Analysis and reflection on the effect difference between the two teaching modes caused by the difference of discipline nature / 中华医学教育探索杂志

In order to further cultivate bioscience talents, we compared and analyzed the teaching effects of different teaching modes of Bioscience courses in our university. Under the condition that the difficulty of the examination subjects and papers remains unchanged, we collected and compared the examination results of the online teaching mode covering three grades of students with the corresponding examination results of the traditional teaching mode of the previous academic year. After comparing the final examination results of 21 courses, we found that the online teaching effect of examination courses with long courses and experimental courses is better (such as physiology, pathology, etc.). The phenomenon that online teaching cannot be carried out normally has affected most students (66.28%, 57/86), indicating that the experimental course cannot be replaced by online teaching. At the same time, students who expected systematic teaching reform of biological science major courses accounted for the majority in the survey (80.23%, 69/86). Based on this, we conclude that the mixed teaching mode with traditional teaching as the main body of teaching and online platform technology as the auxiliary can become a new exploration direction in undergraduate teaching of Bioscience majors in medical colleges and universities.

Knowledge of occupational exposure to HIV among healthcare workers in college campus clinics and tertiary hospitals.

As the number of college students infected with the human immunodeficiency virus (HIV) has increased significantly in China, the risk of occupational exposure to HIV among healthcare workers (HCW) in college campus clinics has also increased. Our study aimed to evaluate the awareness of HCWs in terms of preventing occupational HIV exposure in college campus clinics compared with HCWs in tertiary hospitals. This cross-sectional study was conducted in nine provinces in China from September to October 2019 (10 college campus clinics, 7 tertiary hospitals). The study's response rate was recorded to be at 87.62% (184 of 210). The knowledge score of HIV among all HCWs was determined to be generally low (67.17 ± 11.17 points), and that of college campus clinics and tertiary hospitals showed no significant difference (66.36 ± 10.36 vs. 67.63 ± 11.61 points, P=0.463). Overall, HCWs in both college campus clinics and tertiary hospitals showed inadequate knowledge regarding occupational HIV exposure. Training for the prevention of occupational HIV exposure should be strengthened in both medical institutions.

Klebsiella pneumoniae: A pathogenic bacteria transmitted through Hirudo nipponia that may cause illness in humans.

Hirudo nipponia, or the leech, is not only an important economic pillar for farmers, but is also a precious raw material for medicinal materials. However, in recent years, H. nipponia has suffered from disease with symptoms including systemic oedema and hyperaemia. It has not yet been demonstrated which pathogen causes this disease and whether this could be transmitted to humans. In this study, Klebsiella pneumoniae was isolated and identified and the pathogenicity of the isolated strain was confirmed. Furthermore, by comparing the sequence of the pathogen isolated from leeches to the same pathogen infecting humans, we identified that the isolated strain is a threat to human health. This work emphasizes the importance of the first discovery of pathogenic bacteria from leeches similar to human pathogens, as well as the need for identifying zoonosis for both humans and aquatic animals.

Diagnostic value of serum antibody test and gastroscopy-guided duodenal drainage for clonorchiosis sinensis / 中华消化内镜杂志

Objective:To explore a fast method to identify and confirm suspected clonorchis sinensis infection.Methods:For suspected clonorchis sinensis infection, the clonorchiasis serum antibody was detected first with ELISA. If the antibody was positive, the fecal examination for eggs was performed. If the fecal examination was negative, duodenal drainage under gastroscopy was recommended to detect eggs from the drainage fluid.Results:A total of 126 patients met the requirements and aged 54.14±13.33 (24- 87). There were 83 cases (65.87%, 83/126) with eggs positive in the drainage fluid, of which 53 cases were male, aged 55.91±11.47 (30-86), and 30 cases female, aged 55.87± 13.85(30-87). There was no significant difference in age between males and females( P>0.05). The time of catheterization (T1) of 126 cases was 3.79 ±1.45 min. The time of drainage (T2) of 126 cases was 31.39 ±14.29 min. There was no significant difference in T1 or T2 between the positive group and the negative group( P>0.05). The detection rates of eggs were 91.57% (76 cases) in intrahepatic bile duct drainage, 81.93% (68 cases) in the bile-cyst juice and 75.90% (63 cases) in the common bile duct fluid. No serious adverse reactions occurred during or after the operation. Conclusion:The detection rate of clonorchiosis sinensis can be effectively improved by the combination of clonorchiasis serum antibody test and gastroscopy-guided duodenal drainage.

EphrinA1/EphA2 Promotes Epithelial Hyperpermeability Involving in Lipopolysaccharide-induced Intestinal Barrier Dysfunction

Background/Aims@#Lipopolysaccharide (LPS) is the key factor inducing mucosal and systemic inflammation in various intestinal and parenteral diseases, which could initially disrupt the epithelial barrier function. EphrinA1/ephA2 is speculated to increase the epithelial permeability for its “repulsive interaction” between adjacent cells. This study aim to investigate the role of ephrinA1/ephA2 in LPS-induced epithelial hyperpermeability. @*Methods@#In vivo model challenged with oral LPS in C57BL/6 mice and in vitro model exposed to LPS in Caco2 monolayer were established. The barrier function was assessed including expression of tight junction proteins (occludin and claudin-1), transepithelial electrical resistance, and permeability to macromolecules (fluorescein isothiocyanate-labeled fluorescent dextran 4 kDa [FD4]). Moreover, the expression and phosphorylation of ephrinA1/ephA2 were quantified, and its roles in the process of epithelial barrier disruption were confirmed via stimulating ephA2 with ephrinA1-Fc chimera (ephrinA1-Fc) and inactivating ephA2 with ephA2-Fc chimera (ephA2-Fc), or ephA2 monoclonal antibody (ephA2-mab), as well as inhibiting extracellular signal-regulated kinase 1/2 (ERK1/2) with PD98059. @*Results@#LPS induced significant barrier dysfunction with dismissed occludin and claudin-1 expression, reduced transepithelial electrical resistance and increased FD4 permeability, accompanied by upregulated ephrinA1/ephA2 pathway and phosphorylation of ephA2 receptor. Furthermore, ephA2-Fc, and ephA2-mab ameliorated LPS-induced epithelial hyperpermeability, which was also inhibited by PD98059. Additionally, ephrinA1-Fc led to apparent epithelial leakage in Caco2 monolayer by promoting the phosphorylation of ERK1/2, which could be obviously blocked by ephA2-mab and PD98059. @*Conclusion@#EphrinA1/ephA2 promotes epithelial hyperpermeability with an ERK1/2-dependent pathway, which involves in LPS-induced intestinal barrier dysfunction.

Resistin-Inhibited Neural Stem Cell-Derived Astrocyte Differentiation Contributes to Permeability Destruction of the Blood-Brain Barrier.

Neuroinflammation is an important part of the development of neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's and amyotrophic lateral sclerosis. Inflammatory factors destroy the balance of the microenvironment, which results in changes in neural stem cell differentiation and proliferation behaviour. However, the mechanism underlying inflammatory factor-induced NSC behavioural changes is not clear. Resistin is a proinflammatory and adipogenic factor and is involved in several human pathology processes. The neural stem cell microenvironment changes when the concentration of resistin in the brain during an inflammatory response disease increases. In the present study, we explored the effect and mechanism of resistin on the proliferation and differentiation of neural stem cells. We found that intracerebroventricular injection of resistin induced a decrease in GFAP-positive cells in mice by influencing NSC differentiation. Resistin significantly decreased TEER and increased permeability in an in vitro blood-brain barrier model, which is consistent with the results of an HBMEC-astrocyte coculture system. Resistin-inhibited astrocyte differentiation is mediated through TLR4 on neural stem cells. To our knowledge, this is the first study reporting the effect of resistin on neural stem cells. Our findings shed light on resistin-involved neural stem cell degeneration mechanisms.

Expression of transcription factor SOX12 in lung adenocarcinoma and its clinical significance / 南方医科大学学报

OBJECTIVE@#To explore the expression patterns of transcription factor SOX12 in lung adenocarcinoma and its significance in the diagnosis and prognosis of the malignancy.@*METHODS@#Large cancer genome databases were used to analyze SOX12 expression level in lung adenocarcinoma. Immunohistochemistry (IHC) and semiquantitative PCR were used to detect the expression of SOX12 in 36 specimens of lung adenocarcinoma tissues, 15 adjacent tissues and 21 normal lung tissues. The prognostic value of SOX12 in lung adenocarcinoma and lung squamous cell carcinoma were analyzed using Kaplan-Meier Plotter database, and the relationship between SOX12 expression and the overall survival (OS) and progression free survival (PPS) of the patients were analyzed.@*RESULTS@#Analysis of TCGA database and GEO (GSE40419) database showed that SOX12 expression levels were significantly higher in in lung adenocarcinoma than in normal lung tissues ( < 0.001). The results of IHC and semiquantitative PCR revealed that SOX12 was expressed at significantly higher levels in lung adenocarcinoma than in normal lung tissues ( < 0.001). Kaplan-Meier survival analysis showed that patients with lung adenocarcinoma positive for SOX12 had a significantly shorter OS and PPS time than those negative for SOX12 ( < 0.05), but SOX12 positivity did not significantly affect OS and PPS of patients with lung squamous cell carcinoma.@*CONCLUSIONS@#High expression levels of SOX12 in lung adenocarcinoma are significantly associated with a poor OS of the patients, suggesting the value of SOX12 to assist in early diagnosis and prognostic evaluation of lung adenocarcinoma.

Simultaneous detection of 12 kinds of rodenticides in poisoned samples by ultra performance liquid chromatography-tandem mass spectrometry / 中国职业医学

OBJECTIVE: To establish an ultra-high performance liquid chromatography-tandem mass spectrometry(HPLC-MS) method for simultaneous detection of 12 kinds of rodenticides such as tetramine, warfarin and rodenticide in suspected poisoning patients' residual food, vomit, gastric lavage, serum and urine. METHODS: The residual food, vomit, gastric lavage, serum and urine of patients with suspected rodenticide poisoning were collected. The food, vomit, gastric lavage and urine samples were added with ammonium acetate at a concentration of 2 mol/L, and than were repeatedly extracted twice by ethyl acetate. The serum sample was extracted by adding acetonitrile. After the sample was dried by nitrogen, it was dissolved in methanol ∶ammonium acetate(60 ∶40, V/V), and the supernatant was centrifuged and separated by a C18 column, and quantified by a standard curve method. Samples were detected by HPLC-MS. RESULTS: The linearity of the 12 kinds of rodenticides in the quantitative range of residual food, vomit, gastric lavage, serum and urine in patients with suspected rodenticide poisoning was good, and the correlation coefficient was 0.992 3-0.999 9. The detection limit of food, vomit or gastric lavage was 0.03-0.14 μg/kg, and that in serum and urine were 0.10-0.30 and 0.02-0.04 μg/L, respectively. The standard recovery rate was 84.4%-114.0%, and the within-run and between-run relative standard deviations were 2.7%-6.2% and 2.4%-9.5%, respectively.CONCLUSION: The method has advantages of simple operation, high efficiency and good accuracy. This method is suitable for emergency treatment of poisoning events caused by rodent drugs or poisoning.

Urinary tract lymphoma: a clinical analysis of 16 cases and review of literature / 白血病·淋巴瘤

Objective To analyze the clinical features, treatment outcomes and prognosis of patients with urinary tract lymphoma. Methods The clinical data of 16 patients in Tongji Hospital of Tongji University from January 2009 to April 2016 were collected and retrospectively analyzed. Results The median age of these patients was 68 years. The onset symptoms of 14 cases were related to urinary system and imaging studies of 10 cases showed masses in the urinary system. The onset regions of lymphoma included:4 cases were renal lymphoma, 5 cases were adrenal lymphoma, 5 cases were testicular lymphoma, 1 case was prostate lymphoma and 1 case was from urethral mouth. The histological type of 12 cases was diffuse large B-cell lymphoma and 10 patients were non-germinal center B cell-like (non-GCB) molecular profiling. Twelve cases belonged to Ann Arbor stages ⅢE- ⅣE, 10 cases had international prognostic index scores ≥3, and 7 cases had B symptoms. 10 patients were confirmed by surgery. Fourteen cases accepted rituximab-containing regimen chemotherapy. Five cases achieved complete response and 3 were partial response. Conclusions The clinical manifestations and imagine examination of patients with urinary tract lymphoma are lack of specificity. The clinical features are highly aggressive and most of the patients are diagnosed at advanced stage. The main histological type is diffuse large B-cell lymphoma and non-GCB molecular profiling. Treatment regimens include surgery combined with chemotherapy and radiotherapy. Earlier diagnosis and treatment may improve the survival of patients.

Systematic reform of advanced cellular molecular biology skill experiment teaching / 中华医学教育探索杂志

In order to adapt to the rapid development of experimental techniques in the field of cell molecular biology, to quickly and effectively cultivate the experimental skills of postgraduates, systematic reforms should be carried out on advanced cellular molecular biology skill experiment teaching. The combi-nation of basic theory, biological experiment and practical application enables students to master the basic techniques from drawing materials to molecular biology analysis and construct in vitro transgenic cell model. Adding clinical case analysis, simulated ethical review and other lively classroom activities, which can help students carry out scientific research as soon as possible, improve students' interest and cultivate students' teamwork ability. The teaching effect is good and worth promoting.

The study of the correlations between the mass and fat infiltration of intercostal muscles and the severity of airflow obstruction in patients with chronic obstructive pulmonary disease by quantitative CT / 中华放射学杂志

Objective To investigate the correlations between the mass and fat infiltration of intercostal muscles and their severity of airflow obstruction in patients with chronic obstructive pulmonary disease(COPD). Methods One hundred and sixty-three COPD patients and 102 normal subjects between August 2015 to March 2017 underwent chest MSCT scans and all data were analyzed retrospectively. All subjects underwent pulmonary function tests (PFT). According to the global initiative for chronic obstructive lung disease(GOLD, updated 2015), the COPD patients were classified into GOLD 1(n=37), GOLD 2(n=46), GOLD 3 (n=48), GOLD 4 (n=32) by pulmonary function results, respectively. The mass and fat infiltrations of intercostal muscles were quantified as the cross-sectional area (CSA) and attenuation of these muscles using CT histogram analysis. Intercostal indexes and attenuation indexes were defined as intercostal CSA and attenuation divided by body mass index(BMI). Comparison of intercostal indexes and attenuation indexes between the COPD and control groups was perfomed using t test. The comparisons between the 4 COPD subgroups were carried out using ANOVA test, and comparison between the two groups by LSD. The correlation between intercostal indexes and attenuation indexes and PFT were evaluated by the Spearman rank correlation test. Results The CSA and attenuation indexes of COPD patients groups were(4.3 ± 2.1) mm2 · m2 · kg-1,(-1.6 ± 6.9)HU · m2 · kg-1, respectively,both were significantly lower than that of the control group [(6.9 ± 1.7)mm2 · m2 · kg-1,(11.6 ± 5.7)HU · m2 · kg-1]. The difference was statistically significant(t=12.82,10.87,P<0.01). The CSA and attenuation indexes of COPD patients in any subgroups and the control group were of significant difference(F=92.79, 8.80, P<0.01).The CSA and attenuation indexes were negatively correlated with the GOLD grades, the difference was statistically significant(r=-0.615,-0.551, P<0.05). Conclusions Mass and fat infiltration of intercostal muscles of COPD patients measured by CT histogram analysis were correlated with their severity of airflow obstruction. In other words, a decrease in intercostal mass and an increase in intercostal fat are associated with worsening of COPD severity.

Application of S type incision modified double Kessler suture in the treatment of fresh achilles tendon rupture / 局解手术学杂志

Objective To explore the clinical effect of the treatment for fresh achilles tendon rupture by modified double Kessler suture with S type incision .Methods Totally 21 cases of fresh achilles tendon rupture were admitted into our hospital from January 2012 to Decem-ber 2015, and they were treated by S type incision modified double Kessler suture within 7 days (averagely 4.1 days).Observed the postop-erative complications and evaluated the efficacy with Arner-Lindholm.Results All the 21 patients were followed for 6 to 24 months ( aver-agely 12 months).There was no incision infection ,necrosis, re-fracture of achilles tendon and other complications .There were 16 cases of excellent and 5 cases of good , with the excellent and good rate of 100% through the Arner-Lindholm evaluation criteria .Conclusion Modified double Kessler suture with S incision for the treatment of fresh achilles tendon rupture is conducive to early functional exercise ,and it can obtain satisfactory clinical efficacy .

Effect of Propofol or Sevoflurane on Postoperative Cognitive Function in Elderly Patients Undergoing Non-cardiac Surgery: A Meta-analysis / 医药导报

Objective To systematically review the influence of propofol orsevoflurane on postoperative cognitive dysfunction(POCD) in elderly patients undergoing non-cardiac surgery.Methods Eight databases including Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Pubmed, CNKI, VIP, CBM and Wanfang Database were searched for randomized controlled trials (RCT) about the influence of propofol orsevoflurane on POCD in elderly patients from the time of database establishment to June, 2016.At the same time, the reference materials of included literature were retrieved manually.All data were selected and evaluated by three independent reviewers according to the inclusion and exclusion criterions.RevMan 5.1 was used for the data analysis.Results A total 14 trials were discovered involving 790 elderly patients undergoing non-cardiac surgery.The results of Meta-analysis showed that the eye opening time and extubation time in the propofol group were significant shorter than sevoflurane group[SMDeye opening=-0.83,95%CI(-1.05,-0.61),P0.05].Three days after the operation, the values returned to normal levels, and was still higher in propofol group than in sevoflurane group[SMD3d=-0.32,95%CI(-0.56,-0.07),P0.05].The odds ratio of POCD incidence between propofol and sevoflurane groups was 0.35 [95%CI(0.21,0.58),P<0.05].Conclusion Propofol may lead to shorter eye opening time and extubation time compared to sevoflurane in elderly patients undergoing non-cardiac surgery.Both groups may lead to POCD, while propofol is a better choice for elderly patients when choosing general anesthesia.

Nutrition management in obese patients with type 2 diabetes mellitus after laparoscopic sleeve gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the value of nutrition management in obese patients with type 2 diabetes mellitus(T2DM) after laparoscopic sleeve gastrectomy(LSG).</p><p><b>METHODS</b>Clinical data of 22 obese T2DM patients undergoing LSG from March 2013 to July 2015 in Fudan University Pudong Medical Center were collected. All the patients strictly followed the specialized instruction by nutritionists: diabetic and low calorie diet 3347.2 to 5020.8 kJ (800 to 1200 kcal) per day before the operation; low calorie liquid diet 2510.4 kJ(600 kcal) per day before operation for promoting gastric emptying; fasting diet before postoperative ventilation; clear liquid diet 1673.6 to 2510.4 kJ (400 to 600 kcal) per day after postoperative ventilation (liquid intake >2000 ml); low fat liquid diet 2928.8 to 3765.6 kJ (700 to 900 kcal) per day (protein 60 g per day at least, 2000 ml liquid) 2 weeks after the operation; semi-liquid diet 1 month after operation and gradually normal diet. All the 22 patients were followed up at 1 week, 1, 3, 6 months after operation on time. Changes of body weight, waist circumference, hip circumference, body mass index(BMI), blood glucose indexes induding fasting blood glucose(FBG), 2-hour postparandial blood glucose(PBG), fasting C-peptide, 2-hour postprandial C-peptide, fasting serum inculin(FINS), 2-hour postprandial inculin(INS), HbAlc, blood pressure and blood lipid indexes were observed and analyzed before and 1 week, 1, 3, 6 months after operation.</p><p><b>RESULTS</b>The average age of 22 patients (10 men and 12 women) was 38.6 years (18 to 66 years). The duration of diabetes varied from 1 month to 15 years. Comorbidity included 12 patients of high blood pressure, 14 of fatty liver, 1 of coronary heart disease, 1 of gout, 1 of chronic thyroiditis and 1 of menstrual disorder. LSG was performed successfully in all the patients and no severe complications and transference to laparotomy occurred. As compared to pre-operation, at 6 months after operation, the average body weight decreased from (103.9±20.2) kg to (80.9±12.6) kg (t=6.294, P=0.000), waist circumference from (118.6±13.8) cm to (96.4±8.0) cm (t=6.331, P=0.000), hip circumference from (116.9±12.6) cm to (104.0±7.7) cm (t=3.854, P=0.000), BMI from (36.2±5.9) kg/mto (27.9±3.5) kg/m(t=5.630, P=0.000), showing a decreasing trend over time. There was no underweight patient after 6 months follow-up. As compared to pre-operation, at 6 months after operation, the average FBG reduced from (7.4±1.4) mmol/L to (6.0±0.9) mmol/L (t=3.172, P=0.003), 2 h PBG from (14.1±4.9) mmol/L to (7.5±2.2) mmol/L (t=7.026, P=0.000), FINS from (160.0±71.9) mIU/L to (43.8±20.8) mIU/L (t=7.259, P=0.000), 2-hour postprandial INS from (437.6±261.4) mIU/L to (140.5±104.6) mIU/L (t=5.858, P=0.000), fasting C-peptide from (1.1±0.6) μg/L to (0.7±0.3) μg/L (t=3.560, P=0.000), 2-hour postprandial C-peptide from (2.5±0.9) μg/L to (1.5±0.7) μg/L (t=3.865, P=0.000), HbAlc from (8.0±1.6)% to (5.9±0.6)% (t=5.953, P=0.000), showing a decreasing trend over time except FBG, 2h postprandial C-peptide and HbAlc(all P<0.05). FBG and 2-hour PBG of 16 patients returned to normal 3 months after the operation. Blood pressure and trigly ceride decreased obviously 6 months after operation compared to pre-operation with significant difference(P<0.05). At 6 months after operation, blood pressure of 8 comorbidity patients with high blood pressure became normal (8/12, 66.7%) and of 4 patients improved(4/12, 33.3%); B ultrasound examination revealed normal in 11 comorbidity patients with fatty liver(11/14,78.6%) and improvement in 3 patients (3/14,15.4%). Blood uric acid of the gout patient and the menstruation of the menstrual disorder patient returned to normal 3 months and 1 month after the operation respectively.</p><p><b>CONCLUSION</b>As for obese patients with T2DM undergoing LSG, reasonable nutrition management is helpful to decrease body weight, and to obtain an ideal improvement of blood glucose and blood lipid levels.</p>

Survey on prevalence of healthcare-associated infection in Xiangya Hospital in 15 years / 中国感染控制杂志

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.

The clinical value of calcaneus stiffness index calculated by quantitative ultrasound test in screening and diagnosis of osteoporosis / 中华内科杂志

Objective To evaluate the diagnostic value of quantitative ultrasound test (QUS) in osteoporosis screening by comparing stiffness index (STI) calculated by QUS and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in Chinese community population.Methods A total of 6 105 residents aged 45 years and over from Shanghai Changfeng community were recruited.BMD of lumbar spine (L1-L4) and both femur measured by DXA and calcaneus STI calculated by QUS were observed simultaneously in the same day.The sensitivity,specificity and accuracy of QUS and DXA (gold standard) on the diagnosis of osteoporosis were compared.Results The prevalence of osteopenia or osteoporosis diagnosed by DXA and QUS was 38.82％,10.29％ and 64.50％,4.49％ respectively.STI was correlated with BMD of spine,left and right femur,respectively with the correlation coefficients of 0.536,0.574 and 0.570 (all P ＜ 0.001).The sensitivity and specificity of QUS for osteopenia was 86.16％ and 47.57％ and for osteoporosis was 23.57％ and 97.70％.Conclusion STI calculated by QUS had a good correlation with BMD measured by DXA.The high sensitivity and specificity of QUS made it as a diagnostic tool for osteopenia and osteoporosis screening in community health care center.

The study on lung injury of minipigs' right-thorax with a single high-dose γ-ray irradiation / 中华放射医学与防护杂志

Objective To explore the influence and mechanism of cytokines and protein expression of alveolar epithelial type (ACE) Ⅱ cells in Bama minipigs' right-thorax with a single 15 Gy dose irradiation.Methods All minipigs received either right thoracic irradiation or sham-irradiation under anesthesia.At 4,8,12 and 24 week post-irradiation,5 minipigs respective and random from irradiarion groups and control group were sacrificed to remove the lungs.The protein expression of surfactant associated protein (SP)-A,transforming growth factor (TGF)-β1,Vimentin and E-cadherin were detected by Western blot.The protein expression of α-smooth muscle actin (SMA) was detected by immunohistochemistry.The co-localization of SP-A and α-SMA was visualized by double immunofluorescence staining.Results At 4,8,12 and 24 week post-irradiation,a significant increase in the protein expression of α-SMA,TGF-β1 and Vimentin were observed in irradiated lung compared to sham-irradiated controls(α-SMA:t =2.46-3.26,P ＜0.05;TGF-β1:t =2.96-3.52,P ＜0.05;Vimentin:t =3.24-5.05,P ＜ 0.05).By contrast,the protein expression of SP-A and E-cadherin in irradiation group was lower than it in control group (SP-A:t =3.62-4.65,P ＜ 0.05;E-cadherin:t =2.53-4.15,P ＜ 0.05).Moreover,at 8 week after irradiation,under confocal laser scanning microscope,the co-localization of SP-A and α-SMA was observed in irradiated alveolar epithelium cells,and it was not observed in sham-irradiated controls.Conclusions These data demonstrate that E-cadherin,SP-A and TGF-β1 may act as sensitive predictors of radiation-induced lung injury(RILI).Irradiation may lead to ACE Ⅱ cells achieving a mesenchymal phenotype,namely,epithelial to mesenchymal cells transition occurs,and ACE Ⅱ cells play the important part in the development of RILI by epithelial-mesenchymal transition.

Treatment of Ph-adult acute lymphoblastic leukemia patients with Tongji-96 regimen / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and side effects of the consecutive chemotherapeutic protocol, Tongji-96, for adult patients with Philadelphia chromosome negative acute lymphoblastic leukemia (Ph-aALL).</p><p><b>METHODS</b>A retrospective analysis was conducted on 95 cases of Ph-aALL patients treated between January 2004 and December 2012 with Tongji-96 regimen in Tongji hospital, Shanghai.</p><p><b>RESULTS</b>Among these 95 patients, the overall complete remission (CR) rate was 92.6%, 7-year overall survival (OS) and event-free survival (EFS) rates were (39.3±5.9)% and (31.5±5.3)%, respectively, with the median survival of 28 months. Based on multivariable COX proportional hazards regression model analysis, patients with the poor karyotype and failed to achieve CR after first course induction therapy had a higher risk of mortality compared to those who had good or normal cytogenetics and achieved CR after 1 course of induction treatment [the risk ratios (RR) were 3.380 (95% CI 1.530-7.463, P=0.003) and 3.005 (95% CI 1.522-5.933, P=0.002)，respectively]. By means of Kaplan-Meier analysis and Log-rank test，patients aged less than 60 years and successively achieved CR after first induction therapy had more favorable 7-year OS and EFS rates. Patients with normal karyotype and hyperdiploidy had significantly higher 2-year OS and EFS rates compared with those with complex karyotype, t(4;11) translocation and other karyotypes.</p><p><b>CONCLUSION</b>Age (60 years as the cut-off)，treatment courses for achieving CR and cytogenetics were predictive factors for the prognosis of Ph-aALL from this retrospective study. As a comprehensive and sequential therapy protocol, Tongji-96 regimen was proved to obtain long-term survival, reduce risks for relapse and improve outcomes for part Ph-aALL patients.</p>

Status of healthcare-associated infection management in the grassroots medical institutes / 中国感染控制杂志

Objective To investigate the current situation of healthcare-associated infection(HAI)management in grassroots medical institutes in a province.Methods Forty-six grassroots medical institutes in 13 cities of the prov-ince were selected randomly for the survey,questionnaires about the current situation of HAI management in grass-roots medical institutes were filled out,and related data were analyzed.Results Forty-four qualified questionnaires were adopted for analysis,and 2 unqualified questionnaires from public hospitals were excluded.HAI management in 44 medical institutes (100.00%)was in the charge of major leaders in medical institutes.Only 2 institutes(4.55%) set up independent HAI management departments,and 10 institutes(22.73%)established basic regulations and po-sition responsibilities of HAI management,38.67% of medical institutes established regulations of HAI prevention and control in key departments and responsibilities for key positions.The score for the establishment of basic regu-lations and position responsibilities of HAI management in village clinics was lower than the other medical institutes (F =5.762,P <0.01 ).Except aseptic technique,the core regulations of HAI management weren’t implemented well in village clinics compared with the other institutes(P <0.05).Conclusion Organizational settings,HAI man-agement of key departments,and core regulations of HAI management are not performed well in grassroots medical institutes in this province.Village clinics perform the worst in HAI management among all types of grassroots med-ical institutes.More measures,including education and surveillance,should be taken to improve HAI management in grassroots medical institutes.

Causes analysis of PICC-associated complications in cancer patients and the nursing strategies / 现代临床护理

Objective To investigate the causes of complications induced by peripherally inserted central catheters(PICC)in cancer patients and summarize pertinent nursing measures.Method The clinical data of 26 tumor patients with PICC were analyzed retrospectively .Result The complications occurred in 8 patients with a rate of 30.8%, among which unsuccessful catheteration occurred in 1 case,oozing of blood at the mouth of catheter in 1 case,phlebitis in 1 case,dislocation in 1 case,skin allergy-like reactions in 2 cases and catheter emersion in 1 case,catheter breaking in 1 case and dislocation in 2 cases.Conclusion The skilled operation,preventive maintenance of catheters and health education to the patients are the important measures for prevention and reduction of the complications.