Establishment and effect evaluation of risk prediction model for lung infection after kidney transplantation / 器官移植

Objective To establish and evaluate the predictive value of the risk prediction model for lung infection within postoperative 1 year in kidney transplant recipients. Methods Clinical data of 197 kidney transplant recipients were retrospectively analyzed. All recipients were divided into the infection group (n=42) and non-infection group (n=155) according to the incidence of lung infection within postoperative 1 year. The incidence and risk factors of lung infection after kidney transplantation were analyzed. Risk prediction model was established by multiple logistic regression analysis. Forty-five kidney transplant recipients who met the inclusion criteria, including 8 cases in the infection group and 37 cases in the non-infection group, were selected to verify the predictive effect of the established model. Results The incidence of lung infection within 1 year after kidney transplantation was 21.3% (n=42), including 38 cases (90%) of pneumonia severity index (PSI) class Ⅰ, 1 case (2%) of PSI class Ⅲ and 3 cases (8%) of PSI class Ⅴ. Lung infection occurred within 1 month after operation in 13 cases, within postoperative 2-6 months in 22 cases and after postoperative 6 months in 7 cases. Nineteen recipients were diagnosed with bacterial infection, 7 cases of fungal infection, 10 cases of viral infection and 6 cases of mixed infection. Smoking history, diabetes mellitus history, pulmonary disease history and albumin level of < 35 g/L were the independent risk factors for lung infection after kidney transplantation (all P < 0.05). The equation of risk prediction model for postoperative lung infection in kidney transplant recipients was logit (lung infection within postoperative 1 year in kidney transplant recipients)=-1.891+1.063×smoking history (yes=1, no=0)+1.398×diabetes mellitus history (yes=1, no=0)+1.732×pulmonary disease history (yes=1, no=0)+1.269×albumin level (< 35 g/L=1, ≥35 g/L=0). The area under the curve (AUC) of receiver operating characteristic (ROC) was 0.788, the sensitivity was 0.786, the specificity was 0.645, and the Youden index was 0.431, respectively. Hosmer-Lemeshow goodness-of-fit test demonstrated that the predicted value of this model yielded relatively high consistency with the observed value. The AUC in the verification group was 0.834. Hosmer-Lemeshow goodness-of-fit test validated high degree of calibration of this model. Conclusions The risk prediction model, consisting of smoking history, diabetes mellitus history, pulmonary disease history and albumin level as predictors, may effectively predict the incidence of lung infection within postoperative 1 year in kidney transplant recipients.

IGF2BP1 and cancer / 国际肿瘤学杂志

The insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) is a key regulator of mRNA metabolism and transport during development. Recent studies indicate that IGF2BP1 is aberrantly expressed in liver cancer, lung cancer, colon cancer, ovarion cancer, breast cancer, etc.. IGF2BP1 expression is found to promote tumor cell proliferation, migration, invasion, and correlate with poor prognosis. Further understanding of the mechanism of IGF2BP1 in malignancy may provide new targeted therapy strategies.

Dysregulation of the miR-148a-GLUT1 axis promotes the progression and chemoresistance of human intrahepatic cholangiocarcinoma.

Intrahepatic cholangiocarcinoma (iCCA) is a highly fatal malignant cancer worldwide. Elucidating the underlying molecular mechanism of iCCA progression is critical for the identification of new therapeutic targets. The present study explored the role of the miR-148a-GLUT1 axis in the progression of iCCA. The expression of GLUT1 was detected by using immunohistochemistry, western blot assays, and real-time polymerase chain reaction. The effects of GLUT1 on cell proliferation, invasion, and chemoresistance were investigated both in vitro and in vivo. A luciferase reporter assay was used to explore the effect of miR-148a on GLUT1 expression. GLUT1 was overexpressed in iCCA tissues. GLUT1 overexpression was associated with shorter overall and disease-free survival. Knockdown of GLUT1 reduced, while overexpression of GLUT1 promoted, the proliferation, motility, and invasiveness of iCCA cells in vitro and in vivo. Silencing GLUT1 significantly sensitized iCCA cells to gemcitabine in vitro and in vivo. GLUT1 was directly regulated by miR-148a, whose downregulation was associated with the proliferation, migration, and invasion of iCCA cells. WZB117, a GLUT1 inhibitor, inhibited tumor growth in an iCCA patient-derived xenograft model. These results indicate that downregulation of miR-148a levels results in GLUT1 overexpression in iCCA, leading to iCCA progression and gemcitabine resistance.

MUC13 promotes intrahepatic cholangiocarcinoma progression via EGFR/PI3K/AKT pathways.

BACKGROUND & AIMS: Mucin 13 (MUC13) is reportedly overexpressed in human malignancies. However, the clinicopathological and biological significance of MUC13 in human intrahepatic cholangiocarcinoma (iCCA) remain unclear. The aim of this study was to define the role of MUC13 in the progression of iCCA. METHODS: Expression levels of MUC13 in human iCCA samples were evaluated by immunohistochemistry, western blot, and real-time PCR. In vitro and in vivo experiments were used to assess the effect of MUC13 on iCCA cell growth and metastasis. Crosstalk between MUC13 and EGFR/PI3K/AKT signaling was analyzed by molecular methods. The upstream regulatory effects of MUC13 were evaluated by Luciferase and DNA methylation assays. RESULTS: MUC13 was overexpressed in human iCCA specimens and iCCA cells. MUC13 overexpression positively correlated with clinicopathological characteristics of iCCA, such as vascular invasion and lymph node metastasis, and was independently associated with poor survival. Results from loss-of-function and gain-of-function experiments suggested that knockdown of MUC13 attenuated, while overexpression of MUC13 enhanced, the proliferation, motility, and invasiveness of iCCA cells in vitro and in vivo. Mechanistically, we found that the phosphatidylinositol 3-kinase-AKT signal pathway and its downstream effectors, such as tissue inhibitor of metalloproteinases 1 and matrix metallopeptidase 9, were required for MUC13-mediated tumor metastasis of iCCA. MUC13 interacted with epidermal growth factor receptor (EGFR) and subsequently activated the EGFR/PI3K/AKT signaling pathway by promoting EGFR dimerization and preventing EGFR internalization. We also found that MUC13 was directly regulated by miR-212-3p, whose downregulation was related to aberrant CpG hypermethylation in the promoter area. CONCLUSIONS: These findings suggest that aberrant hypermethylation-induced downregulation of miR-212-3p results in overexpression of MUC13 in iCCA, leading to metastasis via activation of the EGFR/PI3K/AKT signaling pathway. LAY SUMMARY: Mucin 13 overexpression has been implicated in the development of malignancies, although its role in intrahepatic cholangiocarcinoma has not been studied. Herein, we show that mucin 13 plays a critical role in intrahepatic cholangiocarcinoma. Mucin 13 could have therapeutic value both as a prognostic marker and as a treatment target.

Exploration of SPOC-based mixed teaching mode in the teaching of general surgery / 中华医学教育探索杂志

In response to the teaching requirements under the new situation of medical education reform, the Department of General Surgery of the First Affiliated Hospital of Harbin Medical University has actively carried out the SPOC (small private online course). Through special seminars, online platform exchanges and skill operation exercises, students can accurately grasp the learning focus and learn the subject knowledge efficiently, which has realized the teaching goals of situational, problematic, multi-dimensional and task-based teaching and learning. It is a new type of online and offline interactive teaching model, which is worth further promotion.

Application of medical virtual simulation experimental teaching platform in general surgery teaching / 中华医学教育探索杂志

Medical virtual simulation experimental teaching platform has the characteristics of high openness and sharing, overcoming resource constraints, diversified teaching methods and so on. Applying the virtual simulation platform to general surgery teaching, students can break through the constraints of the textbooks, and perform immersive practical operations on the network by watching experimental videos, and simulating virtual instrument, and experimental materials online, so as to improve their hands-on skills and increase their interest in learning.

Present situation and enlightenment of continuing education of dental hygienists in America / 中国实用护理杂志

Introducing the continuing education of the dental hygienist in eight states of the U.S.,to understand the the category of practice,professional ability,curriculum, teaching methods and teaching evaluation standard. To analyze the continuing education in eight states to provide a reference for constructing a curriculum system that is suitable for China.

A qualitative research of the status-quo of service in primary health care for dementia who stay in home in the supply-side perspective / 中国实用护理杂志

Objective:To understand the status quo of primary medical and health services for home aged dementia patients in Weifang from the perspective of medical service providers. And to provide suggestions for improving the primary medical services and community care for home aged dementia patients.Methods:A semi-structured in-depth interview was conducted with 26 primary medical and health care workers in the primary medical and health services of home patients with senile dementia, and the interview data were summarized and extracted by content analysis method.Results:Four themes were extracted according to the primary medical and health services for home aged dementia patients. Theme 1: less chance to contact with dementia patients, and the understanding of the disease is biased. Theme 2: limited medical services and no targeted services. Theme 3: receive less relevant training and need professional technical support. Theme 4: there is no system of medical support, and an effective model needs to be established.Conclusion:There are few primary medical and health services for home patients with senile dementia, and there are regional differences. It is necessary to increase the understanding of home patients with senile dementia by various means and increase the primary medical services for home patients.

Practical exploration of MOOC teaching in general surgery teaching / 中华医学教育探索杂志

This study apply MOOC graduate student in general surgery teaching , with the help of the teaching video quality , flexible learning time , video miniaturization unique advantages , such as students can choose the time and place, through online resource sharing, test evaluation and simulation of the virtual patient, positive interaction with teachers classmates on the Internet, so that the students can study more efficiently and master course knowledge . Studies have shown that students' average scores have improved and their overall scores have also improved . In future teaching , MOOC can be combined with traditional teaching to complement each other's advantages .

Comparison of Six Automated Immunoassays With Isotope-Diluted Liquid Chromatography-Tandem Mass Spectrometry for Total Thyroxine Measurement

BACKGROUND: Accurate serum total thyroxine (TT4) measurement is important for thyroid disorder diagnosis and management. We compared the performance of six automated immunoassays with that of isotope-diluted liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) as the reference method. We also evaluated the correlation of thyroid stimulating hormone (TSH) with TT4 measured by ID-LC-MS/MS and immunoassays. METHODS: Serum was collected from 156 patients between October 2015 and January 2016. TT4 was measured by immunoassays from Abbott (Architect), Siemens (ADVIA Centaur XP), Roche (E601), Beckman-Coulter (Dxi800), Autobio (Autolumo A2000), and Mindray (CL-1000i), and by ID-LC-MS/MS. Results were analyzed using Passing-Bablok regression and Bland-Altman plots. Minimum requirements based on biological variation were as follows: a mean bias of ≤4.5% and total imprecision (CV) of ≤3.7%. RESULTS: All immunoassays showed a correlation >0.945 with ID-LC-MS/MS; however, the slope of the Passing-Bablok regression line varied from 0.886 (Mindray) to 1.23 (Siemens) and the intercept from −12.8 (Siemens) to 4.61 (Mindray). Only Autobio, Beckman-Coulter, and Roche included the value of one in the 95% confidence interval for slope. The mean bias ranged from −10.8% (Abbott) to 9.0% (Siemens), with the lowest value noted for Roche (3.5%) and the highest for Abbott (−10.8%). Only Abbott and Roche showed within-run and total CV ≤3.7%. CONCLUSIONS: Though all immunoassays correlated strongly with ID-LC-MS/MS, most did not meet the minimum clinical requirement. Laboratories and immunoassay manufacturers must be aware of these limitations.

Research the progress of communication tools for conscious patients with mechanical ventilation in ICU / 中国实用护理杂志

The language communication barrier of conscious mechanical ventilation in an intensive care unit (ICU) has brought physiological and psychological discomfort to patients and using communication tools can improve efficiency of communication and patients′ satisfaction, it is also a key factor affecting nursing quality and patients′ safety. This article reviewed the application progress of communication tools for conscious patients with mechanical ventilation in ICU, and analyzed the effects and barriers about different types of communication tools, aimed to provide reference for better communication between nurses and patients in ICU.

Preparation of cholesterol and glycerol reference materials in cyclodextrin aqueous solution / 中华检验医学杂志

Objective Preparation of aqueous reference materials for cholesterol and glycerol.Methods Study on reference materials.The certified reference materials GBW09203b and GBW09149 were weighed accurately and dissolved into 20% of methyl cyclodextrin aqueous solution to prepare six kinds of candidate reference materials of cholesterol and glycerol according to the concentration.The materials were tested for homogeneity and stability using routine methods.The reference methods of isotope dilution liquid chromatography tandem mass spectrometry (ID-LC/MS/MS) were used to determine the concentration of cholesterol and glycerol to evaluate the accuracy of the certified values.Meanwhile, the blank verification test was carried out.The expanded uncertainty was the combination of standard uncertainty of measurement, unhomogeneity and instability.Results It showed that the six candidate reference materials were homogeneous and stable for at least 1 year at-70 ℃ and-20 ℃.The certified values (reference value ± expanded uncertainty,mmol/L) were as follows,for cholesterol:0.65±0.01,1.31 ±0.01,2.57±0.02,5.21±0.06,7.71±0.08,10.24±0.06;for glycerol:0.29±0.01,0.58±0.01,1.22±0.02,2.24±0.02,3.46±0.04,4.52 ±0.04.The results of reference methods were consistent with the certified values.Blank validation tests showed that the concentration of the analytes would not be affected by the reagent and the blank matrix.Conclusions Certified reference materials for cholesterol and glycerol in aqueous solution have been prepared successfully.These materials are homogeneous and stable, and the certified values are reliable.Therefore the materials have been approved to be the Certificate Reference Materials of GBW 09823, GBW 09824, GBW 09825, GBW09826, GBW09827 and GBW 09828.

Application and effect of SBAR communication model in the application of clinical nursing teaching / 中国实用护理杂志

Objective To explore the application and effect of SBAR communication model in clinical nursing teaching. Methods Delphi Method was used to determine SBAR clinical nursing teaching points and the clinical teaching program. A total of 80 baccalaureate and associated students were selected as the research subjects by the method of stratified sampling in the 2015-2016 academic year of Affiliated Hospital of Weifang Medical University.They were divided into experimental group and control group by random digits method.The control group was taught regularly,and the experimental group was given SBAR communication model. Both teachers and nursing students′ satisfaction, patient satisfaction, nursing students and patient communication ability questionnaires were used to observe the effectiveness of SBAR communication model in clinical nursing students teaching. Results Five key points of SBAR communication model in the application of clinical nursing teaching was established,and the corresponding teaching plan was formed.The data of two-way satisfaction survey,patient satisfaction survey, and evaluation of nurse patient communication ability of nursing students of experimental group and control group were analyzed, with statistical significant difference. Data showed that the relevant statistical indicators of the experimental group were better than those of the control group(t = 2.079 5-18.267 6, P<0.05). Conclusions The application of SBAR communication model in clinical nursing teaching can significantly elevate student nurses′communication ability.

Study of the impact of CLPTM1L on radiosensitivity of lung cancer / 国际生物医学工程杂志

Objective To study the correlation of cleft lip and palate transmembrane 1 like(CLPTM1L)expression and radiosensitivity of lung cancer cells.Methods Thiazolyl blue tetrazolium bromide(MTT) and cell colony formation assays were used to determine cell growth and survival.Western Blot assay was employed to measure protein expression.Results The results demonstrated a negative correlation between the CLPTM1L expression level and radiosensitivity of lung cancer cells.A lower radiosensitivity in lung cancer cells containing high level of CLPTM1L expression,and vice versa.Enforced expression of CLPTM1L resulted in a significant reduction of radiosensitivity in lung cancer cells irradiated with γ-rays.On the contrary,a marked elevation of radiosensitivity was observed in lung cancer cells transfected with CLPTM1L siRNA.Conclusions CLPTM1L may be a novel target gene in mediating radiosensitivity of lung cancer cells.

Study on radioprotection of indole-3-carbinol acid condensation products / 国际生物医学工程杂志

Objective To study the radioprotective effect of indole-3-carbinol (I3C) acid condensation products.Methods Cell colony formation assay was used to determine cell survival rate,and Western Blot assay was employed to measure protein expression.Results Seven kinds of the I3C acid condensation products showed different radioprotective effect on normal fibrous epithelial cells 184A1,among which 24 h pre-treatment of CTET (1 μmol/L),LTET (1 μmol/L),HI-IM (1 μmol/L) and 3,3'-diindoly methane (DIM) (0.3 μmol/L) showed significant increase of cell survival rate following irradiation with γ-ray,and the difficence was statistically significant (P＜0.05,P＜0.01).However,CT (1 μmol/L),LTr-1 (1 μmol/L) and ICZ (1 μmol/L) showed no effect on cell survival rate caused by radiation (P＞0.05).Furthermore,CTET,LTET,HI-IM and DIM activated the phosphorylation of ATM,BRCA1 and NBS1 proteins.HI-IM significantly decreased radiation-caused cell death and apoptosis.Conclusions CTET,LTET,HI-IM,and DIM can significantly reduce the radiosensitivity in 184A1 cells,and the mechanism may be related to the regulation of DNA damage and the repair of protein phosphorylation.

Preparation of reference materials of total thyroxine / 中华检验医学杂志

Objective To prepare the serum reference materials for total thyroxine .Methods Individual blood samples were collected from 13 healthy donors (7 males and 6 females) aged from 20 to 50 years old, and the sera were separated and mixed into 4 serum pools according to the concentration of thyroxine.The materials were tested for homogeneity and stability using routine methods .The method of isotope dilution liquid chromatography tandem mass spectrometry ( ID-LC/MS/MS) was used to determine the concentration of thyroxine .The candidate reference materials were also measured by four conventional methods to analyze the commutability of the materials .Results It showed that the four candidate reference materials were homogeneous and commutable in four conventional methods and they were tested to be stable for at least 1 year at -70 ℃using the isochronous stability study .The certified values ( reference value ± expanded uncertainty ,nmol/L) were:75.9 ±1.8,105.3 ±2.2,114.7 ±2.1 and 187.4 ±2.9.Conclusions Certified reference materials for serum thyroxine have been prepared .These materials have been approved to be the Certificate Reference Materials of GBW 09127,GBW 09128,GBW 09129 and GBW 09130.

Measurement of thyroid hormones, harmonization and standardization / 中华检验医学杂志

The incidence of thyroid dysfunction has increased year by year; the degree of public concern about thyroid disease also has been growing; the accuracy and comparability of results given by thyroid hormone assays from clinical laboratories face new challenges .This paper reviewed the clinical significance and measurements of thyroid hormones , also summarized the outcome of IFCC Working Group on Standardization of Thyroid Function Tests .It is expected to bring manufacturers′and clinical laboratories′attention to the importance of standardization/harmonization; and they could collaborate with each other .

HMGB1 increases radiosensitivity by interacting with HDAC1 / 中华放射医学与防护杂志

Objective To study the nuclear protein association of high-mobility group box-1 (HMGB1) and histone deacetylase 1 (HDAC1),and the effect of interaction on radiosensitivity in human breast cancer cells.Methods The protein-protein interaction was determined by immunoprecipitationWestern blot and glutathione-S-transferase capture assays.Cell growth was examined by MTT (methyl thiazolyl tetrazolium)assay and clonogenic assay.Histone deacetylase activity was analyzed by histone deacetylase assay.Results A significant increase of HMGB1 protein and radiosensitivity was observed in MDA-MB-231 and MDA-MB-468 cells transfected with a pCMV-Tag2B expression vector carrying with a full-length of HMGB1 cDNA.HMGB1 binding to HDAC1 was demonstrated as GST (glutathione Stransferase)-pull down and immunoprecipitation Western blot assay,and the association was elevated by irradiation.An LXCXE motif was required for the HMGB1-HADC1 interaction and HMGB1 radiosensitization.A significant difference of IC50 value was observed,for example,1.8 and 2.2 Gy (wtHMGB1 transfectants,P ＜ 0.05),3.6 and 3.8 Gy (HMGB1/C103F transfectants,P ＞ 0.05),both compared with 3.9 and 4.1 Gy (pCMV-Tag2B transfectants) in MDA-MB-231 and MDA-MB-468 cells,respectively.A specific HDAC1 inhibitor trichostatin A markedly reduced the HMGB1-mediated radiosensitivity,0.5 Gy in the presence of trichostatin A versus 1.8 Gy in absence of trichostatin A in MDA-MB-231 transfectants,1.2 Gy (with trichostatin A) versus 2.2 Gy (without trichostatin A) in MDA-MB-468 transfectants,P ＜ 0.05.Histone deacetylase activity was also detected in immunoprecipitates prepared from these cells with antibodies to HMGB1,and this activity was abolished by the histone trichostatin A.Conclusions These results suggest a previous unanticipated role for HDAC1 in modification of HMGB1-mediated radiosensitivity by its direct interaction with HMGB1.

Study of the level of work engagement and the relevance to the professional values in tertiary level 1st class general hospitals of Shandong province / 中国实用护理杂志

Objective To investigate the level of nurses' work engagement and analyze the relevance to the professional values in tertiary level 1st class general hospitals of Shandong province.Methods Totally 960 nurses from 7 tertiary level 1st class hospitals of Shandong province were surveyed by the questionnaires,including the Utrecht Work Engagement Scale,Nurses Professional Values Scale and the nurses' general information.Results The total score of nurses' work engagement was (33.91 ± 11.06); Professional values was correlated with work engagement.Conclusions Nurses' work engagement in tertiary level 1st class hospitals of Shandong province is at middle level.Professional values is the main influencing factor and ward atmosphere,chance of promotion and the professional titles can also influence the work engagement.

The impact of Chitosan Lecithin on the mild cognitive impairment patients' semantic understanding by event-related potential N400 / 中华行为医学与脑科学杂志

Objective To study the impact of Chitosan Lecithin on the mild cognitive impairment(MCI) patients' semantic understanding by event-related potential N400.Methods 32 patients with MCI were screened from 500 elder people aged Court in Weifang by mini-mental state examination (MMSE) scale,and were divided into two groups:the observation group ( n=16) and the control group ( n=16) by the table of random numbers.The observation group were given Chitosan Lecithin while the control group were given an equal dose of placebo.The intervention time was 2 months.The subjects were asked to conduct semantic judgement by semantic violation experiment.Thirty-two channels electroencephalogram(EEG) was recorded by Neuroacan Nuamps Systerm and analyzed data.Results 1 ) Specific component N400 was found in both groups,which was distributed at the frontal,central and parietal regions.2 ) The observation group reaction time and correct rate were respectively (965.13 ± 178.07 ) ms and ( 92.56 ± 2.36 ) ％ ,while the control group were respectively ( 1126.13 ± 252.77 ) ms and (85.28 ± 5.73 )％,with significant difference(P ＜ 0.05 ).3 ) Compared with N400 in control group,N400 latency was shorter ( (425.28 ±47.26) ms vs (456.19 ± 37.75 ) ms,F=6.01,P＜0.05) and amplitude was higher ( (4.79 ±2.18)μV vs (3.59 ± 1.33) pV,F=5.96,P＜0.05).Conclusion Chitosan lecithin has the effect of N400 latency and amplitude,it may be helpful for the patients of MCI in semantic understanding.