Durable remission related to CAR-T persistence in R/R B-ALL and long-term persistence potential of prime CAR-T.

CD19-targeted chimeric antigen receptor T lymphocytes (CAR-T) has demonstrated a high proportion of complete remission in the treatment of relapsed refractory acute B cell lymphoblastic leukemia (r/r B-ALL). It is of great clinical significance to explore which factors will impact long-term disease-free survival of patients with r/r B-ALL after CAR-T therapy without bridging bone marrow transplantation. Our study found that, in patients with r/r B-ALL without bridging transplantation, the patients' age; infusion dosage; whether they had undergone allo-stem cell transplantation before CAR-T therapy, using CD-19-targeted or CD19/CD22-dual-targeted CAR-T; whether there is fusion gene; tumor burden before therapy; and comorbidity had no significant relationship with their long-term disease-free survival. We found only that CAR-T persistence was highly correlated with patients' long-term disease-free survival. So, we further profiled CAR-T cells using single-cell sequencing and found that there is a specific T cell subset that may be associated with the long-term persistence of CAR-T. Finally, according to the single-cell sequencing results, we established cell production process named PrimeCAR, which shared common signaling pathways with the T cell subset identified. In the preliminary clinical study, prime CAR-Ts yield good persistence in peripheral blood of patients with B-ALL and lymphoma, without observing grade 2 or higher cytokine release syndrome.

Basic psychological needs satisfaction and smartphone addiction among high school students： the mediating role of loneliness and social anxiety / 四川精神卫生

ObjectiveTo investigate the mediating role of loneliness and social anxiety in the relationship between basic psychological needs satisfaction and smartphone addiction among high school students， and to provide references for the intervention to smartphone addiction for high school students. MethodsIn April 2022， a total of 14 666 high school students from 5 middle schools in a county of Sichuan Province were included by random sampling method. Basic Psychological Needs Scales （BPNS）， the UCLA Loneliness Scale-3 edition （UCLA-3）， Interaction Anxiousness Scale （IAS） and the Mobile Phone Addiction Index （MPAI） were used for cross-sectional investigation. Bootstrap method was used to analyze the mediating role of loneliness and social anxiety in the relationship between the basic psychological needs satisfaction and smartphone addiction. Results① In this study， 14 036 valid questionnaires were returned， and 1 752 （12.48%， 95% CI： 0.114~0.136） high school students were found to be addicted to smartphone phone. The BPNS score was negatively correlated with UCLA-3， IAS and MPAI scores （r=-0.771， -0.486， -0.417， P<0.01）. And MPAI score was positively correlated with IAS and UCLA-3 scores （r=0.403， 0.424， P<0.01）. IAS score was positively correlated with UCLA-3 score （r=0.458， P<0.01）. ②The degree of basic psychological needs satisfaction in high school students can directly negatively predict smartphone addiction （β=-0.383， P<0.05）， and can also indirectly affect smartphone addiction through loneliness and social anxiety （β=-0.130， P<0.05）. ③Loneliness （indirect effect value was -0.145） and social anxiety （indirect effect value was -0.074） partially mediate between the basic psychological needs satisfaction and smartphone addiction. Loneliness-social anxiety also has significant chain mediating effect （indirect effect value was -0.034）， which accounted for 8.88%. ConclusionThe basic psychological needs satisfaction can not only directly affect the occurrence of smartphone addiction， but also indirectly affect the occurrence of smartphone addiction through the chain mediation of loneliness and social anxiety.

Consideration on Animal Experiment in PET/CT / 中国医疗器械杂志

PET/CT imaging can reflect the physiological metabolic process in living body which is the model experiment incapable to simulate. Animal experiment may be considered for systematic validation of PET/CT products. The obtained research data can be used to evaluate the feasibility, effectiveness and safety of PET/CT products, and be submitted as supporting documents for research data or clinical evaluation data when doing product registration or alteration registration. In this study, the functions and advantages of animal experiments were expounded, and relevant research cases were given as well as the issues that should be paid attention to. It can be a reference for the validation and review of PET/CT products.

Development of a constant temperature disinfection device and evaluation of its clinical application effect / 中国实用护理杂志

Objective:To develop a constant temperature disinfection device and evaluate its clinical effect in perineal disinfection after delivery.Methods:A total of 300 cases of puerpera who met the inclusion and exclusion criteria were selected from Heping Hospital Affiliated to Changzhi Medical College from November to December 2020. The study was designed as a randomized control study. Subjects were randomly divided by random digit table into the control group and the experimental group of 150 cases respectively. The former used conventional methods for perineal disinfection after delivery. The latter performed perineal disinfection assisted by a thermostatic disinfection device. The temperature comfort of perineal disinfection and the perineal wound healing of perineal tear or lateral incision were compared between two groups.Results:The score of temperature comfort feeling of puerpera in the control group and the experimental group was 3 (1.5) and 5 (0), respectively. The maternal temperature comfort feeling score in the experimental group was higher, and the difference between the two groups was statistically significant ( Z=-13.78, P<0.05). There was no grade C healing of perineal wounds in the two groups. The composition ratios of grade A and grade B healing of perineal wounds in the control group were 89.61% (69/77) and 10.39% (8/77), and those in the experimental group were 93.75% (90/96) and 6.25% (6/96). The healing of perineal wound in the latter group was better, but the difference between the two groups was not statistically significant ( Z=0.99, P>0.05). Conclusions:The constant temperature disinfection device meets the clinical nursing needs, enhances the comfort experience of puerpera, and has certain effect on promoting the healing of perineal wound after delivery.

Evaluation of soil environmental quality of cultivated land in the Donghe River Basin of Chenzhou City, Hunan Province by three methods / 环境与职业医学

Background Heavy metal pollution in cultivated land will affect crop yield and quality, as well as groundwater quality, ecological security, and human health. Objective To analyze the pollution status of heavy metal elements such as chromium (Cr), copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd), and lead (Pb) in cultivated soils of the Donghe River Basin in Chenzhou City, and to evaluate the environmental quality of local cultivated soil. Methods A total of 16 samples of cultivated soil from the Donghe River Basin in Chenzhou City were collected, and the contents of Cr, Cu, Zn, As, Cd, and Pb in the samples were determined by inductively coupled plasma mass spectrometry. The Nemerow comprehensive pollution index method (the evaluation indicators included both Nemerow comprehensive pollution index and single pollution index), the geological accumulation index method, and the potential ecological risk index method were used to evaluate the soil environmental quality. Results The average levels of Cr, Cu, Zn, As, Cd, and Pb in the soil samples in the study area were 58.25, 49.50, 273.88, 137.76, 2.92, and 672.29 mg·kg−1, respectively. The average values of Cu, Zn, As, Cd, and Pb were all exceeded the background values of soil elements in Hunan Province. The single pollution indices of As, Cd, Pb, and Zn in soil were 4.40, 9.74, 5.85, and 1.15 respectively. The contamination of As and Pb reached 93.75% and 81.25% respectively. The geological accumulation indices of soil As, Cd, Pb, and Zn were 2.11, 3.71, 2.97, and 0.58, respectively, which showed heavy Cd pollution, moderate As and Pb pollution, and slight Zn pollution. The potential ecological hazard indices of soil Cr, Cu, Zn, As, Pb, and Cd were 1.63, 9.07, 2.90, 87.75, 113.18, and 695.76. 81.Twenty five percent of Cd samples showed heavy pollution and above, and 62.50% of Pb samples had moderate pollution and above. The Nemerow comprehensive pollution index was 7.72, which belonged to heavy pollution; and the comprehensive potential ecological risk index was 910.29, which belonged to high ecological risk. Conclusion There are certain differences in the results of different evaluation methods. The cultivated soils of the Donghe River Basin in Chenzhou City, is seriously polluted by heavy metals, and Cd, As, and Pb are the main polluting elements.

Safety and long-term efficacy of endoscopic resection of large gastric stromal tumors: a multicenter retrospective study / 中华消化内镜杂志

Objective:To evaluate the safety and long-term efficacy of endoscopic resection of gastric stromal tumors with a diameter of >2-4 cm.Methods:The clinical data of 307 patients, who underwent endoscopic or surgical resection and pathologically confirmed to be gastric stromal tumors with a diameter ≤4 cm in Fujian Provincial Hospital, Jinshan Branch of Fujian Provincial Hospital or Fujian Geriatric Hospital from January 2014 to December 2019, were collected. The propensity score matching (1∶1) was performed for the cases with the tumor size of >2-4 cm.Then the incidence of adverse events related to the operation and clinical outcomes were compared between 41 patients in the endoscopic group and 41 patients in the surgical group.Results:Compared with the surgical group, the median operation time in the endoscopic group was significantly shorter (58.0 min VS 108.0 min, Z=-4.789, P<0.001), and the median hospitalization cost was significantly lower (22.7 thousand yuan VS 42.0 thousand yuan, Z=-7.164, P<0.001). There were no significant differences in postoperative fasting time or postoperative hospitalization time between the two groups ( P>0.05). Complications occurred in 7 cases (17.1%) in the endoscopy group, including 5 cases of postoperative acute infection, 1 case of postoperative perforation, and 1 case of postoperative bleeding; all 9 cases (22.0%) in the surgical group developed postoperative acute infection. There was no significant difference in the overall incidence of complications between the two groups ( χ2=0.311, P=0.577). Tumors in both groups were completely removed with negative resection margins. The follow-up time of the endoscopy group was 34.3±15.6 months, and that of the surgical group was 42.2±20.2 months. No recurrence or distant metastasis was observed during the follow-up period in the two groups. Conclusion:Endoscopic resection of large gastric stromal tumor (range>2-4 cm) is safe and effective in the long term, which can be used as one of the methods for gastrointestinal stromal tumors.

Effects of different temperature rewarming on intraoperative brain protection in children with deep hypothermia circulatory arrest / 中国实用护理杂志

Objective:To observe the effect of different temperature rewarming on intraoperative brain protection in children with deep hypothermia circulatory arrest (DHCA).Methods:Totally 24 cases of children undergoing deep hypothermia circulatory arrest under general anesthesia were selected, and randomly divided into 38 ℃ and 43 ℃ groups including 12 cases respectely. Children patients in each group were given forced air rewarming at 38 ℃ and 43 ℃ respectively during the rewarming phase after cross-clamping remission. The age of patients, weight, operation time, intraoperative blood loss, intraoperative fluid infusion and postoperative length of stay were recorded. The arterial blood was taken to determine the serum neuron-specific enolase (NSE) , Platelet activating factor (PAF), and blood lactic acid immediately when the patients were entering into operating room (T 0), before Extracorporeal Circulation (T 1), before aortic cross-clamping (T 2), before DHCA (T 3), rewarming (T 4), temperature to 30 ℃ (T 5), temperature to 33 ℃ (T 6), temperature to 35 ℃ (T 7), CPB was terminated (T 8) and at the end of operation (T 9). And the body temperature were recorded at T 0, T 1, T 3 and T 8. Results:At T 0, T 1, T 3, T 8 and T 9, the temperature difference between the two groups was not statistically significant ( P>0.05). The body temperature first decreased and then increased in the group of 38℃ and 43℃ ( P<0.01). And the serum PAF and NSE significantly increased during the operation ( F values were 5 172.087, 3 535.935, P<0.01). The content of PAF, NSE and lactate in 38 ℃ group and 43 ℃ group increased with time from T 0 to T 9 ( P<0.01).The PAF content of children in the 43℃ group at T 8 and T 9 were (20.34±4.70) μg/L and (25.46±7.75) μg/L respectively, lower than that in the 38℃ group (25.20±3.80) μg/L and (34.97±8.52) μg/L, the differences were statistically significant ( F value was 7.769, P=0.011; F value was 8.193, P=0.009). At T 8 and T 9, NSE content of children in the 43℃ group were (22.13±5.13) μg/L and (28.15±7.90) μg/L respectively, lower than those in the 38℃ group (26.92±3.89) μg/L and (36.57±8.90) μg/L, the differences were statistically significant ( F value was 6.656, P=0.017; F value was 6.012, P=0.023). Blood lactic acid content of children in the 43℃ group at T 4-T 9 respectively (2.77±0.70), (2.93±0.69), (3.13±0.77), (3.39±0.64), (3.77±0.86), (3.83±0.62) mmol/L, lower than 38 ℃ group of children (3.57±0.87), (3.82±0.80), (4.35±0.89), (4.60±0.95), (4.79±0.94), (4.92±0.92) mmol/L, the differences were statistically significant ( F values were 6.125-11.551, P values were 0.022-0.003). Conclusion:Both 38 ℃ and 43 ℃ can ensure that the body temperature of the children increases steadily during the intraoperative rewarming phase in deep hypothermic circulatory arrest operation,but 43℃ can effectively reduce the serum PAF and NSE in children with brain protection, its mechanism may be associated with reduced blood lactic acid.

Analysis of the changes of inflammatory cytokine levels in patients with critical coronavirus disease 2019 undergoing invasive mechanical ventilation / 中华危重病急救医学

Objective:To investigate the relationship between the changes of inflammatory cytokine levels and prognosis of patients with critical coronavirus disease 2019 (COVID-19) undergoing invasive mechanical ventilation (IMV).Methods:A retrospective study was conducted. The clinical date of critical COVID-19 patients undergoing IMV who were hospitalized in Wuhan Union Hospital, Tongji Medical College of Huazhong University of Science and Technology from February 4th to March 25th in 2020 were collected. At the same time, the inflammatory cytokine levels including interleukins (IL-2, IL-4, IL-6, IL-10) and tumor necrosis factor-α (TNF-α) at 48 hours before IMV and 48 hours after IMV of all the patients, as well as the 48 hours after weaning or right before death were recorded. Multivariate unconditional Logistic regression analysis was used to screen the independent risk factors of death during hospitalization.Results:Among the 43 patients, 13 patients improved and 30 died. Compared with the survival group, the patients in the non-survival group were older (years old: 67.6±7.3 vs. 58.5±11.9, P < 0.05), with higher rates of hypertension, diabetes and coronary heart disease (53.3% vs. 15.4%, 63.3% vs. 23.1%, 26.7% vs. 0%, all P < 0.05), and the time from onset to admission to hospital, admission to ICU and IMV were longer (days: it was 9.17±5.00 vs. 5.07±2.49, 17.10±7.11 vs. 12.23±5.05, and 17.90±7.46 vs. 12.61±5.60, respectively, all P < 0.05). The IL-6 and TNF-α levels on 48 hours after IMV in the non-survival patients increased significantly as compared with those before 48 hours and the surviving patients. Especially, the IL-6 levels increased significantly as compared with those at 48 hours after IMV and 48 hours after weaning in the surviving patients [ng/L: 800.00 (194.25, 2 000.00) vs. 22.03 (6.66, 28.21), 3 204.00 (1 264.88, 5 000.00) vs. 5.00 (3.98, 12.27), both P < 0.01]. The IL-10 level before death in the non-survival patients increased significantly as compared with that at 48 hours after weaning in the surviving patients [ng/L: 55.89 (26.07, 100.14) vs. 3.53 (2.76, 12.36), P < 0.05]. There were no significant differences in the levels of IL-2 and IL-4 between the two groups at every time point. The variables of age, basic diseases, the IL-6 level after IMV were included in the multivariate unconditional Logistic regression analysis, which showed that age [odds ratio ( OR) = 0.821, 95% confidence interval (95% CI) was 0.695-0.968], hypertension ( OR = 0.027, 95% CI was 0.002-0.378), diabetes mellitus ( OR = 0.054, 95% CI was 0.005-0.611), coronary heart disease ( OR = 0.042, 95% CI was 0.002-0.968) and the IL-6 level after IMV ( OR = 0.902, 95% CI was 0.819-0.994) were independent risk factors for death during hospitalization in patients with critical COVID-19 undergoing IMV (all P < 0.05). Conclusions:The levels of inflammatory cytokine including IL-6, IL-10, and TNF-α increased significantly with aggravation in critical COVID-19 patients undergoing IMV, especially IL-6. IL-6 was an independent risk factor for death of critical COVID-19 patients undergoing IMV.

The associated factors of cesarean section during COVID-19 pandemic: a cross-sectional study in nine cities of China

BACKGROUND@#Improving and maintaining the health of mothers and newborns is indisputably a global priority, especially during a pandemic. This study intends to examine the factors associated with cesarean section (CS) during lockdown time.@*METHODS@#A total of 678 women who just gave birth within 7 days were enrolled from maternal and children hospitals in nine cities of China from April to May 2020. The delivery modes and potential influencing factors were investigated. The subgroup analysis and sensitivity analysis were used to examine the association of CS and risk factors among populations with different characteristics and to control for possible confounding, respectively.@*RESULTS@#The overall rate of cesarean delivery was 37.3%. In multi-variant model, maternal age > 30 years (OR, 95% CI = 1.71, 1.21-2.41), higher pre-gestational BMI (OR, 95% CI = 1.16, 1.10-1.23), living in regions with confirmed COVID-19 cases > 500 (OR, 95% CI = 2.45, 1.74-3.45), and excess gestational weight gain (OR, 95% CI = 1.73, 1.17-2.55) were associated with cesarean delivery. These trends of associations were not changes in sensitivity analysis and subgroup analysis. Cesarean delivery occurred more in women who got more nutrition instruction during the pandemic period in the univariant model; however, this association showed insignificance in the multiple-variant analysis.@*CONCLUSION@#A high cesarean delivery rate was found in uninfected women who experienced lockdown in their third trimester. During the COVID-19 pandemic, more medical support should be provided in severely affected regions to ensure and promote health in pregnancy.

Risk factors of postoperative bleeding of endoscopic submucosal dissection for early gastrointestinal cancer / 中华消化内镜杂志

Objective@#To analysis the risk factors of postoperative bleeding of endoscopic submucosal dissection (ESD) for early gastrointestinal cancer.@*Methods@#A retrospective study was performed on the data of 430 patients (449 lesions) with early gastrointestinal cancer undergoing ESD in Fujian Provincial Hospital Digestive Endoscopic Center from June 2008 to February 2015 and in Fujian Provincial Hospital South Branch Digestive Endoscopic Center from May 2015 to April 2018. Patients with postoperative bleeding were compared with those without postoperative bleeding on the basis of general conditions, endoscopic performance, postoperative pathology and so on to analysis the risk factors for postoperative bleeding of ESD.@*Results@#Among the 430 cases (449 lesions)of early gastrointestinal cancer undergoing ESD, 16 cases (3.7%) had postoperative bleeding. According to whether the occurrence of postoperative hemorrhage, patients were divided into bleeding group (n=16) and not bleeding group (n=433). Univariate analysis suggested that whether had hypertension was statistically significant between the two groups (χ2=4.793, P=0.029), while patients age (t=0.465, P=0.642), gender (χ2=0.035, P=0.642), whether to have diabetes (χ2=0.647, P=0.421), whether to have coronary heart disease (P=1.000), lesion size (t=1.598, P=0.111), whether two or more lesions (P=1.000), lesion site (χ2=6.183, P=0.289), operation time (t=1.335, P=0.201), pathological grading (χ2=0.687, P=0.709), and lesion infiltration depth (χ2=0.134, P=0.714) were not statistically significant between the two groups. Logistic regression analysis showed that hypertension (OR=3.358, 95%CI: 1.227-9.186, P=0.018) was an independent risk factor of bleeding after ESD for early gastrointestinal cancer.@*Conclusion@#Hypertension is closely related to postoperative bleeding following ESD for early gastrointestinal cancer.Patients with hypertension are at a greater risk of bleeding after ESD.

Risk factors of postoperative bleeding of endoscopic submucosal dissection for early gastrointestinal cancer / 中华消化内镜杂志

Objective To analysis the risk factors of postoperative bleeding of endoscopic submucosal dissection (ESD) for early gastrointestinal cancer. Methods A retrospective study was performed on the data of 430 patients ( 449 lesions ) with early gastrointestinal cancer undergoing ESD in Fujian Provincial Hospital Digestive Endoscopic Center from June 2008 to February 2015 and in Fujian Provincial Hospital South Branch Digestive Endoscopic Center from May 2015 to April 2018. Patients with postoperative bleeding were compared with those without postoperative bleeding on the basis of general conditions, endoscopic performance, postoperative pathology and so on to analysis the risk factors for postoperative bleeding of ESD. Results Among the 430 cases (449 lesions)of early gastrointestinal cancer undergoing ESD, 16 cases ( 3. 7％) had postoperative bleeding. According to whether the occurrence of postoperative hemorrhage, patients were divided into bleeding group ( n = 16 ) and not bleeding group ( n=433) . Univariate analysis suggested that whether had hypertension was statistically significant between the two groups (χ2=4. 793, P=0. 029) , while patients age ( t=0. 465, P=0. 642) , gender (χ2=0. 035, P=0. 642), whether to have diabetes (χ2=0. 647, P=0. 421),whether to have coronary heart disease (P=1. 000), lesion size (t=1. 598, P=0. 111),whether two or more lesions (P=1. 000), lesion site (χ2=6. 183, P= 0. 289 ) , operation time ( t= 1. 335, P= 0. 201 ) , pathological grading (χ2 = 0. 687, P=0. 709),and lesion infiltration depth (χ2=0. 134, P=0. 714) were not statistically significant between the two groups. Logistic regression analysis showed that hypertension ( OR=3. 358, 95％CI:1. 227-9. 186, P=0. 018) was an independent risk factor of bleeding after ESD for early gastrointestinal cancer. Conclusion Hypertension is closely related to postoperative bleeding following ESD for early gastrointestinal cancer. Patients with hypertension are at a greater risk of bleeding after ESD.

Manganese-enhanced MRI for detection of metastatic potential in colorectal cancer / 中华放射学杂志

Objective To study manganese superoxide dismutase (MnSOD) expression in colorectal cancer (CRC) cells and observe its relation to metastatic potential. To investigate the diagnostic performance of manganese-enhanced magnetic resonance imaging (MEMRI) for detecting metastatic potential of CRC. Methods High and low metastatic potential CRC cell lines SW620, HCT116, LoVo and SW480, DLD-1, HCT15, Caco-2, as well as normal colon mucosal cell CCD841 CoN were cultured. MnSOD expression level in cells was detected by western blot and the measurement was repeated for three times. HCT15, DLD-1, LoVo and SW620 cells were selected to perform in vitro MEMRI and subcutaneous xenografts were developed for subsequent in vivo MEMRI. MnCl2·4H2O solution was utilized as the contrast agent and T1 shortening was calculated. The differences of MnSOD expression level in cells, average T1 value shortening of cells and xenografts were separately compared by one-way ANOVA.Results The difference of MnSOD expression level in CRC cells were significant (P0.05). Conclusions MEMRI has the potential to noninvasively distinguish different metastatic potential CRC by revealing greater T 1 value shortening in more aggressive one. However the MnSOD expression in CRC cells is not corresponding to malignant potential.

Impact of Manganese Concentration on Manganese-enhanced Magnetic Resonance Imaging in Different Colon Cancer Cell Lines / 中国医学影像学杂志

Purpose Manganese (Mn) concentration is one of the basic factors that have impact on manganese-enhanced magnetic resonance imaging (MEMRI) enhancement of neoplasm.This study aims to elucidate the impact of Mn concentration on enhancement of MEMRI in different colon cancer cells.Materials and Methods The human colon cancer cell SW620 with high metastatic potential,SW480 with low metastatic potential and the normal cell CCD841 CoN were performed MEMRI under different Mn concentrations (0,0.05,0.10 and 0.20 mmol/L) in vitro.The average values ofT1 shortening were calculated by T1 map scan in different cells under different Mn concentrations.Results When the concentration of Mn was 0.10 and 0.20 mmol/L,the average value of T1 shortening of the three cell lines was SW620＞SW480＞CCD841 CoN (P＜0.01).There was no significant difference in the average T1 value of the normal cell lines under different Mn concentrations (0.05,0.10,0.20 mmol/L) (P＞0.05).The average T1 value of two tumor cells increased with the increase of Mn concentration.Under the condition of high Mn concentration (0.10 and 0.20 mmol/L),SW620 took in more Mn than SW480.Conclusion Colon cancer cells increase Mn uptake with increasing of Mn concentration.MEMRI can distinguish colon cancer cells with different metastatic potential.

The study on effects of indoor air filtration on radon exposure to residents / 中华放射医学与防护杂志

Objective To evaluate the influence of indoor air filtration by air purifier on the behavior of indoor radon progeny and estimate its effects on indoor radon exposure to residents.Methods The concentrations of indoor radon progeny with and without the air filtration were calculated by the theoretical model developed in this study.Based on the dose conversion factors of attached and unattached radon progeny,the mitigation effects of indoor radon exposure due to the air filtration were estimated.Verification experiments were conducted in an airtight room.Results With the air filtration rate increased,the removal efficiency of indoor radon progeny would appear more obvious.For an airtight room with its initial aerosol concentration of 10 000 cm-3,the concentration of total radon progeny would decrease by more than 90％ when the air filtration rate exceeded 10 h-1.But the concentrations of indoor unattached radon progeny would increase by using the air purifier in different extents.The variations of radon progeny concentrations and the decrease of internal doses were closely related to the filtration rate of air purifier.With the air filtration rates increased,the mitigation effects would be better and faster.The internal dose would reduce by more than 70％ when the filtration rate exceeded 5 h-1.Conclusions Although the indoor concentration of unattached radon progeny will increase by using the air purifier,it is still effective in reducing the exposure dose to residents due to the inhalation of radon progeny.

Study on the Equity of Health Human Resource Allocation in Public Hospitals of Zhaotong City / 昆明医科大学学报

Objective To analyze the equity of health human resource allocation in public hospitals of Zhaotong city during 2008-2012,and to provide theoretical basis for the reasonable allocation of health resources.Methods The statistical description was used to analyze the number of the medical health resource,and Gini coefficient and Theli index were used to analyze the equity of health resource allocation in public hospitals of Zhaotong city.Results The amount of medical health resource showed an increasing tendency with low speed,and gaps among different areas were still existed.From 2008 to 2012,Gini coefficients of three medical health resources including the doctors,nurses and health technicians were all under 0.3.And the fluctuant tendency of the Theli Indexes and Gini coefficients were accordant with no significant increase or decrease as a whole.The combination of differences within region and difference between regions leaded to the inequity of health human resource allocation in Zhao tong city,and within region in the contribution rate of the total Theil index was greater than the difference between regions.Conclusions The quantity of health human resource is not enough in Zhaotong.The equity fluctuation of three health resources has no significatnt change.The differences within region mainly cause the inequity of health resource allocation in public hospitals of Zhao tong city.

Experience of endoscopic diagnosis and treatment for gastrointestinal neuroendocriue tumor / 中国内镜杂志

Objective To study the characteristics of endoscopic diagnosis and treatment for gastrointestinal neuroendocriue tumor (GI-NETs).Methods We retrospectively collected the clinical data of 84 patients with endoscopic confirmed GI-NETs from January 2012 to November 2014, including white light, endoscopic ultrasonography, histopathology and post-treatment condition.Results Endoscopic diagnosis for NET were 84 cases, but ifnally conifrmed by pathology were 72 cases, the misdiagnosis rate was 14.3%. Of the 12 misdiagnosed cases, 5 cases were chronic inlfammation, ectopic pancreas in 2 cases, and 5 cases of hyperplasia of Brunner's glands, colorectal hyperplastic polyps, colorectal venous hemangioma, colorectal leiomyoma, metastatic squamous carcinoma respectively. Of 8 cases with EUS, all lesions derived from the submucosal layer, and 6 cases of low echo, and 2 cases of high echo (Brunner's glands) and mixed echo (venous hemangioma) respectively.Conclusions GI-NETs,which possess certain characteristics under endoscopy, may be similar with other digestive diseases, while it can increase the diagnosis accuracy by more careful observation and necessary biopsy.

Trimethyl chitosan nanoparticles coated with Pluronic F-127 for oral insulin delivery system / 中国药科大学学报

@#The purpose of this investigation was to develop Pluronic F-127 coated N-trimethyl chitosan nanoparticles(F-S NPs)of insulin as the model drug and asses their penetration of the mucosal barriers. Single factor screening was used to optimize the formulations of nanoparticles and the nanoparticles were characterized. Their particle size, Zeta potential, encapsulation efficiencies and drug loading were assayed to be(240. 6±6. 51)nm, (10. 42±1. 60)mV, (43. 39±2. 83)% and(3. 39±0. 57)%, respectively. The impact of PF-127 on mucin binding in vitro and nanoparticles′s transport in freshly obtained mucus were also evaluated. The mucin affinity of F-S NPs was significantly reduced when compared to that of the N-trimethyl chitosan nanoparticles(S NPs), i. e. , 28% of the latter. And F-S NPs was found to have an improved mucosal penetrating capability. Mucus-secreting HT29-MTX-E12(E12)cell monolayer was selected to investigate their cellular uptake. F-S NPs exhibited higher penetration coefficient than both free insulin and S NPs in mucus-secreting epithelium cells, i. e. , 16-fold and 1. 4-fold, respectively. Data suggest that F-S NPs be potential carriers to cross mucosal barriers and enhance the cellular uptake of insulin.

The effect observation of different doses of Dezocine used in postoperative analgesia of pediatric tonsillectomy and adenoidectomy / 中国基层医药

Objective To observe safety and effectiveness of Dezocine in postoperative analgesia of pediatric tonsillectomy and adenoidectomy by the continuous intravenous infusion of different doses,and to explore appropriate dosage of Dezocine for pediatric postoperative analgesia.Methods Elective tonsillectomy and adenoidectomy require-ments of postoperative analgesia in children 120 cases,they were randomly divided into A,B,C,D groups of 30 cases by using number table.After surgery patient -controlled intravenous analgesia(PCIA)two days,A,B,C groups were given Dezocine 0.2,0.3,0.4mg·kg -1 ·d -1 continuous intravenous infusion,D group received Sufentanil 1μg· kg -1 ·d -1 continuous intravenous infusion.Observed and recorded pain scores and sedation scores for postoperative 6h,12h,24h and 48h;recorded adverse reactions,pressing the number and effective pressing times of children within 48h after surgery.;recorded overall evaluation of postoperative analgesia of children and parents.Results A group at each time point pain score was significantly higher than B,C,D three groups,the difference was statistically significant (tAB =12.003,PAB =0.049;tAC =7.542,PAC =0.036;tAD =40.990,PAD =0.009);A,B,C three groups at each time point sedation score was significantly lower than D,the difference was statistically significant(tDA =3.894,PDA =0.030;tDB =5.020,PDB =0.039;tDC =36.103,PDC =0.016);D group of adverse reactions were significantly higher than A,B,C three groups,the difference was statistically significant(χ2DA =20.738,PDA =0.000,χ2DB =4.35,PDB =0.029,χ2DC =5.98,PDC =0.025);A group within 48h postoperative analgesia press times and the number of valid pressing were significantly higher than B,C,D three groups,the difference was statistically significant(tAB =3.003, PAB =0.036;tAC =5.720,PAC =0.031;tAD =37.157,PAD =0.015);B,C two groups of children and parents to evaluate postoperative analgesia overall satisfaction rates were 90.0%,93.3%,significantly higher than A 63.3%,D 60.0%,and the difference statistically significant (χ2AB =5.310,PAB =0.031;χ2DC =19.640,PDC =0.000). Conclusion Dezocine 0.3mg·kg -1 ·d -1 continuous intravenous infusion for pediatric tonsillectomy and adenoid-ectomy is safe and effective in postoperative analgesia and fewer adverse reactions,and should be promoted.

Clinical observation of general anesthesia for caesarean section / 中国医师进修杂志

Objective To investigate the safety and feasibility general anesthesia for cesarean section in term matemal.Methods Hospital in January-December 2014 admitted there are contraindications to spinal anesthesia or reject elective spinal anesthesia in term maternal 42 cases were general anesthesia.By intravenous injection of propofol 1.5-2 mg/kg and succinylcholine 1.5-2 mg/kg rapid induction,after video laryngoscopes with endotracheal intubation,immediate surgery to remove the fetus,neonates 1,5 min Apgar score.Results 42 cases of maternal disposable endotracheal intubation success rate of 100％,no regurgitation and aspiration;all fetuses removed within 10 min after induction of anesthesia,neonatal 1,5 min Apgar scores were 8 points or more,with no respiratory depression.Conclusion When patients have contraindications to spinal anesthesia or spinal anesthesia refused general anesthesia is a safe and viable alternative,as long as the rational use of anesthetics,general anesthesia for cesarean section and newborn is safe.

Risk factors for infection following percutaneous nephrolithotomy / 中国感染控制杂志

Objective To explore the risk factors for infection following percutaneous nephrolithotomy(PCNL), and provide the basis for prevention of postoperative infection.Methods 96 patients who were performed PCNL in a hospital between August 2010 and August 2013 were chosen,clinical data of patients were retrospectively analyzed, the occurrence of postoperative infection,risk factors and isolated pathogens were analyzed.Results 35 patients (36.46%[35/96])developed infection following PCNL.Univariate analysis revealed that risk factors for postopera-tive infection were the size and shape of stone,duration of operation,and intraoperative perfusion (all P <0.05). 96 patients before operation and 18 patients after operation were performed bacterial culture for urine,a total of 39 strains were isolated,the main isolated pathogens was Escherichia coli (n=12),followed by Pseudomonas aerugi-nosa (n=8),Streptococcus viridans (n =5 ),Klebsiella pneumoniae (n =4)and Enterobacter cloacae (n =3 ). Conclusion Infection rate following PCNL is high,duration of operation and intraoperative perfusion should be re-duced,antimicrobial agents should be used rationally.