Risk factors for intrapartum fever during labor analgesia and development of a prediction model / 中华麻醉学杂志

Objective:To identify the risk factors for intrapartum fever during labor analgesia and establish the prediction model.Methods:The medical records from pregnant women with intrapartum fever during labor analgesia were retrospectively analyzed. According to whether the highest body temperature ≥38 ℃, the parturients were divided into intrapartum fever group and non-fever group. The general data from patients, duration of hospital stay before labor, induced labor, prenatal hemoglobin concentration, body msaa index (BMI) during pregnancy, artificial rupture of membranes in the incubation period, frequency of vaginal examination and etc. were collected. The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify intrapartum fever-related risk factors, and the weighted score regression prediction model was established. Hosmer-Lemshow Test was used to assess the fit of the model, and the receiver operating characteristic curve was drawn to evaluate the model. The nomogram was drawn for visually presenting the regression model. The clinical calibration curve, decision curve analysis and clinical impact curve were drawn to assess the created prediction model. Results:There were 99 parturients developed fever during labor analgesia, with an incidence of 34.7%. The results of logistic regression analysis showed that duration of hospital stay before labor, prenatal hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination were the independent risk factors for intrapartum fever during labor analgesia. The area under the receiver operating characteristic curve was 0.943, 95% confidence interval was 0.916-0.969, the sensitivity was 86.9%, the specificity was 88.6%, and the Youden index was 0.755. The prediction model of the line chart was assessed by Hosmer-Lemshow, P=0.898. Conclusions:Duration of hospital stay before labor, hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination are independent risk factors for intrapartum fever during labor analgesia in parturients, and the risk prediction model developed can effectively predict the occurrence of intrapartum fever during labor analgesia.

Clinical characteristic of 56 cases with lung cancer in patients with connective tissue disease / 中华风湿病学杂志

Objective:To improve the understanding of patients with connective tissue diseases(CTD) associated with lung cancer.Methods:The clinical manifestations of in-patients diagnosed as CTD associated with lung cancer in our center from January 2011 to May 2022 were retrospectively analyzed,including demographic information,pathological classification of lung cancer,TNM stage,the time sequence of the diagnosis of CTD and lung cancer, treatment and clinical outcomes. The mean±standard deviation was used for the numeric variables and the number of cases (%) was used in the counting data. Fifty patients were cofirmed to have squamous cell carcinoma, adenocarcinoma and small-cell carcinoma group. Chi-square test was used to compare the differences between groups.Results:Fifty-six patients with CTD were complicated with lung cancer, of whom 27 were male, and 29 were female. The age of CTD at diagnosis was (58±15) years. The age of lung cancer at diagnosis was (69±10) years. Of patients with CTD, rheumatoid arthritis was the most common type of rheumatic disease, followed by polymyositis/dermatomyositis, systemic sclerosis and systemic lupus erythematosus. Of patients with CTD, 24 cases (42.9%) had interstitial pulmonary disease. Of patients with lung cancer, mass ( n=26, 46.4%) was the most common initial presentation, followed by cough and expectoration ( n=19, 33.8%). Non small cell lung cancer, the most common pathological type, was found in 47 cases (83.9%), followed by small cell lung cancer in 6 cases(10.7%). Stage Ⅳ was the most common stage in 36 cases(65.5%) by TNM staging. The diagnosis of CTD was earlier than that of lung cancer in 42 cases (42/56), with an median of 90 (45, 244) months, ranged between 7 months and 50 years. The diagnosis of lung cancer was earlier than that of CTD in 2 cases (2/56), with the interval of 7 and 15 months respecticely. Twelve cases (12/56) were diagnosed with CTD at the same time, and the interval between CTD and lung cancer was within 6 months. Fifty-five patients were followed up with an median of 10 (2, 24) months. In 15 patients (26.8%) with stable conditions, stageⅠ( n=10, 66.7%) cancer was the most common stage, followed by stage Ⅱ( n=2, 13.3%). Thirty-seven patients (66.1%) died of end stage lung cancer ( n=21, 56.8%) or infection ( n=16, 43.2%). The most lethal was stage Ⅳ ( n=32, 86.5%) lung cancer. There were significant differences in sex [male 9 cases (90.0%), 13 cases (38.2%) vs 4 cases (66.7%), χ2=8.88, P=0.012], smoking [8 cases (80.0%), 11 cases (32.4%) vs 4 cases (66.7%), χ2=8.24, P=0.016] and TNM stage [stage I for 0 case (0), 12 cases(35.3%) vs 0 case (0), stage Ⅱ-Ⅲ for 4 cases (40.0%), 3 cases (8.8%) vs 0 cases (0), stage Ⅳ for 6 cases (60.0%), 19 cases (55.9%) vs 6 cases (100%), χ2=13.58, P=0.009] among squamous cell carcinoma, adenocarcinoma and small-cell carcinoma groups. Conclusion:The prognosis of patients with CTD complicated with lung cancer is poor and the mortality rate is high. Therefore, close follow-up and regularly imaging are necessary for CTD patients.

Stability of SARS-CoV-2 in cold-chain transportation environments and the efficacy of disinfection measures

Cold-chain environment could extend the survival duration of SARS-CoV-2 and increases the risk of transmission. However, the effect of clod-chain environmental factors and packaging materials on SARS-CoV-2 stability and the efficacy of intervention measures to inactivate SARS-CoV-2 under cold-chain environment remains uncertain. This study aimed to unravel cold-chain environmental factors that preserved the stability of SARS-CoV-2 and disinfection measures against SARS-CoV-2 under the cold-chain environment. The spike gene of SARS-CoV-2 isolated from Wuhan hu-1 was used to construct the SARS-CoV-2 pseudovirus and used as model of the SARS-CoV-2 virus. The decay rate of SARS-CoV-2 pseudovirus in the cold-chain environment, various types of packaging material surfaces i.e., PE plastic, stainless steel, Teflon and cardboard, and in frozen seawater was investigated. The influence of LED visible light(wavelength 450 nm-780 nm) and airflow movement on the stability of SARS-CoV-2 pseudovirus at -18{degrees} C were subsequently assessed. The results show that SARS-CoV-2 pseudovirus decayed more rapidly on porous cardboard surface compared with the non-porous surfaces including PE plastic, stainless steel and Teflon. Compared with 25{degrees} C, the decay rate of SARS-CoV-2 pseudovirus was significantly lower at low temperature. Seawater preserved viral stability both at -18{degrees} C and repeated freeze-thawing cycles compared with deionized water. LED visible light illumination and airflow movement environment at -18{degrees} C reduced the SARS-CoV-2 pseudovirus stability. In conclusion, our results indicate cold-chain temperature and seawater as risk factors for SARS-CoV-2 transmission and LED visible light illumination and airflow movement as possible disinfection measures of SARS-CoV-2 under the cold-chain environment. ImportanceIt is widely recognized that low temperature is a condition for maintaining virus vitality, and cold-chain transportation spreads the events of the SARS-CoV-2 were reported. This study provides that the decay rate of the SARS-CoV-2 pseudovirus at low temperatures varies on different packaging materials, and salt ions present in frozen foods such as seafood may protect virus survival. These results provide evidence for the possibility of SARS-CoV-2 transmission through cold-chain transport and also suggest the importance for disinfection of items. However, the commonly used disinfection methods of ultraviolet radiation and chemical reagents are generally not suitable for the disinfection of frozen food. Our study shows LED visible light illumination and airflow movement as possible disinfection measures of SARS-CoV-2 under the cold-chain environment. This has implications for reducing the long-distance transmission of the virus through cold-chain transportation.

Lymphedema and retroperitoneal fibrosis / 中华风湿病学杂志

Objective:To improve the understanding of the relationship between lymphedema and retroperitoneal fibrosis (RPF).Methods:Four cases with lymphedema and RPF in Beijing Shijitan Hospital Capital Medical University were reported. The diagnosis and treatment were analyzed and discussed.Results:All four patients had lymphedema onset and imaging showed suspicious RPF. One case of non-Hodgkin's lymphoma was confirmed by lymph node biopsy. The malignant lesions were excluded in the other two cases by pathology or positron emission tomography (PET)/computerized tomography (CT). They were proved to be idiopathic retroperitoneal fibrosis after treatment with glucocorticoid combined immunosuppressive agents. Another case was systemic amyloidosis mimicking retroperitoneal fibrosis.Conclusion:Lymphatic involvement in RPF is relatively rare, and the possibility of RPF should be considered when patients develop lymphedema. Even if the initial diagnosis is RPF, we should be wary of tumors or other diseases. Imaging examination should be performed, and tissue biopsy should be used if necessary, so as to facilitate early diagnosis and treatment and improve the prognosis of patients.

Analysis on the effect of two methods in different degrees deep sternal wound infection after undergoing cardiac surgery / 中华胸心血管外科杂志

Objective:To analysis the effect of two methods of transposition of pectoralis major in different degrees deep sternal wound infection(DSWI) after undergoing cardiac surgery.Methods:128 patients with DSWI after cardiac surgery were treated, 72 were mild, and 56 were severe. 66 cases of pectoralis major muscle flap docking method(medial muscle flap docking group) and 62 cases of lateral pectoralis major muscle flap turnover method(lateral muscle flap turnover group) were implemented respectively. Drainage tube indwelling time, reoperation rate, incidence of lung infection, long-term thoracic stability and other aspects were observed to compared the treatment effect.Results:In the mild patients, the medial muscle flap docking group and the lateral muscle flap turnover group were compared( P<0.05). The postoperative hospital stay [(14.2±4.7)days vs.(17.1±3.9)days], drainage tube retention time[(6.2±1.7)h vs.(9.1±2.9)h], and reoperation rate(2.4% vs. 6.7%), the incidence of lung infection(14.3% vs. 23.3%), long-term thoracic stability[73.8%(31/42)vs.43.3%(13/30)]. In the severe patients, the medial muscle flap docking group and the lateral muscle flap turnover group were compared. The postoperative hospital stay[(24.2±7.2)days vs.(20.1±3.5)days], drainage tube retention time[(20.2±6.6)h vs.(13.2±3.1)h], reoperation rate(20.8% vs.12.5%), incidence of pulmonary infection(41.7% vs. 31.3%), long-term thoracic stability[25.0%(6/24)vs.68.8%(22/32)]. The differences of the indicators in each group were significant , P<0.05. In the mild group, each index of the pectoralis major medial muscle flap docking method was superior to the lateral muscle flap turnover method, but the treatment results of the two methods in the severe group were opposite. Conclusion:Patients with mild deep DSWI treated with medial pectoralis major muscle flap docking and suture have less hospital stay, less reoperation rate, less complications and better treatment effect than reverse lateral pectoralis major muscle flap turnover. But the two treatments in the severe DSWI have the opposite effect.

The mRNA level of adiponectin in patients with gallstone of Hui and Han nationality in Qinghai Province and its clinical significance / 中国医师杂志

Objective:To investigate the mRNA level of adiponectin in patients with gallstone of Hui and Han nationality in Qinghai Province and its clinical significance.Methods:From August 2017 to August 2018, 108 patients with gallbladder cholelithiasis and 91 patients with other benign diseases who were hospitalized in the Affiliated Hospital of Qinghai University from August 2017 to August 2018 were selected as the research objects. According to gallbladder cholesterol stone and the classification criteria of adult obesity, they were divided into gallstone-obesity group (56 cases), gallstone non-obesity group (52 cases), non gallstone obesity group (48 cases) and non gallstone non obesity group (43 cases). The levels of serum lipid (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), blood glucose (GLU), uric acid and high-sensitivity C protein (hs-CRP) were measured. Meanwhile, the adiponectin mRNA levels in omental adipose tissue and abdominal subcutaneous adipose tissue were detected by real time fluorescent quantitative polymerase chain reaction (qRT-PCR).Results:Compared with non gallstone and non obesity group, the serum TC [(4.57±0.49)mmol/L vs (5.63±0.53)mmol/L, (6.12±0.51)mmol/L, (6.85±0.43)mmol/L], TG [(1.50±0.32)mmol/L vs (2.06±0.33)mmol/L, (2.53±0.39)mmol/L, (2.96±0.34)mmol/L], LDL-C [(2.14±0.35)mmol/L vs (2.65±0.33)mmol/L, (3.05±0.37)mmol/L, (3.54±0.38)mmol/L], uric acid [(188.63±13.52)mmol/L vs (257.69±14.63)mmol/L, (306.96±18.96)mmol/L, (359.96±16.58)mmol/L], hs-CRP [(228.32±18.96)μmol/L vs (298.96±19.96)μmol/L, (354.96±19.96)μmol/L, (405.98±19.47)μmol/L] were increased in gallstone-obesity group, gallstone non-obesity group, non gallstone obesity group ( P<0.05), while the adiponectin mRNA [subcutaneous adipose tissue: (1.76±0.25) vs (1.43±0.23), (0.98±0.23), (0.68±0.29); omental adipose tissue: (2.15±0.29) vs (1.88±0.28), (1.56±0.27), (1.12±0.25)] and HDL-C levels [(2.15±0.11)mmol/L vs (1.79±0.15)mmol/L, (1.42±0.12)mmol/L, (1.15±0.09)mmol/L] were decreased ( P<0.05). Compared with the non gallstone obesity group, the serum levels of TC, TG, LDL-C, GLU, uric acid were increased in the gallstone non obesity group, gallstone obesity group, while the adiponectin mRNA and HDL-C levels were decreased ( P<0.05). Compared with the gallstone non obese group, the serum levels of TC, TG, LDL-C, GLU, uric acid and hs-CRP were increased in gallstone obese group, while the levels of adiponectin mRNA and HDL-C were decreased ( P<0.05). Adiponectin in omental adipose tissue and abdominal subcutaneous adipose tissue was positively correlated with HDL-C and negatively correlated with TC, TG, LDL-C, uric acid and hs-CRP ( P<0.05). Logistic regression analysis showed that low level of subcutaneous adiponectin, omental adiponectin and high level of TG were risk factors for gallstone in non obese population ( OR=2.340, 1.931, 2.784, P<0.05), while low level of subcutaneous adiponectin, omental adiponectin and high level of LDL-C were risk factors for gallstone in obese population ( OR=2.358, 2.596, 2.115, P<0.05). Conclusions:The adiponectin mRNA is decreased in the patients with gallstone of Hui/Han nationality in Qinghai Province. The low level of subcutaneous adiponectin and omental adiponectin are the risk factors for gallstone in obese or non obese people of Hui/Han nationality in Qinghai Province.

Effect of age-related white matter changes on long-term first symptomatic ischemic stroke events in the oldsters / 中华神经医学杂志

Objective To study the effect of age-related white matter changes (ARWMC) on first symptomatic ischemic stroke events in the oldsters. Methods For the prospective study, a total of 368 eligible oldsters were enrolled in the study from January 2010 to August 2012. The degrees of ARWMC were assessed by ARWMC scale;according to the scores, they were divided into non ARWMC group, mild-moderate ARWMC group and severe ARWMC group. The patients were followed up once every 3 months. The clinical endpoint events and time (first symptomatic ischemic stroke, myocardial infarction and all-cause death) were recorded. Analyses of variance and Chi-square test were used to compare the differences of clinical data among the 3 groups. COX regression was used to assess the risk differences of first symptomatic ischemic stroke in the oldsters of three groups. Results After an average of follow-up for 48.7 months, 50 participants (13.6％) had first symptomatic ischemic stroke;25 (25.8％) were categorized as the severe ARWMC group, 22 (10.9％) were as the mild-medium group, and 3 (4.4％) were as the non ARWMC group. Among the three groups, the differences in age, history of hypertension, systolic blood pressure, incidence of clinical endpoint events and first symptomatic ischemic stroke, and follow-up time of endpoint events were statistically significant (P<0.05); patients from the severe ARWMC group were the oldest, and had the longest history of hypertension, the highest systolic blood pressure, the highest incidence of clinical end events and first symptomatic ischemic stroke, and the shortest follow-up period for clinical end events. COX regression analysis showed that the risk of first symptomatic ischemic stroke in the severe ARWMC group was about 8 times higher than that in the non ARWMC group (hazard ratio=9.012, 95％CI: 2.310-35.154, P=0.002). Conclusion In oldsters, severe ARWMC often accompany hypertension history and poor blood pressure controll, and it is an independent and serious risk factor for long-term first symptomatic ischemic stroke.

The moderating role of self-control between impulsiveness and risky decision-making among college students with pathological internet use / 中华行为医学与脑科学杂志

Objective To explore the relationship between impulsiveness and risky decision-making among college students with pathological internet use ( PIU),as well as the moderating role of self-control. Methods Totally 542 undergraduates anonymously completed the Internet Addiction Test (IAT),Chinese Version of Barratt Impulsiveness Scale,Risk Preference Questionnaire,Self-Control Scale. Results ( 1) In loss frames,the scores of risky decision-making with high (20. 26±4. 83) and medium (20. 40±5. 53) level of impulsiveness among college students with PIU significantly were higher than those with low ( 18. 92 ± 5. 03) level of impulsiveness ( F(2,323)= 3. 79,P<0. 05,η2=0. 02). (2) There was a significant negative correlation between impulsiveness (60. 68±10. 40) and self-control (55. 56±9. 07) (r=-0. 60,P<0. 01). And there was a significant positive correlations between impulsiveness and risky decision-making in loss frames (20. 12±5. 26)(r=0. 13,P<0. 05). The risky decision-making in gain frames ( 17. 17±4. 38) was positively correlated with that in loss frames (r=0. 52,P<0. 01). (3) Self-control played a moderating role in the association between impulsiveness and risky decision-making in loss frames (β=0. 13,t=2. 31,P<0. 05). Conclusion In loss frames,impulsiveness is positively related with risky decision-making,and self-control plays a moderating role between impulsiveness and risky decision-making in loss frames among col-lege students with PIU.

The moderating role of self-control between impulsiveness and risky decision-making among college students with pathological internet use / 中华行为医学与脑科学杂志

Objective@#To explore the relationship between impulsiveness and risky decision-making among college students with pathological internet use (PIU), as well as the moderating role of self-control.@*Methods@#Totally 542 undergraduates anonymously completed the Internet Addiction Test (IAT), Chinese Version of Barratt Impulsiveness Scale, Risk Preference Questionnaire, Self-Control Scale.@*Results@#(1)In loss frames, the scores of risky decision-making with high (20.26±4.83) and medium (20.40±5.53) level of impulsiveness among college students with PIU significantly were higher than those with low (18.92±5.03) level of impulsiveness (F(2, 323)=3.79, P<0.05, η2=0.02). (2)There was a significant negative correlation between impulsiveness (60.68±10.40) and self-control (55.56±9.07)(r=-0.60, P<0.01). And there was a significant positive correlations between impulsiveness and risky decision-making in loss frames (20.12±5.26)(r=0.13, P<0.05). The risky decision-making in gain frames (17.17±4.38) was positively correlated with that in loss frames (r=0.52, P<0.01). (3)Self-control played a moderating role in the association between impulsiveness and risky decision-making in loss frames (β=0.13, t=2.31, P<0.05).@*Conclusion@#In loss frames, impulsiveness is positively related with risky decision-making, and self-control plays a moderating role between impulsiveness and risky decision-making in loss frames among college students with PIU.

Optimized strategy of anesthesia for thoracoscopic radical resection of lung cancer: erector spinae plane block combined with general anesthesia / 中华麻醉学杂志

Objective To evaluate the efficacy of erector spinae plane block (ESPB) combined with general anesthesia when used for thoracoscopic radical resection of lung cancer.Methods Forty patients of both sexes,aged 30-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of lung cancer,were divided into 2 groups (n =20 each) using a random number table method:ESPB combined with general anesthesia group (group EG) and general anesthesia group (group G).ESPB was performed before anesthesia induction,and 20 min later the effect was evaluated by testing the area of block in group EG.Anesthesia was induced with midazolam,propofol,sufentanil and cisatracurium and maintained with sevoflurane and remifentanil to maintain the bispectral index value between 40 and 60.Patient-controlled intravenous analgesia was applied in both groups at the end of operation,flurbiprofen axetil 100 mg was intravenously injected as a remedy for analgesia when necessary,and the visual analog scale score was maintained less than or equal to 3.The intraoperative consumption of sulfentanil and remifentanil,emergence time from anesthesia and time of tracheal extubation were recorded.The development of adverse effects within 48 h after operation,postoperative length of hospital stay,requirement for rescue analgesia and patients' overall satisfaction with postoperative analgesia were also recorded.Results Compared with group G,the intraoperative consumption of sulfentanil and remifentanil was significantly decreased,the emergence time from anesthesia and time of tracheal extubation were shortened,the incidence of nausea and vomiting within 48 h after operation was decreased,the first occurrence time was prolonged,the requirement for rescue analgesia was decreased,postoperative length of hospital stay was shortened,and patients' satisfaction scores were increased in group EG (P＜0.05).Conclusion ESPB combined with general anesthesia can reduce the perioperative consumption of opioids and is helpful in improving prognosis when used for thoracoscopic radical resection of lung cancer.

Survey of prevalence of iron deficiency and iron deficiency anemia in pregnant women in urban areas of China / 中华妇产科杂志

Objective To investigate the prevalence of iron deficiency(ID)and iron deficiency anemia (IDA) in pregnant women in urban areas of China. Methods The study was a national cross-sectional survey conducted from September 19th, 2016 to November 20th, 2016. According to the classification of the National Bureau of Statistics, all survey sites were set up in 6 regions of the country. Pregnant women were continuously selected using multistage stratified sampling. A total of 12 403 pregnant women were collected and examined for serum ferritin and hemoglobin levels. Results The median serum ferritin level during pregnancy was 20.60 μg/L(11.78-36.98 μg/L), the hemoglobin level was(118±12)g/L. With the progress of pregnancy, the levels of serum ferritin and hemoglobin decreased gradually. The median serum ferritin levels in the first, second trimester and third trimester were 54.30 μg/L(34.48-94.01 μg/L), 28.60 μg/L(16.40-50.52 μg/L), and 16.70 μg/L(10.20-27.00 μg/L)respectively(P<0.01). The mean hemoglobin levels were(127 ± 10)g/L,(119 ± 11)g/L and(117 ± 11)g/L respectively(P<0.01). The prevalence of ID in urban pregnant women was 48.16%(5 973/12 403), and IDA prevalence was 13.87% (1 720/12 403). The prevalence of IDA in the first, second trimester and third trimester were 1.96% (20/1 019), 8.40%(293/3 487)and 17.82%(1 407/7 897), respectively(P<0.01). The prevalence of standardized ID and IDA were significantly different in various regions of China(P<0.01). The standardized prevalence of ID were relatively higher in East China and Northeast China, 57.37% and 53.41% respectively, while it was the lowest in Southwest China, 30.51%. The standardized prevalence of IDA in South Central, Northwest, and East China were relatively high, 21.30%, 16.97% and 17.53% respectively, and the standardized prevalence of IDA in Southwest China was the lowest, 5.44%,the differents in various regions were significant(all P<0.01). Conclusion The current phenomenon of ID and IDA in pregnant women is still very common,and nutrition and health care during pregnancy should be strengthened.

The research status and future of the hepatic alveolar echinococcosis in the field of molecular imaging / 中华肝胆外科杂志

Hepatic alveolar echinococcosis is a kind of zoonosis with poor prognosis.At present,the diagnosis and treatment are mainly based on ultrasound,CT diagnosis,MRI and other classical imaging by detecting the terminal effects of the changes on the cell molecules of the disease itself,the organ anatomy changes.However,it is found that the above imaging techniques have limitations in the diagnosis and treatment.For example,the infiltration zone of the lesion is not clear and the degree of biological activity can not be determined.This leads to a higher recurrence rate in the late stage of clinical treatment.In recent years,the molecular imaging shows the abnormal cell and molecular level in the disease process has been developed rapidly.This has led to several diagnosis and treatment problems related to liver vesicular disease.This paper mainly reviews the research results of the disease in the field of molecular imaging and the development direction of this field in the future,to provide guidance for future clinical and scientific research.

Effect of moderate physical activity on cancer related fatigue among breast cancer patients in recovery stage / 中国实用护理杂志

Objective To explore the effectiveness of moderate intensity physical activity on cancer-related fatigue (CRF) in breast cancer patients during the convalescence in China. Methods A total of 61 participants were randomly assigned to two groups:30 cases in the control group, 31 cases in the experimental group. The two groups were given routine care and exercise prescription. The cases in the control group were informed of doing exercises according to physical condition. The experimental group did exercise by exercise prescription of 30-minute walk every day which met the American Cancer Society (ACS) guidelines for moderate physical activity. The patients fatigue index and physical activity were compared, simultaneously the relationship between the two groups in the pre-cheo phase (T0 ), 1 week, after the end of chemotherapy (T1), and 1 month after chemotherapy (T2) was analyzed. Results In terms of the fatigue index, there was no statistical difference between the two groups during the T0 period (t=0.967, P>0.05). The experimental group at T1 and T2 were 6.31±0.81,4.71±0.94, significantly lower than those of the control group 6.92 ± 0.79, 5.36 ± 0.91, with a statistical difference (t=2.987, 2.730, P<0.01). In terms of physical activity level, there was no statistical difference between the two groups during the T0 period (t=1.902, P>0.05). The experimental group at T1 and T2 was (716.94±71.09), (828.87± 118.50) MET-minutes/week, significantly higher than the control group (562.00 ± 94.47),(718.47 ± 61.13)MET-minutes/week, with a statistical difference (t=7.235, 4.548, P<0.01). Using Logistic regression, the correlation between fatigue index and age, physical activity level, cancer staging, and surgical method was analyzed. There was a significant correlation between physical activity level and fatigue index (P<0.05). There was no correlation between fatigue index and age, stage of cancer, and surgical methods (P>0.05). Conclusions Moderate levels of physical activity can help improve the quality of life by means of significantly reduce CRF in patients with breast cancer during the convalescence.

Clinical significance of the expression levels of ERCC1, BRCA1 and TS in advanced colorectal cancer / 中国医师进修杂志

Objective To explore the relationship between the expression levels of excision repair cross complementation group 1(ERCC1), breast cancer susceptibility gene 1(BRCA1), thymidylate synthase (TS) mRNA and clinicopathological features, prognosis in advanced colorectal cancer, and the correlation between the expression levels of ERCC1 and BRCA1. Methods The expression levels of ERCC1, BRCA1 and TS mRNA of postoperative paraffin embedded tissue were tested by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) in 49 advanced colorectal cancer cases. The results were analyzed by χ2 test of the correlation between the expression levels and clinicopathological characteristics. Patients were followed up by clinic or telephone. The prognosis was analyzed by small sample Kaplan-Meier survival analysis and Log-rank time series analysis, and P0.05). The expression level of BRCA1 mRNA had no significant correlation with the above clinical and pathological features (P>0.05) except distant metastasis (P=0.030) and differentiation degree (P=0.002). The expression level of TS mRNA had no significant correlation with the above clinical and pathological features (P>0.05) except distant metastasis (P=0.003). The expression level of ERCC1 and BRCA1 mRNA obviously correlated (P=0.002). The 1 year overall survival rate was 95.92%(47/49);the 2 year overall survival rate was 83.67%(41/49);and the 3 year overall survival rate was 73.47%(36/49). Overall survival and progression-free survival time in ERCC1 mRNA low expression group (47.8, 41.0 months) was higher than that in ERCC1 mRNA low expression group (27.3, 20.0 months) respectively (P=0.001, P=0.001). Overall survival and progression-free survival time in BRCA1 mRNA low expression group (43.7, 42.7 months) was higher than that in BRCA1 mRNA high expression group (29.3, 25.1 months) respectively (P=0.009, 0.006). Overall survival time in TS mRNA low expression group (39.8 months) was higher than that in BRCA1 mRNA high expression group (25.2 months). Conclusions The expression level of ERCC1 mRNA is not correlated with its clinical and pathological characteristics, but with its biological characteristics. BRCA1 and TS levels are correlated with invasion and metastasis. Low levels of ERCC1 and BRCA1 expression have a better prognostic effect on platinum based first-line chemotherapy for advanced colorectal cancer, and they are correlated. Low level of TS also has longer disease-free survival. Three joint detection could be used as a prognostic factor for colorectal cancer chemotherapy.

Effect and mechanism of umbilical cord blood stem cells in the treatment of stroke / 中国组织工程研究

BACKGROUND: Studies have confirmed that umbilical cord blood stem cells can improve the neurologicalfunction after stroke, but the mechanism of umbilical cord blood stem cells in the treatment of stroke is unclear.OBJECTIVE: To review the effect and mechanism of umbilical cord blood stem cells in the treatment of stroke.METHODS: The first author searched PubMed and CNKI databases for relevant articles published from January2005 to December 2015 using key words of umbilical cord blood stem cells, stroke in English and Chinese,respectively. RESULTS AND CONCLUSION: With the further research on the neural differentiation of umbilical cord blood stem cells,umbilical cord blood stem cells have become a hot research topic in the field of neural system disease therapy. Atpresent, some experimental studies on cell transplantation for stroke have achieved ideal curative effects. However, themechanism of umbilical cord blood stem cells in the treatment of stroke is not clear. Known therapeutic mechanismsinclude the recombination of blood vessels, nerve loops and other damage tissue structures, secretion of variousnutritional factors to reduce endogenous apoptosis, promotion of endogenous blood vessels and nerve regeneration, etc.But the following problems need to be further studied, including whether the transplanted cells can be fully filled toreplace necrotic nerve cells and promote recovery of nerve function; how these survived stem cells establish the neuralconnections; how these transplanted cells reduce the apoptosis and necrosis of the host cells to restore the cell function.

Effect of moderate physical activity on cancer related fatigue among breast cancer patients in recovery stage / 中国实用护理杂志

Objective To explore the effectiveness of moderate intensity physical activity on cancer-related fatigue (CRF) in breast cancer patients during the convalescence in China. Methods A total of 61 participants were randomly assigned to two groups:30 cases in the control group, 31 cases in the experimental group. The two groups were given routine care and exercise prescription. The cases in the control group were informed of doing exercises according to physical condition. The experimental group did exercise by exercise prescription of 30-minute walk every day which met the American Cancer Society (ACS) guidelines for moderate physical activity. The patients fatigue index and physical activity were compared, simultaneously the relationship between the two groups in the pre-cheo phase (T0 ), 1 week, after the end of chemotherapy (T1), and 1 month after chemotherapy (T2) was analyzed. Results In terms of the fatigue index, there was no statistical difference between the two groups during the T0 period (t=0.967, P>0.05). The experimental group at T1 and T2 were 6.31±0.81,4.71±0.94, significantly lower than those of the control group 6.92 ± 0.79, 5.36 ± 0.91, with a statistical difference (t=2.987, 2.730, P<0.01). In terms of physical activity level, there was no statistical difference between the two groups during the T0 period (t=1.902, P>0.05). The experimental group at T1 and T2 was (716.94±71.09), (828.87± 118.50) MET-minutes/week, significantly higher than the control group (562.00 ± 94.47),(718.47 ± 61.13)MET-minutes/week, with a statistical difference (t=7.235, 4.548, P<0.01). Using Logistic regression, the correlation between fatigue index and age, physical activity level, cancer staging, and surgical method was analyzed. There was a significant correlation between physical activity level and fatigue index (P<0.05). There was no correlation between fatigue index and age, stage of cancer, and surgical methods (P>0.05). Conclusions Moderate levels of physical activity can help improve the quality of life by means of significantly reduce CRF in patients with breast cancer during the convalescence.

Determination of Amines in Particulate Matter by Gas Chromatography-Mass Spectrometry / 分析化学

A method was developed for determination of thirteen amines including seven aliphatic amines, two heterocyclic amines and four aromatic amines in atmospheric particulate matter (PM) by gas chromatography-mass spectrometry (GC-MS). Samples were ultrasonically extracted with ultra-pure water and derivatized with benzenesulfonyl chloride (BSC) under alkaline conditions. The derivatives were extracted with dichloromethane and then detected by GC-MS using DB-5MS chromatographic column. The method detection limit (S/N=3) and quantitation limit (S/N=10) were 0.00008-0.017 μg/mL and 0.00026-0.0565 μg/mL respectively, and the correlation coefficients were 0.9903-0.9996, which indicated that the standard curve had good linear correlation. In addition, the relative standard deviation was less than 30％ and the average recovery was 54.4％-159.7％ except for methylamine and benzylamine at spiked level of 1.0 μg/mL, showing high precision and accuracy. 9 kinds of amines were detected in the PM2.5 samples collected in Guangzhou city by this method, among which dimethylamine and butylamine accounted for 90％ of the total nine amines, which indicated that they were primary amines in PM2.5; while propylamine exhibited the lowest level in PM2.5 with the concentration less than 1.0 ng/m3.

Expression difference of FKBP51 in colorectal cancer and normal tissues and its relationship with clinicopathological features / 中国医师杂志

Objective To explore the difference of the expression level of FK506 Binding Protein 51 (FKBP51) in colorectal adenocarcinoma and normal colorectal tissues,and the correlation between FKBP51 expression level and clinicopathological characteristics,and to clarify whether FKBP51 is involved in the occurrence and development of colorectal cancer.Methods By immunohistochemical staining [streptavidin-peroxidase (SP) method] and Western blotting methods tested 31 cases of colorectal cancer tumor tissues and normal colorectal tissues far from tumor 5 cm,and explored the expression level difference of FKBP51.Combined with clinical data of patients,results were analyzed by statistical method x2 test of four case table data.Results The high expression rate of FKBP51 in tumor tissues was 74.19％ (23/31 cases),while the high expression rate of FKBP51 in normal tissue was 9.68％ (3/31 cases).The difference was significant.The expression level of FKBP51 in patients with colorectal carcinoma had no obvious correlation with gender (P =0.771),age (P =0.474),tumor location (P =0.213),degree of differentiation (P =0.318),lymph node metastasis (P =0.124),distant metastasis (P =0.318) and clinical stage (P =0.171);and the tumor size (P =0.049),depth of invasion related (P =0.031),the difference was statistically significant.Conclusions The expression of FKBP51 in colorectal cancer was strong,while weak expression in normal colorectal tissues.With the increase of tumor infiltration and deepening,the expression of FKBP51 became stronger,which indicated that FKBP51 participated in the genesis and development of colorectal cancer,and it might become a new target for individual therapy of colorectal cancer.

The Application of Satir Family Therapy in Medical Students with Learning Difficulties / 中国医学伦理学

In order to improve works of helping this special group,medical students' current ideological and political situation and characteristics are analyzed.Then applying the Satir family therapy into the medical students' ideological and political education process and analyzing the applicability of Satir into the ideological and political work from the three views of system,family values and humanity.Family tree technology,home remodeling,empty chair technique and iceberg metaphor technology of Satir family therapy are analyzed in details in ideological and political education of medical students with learning difficulties through some helping cases.the three views of system,family values and humanity of Satir family therapy have some value in helping students,building positive value instead of their negative mind towards learning.With the promotion of Satir family's concept and technology,it also helps the ideological and political educators have deep thoughts about the education methods.

Comparison of therapeutic effects of different tiotropium bromide regimens in adult patients with asthma / 中国生化药物杂志

Objective To analyze the clinical effect and the related performance of different tiotropium bromide in the treatment of adult asthma patients.Methods58 patients in the Second hospital of Shandong University from August 2014 to May 2016 admitted to the adult bronchial asthma, were randomly divided into observation group and control group, each of the 29 cases of patients, two patients were taken on the basis of routine treatment of tiotropium bromide in the treatment, the observation group in each given tiotropium 5 g treatment.The control group took a day sooner or later given tiotropium 2.5 g treatment, analysis of clinical effect of two groups were compared and the related performance.ResultsThis group of patients with different delivery methods after treatment, the observation group and the control group of arterial blood gas analysis results have significant difference compared to the clinical effect compared with statistical difference (P<0.05);treatment group the effective rate of treatment group and control the efficiency compared with significant differences (P<0.05);the two groups of patients after treatment, clinical symptoms were observed in groups of patients with asthma remission time were (6.24±1.92) d, while the control group was (8.33±2.47) d, the two groups were compared with statistical difference (P<0.05).ConclusionDifferent tiotropium dosing regimen for adult patients with asthma curative effect has significant clinical effect, compared with 5 per night given tiotropium Gtherapy and its clinical effect is more obvious.