[Occupational exposure level and requirements for radiation protection of nuclear medical staff].

With the rapid development of nuclear medicine, the number of nuclear medical staff has increased a lot in the past few years in China. Close-range operations, such as preparation and injections of radiopharmaceuticals, are usually carried out in nuclear medicine department. And the use of unsealed radionuclides may also create internal exposure risk. So, occupational exposure of nuclear medical staff is a main issue of occupational health management in China. In this paper, the occupational exposure level and requirements for radiation protection of nuclear medical staff are introduced to provide references for the related work that radiological health technical institutions carry out.

[Association analysis between genetic variants of matrix metalloproteinase enzyme 2 gene and the blood pressure of children and adolescents].

Objective: To explore the association between genetic variants of matrix metalloproteinase enzyme 2 (MMP2) gene and the blood pressure of children and adolescents. Methods: This cross-sectional study was performed in 2016 and included 4 155 children and adolescents in the urban area of Guangzhou. Physical examinations (including body height, weight, and blood pressure), questionnaires (including general characteristics, physical exercise, parental educational level, household income, etc.), and blood sampling were performed. Multivariable linear regression models were used to investigate the associations of MMP2 genetic variations (rs243865, rs7201) and the genetic risk score (GRS) level with standardized blood pressure. Mediating effect of standardized body mass index (BMI) was further assessed by process analysis in the association between GRS level and blood pressure, and potential additive interaction between physical activity and GRS level was analyzed using the product term in the regression model. Results: A total of 4 155 primary and secondary schoolchildren were finally included in the analysis, consisting of 1 401 (33.7%) second grade pupils of primary school, 1 422 (34.2%) first grade pupils of middle school, and 1 332 (32.1%) first-grade students of senior high school. After adjusting for age, sex, parental educational level, and family income, as compared to the rs243865 TT genotype, the CC/CT genotype increased diastolic blood pressure (DBP) by 0.461 standard deviations (SD) (ß for dominant model=0.461, 95%CI 0.199-0.723). When compared to the rs7201 CC genotype, the AA/AC genotype showed 0.147 SD higher systolic blood pressure (SBP) (ß for recessive model=0.147, 95%CI 0.014-0.279) and 0.171 SD increased DBP (ß for recessive model=0.171, 95%CI 0.039-0.304). For each increment of GRS level, SBP and DBP increased by 0.151 SD (ß for dominant model=0.151, 95%CI 0.029-0.272) and 0.242 SD (ß=0.242, 95%CI 0.120-0.363), respectively. The mediating effect of BMI accounted for 28.3% and 12.6% of the total effect of GRS on SBP and DBP, respectively. After controlling BMI, the direct effect of GRS on DBP remained statistically significant (P<0.001). The insufficient moderate-to-vigorous physical activity (<0.5 h/d) showed a significant interaction with GRS on SBP under additive scale (ß for interaction=0.518, 95%CI 0.088-0.949, P=0.018). Conclusions: rs243865 and rs7201 variants in MMP2 gene are associated with the elevated blood pressure of children and adolescents. Obesity may yield a mediation role in the associations, while insufficient physical activity may have a positively additive interaction with MMP2 genetic variants.

[Impact of extended-spectrum ß-lactamase on clinical outcome and medical cost in patients with bloodstream infection due to Klebsiella pneumoniae].

OBJECTIVE: To evaluate the impact of extended-spectrum ß-lactamase (ESBL) on clinical outcome and medical cost in patients with bloodstream infection (BSI) due to Klebsiella pneumoniae. METHODS: A retrospective study was conducted in patients admitted into Changhai Hospital between January 2013 and December 2014, who suffered from BSI due to Klebsiella pneumoniae during hospitalization. Patients were divided into two groups according to whether Klebsiella pneumoniae produced ESBL (ESBL positive group and ESBL negative group). They were matched with propensity score matching method in a 1∶1 ratio and then multiple regression model was used to analyze the impact of ESBL on clinical outcome and medical cost. Clinical outcome was evaluated by 30-day mortality post BSI; medical cost was evaluated by total length of stay (LOS), post-BSI LOS, total hospital cost and antimicrobial cost. RESULTS: Before matching, the two groups were significantly different in age, nosocomial infection rate, LOS before BSI and surgical rate during hospitalization (all P<0.05). The ESBL-positive group had higher 30-day mortality post BSI (21.3% vs 8.7%, P=0.054), and higher total LOS [25.0(12.0, 33.0) vs 16.0(10.0, 23.0) d, P=0.015], post-BSI LOS [16.0(9.0, 26.0) vs 10.0(5.0, 16.0) d, P=0.006], total hospital cost [69 409(40 605, 198 021) vs 45 683(28 448, 67 000) ï¿¥, P<0.001] and antimicrobial cost [10 279(4 815, 25 500) vs 3 783(1 596, 11 879) ï¿¥, P<0.001]. After matching, the two groups had no significant differences in clinical characteristics such as sex, age, nosocomial infection rate, LOS before BSI, APACHEⅡ score, Charlson Comorbidity Index, underlying diseases and surgical rate during hospitalization (all P>0.05). Multiple regression analysis indicated that ESBL could significantly increase the total LOS, post-BSI LOS, total hospital cost and antimicrobial cost (all P<0.001), but did not increase the 30-day mortality post BSI (P=0.910). CONCLUSIONS: ESBL can significantly increase the medical cost in patients with BSI due to Klebsiella pneumoniae but does not increase the 30-day mortality post BSI.

[Empirical therapy of bloodstream infections caused by extended-spectrum ß-lactamase-producing Enterobacteriaceae].

OBJECTIVE: To compare the clinical outcomes and costs associated with carbapenems and ß-lactam/ß-lactamase inhibitor combinations (BLBLIs) for the empirical treatment of patients with extended-spectrum ß-lactamase (ESBL)-positive Enterobacteriaceae bloodstream infections (BSIs). METHODS: The medical records of individuals diagnosed with ESBL-producing Escherichia coli and Klebsiella pneumoniae BSIs between January 2014 and June 2015 at Changhai Hospital were reviewed. Patients were divided into two groups based on the empirical therapy (carbapenems group and BLBLIs group). Propensity score matching in a 1∶1 ratio was used to match the patients from two groups. Clinical outcomes and costs were compared before and after matching. RESULTS: One hundred and fifty-eight patients were analyzed, 93 in the carbapenems group and 65 in the BLBLIs group. Before matching, the two groups were significantly different in department distribution, tumor rate, deep vein catheter rate, urinary catheter rate, nasogastric tube rate, and mechanical ventilation rate (all P<0.05), and the carbapenems group had longer total length of stay (LOS) and post-BSI LOS (26.0 vs 18.0 d, P=0.029 and 12.0 vs 10.0 d, P=0.044) , higher hospital cost and daily hospital cost (84 120 vs 39 000 ï¿¥, P<0.001 and 3 451 vs 2 574 ï¿¥, P=0.002). After matching, the two groups had no significant differences in covariates such as sex, age, department distribution, pathogens, comorbidities, invasive interventions, LOS before BSI, multiple admissions, surgical rate during hospitalization and delayed antimicrobial therapy (all P>0.05). Finally, there were no differences between two groups in mortality, post-BSI LOS, total LOS, hospital cost and antimicrobial cost (all P>0.05). CONCLUSION: BLBLIs may provide a reasonable carbapenem-sparing option for the empirical treatment of ESBL producers.

[Significance of SATB2 in the pathologic diagnosis of osteosarcoma].

OBJECTIVE: To investigate the role of SATB2 in the pathological diagnosis and differential diagnosis of osteosarcoma. METHODS: Immunostaining of SATB2 was performed in 47 cases of osteosarcomas, 5 osteoblastomas, 4 fibrous dysplasias, 5 myositis ossificans, 10 chondroblastomas, 8 chondrosarcomas, 5 Ewing sarcomas, 5 undifferentiated pleomorphic sarcomas, 6 fibrosarcomas and 2 leiomyosarcomas. RESULTS: All osteoblastomas (5/5) and myositis ossificans (5/5), 83.0%(39/47) of osteosarcomas and 2/10 of chondroblastomas showed nuclear immunoreactivity for SATB2. SATB2 staining was negative in all cases of fibrous dysplasia, chondrosarcomas, Ewing sarcomas and all bone primary spindle cell sarcomas(undifferentiated pleomorphic sarcoma, fibrosarcoma and leiomyosarcoma). CONCLUSION: SATB2 is a reliable osteoblastic marker for differential diagnosis of osteosarcoma and non-osteoid sarcoma, although with a limited role in separating osteosarcoma from non-malignant osteoblastic lesions.

DKK1 eukaryotic expression plasmid and expression product identification.

We constructed the human dickkopf 1 (DKK1) eukaryotic expression plasmid and expressed, purified, and identified its expression product. We extracted cancer cells from cervical cancer tissue, followed by extraction of mRNA. Reverse transcription-polymerase chain reaction was conducted to obtain DKK1 gene fragments. Using these fragments, we prepared the recombinant plasmid pCMV-HA2/DKK1. The recombinant plasmid was restriction enzyme-digested and sequenced, and using liposome vectors, was transiently transfected into Free-Style 293-F cells (serum-free medium). DKK1 protein was detected by western blotting. The amplification product showed the expected size. Restriction enzyme digestion and sequence analysis showed that the recombinant plasmid was PCMV-HA2/DKK1. The expression product was verified properly by western blotting using an anti-DKKI antibody. The successful cloning of the DKKI gene and expression of DKKI protein will be useful for studying the biological activity of tumorigenesis.

Gastric emptying and intestinal transit of liquid and solid markers in rats with chronic uremia.

Gastrointestinal motor abnormalities may account for dyspeptic symptoms of chronic uremia patients. However, the data on gastric emptying are conflicting in human studies. We, therefore, assessed gastric emptying and gastrointestinal transit in a rat uremia model. Chronic uremia was induced by five-sixths nephrectomy in the rats. After 20-hour fasting, the rats were loaded with 70 glass beads as solid markers through a gastric catheter. Two hours later, the stomach was exposed and the small intestine was equally divided into 10 segments. The glass beads in the stomach and in each intestinal segment were counted. The gastric emptying was expressed as the ratio of the number of glass beads in the small intestine to that counted from the entire gastrointestinal tract. The intestinal transit was assessed by analyzing the geometric center of the distribution of glass beads in the intestinal segments. Two conventional nonabsorbable markers, radioactive chromate and charcoal, were also used to evaluate gastric emptying and intestinal transit in the fasted state. Additionally, similar experiments of glass beads were performed in the fed state. It was found that, in the fasted state, the gastric emptying and the intestinal transit of liquid or solid markers were little affected by uremia. In the fed state, however, chronic uremia significantly decreased the intestinal transit but hardly affected the gastric emptying. We conclude that the postprandial intestinal transit, but not the gastric emptying, of solid markers may be decreased in the fed state by chronic uremia in a severity-dependent manner of a rat model, which resembles the findings in uremic patients.

A study of the professional commitment changes from nursing students to registered nurses.

The purposes of this longitudinal study were to understand the professional commitment changes from nursing students to registered nurses. A total of 890 subjects completed the questionnaires of the nursing professional commitment and personality test before their graduation, and nursing professional commitment one year after their graduation, respectively. The data were analyzed by mean, correlation, t-test and repeated measures ANOVA. The results showed that: (1) the nurses exhibited a medium-high degree of professional commitment--the average score was 2.99 before graduation and 2.85 after graduation; (2) there was a highly significant correlation between professional commitments for nursing students and registered nurses; (3) The scores of overall commitment and four factors of professional commitment decreased from nursing students to registered nurses significantly; (4) personality traits were positively correlated with professional commitment for nursing students and registered nurses; and (5) there was no significant relationship between nurses' work backgrounds and the changes of professional commitment from nursing students to registered nurses. Implications for nursing education and for hospital management are suggested.

The influence of professional commitment on turnover intention.

This study investigated the influence of professional commitment on turnover intentions of nurses. The study also examined the relationships between demographic data, work-related variables and the professional commitment. The self-administered questionnaires were distributed to one fifth of Southern Taiwan's population of nurses (n = 4,000). A total of 2,543 subjects completed the questionnaires with a 63.6% response rate. The nurses exhibited a medium-high degree of overall professional commitment. Age, salary, years in profession and years in organization were correlated significantly with professional commitment by Pearson's correlation. There were significant correlations between professional commitment and marital status, educational level, status of the youngest child, level of position, and family support in Spearman's correlations. Family support, age, level of position and status of hospital were the significant predictors in the final regression analysis model. The discriminant analysis showed that 45.4% of nursing professional commitment was correctly classified in predicting intention to leave the profession and 33.1% in predicting the intention to leave the organization. The study recommended that nursing professional commitment is an important moderator to affect the turnover intention of staff nurses.

Treatment of osteoporosis with TheraCyte-encapsulated parathyroid cells: a study in a rat model.

INTRODUCTION: The purpose of this study was to evaluate parathyroid function at monthly intervals following the implantation of TheraCyte-encapsulated live human parathyroid cells into ovariectomized rats and to determine the effect on bone mineral density (BMD) 4 months after ovariectomy ( 3 months after implantation). METHODS: Parathyroid tissues were obtained from patients undergoing surgery for secondary hyperparathyroidism. In total, 21 Sprague-Dawley rats divided randomly into three groups were subjected to one of three treatments: (1) implanted with TheraCyte A-encapsulated 4x10(6) live parathyroid cells; (2) implanted with TheraCyte B-encapsulated 4x10(5) live parathyroid cells; (3) a sham operation; the control group. Rats were ovariectomized 1 month prior to the implantation of the TheraCyte. Blood was drawn at the time of implantation and at monthly intervals thereafter for 3 months to check the levels of calcium, phosphorus and intact parathyroid hormone (iPTH). The BMD of the lumbar spine (L1-L5) and of the left femoral bone was measured with dual-energy-X-ray absorptiometry (DEXA) 1 month after ovariectomy and 3 months after implantation of the TheraCyte (4 months after ovariectomy). RESULTS: We found that the viability ratio of cryopreserved tissues was between 55 and 79% after thawing. In the control group, the BMD of the lumbar spine (L1-L5) had not decreased significantly (p=0.237) nor had the BMD of the left femoral bone increased significantly (p=0.063) 3 months after implantation. In the TheraCyte A group, the BMD of both the lumbar spine (p=0.018) and left femoral bone (p=0.018) had increased significantly 3 months after implantation. In the TheraCyte B group, the BMD of both the lumbar spine (p=0.017) and the left femoral bone (p=0.025) had also increased significantly 3 months after implantation. Serum iPTH levels were higher in the TheraCyte A group than in the TheraCyte B group (p=0.006), and higher in the TheraCyte B group than in the control group (p=0.040). Serum calcium levels were not significantly higher in the TheraCyte group A than in the TheraCyte B group or in the control group. Serum phosphorus levels were not significantly different between the TheraCyte A and TheraCyte B groups. CONCLUSIONS: Implantation of TheraCyte A-encapsulated 4x10(5) live parathyroid cells and TheraCyte B-encapsulated 4x10(6) cells can increase the BMD of ovariectomized rats within 3 months of implantation. Neither cause high serum calcium and low phosphorus concentrations.

[Changes in nursing professional commitment among junior college graduates].

The purposes of this longitudinal study were to understand the changes in professional commitment from nursing students before graduation to registered nurses one year and two years after their graduation, and to find the relationship among these changes, work backgrounds and organizational satisfaction. The sample consisted of 890 junior college graduates. The Nursing Professional Commitment Scale was used for data collection at the first and the second test, while work backgrounds and organizational satisfaction were included at the third test. The data were analyzed by using percentage, mean, standard deviation, correlation and repeated measure ANOVA statistical methods. The results showed that: (1) The average scores of the three tests were 2.96, 2.84 and 2.79, with a full point scale of 4. (2) There were positive correlations among the three tests of professional commitments; also, positive correlation was shown between organizational satisfaction and professional commitment on the third test. (3) The scores for overall nursing professional commitment decreased significantly one year after graduation, but there was no significant changes from one year to two years after graduation. (4) There was a significant relationship between the changes in professional commitment and grades of hospital, but no significant relationship with job category or work unit. (5) Organizational satisfaction influenced the decrease in professional commitment from nursing students before graduation to two years after graduation; it also changed professional commitment from one to two years after graduation significantly. The author suggests that nursing educators and administrators should be concerned with changes in the professional commitment of nurses so as to increase nurses' organizational satisfaction.

The regulation mechanism of c-jun and junB by human papillomavirus type 16 E5 oncoprotein.

In this study, we show that HPV-16 E5 induced anchorage-independent growth in immortalized human epidermal keratinocytes and that HPV-16 E5 in human keratinocytes had higher expression of c-jun and junB; also, we investigated the role of transcriptional initiation pathways in the expression elevation. In addition, Ras-dependent pathway, as well as PKC-dependent pathway, leads to HPV-16 E5-induced c-jun gene expression.

Characterization of the manganese-resistant mutants derived from Vibrio parahaemolyticus.

The virulence and some related factors of Vibrio parahaemolyticus are regulated by the level of iron. In this study, five Mn-resistant mutants were selected after N-methyl-N'-nitrosoguanidine treatment and two transfers in medium containing high levels of manganese chloride. Production of siderophores and the 77-kDa iron-regulated outer-membrane protein and the bacterial growth in these Mn-resistants were deregulated, as compared with the wild-type strain. In addition, the regulation of these phenomena was partially or completely restored by the introduction of Escherichia coli fur gene. Also, the total cellular protein profiles of the wild-type and mutants showed that production of some proteins were positively or negatively regulated by iron, and expression of some of these proteins remained unaffected in these mutants. These results suggested the presence of a complicated iron regulation system, similar to the Fur system of E. coli, in this pathogen.