Analysis of the clinical characteristics of 8 cases of spontaneous intracranial hypotension / 中华全科医师杂志

Objective:To analyze the clinical characteristics of patients with spontaneous low intracranial pressure (SIH).Methods:The study is a retrospective series. The clinical data of patients with SIH who visited Beijing Hospital from May 2017 to March 2022, including gender, age, symptoms, signs, imaging findings, treatment and outcome, were collected and their clinical characteristics were analyzed.Results:Finally, 8 patients with SIH, 6 females and 2 males, aged (33.5±7.3) years, were included. There were 6 cases of acute onset, 1 case of subacute onset, and 1 case of chronic onset. Four cases had pre-onset triggers, 3 cases were exertional and 1 case was exercise. All 8 cases had orthostatic headache. Three cases were accompanied by neck pain. Six cases were accompanied by autonomic dysfunction, 1 case with blurred vision and neck resistance, and 1 case with tinnitus in both ears. There were no obvious abnormalities in blood routine, liver and kidney function, electrolytes, and coagulation function in 8 cases. The results of the lumbar puncture showed that the cerebrospinal fluid pressure was≤60 mmH 2O(1 mmH 2O=0.009 8 kPa) in 7 cases, and 2 cases were so low that they were undetectable. One patient had normal cerebrospinal fluid pressure (90 mmH 2O). The routine results of cerebrospinal fluid showed 4 cases of an increased number of red blood cells and 2 cases of leukocytosis. The biochemical results of cerebrospinal fluid in all 8 cases were normal. All 8 patients underwent non-contrast MRI scan of the head, and 6 cases found abnormalities, including 2 cases of subdural hematoma, 1 case of subarachnoid hemorrhage, 1 case of brain tissue sinking, and 3 cases of intracranial venous sinus dilation (including 1 case with subdural hematoma). All 8 patients underwent MRI enhancement scan of the head, and 5 patients showed diffuse dural enhancement. Three patients underwent digital subtraction angiography myelogram and computed tomography myelogram, and 2 cases found dural cerebrospinal fluid leakage. One patient underwent magnetic resonance water imaging and no cerebrospinal fluid leakage was found. Eight patients were followed up for 38.5 (10.3, 63.0) months, after conservative treatment, 6 cases of headache relief or disappearance, 1 case relapsed and was admitted 1 week after discharge, non-targeted epidural blood patching (EBP) did not relapse, 1 case underwent non-targeted EBP after conservative treatment failure, headache relief, recurrence after 2 months, thoracic spine 3-4 space targeted EBP, headache disappeared, did not recur. Conclusions:The present study indicate that SIH prevalence in young age is common, the main symptom is orthostatic headache, accommodated with multiple clinical symptoms with various imaging abnormalities. Most patients with SIH can be treated conservatively, if the effect is not good, non-targeted or targeted EBP is feasible.

Analysis of influencing factors and construction of predictive nomogram on 15-minute retention rate of indocyanine green in hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To analyze the influencing factors of abnormal 15-minute retention rate of indocyanine green (ICG R15) (≥10%) in patients with hepatocellular carcinoma, and to construct a nomogram model, and to evaluate the prediction efficiency of the nomogram model.Methods:The clinical data of 190 patients with hepatocellular carcinoma in Zhengzhou University People's Hospital from December 2017 to June 2022 were retrospectively analyzed, including 148 males and 42 females, aged (57.8±9.9) years. According to ICG R15, the patients were divided into ICG R15 normal group ( n=134, ICG R15<10%) and ICG R15 abnormal group ( n=56, ICG R15≥10%). Univariate and multivariate logistic regression were used to analyze the influencing factors of abnormal ICG R15, and the nomogram model was established. The predictive ability of the model was evaluated by receiver operating characteristic (ROC) curve and C-index, and the model was verified by calibration curve and decision analysis curve. Results:Abnormal ICG R15 group the proportion of liver cirrhosis, albumin ≤35 g/L, hemoglobin ≤110 g/L, platelet count ≤100×10 9/L, prothrombin time >13 s, alanine aminotransferase >40 U/L, aspartate aminotransferase >40 U/L, total bilirubin >34.2 μmol/L, and the largest tumor diameter >5.0 cm, spleen volume >383.1 cm 3, spleen volume to of non-tumor liver volume (SNLR) >0.276 and liver tumor volume >117.2 cm 3 were higher than that of ICG R15 normal group, and the differences were statistically significant (all P<0.05). Logistic regression analysis showed that liver cirrhosis ( OR=3.89, 95% CI: 1.28-11.80, P=0.016), spleen volume >383.1 cm 3( OR=5.17, 95% CI: 1.38-19.38, P=0.015), SNLR >0.276 ( OR=5.54, 95% CI: 1.44-21.26, P=0.013) and total bilirubin >34.2 μmol/L( OR=10.20, 95% CI: 1.88-55.39, P=0.007) increased the risk of abnormal ICG R15. A nomogram model was constructed based on the above risk factors. The C-index of the model was 0.915 (95% CI: 0.872-0.957), and the area under the ROC curve predicted by the nomogram model was 0.915 (95% CI: 0.871-0.958). The calibration curve showed that the correlation index of the abnormal ICG R15 predicted by the nomogram was similar to actual situation. Decision analysis curve showed high returns. Conclusion:Liver cirrhosis, spleen volume >383.1 cm 3, SNLR>0.276 and total bilirubin >34.2 μmol/L were indepentlent risk factors for abnormal ICG R15 in patients with hepatocellur carcinoma. The clinical prediction model of ICG R15 abnormality constructed by nomogram has good prediction efficiency, which can provide a reference for evaluating preoperative liver reserve function of patients with hepatocellular carcinoma.

A qualitative study of parental care experience in the process of hematopoietic stem cell transplantation in children with hematological diseases / 中国实用护理杂志

Objective:To use the interpretative phenomenological analysis method of qualitative research to deeply explore the parental care experience in the process of hematopoietic stem cell transplantation in children with hematological diseases.Methods:Through the semi-structured in-depth interview method, we interviewed 10 pairs (20 persons) parents of children receiving hematopoietic stem cell transplantation in Shanghai Children′s Medical Center from October 2019 to August 2020; And the contents of the interview were recorded and transcribed. The transcription data is analyzed according to the interpretive phenomenological analysis method.Results:The parents′ care experience in the process of hematopoietic stem cell transplantation in children with hematological diseases can be summarized into three themes: the emotional changes in the process of transplantation, the dilemma experienced in the process of care, and the personal growth experienced in the process of caring for the child.Conclusion:Understanding the parents′ care experience during the children′s transplantation process can help us to present the family caregivers′ living status, psychological pressure, and coping strategies and resources, and provide guidance for family-focused supportive interventions.

Serum mitochondrial tsRNA serves as a novel biomarker for hepatocarcinoma diagnosis / 医学前沿

Hepatocellular carcinoma (HCC), which makes up the majority of liver cancer, is induced by the infection of hepatitis B/C virus. Biomarkers are needed to facilitate the early detection of HCC, which is often diagnosed too late for effective therapy. The tRNA-derived small RNAs (tsRNAs) play vital roles in tumorigenesis and are stable in circulation. However, the diagnostic values and biological functions of circulating tsRNAs, especially for HCC, are still unknown. In this study, we first utilized RNA sequencing followed by quantitative reverse-transcription PCR to analyze tsRNA signatures in HCC serum. We identified tRF-Gln-TTG-006, which was remarkably upregulated in HCC serum (training cohort: 24 HCC patients vs. 24 healthy controls). In the validation stage, we found that tRF-Gln-TTG-006 signature could distinguish HCC cases from healthy subjects with high sensitivity (80.4%) and specificity (79.4%) even in the early stage (Stage I: sensitivity, 79.0%; specificity, 74.8%; 155 healthy controls vs. 153 HCC patients from two cohorts). Moreover, in vitro studies indicated that circulating tRF-Gln-TTG-006 was released from tumor cells, and its biological function was predicted by bioinformatics assay and validated by colony formation and apoptosis assays. In summary, our study demonstrated that serum tsRNA signature may serve as a novel biomarker of HCC.

Paternal environmental exposure-induced spermatozoal small noncoding RNA alteration meditates the intergenerational epigenetic inheritance of multiple diseases / 医学前沿

Studies of human and mammalian have revealed that environmental exposure can affect paternal health conditions as well as those of the offspring. However, studies that explore the mechanisms that meditate this transmission are rare. Recently, small noncoding RNAs (sncRNAs) in sperm have seemed crucial to this transmission due to their alteration in sperm in response to environmental exposure, and the methodology of microinjection of isolated total RNA or sncRNAs or synthetically identified sncRNAs gradually lifted the veil of sncRNA regulation during intergenerational inheritance along the male line. Hence, by reviewing relevant literature, this study intends to answer the following research concepts: (1) paternal environmental factors that can be passed on to offspring and are attributed to spermatozoal sncRNAs, (2) potential role of paternal spermatozoal sncRNAs during the intergenerational inheritance process, and (3) the potential mechanism by which spermatozoal sncRNAs meditate intergenerational inheritance. In summary, increased attention highlights the hidden wonder of spermatozoal sncRNAs during intergenerational inheritance. Therefore, in the future, more studies should focus on the origin of RNA alteration, the target of RNA regulation, and how sncRNA regulation during embryonic development can be sustained even in adult offspring.

A Case Report of AFP-producing Primary Lung Squamous Cell Carcinoma with Significant Therapeutic Effect / 中国肺癌杂志

BACKGROUND@#Primary lung squamous carcinoma that produces alpha-fetoprotein (AFP) is rare and only four related cases have been reported so far. The specific reasons for elevated serum level of AFP and effective treatment regimens for AFP-producing lung squamous carcinoma are not clear. This paper reports the diagnosis and treatment of AFP-producing lung squamous carcinoma so as to provide some references for similar cases in clinical practice.@*METHODS@#The diagnosis and treatment of an AFP-producing lung squamous carcinoma patient admitted to the Shandong Cancer Hospital on October 23, 2020 was retrospectively analyzed, and literatures were reviewed.@*RESULTS@#A 52-year-old male patient was diagnosed as T4N3M0 stage, IIIc right upper lobe lung squamous cell carcinoma with mediastinal lymph node metastasis and multiple metastases in the lung. The main tumor marker was abnormally increased serum AFP. After the rapid progression of two lines chemotherapy, the patient was given anlotinib combined with carrizumab as third-line treatment. The efficacy evaluation reached to partial response (PR) and stable disease (SD) after 2 and 4 cycles of treatment, respectively. The treatment regimen was replaced with albumin paclitaxel plus carrizumab due to gastrointestinal bleeding after the fifth cycle. The patient's condition was under continuous control.@*CONCLUSIONS@#The AFP-producing lung squamous carcinoma patient had a good response to anlotinib and immunotherapy in the case report, which may provide some guidances for the clinical practice and the research on AFP-producing lung squamous carcinoma.

Clinical application of noninvasive high frequency oscillatory ventilation and heated humidified high flow nasal cannula in sequential ventilator evacuation of premature infants with respiratory distress syndrome / 中国小儿急救医学

Objective:To investigate the clinical application of noninvasive high frequency oscillatory ventilation(nHFOV)and heated humidified high flow nasal cannula(HHHFNC)in sequential ventilator evacuation of preterm infants with very low birth weight with respiratory distress syndrome(RDS).Methods:A total of 88 preterm infants of very low birth weight with RDS were enrolled in the study, who had received endotracheal intubation invasive ventilation and were ready to be replaced by non-invasive ventilation at neonatal intensive care unit(NICU)of Xuzhou Central Hospital from May 2017 to January 2020.All premature infants were routinely treated with caffeine citrate.They were divided into two groups through random number table: nHFOV/HHHFNC group(45 cases)and continuous positive airway pressure(nCPAP)/oxygen hood group(43 cases). nHFOV was given after invasive ventilator removal and HHHFNC transition was followed after nHFOV withdrawal in the nHFOV/HHHFNC group, while nCPAP was given after invasive ventilator removal and oxygen hood was followed after nCPAP withdrawal in the nCPAP/oxygen hood group.The main observation consequences were compared with arterial blood gas indexes after invasive ventilator evacuation, weaning effect and the incidence of related complications.Results:(1)There were no statistically differences between the two groups in terms of gender, gestational age, birth weight, Apgar score at 1 min and 5 min after birth, the number of glucocorticoid usage in 24 h before delivery, the number of pulmonary surfactant usage, invasive ventilation time and RDS grading( P>0.05). (2)The PaO 2, PaCO 2and oxygenation index(OI=100×MAP×FiO 2/PaO 2)of the nHFOV/HHHFNC group at 1 h and 24 h after invasive ventilator removal showed significant difference compared with the nCPAP/oxygen hood group( P<0.05). The differences as the following listed were statistically significant( P<0.05)between the two groups, including the failure rate of invasive ventilation weaning during 72 h [9%(4/45)vs.26%(11/43)], the incidence of frequent apnea [7%(3/45)vs.23%(10/43)], the failure rate of nHFOV and nCPAP noninvasive ventilation weaning [4%(2/45)vs.21%(9/43)], the oxygen-used time [12.02(9.08~12.31)d vs.14.44(11.32~13.26)d] and the incidence of nasal injury [4%(2/45)vs.26%(11/43)]. (3)The time of the first noninvasive ventilation of nHFOV and nCPAP, the incidences of lung air leakage, neonatal necrotizing enterocolitis, grade Ⅲ to Ⅳ intraventricular hemorrhage, above stageⅡretinopathy, bronchopulmonary dysplasia and the mortality rate between the two groups showed no statistical significance( P>0.05). Conclusion:nHFOV and HHHFNC used in the sequential ventilator evacuation of RDS in preterm infants with very low birth weight could improve oxygenation, reduce CO 2retention, improve the success rate of machine weaning and reduce the occurrence of apnea and nasal injury.

Systematic review and Meta-analysis of qualitative research on caregivers′ experience in patients with hematopoietic stem cell transplantation / 中国实用护理杂志

Objective:To systematically evaluate the real experience of caregivers in patients with hematopoietic stem cell transplantation.Methods:The Cochrane Library, PubMed, Scopus, Web of Science, PsycINFO, CBM, CNKI, VIP, and Wan Fang Data were searched for qualitative studies on caregivers' experience of hematopoietic stem cell transplant patients. The time limit for the search was from inception to June 2019. The results were assessed using a pooled integration approach using the Australian JBI Evidence-Based Health Care Center (2016) Quality Evaluation Standards Evaluation.Results:A total of 6 studies were included to refine 27 complete and definitive findings, and similar results were grouped into 8 new categories and integrated into 5 integrated results: the physical and mental experience of the caregiver, dilemmas and needs, caregivers′ coping style, social support in the care process, caregiver adaptation and growth.Conclusion:Medical staff should pay attention to the psychological state and potential needs of this group. In the process of transplantation, the caregiver should be self-regulated and better qualified as a caregiver.

Myopathy associated with anti-signal recognition peptide antibodies: Five case reports / 中南大学学报(医学版)

Five patients with myopathy associated with anti-signal recognition peptide antibodies, admitted to our hospital from December 2015 to June 2018, were chosen in our study, and their clinical and pathological manifestations and treatments were retrospectively analyzed. Five patients showed subacute or chronic onset and proximal limb muscle weakness. Serum creatine kinase level was significantly elevated. Immunoblotting assay confirmed the positive anti-signal recognition particle antibody. EMG prompted myogenic damage. Pathological features included muscle degeneration, necrosis with regeneration, visible atrophy and hypertrophic of muscle fiber, connective tissue hyperplasia and a small amount of inflammatory cell infiltration. Immunohistochemical staining showed necrotizing muscle fiber infiltrated with CD4-positive and CD8-positive lymphocytes and CD68-positive macrophages, and no CD20-positive lymphocytes and CD303-positive dendritic cells were observed. Two patients had expressed a bit of c5b-9 positive capillary. Anti-sarcoglycans staining, anti-dysferlin staining and dystrophin staining showed continuous strong positive expression. Follow-up study found that all patients were response to glucocorticoid, and a combination therapy of immunoglobulin and immunosuppression were necessary for some patients.

Application of autologous succus entericus reinfusion after enterostomy in neonate / 中华临床营养杂志

Objective To evaluate the application way and value of autologous succus entericus reinfusion in neonatal enterostomy.Methods Clinical data from 109 neonatal patients receiving enterostomy in Children's Hospital of Nanjing Medical University from January 2010 to December 2017 were retrospectively analyzed.The neonatal patients were divided into two groups according to whether succus entericus reinfusion conducted as succus entericus reinfusion group (63 neonatal patients) and control group (46 neonatal patients).The 90-day weight gain of the neonatal patients,age of the second stage enterostomy closure,cessation of intravenous infusion time after operation and the rate of re-admission before the second stage enterostomy closure were collected.Results The distance between enterostomy mouth and the Treitz ligament was 80-120 cm in all the children patients,and there was no significant difference between the two groups (P=0.42).The succus entericus reinfusion group was superior to the control group in the weight gain of 90 days after birth (single lumen group vs.single lumen control group:[1.97±0.55] vs.[1.50±0.57] kg,P=0.017;double lumens group vs.double lumenscontrol group:[1.82±0.49] vs.[1.48±0.65] kg,P=0.013),age of the second stage enterostomy closure (single lumen group vs.single lumen control group:[115.76± 15.85] vs.[117.40 ± 11.06] d,P =0.025;double lumens group vs.double lumens control group:[115.48± 14.33] vs.[126.03±8.85] d,P=0.001),cessation of intravenous infusion time after operation (single lumen group vs.single lumen control group:[14.24±3.30] vs.[16.40±2.74] d,P=0.046;double lumens group vs.double lumens control group:[15.07±3.65] vs.[18.71±3.63] d,P＜0.01),and the rate of re-admission before the second stage enterostomy closure (single lumen group vs.single lumen control group:9.5％ [2/21] vs.20％ [3/15],P=0.337;double lumens group vs.double lumens control group:7.1％ [3/42] vs.25.8％ [8/31],P =0.028).Conclusion Autologous succus entericus reinfusion can improve the absorption of nutrients after the operation of small intestinal stoma,improve the function of the distal enteral tube,and create conditions for the early recovery of intestinal continuity.

Atractylenolide I regulates proliferation and invasion of lung cancer A549 cells through the TLR4/MyD88 pathway / 实用肿瘤学杂志

Objective The objective of this study was to investigate the role and molecular mechanism of AtractylenolideⅠin the progression of lung cancer. Methods qRT-qPCR and immunohistochemistry were used to detect the expression of TLR4 and MyD88 at levels of mRNA and protein in lung cancer and adjacent tissues. Transwell and MTT assays were used to detect effects of at-ractylenolide I(100 μM)on the invasion,migration and proliferation of A549 cells. Western blot was also used to detect the effect of atractylenolide I on the expression of TLR4 and MyD88 proteins. Results The expression of TLR4 and MyD88 at levels of mRNA and protein was highly expressed in lung cancer tissues when compared to adjacent tissues(P<0. 05). Compared with the control group,the invasion ability of A549 cells in the Atractylenolide I group was significantly decreased,and the proliferative activity was in-hibited(P<0. 05). Atractylenolide I inhibited the expression of TLR4 and MyD88 protein in A549 cells( P<0. 05). Conclusion

Relationship between coronary tortuosity and coronary microvascular disease / 中华心血管病杂志

Objective@#To explore the relationship between coronary tortuosity and coronary microvascular disease (CMVD).@*Methods@#Patients with typical angina symptoms and without serious coronary artery stenosis by coronary angiography were enrolled from June 2014 to December 2016, and CMVD was diagnosed by single photon emission tomography (SPECT). According to the SPECT results, patients were divided to the CMVD group and non-CMVD group. The baseline clinical characteristics, results of coronary angiography were compared between the two groups. The logistic analysis was used to analyze the relationship between coronary tortuosity and CMVD.@*Result@#A total of 117 cases were enrolled, with 69 cases in the CMVD group and 48 cases in the non-CMVD group. No differences were found in gender distribution, age, hypertension, lipid abnormality, hyperuricemia and uses of statins between the two groups (all P>0.05). Incidence of diabetes (78.26%(54/69) vs. 35.42% (17/48) , P<0.05), hs-CRP ((4.29±2.15)mmol/L vs. (2.63±1.20)mmol/L, P<0.001), LDL-C ((2.98±0.96)mmol/L vs. (2.52±0.83)mmol/L, P=0.008) and homocysteine ((13.7±5.61)mmol/L vs. (11.5±4.38)mmol/L, P=0.025) levels were higher in the CMVD group than in the non-CMVD group. The data derived from echocardiographic examination were similar between the two groups. The Corrected TIMI frame counts were higher in the CMVD group than in non-CMVD group (LAD: 31.56±4.92 vs. 27.31±3.75, LCX: 29.47±4.18 vs. 26.62±3.19, RCA: 29.09±5.05 vs. 26.24±3.28, all P<0.001). The incidences of coronary atherosclerosis (76.81% (53/69) vs. 27.08% (13/48) , P<0.001) and coronary tortuosity ( (60.87% (42/69) vs. 33.33% (16/48) , P=0.035) were also higher in the CMVD group than in non-CMVD group. Logistic analysis found that coronary tortuosity (OR=6.111, 95%CI 2.707-13.794, P<0.001), diabetes (OR=6.565, 95%CI 2.883-14.948, P<0.001) and coronary atherosclerosis (OR=8.918, 95%CI 3.822-20.808, P<0.001) were independent risk factors of CMVD.@*Conclusion@#Coronary tortuosity, diabetes and coronary atherosclerosis are related to CMVD in this patient cohort.

Analysis of unmet supportive care needs in patients with thyroid cancer during 13I treatment / 中华核医学与分子影像杂志

Objective To investigate the unmet needs of thyroid cancer patients undergoing 131Itreatment and their relationship with psychological distress and quality of life.Methods From October 2014 to March 2016,a total of 338 patients (106 males,232 females,average age (35.50±9.98) years) with thyroid cancer who were receiving 131I treatment were enrolled.The 34 items of Supportive Care Needs Survey Short Form (SNCS-SF34) were used to investigate the unmet care needs of patients.Patients' perceptions of distress and main causes of distress were measured by Distress Thermometers (DT) and issue list.The 12-item Short-Form Health Survey (SF-12) was used to measure patients' quality of life.Pearson correlation analysis was used to analyze the data.Results The degrees of patients' unmet care needs from high to low were as following:health information needs (65.38％,221/338),psychological needs (47.93％,162/338),patients' care and support needs (44.08％,149/338),physical and daily needs (36.09％,122/338) and sexual needs (34.32％,116/338).There were 47.93％(162/388) patients with DT score ＞ 4.The top three causes of patients' distress were fears,fatigue and memory deterioration.Degree of unmet needs for patients had positive correlation with the degree of psychological distress (r values:0.232-0.462,all P＜0.01).The unmet physiological and daily needs and psychological needs of patients had negative correlations with several dimensions of quality of life (r values:from-0.367 to-0.202,all P＜ 0.05).Conclusions The unmet care needs of patients with thyroid cancer have correlations with their psychological distress and quality of life.Evaluation of the unmet care needs of patients with thyroid cancer could be beneficial for providing the targeted care.

Expressions of microRNA-127-5p in bronchoalveolar lavage fluid of patients with severe pneumonia and its diagnostic value / 中华危重病急救医学

Objective To observe differential expressions of microRNA-127-5p (miR-127-5p) in bronchoalveolar lavage fluid (BALF) of patients with severe pneumonia and the value of miR-127-5p in the diagnosis of severe pneumonia. Methods Thirty severe pneumonia patients and 10 non-respiratory infection patients who needed mechanical ventilation after surgery admitted to Department of Critical Care Medicine of General Hospital of Ningxia Medical University from January to December in 2015 were enrolled, whose specimens of BALF were collected. The differential expressions of miRNA in BALF of patients in both groups were screened by miRNA chip technique to preliminarily establish miRNA differential expression profiles in BALF of severe pneumonia, and the miRNAs which were up-regulated and down-regulated were screened out. The expression levels of miR-127-5p were determined using a real-time fluorescent quantitative polymerase chain reaction (PCR). The value of miR-127-5p expression in the diagnosis of severe pneumonia was evaluated with receiver-operating characteristic curve (ROC). Results All of the 40 patients were enrolled in the final analysis. Differential expression spectrum of miRNA in severe pneumonia patients was initially built, in which 40 miRNAs were up-regulated and 113 miRNAs were down-regulated. Compared with non-respiratory infection patients, the expressions of miR-127-5p were significantly lowered in severe pneumonia patients (2-ΔΔCT: 0.578±0.226 vs. 1.004±0.337) with statistical difference (t = 4.552, P = 0.000). ROC curve analysis showed that the area under ROC curve (AUC) of miR-127-5p for diagnosis of severe pneumonia was 0.855 [95% confidence interval (95%CI) = 0.721-0.989, P = 0.001], with the optimal sensitivity and specificity of 86.7%and 70.0% respectively with 0.840 as the critical value, and the positive likelihood ratio was 2.89, the negative likelihood ratio was 0.19. Conclusion miR-127-5p in BALF could be used as a new biomarker for the diagnosis of severe pneumonia.

Impact of Ticagrelor on Myocardial Microcirculation in Patients of Non-ST Elevation Myocardial Infarction After Percutaneous Coronary Intervention / 中国循环杂志

Objective: To explore the impact of ticagrelor on myocardial microcirculation in patients of non-ST elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI). Methods: A total of 80 NSTEMI patients treated in our hospital from 2015-03 to 2015-12 were enrolled. All patients received coronary angiography (CAG) and PCI, they were randomly divided into 2 groups: ticagrelor (TA) group and clopidogrel (CA) group, n=40 in each group. The baseline condition, PCI related parameters, plasma levels of SOD, MDA at pre- and 24h, 72h post-PCI were compared, the incidence of major adverse cardiac events (MACE) within 30 days after PCI was also compared between 2 groups. Results: The baseline condition, proportion of infarction-related vessels, average length and diameter of implanted stents were similar between 2 groups, all P>0.05. Compared with CA group, TA group had the less post-operative CTFC in LAD and RCA, P0.05. The ratios of acute pre-operative, post-operative TIMI grade 3 and slow flow incidence were similar between 2 groups, P>0.05. The peak values of CK-MB and cTnI in TA group were lower than CA group, P<0.05. Compared with baseline condition, MDA levels at 24h and 72h post-operation were increased in both groups, all P<0.001; compared with CA group, TA group had the lower MDA level at 24h post-operation, P=0.023, MAD was further reduced at 72h post-operation in TA group, P=0.043. Compared with baseline condition, SOD levels at 24h and 72h post-operation were decreased in both groups, all P<0.001; compared with CA group, TA group had the higher SOD level at 24h post-operation, P=0.013, SOD was elevated at 72h post-operation in both groups, the elevation was more obvious in TA group, P=0.049. The incidence of MACE was similar between 2 groups within 30 days of PCI,. Conclusion: Ticagrelor could improve myocardial microcirculation in NSTEMI patients after PCI; it was safe and without obvious adverse effects.

The effect of biomechanis with different bone density by the pedicle screws fixation / 重庆医学

Objective To explore the biomechanis with different bone density by the pedicle screws fixation before and after fatigue test.Thus provide biomechanical basis for the clinical work.Methods A total of 27 fresh lumbar vertebrae samples of adult sheep (L1-L5) were equally divided into three groups,such as group A of decalcified with HCL 0 h,group B of decalcified with HCL 2 h and group C of decalcified with HCL 4 h,by using the random number table method,every groups was 9 models.Four screws was performed on the L4-L5 pedicle of vertebral arch of the three groups.Three groups were performed fatigue test of 250 000 times in 4 direction (flexion,extension,left lateral bending,right lateral bending) by (300+ 105) N load.The range of motion(ROM),the axial compressive stiffness were measured and the results in every group were compared before and after fatigue test.Results After fatigue test,ROM and the axial compressive stiffness had no significant change in group A (P＞0.05),but ROM of B group and C group were both increased and the axial compressive stiffness were decreased,Significance was found with and between groups.Conclusion The stability of people who are performed pedicle screws simplly may be decrease when the spine of osteopenia.

A qualitative study on the experience of thyroid cancer patients about diagnosis and post-surgical radioactive iodine treatment / 中国实用护理杂志

Objective To explore the experience of thyroid cancer patients about the diagnosis and post-surgical radioactive iodine treatment. Methods A qualitative, descriptive study was used. Thirty-eight patients with thyroid cancer who were undergoing post-surgical radioactive iodine treatment participated in this study. Dairies about the participants′ experience were collected from them. Interpretative phenomenological analysis was used. Results Three superordinate themes emerged: the psychological process from distress to acceptance; the experience about post-surgical radioactive iodine treatment; and personal growth related to the cancer. Conclusions Understanding the psychological process of patients with thyroid cancer after the diagnosis and their experience about post-surgical radioactive iodine treatment can contribute to the clinical staff to improve the care quality for this group.

Analysis on the results of foodborne disease surveillance in Baiyin City, Gansu Province, 2015 / 中国食品卫生杂志

Objective The aim of this study was to analyze of the prevalence of Norovirus in the foodborne disease surveillance population in Baiyin City in 2015,and provide scientific basis for the prediction,early warning,prevention and control of foodborne diseases caused by Norovirus.Methods A questionnaire survey was conducted on the cases of foodborne disease surveillance.Fecal specimen were collected,and Norovirus GⅠ and GⅡ were detected by real time fluorescence quantitative polymerase chain reaction.Results Three hundred and forty-four foodborne disease cases were reported,78 cases were positive,and the detection rate was 22.7％.Five cases were positive for Norovirus GⅠ,and 71 cases for GⅡ.Two cases were positive for both GⅠ and GⅡ.Forty-six cases were male and 32 cases were female.The oldest patient was 83 years old,and the youngest was only 3 months with an average age of 20.3.Conclusion Norovirus was one of the main foodborne pathogens in the city,and the main epidemic was GⅡ in autumn and winter.Public education and health monitoring should be strengthened.

Decision-making process of changing major for medical students in a comprehensive university: a qualitative study / 中华医学教育探索杂志

Objective To explore the decision-making process of medical students who turned the major from the medicine to other majors,and the related factors that hindered them continuing to study the medicine.Methods According to the design of interpretative phenomenon logical analysis,semi-structured in-depth interviews were used to collect the data.Participants were six undergraduate students who had moved from medical major to another major.Interviews were recorded on audio-tape with the students' permission and then transcribed verbatim.The transcribed interviews were analyzed according to six steps of interpretative phenomenological analysis.Results Even if the participants had left the medical major,they still expressed a strong sense of professional identity for the doctor.However,they also admitted that the professional process of medicine students was very hard and tired,and couldn't get the equal return for their payment.They thus were lack of confidence for the future.Some of the participants talked about the fact that they had been curious about the future of medical students.Internet and seniors were the main avenues for obtaining job-related information,but they were often plagued by the negative information.Education about career adaptation should be carried out as soon as possible,to strengthen the professional identity of medical students,and enhance their ability to defend against negative information,which could help to deal with the status of high turnover rate for medical students.Conclusion Based on the students' perspective,exploring the decision-making process of turning major for medical students will contribute to the educators taking effective strategies to improve the students' career identity,stabilize their professional thought,and reduce the loss of the medical students.

Clinical study of combination treatment with Clofazimine and others for patients with multidrug-resistant tuberculosis / 中国生化药物杂志

Objective To evaluate the clinical efficacy and safety of combination treatment with clofazimine ( Cfz ) and other antituberculosis drugs for patients with multidrug-resistant tuberculosis(MDR-TB).Methods 32 cases of MDR-TB patients were treated with combination regimens that included clofaziminefrom October 2011 to September 2016 in our hospitol,according to the history of drug use and drug susceptibility test results using individualized chemotherapy,the starting dose of clofazimine was 0.1 g/day,oral,some patients with adverse reactions and tolerance adjusted to 0.05 g/day,treatment for the last 12 months for three consecutive sputum mycobacterium tuberculosis culture and sputum smear acid-fast bacilli were cured,observe the clinical efficacy and safety.Results After treatment with the combined regimen,56.2%(18/32) of patients were cured,43.8%(14/32) of patients failed treatment, there was no statistically significant difference in the number of drug-resistant patients before and after CFZ treatment,there was no statistically significant difference between the time of failure and the time of CFZ treatment,after taking CFZ combined with anti-tuberculosis program,the number of drug users was statistically significant of patients cured and failed (P<0.05).The average time of sputum culture inversion was 16w.90.6% (29/32) of patients with adverse reactions,mainly including skin color change,ichthyosis and gastrointestinal tract and other adverse reactions, through dose adjustment and symptomatic treatment to continue treatment.The average duration of treatment with clofazimine was about 13 months.ConclusionClofazimine was welltolerated,combination treatment with Clofazimine and others for patients with MDR-TBhave better efficacy .