Bionic design,preparation and clinical translation of oral hard tissue restorative materials / 北京大学学报(医学版)

Oral diseases concern almost every individual and are a serious health risk to the popula-tion.The restorative treatment of tooth and jaw defects is an important means to achieve oral function and support the appearance of the contour.Based on the principle of"learning from the nature",Deng Xu-liang's group of Peking University School and Hospital of Stomatology has proposed a new concept of"microstructural biomimetic design and tissue adaptation of tooth/jaw materials"to address the worldwide problems of difficulty in treating dentine hypersensitivity,poor prognosis of restoration of tooth defects,and vertical bone augmentation of alveolar bone after tooth loss.The group has broken through the bottle-neck of multi-stage biomimetic technology from the design of microscopic features to the enhancement of macroscopic effects,and invented key technologies such as crystalline/amorphous multi-level assembly,ion-transportation blocking,and multi-physical properties of the micro-environment reconstruction,etc.The group also pioneered the cationic-hydrogel desensitizer,digital stump and core integrated restora-tions,and developed new crown and bridge restorative materials,gradient functionalisation guided tissue regeneration membrane,and electrically responsive alveolar bone augmentation restorative membranes,etc.These products have established new clinical strategies for tooth/jaw defect repair and achieved inno-vative results.In conclusion,the research results of our group have strongly supported the theoretical im-provement of stomatology,developed the technical system of oral hard tissue restoration,innovated the clinical treatment strategy,and led the progress of the stomatology industry.

Efficacy and safety of tyrosine kinase inhibitors in the treatment of HER2-positive breast cancer：a meta-analysis / 中国药房

OBJECTIVE To evaluate the efficacy and safety of tyrosine kinase inhibitors （TKI） in the treatment of HER2- positive breast cancer in order to provide evidence-based evidence for clinical medication. METHODS Retrieved from CNKI， Wanfang database， VIP， PubMed， Cochrane Library， Embase and Web of Science， randomized controlled trial （RCT） about TKI （trial group） versus drugs excluding TKI （control group） in the treatment of HER2-positive breast cancer were collected from the establishment of the database to April 2023. Meta-analysis and sensitivity analysis were performed by using RevMan 5.4.1 and Stata 17 software. RESULTS Total of 24 RCT studies were included， involving 15 538 HER2-positive breast cancer patients. The meta- analysis results showed that compared with the control group， the progression-free survival （PFS） [HR＝0.91， 95%CI （0.80， 1.02）， P＝0.12]， overall survival （OS） [HR＝0.95， 95%CI （0.89， 1.01）， P＝0.11]， objective response rate （ORR） [OR＝1.21， 95%CI （0.86， 1.69）， P＝0.27]， and pathological complete response rate （pCR） [OR＝1.44， 95%CI （0.91， 2.27）， P＝0.12] had no statistically significant difference in the trial group； among the 3/4 grade ADRs， the trial group had a higher incidence of anemia [OR＝1.77， 95%CI （1.16，2.70）， P＝0.008]， rash [OR＝11.26， 95%CI （7.32，17.31）， P＜0.000 01]， paronychia [OR＝8.67， 95%CI（1.62，46.53）， P＝0.01]， diarrhea [OR＝10.17， 95%CI（5.03，20.58）， P＜0.000 01]， oral mucositis inflammation [OR＝ 9.34， 95%CI （3.13， 27.83）， P＜0.000 1]， elevated aspartate aminotransferase [OR＝2.09， 95%CI （1.13，3.84）， P＝0.02]， and hypokalemia [OR＝2.37， 95%CI （1.31，4.30）， P＝0.005] than that of the control group. Subgroup analysis results showed that compared with the placebo group， TKI could improve OS and ORR （P＜0.05）， while compared with trastuzumab， TKI had no advantage in PFS， OS， ORR， and pCR， and TKI combined with trastuzumab could significantly improve PFS， OS， ORR， and pCR compared with the trastuzumab group （P＜ 0.05）. Sensitivity analysis suggested that the results were relatively robust and the risk of publication bias was low. CONCLUSIONS Compared with trastuzumab， TKI has no advantages in PFS， OS， ORR and pCR in the treatment of HER2- positive breast cancer， but TKI combined with trastuzumab can significantly improve PFS， OS， ORR and pCR； TKI can increase the risk of grade 3/4 anemia， rash， paronychia， diarrhea， oral mucositis， elevated aspartate aminotransferase， and hypokalemia.

The relationship between serum interleukin-17A, chemokine ligand 19 levels and disease activity in patients with lupus nephritis / 中国医师进修杂志

Objective:To investigate the relationship between serum levels of interleukin-17A (IL-17A) and chemokine ligand 19 (CCL19) and disease activity in patients with lupus nephritis.Methods:A total of 100 patients with lupus nephritis admitted to Affiliated Hospital of Jining Medical College from June 2020 to February 2023 were collected as the disease group, according to the disease activity index, patients were grouped into inactive group (32 cases), mild active group (21 cases), moderate active group (29 cases), and severe active group (18 cases); another 100 healthy individuals who underwent physical examinations in our hospital during the same period were collected as the control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of IL-17A and CCL19 in serum; Pearson method was applied to analyze the correlation between serum IL-17A, CCL19 and routine indicators in patients with lupus nephritis; receiver operating characteristic curve was applied to analyze the diagnostic value of serum IL-17A and CCL19 for moderate/severe lupus nephritis disease activity.Results:The expression levels of IL-17A and CCL19 in the serum of the disease group were obviously higher than those of the control group: (252.63 ± 64.47) ng/L vs. (123.27 ± 25.12) ng/L and (566.98 ± 73.36) ng/L vs. (275.63 ± 50.48) ng/L ( t = 18.70 and 32.72, P<0.05); the serum levels of IL-17A and CCL19 in the severe active, moderate active, and mild active groups were higher than those in the inactive group: (331.42 ± 87.46), (278.50 ± 74.19) and (232.34 ± 59.16) ng/L vs. (198.18 ± 46.22) ng/L; (662.33 ± 89.57), (606.14 ± 79.25) and (552.84 ± 68.36) ng/L vs. (487.13 ± 62.19) ng/L, and with the increase of disease activity, the levels of serum IL-17A and CCL19 gradually increased ( F = 17.86 and 25.35, P<0.05); the glomerular filtration rate, albumin, complement C 3 and complement C 4 in the active group were obviously lower than those in the inactive group: (69.17 ± 13.25) ml/(min·1.73 m 2) vs. (86.18 ± 14.16) ml/(min·1.73 m 2), (24.18 ± 5.11) g/L vs. (31.25 ± 6.35) g/L, (432.35 ± 95.22) mg/L vs. (675.42 ± 125.16) mg/L, (76.58 ± 17.51) mg/L vs. (121.42 ± 27.18) mg/L, while blood creatinine, urine protein and erythrocyte sedimentation rate were obviously higher than those in the inactive group: (92.34 ± 16.24) μmoI/L vs. (53.21 ± 9.17) μmoI/L, (3.43 ± 0.82) g/24 h vs. (1.26 ± 0.23) g/24 h, (66.37 ± 12.28) mm/1 h vs. (35.62 ± 8.67) mm/1 h ( t = 5.86, 5.97, 10.74, 9.93, 12.70, 14.67 and 12.74; P<0.05); serum IL-17A and CCL19 in patients with lupus nephritis were negatively correlated with glomerular filtration rate, albumin, complement C 3, and complement C 4, while positively correlated with blood creatinine, urine protein, and ESR ( P<0.05); the area under the curve (AUC) of the combined diagnosis of serum IL-17A and CCL19 for lupus nephritis disease activity was 0.961, which was superior to their respective individual diagnoses ( Z = 2.24 and 3.16, P = 0.025 and 0.002). Conclusions:The expression levels of IL-17A and CCL19 in serum gradually increase with the increase of disease activity in patients with lupus nephritis. The combined detection of the two has good diagnostic value for disease activity in lupus nephritis.

Correlation and diagnostic value analysis of VEGF, RDW and myocardial damage in children with severe mycoplasma pneumoniae pneumonia / 中国医师杂志

Objective:To explore the correlation between myocardial damage and vascular endothelial growth factor (VEGF), red blood cell distribution width (RDW), and myocardial enzyme spectrum in children with severe mycoplasma pneumoniae pneumonia.Methods:Sixty children with severe mycoplasma pneumoniae pneumonia and myocardial damage admitted to Jining Medical University from January 2019 to December 2020 were selected as the observation group, and 60 children with severe mycoplasma pneumoniae pneumonia admitted during the same period were selected as the control group. The differences in clinical data and imaging features between the two groups were compared. Pearson correlation analysis was used for correlation analysis; The logistic regression method was applied to analyze the influencing factors of myocardial damage in children with severe mycoplasma pneumoniae pneumonia. The value of VEGF and RDW in predicting myocardial damage in children with severe mycoplasma pneumoniae pneumonia was analyzed using receiver operating characteristic (ROC) curves.Results:The levels of C-reactive protein (CRP), procalcitonin (PCT), VEGF, RDW, creatine kinase isoenzyme (CK-MB), creatine kinase (CK), cardiac troponin I (cTnI), and lactate dehydrogenase (LDH) in the observation group were significantly higher than those in the control group (all P<0.05), and the duration of fever, application of macrolide drugs, and glucocorticoid application time were significantly longer than those in the control group (all P<0.05). There was no statistically significant difference in pulmonary imaging characteristics between the observation group and the control group (all P>0.05). The VEGF and RDW in the observation group were positively correlated with CK-MB and cTnI (all P<0.05). Logistic regression analysis showed that duration of fever, VEGF, RDW, and duration of macrolide drug use were the influencing factors for myocardial damage in children with severe mycoplasma pneumoniae pneumonia (all P<0.05). The area under the ROC curve of VEGF combined with RDW in predicting myocardial damage in children with severe mycoplasma pneumoniae pneumonia was 0.899, significantly higher than that predicted by VEGF and RDW alone (all P<0.05). Conclusions:The serum VEGF and RDW levels in children with severe mycoplasma pneumoniae pneumonia accompanied by myocardial damage are elevated and positively correlated with myocardial enzyme spectrum indicators, which has certain application value in predicting myocardial damage.

Accelerated Hg loss and increased methylmercury covary with soil organic matter mineralization and dissolved organic matter humification under warming conditions in permafrost marsh, Northeast China.

Currently, little is available on how mercury (Hg) methylation couples with soil organic matter decomposition in degraded permafrost in high northern latitudes, where the climate is becoming warmer rapidly. Here, we revealed the complex interactions between soil organic matter (SOM) mineralization, dissolved organic matter (DOM) and methylmercury (MeHg) production based on an 87-day anoxic warming incubation experiment. Results supported remarkably promotion effects of warming on MeHg production, by 130%-205% on average. Total mercury (THg) loss under warming treatment depended on marsh types but showed an increasing trend on the whole. Warming yielded higher proportions of MeHg to THg (%MeHg), increased by 123%-569%. As expected, greenhouse gas emission was significantly enhanced by warming. Warming also strengthened fluorescence intensities of fulvic-like and protein-like DOM, with contributions to total fluorescence intensities of 49%-92% and 8%-51%, respectively. DOM and its spectral features explained 60% variation of MeHg, and the explanation increased to 82% in conjunction with greenhouse gas emissions. The structural equation model implied that warming, greenhouse gas emission, and humification of DOM had positive effects on Hg methylation potential, while microbial-derived DOM showed negative effects on MeHg. These results showed that accelerated Hg loss and increased methylation covaried with greenhouse gas emission and DOM formation under warming conditions in permafrost marsh.

Applicability of public interest litigation to resolve health insurance disputes / 中华医院管理杂志

Medical insurance services provided by medical institutions are managed by medical insurance agencies via agreements, one of the most popular means of management. Hence the safe use of medical insurance funds depends on the correct performance of medical insurance service agreements. To improve the standardization and accuracy of medical insurance agreement management behavior, and protect the interests of medical institutions and the insured at large, the authors demonstrated the feasibility and necessity of public interest litigation in medical insurance agreement management from both theoretical and practical perspectives. They also proposed to promote the effective resolution of medical insurance disputes by expanding clues sources, strictly the initiating thresholds, and maintaining the modesty of public interest litigation.

Risk exploration of liability for medical damages incurred by ambulances based on SHEL model / 中华医院管理杂志

Objective:To analyze the risk factors of medical damage liability in the ambulance management in China, and provide reference for strengthening such management and improving the pre-hospital emergency system.Methods:The judgment documents released by China Judgment Online from 2013 to 2022 regarding damages incurred by improper ambulance management, were used as the sample. Based on the setting of such elements as software, hardware, environment, and liveware in the SHEL model, the text analysis method was applied to encode the text content at three levels according to " main category-sub category-risk behavior" by means of NVivo 12.0 software.Results:A total of 136 valid sample documents were included, finalizing such four main categories as software, hardware, environment, and liveware. Also finalized were 11 subcategories and 30 risk behaviors. The subcategories included the professional awareness and ability of pre-hospital emergency managers, the professional awareness of medical staff, the professional quality and ability of medical staff, as well as vehicle equipment among others. A total of 187 reference points were identified for coding risk behaviors. Risk behaviors with higher reference points included failure of pre-hospital emergency managers to dispatch vehicles (45), incomplete, malfunctioning, or no backup equipment in vehicles (20), failure of medical staff to take treatment measures in vehicles (18), failure to dispatch accompanying medical staff or stretchers (14), and insufficient medication (14), and fall of patients or medical equipment incurred by sudden braking of the drivers (6) among others.Conclusions:Insufficient ambulance equipment, shortage of human resources in the emergency system, inadequate equipment and medication in emergency vehicles, and safety issues for drivers are risk factors in the management of ambulances in China. It is recommended to expand the first aid talent team and enhance first aid capabilities; Reasonably deploy ambulance vehicles and improve the emergency networks; Develop a list of pharmaceutical equipment and establish an early warning mechanism; Strengthen the multi-party coordination, improve the efficiency of referral, further reduce the probability of risk, ensure the quality of emergency treatment, and enhance the effectiveness of pre-hospital emergency treatment.

Efficacy and safety of antibody-drug conjugates in the treatment of breast cancer：a meta-analysis / 中国药房

OBJECTIVE To evaluate the efficacy and safety of antibody-drug conjugates （ADC） in the treatment of breast cancer， so as to provide an evidence-based reference for clinical medication. METHODS Retrieved from CNKI， Wanfang database， VIP， PubMed， the Cochrane Library， Embase， and Web of Science， randomized controlled trials （RCTs） about trastuzumab emtansine， trastuzumab deruxtecan and sacituzumab govitecan （trial group） versus chemotherapy or other anti-tumor drugs （control group）， were collected during the inception to April 2023. After screening the literature， extracting data， and evaluating the quality of the literature， a meta-analysis was conducted by using RevMan 5.4.1 software. RESULTS A total of 8 RCTs were included， with a total of 5 577 patients. The results of the meta-analysis showed that the progression-free survival （PFS） [HR＝0.76， 95%CI （0.69， 0.83）， P＜0.000 01]， overall survival （OS） [HR＝0.87， 95%CI （0.81， 0.93）， P＜0.000 1]， and clinical benefit rate （CBR） [OR＝2.70， 95%CI （1.15， 6.33）， P＝0.02] of the trial group were significantly higher than control group. There was no statistically significant difference in objective response rate （ORR） between the two groups [OR＝2.34， 95%CI （0.59， 9.33）， P＝0.23]. The results of subgroup analysis showed that the PFS of HER2-positive patients and HER2-negative patients， and the OS of HER2-positive patients in the trial group were significantly higher than control group （P＜0.05）. The incidence of anemia and increase of aspartic acid transaminase （AST） in the trial group was significantly higher than control group （P＜0.05）. The results of sensitivity analysis showed that the results obtained with PFS， OS， and ORR as indicators were relatively robust， while the results obtained with CBR as indicators lacked robustness. CONCLUSIONS ADC drugs have significant effects on breast cancer， but will increase the risk of anemia and elevated AST.

Extrapolating neurogenesis of mesenchymal stem/stromal cells on electroactive and electroconductive scaffolds to dental and oral-derived stem cells / 国际口腔科学杂志·英文版

The high neurogenic potential of dental and oral-derived stem cells due to their embryonic neural crest origin, coupled with their ready accessibility and easy isolation from clinical waste, make these ideal cell sources for neuroregeneration therapy. Nevertheless, these cells also have high propensity to differentiate into the osteo-odontogenic lineage. One strategy to enhance neurogenesis of these cells may be to recapitulate the natural physiological electrical microenvironment of neural tissues via electroactive or electroconductive tissue engineering scaffolds. Nevertheless, to date, there had been hardly any such studies on these cells. Most relevant scientific information comes from neurogenesis of other mesenchymal stem/stromal cell lineages (particularly bone marrow and adipose tissue) cultured on electroactive and electroconductive scaffolds, which will therefore be the focus of this review. Although there are larger number of similar studies on neural cell lines (i.e. PC12), neural stem/progenitor cells, and pluripotent stem cells, the scientific data from such studies are much less relevant and less translatable to dental and oral-derived stem cells, which are of the mesenchymal lineage. Much extrapolation work is needed to validate that electroactive and electroconductive scaffolds can indeed promote neurogenesis of dental and oral-derived stem cells, which would thus facilitate clinical applications in neuroregeneration therapy.

Early clinical and CT features of COVID-19 and community-acquired pneumonia from a fever observation ward in Ningbo, China

INTRODUCTION@#We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of COVID-19 patients with those of other community-acquired pneumonia (CAP) patients to differentiate CAP from COVID-19 before reverse transcription-polymerase chain reaction results are obtained.@*METHODS@#The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020.@*RESULTS@#24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients, except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. In total, 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were affected most often, and all lesions were located in the peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients.@*CONCLUSION@#Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.

Impacts of Spartina alterniflora invasion on soil carbon contents and stability in the Yellow River Delta, China.

Spartina alterniflora has rapidly expanded in coastal wetlands of China, and this would affect soil organic carbon (SOC) storage and stability. In the present work, the impacts of S. alterniflora colonization on SOC pool and stability was deciphered to better understand how alien species altered the carbon cycle in the Yellow River Delta (YRD). SOC contents were in the range of 1.29 g/kg-7.02 g/kg, of which wetlands covered by S. alterniflora increased with colonization time and exceed those in wetlands covered by native species after 7 years. Pyrolysis-gas chromatography/mass spectrometry analysis showed that aromatic moieties were predominant components of SOC, and there were remarkable increase trends of phenol and lignin compounds and decrease trend of aromatic moieties with S. alterniflora invasion time. SA had the highest microorganism biomass reflected by phospholipids fatty acid (PLFA) across different wetlands. Salinity had the largest negative effects while nutrients had the largest positive effects on the SOC pool. The proportion of decomposition-resistant compounds (including aromatics, lignin, and phenol) to total SOC was decreasing while the SOC pool was increasing with S. alterniflora invasion time. This study demonstrated that S. alterniflora invasion could promote the SOC pool but weaken its stability in the wetlands of the YRD.

An empirical judicial case study on the authenticity disputes of electronic medical records / 中华医院管理杂志

Based on a research on judicial cases concerning the authenticity of electronic medical records in the past three years, the authors encountered judicial dilemmas in judicial practice. The challenges arise due to the special manifestations of electronic medical records, unclear and disputable criteria for the authenticity of electronic medical records, low application level of electronic medical records identification, and inconsistent responsibility attribution. In order to effectively apply the electronic medical record system, it is recommend to promote pre-litigation prevention by unifying the construction standards of the computerized patient record system, strengthening hospital electronic medical record management and entrusting third-party storage to ensure the evidential weight. In addition, it is necessary to establish standards for authenticity of medical records, improve the electronic medical record forensic identification system and clarify the attribution of the responsibility for untrue medical records, so as to improve the handling of such medical damage cases during litigation.

Variation analysis of uridine diphosphate glucuronosyl transferase 1A1 gene in several nationalities′ neonates with etiology-unknown neonatal hyperbilirubinemia in Qiubei County / 中国小儿急救医学

Objective:To explore the polymorphism of the uridine diphosphateglucuronosyl transferase 1A1 ( UGT1A1) gene in children of multiple nationalities with etiology-unknown neonatal hyperbilirubinemia in Qiubei County. Methods:Full-term neonates with unknown cause hyperbilirubinemia were collected.They were admitted to neonatal ward of Qiubei People′s Hospital from September 2017 to June 2018.All of them were performed UGT1A1 gene test. Results:A total of 100 neonates were enrolled in this study.Among them, 53 infants were Han, and others were minorities.Ten mutation sites of UGT1A1 gene were found.Five sites were never reported before and 4 sites could be pathogenic mutations.In addition, c.211G>A.was the most common genetic mutation, and 13 cases of homozygote and 32 cases of heterozygote were revealed by exome sequencing.The bilirubin levels of children with homozygote c. 211G>A were higher than those without the variation in this study and the differences were statistically significant ( t=2.621, P=0.008). The incidence of c. 211G>A mutation was similar between Han and minority nationalities.Among new-found mutations, c.1091C>CA heterozygous mutation was found in 19 children and in several nationalities, suggesting that this was a common UGT1A1 gene mutation in Qiubei County.Besides c. 211G>A and c. 1091C>CA were the most common variants.The incidence of c. 211G>A had no significant difference between Han and minority nationalities (χ 2=0.215, P=0.643). Neither had the incidence difference of c. 1091C>CA between Han and minority nationalities (χ 2=0.017, P=0.897). Conclusion:c. 211G>A and c. 1091C>CA mutations , which are distributed in both Han and minority nationalities, are common UGT1A1 mutations in Qiubei County.The distribution rate of c. 211G>A mutation is high in the population.The homozygous variation of c. 211G>A is associated with neonatal hyperbilirubinemia.

Analysis of the expression of mesothelin mRNA and KISS1 mRNA in epithelial ovarian cancer and its correlation with prognosis / 中国医师进修杂志

Objective:To investigate the expression of mesothelin mRNA (MESO mRNA) and tumor metastasis suppressor gene KISS1 mRNA in epithelial ovarian cancer (EOC) and its correlation with prognosis.Methods:From January 2017 to January 2019, 52 patients with EOC in Tangshan Maternal & Child Health Care Hospital were selected as the observation group, and 52 healthy controls were selected as the control group. The levels of MESO mRNA and KISS1 mRNA between the two groups were compared; the correlation of MESO mRNA and KISS1 mRNA and EOC were analyzed; the correlation between MESO mRNA and KISS1 mRNA and clinicopathological characteristics was analyzed, and the expression of MESO mRNA and KISS1 mRNA in patients with different prognosis was compared after followed up for 1 year.Results:The levels of MESO mRNA and KISS1 mRNA in the observation group were higher than those in the control group (1.41 ± 0.40 vs. 1.41 ± 0.40, 0.73 ± 0.08 vs. 0.54 ± 0.07), and the differences were statistically significant ( P<0.05). The area under the curve(AUC) of combined diagnosis of EOC with MESO mRNA and KISS1 mRNA was 0.892 (95% CI 0.816 - 0.944), which was higher than the AUC of MESO mRNA and KISS1 mRNA single diagnosis ,which were 0.798 (95% CI 0.708 - 0.870), and 0.812 (95% CI 0.723 - 0.882). The differences of blood MESO mRNA level in different pathological types, operations-pathological stage, pathological grade, tumor diameter, lymph node metastasis were statistically significant ( P<0.05); the differences of blood KISS1 mRNA level in different operations-pathological stage, pathological grade, tumor diameter, lymph node metastasis were statistically significant ( P<0.05). The blood MESO mRNA level of the dead was higher than that of the survivors(1.52 ± 0.17 vs. 1.38 ± 0.15), the blood KISS1 mRNA level was lower than that of the survivors (0.69 ± 0.07 vs. 0.74 ± 0.06), and the differences were statistically significant ( P<0.05).The 1-year survival rate of patients with high expression of blood MESO mRNA was lower than that with low expression, and the 1-year survival rate of patients with high expression of KISS1 mRNA was higher than that with low expression ( P<0.05). Conclusions:The expression of MESO mRNA and KISS1 mRNA in the peripheral blood of patients with EOC is increased, but with the progression of the disease, MESO mRNA is increased and KISS1 mRNA is decreased. The abnormal expression of the two may participate in the development of EOC.

Association between corticotropin releasing hormone receptor 1 (rs4458044)polymorphism and persistent pulmonary hypertension of the newborn / 中华实用儿科临床杂志

Objective To investigate the association between rs4458044 site of corticotropin releasing hormone receptor 1 (CRHR1) polymorphism and persistent pulmonary hypertension of the newborn (PPHN).Methods Eighty-five blood specimens were collected from newborns with PPHN in Affiliated Hospital of Jining Medical University between March 2012 and March 2018,and 50 blood specimens were collected from healthy newborns as controls.The basic clinical data,clinical laboratory results,distribution of CRHR1 (rs4458044) polymorphism were retrospectively analyzed by t-test andx2 test.Results No significant difference existed in gender,gestational age,birth weight and 1 minute Apgar score between newborns with PPHN and the normal controls (all P ＞ 0.05).Significant difference existed in auxiliary ventilation time and maximum oxygenation index between newborns with PPHN and the normal controls (all P ＜ 0.05).Gene frequency of CRHR1 (rs4458044) GG,CG and CC gene types in newborns with PPHN and controls was 2.35％,43.53％,54.12％ and 50.00％,38.00％,12.00％,respectively.The CG/CC gene type was significantly higher in newborns with PPHN than the normal controls (P ＜ 0.05).The CG/CC gene type newborns had a higher risk for getting PPHN than GG gene type newborns (GG gene type as reference,C G gene type OR =24.34,95％ CI:5.20-113.87,P =0.00;CC gene type OR =95.83,95％ CI:17.99-510.49,P =0.00).Auxiliary ventilation time and maximum oxygenation index of newborns carrying C allele were higher than those without carrying C allele.Conclusion CRHR1 (rs4458044) polymorphism is closely associated with PPHNs.

Protection of medical data rights from the perspective of private law / 中华医院管理杂志

With the rapid development of " Internet+ healthcare" , medical data has gained an ever important role. How to determine the reasonable use boundary of medical data and leverage its supporting role, has grown an urgent problem to be solved. The authors analyzed the characteristics of medical data, and held that medical data is not equivalent to information, as it does not have the characteristics of legal objects in nature. In addition, it lacks originality. Therefore it is difficult to protect through the existing rights system. However, due to its property interest and personality, the authors tried to establish a new right for protection. In the construction of such medical data right, the authors claimed that patients should be the subject of the right, and medical institutions can appropriately restrict the freedom of patients′ through reasonable use rules and legal licensing system. In this way, we can not only promote medical data sharing and the development of social health, but also fully protect the legitimate rights and interests of patients.

Clinical study of ventilated-associated pneumonia after cardiac surgery in adults / 中国实用护理杂志

Objective@#To investigate the epidemiological data of ventilator-associated pneumonia(VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients.@*Methods@#Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed.@*Results@#Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively; Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48%. Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors.@*Conclusions@#The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care

Association between corticotropin releasing hormone receptor 1 (rs4458044) polymorphism and persistent pulmonary hypertension of the newborn / 中华实用儿科临床杂志

Objective@#To investigate the association between rs4458044 site of corticotropin releasing hormone receptor 1 (CRHR1) polymorphism and persistent pulmonary hypertension of the newborn (PPHN).@*Methods@#Eighty-five blood specimens were collected from newborns with PPHN in Affiliated Hospital of Jining Medical University between March 2012 and March 2018, and 50 blood specimens were collected from healthy newborns as controls.The basic clinical data, clinical laboratory results, distribution of CRHR1 (rs4458044) polymorphism were retrospectively analyzed by t-test and χ2 test.@*Results@#No significant difference existed in gender, gestational age, birth weight and 1 minute Apgar score between newborns with PPHN and the normal controls (all P>0.05). Significant difference existed in auxiliary ventilation time and maximum oxygenation index between newborns with PPHN and the normal controls (all P<0.05). Gene frequency of CRHR1 (rs4458044) GG, CG and CC gene types in newborns with PPHN and controls was 2.35%, 43.53%, 54.12% and 50.00%, 38.00%, 12.00%, respectively.The CG/CC gene type was significantly higher in newborns with PPHN than the normal controls (P<0.05). The CG/CC gene type newborns had a higher risk for getting PPHN than GG gene type newborns (GG gene type as reference, CG gene type OR=24.34, 95%CI: 5.20-113.87, P=0.00; CC gene type OR=95.83, 95%CI: 17.99-510.49, P=0.00). Auxiliary ventilation time and maximum oxygenation index of newborns carrying C allele were higher than those without carrying C allele.@*Conclusion@#CRHR1 (rs4458044) polymorphism is closely associated with PPHNs.

Clinical study of ventilated-associated pneumonia after cardiac surgery in adults / 中国实用护理杂志

Objective To investigate the epidemiological data of ventilator-associated pneumonia (VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients. Methods Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed. Results Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively;Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48% . Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors. Conclusions The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care

Construction Exploration of a Team of Professional Drug Inspectors in Hubei Province / 中国药师

Objective: To explore the ways to build a team of professional drug inspectors in Hubei province in oder to improve the quality and effectiveness of drug inspections in our province, reduce the risk of supervision, and ensure the safety of people's drug use. Methods: The requirements of national regulations and policies for the inspectors were interpreted, the construction system of profes-sional drug inspectors in Shanghai drug review and verification center was selected as comparison, the current situation and existing problems of the construction of drug inspectors in our province were analyzed, and the construction methods of professional inspectors in Hubei province were found out. Results: On the basis of the existing team of drug inspectors, a standardized system for selection, training, evaluation and grading of drug inspectors should be established, and the establishment of a team of professional drug inspec-tors in our province should be gradually completed. Conclusion: Our province can gradually establish a team of professional drug in-spectors, firstly from the current "main part-time assisted by full-time" to " lay equal stress on part-time and full-time", and then to"main full-time assisted by part-time", till the final realization of all professional drug inspectors.