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Objective:To analyze the risk factors for asparaginase-associated pancreatitis (AAP) in children with acute lymphoblastic leukemia (ALL) after treatment with pegaspargase and evaluate the predictive value of pediatric sequential organ failure assessment (SOFA) score, pediatric acute pancreatitis severity (PAPS) score, Ranson′s score and pediatric Ministry of Health, Labour and Welfare of Japan (JPN) score for severe AAP.Methods:Cross-sectional study.The clinical data of 328 children with ALL who received pegaspargase treatment in the Department of Pediatric Hematology, Zhujiang Hospital, Southern Medical University from January 2014 to August 2021, as well as their clinical manifestations, laboratory examinations, and imaging examinations were collected.The SOFA score at the time of AAP diagnosis, PAPS score and Ranson′s score at 48 hours after AAP diagnosis, and JPN score at 72 hours after AAP diagnosis were calculated, and their predictive value for severe AAP was evaluated by the receiver operating characteristic (ROC) curve.Results:A total of 6.7%(22/328) of children had AAP, with the median age of 6.62 years.AAP most commonly occurred in the induced remission phase (16/22, 72.7%). Three AAP children were re-exposed to asparaginase, and 2 of them developed a second AAP.Among the 22 AAP children, 16 presented with mild symptoms, and 6 with severe symptoms.The 6 children with severe AAP were all transferred to the Pediatric Intensive Care Unit (PICU). There were no significant differences in gender, white blood cell count at first diagnosis, immunophenotype, risk stratification, and single dose of pegaspargase between the AAP and non-AAP groups.The age at diagnosis of ALL in the AAP group was significantly higher than that in the non-AAP group ( t=2.385, P=0.018). The number of overweight or obese children in the AAP group was also higher than that in the non-AAP group ( χ2=4.507, P=0.034). The areas under the ROC curve of children′s JPN score, SOFA score, Ranson′s score, and PAPS score in predicting severe AAP were 0.919, 0.844, 0.731, and 0.606, respectively.The JPN score ( t=4.174, P=0.001) and the SOFA score ( t=3.181, P=0.005) showed statistically significant differences between mild and severe AAP. Conclusions:AAP is a serious complication in the treatment of ALL with combined pegaspargase and chemotherapy.Older age and overweight or obesity may be the risk factors for AAP.Pediatric JPN and SOFA scores have predictive value for severe AAP.
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Objective@#To investigate the incidence of microvascular myocardial ischemia in diabetic patients without obstructive coronary artery disease (CAD) and its relationship with angina. @*Materials and Methods@#Diabetic patients and an intermediate-to-high pretest probability of CAD were prospectively enrolled. Non-diabetic patients but with an intermediate-to-high pretest probability of CAD were retrospectively included as controls. The patients underwent dynamic computed tomography-myocardial perfusion imaging (CT-MPI) and coronary computed tomography angiography (CCTA) to quantify coronary stenosis, myocardial blood flow (MBF), and extracellular volume (ECV). The proportion of patients with microvascular myocardial ischemia, defined as any myocardial segment with a mean MBF ≤ of 100 mL/min/100 mL, in patients without obstructive CAD (Coronary Artery Disease–Reporting and Data System [CAD-RADS] grade 0–2 on CCTA) was determined. Various quantitative parameters of the patients with and without diabetes without obstructive CAD were compared. Multivariable analysis was used to determine the association between microvascular myocardial ischemia and angina symptoms in diabetic patients without obstructive CAD. @*Results@#One hundred and fifty-two diabetic patients (mean age: 59.7 ± 10.7; 77 males) and 266 non-diabetic patients (62.0 ± 12.3; 167 males) were enrolled; CCTA revealed 113 and 155 patients without obstructive CAD, respectively. For patients without obstructive CAD, the mean global MBF was significantly lower for those with diabetes than for those without (152.8 mL/min/100 mL vs. 170.4 mL/min/100 mL, P < 0.001). The mean ECV was significantly higher for diabetic patients (27.2% vs. 25.8%, P = 0.009). Among the patients without obstructive CAD, the incidence of microvascular myocardial ischemia (36.3% [41/113] vs. 10.3% [16/155], P < 0.001) and interstitial fibrosis (69.9% [79/113] vs. 33.3% [8/24], P = 0.001) were significantly higher in diabetic patients than in the controls. The presence of microvascular myocardial ischemia was independently associated with angina symptoms (adjusted odds ratio = 3.439, P = 0.037) in diabetic patients but without obstructive CAD. @*Conclusion@#Dynamic CT-MPI + CCTA revealed a high incidence of microvascular myocardial ischemia in diabetic patients without obstructive CAD. Microvascular myocardial ischemia is strongly associated with angina.
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Medical service price reflects the value and the financial compensation for medical services.The medical service price reform plays an important role in optimizing the allocation of medical resources and transforming the operating mechanism of public hospitals.The pricing of medical services should take many factors into consideration such as the characteristics of medical service,service markets,service costs,supply and demand relationships,medical insurance payment policies,compensation mechanisms,and so on.In response to the current situation of price management methods and price levels for medical service in China,various pricing methods such as cost-based pricing,price-regulation pricing,and demand-oriented pricing should be comprehensively utilized to ex-plore a pricing mechanism that separates medical service value from medical service price,human resource value from material con-sumption value,and build a medical service pricing system that could be coordinated with policy objectives.
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Based on the research of current domestic medical service item and the financial classification policy,combined with the existing problem during the practice,it analyzes the existing problem of financial classification in medical service item cost,and discusses the proposal of nationwide unified mapping between medical service item and their financial classification,the practice path-way of implementation,it can be the valuable reference for hospital's refined financial management and payment reform.
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Objective:To explore the radiation dose of brachytherapy plan for cervical cancer patients under different image-guided method and the time efficiency characteristics of each part of the clinical workflow, so as to provide reference for the overall arrangement of clinical brachytherapy.Methods:The workflow of 223 patients with brachytherapy was retrospectively analyzed. The whole workflow was divided into 5 parts: applicator placement, image acquisition, delineation of target and organs at risk, plan design and review, and treatment implementation. The image-guided brachytherapy was divided into X-ray guided 2D treatment groups, and computed tomography(CT)and magnetic resonance imaging (MRI) guided 3D treatment groups. The radiation dose and the time spent in each part of the three image-guided brachytherapy workflow were calculated. The radiation dose was evaluated using total reference air kerma (TRAK). The results were analyzed using the nonparametric test of SPSS 20 software.Results:TRAK 4.2(4.4, 3.9) cGy was significantly higher in X-ray guided 2D treatment group than in the CT guided 3D treatment group [3.5(3.9, 2.7) cGy, H =90.73, P < 0.01] and the MRI guided 3D treatment group[2.7(2.9, 2.4) cGy, H =90.73, P < 0.01]. The total workflow time of the X-Ray film guidance group was the shortest [55.0(67.0, 50.0) min], followed by the CT guidance group [80.0(91.0, 72.0) min], and the total workflow time of the MRI image guidance group was the longest [119.0(143.0, 105.5) min, H =106.39, P <0.01]. The image acquisition time of the MRI-guided group was significantly higher than that of the X-ray film guidance group and the CT-guided group ( H =44.80, P<0.01). The time of target delineation in the MRI-guided group was significantly longer than that in the CT-guided group ( Z=-5.10, P<0.01). The MRI-guided group took the longest time for planning, followed by the CT-guided group, and the X-ray guided group took the shortest time ( H =57.93, P<0.01). Conclusions:The 2D brachytherapy mode guided by X-ray film had the shortest process time but higher TRAK, while the 3D brachytherapy mode guided by MR had the longest process time, and the planned TRAK result were comparable to those guided by CT. When multiple patients are treated with brachytherapy at the same time, the work efficiency can be improved by interspersing different phases and the waiting time can be avoided.
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Objective:To investigate the risk factors and prognoses of cerebral venous sinus thrombosis (CVST) caused by pegasparaginase (PEG-Asp).Methods:A total of 252 children with acute lymphoblastic leukemia (ALL) were treated with PEG-Asp chemotherapy in our hospital from December 2016 to July 2021, including 8 children with CVST. The clinical manifestations, laboratory and imaging features, treatments and prognoses of these children with CVST caused by PEG-Asp were analyzed retrospectively.Results:(1) CVST occurred during induction chemotherapy in 4 children, during re-induction chemotherapy in 3 children, and during consolidation stage in one child. CVST occurred in two children who received PEG-ASP chemotherapy once, in one child who received PEG-Asp chemotherapy twice, and 5 children who received PEG-Asp chemotherapy more than twice. The median time between CVST occurrence and last treatment of PEG-Asp was 20.5 d. (2) The clinical manifestations included paroxysmal headache ( n=4), nausea or vomiting ( n=3), convulsions ( n=2) and persistent blurred vision ( n=1). (3) CVST appeared at the sigmoid sinus ( n=6), transverse sinus ( n=4) and superior sagittal sinus ( n=4), of which one child was complicated with hemorrhage in left frontal parietal and right parietal cortex, and one with reversible posterior encephalopathy syndrome; 8 children were not complicated with thrombus in other parts. (4) Some of the children were complicated with abnormal blood coagulation. When CVST occurred, fibrinogen level decreased in 3 children, anti-thrombin III level decreased in 2 children, and D-dimer level increased in 3 children. (5) Six children were treated with low molecular weight heparin (LMWH), of which, 4 were treated with rivasaban and one with warfarin sequentially. The total course of anticoagulation was 56 d. (6) The symptoms of 6 children disappeared after anticoagulation; Magnetic resonance venography (MRV) showed disappeared thrombus in 4 children and reduced thrombus range in 2 children. One child with intracranial hemorrhage did not use PEG-Asp anymore; 7 accepted PEG-Asp further during follow-up chemotherapy, of which one had CVST recurrence and the range of thrombus was reduced after anticoagulant therapy. Conclusions:When children with ALL develop unexplained neurological symptoms during PEG-Asp chemotherapy, CVST should be highly vigilant. Enhanced MRI and MRV should be performed for early diagnosis. Some children are complicated with abnormal blood coagulation, and LMWH, warfarin and rivasaban are effective. The prognosis is good and there are no sequelae. Most children accepted PEG-Asp again will not have CVST again.
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Objective@#To investigate the diagnostic performance of CT fractional flow reserve (CT-FFR) for myocardial bridging-related ischemia using dynamic CT myocardial perfusion imaging (CT-MPI) as a reference standard. @*Materials and Methods@#Dynamic CT-MPI and coronary CT angiography (CCTA) data obtained from 498 symptomatic patients were retrospectively reviewed. Seventy-five patients (mean age ± standard deviation, 62.7 ± 13.2 years; 48 males) who showed myocardial bridging in the left anterior descending artery without concomitant obstructive stenosis on the imaging were included. The change in CT-FFR across myocardial bridging (ΔCT-FFR, defined as the difference in CT-FFR values between the proximal and distal ends of the myocardial bridging) in different cardiac phases, as well as other anatomical parameters, were measured to evaluate their performance for diagnosing myocardial bridging-related myocardial ischemia using dynamic CT-MPI as the reference standard (myocardial blood flow < 100 mL/100 mL/min or myocardial blood flow ratio ≤ 0.8). @*Results@#ΔCT-FFRsystolic (ΔCT-FFR calculated in the best systolic phase) was higher in patients with vs. without myocardial bridging-related myocardial ischemia (median [interquartile range], 0.12 [0.08–0.17] vs. 0.04 [0.01–0.07], p < 0.001), while CT-FFR systolic (CT-FFR distal to the myocardial bridging calculated in the best systolic phase) was lower (0.85 [0.81–0.89] vs. 0.91 [0.88–0.96], p = 0.043). In contrast, ΔCT-FFRdiastolic (ΔCT-FFR calculated in the best diastolic phase) and CT-FFR diastolic (CT-FFR distal to the myocardial bridging calculated in the best diastolic phase) did not differ significantly. Receiver operating characteristic curve analysis showed that ΔCT-FFRBsystolic had largest area under the curve (0.822; 95% confidence interval, 0.717–0.901) for identifying myocardial bridging-related ischemia. ΔCT-FFRsystolic had the highest sensitivity (91.7%) and negative predictive value (NPV) (97.8%). ΔCT-FFRdiastolic had the highest specificity (85.7%) for diagnosing myocardial bridging-related ischemia. The positive predictive values of all CT-related parameters were low. @*Conclusion@#ΔCT-FFR systolic reliably excluded myocardial bridging-related ischemia with high sensitivity and NPV. Myocardial bridging showing positive CT-FFR results requires further evaluation.
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Abstract@#According to the Healthy China Action Plan, Wuhan gives full play to the role of preventing and controlling student myopia by promoting student health. The primary focus is placed on education in schools, and Wuhan has integrated educational resources to develop a multi-level myopia prevention and control system and service network for school students. The network contains educational adminstrative, schools, families, and professional technical service organizations. By integrating multiple disciplines, Wuhan has built a comprehensive vision health management service system for all students. The Internet and cloud intelligent monitoring facilitated the establishment of a smart vision health management platform for students, which thoroughly and efficiently implemented myopia prevention and control to safeguard students visual health by engaging in education, monitoring, and supervision. The prevention and control of student myopia is a breakthrough for comprehensive healthy development of students. A comparison of the standard myopia rate in Wuhan in 2019 and 2018 revealed that the standard myopia rate at different learning stages of primary school, junior high school, and high school dropped by 3.31, 2.50, and 2.26 percentage points, respectively, and the rate of myopia in primary school was significantly lower than the national level. Post-epidemic surveys showed that the compliance rate and the awareness rate of the visual environment and visual behaviors of primary and secondary school students in Wuhan reached more than 80%, and prevalence of newly onset myopia or decreased vision was 30%, which was lower than the national average. The "Wuhan Model" provides an important referential framework for public health services for school students.
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Objective@#The present study aimed to investigate the association between myocardial blood flow (MBF) quantified by dynamic CT myocardial perfusion imaging (CT-MPI) and the increments in heart rate (HR) after stress in patients without obstructive coronary artery disease. @*Materials and Methods@#We retrospectively included 204 subjects who underwent both dynamic CT-MPI and coronary CT angiography (CCTA). Patients with more than minimal coronary stenosis (diameter ≥ 25%), history of myocardial infarction/ revascularization, cardiomyopathy, and microvascular dysfunction were excluded. Global MBF at stress was measured using hybrid deconvolution and maximum slope model. Furthermore, the HR increments after stress were recorded. @*Results@#The median radiation dose of dynamic CT-MPI plus CCTA was 5.5 (4.5–6.8) mSv. The median global MBF of all subjects was 156.4 (139.8–180.4) mL/100 mL/min. In subjects with HR increment between 10 to 19 beats per minute (bpm), the global MBF was significantly lower than that of subjects with increment between 20 to 29 bpm (153.3 mL/100 mL/min vs. 171.3 mL/100 mL/min, p = 0.027). This difference became insignificant when the HR increment further increased to ≥ 30 bpm. @*Conclusion@#The global MBF value was associated with the extent of increase in HR after stress. Significantly higher global MBF was seen in subjects with HR increment of ≥ 20 bpm.
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Background/Aims@#Studies have shown that nucleos(t)ide analogue (NA) treatment can reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients, but it is unclear which NA is most effective. We performed a meta-analysis and systematic review comparing the efficacies of NAs in CHB patients. @*Methods@#We searched literature databases for randomized controlled trials (RCTs) and observational studies that analyzed the hepatic biochemical response, virological response, seroconversion rate, drug resistance rate, and HCC incidence rate in CHB patients treated with NAs. Meta-analyses were performed with RevMan and Stata/SE software. @*Results@#Twelve cohort studies and one RCT were selected, in which entecavir (ETV), lamivudine (LAM), telbivudine (LdT), and/or tenofovir disoproxil fumarate (TDF) were evaluated in CHB patients. The meta-analysis showed that ETV was superior to LAM with regard to the HCC incidence (p<0.001), biochemical response (p=0.001), virological response (p=0.02), and drug resistance (p<0.001), and ETV was superior to LdT with regard to the virological response (p<0.001) and drug resistance (p<0.001). We found no significant difference between ETV and TDF with regard to the HCC incidence (p=0.08), biochemical response (p=0.39), virological response (p=0.31), serological conversion (p=0.38), or drug resistance (p=0.95). NA-treated patients with pre-existing cirrhosis had a 5.49 times greater incidence of HCC than those without cirrhosis (p<0.001). @*Conclusions@#ETV or TDF should be used for long-term first-line monotherapy in CHB patients according to the current guidelines. Standardized protocols are needed for future studies of ETV and TDF to facilitate conclusive comparisons. Patients with cirrhosis are at significantly elevated risk for HCC, despite the benefits of NA treatment.
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Objective To investigate the efficacy and safety of Posaconazole (Posa) in prophylaxis and salvage treatment of invasive fungal infections (IFI) during neutropenia in pediatric patients with leukemia.Methods A total of 18 pediatric patients (55 case-time) with leukemia in neutropenia stage receiving Posa treatment from December 2015 to August 2017 in Zhujiang Hospital of Southern Medical University,were analyzed retrospectively.Taking one induction chematherapy or one consolidation chemotherapy stage receiving Posa treatment was defined as 1 case-time.Results Out of 18 participants,13 cases were patients with acute myeloid leukemia (AML) and 5 cases were patients with acute lymphocytic leukemia (ALL),including 36 males and 19 females.Median age of the participants was 7 years,ranged from 10 months to 14 years.Out of 55 case times,45 of them were of primary prevention and the neutropenia periods ranged from 4 to 46 days,with the median of 15 days,and 93.33％ of them were prevented from fungal infection.However,3 of the 45 cases had sudden fungal infections and the Voriconazole was an effective treatment,and no one died.Six cases in this study experienced secondary prevention,and no patient experienced reinfection.The neutropenia terms of the 6 cases ranged from 10 to 17 days,with the median of 14 days.Four patients who suffered from Voriconazole and/or Carbophenol therapy failure received Posa as a rescue therapy and the response rate was 100％.None of patients had Posa intolerance due to severe adverse reaction and no Posa treatment-related grade Ⅱ toxic effects occurred.Conclusions Posa is an effective and safe therapy for pediatric patients with leukemia and IFI,and available for long-time usage.Serious adverse reaction is rare.
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A simple, robust and highly sensitive TB-ARMS method based on qPCR technique was developed to detect kras mutations. The technique was evaluated, and its clinical application was investigated. Mutation specific primers for eight common kras mutations and wild type gene targeted blockers were designed and optimized. Moreover, a mutant-enriched condition was used in to improve the sensitivity and specificity of mutation detection. Constructed plasmids carrying mutant kras genes, as well as confirmed wild type genomic DNA, were used as standard samples for evaluation of the methodology. The performance of our new method was validated by comparing the results of our method with that of a commercial kras kit in testing 40 clinical samples. Preoperative plasma samples, as well as paired tissue samples, were tested in parallel for evaluation of its clinical application. We have developed a new TB-ARMS method for kras mutation detection that can detect minor mutant alleles with a frequency as low as 0.01% in a heterogeneous sample. We have successfully demonstrated its 0.01% detection sensitivity with highly specific mutant amplification in conjunction with selective wild type suppression by blocker under a mutant-enriched reaction condition. We also showed that our TB-ARMS method was more accurate than the commercial kras kit, which is widely used presently. Furthermore, we have validated our method as an efficient liquid biopsy method, and the results of the plasma DNA detection with our TB-ARMS method were in consistent with the sequencing results of paired tissue samples. In conclusion, our TB-ARMS qPCR method could be effectively applied in kras mutation test for clinical tissue samples, as well as for liquid biopsy samples such as plasma.
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Humans , DNA Primers , Diagnostic Techniques and Procedures , Mutation , Neoplasms , Diagnosis , Genetics , Proto-Oncogene Proteins p21(ras) , Genetics , Real-Time Polymerase Chain ReactionРеферат
Objective To analyze the effect of long-term wearing of hard corneal contact lens and its effect on the stability of tear film.Methods From April 2016 to April 2017,150 patients of myopia in Yongkang Hospital were selected in this study and randomly divided into study group and control group,with 75 cases in each group.The patients in the study group wore hard corneal contact lens for a long time before operation,the patients in the control group had no hard corneal contact lens before operation.The basal tear secretion amount,tear film break-up time(TBUT) and the incidence of postoperative complications were compared between the two groups.Results One year after operation,the basal tear secretion amount of the study group [(11.1 ± 1.5) mL] was significantly lower than that of control group[(18.5 ± 3.2) mL] (t =12.235,P ＜ 0.05).The TBUT of the study group [(15.8 ± 1.5) min] was significantly shorter than that of the control group [(25.1 ± 4.8) min] (t =11.935,P ＜ 0.05).The incidence rates of dry eye,corneal staining in the study group were 22.7％,18.7％,respectively,which were significantly lower thanthose in the control group (33.3％,34.7％),there were statistically significant differences between the two groups (x2 =5.931,6.425,all P ＜ 0.05).Conclusion Long-term wearing hard contact lens seriously affects the tear secretion and TBUT,and reduces the stability of tear film.Although the incidence of postoperative complications islow,tear film damage can not be avoided.In order to protect the stability of the tear film,the patients with myopia should try to avoid the wear of the hard corneal contact lens and choose to wear frame glasses.
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Objective@#To investigate the efficacy and safety of Posaconazole (Posa) in prophylaxis and salvage treatment of invasive fungal infections (IFI) during neutropenia in pediatric patients with leukemia.@*Methods@#A total of 18 pediatric patients (55 case-time) with leukemia in neutropenia stage receiving Posa treatment from December 2015 to August 2017 in Zhujiang Hospital of Southern Medical University, were analyzed retrospectively.Taking one induction chematherapy or one consolidation chemotherapy stage receiving Posa treatment was defined as 1 case-time.@*Results@#Out of 18 participants, 13 cases were patients with acute myeloid leukemia (AML) and 5 cases were patients with acute lymphocytic leukemia (ALL), including 36 males and 19 females.Median age of the participants was 7 years, ranged from 10 months to 14 years.Out of 55 case times, 45 of them were of primary prevention and the neutropenia periods ranged from 4 to 46 days, with the median of 15 days, and 93.33% of them were prevented from fungal infection.However, 3 of the 45 cases had sudden fungal infections and the Voriconazole was an effective treatment, and no one died.Six cases in this study experienced secondary prevention, and no patient experienced reinfection.The neutropenia terms of the 6 cases ranged from 10 to 17 days, with the median of 14 days.Four patients who suffered from Voriconazole and/or Carbophenol therapy failure received Posa as a rescue therapy and the response rate was 100%.None of patients had Posa intolerance due to severe adverse reaction and no Posa treatment-related grade Ⅱ toxic effects occurred.@*Conclusions@#Posa is an effective and safe therapy for pediatric patients with leukemia and IFI, and available for long-time usage.Serious adverse reaction is rare.
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Objective To investigate the precipitating factors,clinical manifestations,magnetic resonance imaging (MRI) features and prognoses of children with posterior reversible encephalopathy syndrome (PRES) during the treatment of hematological diseases,and to improve the understanding of the diseases.Methods A total of 9 children with PRES,admitted to our hospital from January 2012 to December 2016,were chosen.The clinical data,including precipitating factors,clinical manifestations,MRI features and prognoses,were retrospectively analyzed.Results (1) Precipitating factors:6 patients with acute lymphoblastic leukemia occurred PRES during remission induction therapy (6/9,66.7％) and 3 occurred PRES during oral cyclosporine A after hematopoietic stem cell transplantation or autoimmune diseases (3/9,33.3％).(2) Clinical manifestations:all of them were acute onset,and the main symptoms were seizures (8/9,88.9％) and hypertension (7/9,77.8％);some patients suffered from headache,vomiting,visual disturbances,disturbance of consciousness and poor mental symptoms.(3) Features of head MR imaging:the lesions were mainly located in the parietal-occipital lobe,showing patchy long T1 and long T2 signals,and bilateral imperfect symmetry;FLAIR imaging showed high signal distinctly,and other parts of brain could also been involved in.(4) Prognoses:7 children (77.8％) recovered well,one (11.1％) left frequent seizures during 2 years of follow up,one (11.1％) left mental retardation.Conclusion Methotrexate,cyclosporine A and other agents are important incentives in children with PRES during the treatment of hematological diseases;seizures and hypertension are the main clinical manifestations;MR imaging is important in diagnosing the disease;and PRES is not completely reversible.
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Objectives To explore the correlation of the expression lcvel of Calpain-9 in gastric carcinoma with clinico pathological features and metastasis of gastric cancer.Methods The expression level of Calpain-9 in gastric carcinoma and matched para-cancerous normal mucosa tissues were detected by Western blotting and immunohistochemistry in 146 patients with gastric cancer respcctively.The relationship between the expression level of Calpain 9 and the various clinicopathological indexes was analyzed.Results The expression level of Calpain-9 was significantly lower in cancerous tissues than in matched para cancerous normal mucosa tissues (P ＜ 0.05),with significantly different expression levels of Calpain-9 in different gastric cancerous histological differentiation degrees,different clinical stages,and with or without a lymph node metastasis(all P＜ 0.05).But no statistical difference was found in different sexes,different ages,different tumor sizes,with or without a distant metastasis (all P＞0.05).The spearman's correlation analysis showed that thc expression level of Calpain-9 in gastric cancer was negatively correlated with lymph node metastasis (r=-0.3826,P＜0.05).Conclusions The expression level of Calpain-9 in gastric cancer tissues is decreased,is negatively correlated with clinical stages,pathological differentiation,and cancerous lymph node metastasis.
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Objective To compare the production of farnesol between Candida albicans (C.albicans) biofilms formed by resistant and standard strains in different media,and to investigate the changing trend of farnesol production in different phases of biofilm formation and the features of farnesol production by resistant C.albicans.Methods Fluconazole-resistant C.albicans strains were induced in vitro.Standard strains and fluconazole-resistant strains of C.albicans were separately inoculated onto different media,including RPMI 1640 medium,yeast extract peptone dextrose (YPD) medium,yeast nitrogen base (YNB) + 0.5％ glucose medium,RPMI 1640 + 10％ fetal calf serum (FCS),so as to form C.albicans biofilms.Morphological changes of C.albicans biofilms at 24 hours were observed under an inverted microscope,and gas chromatography-mass spectrometry (GC/MS)was performed to detect the level of farnesol at 1.5,3,6,12,24,36 and 48 hours.Results There were no obvious differences in the morphology of C.albicans biofilms between the resistant and standard strains when they were cultured in the same medium,while the morphology of C.albicans biofilms markedly differed between the 2 kinds of strains in the different media.Three-factor analysis of variance showed that the production of farnesol in the C.albicans biofilms changed over time (F =70.628,P ＜ 0.001).Concretely speaking,during the formation of resistant and standard C.albicans biofilms,the production of farnesol gradually increased in the RPMI 1640,YPD and YNB + 0.5％ glucose media until the biofilms matured,then showed a decreasing trend.However,the time to peak levels of farnesol was different between the 2 kinds of strains in these media.Moreover,the levels of farnesol in the 2 kinds of strains both slowly increased in the RPMI 1640 + 10％ FCS medium within 12-48 hours.Culture media also significantly affected the production of farnesol (F =176.665,P ＜ 0.001),and the levels of farnesol in the resistant and standard C.albicans biofilms were both higher in the YNB + 0.5％ glucose medium.When resistant and standard strains were separately cultured in the RPMI 1640 media and the YPD media,the level of farnesol was significantly higher in the resistant strains than in the standard stains (RPMI 1640 media at 36 hours:1.157 ± 0.064 vs.0.250 ± 0.075,P ＜ 0.05;YPD media at 6 hours:0.262 ± 0.036 vs.0.055 ± 0.062,P ＜ 0.05;YPD media at 12 hours:0.730 ± 0.030 vs.0.482 ± 0.024,P ＜ 0.05).However,when they were separately cultured in the YNB + 0.5％ glucose media,the farnesol level was significantly higher in the standard stains than in the resistant strains (36 hours:2.950 ± 0.677 vs.0.523 ± 0.266,P =0.020).Conclusion The media markedly affect the production of farnesol in the C.albicans biofilms,and there is a certain difference in the production of farnesol between resistant and standard C.albicans strains.
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Objective To compare the ear baric function between 4000m altitude chamber test with inhaling air and 6900m altitude chamber test with inhaling pure oxygen.Methods Eleven healthy male volunteers attended two tests as two groups by self-comparison. As the air group the volunteers inhaled air at 4000m, while as the pure oxygen group they inhaled pure oxygen at 6900m altitude, and the time interval between the two tests was more than two weeks. During the test, the volunteers breathed air or pure oxygen at random for 1h, and then were exposed at a speed of 20m/s to the target altitude for 5min. Hereafter they were sent back to the ground at the same speed. The changes of subjective symptoms, degree of tympanic congestion, acoustic immitance index and pure-tone auditory threshold were recorded before and after the test. The acoustic impedance index and pure-tone threshold were statistically analyzed.ResultsFour volunteers (4 ears) in air group and 7 volunteers (7 ears) in pure oxygen group reported ear pain in altitude chamber exposures, respectively. The pain-triggering altitude was higher in the pure oxygen group. Immediately after tests, there were 3 (3 ears) and 5 volunteers (5 ears) with Ⅲ degree congestion of the tympanic membrane in the two groups respectively. Four volunteers (6 ears) developed gradually aggravated hemorrhages after altitude exposure. And the tympanic membrane congestion difference between groups was statistically significant at 3 and 24h after tests (P<0.01). The type A tympanogram appeared in 11 (15 ears) and 11 (14 ears) volunteers respectively immediately after tests. The increase of static compliance value was significantly greater in pure oxygen group than in air group immediately after tests (P<0.05), the decrease of middle ear pressure was more significant in pure oxygen group than in air group at 3 and 24h after tests (P<0.05). Both the two altitude exposure tests resulted in eustachian tube dysfunction. At 3 and 24h after the tests, the increase of individual frequency pure-tone threshold was significantly higher in pure oxygen group than in air group (P<0.05).Conclusion Breathing pure oxygen and lifting height could increase the screening degree of ear baric function test in hypobaric chamber, and have greater influence on degree of tympanic congestion, acoustic immittance and pure-tone auditory threshold in 24 hours.
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Objective To develop a kind of rapid decompression equipment replacing the toughened glass simulating the state of aircraft cabin glass bursting on the fly.Methods The metallic membrane was used to isolate both chambers with different air pressures.The areas of decompression membrane and path were determined by calculating on the basis of aircraft decompression altitude,cabin pressure differential and decompression time.The structural strength was determined according to enduring force of the metallic membrane.The membrane was ejected by high pressure air using the ejection launch technology of aircraft missile.The result of simulating aircraft cabin glass bursting on the fly was achieved.Results The rapid decompression equipment ejected by air pressure in low-pressure chamber could achieve the state of simulating aircraft cabin glass bursting on the fly,and the best decompression time was 0.16 s.Conclusion The rapid decompression equipment ejected by air pressure accomplishes the decompression preparative in short time with easy operation,and can satisfy the desired requirements for the performance and precision.
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The Pricing and Payment Regulation on Chinese Diagnosis Related Groups (C-DRG) was designed by National Health Development Research Center,directly under the leadership of Department of Finance,NHFPC (formerly Dept.of Planning and Finance,Ministry of Health),which organized a large study group consisted of nearly 1 000 experts since 2010.It introduced the general design of C-DRG and the principles and main points of applying C-DRG system,which could be referenced by all countries in carrying out the pricing and payment reform system.