the out of bag error rate estimation was the lowest; with such parameter settings, the classification accuracy was 64.3%, the sensitivity was 64.2%, and the specificity was 64.4%. The top10 predictive UI factors that screening by the variable importance measure in random forest model were obtained as follows: age, parity, delivery pattern, body mass index (BMI), menopause, history of diabetes, education level, history of pelvic surgery, regions, and marital status.Conclusion:We identified the top10 predictive UI factors that screening by the variable importance in random forest model as follows: age, parity, delivery pattern, BMI, menopause, history of diabetes, education level, history of pelvic surgery, regions, and marital status.

Construction and application of the health appropriate technology database in Zhejiang Province / 中华医学科研管理杂志

Objective Analyzing the construction process and application of health appropriate technology database in Zhejiang province and proposing related considerations and recommendations for the database construction.Methods To design and construct the technology database system,and using excel software to calculate statistic data.Results Established a health appropriate technology database,which contains 826 technologies that can be selected and promoted by the demonstration bases in the whole province.Conclusions The establishment of the technology database increased the efficiency of health appropriate technology transformation at the provincial level,and also provided a reference for the national-wide generalizing of health appropriate technology.

Research on performance evaluation index system for the innovative medical devices transforming project in Zhejiang Province / 中华医学科研管理杂志

Objective Establish an overall performance evaluation index system for innovative medical devices transforming project,a major science and technology project in Zhejiang province.Methods The weight of indexes was calculated using Delphi method,analytic hierarchy process and weight of percentile method.Results A three-level performance evaluation index system was established.First level included 3 indexes,as condition index,process index and result index,with weight of 0.3401、0.4042 and 0.2557 respectively.Meanwhile,second level and third level included 13 and 38 indexes.Conclusions The index system provide a performance evaluation tool for the innovative medical devices transforming project.

Construction of Experimental Animal Model of Overactive Bladder in Rat Induced by Cyclophosphamide Intraperitoneal Injection and Intravesical Instillation / 中国医科大学学报

Objective To compare the advantages and disadvantages of two methods for rat overactive bladder(OAB)model construction in?duced by intraperitoneal injection and intravesical instillation cyclophosphamide. Methods A total of 30 female SD rats weighting 200?250 g were randomly categorized into three groups:intraperitoneal injection?induced OAB(Ip?OAB),intravesical instillation?induced group(Iv?OAB)and con?trol group. Ip?OAB rats was i.p. administrated cycbophosphe mide three times in dose of 75 mg/kg body weight,while Iv?OAB rats received intravesi?cal instillation three times in drug dose of 75 mg/kg body weight. Control group rats received no treatment. Maximum bladder capacity(MBC),maxi?mum voiding pressure(MVP),frequency of spontaneous contraction of each group were recorded. The incidence,the mortality and the pathology of the three groups were compared. Results MBC,MVP and frequency of spontaneous contraction between Ip?OAB group and Iv?OAB group had no statistically significant difference(P>0.05). Compared with the control group,MBC significantly increased(P<0.05),MVP significantly decreased (P<0.05),and frequency of spontaneous contraction significantly increased(P<0.05)in Ip?OAB and Iv?OAB rats. The modeling success rate and mortality were 100%and 80%in Ip?OAB group,and were 50%and 0%in Iv?OAB group,and pathological changes were found in the two groups. Conclusion The construction of experimental animal model of OAB in rat induced by intraperitoneal injection and intravesical instillation cyclo?phosphamide are both reliable methods. Ip?OAB rats exhibit high incidence and mortality rate,while Iv?OAB rats show low incidence and mortality rate.

Quality assurance system of the standardized residency training bases in Zhejiang province: establishment and implementations / 中华医院管理杂志

A study of the quality assurance system building made at the training bases in Zhejiang since 2011 found the following.Five management systems on training quality have been established, covering basic clinical conditions, training management, faculty management and training, training assessment,and training incentives.PDCA is called into play for continuous improvement and perfection to develop a training quality management system of local features and continuous improvement.

Curative Effect of Different Biofeedback and Electrical Stimulation Solutions on Female Stress Urinary Incontinence / 中国医科大学学报

Objective To investigate the curative effect of different biofeedback and electrical stimulation solutions on female stress urinary inconti-nence(SUI). Methods A total of 40 female patients with mild-to-moderate SUI were randomly divided into two groups(n=20 each group)and treated by the biofeedback and electrical stimulation. In the treatment group,the current increased in the middle of the treatment on the basis of the initial threshold of stimulus intensity to make a new tolerable threshold of stimulus intensity. In the control group,the patients were treated with the initial threshold of stimulus intensity during the whole treatment. The curative effects in these two groups were determined by the comprehensive strength of pelvic floor,the 1 h urine pad test results,and the life quality scores of urinary incontinence. Results After treatment,there were signifi-cant improvements in all the above indicators in two groups(P<0.05),and the results is better in the treatment group than in the control group. The effective rate in treatment group(95%,19/20)was higher than that in the control group(65%,13/20)(P<0.05). Conclusion The biofeedback and electrical stimulation were effective and safe in the treatment of women with SUI. The curative effect of patients treated with increasing current in the middle of the treatment is better,suggesting that it can be widely applied in clinic.

Medical Ethics Education for Standardization Training and Teacher Training of Resident Doctors in Zhejiang Province / 中国医学伦理学

Under the background of resident standardization training pilot in Zhejiang province , this paper put forward the scheme of resident doctors standardization training and teacher training for the first time .This paper an-alyzed the necessity of medical ethics education in teacher training and standardization training and the requirements of teacher training in ethical education and ways for ethical education .Carrying out medical ethics education not only improves teachers'medical ethics knowledge , but also let them master the medical ethics teaching methods and skills.

System model for transfer and application of the appropriate health technologies in rural areas / 中华医学科研管理杂志

Considering the core concept of the system theory,the author describes the conception,components and main functions of the subjects,the objects and behavioral factors for the popularization and application of appropriate health technologies.This theoretically built up the system model for transfer and application of the appropriate health technologies in Chinese rural areas.

Analysis on the external macro factors and internal function mechanisms of the transformation and application system for appropriate health technologies in rural areas / 中华医学科研管理杂志

This paper discussed in detail the external macro factors and internal key function mechanisms of the transformation and application system for appropriate health technologies in rural areas.The macro components include political factors,social factors,population factors,environmental factors and health policy factors.The internal key function mechanisms include policy mechanism,benefit mechanism and guarantee mechanism.

Need analysis of information resource for appropriate health technologies / 中华医学科研管理杂志

The need analysis of information resource for appropriate health technologies is important for the related information transmission channel and promotion of those technologies at primary level.This paper introduces the current status of the information resource construction of appropriate health technologies in China,and analyzes the needs and means of transmission in terms of users,holders and spreader,taking Zhejiang as an example.Methods of literature review,questionnaire survey,interview,and symposium were employed.

Retrospective analysis of appropriate health technology policy in Zhejiang Province from 1991 to 2012 / 中华医学科研管理杂志

This paper reviews the development of appropriate health technology policy from 1992 to 2012 in Zhejiang province.The evolvement of recent twenty years is classified into several stages and each is analysed and evaluated.This study provides reference for the establishment of appropriate health technology policy and the transformation of science and technology policy across the country.

Study on the construction of policy system for the application of appropriate health technologies in rural areas / 中华医学科研管理杂志

To enhance the capacity for extending and applying appropriate health technologies in rural areas in China,this paper proposes a supportive policy system that incoperates macro,average and microlevels. Thepolicysystemfocusesonorientation, incentives, regulationsand standardization,and its objectives and measures of each level are described.The policy system will contribute to the sustainable development rural health work.

Efficacy of Total Pelvic Floor Reconstruction with Pesh Match for Presby-pelvic Floor Dysfunction / 中国医科大学学报

Objective To compare the efficacy of total pelvic floor reconstruction with mesh patch and vaginal hysterectomy with anterior and posterior vaginal wall repair for presby-pelvic floor dysfunction patients.Methods We randomly chose 92 pelvic floor dysfunction inpatients of our hospital from September 2007 to February 2009 and divided them into 2 groups:total pelvic floor reconstruction group(n=70) underwent total pelvic floor reconstruction with mesh patch[12 patients of this group complicated with stress incontinence,4 patients received tension free vaginal tape-obturator(TVT-O) simultaneously];control group(n=22) received vaginal hysterectomy with anterior and posterior vaginal wall repair(3 patients of this group complicated with stress incontinence).A follow-up for 3 to 18 months after the surgery were taken in all the patients.Results In total pelvic floor reconstruction group,no recidivate case was found and the FOP scores and cure rate were 0 and 100% respectively.In control group,there were 7 recidivate cases,all of who were primary vagina anterior wall bulge patients.The cure rate of control group was 68%;For the patients complicated with stress incontinence,they were all cured by TVT-0 or by ascending the front patch in total pelvic floor reconstruction group,but 1 case was as before operation and 2 cases were even worse in control group.Conclusion Total pelvic floor reconstruction with vicarious materials had a definite efficacy for presby-pelvic floor dysfunction.

Efficiency of Biofeedback and Pelvic Electric Stimulation Therapy for Female Stress Urinary Incontinence / 中国医科大学学报

Objective To evaluate the clinical results of biofeedback and pelvic electric stimulation therapy for stress urinary incontinence in women. Methods Totally 36 women with stress urinary incontinence were prospcctively studied by treating with biofeedback and pelvic electric stimulation therapy (MeprasolBIO2001). All the patients were follow-up for 3 months. Results About 70% of the patients were completely dry and 22% reported subjective improved,the recurrence rate at 3 months follow-up was 60%. Conclusion Biofeedback and pelvic electric stimulation therapy is a safe method for treating stress urinary incontinence. It is effective and easy to perform as an outpatient treatment. But the therapy should be performed for a longterm.

Study on approaches to popular application effect of the feasible medical technology in rural area / 中华医学科研管理杂志

Objective Analysis of the applied effect on three kinds of feasible diagnosis techniques in the rural area of Yuhang.Methods First,we adopted the technology training through classroom teaching.and second the model of technology extension with combination of administrative interfering and research group studying was used to promote the popular application of these techniques.Results The total cases of used these techniques were 40526.During 2006 the training rate of these techniques was 100.0%.The applicative rates for ECG,NBAP and toxoplasmosis diagnostic technology were 76.5%,100.0%,and 88.2% respectively.Conclusions Nowadays it would be the effective approaches for improving technology extension of feasible diagnosis to implement the classified administration of the technology,to strengthen the technical services,and to impmve the conditions of the technology extension based on the technical usability.

Effects of optional cesarean section on the level of plasma motilin and serum gastrin in neonatal umbilical blood / 中国实用妇科与产科杂志

ObjectiveTo explore the effects of optional cesarean section on the level of plasma motilin and serum gastrin in umbilical blood and their relationship with gastroenteric symptoms of neonates. MethodsWe measured the concentrations of plasma motilin and serum gastrin in umbilical blood from neonates undergoing optional cesarean operation, emergency cesarean section and vaginal delivery by radioimmunoassay(RIA). ResultsFull-term deliveries undergoing optional cesarean section were with significant gastrointestinal symptoms. Plasma motilin and serum gastrin were significantly lower in neonates undergoing cesarean operation without birth initiate group(optional cesarean section)than that in cesarean section with birth initiate group and vaginal delivery group (P<0.05). ConclusionCesarean operation without birth initiate influences neonatal gastroenteric symptoms.Breast feeding which begins as early as possible will help to relieve those symptoms.

Expression of CD44 gene nm23 gene TGFα and TNFα in epithelial ovarian cancer / 中国实用妇科与产科杂志

ObjectiveTo explore the relation of the expression of intron 9 in CD44 gene,nm23 gene and the serum levels of TGFα and TNFα to the development, metastasis and prognosis of epithelial ovarian cancer. Methods The expressions of intron 9 in CD44 gene, nm23 gene, TGFα and TNFα in epithelial ovarian cancer were measured by semi -quantitative RT - PCR, immunohistochemical technique and radioimmunoassay ( RIA ). Results There was positive expression of intron 9 in CD44 gene,nm23 gene,TGFα and TNFα in 36 cases of epithelial ovarian cancer. The higher levels of nm23 gene and TGFa were obvious in early stage of ovarian cancer. ConclusionTo study the ovarian cancers biologic behavior with these multipe factors can provide theoretical basis for early diagnosis, gene therapy and predicting prognosis.

Relation of ME491/CD_(63) gene and integrin ?5 in the invasion and metastases of ovarian cancer / 中华妇产科杂志

0.05). There was significant difference between G_1, G_2and G_3(P0.05). Low expression levels in G_4 (Ⅲ,Ⅳ) were observed.Significant differences were noted between expression levels in G_4 (Ⅲ,Ⅳ) and in G_2, G_3 or G_4 (Ⅰ,Ⅱ; P