Application of teacher standardized patients combined case-based leaching in the acceptation ability training of general practitioners in medically unexplained physical symptoms / 中华医学教育探索杂志

Due to the reduction of patient cooperation and the limitation of clinical diseases, general practitioners lack effective acceptation training in the training process. To improve this situation, this study applies teacher standardized patients (TSP) combined case-based learning (CBL) to the acceptation ability training of general practitioners in medically unexplained physical symptoms (MUPS). And the acceptation ability and communication ability of 15 general practitioners were evaluated before, during and after the training. It shows that the application of "TSP + CBL" in the acceptation ability training of general practitioners in MUPS can effectively improve the acceptation ability and communication ability of general practitioners.

Expression, purification and characterization of a novel bis (hydroxyethyl) terephthalate hydrolase from Hydrogenobacter thermophilus / 生物工程学报

PET (polyethylene terephthalate) is one of the most important petrochemicals that is widely used in mineral water bottles, food and beverage packaging and textile industry. Because of its stability under environmental conditions, the massive amount of PET wastes caused serious environmental pollution. The use of enzymes to depolymerize PET wastes and upcycling is one of the important directions for plastics pollution control, among which the key is the depolymerization efficiency of PET by PET hydrolase. BHET (bis(hydroxyethyl) terephthalate) is the main intermediate of PET hydrolysis, its accumulation can hinder the degradation efficiency of PET hydrolase significantly, and the synergistic use of PET hydrolase and BHET hydrolase can improve the PET hydrolysis efficiency. In this study, a dienolactone hydrolase from Hydrogenobacter thermophilus which can degrade BHET (HtBHETase) was identified. After heterologous expression in Escherichia coli and purification, the enzymatic properties of HtBHETase were studied. HtBHETase shows higher catalytic activity towards esters with short carbon chains such as p-nitrophenol acetate. The optimal pH and temperature of the reaction with BHET were 5.0 and 55 ℃, respectively. HtBHETase exhibited excellent thermostability, and retained over 80% residual activity after treatment at 80 ℃ for 1 hour. These results indicate that HtBHETase has potential in biological PET depolymerization, which may facilitate the enzymatic degradation of PET.

Satisfaction degree and related factors of community health services among residents in Zhejiang province / 中华全科医师杂志

Objective:To analyze the satisfaction degree and related factors of community health services among residents in Zhejiang province.Methods:A service satisfaction survey was conducted during July to October 2019; using purpose sampling method three community health service centers were selected as survey sites in Hangzhou, Jiaxing, and Lishui cities, representing high, medium, and low economic development levels in Zhejiang province. The short-form Patient Satisfaction Questionnaire (PSQ-18) was used in the survey. SPSS 19.0 was adapted for data analysis, and multivariate logistic regression was applied use of analyze the affecting factors of satisfaction.Results:A total of 464 questionnaires were distributed, and 429 valid ones were returned with a response rate of 92.46%. Among them, 112 were from Hangzhou, 159 from Jiaxing, and 158 from Lishui. The overall satisfaction score of community health services was (4.22±0.59), and the satisfaction rate was 85.8%(368/429).Among the three cities, the overall satisfaction score in Lishui was the highest (4.28±0.51) with a satisfaction rate of 88.7% (140/158). The satisfaction scores of service quality, doctors' interpersonal communication ability, doctor-patient communication level, economic efficiency of service, timeliness of service, and accessability of service were (3.99±0.57), (4.10±0.77), (4.27±0.56), (3.54±0.84), (4.13±0.68) and (3.88±0.55); the satisfaction rates of those items were 59.6%(256/429), 79.4%(340/429), 86.3%(370/429), 43.6%(187/429), 78.9%(338/429)and 50.3%(216/429), respectively. Multivariate logistic regression analysis indicated that the quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service were the affecting factors of the residents' satisfaction to community health services ( OR=3.734, 2.928, 7.732, 4.275; P<0.05). Conclusion:The residents of Zhejiang province have a high overall satisfaction with community health services. The quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service are the affecting factors of the overall satisfaction degree.

Application of perforator flap in repair of limb defects: 56 cases report / 中华显微外科杂志

Objective:To investigate the clinical effects of perforator flaps in the repair of limb defects.Methods:Anterolateral thigh perforator flap (ALTP), deep inferior epigastric perforator flap (DIEP), posterior in- terosseous artery perforator flap (PIAP), thoracodorsal artery perforator flap (TDAP), medial sural artery perforator flap (MSAP) and radial collateral artery perforator flap (RCAP) were used to repair 56 cases of limb wounds from Novem- ber, 2016 to October, 2018. The sizes of soft tissue defect were ranged from 1.5 cm×1.5 cm to 10.0 cm×24.0 cm, while the sizes of flap were ranged from 2.0 cm×2.0 cm to 11.0 cm×25.0 cm. The recipient sites were all sutured di- rectly. The flaps survived and wound healing were observed postoperatively. Appearance, texture, recovery of the limb function, shape and function of donor site were followed-up regularly.Results:One case of venous crisis occurred on the 3rd day after inferior epigastric artery perforator flap surgery, and survived after exploratory surgery with the necrosis in the distal part of the flap, which healed after dressing. Other 55 flaps all survived. Both recipient site and donor site healed in primary union. The color of the flaps was normal. The skins were soft, and the functions of the limbs recovered well. Only a linear scar remained in the donor area without dysfunction.Conclusion:The perforator flap surgery is reliable for limbs repair and can be promoted and applied.

Clinical characteristics and treatment outcomes of relapsing, recurrent and repeat peritoneal dialysis-associated peritonitis: a multicenter study / 中华肾脏病杂志

Objective:To explore the clinical characteristics and treatment outcomes of different types of peritoneal dialysis-associated peritonitis (PDAP).Methods:The clinical data of PDAP patients admitted to the Second Hospital of Jilin University, Second Part of the First Hospital of Jilin University, Jilin Central Hospital and Jilin First Automobile Work General Hospital in Jilin province from 2013 to 2019 were reviewed. According to the type of PDAP, the patients were divided into relapsing group, recurrent group, repeat group and control group, and the baseline data, pathogens culture and treatment outcomes among the four groups were compared.Results:A total of 542 patients with PDAP were enrolled in the study, including 43 cases in relapsing group, 32 cases in recurrent group, 27 cases in repeat group and 440 cases in control group. The median follow-up time was 30.5 (16.0, 50.0) months. The rate of Gram-positive bacteria in repeat group was higher than that of control group (70.37% vs 42.95%, P=0.030); the rate of fungi in recurrence group was higher than that of control group (21.88% vs 3.86%, P=0.006). Compared with control group, relapsing group had a lower cure rate (67.44% vs 83.64%, P=0.048) and a higher relapse rate (23.26% vs 2.27%, P=0.002), and recurrent group had a higher catheter removal rate (28.13% vs 8.18%, P=0.012). Multivariate logistic regression showed that recurrence was an independent risk factor for catheter removal ( OR=5.137, 95% CI 2.105-12.539, P<0.001). The technical failure rates in relapsing group and recurrent group were both higher than those in control group (41.86% vs 17.05%, P=0.002; 46.88% vs 17.05%, P=0.002). Multivariate Cox regression showed that relapse and recurrence were both independent risk factors for technical failure ( HR=2.587, 95% CI 1.525-4.389, P<0.001; HR=3.571, 95% CI 2.022-6.306, P<0.001), and also were independent risk factors for composite endpoint ( HR=1.565, 95% CI 1.045-2.344, P=0.030; HR=2.004, 95% CI 1.269-3.164, P=0.003). Conclusion:Compared with common PDAP, the therapeutic effects and prognosis of relapsing and recurrent PDAP are worse.

Comparison of Zero-profile fusion and titanium plate combined with cage fusion in treating symptomatic adjacent segment disease after anterior cervical discectomy and fusion / 中华骨科杂志

Objective:To compare the clinical effects of Zero-profile (Zero-p) intervertebral fusion and titanium plate combined with cage fusion in treating symptomatic adjacent segment disease (ASD) after anterior cervical discectomy and fusion (ACDF).Methods:Retrospective analysis was performed on 26 patients who underwent ACDF and readmission due to concurrent symptomatic ASD from October 2014 to June 2019. There were 17 males and 9 females, aged 54.15±8.60 (range 41-68) years. The index level included C 2, 3 1 case, C 3, 4 3 cases, C 4,5 9 cases, C 5, 6 6 cases, C 6, 7 7 cases. Twelve cases underwent anterior cervical decompression with Zero-p intervertebral fusion and fixation (Zero-p group), while 14 cases underwent anterior cervical decompression with titanium plate combined with cage fusion and fixation (titanium plate group). The following parameters, including operative duration, intraoperative blood loss, Japanese Orthopaedic Association (JOA) score, visual analogue score (VAS), neck disability index (NDI), dysphagia Bazaz grade, bone graft fusion Eck grade, C 2-C 7 Cobb angle, and related complications, were compared between the two groups. Results:The operation was performed successfully in all the patients. The patients were followed up for averagely 33.38±21.26 (range 12-71) months. The operation duration was 95.83±5.47 (range 89-105) min in the Zero-p group, which was shorter than 121.28±8.24 (range 106-131) min in the titanium plate group. The Bazaz classification of dysphagia in the Zero-p group was superior to the titanium plate group at 1 month after operation ( W=126.00, P=0.022). Neither group had dysphagia 3 months after surgery. The JOA score increased from preoperative 9.50±1.31 to 14.33±0.78, and VAS decreased from 5.33±1.67 to 0.83±0.72 in the Zero-p group. The NDI decreased from 43.62%±9.31% to 14.99%±3.26%, and C 2-C 7 Cobb changed from 8.26°±2.92° to 14.80°±4.18° in the Zero-p group. The JOA score increased from preoperative 9.14±1.79 to 14.71±0.73, and VAS decreased from 5.43±1.55 to 1.43±0.76 in the titanium plate group. The NDI decreased from 43.76%±8.47% to 14.22%±4.59%, and C 2-C 7 Cobb changed from 5.53°±9.04° to 14.68°±6.89° in the titanium plate group. No complication, such as screw loosening or breakage or esophageal injury, occurred during the follow-up. Conclusion:Both methods can achieve good clinical effects in treating symptomatic ASD and can restore the physiological curvature of the cervical spine to a certain extent. Furthermore, the advantages of Zero-p intervertebral fusion include shorter operation duration, reducing soft tissue injury and less postoperative dysphagia.

Diagnostic and therapeutic analysis of primary angiosarcoma of long bone / 中华骨科杂志

Objective:To explore the clinical, imaging manifestations, treatment methods and prognosis of primary angiosarcoma of longbone, with the aim of improving the diagnosis and treatment.Methods:During April 2014 to April 2018, 5 patients with histopathologically-proven primary angiosarcoma of longbone were enrolled in this retrospective study, clinicaland imagingcharacteristics wereanalysiaed. Thetreatment and follow-up results werediscussed.There were 3 males and 2 females; the age ranged from 27 to 79 years and an average age of 45.2±3.5 years. Theproximal humeruswas1case. Thedistal humeruswas1case.The proximalfemur was 2 cases.Thediatalfemur was 1case. Pathological fracturewas2case.According to the tumor site and the presence or absence of pathological fractures, lesion curettage and large-scale resection were taken separately. Adjuvant treatment was given according to the patient's condition after surgery. The length of the lesion wasmeasured and recorded. The X-ray, CT, MRI and nuclear medicine imaging features of the tumor and its characteristics were recorded and analyzed. The pathological characteristics of the tumor were recorded and analyzed. The treatment of the tumor and treatment effect and prognosis were analyzed.Results:The clinical manifestations of angiosarcoma of long bone are non-specific,local pain and swelling. The imaging manifestationsin X-ray, CT and MRI imaging have certain characteristics, such as osteolytic bone destruction in bone marrow cavity and/orcorti-calmostly,without scleroticrim, soft tissue mass, centripetal non-progressive filling and unevenenhancement or nodules gradual enhancement. The length of the tumor lesion is usually larger, the size is about 6.6±1.2 cm. The expression of CD31 and CD34 inosteoangio sarcoma lesions was higher, and the positiverate of ERG expression was about 100%. The survival time of 2 patients who underwent adjuvant chemotherapy after surgery was15 months, 37 months with median survival time was28 months. One patient who survived radiotherapy survived for 40 months. The survival time of 2 patients who underwent surgery alone was 8 months, 30 months, and the median survival time was19 months.Conclusion:Imaging finding scan beused as adjunctive diagnois of the primary angio sarcoma of bone. ERG is the most specific and sensitive marker in the pathological diagnosis of osteoangiosarcoma. Surgical resectionis still the first choice of treatment for long bone angiosarcoma. Surgical combined with radiotherapy can appropriately extend the survival time, and this program can be used as a treatment method chosen by doctors and patients.

Study on Preparation and in vitro Release Characteristic of Ursolic Acid/PF 127/TPGS-doxorubicin Mixed Nanomicelles / 中国药房

OBJECTIVE： To prepare Ursolic acid （UA）/Pluronic F127 （PF127）/TPGS-doxorubicin （DOX） mixed nanomicelles， and to characterize it and study its in vitro release behavior. METHODS： UA/PF127/TPGS nanomicelles were prepared by thin film hydration method. Using encapsulation efficiency of UA as index， combined with the results of single factor tests， L9（34） orthogonal test was used to optimize drug dosage of UA， molar ratio of PF127 to TPGS， hydration temperature and hydration volume， validation test was performed. On the basis of succinylated TPGS， TPGS-DOX was synthesized and mixed with UA/PF127/TPGS to prepare UA/PF127/TPGS-DOX mixed nanomicelles， the appearance， particle size and critical micelle concentration （PF127/TPGS） were investigated. The drug release behavior was examined by dialysis bag diffusion method. RESULTS： The optimal preparation technology of UA/PF127/TPGS nanomicelles was as follows as drug dosage of UA 8 mg， molar ratio of PF127 to TPGS 3 ∶ 7， hydration temperature 50 ℃， hydration volume 4 mL. Average encapsulation efficiency of UA in nanomicelles was 89.00％ （RSD＝0.43％， n＝3）. The prepared UA/PF127/TPGS-DOX mixed nanomicelles solution was clear with opalescence. The nanomicelles were spherical and uniform in size； average particle size was （115.00±9.42） nm； critical micelle concentration of PF127/TPGS （molecular ratio 3 ∶ 7） was 0.001 3％. The in vitro drug release of UA and DOX in the mixed nanomicelles was significantly slowed down， compared with raw materials or substance control. The drug release process of the two drugs in the nanomicelles conformed to Weibull equation. CONCLUSIONS： UA/PF127/TPGS-DOX mixed nanomicelles are successfully prepared with uniform particle size， good stability and good sustained-release effect.

Optimization of Preparation Technology of Celastrol Nanostructured Lipid Carrier and Its Characterization / 中国药房

OBJECTIVE： To optimize the preparation technology of Celastrol nanostructured lipid carriers （Cel-NLC）， and to characterize it. METHODS： Cel-NLC was prepared by melt-emulsification ultrasonic method. Based on single factor test， using encapsulation rate of Cel as index， the ratio of liquid lipid （the ratio of total mass）， the amount of compound emulsifier and the dose of main drug were optimized by central composite design-response surface methodology. Validation test was conducted. Zeta potential and particle size of Cel-NLC that prepared by optimal prescription were determined by using granularity and Zeta potential analyzer. The morphology of liposome was observed by TEM. RESULTS： The optimal prescription included that the ratio of liquid lipid was 39％；the amount of compound emulsifier was 196 mg；the dose of main drug was 8 mg. The average encapsulation efficiency of 3 batches of Cel-NLC was 87.22％； average particle size was （41.2±1.1） nm，and average Zeta potential was        （－18.4±0.2） mV （n＝3）. It was spherical under electron microscopy. CONCLUSIONS： The optimized technology is simple， stable and feasible， and it is suitable for the preparation of Cel-NLC.

Role of ERK signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion (I/R)injury in rats.Methods Eighty clean-grade male Sprague-Dawley rats,aged 9-10 weeks,weighing 300-350 g,were divided into 4 groups (n =20 each) using a random number table method:sham operation group (group S),spinal cord I/R group (group I/R),dexmedetomidine group (group D),and dexmedetomidine plus ERK signaling pathway blocker PD98059 group (group P).Spinal cord ischemia was produced by cross-clamping of the abdominal aorta distal to the left renal artery for 25 min followed by reperfusion to establish the model of spinal cord I/R injury.Dexmedetomidine 1 μg/kg was intrathecally injected at 20 min before establishing the model in D and P groups,PD98059 2 mg/kg was given via the tail vein at the same time in group P,and the equal volume of normal saline was given instead in S and I/R groups.Five rats were selected at 6,8,10 and 12 h of reperfusion,and the modified Basso,Beattie,Bresnahan (BBB) scale was used to assess the hindlimb locomotor function.Five rats were sacrificed after assessing the locomotor function at 6 h of reperfusion,and the L3-5 segments of the spinal cord were taken for determination of cell apoptosis (by TUNEL) and expression of phosphorylated ERK (p-ERK) (by Western blot).The apoptosis index was calculated.Results Compared with group S,the BBB scores were significantly decreased at each time point of reperfusion,the apoptosis index was increased,and the expression of pERK was up-regulated in the other three groups (P＜0.05).Compared with I/R group,the BBB scores were significantly increased at each time point of reperfusion,the apoptosis index was increased,and the expression of p-ERK was up-regulated in group D,and no significant change was found in the apoptosis index or p-ERK expression in group P (P＞0.05).Compared with group D,the BBB scores were significantly decreased at each time point of reperfusion,the apoptosis index was increased,and the expression of pERK was down-regulated in group P (P＜0.05).Conclusion The mechanism by which intrathecal dexmedetomidine reduces spinal cord I/R injury is related to activating ERK signaling pathway in rats.

Kir2.1 Channel Regulation of Glycinergic Transmission Selectively Contributes to Dynamic Mechanical Allodynia in a Mouse Model of Spared Nerve Injury / 神经科学通报·英文版

Neuropathic pain is a chronic debilitating symptom characterized by spontaneous pain and mechanical allodynia. It occurs in distinct forms, including brush-evoked dynamic and filament-evoked punctate mechanical allodynia. Potassium channel 2.1 (Kir2.1), which exhibits strong inward rectification, is and regulates the activity of lamina I projection neurons. However, the relationship between Kir2.1 channels and mechanical allodynia is still unclear. In this study, we first found that pretreatment with ML133, a selective Kir2.1 inhibitor, by intrathecal administration, preferentially inhibited dynamic, but not punctate, allodynia in mice with spared nerve injury (SNI). Intrathecal injection of low doses of strychnine, a glycine receptor inhibitor, selectively induced dynamic, but not punctate allodynia, not only in naïve but also in ML133-pretreated mice. In contrast, bicuculline, a GABA receptor antagonist, induced only punctate, but not dynamic, allodynia. These results indicated the involvement of glycinergic transmission in the development of dynamic allodynia. We further found that SNI significantly suppressed the frequency, but not the amplitude, of the glycinergic spontaneous inhibitory postsynaptic currents (gly-sIPSCs) in neurons on the lamina II-III border of the spinal dorsal horn, and pretreatment with ML133 prevented the SNI-induced gly-sIPSC reduction. Furthermore, 5 days after SNI, ML133, either by intrathecal administration or acute bath perfusion, and strychnine sensitively reversed the SNI-induced dynamic, but not punctate, allodynia and the gly-sIPSC reduction in lamina IIi neurons, respectively. In conclusion, our results suggest that blockade of Kir2.1 channels in the spinal dorsal horn selectively inhibits dynamic, but not punctate, mechanical allodynia by enhancing glycinergic inhibitory transmission.

Role of ERK signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective@#To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion (I/R) injury in rats.@*Methods@#Eighty clean-grade male Sprague-Dawley rats, aged 9-10 weeks, weighing 300-350 g, were divided into 4 groups (n=20 each) using a random number table method: sham operation group (group S), spinal cord I/R group (group I/R), dexmedetomidine group (group D), and dexmedetomidine plus ERK signaling pathway blocker PD98059 group (group P). Spinal cord ischemia was produced by cross-clamping of the abdominal aorta distal to the left renal artery for 25 min followed by reperfusion to establish the model of spinal cord I/R injury.Dexmedetomidine 1 μg/kg was intrathecally injected at 20 min before establishing the model in D and P groups, PD98059 2 mg/kg was given via the tail vein at the same time in group P, and the equal volume of normal saline was given instead in S and I/R groups.Five rats were selected at 6, 8, 10 and 12 h of reperfusion, and the modified Basso, Beattie, Bresnahan (BBB) scale was used to assess the hindlimb locomotor function.Five rats were sacrificed after assessing the locomotor function at 6 h of reperfusion, and the L3-5 segments of the spinal cord were taken for determination of cell apoptosis (by TUNEL) and expression of phosphorylated ERK (p-ERK) (by Western blot). The apoptosis index was calculated.@*Results@#Compared with group S, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in the other three groups (P<0.05). Compared with I/R group, the BBB scores were significantly increased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in group D, and no significant change was found in the apoptosis index or p-ERK expression in group P (P>0.05). Compared with group D, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was down-regulated in group P (P<0.05).@*Conclusion@#The mechanism by which intrathecal dexmedetomidine reduces spinal cord I/R injury is related to activating ERK signaling pathway in rats.

Efficiency and safety of endoscopic therapy for early esophageal cancer and precancerous lesions with length more than 5 cm / 中华消化内镜杂志

Objective To compare the effectiveness and safety of endoscopic submucosal dissection ( ESD) with endoscopic piecemeal mucosal resection ( EPMR) for early esophageal cancer and precancerous lesions with length more than 5 cm. Methods A retrospective analysis was performed on data of 85 patients diagnosed as early esophageal cancer and precancerous lesions with length more than 5 cm in Fujian Medical Association of Early Esophageal Carcinoma from January 2012 to July 2017. The patients were divided into ESD group (52 cases) and EPMR group (33 cases), and the effectiveness and safety between the two groups were compared. Results There was no significant difference on the complete resection rate between the two groups[86. 5％ (45/52) VS 87. 9％ (29/33), P>0. 05]. The operative time (58. 53±30. 50 min VS 32. 06±9. 12 min), postoperative fasting time (4. 18±1. 30 d VS 3. 67±0. 96 d), postoperative hospital-stay time (7. 45±2. 44 d VS 6. 54±1. 73 d), and postoperative antibiotics using time (3. 48±2. 33 d VS 1. 96±2. 20 d) in ESD group were higher than those in EPMR group (all P<0. 05). There were no significant difference in the rate of intraoperative complication and short-term postoperative complication, such as fever, chest pain, and postoperative bleeding, between the two groups ( all P>0. 05 ) . But the postoperative stricture rate of ESD group was higher than that of EPMR group[23. 1％ (12/52) VS 6. 1％(2/33), P<0. 05]. During the follow-up of 3-63 months, 5 cases recurred in ESD group and 1 case in EPMR group, with no significant difference ( P>0. 05). Conclusion ESD and EPMR have equivalent efficacy and safety on the treatment of early esophageal cancer and precancerous lesion. EPMR has a shorter operative time, lower rate of post-operative stricture, and is easier to master.

Application of testa triticum tricum purif to colonoscopy bowel preparation in constipation patients / 中华消化内镜杂志

Objective To evaluate the efficacy of testa triticum tricum purif combined with polyethylene glycol electrolyte powder for bowel preparation before colonoscopy in patients with constipation. Methods A total of 190 patients with constipation who underwent colonoscopy were randomized into 2 groups. The study group(n=93)were given testa triticum tricum purif and polyethylene glycol electrolyte powder,whereas the control group(n=97)were given polyethylene glycol electrolyte powder only.The bowel cleanness,adenoma detection rate,and incidence of adverse events during bowel preparation were compared. Results The bowel preparation score(7.31±1.14 VS 6.06±1.22,P=0.000)and effective rate(95.70%VS 69.07%, P=0.000)in the study group was significantly higher than that in the control group. The incidence of adverse events in the study group was lower than that in the control group(5.38% VS 17.53%, P=0.009). There was no significant difference in the adenoma detection rate between the two groups (36.56% VS 26.80%, P=0.148). Conclusion Testa triticum tricum purif combined with polyethylene glycol electrolyte powder is superior to conventional method of polyethylene glycol electrolyte powder alone for colonoscopy bowel preparation in patients with constipation.

Diagnostic value of pink sign of endoscopic iodine staining for early esophageal carcinoma / 中华消化内镜杂志

Objective To explore the diagnostic value of pink sign of iodine staining for early esophageal carcinoma. Methods Data of 312 lesions of 306 patients with suspected early esophageal carcinoma who received iodine staining from November 2015 to October 2017 were analyzed retrospectively. Lesions were divided into positive pink sign group and negative pink sign group according to the result of iodine staining. The relationship between pink sign and pathology were analyzed. Lesions recorded onset time of pink sign were divided into 4 groups by the onset time of pink sign, 0-30 s,>30-60 s,>60-90 s and>90-120 s, the diagnostic value of which was assessed with the receiver operating characteristic ( ROC) curve. Results Among the 312 lesions, 208 were identified positive pink sign, including 28 of inflammation or low-grade intraepithelial neoplasia ( LGIN ) , 180 of high-grade intraepithelial neoplasia ( HGIN ) or carcinoma, and 104 lesions were identified negative pink sign, including 69 of inflammation or LGIN, 35 of HGIN or carcinoma. The sensitivity, specificity and accuracy of positive pink sign in the diagnosis of HGIN and early esophageal carcinoma was 83. 7％, 71. 1％ and 79. 8％, respectively. Multivariate analysis showed a significant association between the onset time of pink sign and histopathology ( P=0. 000, OR=0. 016, 95％CI=0. 042-0. 324) . The onset time of pink sign was recorded in 89 lesions in the positive group. The area under ROC curve of the onset time of pink sign was 0. 899, and the optimal cut-off value was 60 s, which indicated the good validity of the test with the sensitivity, specificity and accuracy of 92. 8％, 84. 2％and 91. 0％, respectively. Conclusion The pink sign of iodine staining for diagnosis of early esophageal carcinoma shows a high consistance rate, especially that appears within 60 s.

Oral lactitol combined with polyethylene glycol electrolyte powder for bowel preparation before colonoscopy in hospitalized patients / 中国内镜杂志

Objective To evaluate the efficacy of combined application of lactitol oral solution and polyethylene glycol electrolyte (PEG) powder compared with conventional method in bowel preparation before colonoscopy. Methods 205 patients who underwent colonoscopy were randomly divided into experimental group and control group. The experimental group (n = 102) were given lactitol and polyethylene glycol electrolyte powder, whereas the patients in control group (n = 103) were given polyethylene glycol electrolyte powder only. The visibility and adverse effects during colonoscopy were observed. Results The cleaning satisfaction rate was not statistically significant between the two groups. The proportion of cleanliness to grade 1 in experimental group was higher than that in control group. The incidence of adverse effects in experimental group was lower, and there was no effect on sleeping night. The compliance and tolerance of hospitalized patients were significantly improved. Conclusion Lactitol combined with polyethylene glycol electrolyte (peg) powder is safe, effective, with low incidence of adverse effect for bowel preparation in hospitalized patients.

The definition and laboratory tests for chronic kidney disease and acute kidney injury / 中华检验医学杂志

Chronic kidney disease (CKD) is a general term for heterogeneous disorders affecting kidney structure and function.It can be detected by routine laboratory tests.Acute kidney injury ( AKI),previously referred to as acute renal failure(ARF), represents a persistent problem in clinical medicine.Despite significant improvements in therapeutics,the mortality and morbidity associated with AKI remain high.A major reason for this is the lack of markers for early diagnosis of AKI.In this paper,we discuss recommendations for AKI and CKD laboratory assessment and management,and future challenges.( Chin J Lab Med,2012,35:773-779)