Clinical significance of alveolar-arterial oxygen gradients for late preterm and full-term infants with acute respiratory distress syndrome / 中国新生儿科杂志

Objective:To study the clinical significance of alveolar-arterial oxygen gradients (P A-aO 2) for late preterm and full-term infants with acute respiratory distress syndrome (ARDS). Methods:From January 2020 to June 2022, infants (gestational age ≥34 weeks) diagnosed with ARDS were admitted to the Neonatology Department of our hospital. The infants were assigned into the invasive group and the non-invasive group according to the ventilation mode. The infants with the same gestational age and diagnosed with neonatal wet lung were assigned into the control group. P A-aO 2 levels within 1 h after birth were compared among the three groups. The correlation of P A-aO 2 with ARDS, ventilation mode and duration were studied. Receiver operating characteristic (ROC) curve was used to determine the predictive value of P A-aO 2 within 1 h after birth for ARDS and the need of invasive ventilation. Results:A total of 36 cases were enrolled in the invasive group, 19 cases in the non-invasive group and 50 cases in the control group. Within 1 h after birth, P A-aO 2 in the invasive group was significantly higher than the non-invasive group and the control group ( P<0.05), and the non-invasive group higher than the control group ( P<0.05). Correlation analysis showed that P A-aO 2 within 1 h after birth in the invasive group was positively correlated with the duration of invasive ventilation and total mechanical ventilation ( r=0.601, P<0.001; r=0.504, P=0.002); P A-aO 2 before successful withdrawal of invasive ventilation was not correlated with subsequent non-invasive ventilation duration; and no correlation existed between P A-aO 2 within 1 h after birth and the duration of non-invasive ventilation in the non-invasive group. The area under the ROC curve for P A-aO 2 within 1 h after birth to predict ARDS was 0.875, with a sensitivity of 87.3% and a specificity of 72.0% at a cutoff value of 50.0 mmHg. The area under the ROC curve for predicting the need for invasive ventilation in infants with ARDS was 0.851, with a sensitivity of 80.0% at a cutoff value of 73.3 mmHg and a specificity of 75.0%. Conclusions:Late preterm and full-term infants have a higher risk of ARDS at P A-aO 2>50.0 mmHg within 1 h after birth. Infants with ARDS are more likely to require invasive ventilation if P A-aO 2>73.3 mmHg. The higher the level of P A-aO 2, the longer the duration of invasive ventilation and total duration of mechanical ventilation.

Analysis of the clinical characteristics of 69 cases of occupational melanosis / 中国职业医学

Objective To summarize the clinical characteristics of patients with occupational melanosis. Methods Diagnostic data of 69 patients with occupational melanosis was analyzed using retrospective analysis. Results The main occupational hazards for the 69 patients with occupational melanosis were coal tar, petroleum and its fractionated products, pigments and dyes and their intermediates, rubber additives and rubber products. The median length of occupational exposure and disease latency were 8.0 and 6.0 years, respectively, with a highly positive correlation between them (Spearman correlation coefficients=0.962, P<0.01). Skin lesions were mainly found on exposed areas such as the face-to-neck and limbs, prevalence of 94.2% and 75.4% respectively. And 78.3% of patients had skin lesion on more than two sites. The lesions were mostly in the form of irregular flakes (59.4%), with a gray-black color (44.9%). About 43.5% of patients experienced skin itching. Complete blood count, liver function, and kidney function were all within normal ranges. Skin biopsy results showed that epidermal hyperkeratosis, thinning of the spinous layer, liquefaction degeneration of basal cells, increased superficial dermal melanocytes, and infiltration of lymphocytes, histiocytes, and melanocytes around the blood vessels. Reflectance confocal microscopy (RCM) detection showed focal liquefaction degeneration of basal cells in the lesions, with a significant infiltration of melanocytes and inflammatory cells in the dermal papillae and superficial layers. Conclusion The primary target organ of occupational melanocytes is the skin, and no damage to other organs was identified thus far. Results from skin biopsies and RCM examinations can be used for differential diagnosis.

OShnscc: a novel user-friendly online survival analysis tool for head and neck squamous cell carcinoma based on RNA expression profiles and long-term survival information / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.

Input-output efficiency analysis for children′s diagnosis and treatment service at 27 community health service centers in China / 中华医院管理杂志

Objective:To provide strategic suggestions for optimizing children′s diagnosis and treatment services in the communities, by means of analyzing the overall efficiency of children′s diagnosis and treatment services in the sample community health service centers, and learning the current input and output of children′s diagnosis and treatment resources.Methods:In April 2020, a total of 27 community health service centers in 14 cities were selected by random sampling. Data such as the number of medical visits by children aged 0 to 18 years and the area of pediatric diagnosis and treatment departments in the sample centers in 2019 were collected by self-filling questionnaires. Excel was used for data sorting. Data envelopment analysis(DEA) was used for data processing. The data processing tool was DEAP 2.1.Results:The average comprehensive efficiency, the average technical efficiency and the average scale efficiency of the 27 sample community health service centers were 0.445, 0.865 and 0.494 respectively. There were five DEA efficient centers, 4 DEA weak inefficiency centers and 18 inefficient centers. Six out of 18 DEA inefficient centers had redundant input of healthcare professionals capable pediatrics; 12 centers were short of children visits, and 15 were short of visits by children aged 0-6 years.The centers where DEA was inefficient were concentrated in the central region, the suburbs and " centers with independent pediatric clinics but without pediatric wards" .Conclusions:The comprehensive efficiency of children′s diagnosis and treatment services in the sample community health service centers is relatively low. Currently, the sample community health service centers are faced with such problems as small and insufficient input of children′s diagnosis and treatment resources in the community, unbalanced development of children′s diagnosis and treatment services in the region among others. It is suggested that on the basis of making full use of the existing resources to create the maximum output value, we should consider appropriately expanding the scale of resource input to improve the efficiency of children′s diagnosis and treatment services at the primary level and further give play to the value of the " gatekeepers" at the primary level in children′s diagnosis and treatment.

Effect of 12 week aerobic exercise on microcirculation function of sedentary college students / 中国学校卫生

Objective@#To investigate the effects of different doses of aerobic exercise on the microvascular function of habitually sedentary college students.@*Methods@#A total of 69 students from Hubei Minzu University were recruited and divided into sports group A, sports group B and control group, with 23 students in each group (12 boys and 11 girls). The exercise group received 12 weeks of aerobic exercise intervention, in which group A exercised 1-2 times a week, group B exercised≥3 times a week, and the control group did not carry out any systematic sports. Microvascular response, Transcutaneous partial pressure of oxygen(TcpO 2), Nitric oxide, Nitric oxide synthase (NOS) and En dothelin-1 (ET-1) were measured before and after the test.@*Results@#After the test, the microvascular reactivity showed group and time interaction( P <0.01), in which exercise group B was greater than that of control group and exercise group A ( P <0.01). There was no significant difference between exercise group A and control group ( P >0.05), but the percutaneous partial pressure of oxygen ( P =0.53) had no time interaction with other groups; NO( F =6.32) and NOS( F =7.91) had group and time interaction, in which exercise group B was greater than control group and exercise group A ( P <0.01), and there was no significant difference between exercise group A and control group ( P >0.05).@*Conclusion@#There is a "dose effect" relationship between aerobic exercise and microcirculatory blood perfusion and endogenous NO. Continuous aerobic exercise ≥3 times a week for 12 weeks improved microcirculatory blood perfusion and promoted endogenous NO production in sedentary college students, but doing aerobic exercise for 1-2 times a week had no significant effect on microcirculatory blood perfusion and endogenous NO.

Analysis of etiology and cytokines of benign infantile convulsions with mild gastroenteritis / 中国小儿急救医学

Objective:To investigate the pathogenic distribution of benign infantile convulsions with mild gastroenteritis(BICE)and explore the relevance of serum cytokines and BICE.Methods:Eighty BICE infants admitted in Inner Mongolia Maternal and Child Health Hospital from January 2017 to December 2019 were selected as BICE group, and 80 mild gastroenteritis infants without convulsion attack were selected as control group during the same period.Fluorometric real-time PCR was used to detect the pathogen of enterovirus.Serum cytokines including interleukin(IL)-6, tumor necrosis factor(TNF)-α, IL-8 and soluble interleukin-2 receptor(SIL-2R)were detected by using chemiluminescence method.The relevance of frequency and duration of convulsion in infants with BICE and the indicators above were analyzed.Results:Rotavirus infection was the main cause of BICE during the study period in this region.Among 80 cases in the BICE group, rotavirus positive infants accounted for 38.8%(31/80) and norovirus positive infants accounted for 10.0%(8/80). The levels of IL-6, IL-8 and SIL-2R in the BICE group were prominently higher than those in the control group( P<0.05); the difference of TNF-α level between two groups had no statistical significance( P>0.05). The levels of IL-6, TNF -α, IL-8, SIL-2R in the group with convulsion attack times ≥ 2 and convulsion duration ≥5 min were higher than those in the group with convulsion attack times<2 and convulsion duration<5 min( P<0.05). The frequency and duration of convulsions were positively correlated with the levels of IL-6, TNF -α, IL-8 and SIL-2R( P<0.05). Conclusion:Rotavirus is the main pathogen of BICE in this region.There is immunologic imbalance in children with BICE, especially the changes of IL-6 and SIL-2R levels, which may provide effective cytological and experimental data evidence for judging progression and prognosis of the disease.

Study on RAD51 Gene Regulatory Mechanism of Apigenin Affecting Cisplatin Sensitivity to NSCLC A 549 Cells / 中国药房

OBJECTIVE：To study the effects and mechanism o f apigenin on cisplatin sensitivity of NSCLC A 549 cells by regulating RAD51 gene. METHODS ：Human lung cancer cisplatin-resistant cells A 549/DDP were selected and divided into control group（blank culture medium ），cisplatin group （5 g/L），apigenin low-dose and high-dose groups （10，20 μmol/L）. MTT assay was used to detect the growth of A 549/DDP cells ，while the Annexin Ⅴ/PI double staining combined with flow cytometry were used to detect the apoptosis. A 549/DDP cells were collected and divided into cisplatin alone group （1，2，4，8，16 μg/mL）， apigenin combination group （10 μmol/L，based on cisplatin ）. MTT method was used to determine and calculate inhibitory rate of cell proliferation. IC 50 values of drugs were calculated by regression model ，and reversion index of apigenin was calculated. 18 nude mice were randomly divided into control group ，cisplatin alone group and apigenin combination group ，with 6 mice in each group. After A 549/DDP cells were inoculated to form the transplanted tumor ，normal saline ，cisplatin（2 mg/kg，once every other day ）， cisplatin（the same dosage and usage ）+apigenin solution （30 mg/kg，once a day ）were injected intraperitoneally respectively. After 18 days of continuous administration ，the body weight of mice and the mass of the transplanted tumor were detected and the tumor inhibition rate was calculated. Human lung cancer cells A 549 and A 549/DDP were collected and divided into normal group （A549 cells），control group （A549/DDP cells ），cisplatin group （5 g/L，A549/DDP cells ）and apigenin low-dose and high-dose groups （10，20 μmol/L，A549/DDP cells ），respectively. mRNA and protein expression of RAD51 were detected by real-time fluorescence quantitative PCR and Western blotting assay. RESULTS ： Δ 基金项目：四川省教育厅（自筹经费）科研项目（No.12ZB227） ＊讲师，硕士。研究方向：肿瘤病理。E-mail：molin212@163.com Compared with control group ，the cell growth of apigenin # 通信作者：副教授，硕士生导师，硕士。研究方向：肿瘤病理。 low-dose and high-dose groups were decreased significantly ， E-mail：xinrongH292@163.com apoptosis rates of them w ere increased significantly and higher ·708· China Pharmacy 2020Vol. 31 No. 6 中国药房 2020年第31卷第6期 than those of cisplat in group （P＜0.05 or P＜0.01）. After combined with apigenin ，proliferation inhibition rate of A 549/DDP cells was increased significantly ，compared with cisplatin alone group with the same concentration （P＜0.05）. The IC 50 in the apigenin combination group was （5.81±0.47）μg/mL，significantly lower than （14.44±0.52）μg/mL in cisplatin alone group（P＜0.05），and reversal index of apigenin was 2.49. The results of nude mice tumor inhibition experiment showed that after combined with apigenin，tumor inhibition rate of A 549/DDP bearing nude mice was 68.72％，significantly lower than 33.82％ in cisplatin alone group. Compared with A 549 cells of normal group ，relative expression of RAD51 mRNA and protein were increased significantly in A549/DDP cells of control group （P＜0.05）. Compared with A 549/DDP cells of control group ，relative expression of RAD51 mRNA and protein in A 549/DDP cells were decreased significantly in apigenin low-dose and high-dose groups （P＜0.05）. Compared with cisplatin group ，relative expression of RAD51 mRNA and protein in A 549/DDP cells of apigenin low-dose and high-dose group were decreased significantly （P＜0.05）. CONCLUSIONS ：Apigenin can effectively reverse drug resistance of cisplatin-resistant A 549/DDP cells in human lung cancer. The mechanism may be related to the reduction of RAD51 gene transcription and protein expression.

Analysis of pathogen distribution and drug resistance of pediatric purulent meningitis / 中国基层医药

Objective@#To explore the bacteriological characteristics and bacterial resistance of children with purulent meningitis in the Shenmu Hospital, and to provide evidence for the rational use of antibiotics.@*Methods@#We retrospectively analyzed the clinical data and bacterial culture results of 43 children with purulent meningitis in our hospital from June 2009 to March 2017.@*Results@#There were 21 types of bacteria culture and drug susceptibility test: Gram-positive bacteria in 16 cases(76.19%), Gram negative bacilli in 5 cases(23.81%), including 8 staph infections, gambogic/lira micrococcus in 4 cases, excrement enterococcus in 1 case, streptococcus pneumoniae in 2 cases, produce mononuclear listeria in 1 case.All the Gram-negative bacilli were Escherichia coli.In cerebrospinal fluid culture, Gram-positive bacteria were significantly higher than Gram-negative bacteria, and the difference was statistically significant(χ2=7.813, P=0.005). There was no statistically significant difference in the number of Gram-positive cases between cerebrospinal fluid and blood culture pathogens(χ2=0.075, P=0.78). Gram positive coccus was generally resistant to penicillin, erythromycin and clindamycin, generation 1 cephalosporin antibiotic, including pneumococcal resistance rate was 100.0%, coagulase negative staphylococcus resistance rate was 87.5%, E.coli was resistant to ampicillin and levofloxacin.@*Conclusion@#In the pediatric treatment of our hospital, coagulase negative staphylococcus aureus and vine/Lila micrococcus is the important pathogenic bacteria that causes the children purulent meningitis, Escherichia coli is the only pathogenic bacteria of the Gram-negative bacterial meningitis.Vancomycin and linezolide are sensitive to cocci, and Escherichia coli is sensitive to antibiotics in the second and third generation of cephalosporins.

Analysis of pathogen distribution and drug resistance of pediatric purulent meningitis / 中国基层医药

To explore the bacteriological characteristics and bacterial resistance of children with purulent meningitis in the Shenmu Hospital ,and to provide evidence for the rational use of antibiotics.Methods We retrospectively analyzed the clinical data and bacterial culture results of 43 children with purulent meningitis in our hospital from June 2009 to March 2017.Results There were 21 types of bacteria culture and drug susceptibility test :Gram-positive bacteria in 16 cases (76.19%), Gram negative bacilli in 5 cases (23.81%), including 8 staph infections,gambogic／lira micrococcus in 4 cases, excrement enterococcus in 1 case, streptococcus pneumoniae in 2 cases,produce mononuclear listeria in 1 case.All the Gram-negative bacilli were Escherichia coli.In cerebrospinal fluid culture,Gram-positive bacteria were significantly higher than Gram -negative bacteria,and the difference was statistically significant(χ2 ＝7.813,P ＝0.005).There was no statistically significant difference in the number of Gram-positive cases between cerebrospinal fluid and blood culture pathogens (χ2 ＝0.075,P＝0.78).Gram positive coccus was generally resistant to penicillin , erythromycin and clindamycin , generation 1 cephalosporin antibiotic , including pneumococcal resistance rate was 100.0%,coagulase negative staphylococcus resistance rate was 87.5%, E.coli was resistant to ampicillin and levofloxacin.Conclusion In the pediatric treatment of our hospital ,coagulase negative staphylococcus aureus and vine／Lila micrococcus is the important pathogenic bacteria that causes the children purulent meningitis, Escherichia coli is the only pathogenic bacteria of the Gram -negative bacterial meningitis. Vancomycin and linezolide are sensitive to cocci ,and Escherichia coli is sensitive to antibiotics in the second and third generation of cephalosporins.

Subacute insomnia treated with 's three-promotion needling method: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the differences in the sleep quality and the effects on insomnia severity between 's three-promotion needling method and the oral administration of estazolam.@*METHODS@#A total of 70 patients of subacute insomnia were randomized into a three-promotion needling group and a medication group, 35 cases in each one. In the three-promotion needling group, the mild promotion technique with the filiform needle, the warm promotion technique with the fire needle and the strong promotion technique with the three-edged needle were adopted in combination. The acupuncture with the filiform needle was used at Baihui (GV 20), Sishencong (EX-HN1), Shenting (GV 24), Shenmen (HT 7), etc, The treatment was given 3 times a week, once every 2 days. The pricking technique with fire needle was applied to Ganshu (BL 18), Xinshu (BL 15), Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23) and Geshu (BL 17), once every 3 days, twice a week. The bleeding technique with the three-edged needle was used at the ear apex, once every 2 days, 3 times a week. In the medication group, the estazolam tablets were taken orally before sleep, 1mg once every 2 days. The treatment was given consecutively for 4 weeks in the two groups. Separately, before treatment, in 2-week treatment and in 4-week treatment as well as in 1-month follow-up after treatment, the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI) scores were recorded in the patients of the two groups. The clinical effects were evaluated in the two groups.@*RESULTS@#In 2 weeks and 4 weeks of treatment, as well as in the follow-up, PSQI scores and ISI scores were all reduced obviously as compared with those before treatment in the two groups (all <0.05). In the three-promotion needling group, the PSQI score at each time point was reduced much more obviously as compared with the medication group (all <0.05). In the follow-up, the ISI score in the three-promotion needling group was lower than the medication group (<0.05). The total effective rates were 97.2% (34/35) and 91.4% (32/35) at the end of treatment and in the follow-up respectively in the three-promotion needling group, higher than 85.7% (30/35) and 71.4% (25/35) in the medication group (both <0.05).@*CONCLUSION@#'s three-promotion needling method much more effectively improves the sleep quality and reduces insomnia severity in the patients of subacute insomnia. This therapy presents the satisfactory short-term and long-term effects.

lntervention effects of the triterpenoids from Cyclocarya paliurus on free fatty acids-induced steatosis in HepG2 cells / 中国药科大学学报

To investigate the therapeutic effects of triterpenoids from Cyclocarya paliurus on non-alcoholic fatty liver disease (NAFLD),the model of NAFLD in HepG2 cells was induced by free fatty acids (FFAs). Cytotoxicity of the triterpenoids from C. paliurus was determined by MTT method,and the effects of triterpenoids without cytotoxicity on intracellular triglyceride (TG)and superoxide dismutase (SOD)were detected by the kits. Data indicated that compound 4 [2α,3α,23-trihydroxy-12,20 (30)-dien-28-ursolic acid,TUA]had hypolipidemic and antioxidant activities. After being treated with TUA and FFAs for 24 h,the intracellular lipid content was observed using Oil Red O staining,and intracellular TG,malondialdehyde (MDA ),SOD and reactive oxygen species (ROS)levels were determined by the assay kits. The protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2),heme oxygenase-1 (HO-1 )and NAD (P)H quinone oxidoreductase 1 (NQO-1 )were measured by Western blot. The results showed that TUA significantly increased SOD activity,and decreased intracellular TG, ROS and MDA levels in FFAs-induced HepG2 cells. Moreover,TUA dramatically improved Nrf2,NQO-1 ,and HO-1 expression. However,the dramatic increase in TG,ROS,MDA levels and the reduction in SOD,NQO-1 and HO-1 expression following Nrf2 inhibitor brusatol treatment were observed. In conclusion,these results suggest that TUA has the therapeutic effect on NAFLD which may be associated with Nrf2 activation.

Clinical effect of rock salt aerosol therapy in treatment of occupational allergic contact dermatitis / 中华劳动卫生职业病杂志

Objective@#To investigate the clinical effect and safety of rock salt aerosol therapy in the treatment of occupational allergic contact dermatitis.@*Methods@#A total of 65 patients with acute exacerbation of occupational allergic contact dermatitis who were treated in the Outpatient Service and Inpatient Department of our hospital from March 2013 to December 2015 were enrolled and randomly divided into observation group and control group using a random number table. Both groups were givensymptomatic treatment including desensitization, and the patients in the observation group were given rock salt aerosol therapy for 2 courses in addition to the symptomatic treatment. The changes in symptoms, signs, blood eosinophil count, and IgE were observed.@*Results@#There were significant changes in symptom score at the first and second courses of the treatment (P<0.05) , and there was an interaction between time of therapy and grouping (P<0.05) . There was no significant difference in symptom score before treatment between the two groups (P>0.05) , while there were differences at the first and second courses of the treatment (P<0.05) . After the second course of treatment, the observation group had a significantly higher overall response rate than the control group (P<0.05) ; both groups had significant reductions in blood eosinophil count and the observation group had a significantly greater reduction than the control group (P<0.05) . After two courses of treatment, both groups had significant increases in the number of patients with normal IgE (both P<0.05) , and after the second course of treatment, the observation group had a significantly higher number than the control group (P<0.05) . Both groups had mild adverse events, which did not affect the treatment.@*Conclusion@#In the treatment of occupational allergic contact dermatitis, rock salt aerosol therapy has a certain effect on the recovery of symptoms, signs, blood eosinophil count, and IgE.

The treatment of acute exacerbation of chronic obstructive pulmonary disease by point injection of spleen ;polypeptides / 中国基层医药

Objective To observe the clinical efficacy of point injection of spleen polypeptides in the treat-ment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Totally 60 patients with AECOPD were randomly divided into the observation group and the control group,30 cases in each group.Based on conventional treatment,the observation group was treated by point injection of spleen polypeptides,4ml for each time, 1 time a day;and the control group was given equivalent volume of spleen polypeptides by intramuscular injection.The treatment lasted two weeks.The clinical efficacy,PCT,inflammatory and ADRs of patients in the two groups were observed.Results In 7 days of treatment,the clinical efficacy was 87% in the observation group,which was better than 60% of the control group (χ2 =5.45,P=0.019).PCT,interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF -α)of the observation group and the control group were (1.84 ±1.48)ng/mL and (2.21 ±1.75)ng/mL,(32.54 ±6.62)ng/L and (38.94 ±5.69)ng/L,(31.51 ±6.03)ng/L and (36.75 ± 7.95)ng/L,(45.90 ±4.40)ng/L and (51.53 ±2.21)ng/L respectively,which were lower than before treatment (t=12.76 and 15.25,13.23 and -8.42,-10.43 and 5.78,25.04 and 26.95,all P<0.01),which of the obser-vation group were lower than the control group(t=-2.84,4.01,-2.74,-6.27,all P<0.01).After treatment, PCT,IL-6,IL-8,TNF-αof the observation group and the control group were (1.05 ±0.74)ng/mL and (1.38 ± 0.87)ng/mL,(26.89 ±3.57)ng/L and (32.44 ±5.96)ng/L,(21.40 ±3.41)ng/L and (27.71 ±5.50)ng/L, (32.29 ±2.40)ng/L and (39.77 ±2.57)ng/L respectively,which were lower than before treatment(t=22.40 and 22.44,23.10 and -11.96,21.40 and 12.66,48.94 and 38.81,all P<0.01),which of the observation group were lower than the control group(t=-4.09,-4.26,-5.29,-11.68,all P<0.01).No obvious side effect was found in the two groups in the treatment and followed-up period.Conclusion Point injection of spleen polypeptides can effectively reduce the inflammatory response in patients with AECOPD,improve clinical outcomes,shorten course of treatment,has better clinical value.

Measurement and analysis of community health staffing standards / 中华医院管理杂志

Objective To measure the gap of community health staffing and establish new norms for community health facilities by means of the WHO Workload indicator of staffing need (WISN) method,for reference of the government in evaluation and decision making of community health staffing. Methods With Xicheng District of Beijing as an example,we collected data on community health staffing and calculated the total demand,measuring the total demand and supply,and gap or surplus in the staffing.Results in 2013,the demand of community health staffing was about 1 7.18 million standard equivalents in Xicheng,while the supply was 10.5 12 million.The WISN ratio was 0.67 for community health supply and demand,in which the ratio of physicians was close to 1,while that of nurses and public health workers was far below 1.850 extra community health staff was needed to reach the total of 2 602 persons.Conclusion The demand and supply of community health service in Xicheng District was seriously unbalanced,a huge gap featuring overstaffing of nurses and inadequate public health workers.This results from the enhancement of primary public health services and rising utilization of community healthcare services in recent years,which deserves high attention from government of all levels,by increasing the staffing of community health staffing standards.

Clinical significance of single tidal breathing testing in bronchiolitis / 临床儿科杂志

Objective To study clinical signiifcance of single tidal breathing testing in bronchiolitis. Methods Infants with bronchiolitis at ifrst wheezing (bronchiolitis group, n=756), and 115 infants with bronchopneumonia (bronchopneumonia group) hospitalized were enrolled. Tidal breathing parameters were analyzed in two groups. Bronchiolitis group was divided according to percentiles of the fraction of exhaled time at peak tidal expiratory lfow to total expiratory time (TPTEF/TE). The episodes of recurrent wheezing of infants below the 20th or above the 80th percentile of TPTEF/TE were followed up by phone calls within 1 year after discharge from the hospital. Results There were signiifcant differences in TPTEF/TE, VPEF/VE, Ti, Ti/Te, TEF75 and TEF50 between bronchiolitis group and bronchopneumonia group. The recurrent wheezing rate of infants with bronchiolitis below the 20th percentile of TPTEF/TE was signiifcantly higher than that above the 80th percentile of TPTEF/TE (37.5%vs 11.3%). Conclusions There is the greater possibility of recurrent wheezing in the infants with the more serious airway obstruction relfected by single tidal breathing testing in bronchiolitis.

Impact analysis on the health management programs among community-based 0-36-month-olds on their growth and development / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the impact of implementation on health management programs among the community-based 0-36-month-olds regarding their growth and development.</p><p><b>METHODS</b>18 Monitoring Bodies in 8 pilot areas were selected to enroll this study, using a multistage stratified cluster sampling method. All the children aged 0 to 36 months were followed, according to the health management specification, and their health archives were collected.</p><p><b>RESULTS</b>A total of 13 464 children were involved in the specified management program with a total of 59 648 person-time under follow-up, with 54.26% of them were boys. Results from the multi-layer linear model indicated that the average height of children in the specified management group was higher than that in the non-standardized management group. Children in the specification management group, their weight gain had also been more effectively controlled. At the same time, with the increasing number of follow-ups according to the specification, the prevalence rates of under weight, stunt, emaciation and overweight were all significantly decreased (P < 0.05).</p><p><b>CONCLUSION</b>The implementation of the community-based programs on 0-36-month-olds regarding their health management specification had improved children's growth and development.</p>

Discussion on pathology experimental teaching reform of medical undergraduate students / 中华医学教育探索杂志

The traditional experimental teaching of pathology has defect in training the students' operating ability and mobilizing the initiative of students to observe.Pathology Department of North Sichuan Medical College has developed pathology specimens-making competition for undergraduate students.The students observed,chose and made specimens by themselves after sufficient review of the relevant pathology knowledge.The competition has mobilized the enthusiasm of students effectively and developed their operating ability.This form of teaching should become beneficial supplement to the experimental teaching of pathology.

Effects of corticotrophin-releasing factor on the Toll-like receptor 4/nuclear factor-rB signaling pathway in human intestinal epithelial cell line HT-29 / 中华消化杂志

Objective To investigate the effect of corticotrophin-releasing factor (CRF) on the regulation of Toll-like receptor 4/NF-κB signaling pathway expression in human intestinal epithelial cell line HT-29. Methods HT-29 cells were divided into four groups, normal control group, LPS group (LPS 20 μg/ml stimulated for 24 h), CRF group (CRF 20 ng/ml stimulated 24 h) and CRF+ LPS group (CRF incubated for 12 h then changed to LPS for another 12 h). After stimulation, the expression of TLR4 mRNA of each group was examined by reverse transcriptase polymerase chain reaction (RT-PCR). Total cell protein were extracted and the expression of TLR4 and NFκB p65 at protein level were detected by western blotting.Cell culture supernatant was collected and the secretion of interleukin-8 was detected by enzyme-linked immunoasorbent assay (ELISA). Results The expression of TLR4 in LPS group at mRNA and protein level were 0.31±0.04 and 0.48±0.17,there was no significant difference compared with normal control group (0.28±0.02 and 0.45±0.12,t＝0.216 and 0.712 , P＞0.05 ). In CRF group which were 1.05±0.06 and1. 08±0.21, significantly higher than normal control group (t＝3.721 and 3.802, P＜0.05). In CRF+LPS group which were 1.68±0.05 and 1.81±0. 18,significantly higher than CRF group (t＝4. 816 and 3. 918, P＜0.05).The results of NF-κB p65 expression at protein level and interleukin-8 expression of cell culture supernatant were consistent with the results of TLR4 expression at mRNA and protein level.Conclusion CRF not only activate TLR4/NF-κB signaling pathway in human intestinal epithelial cell,but enhance the reaction of intestinal epithelial cell to LPS as well, which resulting in increased interleukin-8 secretion.

A survey on training and satisfaction of staff working at community health-care service centers employing appropriate techniques on a trial basis in east and west China / 中华全科医师杂志

Objective A cross-sectional survey was conducted to investigate difference in job-related satisfaction indexes among staff working at community health-care service centers ( CHSC ) employing appropriate techniques on a trial basis between east and west areas of China. Methods In total, 339 staff members working at CHSC employing appropriate techniques on a trial basis, including good practice of community medical records management for hypertension , good practice of community case management for type 2 diabetes , good practice of community case management for tuberculosis , etc. , were recruited for questionnaire survey from Tianjin, Jinan and Shenzhen of east China and Chengdu and Chongqing in westChina by cluster sampling. Their demographic information, training for appropriate techniques and job-related satisfaction were collected. Results There was a significant difference in proportion of CHSC staff who receiving training for tuberculosis management launched by local government between west and east areas (34. 8% vs. 41. 4% , P <0. 05). There also was significant difference in satisfaction with the support from the superior sectors of government between west and east areas ( 59. 6% vs. 52. 0% , P = 0. 022 ) . Satisfaction towards income ranked the highest, and that towards work environment the lowest among the staff either in west or east areas. Conclusions Proportion of CHSC staff receiving training for tuberculosis and satisfaction with the support from superior sectors of government vary with communities in east and west areas employing appropriate techniques on a trial basis, and work condition of CHSC should be improved further.

The clinical application of dynamic monitoring of mainstream end-tidal carbon dioxide in neonatal respiratory distress syndrome / 中国实用护理杂志

Objective To study the clinical application of dynamic monitoring of mainstream endtidal carbon dioxide in neonatal respiratory distress syndrome.Methods All of 23 premature neonates diagnosed with NRDS and placed on mechanical ventilation were admitted in this study.Their PetCO_2 was continuously monitored and paired with PaCO_2 at 112 different time points.The correlation between PetCO_2and PaCO_2 was compared.Results This study showed that the average PaCO_2 measured for 112 times was(38.2±5.6)mm Hg(1 mm Hg=0.133kPa)and the corresponding PetCO_2 was,(32.4±4.9)mm Hg;it also showed that PetCO_2 was positively correlated with PaCO_2 and PetCO_2 was even more closely correlated with PaCO_2 in infants with second degree of NRDS than in patients with third and fourth degree of NRDS.Conclusions Dynamically monitoring mainstream PetCO_2 is applicable in mechanically ventilated premature infants with NRDS,it can accurately reflect the level of PaCO_2;Thereby reducing the blood gas analysis,thus reducing the suffering of nursing workload and children.But it has limited significance in cases of severe NRDS.