Clinical characteristics of patients with acute pulmonary embolism in high altitude area of Yunnan province in China / 中华心血管病杂志

Objective: To analyze the clinical features of patients with acute pulmonary embolism (APE) living in high altitude area of Yunnan province. Methods: This was a cross-sectional retrospective study. APE patients, hospitalized in our hospital between January 2017 and December 2019, were included. The selected patients were divided into low-risk group, medium-risk group and high-risk group according to risk stratification. The clinical data of patients, including demographic data, the main symptoms, risk factors of APE, heart rate and systolic blood pressure and laboratory testing results (D-dimer, cardiac troponin I (cTNI), N terminal B-type natriuretic peptide (NT-proBNP)) and echocardiography and electrocardiogram examination results, were obtained through the electronic medical record system. The clinical characteristics of selected patients were analyzed. Results: A total of 392 patients, aged (63.5±15.7) years, 224 males (57.14%), were included in this study and there were 59 low-risk, 304 medium-risk and 29 high-risk patients in this cohort. The main clinical manifestations were chest pain (157(40.05%)), dyspnea (107(27.30%)), hemoptysis (55(14.03%)), syncope as the first symptom (20(5.10%)), and only 6 cases (1.53%) presented with the typical "Virchow's triad". Most of the patients were accompanied by atypical chest tightness (223(56.89%)) and cough (208(53.06%)). The main risk factors were venous thrombosis of lower limbs (179(45.66%)), hypertension (138(35.20%)), surgery (63(16.07%)), and chronic obstructive pulmonary disease (COPD) (62(15.82%)). There were 57 cases (14.54%) of coronary heart disease, 57 cases (14.54%) of diabetes, 51 cases (13.01%) of cerebral infarction, 47 cases (12.00%) of advanced age, 15 cases (3.83%) of tumor, 7 cases (1.79%) of activity restriction, 6 cases (1.53%) of pregnancy and 4 cases (1.02%) of hormone use in this cohort. The proportion of lower extremity venous thrombosis was significantly higher in low-risk group than in medium-risk group (P<0.01), COPD was more common in high-risk and medium-risk groups than in low-risk group (P<0.01), hypertension was more common in high-risk group than in medium-and low-risk groups (P<0.01). The proportion of advanced age was significantly higher in medium-risk group than in low-risk group (P<0.01). There were no significant differences in RBC and hemoglobin level between low-, medium-and high-risk groups (P>0.05). The level of D-dimer was significantly higher in high-risk group than in medium-and low-risk groups (P<0.05). Levels of NT-proBNP and cTNI were significantly higher in high-risk group than in medium- and low-risk groups (P<0.05). Increased proportion of cTNI and NT-proBNP was significantly higher in high-risk group than in medium- and low-risk groups (P<0.05). There were 105 (26.79%) patients with pulmonary hypertension (PAH). The incidence of PAH was significantly higher in high-risk group than in low-risk group (P<0.01). There were 104 patients (26.53%) with right ventricular enlargement, and the incidence of right ventricular enlargement was significantly higher in high-risk group than in medium-and low-risk groups (P<0.01). Characteristic changes of electrocardiogram in patient with APE were T-wave inversion of limb leads (98(25.00%)), followed by SⅠQⅢTⅢ (83(21.17%)). Conclusions: The main clinical manifestations of APE in Yunnan high altitude area are chest pain and dyspnea, and syncope is the first symptom in some patients, but the typical "Virchow's triad" is rare. The most common risk factors are lower extremity venous thrombosis, hypertension, and COPD. Clinical symptoms, risk factors and laboratory examination results differ among patients with different risk stratification.

Construction of a risk prediction and evaluation system for postoperative incisional infection after spinal surgery / 中华创伤骨科杂志

Objective:To construct a risk prediction and assessment system for incisional infection after spinal surgery.Methods:Based on the failure mode and effect analysis (FMEA), risk factors and assessment indicators of postoperative incisional infection in spinal surgery were sorted out through literature search followed by expert consultation using the Delphi expert consultation method. After three-level assessment indicators were selected according to their importance and expert opinions and assigned by different scores, a risk prediction and evaluation system was constructed for postoperative incisional infection after spinal surgery.Results:The 2 rounds of expert consultation questionnaire resulted in an effective response rate of 100%. The degree of expert consultation authority was 0.85, showing high reliability; the Kendall coordination coefficients of expert consultation ranged from 0.525 to 0.686, showing good coordination ( P<0.05). The three-level assessment indicators consisted of 3 primary, 18 secondary and 54 tertiary ones. After statistical analyses of the important risk indicators selected which consisted of 6 preoperative evaluation ones and 18 postoperative evaluation ones, 6 preoperative and 12 postoperative predictive indicators were obtained. The values of risk priority number (RPN) were calculated for high, medium and low risks for postoperative incisional infection using a semi-quantitative method. Conclusion:A self-designed system has been constructed for risk prediction and assessment of incisional infection after spinal surgery based on expert consultation and FMEA method.

Recent progress of nanoparticle-enabled modulation of macrophages for cancer immunotherapy / 药学学报

Macrophages play an important role in maintaining homeostasis of the body, and they are also one of the most abundant immune cells in the tumor microenvironment (TME). These macrophages are often called tumor-associated macrophages (TAMs), which play an important role in the development of tumor and are an important target for tumor therapy. Studies have shown that tumor growth and metastasis can be inhibited by regulating the function of macrophages, but the therapeutic efficacy was often hampered by the poor performance of the drugs such as lack of targeting, poor solubility, low bioavailability, and severe side effects. After introduction of the background of macrophage and tumor therapy, this review focuses on the research progress of nano-drug delivery systems in the modulation of the function of macrophages to enhance tumor immunotherapy. Nano-drug delivery systems are diverse in structures and functions, and can regulate macrophage functions through a variety of mechanisms. Four important aspects of macrophage modulation, which included TAMs depletion, repolarization of TAMs, promoted phagocytosis of TAMs, and combinational modulation of TAMs were summarized. Each strategy together with typical examples was reviewed and future directions in this field were also prospected.

Detection of EDA gene mutation and phenotypic analysis in patients with hypohidrotic ectodermal dysplasia / 北京大学学报(医学版)

OBJECTIVE@#To detect the ectodysplasin A (EDA) gene mutation in patients with hypohidro-tic ectodermal dysplasia (HED), and to analyze the distribution pattern of missing permanent teeth and the systemic manifestation of HED patients with EDA gene mutation.@*METHODS@#Twelve HED families were enrolled from clinic for genetic history collection, systemic physical examination and oral examination. Peripheral blood or saliva samples were collected from the probands and the family members to extract genomic DNA. PCR amplification and Sanger sequencing were utilized to detect the EDA gene variations, which were compared with the normal sequence (NM_001399.5). The functional impact of EDA gene variants was then evaluated by functional prediction of mutation, conservation analysis and protein structure prediction. The pathogenicity of each EDA gene variation was assessed according to the stan-dards and guidelines of the American College of Medical Genetics and Genomics (ACMG). The systemic phenotype and missing permanent tooth sites of HED patients with EDA gene mutations were summarized, and the missing rate of each tooth position was analyzed and compared.@*RESULTS@#Eight out of twelve HED families were identified to carry EDA gene mutations, including: c.164T>C(p.Leu55Pro); c.457C>T (p.Arg153Cys); c.466C>T(p.Arg156Cys); c. 584G>A(p.Gly195Glu); c.619delG(p.Gly207Profs*73); c.673C>T(p.Pro225Ser); c.676C>T(p.Gln226*) and c.905T>G(p.Phe302Cys). Among them, c.164T>C(p.Leu55Pro); c.619delG(p.Gly207Profs*73); c.673C>T(p.Pro225Ser); c.676C>T(p.Gln226*) and c.905T>G(p.Phe302Cys) were novel mutations. The HED patients with EDA gene mutations in this study were all male. Our results showed that the average number of missing permanent teeth was 13.86±4.49, the average number of missing permanent teeth in the upper jaw was 13.14±5.76, the missing rate was 73.02%. And in the lower jaw, the average number of missing permanent teeth was 14.57±3.05, the missing rate was 80.95%. There was no significant difference in the number of missing teeth between the left and right sides of the permanent dentition (P>0.05). Specifi-cally, the maxillary lateral incisors, the maxillary second premolars and the mandibular lateral incisors were more likely to be missing, while the maxillary central incisors, the maxillary and mandibular first molars had higher possibility of persistence.@*CONCLUSION@#This study detected novel EDA gene pathogenic variants and summarized the distribution pattern of missing permanent teeth of HED patients, thus enriched the variation and phenotype spectrum of EDA gene, and provided new clinical evidence for genetic diagnosis and prenatal consultation.

A novel tray for recording maxillomandibular relationship of edentulous patients based on dimensional surveying of complete dentures / 北京大学学报(医学版)

OBJECTIVE@#To measure the dimensional data of complete dentures and to design a novel tray for recording maxillomandibular relationship of edentulous patients.@*METHODS@#For the measurement, 100 pairs of complete dentures from the clinic were surveyed for the following parameters: a1, the distance between the middle fossa of the upper left and right first molars; a2, the anterior-posterior distance between the middle fossa of the upper first molars and the incisal edge; a3, the width of the upper denture; a4, the anterior-posterior length of the upper denture; a51, the height from the mesio-lingual cusp of the right upper first molar to the saddle surface; a52, the height from the central fossa of the right lower first molar to the saddle surface; a6, the height from the notch of the upper lip frenulum to the upper central incisor edge; a7, the least thickness of the labial saddle base in the upper central incisor region. Based on the data, the trays with different sizes were designed and fabricated, and the key parameters were: b1, the distance between the foramina of screw posts, b2, the anterior-posterior distance between the foramina of the screw posts and the incisal edge; b3, the width of the tray; b4, the anterior-posterior length of the tray; b51, the height of the posterior platform with the screw nut; b52, the height of the screw post; b6, the height of the anterior tray handle; b7, the thickness of the anterior tray handle.@*RESULTS@#The minimum, average and maximum data for each parameter were (in millimeter): a1: 37.1, 44.5, and 59.6; a2: 22.6, 29.0, and 38.1; a3: 48.5, 58.2, and 76.6; a4: 37.4, 50.8, and 61.0; a51: 5.6, 9.5, and 14.7; a52: 3.8, 9.9, and 18.8; a6: 8.9, 16.6, and 24.7; a7: 1.2, 2.8, and 5.9. Based on the data, the trays in small, medium and large sizes were designed and fabricated. In clinical application, the putty silicone rubber impression material was used to reline the tray, meanwhile the posterior platform and anterior tray handle were set as the occlusal plane, then the screw posts were added and adjusted till the proper vertical dimension, after that, the putty silicone rubber impression material was added around the screw posts to record the horizontal maxillomandibular relationship, finally, the anterior surface of the tray handle was used to record the midline of the face and lower edge of the upper lip at rest and with smile.@*CONCLUSION@#The dimensional data offered reference for the analysis of restoration space in edentulous patients. The tray designed and fabricated in this study may serve as a new tool for recording the maxillomandibular relationship.

Initial exploration of discordance in public health standards in China / 中华流行病学杂志

Discordance, such as overlap, repetition and inconsistent, of standards is one of the major problems in current standardization affair in China. Therefore, improving the unity and authority of standards through reduction of overlap, repetition and inconsistency has become the main goal of deepening standardization reform in China. This paper summarizes the discordance in public health standards in China, analyzes the major reasons and provides specific strategic suggestions through case analysis of public health standards in the ways of comparisons of same kind standards of other deparments and standards in administration documents and guidelines or technical specifications of academic associations or societies.

Interpretation of policies for group standards and the practice of group standardizations in Chinese Preventive Medicine Association / 中华流行病学杂志

Recent years, national laws and government policies were published as series to encourage the development of group standardizations. The updated Standardization Law of the People's Republic of China, implemented on January 1st, 2018, stipulates that group standard is a part of the Chinese standard system. Under the current supportive circumstances, more institutes and organizations have joined in the writing and releasing procedures of group standards’. Despite the rapid development of group standardization to publish, we are still at the phase of exploring and regulating group standardizations. This review summarizes the development and practice on the development group standardization in the Chinese Preventive Medicine Association and analyzes current condition and deficiency of the work in China, in order to develop suggestions and strategies to improve and regulate group standardization.

Modulation of drug-metabolizing enzymes and transporters under hypoxia environment / 生理学报

Drug metabolism is significantly affected under hypoxia environment with changes of pharmacokinetics, expression and function of drug-metabolizing enzymes and transporters. Studies have shown that hypoxia increases the release of a series of inflammatory cytokines which can modulate drug metabolism. Besides, both hypoxia inducible factor 1α (HIF-1α) and microRNA-mediated pathways play a role in regulating drug metabolism. This article reviewed the impact and single-factor modulating mechanisms of drug metabolism under hypoxia, and put forward the speculation and prospects of multi-factor modulating mechanisms.

SCD40 ligand expression and inflammatory response in acute aortic dissection patients / 中国胸心血管外科临床杂志

@#Objective To investigate the relationship of cluster of differentiation 40L (CD40L) between inflammatory response mediated by vascular endothelial injury and Stanford A type aortic dissection (STAAD). Methods In this study from August 2016 to February 2017, a total of 215 blood samples from 95 STAAD patients (67 males and 28 females aged 48.33±12.19 years) and 120 healthy volunteers (94 males and 26 females aged 48.64±10.13 years) were collected. The patients with aortic dissection were taken blood 1 hour before the operation and the healthy volunteers were taken blood from the elbow vein. All STAAD patients were diagnozed by computed tomography angiography (CTA) and patients with Marfan syndrome were excluded. Blood samples were tested by enzyme-linked immunosorbent assay (ELISA) for CD40L, vascular cell adhesion molecule (VCAM-1), E-selectin, interleukin-1 (IL-1) beta, IL-6, tumor necrosis factor-alpha (TNF-α) and so on. Results Compared with the healthy population, the level of SCD40L(26.87±5.50 ng/ml vs. 13.39±4.03 ng/ml, P<0.001) in the STAAD patients was significantly higher. E-Selectin (116.62±25.24 ng/ml vs. 77.05±14.30 ng/ml, P<0.001), VCAM-1 (P<0.001), TNF-α (55.35±9.12 ng/ml vs. 37.33±5.61 pg/ml, P<0.001)，IL-1β (62.12±13.37 ng/ml vs. 48.68±9.86 pg/ml, P<0.001)，IL-6 (499.54±90.45 ng/ml vs. 422.44±34.00 pg/ml, P<0.001) significantly increased. Conclusion The increased expression of SCD40L in STAAD patients and the inflammatory reaction induced by endothelial injury in aortic dissection patients are obvious.

Spectrum-effect relationship between HPLC fingerprints and bioactive components of Radix Hedysari on increasing the peak bone mass of rat / 药物分析学报

The traditional Chinese medicine of Radix Hedysari plays an important role in invigorating gas for as-cending, benefiting blood for promoting production of fluid, and promoting circulation for removing obstruction in collaterals, which is consistent with the principle of treatment for osteoporosis. This study is designed to investigate the bioactive components on increasing peak bone mass (PBM) by exploring the spectrum-effect relationship between chromatography fingerprints and effect. Multiple indicators are selected to evaluate the pharmacological activity. In fingerprints, 21 common peaks are obtained, five of which are identified. Furthermore, gray relational analysis (GRA) is a quantitative method of gray system theory and is used to describe the correlation degree of common peaks and pharmacological activities with relational value. 21 components are then divided into three different regions, of which ononin and calycosin play an extremely significant role in increasing PBM. In addition, factor analysis and hierarchical cluster analysis (HCA) are used to screen the optimal producing area for Radix Hedysari. This provides a comprehensive and efficient method to improve the quality evaluation of Radix Hedysari, confirming the bioactive components for PBM-enhancement and further develop its medicinal value.

Oral hygiene maintenance of locator attachments implant overdentures in edentulous population: A longitudinal study / 北京大学学报(医学版)

OBJECTIVE@#To investigate the oral hygiene status of edentulous patients with locator attachments implant overdentures (IOD) and to analyze the relationship among daily hygiene behavior, oral hygiene status and peri-implant diseases.@*METHODS@#Edentulous patients who received IOD treatment with locator attachments from January 2012 to May 2016 were recruited. Clinical and radiographic examinations were conducted to assess the peri-implant tissue status. Modified plaque index (mPLI), sulcus bleeding index (SBI), gingival index (GI), and probing depth (PD) were recorded and peri-implant marginal bone loss (MBL) was measured using paralleling projection technique. Patients' peri-implant oral hygiene maintainence habits were investigated. The correlation between peri-implant diseases and oral hygiene status and behaviors was analyzed.@*RESULTS@#Fifty patients (125 implants) with an average follow-up time of 22 months (6-54 months) were enrolled. The mean values of mPLI, SBI, and GI were 1.4±1.2, 0.8±0.7, and 0.7± 0.6, respectively. Average PD was (2.2±0.7) mm. Mesial and distal maginal bone resorptions were (1.1±1.1) mm and (0.9±0.9) mm, respectively. The prevalance of mucositis and peri-implantitis of the implants were 49.6% and 0. The prevelance of mucositis in the patients with poor oral hygiene (mPLI≥2) was 11.9 times as much as that of those with adequate oral hygiene (mPLI<1). The patients who performed oral hygiene procedure on attachments at least twice a day achieved much lower mPLI scores than those who cleaned less than twice a day.@*CONCLUSION@#Oral hygiene condition in the group of patients with implant overdentures was poor, and it contributed to increased risk of peri-implant mucositis. The prevelance of musositis of the paitients with poor oral hygiene was 11.9 times as much as that of those with proper oral hygiene. Patients wearing IOD should pay more attention to the hygiene of the attachments.

Analysis of edge morphology of partial veneers made by different processing techniques and materials / 北京大学学报(医学版)

OBJECTIVE@#To compare the edge morphology of partial veneers made of different materials by slurry molding, heat-pressed and computer aided design/computer aided manufacturing (CAD/CAM) techniques.@*METHODS@#Thirty premolars with smooth surface and intact enamel were selected and randomly divided into five groups, 6 specimens for each group. Group A were made from feldspathic porcelain (Noritake®) by slurry molding, while Group B were made from lithium disilicate glass ceramic (IPS E.max® Press) by heat-pressed. Group C/D/E were respectively made from feldspar porcelain block (VITA Mark II®), zirconia-reinforced glass ceramic (VITA Suprinity®) and hybrid ceramic with a ceramic-polymer network (VITA Enamic®) by CAD/CAM techniques. All the partial veneers luted with light-cured composite resin. Then the partial veneers were trimmed and polished to achieve the smooth finishing margin, clinical polishing sets were used according to the product descriptions. Scanning electron microscope (SEM) was used to observe the edge morphology of prostheses and the exposure of resin cements.@*RESULTS@#The smooth surface and knife-like edge of the partial veneers could be obtained after bonding, trimming and polishing. The edges of Group A were slightly rough and the width of the exposed adhesive was (106.00±9.17) μm. In Group B, the edges were smoother than Group A, and the exposed wide adhesive strip was visible, which was (138.33±20.59) μm. In Group E, the edges were smooth too, and the width of exposed adhesive strip was (186.00±5.66) μm. The edges of Group C and Group D were rough and uneven, and the adhesive was rarely exposed, they were (50.67±7.51) μm and (65.67±17.90) μm. There were all significant differences between two groups, except Group C and Group D.@*CONCLUSION@#After trimming and polishing in accordance with clinical procedures, the expected knife-like edge can be obtained in all groups. The width of the exposed resin adhesive of each group is different, the order: Mark II/Suprinity < Noritake < E.max Press < Enamic. The edge morphology of partial veneers in different processing technic and materials are different.

Detection and functional analysis of BMP2 gene mutation in patients with tooth agenesis / 北京大学学报(医学版)

OBJECTIVE@#To screen for BMP2 mutation with functional impact in patients with congenital tooth agenesis and to make oral and skeletal phenotype record and functional analysis with in vitro experiments.@*METHODS@#We enrolled eighteen patients with congenital tooth agenesis. The medical and dental history was collected,and clinical and dental examinations including the X-ray examination of oral-facial and skeletal bone were performed for the phenotypic analysis. Blood samples were collected to extract DNA and whole exome sequencing was conducted. The genes involved in oral-facial development and congenital skeletal diseases were investigated for mutation screening. The mutations with functional impact were then investigated. In one patient, the BMP2 mutation with putative functional impact was selected for functional analysis. Wild type and mutant BMP2 plasmids with green fluorescent protein (GFP) tag were constructed and transfected into HEK293T cells. Subcellular protein distribution was observed under laser scanning confocal microscope. The activation of downstream SMAD1/5/9 phosphorylation by BMP2 was detected by Western blotting to investigate the functional impact and genetic pathogenicity.@*RESULTS@#BMP2 mutation NM_001200.3:c.393A>T (p.Arg131Ser), rs140417301 was detected in one patient with congenital tooth agenesis, while for other genes involved in oral-facial development and congenital skeletal diseases, no functionally significant mutation was found. The proband's parents didn't carry this mutation. The father had normal dentition, while the mother lacked one premolar, and both the parents showed normal palate and maxilla. The patient also had maxillary hypoplasia in both sagittal and coronal planes, palatal dysmorphology, and malocclusion, and was diagonsed with osteopenia after the X-ray examnination of his skeletal bone. Functional analysis showed this mutation had normal subcelluar localization but reduced phosphorylation of SMAD1/5/9 (reduction by 32%, 22%, and 27% in three independent replicates). Taken together with family co-segregation, this mutaion was considered as "likely pathogenic".@*CONCLUSION@#BMP2 mutation c.393A>T (p. Arg131Ser) affects bone morphogenetic protein signaling activity, and may affect the number of teeth, growth of maxilla and palate, and bone mineral density.

Determination of Paraben and Its Metabolite in Sediments by Ultra Performance Liquid Chromatography-Triple Quadrupole Tandem Mass Spectrometry / 分析化学

A new method for simultaneous determination of six benzoic acid esters and their metabolite p-hydroxybenzoic acid (p-HB) in sediments was developed.The samples were extracted with methanol and water,and then the extraction was purified by Oasis MCX solid phase column.The separation of targets was conducted by passing through a UPLC?HSS T3 column with a methanol-0.1% acid aqueous solution as the mobile phase under gradient elution.The qualitative analysis of the analytes was measured by Ultra performance liquid chromatography-Triple quadrupole tandem mass under multiple reaction monitoring mode (MRM) and the internal standard method was applied for quantitative analysis.The results indicated that seven target substances had a good linear relationship in the range of 0.1-500 μg/L with correlation coefficients above 0.9995 and the detection limits of 0.75-1.23 ng/g.The recoveries ranged from 65.5% to 88.3% and the relative standard deviation was 7.4%-13.6%.This method was suitable for the measurement of benzoic acid esters with the advantages such as simple processing,good selectivity and high sensitivity.

Relationship of CEUS quantitative parameters and enhance patterns with therapeutic effect of high-intensity focused ultrasound for hysteromyoma / 中国介入影像与治疗学

Objective To observe the relationship of efficacy of high-intensity focused ultrasound (HIFU) in treatment of hysteromyoma and quantitative parameters and enhance manifestations of CEUS.Methods Forty patients with single hysteromyoma underwent CEUS before HIFU,immediately after and 6 months after treatment,respectively.Time to peak (TTP),peak intensity (PI) of time-intensity curve were analyzed,and the enhance manifestations were observed.The ablation ratio of hysteromyoma immediately after HIFU and the ratio of reduction volume 6 months after treatment were also analyzed.Results Among 40 hysteromyomas,21 evenly enhanced (even enhance group) and 19 unevenly enhanced (uneven enhance group).The ablation rate greater than or equal to 80 ％ were observed in 22 hysteromyomas (ablation rate ≥80％ group),while ablation rate less than 80％ were observed in 18 lesions (ablation rate ＜80％ group).There were significant differences of TTP ([27.48 ± 7.89] s vs [21.78 ± 4.76] s;t =2.69,P =0.01),PI ([44.29 ± 3.74] dB vs [47.39±4.68]dB;t=-2.34,P=0.02) and the ratio of reduction volume 6 months after HIFU ([59.47±16.21]％ vs [37.30±11.89]％;t=4.83,P＜0.01) between ablation rate ≥80％ group and ablation rate ＜80％ group.The ablation rate ([65.03±18.39]％ vs [41.64±18.78]％;t=-4.49,P＜0.01) and the ratio of reduction volume 6 months after HIFU ([84.74±7.76]％ vs [58.18±12.94]％;t=-3.21,P＜0.01) were significantly different between even enhance group and uneven enhance group.TTP and the ratio of reduction volume 6 months after HIFU positively correlated with the ablation rate (r =0.448,0.660,both P＜ 0.01),while PI and enhance manifestations negatively correlated with ablation rate (r =-0.460,rs =-0.614,both P＜ 0.01).Conclusion TTP,PI of time-intensity curve and enhance patterns of hysteromyoma correlated with the ablation rate of HIFU,which having certain clinical value in evaluation of therapeutic efficacy.

Mitochondrial damage in early stage of pressure ulcer in rats / 基础医学与临床

Objective To investigate the mitochondrial damage and its effect in early stage of pressure ulcer in rats.Methods Forty rats were randomly divided into 5 groups(n=8), control group(Con group) rats without stress, the experimental group was treated with of 170 mmHg for 2 h and relax 0.5 h as one cycle(1C), experi-mental group was divided into 3C, 6C, 9C and 12C group.The pathological changes of the compressed muscle tissue of the rats in each group were observed by HE staining , Western blot was used to detect the expression of Bcl-2 and Bax in the compressed tissue , and the ultrastructure of muscle fibers and mitochondria were observed by transmission electron microscope .Results There were pathological damage and gradually increased in the ex-perimental groups, with the increase of compression cycle; the expression of Bcl-2 in each experimental group was significantly increased as compared with the control group(P<0.05), in the 3C group reached the peak, and then decreased; the expression of Bax was increased gradually with the increase of compression cycle ( P<0.05) , and in the 12C group reached the peak;with the increase of the compression cycle the muscle fibers of each experimental group appeared gradually increased pathological damage:disorder, dissolution and fracture, the ridge of the mitochondria disappeared, vacuolar degeneration, et al.Conclusions In the early stage of pres-sure ulcer in a rat , it brings occurred mitochondrial damage and induces apoptosis .

The application of superb micro-vascular imaging in evaluating the therapeutic efficacy of uterine fibroids treated with high intensity focused ultrasound / 中华超声影像学杂志

Objective To evaluate the value of superb micro-vascular imaging( SMI) in evaluating the efficacy of uterine fibroids treated with high intensity focused ultrasound( HIFU) . Methods Forty patients with single fibroid were selected before and after HIFU treatment ,color Doppler flow imaging(CDFI) ,SMI and contrast-enhanced ultrasound ( CEUS ) pattern were used to detect the lesions . CEUS was used as standard . The correlation of different blood flow levels in the fibroids with SMI and the efficacy of HIFU were evaluated . Results Before HIFU treatment ,the blood flow signals of different degrees were found in the uterine fibroids . SMI showed that 4 fibroids( 10 .0％ ) were in the first degree ,21 fibroids( 52 .5％ ) were in the second degree and 15 fibroids ( 37 .5％ ) were in the third degree . CEUS showed that 8 fibroids ( 20 .0％ ) were hypo-enhanced ,19 fibroids( 47 .5％ ) were iso-enhanced and 13 fobroids(32 .5％ ) were hyper-enhanced . The correlation analysis showed that there was close relationship between the results of SMI and CEUS( Kappa = 0 .754 , P = 0 .00) . After HIFU treatment ,SMI and CEUS had no statistical difference in evaluating the efficacy of HIFU( P > 0 .05) . The ratio of non-perfused volume and the ratio of the volume reduction at 6 months after HIFU in the third degree of SMI were lower than those in the first and second degrees( P < 0 .05) . Conclusions There are some relationships between SMI and CEUS in evaluating the blood flow signal of uterine fibroids . SMI can prompt therapeutic efficacy of uterine fibroids ablated by HIFU and provide some clinical reference values .

Discussion on implementation of public health standards adopted in centers for disease control and prevention / 中华流行病学杂志

As the most important phase in standardization activity,implementation saves as the essence.CDC in China are the major institutions undertaking disease control and prevention.Implementing the standards of public health provides technical basis for CDC to complete the task of disease control and prevention.In the study,spot conversation and questionnaire were used to investigate the implementation of standards on public health in CDC.Results showed that the staff of CDC got to know the standards through the Intemet.The departments of CDC which conducted training and sent staff to attend training courses accounted for 50.00％(25/50) and 34.00％ (17/50),respectively.State mandatory rule is still the main reason for relevant departments to implement the standards of the public health.Government promotion activities facilitate the implementation of Standards,and the degree of familiarity with Standards affects the implementation as well.The paper summarizes the existing problems,such as the lack of coordination between departments of public health at provincial level or below,lack of access to standards,and the need to strengthen the training of the standard implementation etc.It puts forward some suggestions to strengthen the implementation of public health Standards.

Discussion on implementation of public health standards adopted in centers for disease control and prevention / 中华流行病学杂志

As the most important phase in standardization activity,implementation saves as the essence.CDC in China are the major institutions undertaking disease control and prevention.Implementing the standards of public health provides technical basis for CDC to complete the task of disease control and prevention.In the study,spot conversation and questionnaire were used to investigate the implementation of standards on public health in CDC.Results showed that the staff of CDC got to know the standards through the Intemet.The departments of CDC which conducted training and sent staff to attend training courses accounted for 50.00％(25/50) and 34.00％ (17/50),respectively.State mandatory rule is still the main reason for relevant departments to implement the standards of the public health.Government promotion activities facilitate the implementation of Standards,and the degree of familiarity with Standards affects the implementation as well.The paper summarizes the existing problems,such as the lack of coordination between departments of public health at provincial level or below,lack of access to standards,and the need to strengthen the training of the standard implementation etc.It puts forward some suggestions to strengthen the implementation of public health Standards.

Recombinant human serum albumin promotes differentiation of human pluripotent stem cells into cardiomyocytes in vitro / 中国胸心血管外科临床杂志

@#Objective    To investigate whether recombinant human serum albumin (rHSA) can replace traditional B27 as a basic medium for differentiation of human pluripotent stem cells (hPSCs) into cardiomyocytes. Methods     hPSCs were seeded at a cell density of 1.2×104/cm2; until up to 75% confluency hPSCs were induced by differentiation medium containing various concentration of rHSA (0, 50, 100, 200 g/L). Light microscope and fluorescence microscope recorded the whole process of stem cells differentiating into myocardium. Flow cytometry was used to detect the cardiac differentiation efficiency at different concentrations of rHSA. Immunofluorescence staining was used to detect the cardiac specific protein α-actinin and troponin T (cTnT) and electron microscope to observe the ultrastructure of human pluripotent stem cell-derived cardiomyocytes (hPSC-CM) and beating rates of hPSC-CMs response to drugs. Results     A large number of spontaneous beating cardiomyocytes were observed 9 days after induction and differentition. The percentage of colonies showing beating cardiomyocytes was 60.4% at the concentration of 200 g/L of rice derived-rHSA. Beating cardiomyocytes were α-actinin and cTnT positive. Ultrastructural analysis showed scattered sarcomeres and mitochondrial. hPSC-CMs were dose-dependent on isopropyl adrenaline and verapamil. Conclusion     Using such simple media to differentiate hPSCs into functional cardiomyocytes is cost-effective and highly efficient, and can be used in the clinical research.