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Objective To investigate the expression level of serine/threonine phosphoprotein phosphatase 4C(PPP4C)in gastric cancer,and analyze its relationship with prognosis and the underlying regulatory mechanism.Methods The clinical data of 104 gastric cancer patients admitted to the First Affiliated Hospital of Bengbu Medical College between January 2012 and August 2016 were collected.Immunohistochemical staining was employed to determine the expression levels of PPP4C and Ki-67 in the gastric cancer tissue.The gastric cancer cell lines BGC823 and HGC27 were cultured and transfected with the vector for PPP4C knockdown,the vector for PPP4C overexpression,and the lentiviral vector(control),respectively.The effects of PPP4C on the cell cycle and proliferation were analyzed and the possible regulatory mechanisms were explored.Results PPP4C was highly expressed in gastric cancer(P<0.001),and its expression promoted malignant progression of the tumor(all P<0.01).Univariate and Cox multivariate analysis clarified that high expression of PPP4C was an independent risk factor affecting the 5-year survival rate of gastric cancer patients(P=0.003).Gene ontology and Kyoto encyclopedia of genes and genomes enrichment analysis suggested that PPP4C may be involved in the cell cycle.The correlation analysis showed that the expression of PPP4C was positively correlated with that of Ki-67 in gastric cancer(P<0.001).The up-regulation of PPP4C expression increased the proportion of tumor cells in the S phase,alleviated the G2/M phase arrest,and promoted the proliferation of gastric cancer cells and the expression of cyclin D1 and cyclin-dependent kinase 6(CDK6)(all P<0.05).The down-regulation of PPP4C decreased the proportion of gastric cancer cells in the S phase,promoted G2/M phase arrest,and inhibited cell proliferation and the expression of cyclin D1,CDK6,and p53(all P<0.05).p53 inhibitors promoted the proliferation of BGC823 and HGC27 cells in the PPP4C knockdown group(P<0.001,P<0.001),while p53 activators inhibited the proliferation of BGC823 and HGC27 cells in the PPP4C overexpression group(P<0.001,P=0.002).Conclusions PPP4C is highly expressed in gastric cancer and affects the prognosis of the patients.It may increase the proportion of gastric cancer cells in the S phase and alleviate the G2/M phase arrest by inhibiting p53 signaling,thereby promoting cell proliferation.
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Humains , Tumeurs de l'estomac/génétique , Cycline D1/métabolisme , Protéine p53 suppresseur de tumeur , Phosphoprotéines/métabolisme , Antigène KI-67 , Lignée cellulaire tumorale , Pronostic , Prolifération cellulaire , Phosphoprotein Phosphatases/métabolisme , Thréonine , SérineRésumé
Objective To investigate the expression and prognostic significance of mediator complex subunit 8 (MED8) in gastric cancer and its impact on the cell cycle.Methods The expression of MED8 in gastric cancer and adjacent tissues and its correlation with patients' prognosis were analyzed using public databases.A validation cohort of 104 patients who underwent radical resection for gastric cancer in the First Affiliated Hospital of Bengbu Medical College from June 2012 to July 2017 was included.The receiver operating characteristic curve was established to evaluate the predictive value of MED8 for postoperative 5-year survival.Bioinformatics tools were used to predict the biological roles of MED8 in gastric cancer.The effect of the MED8 level on the G1/S phase transition of gastric cancer cells (MGC-803) was analyzed via lentivirus transduction and flow cytometry.Western blotting was carried out to assess the impact of MED8 expression on the protein levels of cyclin-dependent kinase 4(Cdk4) and G1/S-specific cyclin-D1(CyclinD1) in MGC-803 cells.Results The high expression of MED8 in the gastric cancer tissue was associated with poor prognosis (P<0.001) and had prognostic significance (area under curve=0.733,P<0.001).Gene enrichment analysis suggested that MED8 may participate in the cell cycle process.Flow cytometry results revealed that the upregulation of MED8 expression promoted the transition of MGC-803 cells from the G1 phase to the S phase (P<0.001),while the downregulation of MED8 had the opposite effect (P<0.001).Western blotting showed increases in the protein levels of Cdk4 and CyclinD1 in MGC-803 cells with upregulated MED8 expression (all P<0.001),and decreases in the cells with downregulated MED8 expression (all P<0.001).Conclusion MED8 is highly expressed in gastric cancer and may affect its progression and prognosis by regulating the G1/S phase transition of gastric cancer cells.
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Humains , Tumeurs de l'estomac , Pronostic , Prolifération cellulaire , Cycle cellulaire , Complexe médiateur/métabolisme , Lignée cellulaire tumoraleRésumé
AIM:To explore the influence factors of the treatment zone diameter(TZD)and its correlation with axial length growth(ALG)after Paragon CRT orthokeratology.METHODS: Retrospective clinical study. The data of 226 myopic patients(226 eyes)wearing Paragon CRT orthokeratology from April 2020 to September 2022 were collect. The correlated factors of TZD after wearing lens for 1mo, and the relationship between the overlapping treatment zone/ pupil area ratio and the ALG after wearing lens for 1a were analyzed.RESULTS: After wearing lens for 1mo, the TZD was negatively correlated with central corneal thickness(CCT)and positively correlated with the flat corneal eccentricity. After wearing lens for 1a, the ALG of the small TZD group(0.25±0.18mm)was significantly smaller than that of the large TZD group(0.34±0.24mm, P=0.002), and the ALG of the small area ratio group(0.24±0.19mm)was significantly smaller than that of the large area ratio group(0.35±0.23mm,P<0.001). Age and overlapping treatment zone area/pupil area ratio were significantly associated with the ALG in multivariate linear regression(all P<0.05).CONCLUSION: The wearers with thicker CCT and smaller flat corneal eccentricity usually had smaller TZD, and both the TZD and the overlapping treatment zone area/pupil area ratio were correlated with the ALG.
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Aim To explore and optimize the different separation and purification methods of neural stem cells (NSCs) , and compare the cell viability and purity after separation and purification.Methods (X) Separation of NSCs: The brains of ICR mice born within 24 h were isolated ( the cerebellum and olfactory bulb removed) , chopped and digested by mechanical pipetting, trypsin digestion, and PDD enzyme digestion.After sieving and centrifugation, the brain tissues were inoculated at a concentration of 1 X 10 • L , and cultured in serum-free medium to observe and compare the activity, proliferation and number of miscellaneous cells.(2) Purification of NSCs: The brain tissues of mice born within 24 h were isolated, and NSCs were purified by differential centrifugation and sieving, and the purity was identi-fied by immunofluorescence.Results NSCs separated by PDD enzyme digestion had high survival rate and rapid proliferation rate; the Nestin positive rate of NSCs in both Sieving assay and Differential centrifugation assay groups was higher than that of primary NSCs (59.14% ± 0.16% , P <0.05) , and the former (93.54% ± 0.02%) was higher than the latter (86.12% ± 0.04% ) .Conclusions The three separation methods can obtain a large amount of NSCs.Among them, the PDD enzymatic digestion method has little damage to the NSCs, and the neuro-sphere proliferation speed is fast; the NSCs obtained by the sieving assay have higher purity.
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AIM: To construct and validate a diagnostic model for early detection of keratoconus based on parameters in Sirius.METHODS: The study comprised of 46 early keratoconus eyes(including 20 right eyes and 26 left eyes in 34 patients)and 46 age- and gender-matched normal eyes(including the right eyes of 46 patients)in the prediction group. The predictive index was constructed using LASSO and Logistic regression analyses based on the topographic, pachymetric and aberrometry variables of Sirius. There were 23 early keratoconus eyes categorized as suspected keratoconus cases by Sirius(including 12 right eyes and 11 left eyes in 23 patients)and 23 age- and gender-matched normal eyes(including the right eyes of 23 patients)included in the application cohort. External validation of predictors was performed for the application cohort.RESULTS: Sirius Keratoconus Index(SKI)was calculated based on the minimum corneal thickness and symmetry index back of Sirius. Highest AUC values were obtained in the prediction group(AUC=0.932)after Logistic regression analysis. The cut-off value of SKI was set at 0.44. Then, the receiver operating characteristic(ROC)curve, calibration plot and nomogram of the diagnostic formula were analyzed for the prediction cohort in detail. Finally, the accuracy of the SKI was evaluated in the application cohort; the sensitivity was 91% and the specificity was 96%.CONCLUSION: SKI based on minimum corneal thickness and symmetry index back of Sirius is a simple and effective method for early detection of keratoconus in the preoperative screening for refractive surgery.
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OBJECTIVE@#To investigate the expression of aldehyde dehydrogenase 3B1 (ALDH3B1) in gastric cancer and explore its correlation with the pathological parameters and long-term prognosis of the patients.@*METHODS@#We analyzed the clinical data of 101 patients who underwent radical gastrectomy for gastric cancer in our hospital between January, 2013 and November, 2016, and examined the expression of ALDH3B1 in paraffin-embedded samples of gastric cancer tissues and adjacent tissues from these cases by immunohistochemical staining. We evaluated the correlation between ALDH3B1 expressions and histopathological parameters and assessed the predictive value of ALDH3B1 expression for long-term survival of the patients. We also examined the effect of lentivirus-mediated interference and overexpression of ALDH3B1 on the malignant behaviors of MGC-803 gastric cancer cells.@*RESULTS@#The expressions of ALDH3B1 and Ki67 were significantly higher in gastric cancer tissues than in adjacent tissues (P < 0.05). In gastric cancer patients, ALDH3B1 expression was positively correlated with peripheral blood CEA and CA19-9 levels (P < 0.01). The proportion of patients with CEA ≥5 μg/L, CA19-9 ≥37 kU/L, T stage of 3- 4, and N stage of 2-3 was significantly greater in high ALDH3B1 expression group than in low expression group. Kaplan-Meier survival analysis showed that the 5-year survival rate was significantly lower in gastric cancer patients with high ALDH3B1 expressions (P < 0.01). Univariate and Cox multiple regression analyses identified a high expression of ALDH3B1 (P < 0.05, HR= 0.231, 95% CI: 0.064-0.826), CEA≥5 μg/L (P < 0.01, HR=4.478, 95% CI: 1.530-13.110), CA19-9≥37 kU/L (P < 0.01, HR=3.877, 95% CI: 1.625-9.247), T stage of 3-4 (P < 0.01, HR=4.953, 95% CI: 1.768-13.880), and N stage of 2-3 (P < 0.05, HR=2.152, 95% CI: 1.152-4.022) as independent risk factors affecting 5-year survival after radical gastrectomy. The relative ALDH3B1 expression level, at the cut-off point of 4.66, showed a sensitivity of 76.47% and a specificity of 76% for predicting 5-year postoperative death (P < 0.01). In the cell experiment, overexpression of ALDH3B1 obviously promoted the proliferation, migration and invasion of MGC-803 cells.@*CONCLUSION@#As an independent risk factor affecting 5-year survival after radical gastrectomy, ALDH3B1 is highly expressed in gastric cancer and correlated with pathological parameters of the tumor, and a high ALDH3B1 expression may promote proliferation, invasion and metastasis of gastric cancer cells.
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Humains , Aldehyde oxidoreductases , Antigène CA 19-9 , Antigène carcinoembryonnaire , Gastrectomie , Stadification tumorale , Pronostic , Études rétrospectives , Tumeurs de l'estomac/anatomopathologieRésumé
ObjectiveOnly few studies have been published of the effect of microvascular invasion (MVI) on long-term prognosis of liver resection (LR) for multiple hepatocellular carcinomas (mHCCs). Therefore, we investigate the efficacy of MVI on long-term prognosis of the patients undergoing LR formHCCs.MethodsThe clinical data of 505 patients undergoing LR for mHCCs in the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University between March 2009 and March 2015 were retrospectively analyzed. Patients were divided into the MVI(+) group (n=279)and MVI (-) group (n=226), and146 patients in MVI (+) group and 124 patients in MVI (-) group received adjuvant transarterial chemoembolization (TACE). The Kaplan-Meier approach was used for survival analysis and the Cox proportional-hazards regression model was used forthe risk factors of long-term survival rate.ResultsThe early recurrence rate of MVI (+) group was significantly higher than that of MVI (-) group (60.4% vs 40.5%, P<0.01), and the 1-, 3-, 5-year overall survival rate of MVI (+) group was significantly lower than those in MVI (-) group (70.5%, 47.4%, 33.4% vs 86.6%, 66.8%, 50.1%, P<0.05). Among MVI (+) patients, the early recurrence rate and 1-, 3-, 5-year overall survival rate in the adjuvant TACE group were better than those in the control group (early recurrence rate 41.3% vs 39.3%, P<0.05; 1, 3, 5 year overall survival rate 92.8%, 72.5%, 53.1% vs 78.6%, 59.5%, 47.3%, P<0.05). Multivariate Cox model indicated that the Alpha-foetoprotein (AFP) level, maximum tumor diameter/minimum tumor diameter, MVI and adjuvant TACE were independent risk factors for early recurrence (HR=1.48, 1.51, 1.34, 0.76, P<0.05); maximum tumor diameter, intraoperative blood transfusion, MVI and adjuvant TACE were independent risk factors for postoperative overall survival (HR=1.75, 1.75, 1.36, 0.68, P<0.05).ConclusionMVI is a risk factor for early recurrence and poor long-term prognosis after LR for mHCCs. For mHCCs with MVI, adjuvant TACE after LR could reduce the early recurrence rate and improve the long-term survival rate.
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OBJECTIVE@#To observe the effect of lumbar disc herniation treated with acupuncture at different time intervals.@*METHODS@#A total of 180 patients of lumbar disc herniation were randomized into an observation group 1, an observation group 2 and an observation group 3, 60 cases in each one. All patients were treated with acupuncture at Jiaji L-L (EX-B 2), Huantiao (GB 30), Weizhong (BL 40), etc. And then KWD-808 electroacupuncture instrument was connected, time intervals of acupuncture were once every day, once every 2 days and once every 3 days, 3 weeks were provided. At 1-week, 2-week and 3-week treatment, the visual analogous scale (VAS) and Japanese Orthopedics Association (JOA) scale were observated, and the effects were evaluated.@*RESULTS@#The effective rates in the observation group 1 and the observation group 2 were 96.7% (58/60) and 95.0% (57/60), there was no significant different between the two groups (>0.05), which were superior to 88.3% (53/60) in the observation group 3 (both 0.05) at 1-week, 2-week and 3-week treatment, however, they were significantly reduced compared with the observation group 3 (all 0.05) at 1-week, 2-week and 3-week treatment, however, they were significantly increased compared with the observation group 3 at 3-week treatment (both <0.05).@*CONCLUSION@#Acupuncture once every day and once every 2 days in the treatment of lumbar disc herniation is equally effective, better than once every 3 days.
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Humains , Points d'acupuncture , Électroacupuncture , Déplacement de disque intervertébral , Thérapeutique , Résultat thérapeutiqueRésumé
Objective: To extract,isolate,purify and identify the structures of the flavonoid glycoside in Dendrobium officinale from two different origin places (Danxia species and Yunnan Guangnan species),and provide experimental reference for confirming the common flavonoid glycoside components in D. officinale. Method: ① 70% ethanol was applied to extract the total flavonoids in leaves of D. officinale from two different species. Organic solvents petroleum ether,acetic ether and water saturated n-butyl alcohol were used in turn to extract the crude extraction. Then AB-8 Macroporous resin,Sephadex LH-20 and ODS chromatographic column were applied to isolate and purify the water saturated n-butyl alcohol extraction fraction. The structures of flavonoid glycoside were identified by studying physicochemical property,applying modern spectroscopy method like HPLC,ESI-MSn,1H-NMR,13 C-NMR,etc. ② HPLC characteristic spectrum technique was used to analyse and compare the common flavonoid glycoside components in Dendrobium officinale from different origin places (Danxia species,Yunnan Guangnan species,Guangxi Tiepilan species and Zhejiang native species). Result: Five flavonoid glycoside compounds were isolated from the crude extractions of the leaves of D. officinale from two different species,and they were identified as rutin,vicenin Ⅱ,viceninⅠ,violanthin and isoviolanthin. The characteristic spectrum of vicenin Ⅱ and viceninⅠwere detected in stems of D. officinale from four different origin places (Danxia species,Yunnan Guangnan species,Guangxi Tiepilan species and Zhejiang native species),and vicenin Ⅱ had a better separation degree in the characteristic spectrum. However,the characteristic spectrum of violanthin and isoviolanthin were more obvious in Yunnan Guangnan species and Guangxi Tiepilan species,while rutin was obvious in the Danxia species. Conclusion: Vicenin Ⅱis the common flavonoid glycosides component in D. officinale from different origin places (Danxia species,Yunnan Guangnan species,Guangxi Tiepilan species and Zhejiang native species),and can be used as the internal reference material for the characteristic spectrum of D. officinale.
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Hepatocellular carcinoma(HCC) is one of the most common malignancies in the world. Liver resection and transplantation are currently the most important treatments,but the high recurrence rate of postoperative tumors significantly reduces long-term survival. Microvascular invasion(MVI) predicts the risk of postoperative tumor recurrence and is an independent risk factor for recurrence after resection. Furthermore,focusing on how the postoperative management can be improved on histopathologically confirmed patients with HCC with MVI,and the potential roles of using predictive tests to estimate the risk of presence of MVI,help in preoperative therapeutic decision-making in patients with HCC.
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A one-step dual flow immunochromatographic assay (DICGA), based on a competitive format, was developed for simultaneous quantification of ochratoxin A (OTA) and zearalenone (ZEN) in corn, wheat, and feed samples. The limit of detection for OTA was 0.32 ng/ml with a detection range of 0.53‒12.16 ng/ml, while for ZEN it was 0.58 ng/ml with a detection range of 1.06‒39.72 ng/ml. The recovery rates in corn, wheat, and feed samples ranged from 77.3% to 106.3% with the coefficient of variation lower than 15%. Naturally contaminated corn, wheat, and feed samples were analyzed using both DICGA and liquid chromatography-tandem mass spectrometry (LC-MS/MS) and the correlation between the two methods was evaluated using a regression analysis. The DICGA method shows great potential for simple, rapid, sensitive, and cost-effective quantitative detection of OTA and ZEN in food safety control.
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Aliment pour animaux , Calibrage , Chromatographie d'affinité , Chromatographie en phase liquide , Colloïdes , Contamination des aliments/analyse , Sécurité des aliments , Or , Dosage immunologique/méthodes , Concentration inhibitrice 50 , Limite de détection , Nanoparticules métalliques , Ochratoxines/analyse , Analyse de régression , Reproductibilité des résultats , Sensibilité et spécificité , Triticum , Zea mays , Zéaralénone/analyseRésumé
Objective To compare the effect of different intestinal loop labeling methods under single balloon enteroscopy for ERCP. Method From June 2015 to May 2017, 36 cases of single balloon enteroscopy assisted ERCP patients, according to the study period divided into A, B, C three groups, In group A, the afferent loops were confirmed by titanium clips, labeled intestinal loops, and the B group was identified by methylene blue labeling and intestinal loops, and the C group was the control group, the operation time of the 3 groups was recorded (the starting time of operation, the time of reaching the nipple of the input loop or the time of the Roux-en-Y biliary anastomosis), the incidence of complications and the success rate of operation. Results The operation time was 42.17 min in group A and 59.83 min in group C, and there was significant difference between the two groups (P < 0.01),There was no statistically significant difference between group A and group B, group B and group C (P > 0.05), the complication rate and the operation success rate were not statistically different between the three groups (P > 0.05). Conclusion The operation time of the input loop at the time of ERCP assisted by single balloon enteroscopy has a clear advantage over the examination of the intestinal loop with a titanium clip.
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Objective To compare the agreement between corneal-compensated intraocular pressure (IOPcc) measured by ocular response analyzer (ORA) and 5 corrected intraocular pressures from Sirius anterior system,and analyze the correlation of ocular biometries with IOPcc and Goldmann-correlated IOP (IOPg).Methods Together 90 eyes of 90 patients,aged 18-37 (24.47 ± 5.57) years,without refractive surgery contraindications undergoing myopic laser treatment were enrolled in this study.Each eye was measured 3 times by Sirius anterior system,with the best results of IOPcc and IOPg was selected.And patients' corneal biomechanical parameters were measured using an ORA (Reichert,Inc.,USA).The IOPg from ORA were entered into the 5 IOP formulas embedded in Sirius anterior system to generate the corrected IOPs,which were recorded as the Dresdner corrected IOP,Ehlers corrected IOP,Kohlhaas corrected IOP,Orssengo/Pye corrected IOP and Shah corrected IOP,accordingly.Meanwhile the agreement of the 5 corrected IOPs and the IOP measured non-contact tonometer with IOPcc was analyzed,respectively.Corneal biomechanics,including corneal hysteresis and corneal resistance factor,and ocular biometries were also recorded,and the correlation of these parameters with IOPcc and IOPg was assessed with correlation coefficient.Resuits The pair comparison of IOPcc and Kohlhaas corrected IOP was statistically significant (P < 0.05).Dresdner corrected IOP and Orssengo/Pye corrected IOP showed a good agreement with IOPcc,and the 95% limits of agreements (LoA) were (-2.09 ~2.55)mmHg (1 kPa=7.5 mmHg) and (-2.38~2.37) mmHg,respectively.The 95%LoA of Dresdner's corrected IOP and IOPcc was the narrowest.No statistical significance was found between IOPcc and corneal hysteresis,corneal resistance factor,ocular biometries,but there was a positive correlation between IOPg and corneal resistance factor,central corneal thickness,and corneal volume (all P < 0.05).Conclusion Dresdner and Orssengo/Pye corrected IOP had a good agreement with IOPcc,and most ocular biometries have a little effect on IOPcc.
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Objective To establish an infectious disease field prevention and control equipment system to facilitate equipment efficacy evaluation. Methods The equipment system was determined by analyses on the main procedure of infectious disease field prevention and control,researches on the missions and equipment requirements of grades of facilities for disease prevention and control,references to related equipment allocation standards as well as expert consulting.Results The first-grade system consisted of six classes and 136 subclasses of equipment,the second-grade system was made up of six classes and 114 subclasses of equipment and the third-grade system included six classes and 58 subclasses of equipment. Conclusion The three-grade infectious disease field prevention and control equipment system contributes to equipment efficacy evaluation.
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Objective To design a multi-function first-aid module integrating instruments with the box to solve the existing problems in integration, operation, deployment, withdrawal, environmental adaptability and etc, so as to realize integrated storage, transport and operation of the instruments. Methods The module had its structure, modes of deployment and withdrawal, instruments buffering and vibration isolation, ergonomics and etc designed with the technologies of integrating box and instruments, integration, buffering and vibration isolation, centralized oxygen and power supply as well as the methods of system modeling,structure simulation and CAD.Results The first-aid module was gifted with the functions of respiratory and circulatory rehabilitation,vital signs monitoring,emergency treatment of complex and multi injuries, which could be used as a 2 000 mm×800 mm×600 mm emergency treatment platform when deployed. There were 4 angles for adjusting the backboard to form anti-shock positions for the severe casualties.The module had the time for deployment and withdrawal not more than 5 min,and was easy to deploy,withdraw,transport and store.Conclusion The module behaves well in structure,function,layout,operation and military service when used for the treatment of the severe casualties in the tent-form field medical system,which contributes to enhancing the casualty treatment efficiency and prognosis.[Chinese Medi-cal Equipment Journal,2018,39(5):12-16]
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Objective: To isolate dehydrocorydaline and glaucine by high-speed counter-current chromatography (HSCCC) from the extraction of Corydalis Rhizoma (CR). Methods: A mixture of chloroform-n-butanol-methanol-water (4:1:2:5) was used as the two phase solvent system both in forward and reversal direction, with a flow rate of 10.0 mL/min and a rotary speed of 800 r/min eluting for 30 min. The detection wavelength was 282 nm and injection volume was 50 mg. The purity of the target product was analyzed by HPLC-UV and the structure was identified by ultra performance liquid chromatography-tandem quadrupole time-of- flight mass spectrometry (UPLC-Q-TOF-MS/MS). Results: Under optimized conditions, 7.1 mg and 3.4 mg of two compounds were obtained and their yields were 81.43% and 91.11% respectively. Their purities were 98.9% and 94.3% detected by HPLC. dehydrocorydaline and glaucine were identifiled through HPLC, ultraviolet absorbance, and UPLC-Q-TOF-MS/MS. Conclusion: The result indicate that HSCCC is a powerful technique for the purification of dehydrocorydaline and glaucine from CR.
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OBJECTIVE: To investigate the job burnout status and its influencing factors in personnel of community public health service in Wanzhou District of Chongqing. METHODS: By stratified cluster sampling method,220 workers in community public health service in Wanzhou District of Chongqing City were selected and investigated by Maslach Burn-out Inventory-general Survey. Their job burnout situation and influencing factors were analyzed. RESULTS: The median( the 25 th and 75 th percentiles) of dimension scores of emotional exhaustion,cynicism,and low sense of personal achievement of these 220 workers were 1. 1( 0. 6,2. 4),0. 5( 0. 0,1. 5),4. 7( 2. 3,6. 0) respectively. In each dimension,the ratios of moderate and severe job burnout were 33. 2%,20. 0%,and 40. 9%. Workers whose monthly income was less than2 000 yuan had a higher emotional exhaustion score than those who owed more than 2 000 yuan and more than 2 500 yuan per month( P < 0. 05); workers who work less than 15 years had a higher score in cynicism than those work over 15 years and 25 years( P < 0. 05). The multiple regression analysis results showed that low sense of personal achievement was related to genders( P < 0. 01),and the score of male was lower than that of female. CONCLUSION: Job burnout in workers of community public health service is severe,the degree of job burnout is mainly influenced by monthly income,gender,and length of service.
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<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of Yinchen Zhufu Decoction (, YCZFD) in the treatment of acute-on-chronic liver failure caused by hepatitis B virus (HBV-ACLF) with cold pattern in Chinese medicine (CM).</p><p><b>METHODS</b>This is a multi-center randomized controlled trial of integrative treatment of CM and Western medicine (WM) for the management of HBV-ACLF patients. A total of 200 HBV-ACLF patients with cold pattern were equally randomly assigned to receive YCZFD and WM (integrative treatment) or WM conventional therapy alone respectively for 4 weeks. The primary end point was the mortality for HBV-ACLF patients. Secondary outcome measures included Model for End-Stage Liver disease (MELD) score, liver biochemical function, coagulation function and complications. Adverse events during treatment were reported.</p><p><b>RESULTS</b>The mortality was decreased 14.28% in the integrative treatment group compared with WM group (χ(2) =6.156, P=0.013). The integrative treatment was found to signifificantly improve the MELD score (t=2.353, P=0.020). There were statistically signifificant differences in aspartate transaminase, total bilirubin, indirect bilirubin, direct bilirubin and prothrombin time between the two groups (P<0.05 or P<0.01). The complications of ascites (χ(2)=9.033, P=0.003) and spontaneous bacteria peritonitis (χ(2)=4.194, P=0.041) were improved signifificantly in the integrative treatment group. No serious adverse event was reported.</p><p><b>CONCLUSIONS</b>The integrative treatment of CM and WM was effective and safe for HBV-ACLF patients with cold pattern in CM. The Chinese therapeutic principle "treating cold pattern with hot herbs" remains valuable to the clinical therapy. (Trial registration No. ChiCTR-TRC-10000766).</p>
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Adulte , Femelle , Humains , Mâle , Insuffisance hépatique aigüe sur chronique , Traitement médicamenteux , Mortalité , Virologie , Ascites , Démographie , Médicaments issus de plantes chinoises , Pharmacologie , Utilisations thérapeutiques , Électrolytes , Hépatite B , Traitement médicamenteux , Mortalité , Virus de l'hépatite B , Physiologie , Médecine intégrative , Foie , Anatomopathologie , Virologie , Tests de la fonction hépatique , Péritonite , Facteurs temps , Résultat thérapeutiqueRésumé
<p><b>BACKGROUND</b>In qualitative diagnosis of bile duct stenosis, single diagnostic measure is difficult to make a correct diagnosis, to combine several diagnostic techniques may be helpful to make an accurate diagnosis. The aim of this study was to evaluate the value of intraductal ultrasonography (IDUS), endoscopic brush cytology and K-ras, P53 gene mutation in the early diagnosis of malignant biliary stricture.</p><p><b>METHODS</b>From February 2012 to February 2013, 84 patients with suspected malignant biliary stricture were performed IDUS firstly, then endoscopic brush cytology and finally K-ras, P53 gene mutation detection, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of all above ways were evaluated and compared.</p><p><b>RESULTS</b>Of 84 patients, 52 cases were ultimately diagnosed malignant biliary stenosis; of which, 9 cases had no recurrence or metastasis to other organs after radical operation during the follow-up period. IDUS combined with brush cytology and K-ras + P53 gene mutation detection had obvious advantage in the sensitivity, accuracy and negative predictive value than any other joint detection and single detection (the advantage was more significant compared with IDUS + brush cytology or any single detection P < 0.01). There were obvious statistical significance in the sensitivity and accuracy between IDUS + brush cytology + P53 or IDUS + brush cytology + K-ras and IDUS + brush cytology or IDUS (P < 0.05). There was no statistical significance in the sensitivity, specificity, positive predictive value, negative predictive value and accuracy between IDUS + brush cytology + P53 and IDUS + brush cytology + K-ras (P > 0.05).</p><p><b>CONCLUSIONS</b>IDUS combined with brush cytology and K-ras, P53 gene mutation detection is better than the separate detection and contribute to the early diagnosis of malignant biliary stricture. Its more widespread use is recommended.</p>
Sujets)
Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Maladies des canaux biliaires , Diagnostic , Génétique , Tumeurs des canaux biliaires , Diagnostic , Génétique , Conduits biliaires , Anatomopathologie , Sténose pathologique , Diagnostic , Génétique , Gènes p53 , Génétique , Gènes ras , Génétique , MutationRésumé
<p><b>BACKGROUND</b>Currently, the recommendation when treating acute biliary or pancreatic disease during pregnancy is to perform endoscopic retrograde cholangiopancreatography (ERCP) without radiation exposure, either empirically (with no radiographic guidance) or with ultrasound guidance. However, few published studies compared these two ways. This study aimed to compare ultrasound-guided ERCP with the procedure without radiographic guidance in the treatment of acute pancreaticobiliary disease in pregnant patients.</p><p><b>METHODS</b>The clinical data of 68 pregnant patients with acute pancreaticobiliary disease admitted to our hospital between January 2004 and May 2010 were reviewed retrospectively. ERCP was performed without radiographic guidance in 36 cases (group A) and with ultrasound guidance in 32 cases (group B). Data on the following variables were compared between the two groups: surgical success rate, rate of complete stone removal, time to resolution of clinical manifestations and laboratory indicators, length of hospital stay, complications, outcome and differences in efficacy of ERCP during different stages of pregnancy.</p><p><b>RESULTS</b>In group A, the rates of surgical success and complete removal of stones were 69% and 60%, respectively; the corresponding values were 91% and 89% in group B (P < 0.05). Postoperatively, clinical manifestations improved rapidly in all patients; there was no statistically significant difference between the groups (P > 0.05). Leukocyte counts and liver function had improved significantly after one week in all patients; they recovered more quickly in group B ((8.64 ± 1.83) days vs. (14.57 ± 3.74) days, (14.29 ± 4.64) days vs. (20.00 ± 5.40) days, P < 0.01). The hospital stay was shorter in group B ((16.28 ± 7.25) days vs. (28.00 ± 6.83) days, P < 0.001). The complication rate was 14% in group A and 3% in group B (P < 0.05). There were no significant differences between the two groups in the procedure's efficacy during different stages of pregnancy.</p><p><b>CONCLUSIONS</b>In the treatment of acute pancreaticobiliary disease during pregnancy, ultrasound-guided ERCP is safer and more effective than performing the procedure empirically without radiographic guidance when performed by experienced practitioners. Its more widespread use is recommended.</p>