Progress of research on health effects and healthy risk assessment of ionizing radiation / 中国辐射卫生

Occupational exposure to ionizing radiation represents a critical factor contributing to health risks in workplaces. Previous experimental and clinical studies have demonstrated that ionizing radiation affects human health. Therefore, scientific assessment of health risk caused by ionizing radiation and effective protection against ionizing radiation are of great importance to formulate the preventive interventions against occupational exposure to ionizing radiation. This review summarizes the advances in the research on health effects, health risk assessment methods, and protective interventions of ionizing radiation. We call for research on the health effects of low-dose radiation, individual difference, and optimization of preventive strategies. In addition, improved mechanisms of health monitoring, periodical healthy examinations, and monitoring of radiation doses should be implemented. Moreover, strict compliance to operating procedures and occupational preventive interventions are recommended. These measures aim to minimize the potential harmlessness of occupational exposure to ionizing radiation, thereby safeguarding the health and safety of individuals exposed to ionizing radiation.

Application value of 3.0T MRI combined with transvaginal ultrasound elastography technique in diagnosing uterine fibroids and adenomyosis / 中国医学装备

Objective:To explore the application value of 3.0T magnetic resonance imaging(MRI)combined with transvaginal ultrasound elastography technique in diagnosing uterine fibroids and adenomyosis.Methods:A retrospective analysis was performed on 56 patients with uterine fibroids and 41 patients with adenomyosis who admitted to Fengfeng General Hospital of North China Medical and Health Group from January 2021 to January 2022.MRI and transvaginal ultrasound elastography were respectively performed on all patients,and pathological diagnosis was taken as the"gold standard".The diagnostic results of MRI,transvaginal ultrasound elastography technique and their combination were compared,and the diagnostic situation of different examination methods were recorded.And then,the total coincidence rate was analyzed,and the sensitivity,specificity and accuracy were further calculated.Results:The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 96.43% in detecting uterine fibroids,and that of MRI was 75.00%,and that of transvaginal ultrasonography was 80.36%.The differences of totally diagnostic coincidence rates among combined detection and single detection were significant(x2=10.500,7.049,P＜0.05).The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 97.56% in detecting adenomyosis,which was significantly higher than that(78.05%)of MRI and that(78.05%)of transvaginal ultrasound elastography,and the differences were significant(x2=7.289,7.289,P＜0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 71.74%,78.26% and 95.62% in detecting uterine fibroids,and the specificities of them were 90.00%,90.00% and 100.00%,and the accuracies of them were 75.00%,80.36% and 96.43%,respectively.The sensitivity and accuracy of the combined detection were significantly higher than those of single MRI detection(x2=5.029,10.500,P＜0.05),respectively.The accuracy of the combined detection was significantly higher than that of the single detection of vaginal ultrasonography(x2=7.049,P＜0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 81.25%,78.73% and 96.88% in detecting adenomyosis,and the specificities of them were 66.67%,77.78% and 100.00%,and the accuracies of them were 78.05%,78.05% and 97.56%,respectively.The accuracy of the combined detection was significantly higher than that of single MRI detection(x2=7.289,P＜0.05),and the accuracy of the combined detection was significantly higher than that of single detection of vaginal ultrasonography(x2=7.289,P＜0.05).Conclusion:The diagnosis rate of MRI combined with transvaginal ultrasound elastography technique is higher for uterine fibroids and adenomyosis,which has better diagnostic value,and can provide reliable reference materials for clinicians in performing treatment.

Analysis of individual dose monitoring results for radiation workers in Shandong province from 2016 to 2020 / 中华放射医学与防护杂志

Objective:To summarize the levels of individual dose to radiation workers in Shandong province from 2016 to 2020, and to analyze the trends in their change in order to provide scientific basis for radiation workers′ health management.Methods:The experimental detection and quality control were carried out in compliance with the national standards Specifications for individual monitoring of occupational external exposure (GBZ 128-2019) and the Testing criteria of personnel dosimetry performance for external exposure (GBZ 207-2016). The result of the personal dose monitoring of occupational external exposure of all radiation workers monitored by the Centers for Disease Control and Prevention in 16 cities of Shandong province were retrospectively analyzed by using SPSS 23.0 software.Results:The total number of monitored workers were 25 523 with an average annual individual effective dose of 0.28 mSv. There were statistically significant differences among radiation workers in different years ( H= 2 815.91, P<0. 001). The average annual individual effective dose showed an upward trend followed by a downward trend. The average annual effective dose of 0.55 mSv for nuclear medicine radiation workers in medical applications was the highest, with statistically significant differences among different occupational radiation workers ( H=310.37, P<0.001). The average annual effective dose of 0.37 mSv for radioactivity logging workers in industrial applications was the highest, with statistically significant differences among different occupational radiation workers ( H=448.07, P<0. 001). The average annual effective dose to radiation workers in medical applications was higher than in industrial applications ( Z = -14.93, P<0.001). Conclusions:The average annual effective dose to nuclear medicine radiation workers in medical applications and logging radiation workers in industrial applications are relatively high. There would be a push to furthe improve workplace protection measures and strengthen the management and supervision of radiological workers.

Survey of current radiological health capabililty of 16 disease control centers at prefecture-level in Shandong province / 中华放射医学与防护杂志

Objective:To survey the current radiological health capability of 16 perferture-level disease control centers (CDCs) in Shandong province and analyze their shortcomings and disadvantages, in order to provide relevant reference basis for the radiological health capability building of such CDCs.Methods:Survey was carried out of radiology department, radiological health staff, equipment allocation, capabillity building and scientific research of these CDCs, together with the relevant data obtained being statistically analyzed.Results:In these CDCs of 16 cities in Shandong province, there were 70 staff engaged in radiological health, with 3 cities having independent radiological departments in place. There were statistically significant differences between independent departments and non-independent departments in the exclusive use of X-ray diagnostic examination equipment, medical electron accelerator examination equipment and on-site quality control testing work ( χ2=0.04, 0.01, 0.04, P<0.05). Between inland and coastal cities there was statistically significant difference in the capability dealing with nuclear and radiological emergency ( χ2=0.02, P<0.05). Conclusions:Independent departments are more conducive to the implement of government′s functional tasks than non-independent departments. There exist shortcomings and weaknesses in human resources, equipment allocation, in-food radioactivity testing, nuclear and radiological emergency in 16 prefectures and cities, so that the capability building needs to be further improved.

Study on the correlation between the time within the glucose target range, the level of glycosylated hemoglobin and the risk of diabetic retinopathy / 中华眼底病杂志

Objective:To observe and analyze the correlation between time within target glucose range (TIR) and hemoglobin A1c (HbA1c) and the risk of diabetic retinopathy (DR).Methods:A retrospective clinical study. From March 2020 to August 2021, 91 patients with type 2 diabetes mellitus (T2DM) who were hospitalized in Department of Endocrinology and Metabolic Diseases, Affiliated Hospital of Weifang Medical University, were included in the study. All patients underwent Oburg's no-dilatation ultra-wide-angle laser scan ophthalmoscopy, HbA1c and continuous glucose monitoring (CGM) examinations. According to the examination results and combined with the clinical diagnostic criteria of DR, the patients were divided into non-DR (NDR) group and DR group, with 50 and 41 cases respectively. The retrospective CGM system was used to monitor the subcutaneous interstitial fluid glucose for 7 to 14 consecutive days, and the TIR was calculated. Binary logistic regression was used to analyze the correlation between TIR, HbAlc and DR in patients with T2DM0. At the same time, a new indicator was generated, the predicted probability value (PRE_1), which was generated to represent the combined indicator of TIR and HbA1c in predicting the occurrence of DR. The receiver operating characteristic curve (ROC curve) was used to analyze the value of TIR, HbAlc and PRE_1 in predicting the occurrence of DR.Results:The TIR of patients in the NDR group and DR group were (81.58±15.51)% and (67.27±22.09)%, respectively, and HbA1c were (8.03±2.16)% and (9.01±2.01)%, respectively. The differences in TIR and HbA1c between the two groups of patients were statistically significant ( t=3.501,-2.208; P=0.001, 0.030). The results of binary logistic regression analysis showed that TIR, HbA1c and DR were significantly correlated (odds ratio=0.960, 1.254; P=0.002, 0.036). ROC curve analysis results showed that the area under the ROC curve (AUC) of TIR, HbA1c and PRE_1 predicting the risk of DR were 0.704, 0.668, and 0.707, respectively [95% confidence interval ( CI) 0.597-0.812, P=0.001; 95% CI 0.558-0.778, P=0.006; 95% CI 0.602-0.798, P=0.001]. There was no statistically significant difference between TIR, HbA1c and PRE_1 predicting the AUC of DR risk ( P>0.05). The linear equation between HbAlc and TIR was HbAlc (%) = 11.37-0.04×TIR (%). Conclusions:TIR and HbA1c are both related to DR and can predict the risk of DR. The combined use of the two does not improve the predictive value of DR. There is a linear correlation between TIR and HbAlc.

The influence of childhood trauma on internet addiction of adolescents: mediating effect of self-concealment / 中华行为医学与脑科学杂志

Objective:To investigate the influence of childhood traumatic experience on internet addiction of adolescents and the mediating effect of self-concealment.Methods:Childhood trauma questionnaire(CTQ), self-concealment scale(SCS) and adolescent pathological internet use scale(APIUS) were used to investigate 532 college students.SPSS 22.0 was used for descriptive statistics, correlation analysis and regression analysis.Amos 24.0 was used for confirmatory factor analysis, and the relevant assumptions were verified through structural equation model.Results:The total scores of childhood abuse, self-concealment and adolescent pathological internet use were (37.23±11.91), (26.09±9.26) and (82.15±28.09), respectively.Correlation analysis showed that childhood trauma was positively correlated with self-concealment ( r=0.27, P<0.01). Self-concealment was positively correlated with internet addiction ( r=0.47, P<0.01). Childhood trauma was positively correlated with internet addiction ( r=0.36, P<0.01). Mediating effect test showed that childhood trauma had a significant positive predictive effect on self-concealment ( β=0.34, P<0.01), self-concealment had a significant positive predictive effect on internet addiction ( β=0.34, P<0.01), and childhood trauma had a direct predictive effect on internet addiction ( β=0.31, P<0.01). Conclusion:Childhood trauma and self-concealment have significant influence on internet addiction, and self-concealment plays a partial mediating role between childhood trauma and internet addiction of adolescents.

Integrative analysis of in vivo recording with single-cell RNA-seq data reveals molecular properties of light-sensitive neurons in mouse V1

Vision formation is classically based on projections from retinal ganglion cells (RGC) to the lateral geniculate nucleus (LGN) and the primary visual cortex (V1). Neurons in the mouse V1 are tuned to light stimuli. Although the cellular information of the retina and the LGN has been widely studied, the transcriptome profiles of single light-stimulated neuron in V1 remain unknown. In our study, in vivo calcium imaging and whole-cell electrophysiological patch-clamp recording were utilized to identify 53 individual cells from layer 2/3 of V1 as light-sensitive (LS) or non-light-sensitive (NS) by single-cell light-evoked calcium evaluation and action potential spiking. The contents of each cell after functional tests were aspirated in vivo through a patch-clamp pipette for mRNA sequencing. Moreover, the three-dimensional (3-D) morphological characterizations of the neurons were reconstructed in a live mouse after the whole-cell recordings. Our sequencing results indicated that V1 neurons with a high expression of genes related to transmission regulation, such as Rtn4r and Rgs7, and genes involved in membrane transport, such as Na/K ATPase and NMDA-type glutamatergic receptors, preferentially responded to light stimulation. Furthermore, an antagonist that blocks Rtn4r signals could inactivate the neuronal responses to light stimulation in live mice. In conclusion, our findings of the vivo-seq analysis indicate the key role of the strength of synaptic transmission possesses neurons in V1 of light sensory.

Integrative analysis of in vivo recording with single-cell RNA-seq data reveals molecular properties of light-sensitive neurons in mouse V1

Vision formation is classically based on projections from retinal ganglion cells (RGC) to the lateral geniculate nucleus (LGN) and the primary visual cortex (V1). Neurons in the mouse V1 are tuned to light stimuli. Although the cellular information of the retina and the LGN has been widely studied, the transcriptome profiles of single light-stimulated neuron in V1 remain unknown. In our study, in vivo calcium imaging and whole-cell electrophysiological patch-clamp recording were utilized to identify 53 individual cells from layer 2/3 of V1 as light-sensitive (LS) or non-light-sensitive (NS) by single-cell light-evoked calcium evaluation and action potential spiking. The contents of each cell after functional tests were aspirated in vivo through a patch-clamp pipette for mRNA sequencing. Moreover, the three-dimensional (3-D) morphological characterizations of the neurons were reconstructed in a live mouse after the whole-cell recordings. Our sequencing results indicated that V1 neurons with a high expression of genes related to transmission regulation, such as Rtn4r and Rgs7, and genes involved in membrane transport, such as Na/K ATPase and NMDA-type glutamatergic receptors, preferentially responded to light stimulation. Furthermore, an antagonist that blocks Rtn4r signals could inactivate the neuronal responses to light stimulation in live mice. In conclusion, our findings of the vivo-seq analysis indicate the key role of the strength of synaptic transmission possesses neurons in V1 of light sensory.

Clinical efficacy of total hip arthroplasty with pelvic sagittal alignment pathology / 中国医师进修杂志

Objective To investigate the preliminary clinical efficacy of total hip arthroplasty (THA) patients with pelvic sagittal alignment pathology. Methods The clinical data of 120 THA patients who had normal pelvic sagittal alignment and 40 THA patients who had pathology between 2013 and 2016 were retrospectively studied. Complication rate and survival rate were collected and analyzed. Results Complete case records were documented in 160 cases who were followed up for an average 26 months (range, 2—45 months). For pelvic alignment parameters: the average pelvic incidence (PI) of normal group was similar to pathology group, and no significant difference was found in two groups:(46.32 ± 4.29)°vs. (45.15 ± 3.16)°, P>0.05. There were significant differences in pelvic tilt (PT) and sacral slope (SS) between two groups: (46.32 ± 4.29)°vs. (17.51 ± 2.31)°, (38.01 ± 1.92) vs. (27.64 ± 1.72)°, P＜0.05. Two cases suffered from dislocation, half year successful rate was 99.2%, 1-year was 98.3% and 2-year was 98.3% in normal group. Four cases suffered from dislocation, half year successful rate was 95.0%, 1-year was 92.5% and 2-year was 90.0% in pathology group. Conclusions Prior lumbar-pelvic sagittal alignment pathology increases risk of complication in THA, which can obviously change hip biomechanical characteristic.

Study on estimation methods of absorbed dose to eye lens of infants from CT head and neck scanning based on one-year old anthropomorphic phantom / 中华放射医学与防护杂志

Objective To study the methods to estimate absorbed dose to eye lens of infants from CT scanning using different protocols and try to find a practical quick way for estimating absorbed dose to eye lens.Methods By scanning one-year old anthropomorphic phantom using 7 kinds of different protocols,all TLDs were measured for final estimation of absorbed dose to eye lens using two different dose conversion methods.Meanwhile,linear regression equation was established between absorbed dose to eye lens and CTDI.Results Absorbed doses to eye lens of infants from children CT scanning using 7 kinds of different protocols were (9.96±0.69) mGy in head axis,(7.01±0.42) mGy in head helical,(12.60± 0.97) mGy in sinus,(12.97±0.42) mGy in inner ear,(0.63±0.03) mGy in neck soft tissue,(8.89± 0.44) mGy in cervical vertebra,and (0.34± 0.01) mGy in chest,respectively.There were statistically significant difference in doses among different groups (F =846.826,P ＜ 0.05).For different scanning locations,there was linear relation between absorbed dose to eye lens and CTDI(r=0.986-0.999,P＜ 0.05).Conclusions Absorbed dose to eye lens of infants from children CT scaning with single dose may not be above threshold dose.In addition,absorbed dose to eye lens can be estimated quickly by linear regression equation between absorbed dose to eye lens and CTDI.

HIV-positive patient receiving living related renal transplantation : a report of one case and literature review / 中华器官移植杂志

Objective To summarize the outcomes and clinical experiences of renal transplantation in human immunodeficiency virus (HIV)-positive patients .Methods The clinical data were retrospectively analyzed for one HIV-positive case of renal transplantation .Diagnosed as chronic renal insufficiency 1 year ago ,he received hemodialysis .After a positive screen for HIV ,he received highly active antiretroviral therapy (HAART) and HIV RNA turned negative 3 months later .CD4 + T cell count was 331 cell/μl at pre-operation and there was no HIV-rated opportunistic infection or cancer . Her mother donated her kidney . Basiliximab and steroid pulse therapy were used preoperatively and immunosuppressants were used after transplantation , including tacrolimus , corticosteroids and mycophenolate mofetil .Results The kidney was transplanted successfully and serum creatinine declined to a normal level at day 4 after transplantation .Because of an interaction between efaverenz and tacrolimus ,the blood concentration of tacrolimus was extremely low and the dose of tacrolimus had to be raised to 0 .2 mg/(kg·d) .Antiroviral therapy remained unchanged .No rejection and other complications were observed .And HIV RNA remained negative .Conclusions Renal transplantation is optimal for HIV-positive patients whose HIV status is completely under control .However ,drug interactions needs to be considered during perioperative and postoperative periods .

The value of measuring cysC, β2-microglobulin and neutrophil gelatinase-associated lipocalin as a test panel for detection of early renal damage in lung cancer patients receiving chemotherapy / 中华老年医学杂志

Objective To compare the value of serum cystatin C (CysC),urine β2-microglobulin (β2-MG),and neutrophil gelatinase-associated lipocalin (NGAL) as a test panel with that of traditional indicators,serum Cr and urea,for detection of early renal damage in lung cancer patients after chemotherapy.Methods This prospective study collected data at our hospital on levels of serum cystatin C (CysC),urine β2-microglobulin (β2-MG),and neutrophil-gelatinase associated lipocalin (NGAL) from 63 lung cancer patients aged 60 and over.In addition,levels of traditional indicators including serum Cr and urea were also measured.Participants were divided into three groups:a prechemotherapy group,an under chemotherapy group,and a post-chemotherapy group.Results Levels of serum CysC,urine β2-MG,and NGAL in the post-chemotherapy group markedly increased,whereas levels of serum Cr and urea had no significant increase;furthermore,levels of serum CysC,urine β2-MG,and NGAL went up steadily as the time of exposure to chemotherapy drugs increased.Pearson's test showed that the sensitivity of CysC,beta 2-MG and NGAL as a panel was statistically significant for both the under chemotherapy group and the post-chemotherapy group (x2 =31.32,P=0.00;x2 =60.38,P=0.00).Conclusions Serum CysC,urine β2-MG and NGAL as a panel have good diagnostic value for early renal function damage in lung cancer patients after chemotherapy and are superior to traditional renal function indicators such as serum creatinine and urea.

Visualization Analysis of International Biomedical Big Data Research / 医学信息学杂志

The literatures of biomedical big data are collected with the database of WOS as the data sources.CiteSpace and VOS-Viewer are used to draw scientific knowledge maps to analyze the research strength,research hotspot and evolution trend of current biomedical big data research in the paper.

Effect of YunKe on bone metabolism of patients with rheumatoid arthritis / 实用医学杂志

Objective To evaluate the effect of YunKe on bone metabolism of patients with rheumatoid arthritis (RA). Methods A total of 108 RA patients were divided into YunKe group (n = 72), non-YunKe group (n = 36), and 54 controls. The bone mineral densities (BMDs) of the wrists, hips and lumbar spines were measured by dual-energy X-ray absorptiometry. Moreover , the expression of cross-linked N-telopeptides of type I collagen (NTX) in the serum was detected for statistically analyzing the difference between YunKe group and non-YunKe group. Results In RA group, the BMDs of wrist, hip and lumbar spine declined compared with that of control group (P < 0.001, respectively). In YunKe group, the BMDs of wrist, hip and lumbar spine after 6 months all were improved with statistically significance (P < 0.01, respectively); The differences also were statistically significant when compared with those in non-YunKe group (P < 0.01, respectively). In YunKe group, NTX level in the serum declined after 3 months of the treatment. The difference was statistically significant when compared with that in non-YunKe group (P < 0.001), but the difference disappeared 6 months later. Conclusions The BMD of wrist joints is low and declines in RA patients significantly. The treatment withYunKe improves the BMDs of the wrist , hip and lumbar spine and decreases the serum NTX. This study proposed that YunKe could inhibit the chronic loss of bone mass induced by RA.

Prognostic value of lymph node ratio and N stage in stage III colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the prognostic value of lymph node ratio and N staging in stage III colorectal cancer.</p><p><b>METHODS</b>The clinicopathologic factors and follow-up data of 304 cases with stage III colorectal cancer from January 1998 to December 2011 were analyzed retrospectively. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Patients were divided into different subgroups according to the number of lymph nodes sample.</p><p><b>RESULTS</b>LNR and N stage were independent risk factors for stage III colorectal cancer, the prognostic value of LNR was better than that of N stage [Odds ratio were 1.838(95% CI:1.563~2.161) vs. 1.625 (95% CI:1.392~1.898)]. Subgroup analysis showed that, when the number of lymph nodes sample was less than 13, the prognostic value of LNR was better than that of N stage (Odds ratio were 1.836 vs. 1.639). But when the number of lymph nodes sample was more than 13, they were comparable (Odds ratio were 1.876 vs. 1.853).</p><p><b>CONCLUSIONS</b>The prognostic value of LNR and N stage were comparable for stage III colorectal cancer, but when the number of lymph nodes sample was less than 13, LNR was more valuable.</p>

The role of CXCR2 in the invasion and metastasis of head and neck squamous cell carcinoma / 实用口腔医学杂志

Objective:To explore the role of CXCR2 in the invasion and metastasis of head and neck squamous cell carcinoma (HNSCC).Methods:The expression of CXCR2 in HNSCC tissues of 105 cases was detected by immunohistochemical staining,the correlation between CXCR2 expression and cervical lymph node metastases of HNSCC was analysed.Then,3 stable HNSCC cell lines with CXCR2 interference were established,the effects of CXCR2 silencing on cell migration and invasion were observed by in vitro tests.Results:CXCR2 was positively expressed in 51.43% of HNSCC specimens and was statistically associated with the cervical lymph node metastases of HNSCC.CXCR2 silencing markedly inhibited the migration and invasion of HNSCC cells in vitro.Conclu-sion:CXCR2 may play a key role in the invasion and metastases of HNSCC.

Perioperative application of preventive antibiotics for patients with esophageal carcinoma / 中华消化外科杂志

Objective To analyze the distribution and antibiotic resistance of pathogens isolated from sputum in early postoperative patients after esophageal surgery, and investigate the risk factors of pulmonary infections after esophageal carcinoma and reasonable application of antibiotics during perioperative period.Methods The clinical data of 414 patients with esophageal carcinoma who were admitted to the Affiliated Hospital of Binzhou Medical University from January 2012 to June 2014 were retrospectively analyzed.The second generation cephalosporins were used as preventive antibiotics for the 181 patients between January and December 2012 and the third generation cephalosporins were used for the 233 patients between January 2013 and June 2014.Sputum samples were collected and inspected before operation and in the first three days after operation for observing distribution and antibiotic resistance of pathogens.The incidence of postoperative pulmonary infection was observed in the two kinds of patients.The risk factors closely related to the occurrence of postoperative pulmonary infections were analyzed.Comparison of rate and univariate analysis were done by chi-square test.Multivariate analysis was done with logistic regression.Results The positive rate of early post-operative sputum culture was 24.64％ (102/414), 32.04％ (58/181) in patients receiving the second generation cephalosporins and 18.88％ (44/233) in patients receiving the third generation cephalosporins, respectively, with a significant difference between the two generations of cephalosporins (x2 =9.502, P ＜ 0.05).A total of 131 strains of pathogens were isolated from early postoperative sputum samples including 12 strains of gram-positive bacteria and 119 strains of gram-negative bacteria.The top three bacteria were Klebsiella pneumoniae subsp pneumoniae (33 trains), Acinetobacter baumannii (20 strains) and Pseudomonas aeruginosa (19 strains).The resistance rate of gram-negative bacteria in early postoperative sputum samples to meropenem, ciprofloxacin and levofloxacin were 5.0％-25.0％, 2.6％-15.2％, 2.6％-20.0％, respectively.Among cephalosporins, the resistance rate to ceftriaxone, cefotaxime, cefepime, ceftazidime, cefuroxime and cefazolin were 10.3％-20.0％ , 5.3％-30.0％ , 12.8％-31.6％, 15.4％-42.1％ , 21.2％-55.0％ and 15.2％-60.0％, respectively.The overall postoperative pulmonary infection rate was 18.60％ (77/414).The pulmonary infection rate of patients receiving the second generation cephalosporins was 26.52％ (48/181), which was higher than 12.45％ (29/233) of patients receiving the third generation cephalosporins (x2=13.326, P ＜ 0.05).The results of univariate analysis showed that smoking, chronic obstructive pulmonary disease, application of the second generation cephalosporins during the perioperative period and early postoperative sputum culture positive were correlated with the postoperative pulmonary infection after esophageal carcinoma surgery (x2 =5.149, 22.765, 13.326, 159.092, P ＜ 0.05).Multivariate statistical analysis with logistic regression demonstrated that application of the third generation cephalosporins during the perioperative period was independent protective factor of postoperative pulmonary infection (OR =2.582, 95％ confidence interval: 1.331-5.009, P ＜ 0.05).Conclusions The pathogens from sputum in early postoperative period after esophageal surgery are complicated with gram-negative bacteria as the main pathogens especially Klebsiella pneumoniae subsp, pneumoniae, and different levels of antibiotic resistance are ubiquitous.The third generation cephalosporins can effectively prevent the postoperative pulmonary infection after esophageal carcinoma surgery.

Expression of Mus81 gene in Chinese Han patients with colorectal cancer and its clinical significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the expression pattern of Mus81 gene in Chinese Han patients with colorectal cancer and analyze its correlation with the clinicopathological parameters and the tumor markers.</p><p><b>METHODS</b>Mus81 expression was detected using nested quantitative real-time PCR in the colorectal cancer tissues and corresponding adjacent normal tissues from 43 Chinese Han patients. The correlations of Mus81 expression profile with the clinicopathological parameters and common tumor markers were evaluated.</p><p><b>RESULTS</b>Mus81 expression level was significantly lower in the colorectal cancer tissues than in the corresponding adjacent normal tissues (114.6 ± 68.0 vs 202.5 ± 109.0, P<0.001). Of the 43 patients, 32 (74.4%) showed down-regulated Mus81 expression, which correlated significantly with distant metastasis (P=0.043), high TNM stage (P=0.022) and high P53 protein expression (P=0.011) of the tumor.</p><p><b>CONCLUSION</b>Down-regulation of Mus81 in colorectal cancer is correlated with tumor metastasis and progression, suggesting the value of Mus81 as a potential marker for colorectal cancer in Chinese Han patients.</p>

Predication analysis of microarray data to determine altered gene profiles in liver carcinoma related to HBV-related cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether gene expression profiles can be used to determine risk genes and predict HBV-related cirrhosis progression to liver carcinoma using Significance Analysis of Microarray (SAM) and Prediction Analysis of Microarray (PAM) methods.</p><p><b>METHODS</b>The Affymetrix GeneChip was used to establish the gene expression profiles of liver tissues from 15 patients with chronic hepatitis B and cirrhosis or hepatocellular carcinoma (HCC). Differentially expressed genes (fold-change more than 2; P value less than 0.01) were selected by GeneSpring GX software. Risk genes related to cirrhosis and liver carcinoma were generated by SAM and PAM methods. Real-time PCR was used to verify the expression of risk genes in the liver tissues.</p><p><b>RESULTS</b>Samples were clustered into the cirrhosis subgroup (n =15) or the HCC subgroup (n =15). A total of 497 differentially expressed genes were identified, SAM identified 162 significant genes, including 18 up-regulated genes and 144 down-regulated genes (fold-change:-1.46 to 1.28). PAM identified 22 genes with a "poor risk signature" (defined with a threshold of 5.5), which were associated with classifying cirrhosis and liver carcinoma; of these risk genes, 4 were down-regulated and 18 were up-regulated in the HCC group compared to the cirrhosis group (fold-change: 2.038 to 7.897, P value less than 0.01). The correction of classification was more than 80% . FOXP1, SPINK1 and KCNJ16 were verified by real-time PCR as differently expressed in the two subgroups (P value =0.011, 0.002 and 0.004, respectively).</p><p><b>CONCLUSION</b>The altered gene profiles of carcinogenesis in HBV-related cirrhosis involves hundreds of genes. The combination of three "poor risk genes" may represent potential targets for diagnosis and prediction of liver carcinoma progression.</p>

Polytetrafluoroethylene segment implantation for arteriovenous internal fistula with outflow tract obstruction / 中国组织工程研究

BACKGROUND:Arteriovenous internal fistula is the first choice for hemodialysis. In the process of hemodialysis, many patients suffer from venous outflow stenosis. The methods including thrombolysis, intervention, surgical repair and fistula reconstruction al have their disadvantages. OBJECTIVE:To compare the midterm effects of polytetrafluoroethylene segment implantation and exclusively surgical repair in arteriovenous internal fistula with outflow tract obstruction. METHODS:Eighty patients with venous outflow stenosis, aged 22-80 years, were divided into test group (n=50;polytetrafluoroethylene segment implantation) and control group (n=30;simple surgical repair). The post-operative infection rate, postoperative time til recurrence of fistula dysfunction, and accumulate survival rate were compared between the two groups. RESULTS AND CONCLUSION:During the fol ow-up period of 10-28 months in the test group, there were nine patients with vascular access dysfunction, and the accumulate survival rate was 100%for 6 postoperative months, 92%for 12 months, and 82%for 18 months. In the control group, there were seven cases of vascular access dysfunction at 8-28 months of fol ow-up, and the accumulate survival rate was 93%for 6 postoperative months, 87%for 12 months, and 77%for 18 months. No statistical y significant difference in the postoperative infection rate was observed between the two groups. The Kaplan-Meier survival curves showed that the accumulate survival rate was slightly higher in the test group than the control group, but there was no significant difference based on log-rank test (P=0.44). These findings indicate that polytetrafluoroethylene segment implantation for arteriovenous internal fistula with outflow tract obstruction has the similar effects as the surgical repair if it does not alter the autologous behavior of the initial access and maximal y reserve the vessels for puncture.