Cumulative exposure to AHA Life's Essential 8 is associated with nonalcoholic fatty liver disease: a large cohort study.

BACKGROUND AND AIM: We aimed to explore the associations of baseline and cumulative cardiovascular health with nonalcoholic fatty liver disease (NAFLD) development and regression using the new Life's Essential 8 score. METHODS: From a health screening database, participants who underwent at least 4 health examinations between 2012 and 2022 were recruited and categorized into two cohorts: (a) the NAFLD development cohort with no history of NAFLD prior to Exam 4 and (b) the NAFLD regression cohort with diagnosed NAFLD prior to Exam 4. The LE8 score was calculated from each component. The outcomes were defined as newly incident NAFLD or regression of existing NAFLD from Exam 4 to the end of follow-up. RESULTS: In the NAFLD development cohort, of 21,844 participants, 3,510 experienced incident NAFLD over a median follow-up of 2.3 years. Compared with the lowest quartile of cumulative LE8, individuals in the highest quartile conferred statistically significant 76% lower odds (hazard ratio [HR] 0.24, 95% confidence interval [CI], 0.21-0.28) of NAFLD incidence, and corresponding values for baseline LE8 were 42% (HR 0.58, 95% CI 0.53-0.65). In the NAFLD regression cohort, of 6,566 participants, 469 experienced NAFLD regression over a median follow-up of 2.4 years. Subjects with the highest quartile of cumulative LE8 had 2.03-fold (95% CI, 1.51-2.74) higher odds of NAFLD regression, and corresponding values for baseline LE8 were 1.61-fold (95% CI, 1.24-2.10). CONCLUSION: Cumulative ideal cardiovascular health exposure is associated with reduced NAFLD development and increased NAFLD regression. Improving and preserving health behaviors and factors should be emphasized as an important part of NAFLD prevention and intervention strategies.

Not only baseline but cumulative exposure of remnant cholesterol predicts the development of nonalcoholic fatty liver disease: a cohort study

BACKGROUND AND AIM@#Remnant cholesterol (remnant-C) mediates the progression of major adverse cardiovascular events. It is unclear whether remnant-C, and particularly cumulative exposure to remnant-C, is associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to explore whether remnant-C, not only baseline but cumulative exposure, can be used to independently evaluate the risk of NAFLD.@*METHODS@#This study included 1 cohort totaling 21,958 subjects without NAFLD at baseline who underwent at least 2 repeated health checkups and 1 sub-cohort totaling 2,649 subjects restricted to those individuals with at least 4 examinations and no history of NAFLD until Exam 3. Cumulative remnant-C was calculated as a timeweighted model for each examination multiplied by the time between the 2 examinations divided the whole duration. Cox regression models were performed to estimate the association between baseline and cumulative exposure to remnant-C and incident NAFLD.@*RESULTS@#After multivariable adjustment, compared with the quintile 1 of baseline remnant-C, individuals with higher quintiles demonstrated significantly higher risks for NAFLD (hazard ratio [HR] 1.48, 95%CI 1.31-1.67 for quintile 2; HR 2.07, 95%CI 1.85-2.33 for quintile 3; HR 2.55, 95%CI 2.27-2.88 for quintile 4). Similarly, high cumulative remnant-C quintiles were significantly associated with higher risks for NAFLD (HR 3.43, 95%CI 1.95-6.05 for quintile 2; HR 4.25, 95%CI 2.44-7.40 for quintile 3; HR 6.29, 95%CI 3.59-10.99 for quintile 4), compared with the quintile 1.@*CONCLUSION@#Elevated levels of baseline and cumulative remnant-C were independently associated with incident NAFLD. Monitoring immediate levels and longitudinal trends of remnant-C may need to be emphasized in adults as part of NAFLD prevention strategy.

Metabolically healthy transition and its association with body size change patterns among different adult age groups.

OBJECTIVE: To explore the metabolically healthy (MH) to metabolically unhealthy (MU) transition and its association with body size change patterns according to age. METHODS: In total, 12,910 MH subjects were evaluated in 2013 and reevaluated in 2020. A MH state was defined as a score ≤ 1, and a MU state was defined as a score > 1 on the National Cholesterol Education Program-Adult Treatment Panel III criteria. RESULTS: Approximately 27.0% of MH individuals converted to MU status over the follow-up. Compared with young adults, middle adulthood individuals had a 1.33-fold (95% CI: 1.21-1.46) and late adulthood individuals had a 1.55-fold (95% CI: 1.41-1.70) risk of transition. The body mass index (BMI)/waist circumference (WC)-value change was positively associated with metabolic deterioration; the association weakened with age. With stable normal body size (defined by BMI) as a reference, changing phenotype categories of maximum overweight [hazard ratio (HR): 1.75; 95% CI: 1.56-1.95], non-obesity to general obesity (HR: 2.96; 95% CI: 2.47-3.54) and stable general obesity (HR: 2.44; 95% CI: 1.92-3.10) conferred a higher risk of metabolic deterioration. CONCLUSIONS: MH status is a transient state, especially in late and middle adulthood. Individuals transitioning to an obese phenotype should receive attention for concomitant metabolic deterioration.

Association between non-alcoholic fatty liver disease and metabolically healthy deterioration across different body shape phenotypes at baseline and change patterns.

Non-alcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome (MetS), and the relationship between NAFLD and metabolic deterioration remains unclear. This study aimed to investigate dynamic changes in metabolically healthy phenotypes and to assess the impact of non-alcoholic fatty liver disease (NAFLD) on the conversion from metabolically healthy (MH) to metabolically unhealthy (MU) phenotypes across body shape phenotypes and phenotypic change patterns. We defined body shape phenotypes using both the body mass index (BMI) and waist circumference (WC) and defined metabolic health as individuals scoring ≤ 1 on the NCEP-ATP III criteria, excluding WC. A total of 12,910 Chinese participants who were MH at baseline were enrolled in 2013 and followed-up in 2019 or 2020. During a median follow-up of 6.9 years, 27.0% (n = 3,486) of the MH individuals developed an MU phenotype. According to the multivariate Cox analyses, NAFLD was a significant predictor of conversion from the MH to MU phenotype, independent of potential confounders (HR: 1.12; 95% confidence interval: 1.02-1.22). For the MH-normal weight group, the relative risk of NAFLD in phenotypic conversion was 1.21 (95% CI 1.03-1.41, P = 0.017), which was relatively higher than that of MH-overweight/obesity group (HR: 1.14, 95% CI 1.02-1.26, P = 0.013). Interestingly, the effect of NAFLD at baseline on MH deterioration was stronger in the "lean" phenotype group than in the "non-lean" phenotype group at baseline and in the "fluctuating non-lean" phenotype change pattern group than in the "stable non-lean" phenotype change pattern group during follow-up. In conclusion, lean NAFLD is not as benign as currently considered and requires more attention during metabolic status screening.

Comparison of two risk assessment methods to assess occupational health risk in key industries of dichloromethane in Shenzhen City / 中国职业医学

OBJECTIVE: To compare the applicability of two risk assessment methods to assess the occupational health risk of key industries of dichloromethane in Shenzhen City. METHODS: The Singapore ministry of manpower risk(MOM) method and the comprehensive index method were used to evaluate the risk of 123 positions in 47 key industries of dichloromethane in Shenzhen City. Then the risk classification results of the two assessment methods were compared. RESULTS: The results of MOM method showed that the median and the 0 th to 100 th percentile [M(P_0-P_(100))] of risk of dichloromethane in electronics industry was 2(2-3), and the risk level was low to medium. The M(P_0-P_(100)) of risk of dichloromethane in printing industry was 2(2-4), and the risk level was low to high. The results of the comprehensive index method showed that the M(P_0-P_(100)) of risk of dichloromethane in electronics industry and printing industry were 3(3-4), and the risk level was medium to high. There was no significant difference in the assessment results of occupational health risk of dichloromethane between the electronic industry and the printing industry by MOM evaluation method(P>0.05). The occupational health risk assessment of dichloromethane in printing industry was higher than that in electronic industry by the comprehensive index method(P<0.01). Both evaluation methods were not consistent in the electronics industry and the printing industry(k values were-0.01 and 0.04, all P>0.05). After merging the evaluation results of the two industries, there was no consistency in the evaluation results of the two evaluation methods(k value=0.01, P>0.05). CONCLUSION: The risk level of dichloromethane in printing industry is higher than that in printing industry in Shenzhen City. The comprehensive index method may comprehensively and objectively assess the occupational health risk level of dichloromethane in key industries in Shenzhen City.

Effectiveness evaluation and quality control strategy at primary-level chest pain centers / 中华全科医师杂志

The real-time reported data of treated patients from July 2017 to June 2019 Nanxiang Hospital of Jiading District were collected from chest pain center platform. The results showed that the average time of completing ECG examination from the first medical contact was 1.3 to 6.9 min with a median of 1.9 min (1.7, 2.2), meeting the quality control requirements (10 min); the time required to obtain troponin test results was 13.0 to 48.4 min with a median of 14.1 min (13.4, 18.1), meeting the requirements for quality control of 20 min; time from entry to transfer out of PCI patients was 19.0-100.0 min, with median 37.2 (29.3, 66.6) min, basically reaching quality control (30 min); the entering catheter chamber rate of STEMI patients was 50.0% to 100.0% with a median of 100.0% (73.3%, 100.0%), meeting the requirements of quality control (≥50%). Through the active construction, the main quality control indicators were well reached, the reported cases were basically stable, and the disease distribution was basically reasonable in the primary-level chest pain centers. Informed notification of transshipment and subsequent management of low-risk chest pain patients need to be further strengthened. It is suggested that the construction of chest pain centers should establish long-term normal working mechanism, strengthening the control of key quality control indicators, to play the important role of the regional treatment system.

Monitoring of cerebrospinal fluid dynamics in a model of brain herniation induced by acute intracranial hypertension by PC cine MRI / 中华急诊医学杂志

Objective To explore the monitoring of cerebrospinal fluid (CSF) dynamics in a model of brain herniation induced by acute intracranial hypertension in Guangxi Bama-Mini pigs by phasecontrast cine magnetic resonance imaging (PC cine MRI).Methods Femoral artery blood were extracted from 10 pigs,and injected into the frontal and temporal parietal lobe to make a model of brain herniation induced by acute intracranial hypertension.The mean arterial blood pressure (MAP),intracranial pressure (ICP),and cerebral perfusion pressure (CPP) were monitored.Routine T1WI,T2WI,coronal,sagittal and cerebrospinal fluid flow sequence (fast PC cine slice) which positioned on the cervical 3 (C3) vertebral body as the center and perpendicular to the spinal scans were performed on all experimental animals before and after blood injection with 3.0T Magnetic Resonance Imaging.The ICP,MAP,CPP,the absolute values of CSF peak flow velocity and the absolute value of carotid peak flow velocity before and after blood injection were compared.Results The ICP,MAP,CPP,and the absolute value of CSF peak flow velocity before injection of autologous arterial blood were statistically significant as compared with those after blood injection [(6.80±2.044) mmHg vs (52.20±1.619) mmHg,(76.80±7.068) mmHg vs (142.80±12.399) mmHg,(70.00±6.074) mmHg vs (90.50±12.250) mmHg,and the absolute value of CSF peak flow velocity was (243.20±77.671) mm/s vs (201.40±55.482) mm/s,respectively,P＜0.01].The absolute value of the peak velocity of the carotid artery before blood injection was not statistically significant compared with that after blood injection [(876.80±239.908) mm/s vs (799.40±241.829) mm/s,P＞0.05].Conclusion After the formation of brain herniation induced by acute intracranial hypertension,the CSF flow in the C3 level spinal canal showed a low dynamic change,and the CSF flow velocity waveform was disordered and malformed.The non-invasive measurement of CSF dynamics by PC cine MRI can provide an important basis for the change of CSF dynamics in the model of brain herniation induced by acute intracranial hypertension,and provide a theoretical basis for further research on damage control neurosurgery in the future.

Multivariate analysis of coronary heart disease and cerebral infarction after long-term treatment of type 2 diabetes / 重庆医学

Objective To study the prevalence and related risk factors of type 2 diabetes with coronary heart disease(CHD) and cerebral infarction after long-term treatment.Methods Two hundred and eighty-five patients with type 2 diabetes who had a hospitalization interval for four to twelve years between the first and second hospital stays were included in group A.Among them,85 patients (about 4 to 7 years) with a hospitalization interval about 5 years (4 to 7 years) between the first and second hospital stays(group B).100 patients with a hospitalization interval about 10 years (8 to 12 years) between the first and second hospital stays(group C).Blood pressure,blood glucose,HbA1c,blood lipids,myocardial enzymology,electrocardiogram,coronary angiography,cranial CT or MRI were tecorded.The prevalence of CHD and cerebral infarction were compare,regression analysis was conducted between coronary heart disease,cerebral infarction and the risk factors.Results DBP,FBG,PBG2h,TC,LDL-C of the second hospitalization were significantly lower than those of the first hospitalization.The morbidity of CHD and cerebral infarction increased along with the extension of the course.The morbidity of cerebral infarction in CHD patients were significantly higher than those in non-CHD patients with the interval about 10 years.Logistic regression analysis proved that age was risk factor and HDL-C was protective factor of CHD,SBP,FBG were risk factors of cerebral infarction.Conclusion The morbidity of CHD and cerebral infarction increased along with the extension of the course and there were significantly relationship between CHD and cerebral infarction in T2DM patients after about 10 years treatment.

Status of healthcare-associated infection management professionals in 85 traditional Chinese medicine institutions / 中国感染控制杂志

Objective To investigate the current status of healthcare-associated infection(HAI) management professionals in county and above levels of traditional Chinese medicine(TCM) institutions in a province.Methods The uniform questionnaires were adopted to investigate the basic status of HAI professionals in county and above levels of TCM institutions in a province.Results There were 117 county and above levels of TCM institutions in this province,85 TCM institutions participated the investigation,there were a total of 128 professionals,including 82 professionals in 65 secondary hospitals,and 46 in 20 tertiary hospitals.Among the investigated TCM hospitals,83 (97.65 ％) set up HAI management committees,77 (90.59％) set up independent HAI management departments,55 (64.71％) assigned HAI professionals that met The Requirements of HAI Surveillance Guideline,27 (31.76 ％) exclusively engaged in management of HAI,58 (68.24 ％) were also responsible for other management besides HAI management.Among investigated professionals,91.41％ were nursing staff,55.47％ received undergraduate course or above,54.69％ had intermediate professional titles,61.72％ were at the age of 41-50,45.31 ％ engaged in HAI management for 1-3 years,115 professionals had management certificates.Conclusion The infec tion management in provincial traditional Chinese medicine institutions are understaffed,professional structure is unitary,professional quality is low,leaders in different levels of TCM institutions should enhance HAI management awareness,strengthen the construction of professional quality,and cultivate multi-disciplinary talents as soon as possible.

Changes of cerebrovascular hemodynamic accumulative scores in health checkup population and their influencing factors / 中华健康管理学杂志

Objective To investigate the changes of cerebrovascular hemodynamic accumulative score in health checkup population and their influencing factors.Methods A total of 1 840 people aged 23-88 years were checked by CVHI and accumulative scores were calculated.The general information,blood biochemistry,highly sensitive C-reaction protein (hs-CRP),homocysteine (Hcy),carotid intima-media thickness (CIMT) and brachial-ankle pulse wave velocity (baPWV) were also collected during the corresponding period.Results The proportion of abnormal CVHI accumulative score (＜75 points) was increasing with age.Compared with the normal CVHI accumulative score (≥75 points) group,the proportion of hypertensive disease,diabetes and stroke family history was significantly higher in the abnormal group (P＜ 0.05).In addition,the levels of age,body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG),hs-CRP,Hcy,CIMT and baPWV were also significantly increased in the abnormal group (P＜0.05).Correlation analysis showed a negative correlation between CVHI accumulative score and age,history of hypertension,diabetes,BMI,WC,SBP,DBP,LDL-C,TG,FPG,hs-CRP,Hcy,baPWV (P＜ 0.05),but a positive correlation with HDL-C (P＜0.05).Multiple factor analysis determined that age [OR(95％C1):1.017(1.002-1.033)],history of hypertension [OR(95％CI):1.510(1.096-2.081)],BMI [OR(95％CI):1.235(1.135-1.344)],SBP [OR(95％CI):1.044(1.030-1.059)],LDL-C [OR(95％CI):1.673(1.444-1.937)],TG [OR(95％CI):1.116(1.035-1.204)],hs-CRP [OR(95％CI):1.037(1.003-1.073)],Hcy [OR(95％CI):1.099(1.062-1.136)],baPWV [OR(95％CI):1.001(1.000-1.002)] were being selected into the regression model (P＜0.05),and they were independent influencing factors of decreased CVHI accumulative scores.Conelusion The decreased CVHI accumulative score has a significant relationship with exposure levels of risk factors in stroke.Therefore,we conclude that the detection of CVHI is a convenient and feasible method to screen high risk individuals for stroke in middle and old aged population undergoing medical examination.

Mosapride citrate in reflux esophagitis treatment and intervention effect analysis / 中国生化药物杂志

Objective To explore the use of mosapride citrate in treating reflux esophagitis and nursing intervention spitley effect. Methods In 40 cases of reflux esophagitis in patients with routine therapy, and classified as the control group, the other 40 patients in the control group based on the use of mosapride citrate. And classified as the observation group, two groups of patients were in our hospital from June 2015 to January 2017. Results The study in the treatment of the two groups of patients with effective rate of 95.0%, the observation group was significantly higher than the control group 80.0%, between the two groups showed significant differences (P<0.05). The adverse effects of more than two groups found, two groups of patients with adverse reaction incidence was no significant difference, that shows no significant difference. Conclusion Mosapride citrate in reflux esophagitis treatment and intervention effect analysis found that the compared with conventional therapy, can be in At the same time, it can improve the curative effect of the patients, and will not increase the possibility of adverse reactions, so it is worthy of clinical reference.

Effect of stress-induced hyperglycemia on myocardial perfusion and prognosis in elderly patients ;with acute myocardial infarction undergoing primary percutaneous coronary intervention / 中国医师进修杂志

Objective To investigate the effect of stress-induced hyperglycemia (SHG) on myocardial perfusion and clinical prognosis in elderly patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI). Methods In this study, 459 elderly patients with first-time occurrence of acute ST-elevation myocardial infarction (STEMI) who underwent primary PCI within 12 h from January 2012 to January 2015 were enrolled and followed up. All patients were divided into three groups according to serum glucose (SG) on admission: normal group (SG11.1 mmol/L, 142 patients). Myocardial perfusion indexes, including ST segment resolution (STR), TIMI myocardial perfusion grade (TMPG), peak value of creatine kinase (CK)-MB, left ventricular ejection (LVEF), and major adverse cardiac events (MACE) of patients in three groups were measured and compared after emergency PCI. Results The blood glucose levels were increased, ST-elevation 2 h after PCI were well declined, the percentages of patients with TMPG 2-3 were decreased and peak values of CK-MB were increased in the three groups (P<0.05). After 12 months of follow-up, Kaplan-Meier survival analysis showed that cumulative non-events survival rates in three groups had significantly different: 89.2% (132/148) vs. 85.8% (145/169) and 76.1% (108/142), P<0.05. Multivariate Cox regression analysis showed that SHG was the independent predictor for the occurrence of MACE in patients undergoing PCI after adjusting for age and gender (P<0.05). Conclusions SHG in elderly patients with STEMI can decrease myocardial perfusion level after primary PCI, which will lead to high incidence of MACE.

Analysis on the Economic Operation and Development Status of County Traditional Chinese Medicine Hospitals in Chongqing from 2012 to 2014 / 中国中医药信息杂志

Objective To learn the economic operation and the existing problems of county TCM hospitals in Chongqing from 2012 to 2014.Methods 2012-2014 data of annual health financial report were used to conduct descriptive statistics and analysis of the current operation benefit, operating efficiency, debt paying ability, development ability, and cost management ability.Results From 2012 to 2014, the annual incomes of TCM county hospitals in Chongqing were 2.802, 3.412, and 4.385 billion RMB; the annual expenses were 2.813, 3.343, and 4.347 billion RMB; the ratios of income and expense about medical treatment were 0.86, 0.90, and 0.92; the ratios of income and expense of medicine were 1.16, 1.15, and 1.11; the outpatient amounts were 5.45, 5.87, and 6.99 million; the hospital discharge amounts were 330.4, 405.2, and 469.3 thousand; the charges per patient were 153.40, 177.12, and 188.71 RMB; the charges pre bed were 465.83, 533.14, and 571.02 RMB; medical expenses per patient were 4923.26, 5416.77, and 5576.01 RMB; the current ratios were 1.00, 1.06, and 1.09; the asset-liability ratios were 62.25%, 63.79%, and 61.37%; the annual growth rates of total assets were 14.06 % and 24.54%, and the annual growth rates of net assets were 19.44% and 21.70% during 2013 to 2014; 100-yuan hygienic materials and medicine consumption were 51.23, 51.10, and 50.07 RMB during 2012 to 2014; the management fee rates were 18.55%,15.44%, and 14.82%.Conclusion The general economic running of county TCM hospitals in Chongqing is stable and financial balance moves towards rationality; social benefit, expand capacity and cost management ability are enhanced gradually. However, the problems about insufficient government finance input, small medical income elasticity, poor debt paying ability, and diseconomies of scale still exist.

Content Determination of the 2 Lignan Components in Mongolian Medicine Compound Nutmeg-5 by HPLC / 中国药房

OBJECTIVE:To establish a method for the determining contents of 2 lignan components[dehydrodiisoeugenol and 2,3-dihydro-7-methoxy-2-(3,4-methylened ioxyphenyl)-3-methyl-5-(E)-propenyl-benzofuran(referred to“lignanoid 2”)]. METH-ODS:HPLC method was adopted. The column was Elite C18 with the mobile phase of water-methanol(gradient elution)at the flow rate of 1.0 ml/min;the detection wavelength was 225 nm and the column temperature was 30 ℃. The sample size was 20 μl. RE-SULTS:There was a good linear relationship between sample quantity and the peak area in the range of 0.202-2.02 μg(r=0.999 9) and 0.204-2.04 μg(r=0.999 9)for 2 lignan components. The RSD of precision,stability and repeatability tests were less than 2%with the average recovery of 101.54%(RSD=0.60%,n=6)and 99.43%(RSD=1.09%,n=6). CONCLUSIONS:The method is simple,sensitive and accurate,and can be used for the quantization determination of dehydrodiisoeugenol and lignanoid 2 in nut-meg-5.

Exploratory development of rapid immunohistochemical staining technique in prostate biopsy tissue frozen section diagnosis / 中国基层医药

in 30minutes.Antibody expression located accurately.Background stained clearly and no interfering signal.The back-ground was better than conventional immunohistochemistry of frozen remaining tissue.The positive expression rate of p40,34βE12,p504s with rapid immunohistochemistry in prostatic hyperplasia was 97.4%(77 /79),93.7%(74 /79),0%(0 /79),and in prostatic carcinoma was 0%(0 /39),0%(0 /39),97.4%(38 /39).The positive expression rate of p40,34βE12,p504s with conventional immunohistochemistry in prostatic hyperplasia was 96.2%(76 /79), 93.7%(74 /79),2.5%(2 /79),and in prostatic carcinoma was 0%(0 /39),0%(0 /39),92.3%(36 /39).The difference of expression between prostatic hyperplasia and prostatic carcinoma with rapid immunohistochemical detec-tion p40 group:χ2 =109.402,P =0.000,34βE12 group:χ2 =97.971,P =0.000,p504s group:χ2 =113.537,P =0.000;The difference of expression between prostatic hyperplasia and prostatic carcinoma with conventional immuno-histochemical detection p40 group:χ2 =105.410,P =0.000,34βE12 group:χ2 =97.971,P =0.000,p504s group:χ2 =96.388,P =0.000;The expression of prostatic hyperplasia with between rapid immunohistochemical detection and conventional immunohistochemical detection 34βE12 group was identical,p40 group:χ2 =0.207,P =0.649, p504s group:χ2 =2.026,P =0.155;The expression of conventional immunohistochemical detection with between rap-id immunohistochemical detection and conventional immunohisto -chemical detection p40 group and 34βE12 group were identical,p504s group:χ2 =1.054,P =0.305.The expression of three markers between prostatic hyperplasia and prostatic carcinoma had statistical significance(P 0.05).Conclusion MaxVision rapid immunohisto -chemical staining technique has the advantages of rapid,accurate,timely.It could be used to rapid diagnosis of prostate biopsy tissue.The combined detection of p40,34βE12,p504s has very high practi-cal value in the differential diagnosis of benign and malignant lesions of the prostate.

Diagnostic value of serum anti-PLA2 R in idiopathic membranous nephropathy:a meta-analysis / 中国免疫学杂志

Objective:To investigate the value of serum anti-PLA2 R as a diagnostic marker of idiopathic membranous nephropathy( IMN).Methods:All available articles about serum anti-PLA2 R as a marker of IMN which were published at home and abroad from 2009.1 to 2013.12 were pooled from the databases of PubMed,Elsevier,Springer,CNKI,VIP and Wanfang database et al. The quality of the papers were evaluated by the quality assessment for studies of diagnostic accuracy studies( QUADAS).And then a meta-analysis was conducted by the statistical softwares of Meta-Disc and Stata.The diagnostic value of serum anti-PLA2 R in IMN was evaluated by the statistical indicators of pooled sensitivity, pooled specificity, pooled likelihood ratio and summary receiver operating characteristic curve( ROC curve).Sensitivity analysis was performed by reducing a paper in order,and publication bias was tested by Egger funnel plot.Results: Seven articles were selected to the meta-analysis according to the inclusion criteria and 967 cases were included in the study ( 454 IMN patients and 513 controls ).Heterogeneity test showed no heterogeneity threshold effect ( Spearman correlation coefficient was 0.107,P=0.819),but there was heterogeneity caused by non threshold effects(Cochrane-Q was 16.89,P=0.009 7).So random model was used to pool the effect size.The overall combined effect sizes:sensitivity was 69%,95%CI:0.65-0.73;specificity:98%,95%CI:0.96-0.99;pooled positive likelihood ratio 16.37,95%CI:4.06-65.95;pooled negative likelihood ratio 0.32,95%CI:0.24-0.43;AUC of SROC:0.854 0,Q*=0.785 0.Sensitivity analysis showed that this research was stable and reliable and Egger funnel plot showed little publication bias.Conclusion: Serum anti-PLA2 R is an useful biomarker to the diagnosis of IMN.

Qualitative study on preventive strategies of unplanned endotracheal extubation among adult patients / 中国实用护理杂志

Objective To understand the available preventive strategies of unplanned endotracheal extubation (UEX) among adult patients.Methods Twelve nurses were in-depth interviewed and data were processed and analyzed using categorization analysis method.Results Major themes were identified as follows:the incidence rate of UEX,tube fixation,efficacious physical restraint,appropriate sedation and training for younger nurses.Conclusions Nursing leaders should further standardize nursing process related to prevention of UEX,strengthen training for nurses,choose appropriate fixation method for patients and promote physical restraint and sedation care to prevent UEX and improve patient clinical outcomes.

Role of poly (ADP-ribose) polymerase 1 in DNA methylation changes induced by hydroquinone in human bronchial epithelial cell / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the DNA methylation changes induced by hydroquinone (HQ) in human bronchial epithelial cells and to explore the role of poly (ADP-ribose) polymerase-l (PARP-l) in this process.</p><p><b>METHODS</b>Human bronchial epithelial 16HBE cells and PARP-l-deficient 16HBE cells (16HBE-shPARP-l cells) were exposed to HQ (10, 20, 40, 60, and 80 µmol/L) for 48h, while control cells were treated with an equal volume of PBS solution. The changes in genomic DNA methylation were investigated by high-performance capillary electrophoresis, and the expression levels of PARP-l and DNA methyltransferase 1 (DNMT1) were measured.</p><p><b>RESULTS</b>The percentages of methylated DNA of overall genome (mCpG%) in 16HBE and 16HBE-shPARP-l cells were 4.89%±0.07% and 9.53%±0.51%, respectively; after treatment with 5-aza-2'-deoxycytidine for 72 h, mCpG% decreased to 3.07±0.12% and 6.34%±0.3%, respectively. The one-way analysis of variance revealed significant differences in mCpG% between the cells exposed to different concentrations of HQ in both 16HBE and 16HBE-shPARP-l groups (F = 61.25, P < 0.01; F = 60.36, P < 0.01). For 16HBE cells treated with HQ (10, 20, 40, 60, and 80 µmol/L), the mRNA expression levels of PARP-1 were 145.0%, 159.0%, 169.0%, 215.0%, and 236.0%, respectively, compared with those in the control group, with significant differences (P < 0.01 for all); for 16HBE-shPARP-l cells treated with HQ (10, 20, 40, 60, and 80 µmol/L), the mRNA expression levels of PARP-l were 170.0%, 223.0%, 264.0%, 327.0%, and 320.0%, respectively, compared with those in the control group, with significant differences (P < 0.01 for all). When the dose of HQ reached 20, 40, 60, and 80 µmol/L, the mRNA expression levels of DNMT1 in 16HBE group were 114.0%, 126.0%, 136.0%, and 162.0%, respectively, compared with those in the control group, with significant differences (P < 0.01 for all); when the dose of HQ reached 10, 20, 40, 60, and 80 µmol/L, the mRNA expression levels of DNMT1 in the 16HBE-shPARP-l group were 141.0%, 165.2%, 186.9%, 202.1%, and 217.3%, respectively, compared with those in the control group, with significant differences (P < 0.01 for all).</p><p><b>CONCLUSION</b>HQ can induce hypomethylation in 16HBE cells, and PARP-1 can regulate DNA methylation in 16HBE cells by influencing the expression and activity of DNMT1.</p>

The impact of pre-primary percutaneous coronary intervention β blocker use on the no-reflow phenomenon in patients with acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the impact of pre-primary percutaneous coronary intervention (PCI) β blocker use on the development of no-reflow in ST-segment elevation myocardial infarction (STEMI) patients post PCI.</p><p><b>METHODS</b>We retrospectively evaluated 1 615 outpatients with STEMI who underwent primary primary PCI with in 12 hours from symptom onset admitted to Beijing Anzhen Hospital and Chinese people's liberation army general hospital from January 2007 to June 2011. The study population was divided into the following 2 groups: β blocker group (pretreatment with β blockers ≥ one month before admission, n = 257) and non-β blockers group (pretreatment with β blockers < one month before admission or had no β blocker, n = 1 358). No-reflow was defined as TIMI grade < 3 in last imaging of coronary artery after stenting. Multivariable logistic regression analyses were used to identify independent predictors for the no-reflow after primary PCI.</p><p><b>RESULTS</b>Incidence of the no-reflow was significantly lower in the β blocker group than in non-β blockers group (13.6% (35/257) vs. 21.2% (289/1 358), P = 0.017). Multivariable logistic regression analysis revealed that pre-PCI β blocker use was a protective predictor of the no-reflow (OR = 0.594, 95%CI:0.394-0.893, P = 0.012), while age ≥ 55 years old (OR = 2.734, 95%CI:1.959-3.817, P < 0.001), high neutrophil count (OR = 1.257, 95%CI: 1.169-1.351, P < 0.001), admission plasma glucose (OR = 1.060, 95%CI:1.018-1.103, P = 0.004), Killip classes IV (OR = 3.383, 95%CI:1.924-5.948, P < 0.001) and reperfusion time ≥ 4 h(OR = 1.503, 95%CI:1.124-2.009, P = 0.006) were risk factors for the development of no-reflow post PCI.</p><p><b>CONCLUSION</b>Previous long term β blockers use before STEMI is associated with lower incidence of no-reflow in patients with STEMI treated with primary PCI.</p>

Different diagnostic value of p40 in benign and malignant lesions of the prostate / 肿瘤研究与临床

Objective To investigate the expression of p40 (ANp63),p504s and their diagnostic value in benign and malignant lesions of the prostate,also to compare with the expression of p63.Methods The expression of p40 (ANp63),p63 and p504s in 92 cases of benign prostatic hyperplasia and 67 cases of prostatic carcinoma were detected by immunohistochemical MaxVision method.Results p40 and p63 were positive in 95.7 ％ (88/92) and 87.0 ％ (80/92) of benign prostatic hyperplasia,and the intermittent and low expression in p63 were more common than those in p40.The positive expression rate of p40 was obviously higher than that of p63 in benign prostatic hyperplasia (x2 =4.381,P ＜ 0.05).Both p40 and p63 showed no expression in prostatic carcinoma,but p63 appeared with abnormal cytoplasmic staining in many cases of cancer cells,which was 17.9 ％ (12/67).The specificity of combined detection of p40 and p504s in the diagnosis of benign prostatic hyperplasia and prostate carcinoma was as high as 100 ％.Conclusion p40 is more sensitive than p63 in prostate basal cells.Combined detection of p40 and p504s is valuable to distinguish poorly differentiated benign prostatic hyperplasia from prostatic carcinoma.