Establishment of an indicator system for schistosomiasis transmission risk assessment after transmission interruption in Hubei Province based on the Delphi method / 中国血吸虫病防治杂志

Objective To establish an indicator system for assessment of schistosomiasis transmission risk after transmission interruption in Hubei Province, so as to provide insights into the precise control of schistosomiasis. Methods The indicator system was preliminarily established based on data collection, literature review, expert interviews. Two rounds of expert consultation were performed. The indicator system was screened based on the importance, operability, sensitivity and comprehensive score of the indicators, and the weights of each indicator were calculated. The credibility of the Delphi method was evaluated by calculating the active coefficient of the experts, degree of expert authority and coordination levels of experts’ opinions. Results An indicator system for assessment of schistosomiasis transmission risk was preliminarily established, including 3 primary indicators, 12 secondary indicators and 44 tertiary indicators. A Delphi consultation was performed among 17 experts participating in schistosomiasis control, management and research. Following two rounds of consultation, a risk assessment indicator system was finally constructed, including 3 primary indicators, 10 secondary indicators and 35 tertiary indicators. Among the primary indicators, the variable with the highest normalized weight was the current status of schistosomiasis (0.420 2), followed by social factors (0.397 3) and natural environments (0.182 5). Among the secondary indicators, those with high combined weights included risk monitoring (0.142 3), current snail status (0.140 1), and current prevalence of human and livestock infections (0.137 8). Among the tertiary indicators, those with high combined weights included the positive rate of wild feces (0.049 8), the prevalence of snail infections (0.047 4), and the area of snail habitats submerged by floods (0.046 8). During the two-round consultation, the active coefficients of the experts were 85.00% and 100.00%, the degree of expert authority was both 0.75 and greater, and the coordination levels of experts’ opinions were 0.405 to 0.521 and 0.592 to 0.695 (all P values < 0.05). Conclusion An indicator system for assessment of schistosomiasis transmission risk is successfully established after transmission interruption in Hubei Province based on the Delphi method, which provides insights into the identification of the schistosomiasis transmission risk and the targets for schistosomiasis control in Hubei Province.

External and Internal Validation of a Computer Assisted Diagnostic Model for Detecting Multi-Organ Mass Lesions in CT images / 中国医学科学杂志(英文版)

Objective We developed a universal lesion detector (ULDor) which showed good performance in in-lab experiments. The study aims to evaluate the performance and its ability to generalize in clinical setting via both external and internal validation. Methods The ULDor system consists of a convolutional neural network (CNN) trained on around 80K lesion annotations from about 12K CT studies in the DeepLesion dataset and 5 other public organ-specific datasets. During the validation process, the test sets include two parts: the external validation dataset which was comprised of 164 sets of non-contrasted chest and upper abdomen CT scans from a comprehensive hospital, and the internal validation dataset which was comprised of 187 sets of low-dose helical CT scans from the National Lung Screening Trial (NLST). We ran the model on the two test sets to output lesion detection. Three board-certified radiologists read the CT scans and verified the detection results of ULDor. We used positive predictive value (PPV) and sensitivity to evaluate the performance of the model in detecting space-occupying lesions at all extra-pulmonary organs visualized on CT images, including liver, kidney, pancreas, adrenal, spleen, esophagus, thyroid, lymph nodes, body wall, thoracic spine,

Administrative village-based spatial distribution specificity of Oncomelania hupensis and its relationship with water systems in Hubei Province / 中国血吸虫病防治杂志

Objective To investigate the spatial distribution of Oncomelania hupensis snail habitats at the administrative village scale in schistosomiasis-endemic areas of Hubei Province, so as to provide scientific bases for precise control of O. hupensis snails in the province. Methods Data regarding snail distribution at the village level in Hubei Province in 2017 were collected to create a spatial analysis database of snail distribution in Hubei Province. The spatial aggregations of O. hupensis distribution were analyzed using Moran’s I index and Local Moran’s I index. In addition, the distances from schistosomiasis-endemic villages to the Yangtze River were captured using the software ArcGIS 13.0, and their correlations with area of snail habitats were examined with the Spearman correlation method. Results O. hupensis snails were mainly distributed in 5 450 endemic villages from 63 counties of 13 cities in Hubei Province in 2017. The global spatial autocorrelation analysis showed spatial aggregations in the areas of historically accumulated snail habitats, current areas of snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment (all Z Scores > 0, all P values < 0.05), and no spatial aggregation was seen in the areas of snail habitats in hilly areas (Z Score > 0, P > 0.05). There were four types of spatial distribution of historically accumulated areas of snail habitats, areas of current snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment, including the high-high type (H-H type), high-low type (H-L type), low-high type (L-H type) and random distribution type, and a high percentage of the H-H type was found. There were 340, 125 and 110 endemic villages with the H-H type of areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment, and these villages were mainly concentrated in Wuhan and Jingzhou cities, with almost consistent spatial aggregation locations. There were 319 endemic villages with the H-H type of distribution of snail habitats inside the embankment, which were mainly distributed in Jingzhou, Xiaogan and Huangshi cities. In addition, the areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment negatively correlated with the distance from the endemic villages to the Yangtze River (r = −0.094, P < 0.01; r = −0.225, P < 0.01; r = −0.177, P < 0.01). Conclusion The clustering areas of snail habitats along the Yangtze River Basin, notably the villages near the Yangtze River are key regions for snail monitoring and control in Hubei Province.

Advance in Rehabilitation Effects for Individualized Exercise Prescription on Cardiovascular Disease (review) / 中国康复理论与实践

Currently, individualized exercise prescription plays a vital role in the cardiac rehabilitation of patients with chronic cardiovascular diseases. Many cardiopulmonary exercise tests proved that individualized exercise prescription can lower blood pressure and glucose of patients with cardiovascular diseases, improve cardiopulmonary function, and improve exercise endurance and quality of life. At the same time, this paper also summarized that the individualized exercise prescription should be formulated in compliance with the principle (individuality, effectiveness, safety, professionalization, comprehensiveness and permanence), exercise intensity evaluation method (from previous heart rate, fatigue grading methods into cardiopulmonary exercise test) and the contents of the individualized exercise prescription (with a focus on the exercise intensity formulation).

Effect of Exercise on Blood Lipid for Patients with Type 2 Diabetes: A Network Meta-analysis / 中国康复理论与实践

Objective:To evaluate the effects of aerobic exercise, resistance exercise, and aerobic combined resistance exercise (combined exercise) on blood lipids for patients with type 2 diabetes with network meta-analysis, to develop exercise prescription. Methods:Randomized controlled trials (RCTs) about the above exercises for blood lipid in patients with type 2 diabetes were searched in databases of PubMed, Ovid, Web of Science, Cochrane Library, Springer Link, Science Direct, CNKI, Wanfang data and CBM, and were supplied by retrospective references. After evaluating the methodological quality of the RCTs, the data were analyzed with R-Studio, Stata 14.0 and Review Manager 5.3. Results:A total of 21 RCTs were recalled, with 1735 patients. Two poor quality literatures were excluded based on sensitivity analysis. Compared with the control group, all three kinds of exercise significantly reduced the level of fasting glucose, total cholesterol, triglyceride, low density lipoprotein, increased the level of high density lipoprotein, with good homogeneity. Rank probability graph showed that the combined exercise was the best for fasting glucose, total cholesterol triglyceride and high density lipoprotein, while aerobic exercise was the best for low density lipoprotein. Conclusion:It is the best to select the combined exercise to improve fasting glucose, total cholesterol, triglycerides and high density lipoprotein, and aerobic exercise for low density lipoprotein.

Characteristics as well as prevention and control costs of occupational ex-posure to blood-borne pathogens / 中国感染控制杂志

Objective To study the characteristics of occupational exposure to blood-borne pathogens and the cost of prevention and control,and provide evidence for policy making in medical institutions.Methods A prospective study was conducted to collect the data and follow-up data about occupational exposure of health care workers(HC-Ws)from the occupational exposure reporting system of a hospital between June 1,2016 and May 30,2017.Results There were 95 cases of occupational exposure to blood-borne pathogens.Occupational exposure occurred mainly in June,July,and November,peak time for occurrence was 12∶00 at noon.The main occupations of HCWs who sustained occupational exposure were nurses (41.05%),doctors (28.42%),and practice nurses (15.79%).The main departments of occupational exposure were central operating room (21.05%), emergency department (1 1.58%),and interventional radiology department (6.32%).The total cost of prevention and control for 95 times of occupational exposures were 33 235.20 Yuan,with an average of 349.84 Yuan per case.The average cost per case after human immunodeficiency virus (HIV)exposure was the highest (2 787.50 Yuan);and cost of syphilis exposure was the lowest (58.88 Yuan).Conclusion It is necessary to strengthen the training and education of high-risk time,high-risk population,and high-risk departments of occupational exposure to blood-borne pathogens,pre-vention of occupational exposure with high cost of prevention and control such as HIV should be especially paid attention.

A multi-center study on cost-effectiveness of prevention and control of ventilator-associated pneumonia in tertiary comprehensive hospitals in Jiangsu Province / 中国感染控制杂志

Objective To explore the cost-effectiveness of infection prevention and control of ventilator-associated pneumonia(VAP).Methods 12 hospitals in Jiangsu Province were chosen, a1∶1 matched case-control multicenter study was adopted.The rate difference was calculated by Meta analysis.Results A total of 255 cases and controls were enrolled in this study.The study found that each VAP patient had to spend additional 103 799.00 yuan, stay in ICU for extra 11.72 days, and in hospital for extra 15.53 days.On the basis of the price index of different years, compared with 2014, 2015 saved 36 million yuan for patients.Prevention of one case of VAP in ICU could treat 0.76 more new patients.The hospital revenue was 24 464 560.5 yuan in2015.The total direct economic benefits of hospitals and patients were 60 883 996.6 yuan.Conclusion Prevention and control of HAI is one of the medical ontology connotation, it can greatly reduce the economic burden of patients, save economic cost, create benefits and enhance the image for hospital, and achieve a triple win situation for"patients-hospital-society".

Monitoring results of soil-transmitted nematodiasis in national surveillance site of Huaiyang County in Henan Province,2006-2015 / 中国血吸虫病防治杂志

Objective To understand the epidemic situation of soil-transmitted nematodiasis in the national surveillance site in Henan Province. Methods Over 1000 fecal samples from inhabitants in Huaiyang County of Henan Province,which was a national surveillance site,were collected each year from 2006 to 2015,the eggs of soil-transmitted nematodes and other intesti-nal helminths were examined by Kato-Kats technique. The cellophane swab method was used to detect Enterobius vermicularis eggs in children aged 3 to 12 years. In addition,the soil samples were collected from vegetable fields,lavatories,courtyards and kitchens of 10 families randomly selected in each year to examine Ascaris eggs by a modified saturated sodium nitrate floatation method. Results From 2006 to 2015,10419 persons were investigated,and the eggs of five species of intestinal helminths, Ascaris lumbricoides,Trichuris trichiura,hookworm,E. vermicularis,and Trichostrongylus orientalis,were detected,The aver-age infection rate of soil-transmitted nematodes in residents in Huaiyang County was 3.69%. The intensity of infection was mild and a family clustering was obvious. Both the infection rates of E. vermicularis in children and soil-transmitted nematodes in vil-lagers had no significant differences between different genders (both P>0.05). The infection rates of soil-transmitted nema-todes,A. lumbricoides and E. vermicularis all reached the highest in the age group of 1-10 years. For different education back-ground,the people with primary school education had the highest infection rate,and the infection rate showed a decreasing trend with the increase of the educational level. The infection rate of soil-transmitted nematodes in the national surveillance site in Henan Province showed a decreasing trend from 2006 to 2015. Unfertilized and fertilized A. lumbricoides eggs were detected in the soil samples,but the positive rate was very low. Conclusions In the recent 10 years,the infection rate of soil-transmit-ted nematodes in the national surveillance site in Henan Province shows a decreasing trend and maintains at a low level. The in-fection shows a family clustering. The children,especially those aged 3-9 years are the main infected population,and E. vermic-ularis infection is the key point of prevention and control.

Survey and analysis of epidemic status of principal human parasitosis in eco-logical region of Huaiyang hills of Henan Province in 2015 / 中国血吸虫病防治杂志

Objective To understand the epidemic status of principal human parasitosis in the ecological region of Huaiyang hills of Henan Province. Methods According to the scheme of The 3rd National Survey of Principal Human Parasites made by National Institute of Parasitic Diseases,the survey was performed based on the ecological regions. The stratified cluster sampling was made combined with the economic and geographical conditions. The infections of intestinal helminths and protozoans in per-manent residents were respectively detected by Kato-Kats technique and iodine solution. Trichuris trichiura infection was detect-ed by the cellophane swab method in children aged 3 to 6 years. Results Totally 6710 residents in 26 survey spots from 9 coun-ties were detected,in which 528 children aged 3 to 6 years were detected for T. trichiura infection. Eleven kinds of parasites were found in this survey,including 5 species of helminthes and 6 species of protozoans. The infection rates of overall parasites, helminthes and protozoans were respectively 1.65%,1.07%and 0.61%. The infection rate of T. trichiura in the children aged 3 to 6 years was 3.79%. Only 0.10 percent of the infections were co-infection,and all were infected by 2 kinds of parasites. The principal parasites in this district were Ascaris lumbricoides(0.31%),Blastocystis hominis(0.28%)and hookworm(0.27%). The T. trichiura infection rate among children was 3.79% by the cellophane swab method. The infections of protozoans were found in all age groups. In the group aged 9 years and below,the maximum kinds of parasites were found. Conclusion The in-fection rates of principal human parasites in Huaiyang hilly ecological region of Henan have decreased sharply ,but more efforts still should be paid on the prevention and control of parasitosis in children.

Microsurgical anatomy of ophthalmic segment of internal carotid artery by the lateral orbital keyhole approach / 局解手术学杂志

Objective To study the anatomical features and operative significance of ophthalmic segment of internal carotid artery by the lateral orbital keyhole approach .Methods Selected 15 cases (30 sides) adult cadavers with formalin perfusion including 2 fresh cadavers perfused with red and blue latex and simulated by lateral orbital keyhole craniotomy .Surgical microscope was used to observe the morphologi-cal characteristics ,adjacent relaionship and important perforating vessels of the ophthalmic artery segment of internal carotid artery .The data measured after the brain was removed from the brain .Results The ophthalmic segment of internal carotid artery originated from the distal dura ring of upper cavernous sinus sphenoidalis and ended at the initial side of posterior communicating artery .The anterior half segment was blocked by the anterior process and the optic nerve and sent out fibrous structures to wrap the surrounding tissue .The starting point of oph-thalmic artery located at 5 mm of anterior end of the anterior process in 28 sides (82.4％),5 mm of the medial aspect of the anterior process in 22 sides (64.7％).The superior hypophyseal artery (SHA) could send 2 to 3 grades of perforating vessels to supply the anterior optic nerve,optic chiasma and pituitary stalk .Conclusion When we treat sellar region lesions by the lateral orbital keyhole approach ,especially for clipping the aneurysm at the ophthalmic segment ,we should expertly master the anatomical features of ophthalmic segment of internal ca -rotid artery,focus on protecting these perforating vessels ,and it has important clinical significance for the prognosis of the patients .

Closed reduction and percutaneous double K-wires internal fixation for the treatment of multisegmental fracture of humeral shaft / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical effects of closed reduction and percutaneous double K-wires internal fixation in treating multisegmental fracture of humeral shaft.</p><p><b>METHODS</b>From January 2009 to April 2015, 27 patients with multisegmental fracture of humeral shaft were treated with closed reduction and percutaneous double K-wires internal fixation, including 10 males and 17 females, ranging in age from 26 to 81 years with an average of 52 years;the disease course ranged from 2 hours to 6 days with an average of 1.5 days. Operative time, intraoperative blood loss, hospital stay, fracture healed time, complications were observed and recovery of shoulder joint function was evaluated by Constant-Murley shoulder score.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 24 weeks with an average of 16 weeks. Operative time was 20 to 40 min with an average of 28 min; intraoperative blood loss was 5 to 25 ml with an average of 10 ml;hospital stay was 3 to 5 days with an average of 3.5 days. All fractures got bone healing and healed time was 12 to 22 weeks with average of 14 weeks. Postoperatively 1 case complicated with wire tail bulging and local irritation symptoms, and the symptoms disappeared when the wire was removed out after the fracture healing; 1 case complicated with local infection after wire tail disengaging, and recovered through anti-septic treatment. According to the Constant-Murley standard of shoulder joint function, 10 cases got excellent results, 15 good, 2 fair, with scores of 89.1±2.7.</p><p><b>CONCLUSIONS</b>Closed reduction and percutaneous double K-wires fixation for the treatment of multisegmental fractures of humeral shaft have advantages of simpler manipulating, less bleeding, less invasive, less complications, and shoulder and elbow joint can obtain good recovery. But closed reduction and percutaneous double K-wires internal fixation cannot be effective against rotation and provide axial stability, the immoblization with a sling or other auxiliary methods should be applied.</p>

Analysis on the treatment of complicated ocular trauma accompanied with cyclodialysis / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To explore the effective method for the treatment of complicated ocular trauma accompanied with cyclodialysis.METHODS: Sixty - eight cases of complexity ocular trauma with cyclodialysis in different degrees were undergone vitrectomy and ( or ) combined with ciliary body reduction.RESULTS:All patients were followed up for 10 ~36mo (mean 17. 0±5. 7mo). The postoperative visual acuity was better than that of preoperation (P<0. 05). Compared with preoperative, intraocular pressure was significantly increased ( P < 0. 05 ). Successful rate of ciliary body restoration was 91%. CONCLUSlON: For the complicated ocular trauma accompaniedwith cyclodialysis, vitrectomy and ( or ) ciliary body reduction is an effective treatment method.

Granulosa cells model transfected by ENO1 overexpression adenovirus vector and the effect of ENO1 overexpression on progesterone secretion / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To construct primary cultured granulosa cells model of Zi Gooses tansfected by alpha-enolase (ENO1) overexpression adenovirus vector, and to detect the effect of ENO1 overexpression of granulose cells on progesterone secretion.</p><p><b>METHODS</b>Granulosa cells were infected with Ad-CMV-ENO1 in gradient multiplicity of infection(MOI) levels:100, 250, 350 and 400 pfu/cell. Twenty four hours and 48 h after infection, green fluorescent protein (GDP) was respectively detected by fluorescence inverted microscopy. The effect of ENO1 overexpression of granulose cells on progesterone secretion was detected by the step double antibody sandwich enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>The optimal infection rate (100%) was achieved when MOI was 800 pfu/cell,48h after infection. Real time RT-PCR and Western blot showed that the level of mRNA and protein expression ENO1 were increased significantly after infection (P < 0.01); The granulosa cells progesterone secretion of Ad-CMV-ENO1 group increased signigicantly (P < 0.01).</p><p><b>CONCLUSION</b>ENO1 overexpression could make the primary culture follicle granulosa cells in vitro improve progesterone secretion.</p>

Improved minimally invasive DHS internal fixation for old age patients with intertrochanteric fractures / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged and the influence on the lateral wall of the femoral.</p><p><b>METHODS</b>From January 2005 to December 2010,480 aged patients with intertrochanteric fractures were treated by modified minimally invasive DHS fixation. There were 21 males and 268 females,with an average age of 78.3 years old ranging from 60 to 103 years. Aaccording to the Evans type,there were 166 cases of type 1,212 of type II , 86 of type 111, 16 of type IV, among them 46 cases had the dangerous fractures of the lateral wall. The incision length,blood loss volume,time from extending surgical incision in the side panel to close and postoperative complications were observed and recorded. At 1 month, 3 and 6 months after operation,the patients were followed-up,the outcome were evaluated according to the imaging evaluation index and clinical effect assessment indexes.</p><p><b>RESULTS</b>The surgical incision length averaged (8.0+/-1.2) cm, peri-operative bleeding averaged (150.0+/-6.4) ml,time from extending the incision in the operation to close incision averaged (22.0+/-1.3) min, 1 case had postoperative rupture of the external wall, and 3 cases had tension screw cut out in the femoral head,4 cases had excessive shrink back. Postoperative 6 months basic daily living skills (BADL) averaged (14.8+/-1.1) scores, and the ability of walk averaged (6.40+/-0.34) scores.</p><p><b>CONCLUSION</b>Improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged had advantages of small trauma surgery,short wound exposure time, less peri-operative bleeding and the integrity of the lateral wall after operation, the basic daily living skills and ability to walk has an ideal recovery activities, satisfied clinical curative effect.</p>

Magnetic resonance imaging findings of pituitary hyperplasia due to primary hypothyroidism / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the clinical and magnetic resonance imaging (MRI) findings of pituitary hyperplasia due to primary hypothyroidism.</p><p><b>METHOD</b>The clinical presentations, laboratory examinations, and MRI findings of 11 patients with pituitary hyperplasia secondary to primary hypothyroidism diagnosed at our hospitals from the beginning of 2008 to the end of 2011 were retrospectively reviewed.</p><p><b>RESULTS</b>The clinical manifestations in 11 patients included growth arrest(7/8), mental retardation (6/8), cold intolerance and fatigue(6/11), slightly increased body weight (6/11), galactorrhea (3/11), paramenia (8/9), precocious puberty companying vaginal bleeding (2/2),and blurry vision (3/11). Laboratory investigations revealed grossly increased thyroid stimulating hormone, decreased thyroxine, and slightly elevated prolactin levels in all cases. Thyroid antibody was positive in six cases. On MRI, pituitary mass were detected a large intrasellar with/without suprasellar extension in all patients,showing the characteristic of symmetric enlargement. Spherical shape was viewed in 5 cases,with the height of (12.22 ± 3.12)mm. In the other 6 cases, the pituitary mass with the shape of calabash extended superiorly to suprasellar area, with a height of(18.95 ± 2.23)mm. The signal of pituitary mass was isointense to grey matter both on T1 weighted imaging and T2 weighted imaging. Bright short T1 signal in posterior lobe of pituitary was visible. Pituitary stalk was detected only in 4 cases from MRI without dislocation, while the width of pituitary stalk was within the normal limit.</p><p><b>CONCLUSIONS</b>Pituitary hyperplasia should be considered when homogenous enlargement of the pituitary gland is found on MRI. The integration of MRI findings, clinical manifestations, and laboratory findings is helpful for the proper identification of the primary endocrine disease and thus avoid misdiagnosis.</p>

Clinical factors related to bone metastases from breast cancer / 中华核医学杂志

Objective To study the clinical and imaging features of patients with bone metastases from breast cancer and identify the factors related to the incidence of bone metastases. Methods Three hundred and thirty-four patients with breast cancer were recruited into this study. Whole-body 99Tcm-methylene disphosphonate (MDP) bone scan, clinical staging, pathological, immunohistochemical and serological test results were analyzed retrospectively. χ2 test was used for statistical analysis. Results The incidence rate of bone metastases for patients with and without lymph node metastases was 71% (152/214) and 22. 5% (27/120), respectively (χ2 =72.80, P =0.000). The incidence rate of bone metastases from infiltrated non-specified and specified breast cancer was 69% (203/294) and 41.7% (5/12), respectively (χ2 =3. 97, P=0.046). Alkaline phosphatase (ALP) was elevated in 28.5% (51/179) and 14.9%(11/74) of patients with and without bone metastases, respectively (χ2 = 5. 25, P = 0.022 ). Carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 15-3, CA125, CA19-9 increased in 68.7% ( 123/179) and 27.0% (20/74) of patients with and without bone metastases, respectively (χ2 = 37. 03, P =0. 000). Conclusions The incidence of bone metastases from breast cancer is correlated to pathological types of primary tumor and lymph node metastases. Bone metastases occurs more frequently in patients with infiltrated, non-specified, primary cancer and with lymph node metastases. Serum ALP, CEA, CA15-3,CA125, CA19-9 might be the tumor makers for early diagnosis of bone metastases from breast cancer.

Nerve Stem Cells Orientation Differentiation in Neonatal Rat Hippocampus Induced by Brain-Derived Neurotrophic Factor in Vitro / 实用儿科临床杂志

Objective To explore the influence of brain-derived neurotrophic factor (BDNF) on the differentiation of nerve stem cells (NSCs) from neonatal rat hippocampus in vitro and to find new revulsant of NSCs,which can improve the percentage of NSCs differentiating into neurons.Methods Twenty-four hours neonatal rats were selected to obtain hippocampus tissue to culture NSCs in serum-free culture medium by suspending culture.The high pure NSCs were obtained after passing 2 generations.The culture cells were identified as NSCs by staining of nestin,which was NSCs special marker.After passaged three generations,the NSCs were randomly classified into 2 groups:test group and control group.There were 15 pieces per group.There was 2 mL per piece,which contains 1?105 cells.50 g/L fetal bovine serum(FBS) and 20 ?g/L BDNF were added into foundational culture medium in test group;only 50 g/L FBS was added into foundational culture medium in control group.The neurons and their percentage were tested using the immunofluorescence labeling and flow cytometer after 7 days of differentiated cultivation.Results The hippocampus tissue cells grew in globular in serum-free culture medium by suspending culture,which expressed highly positive by nestin immunofluorescence staining.Its purity was above 90%.The percentage of neurone specific enolase(NSE)-positive cells in test group was 60.45%,which was obviously higher than that of control group (23.67%).The difference was significant between 2 groups(?2=27.75 P

Fracture strength of custom-fabricated Celay all-ceramic post and core restored endodontically treated teeth / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The increased use of all-ceramic crown provides a rationale for tooth-colored core. Due to superior mechanical properties, Vita Celay infiltration ceramic developed for crown and bridge works presents the potential for fabricating all-ceramic posts and cores in one piece. This study was conducted to compare the fracture strength of endodontically treated teeth which were thereafter given different types of posts and cores and crowns restoration, respectively. The evaluated post-and-core systems are: custom-fabricated Celay all-ceramic post-core, custom cast metal post-core, and prefabricated stainless steel post (Parapost) with and without 2.0 mm dentine ferrule.</p><p><b>METHODS</b>Sixty freshly extracted human maxillary central incisors were endodontically treated and randomly divided into five groups with 12 samples each. Group A: Celay ceramic post-cores restored teeth with 2.0 mm dentine ferrule. Group B: Celay ceramic post-cores restored teeth with no dentine ferrule. Group C: cast metal post-cores restored teeth with 2.0 mm dentine ferrule. Group D: cast metal post-cores restored teeth with no dentine ferrule. Group E: prefabricated post and composite cores restored teeth with 2.0 mm dentine ferrule. All teeth were restored with Celay ceramic crowns. Each specimen was subjected to a load at a 45-degree angle to the long axis on MTS 810 material testing machine until failure, at crosshead speed of 0.02 cm/minute. Analysis of variance followed by the Newman-Keuls pairwise multiple comparison tests were used to compare the results of the groups tested.</p><p><b>RESULTS</b>There was a statistically significant difference among the five groups (P < 0.01). Celay ceramic post-cores restored teeth with 2.0 mm dentine ferrule [(758.35+/-19.26) N] and cast metal post-cores restored teeth with 2.0 mm dentine ferrule [(756.63+/-66.22) N] had a significantly greater mean fracture strength than the other three groups in which no significant difference was observed. The 2.0 mm dentine ferrule could cause significant fracture resistance alteration of Celay post-core restored teeth.</p><p><b>CONCLUSIONS</b>When covered with Celay ceramic crowns, Celay post-cores restored teeth with 2.0 mm dentine ferrule and cast metal post-cores restored teeth with 2.0 mm dentine ferrule have similar fracture strength. There was a statistically significant difference between the fracture resistance of Celay post-core restored teeth with and without 2.0 mm dentine ferrule.</p>

Diffuse panbronchiolitis with histopathological confirmation among Chinese / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diffuse panbronchiolitis (DPB) was originally and is still primarily reported in Japan, rarely in other countries. As macrolide therapy is effective for this disease with once dismal prognosis, familiarity with its clinical features is urgently needed, especially for clinicians outside Japan. The objectives of this study were to investigate the clinical features of DPB in a Chinese population and propose diagnostic procedures that will lead to increased awareness of this treatable disease among clinicians, ultimately allowing for more rapid diagnosis.</p><p><b>METHODS</b>After a literature review, the clinical features of DPB were histopathologically confirmed in a series of 9 cases either by open lung biopsy or video-assisted thoracic surgical biopsy, resulting in the largest series of confirmed DPB cases in a non-Japanese population. Here, the cases are retrospectively described and diagnostic procedures are discussed.</p><p><b>RESULTS</b>Persistent cough, sputum, and exertion dyspnea occurred in 89% of patients, a history of or current chronic sinusitis in 78%, centrilobular micronodules appearing on chest CT scans in 100%, coarse crackles in 78%, FEV1/FVC < 70% in 44%, PaO2 < 80 mmHg in 56%, and titer of cold hemagglutinin > or = 1:64 in 11%. According to its clinical diagnostic criteria, diagnosis was definitive in 44%, suggested in 33%, and excluded in 23% at the time of diagnosis. However, DPB was clinically considered before confirmation in only 22% of patients, with the remaining 78% of cases missed or mistaken for other diseases. Of the 9 cases, 8 received transbronchial biopsies before confirmation of the diagnosis, but all showed non-specific inflammation.</p><p><b>CONCLUSIONS</b>Although its clinical features may vary with disease course and ethnic populations, most cases of DPB can be diagnosed or suggested according to clinical diagnostic criteria. However, underdiagnosis as a result of unfamiliarity with its clinical features and diagnostic criteria prevails. If difficulty in diagnosis arises, the diagnosis should be based on clinicopathological features and the exclusion of other diseases. Few cases can be confirmed by transbronchial biopsies; in these cases, either an open-lung biopsy or a video-assisted thoracic surgical lung biopsy should be recommended.</p>

The significance of cost accounting in military hospital department / 医学研究生学报

Currently, competition in the market of health service of our country is very fierce. In this circumstance, realization of military hospital's development aim-focuse on people, leading position in technology-to provide better service armyman is depend on economic foundation. To increase economic benefit of hospital, it is necessary to intensify management of cost accounting first, in which cost accounting of clinical department is of especial importance. In this article, we probe into the significance, content, method and problems of cost accounting in clinical department of military hospital.