Purpose:To evaluate the effect of preoperativ e chemotherapy or brachtherapy and radical hysterectomy on stage Ⅰb-Ⅱb locally advanced cervical cancer with high risk factors. Methods:preoperative chemotherapy or radiotherapy followed by r adical hysterectomy compared to radical hysterectomy alone in stage Ⅰb-Ⅱb cer vical cancer with higher risk factors(bulky,lower grade,small cell cancer or ade nocarcinoma). Results:①Pelvic lymphnode metastases rate was significantly decreased in the neoadjuvant chemotherapy arm compared with surgery alone(P 0.05). Conclusions:Preoperative chemotherapy followed by surgery is e ffective and superior to surgery alone in stage Ⅰb-Ⅱb cervical cancer with high risk factors.It might be able to reduce tumor volume and eliminate effectiv ely disease in lymphnodes and possibly micrometastases.It may be beneficial in improving quality of life of patients by decreasing the need for postoperative r adiotherapy. Response to chemotherapy may be a prognostic factor.Preoperative br achytherapy showed no significant advantage in eliminating lymphnodes matastases as compared to surgery alone.

This article introduced the thoughts and practice of implementing microbiology course reform for stomatology majors in school of stomatology and department of microbiology in Tianjin medical university.To make the introductory courses more suitable and meet the needs of stomatology better,our microbiology classes included the basic knowledge of oral microoganism.

This paper gives a report on a new species of paragonimus in MT.Wuyishan,Fujian province during 1978 to 1983.All the type are deposited in the Center for Disease Control and Prevention of Fujian province.Holotype body short-oval,12.5 by 7.0mm,ratio of width to length 1:1.79.Ovary 2.0×2.13mm in size,the third class branches.Testes big,2.5 by 3.75mm(left) and 2.0 by 4.75mm(right)in size,as piece-shapy,only 2 litter branches,being much larger than the ovary.cuticular spines slender,sing in arrangement.Matacercaria obtained from the fresh-water crab,Sinopotamon fujianensis Dai et Chen,1979,measuring 395 by 410 micra,its cyst wall sing ,only 3-5 micra.Basing on the characteristic features mentioned above,This worm found by us differs fromP.westermani,P.skrijabini,P.macrorchis,P.mingqingensis and Euparagonimus cenopiosus,and can be considered as a new species of Paragonimus.

In order to understand the situation of schistosomiasis in Fujian Province, the surveillance and field survey data of 16 counties (cities or districts) were statistically analyzed from 2003 to 2008 according to the national and provincial surveillance protocols. The snail areas were 69 400 m~2 in 2003, and 506 700 m~2 in 2004, then decreased to 57 700 m~2 in 2008 after the snail control in 2005 and 2006. Serological examinations were conducted in 18 000 people, among which 5 412 people were the mobile population from schistosome-endemic areas, and 110 persons were positive, among which 8 persons had eggs and miracidia in their stools, among 7 885 appendix samples, Schistosoma japonicum eggs were found in 8 samples of the patients who came from the o-riginal endemic areas. By the stool examination, 2 709 head of farm cattle in the region with snails were not found infected with Schistosoma japonicum. It is suggested that the areas of residual snails are large and widespread, and the imported patients are found frequently, so the danger of schistosomisis transmission still remains.

Objective:To investigate whether the nutrition support team (NST) benefits esophageal carcinoma (EC) patients who are concurrently undergoing chemoradiotherapy. Methods: Between June 2012 and December 2013, 40 EC patients undergoing chemoradiotherapy were divided into the NST group and routine treatment (RT) group, with 20 patients in each group. At the end of chemoradiotherapy, the nutritional status, incidence of complications, and completion rates of radiotherapy were evaluated. The length of hospital stay (LOS) and cost were also compared between the two groups. Results:The nutrition and blood parameter values of the NST group were better (P<0.05) than those of the RT group. The incidence of complications was lower in the NST group (P<0.05) than that in the RT group. In addition, all patients in the NST group achieved the treatment plan, whereas five of the patients in the RT group interrupted or delayed the plan (P<0.05). The average LOS decreased by 3.8 d (P<0.05), and the hospitalization costs were reduced to 6300 RMB person-times (P>0.05) for the patients of the NST group. Conclusion: NST could maintain the nutritional status and improve the treatment compliance and tolerance of EC patients undergoing chemoradiotherapy, thereby shortening the LOS time and reducing the costs.

Objective To analyze the impacts of bureaucracy management at tertiary public hospitals in Beijing on exchange modes and trust between doctors and patients, using both the bureaucracy theory and trust theory. To study the role of such management as an organizational structure for hospital operation and service, in the transition of doctor-patient trust from traditional special trust to a universal trust based on bureaucracy structure and specialized job division. Methods The purpose sampling method was used to select 94 hospital administrators, medical staff, and patients from six tertiary hospitals for a field survey. Results Bureaucracy at public tertiary hospitals keeps improving, and its systematic and refined organizational structure is changing the exchanges between doctors and patients, earmarking universal trust of the fundamental type of doctor-patient trust, aided by special trust. Rules and regulations of bureaucracy normalize medical services, and specialization enables medical workers in their clinical work against difficult and severe diseases, winning both reputation and patient trust as well. However, the specialized, professional and dehumanized characteristic of bureaucracy tend to encourage doctors to attend to diseases than patients, and separate links in medical services to decrease doctor-patient trust in the meantime. Conclusions Bureaucracy is a necessary organizational form of urban public hospitals, but it should strengthen their humanity feature and improve their communication with patients with rules and regulations. At the same time, with the use of integrated medical mode in clinical practice, bureaucracy could be improved to benefit patients and enhance trust of patients.

Objective To investigate the influence of abdominal adipose tissue on insulin resistance and other metabolic indicators in the patients with type 2 diabetes mellitus(T2DM)complicating obesity.Methods Fifty-one patients with newly diagnosed T2DM complicating obesity (T2DM group) and 50 cases of simple obesity(control group) in Jishuitan Hospital were enrolled.The two groups were performed QCT for measuring the total abdominal adipose tissue volume (TAV),subcutaneous adipose tissue volume (SAV),visceral adipose tissue volume (VAV),and then the VAV/SAV ratio was calculated.Meanwhile the waist circumference,body mass index(BMI),blood uric acid (UA),total cholesterol (C H O),triglycerides (TG),high-density lipo protein cholesterol (HDL),low density lipoprotein cholesterol(LDL),homocysteine(HCY),dosage of basal insulin(DBIns),dosage of prandial insulin (DPIns),fasting plasma glucose(FBG),fasting blood insulin (FIns) and HbA1c levels were also measured.The relationship between TAV,SAV and VAV with HOMA-RI and other indicators was investigated.The influence of abdominal adipose tissue on insulin resistance and other metabolic indicators was determined.Results The UA,TG,LDL,FPG and HbA1c levels in the T2DM group were increased compared with the control group(P＜0.05).Compared with the control group,the SAV level in the T2DM group was decreased(P＜0.05),the VAV and VAV/SAV levels were increased(P＜0.05).The multivariate regression analysis showed that VAV was the natural logarithm affecting In (HOMA-RI),UA,CHO,TG,LDL,HCY,DBIns (β=0.399,0.398,0.389,0.447,0.440,0.372,0.307;P＜ 0.05).TAV was the main factor affecting the waist circumference and BMI (β=0.868,0.639;P＜0.05).Conclusion The visceral adipose tissue volume has larger influences on insulin resistance,blood lipids,UA,HCY and DBIns.

Objective: To investigate the quantitative relationship between liver fat content and bone mineral density (BMD) in middle-aged and elderly people. Methods: Totally 184 middle-aged and elderly community residents were recruited from March to June 2016, including 68 males and 116 females. MRI mDIXON-Quant and quantitative CT (QCT) examinations were performed to determine the content of liver fat and L1-L3 vertebral BMD. The subjects were divided into four groups according to the quartiles of liver fat content, and the baseline characteristics and other variables of different groups were were identified by using one-way analysis of Variance. The relationship between liver fat content and lumbar vertebral BMD was assessed with Spearman correlation and partial correlation analysis. Result: Subjects with higher hepatic fat content had lower spine BMD and higher body mass index (BMI), waist circumference. Liver fat content was negatively correlated with BMD (r=-0.203, P=0.003). After age and body weight were controlled, the negative correlation between liver fat content and BMD was still significant (r=-0.291, P<0.001), in males (r=-0.283, P=0.021) and in females (r=-0.210, P=0.025). Conclusion Liver fat content is negatively correlated with lumbar vertebral BMD in middle-aged and elderly people.

BackgroundThe existing tools in China for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint do not sufficiently consider the specialty in psychiatric practice， and the scale items are somewhat cumbersome to use， which together restrict their further promotion and application. Accordingly， there is an urgent need for developing a more scientific assessment tool. ObjectiveTo construct a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint and to verify its reliability and validity， so as to provide a generic tool for the assessment. MethodsBased on the theoretical framework of the knowledge-attitude-practice model， the preliminary scale was formed through systematic literature review， qualitative interview and Delphi method. From July to December 2021， a stratified sampling was utilized to select 729 psychiatric nurses from tertiary， secondary and primary （including unclassified medical institutions and grassroots hospitals） psychiatric hospitals in Guangdong Province. The formal scale was developed through item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated by content validity and structure validity， and the reliability was verified by procedures including Cronbach's α coefficient， test-retest reliability， and split-half reliability. ResultsA total of 12 items of three dimensions （knowledge， attitude， practice） were included in the scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. The scale-level content validity index （S-CVI） was 0.941， and the item-level content validity index （I-CVI） ranged from 0.812 to 1.000. Exploratory factor analysis extracted three common factors， and the cumulative variance contribution rate was 62.948%. The confirmatory factor yielded adequate fit. Cronbach's α coefficient was found to be 0.887 for the scale， 0.819 for knowledge dimension， 0.842 for attitude dimension， and 0.831 for practice dimension. The split-half reliability and test-retest reliability for the scale were 0.712 and 0.922， respectively. ConclusionThe scale shows satisfactory reliability and validity， which can be used to assess psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. ［Funded by Guangdong Clinical Teaching Base Teaching Reform Research Project （number， 2021JD119）］

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.