Objective Developing an index system to evaluate the community teaching bases of general practice, for the purpose of identifying and completing at least one demonstration teaching base for general practice in each city in 2010. Methods Initial building of the index system by means of Delphi method and experts interview, followed by selection of experts for consultation, statistical analysis on the results of letter inquiries, and rounded up by the establishment of the index system for evaluation in the end. Results The recovery rates of a two-round Delphi questionnaire response are 94.12% and 100.00%respectively. Expert's authority degrees of five indexes are all over 0.8, which suggests high expert's authority. The average coordination coefficient of two-round Delphi experts consultation is 0.262and 0.534 respectively, showing good experts coordination. In the end, the study established four first-class indexes, ten second-class indexes, 41 third-class indexes and five additional indexes. Conclusions The index system is established in view of the current development of community teaching bases. It focuses on evaluating teachers, the teaching process and base's function. The evaluation system provides reference for selecting demonstration community teaching bases of general practice.

Objective To discuss the experience of medical treatment and rescue of the ‘SHENZHOU' astronauts in the landing place in the past 10 years,and to establish more effective mobile ICU in medical helicopters to ensure ‘SHENJIU' astronauts safety.Methods The data collected from foreign nations and our country was reviewed.Formerly experience in first-aid and rescue astronauts of our team was summerized.The important reasons of accidental injuries of astronaut during aerospace flight were listed.More effective and reasonable prophylactic measurements and clinical treatments of the accidental injuries of astronauts were brought forward.Results we established three effective mobile ICU that could ensure the safety of the astronauts.The carriers of the ICU were helicopters,and damage control surgery can be performed there.Fine armature made us more effective.Conclusions Reasonable and effective prophylactic measurements and clinical treatments were the important aspect of the successful manned aerospace flight.The first-aid system in helicopters could realize the destination of swift response and first-aid.

Objective To discuss the experience of medical care for the assurance of security of the'Shenzhou Ⅶ'astronauts at the landing venue in order to innovate a high efficient mobile ICU in medical helicopters.Method The data collected from over.as and domestics were reviewed and analyzed to find out the possible causes of accidental injuries to astronauts during acmspaec flight,and to pmpose a practicably and effectively prophylactic strategy and reasonable treatments for the astronauts with accidental injuries.Results Three,high efficient mobile ICU innovated could elqsure the safety ofthe astronauts.The ICUs with high efficiency were set up in the helicopters where the surgery Call he peormed for controlling the danlage.Fine armature made our work mole effective.Conclusions Practicably and effectively Plephylactic measurements and reasonable treatments are the essential aspect of the successfulness for the security of astronauts of manned aemspacecraft flights.The innovated medical care system in helicopters could realized the obligation of swift response and the duty offirst-md.

OBJECTIVETo study the application of three-dimensional visualization technology for laparoscopic resection of cystic carcinoma in the pancreatic body and tail.

METHODSSix cases of cystic carcinoma in the pancreatic body and tail treated between Nov, 2009 and Mar, 2011 were retrospectively analyzed. The original image data of 64-slice spiral CT were collected and using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted to obtain the 3-dimensional reconstruction images with customized image manipulation software. The specific surgical approach (the trocar position) and surgical procedure were planned based on the reconstructed mode.

RESULTSThe reconstructed 3-dimensional model clearly displayed cystic carcinoma in the pancreatic body and tail and the adjacent organs, showing distinct relationship between the cystoma and the splenic artery and vein. All the patients successfully underwent laparoscopic resection of the pancreatic body and tail without perioperative death. The spleen was preserved in 5 cases and removed in 1 case due to mucinous cystadenocarcinoma. The overall rate of pancreatic fistulae was 33.3% without incidences of postoperative hemorrhage. The average hospital stay of the patients was 12 days.

CONCLUSIONThree-dimensional reconstruction based on pancreatic CT data provides valuable assistance for laparoscopic resection of cystic carcinoma in the pancreatic body and tail.

Adult ; Aged ; Computer Simulation ; Cystadenocarcinoma, Mucinous ; diagnostic imaging ; surgery ; Cystadenoma, Mucinous ; diagnostic imaging ; surgery ; Cystadenoma, Serous ; diagnostic imaging ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; Laparoscopy ; adverse effects ; methods ; Length of Stay ; Male ; Middle Aged ; Pancreas ; diagnostic imaging ; surgery ; Pancreatectomy ; adverse effects ; methods ; Pancreatic Fistula ; etiology ; Pancreatic Neoplasms ; diagnostic imaging ; surgery ; Retrospective Studies ; Spleen ; surgery ; Tomography, Spiral Computed

Objective:To prepare nanoprobes by using polydopamine (PDA) as a carrier which is modified with the sonosensitizer protoporphyrin Ⅸ (PpⅨ) and labeled with 131I, 99Tc m or 177Lu, and to explore the value of these new nanoprobes in diagnosis and combination therapy of breast cancer. Methods:PDA particles were synthesized by aqueous oxidation, and a layer of polyethylene glycol (PEG) and PpⅨ were modified on the surface to product PDA-PEG-PpⅨ. Then the nuclides 131I, 99Tc m and 177Lu were labeled on PDA, respectively, and the labeling yield and stability were determined. The cytotoxicity test was conducted by comparing the viabilities of 4T1 tumor cells in free 131I group and 131I-PDA-PEG-PpⅨ group. The 4T1 cells were divided into 7 groups according to different treatment methods: PDA-PEG-PpⅨ group, PDA-PEG-PpⅨ+ photothermal therapy (PTT) group, PDA-PEG-PpⅨ+ sonodynamic therapy (SDT) group, 131I-PDA-PEG-PpⅨ+ PTT group, 131I-PDA-PEG-PpⅨ+ SDT group, 131I-PDA-PEG-PpⅨ+ PTT+ SDT group (100 μg/ml PDA-PEG-PpⅨ, 925 kBq/ml 131I), and the control group (DMEM culture medium). The cell viabilities of those groups were compared to evaluate the therapeutic effect. 4T1 tumor bearing mouse models were established, then 99Tc m-PDA-PEG-PpⅨ was injected through the tail vein (29.6 MBq) or intratumorally (14.8 MBq) to perform gamma imaging. The independent-sample t test and one-way analysis of variance were used for data analysis. Results:The PDA particles were uniform in size, with a particle size of (160.0±1.5) nm. They had a good photothermal conversion effect. A characteristic peak consistent with PpⅨ (400 nm) appeared in the UV-Vis absorption spectrum of PDA-PEG-PpIX. In the cytotoxicity test, when the radioactivity was 1.850 or 3.700 or 7.400 MBq/ml, the cell viabilities of free 131I group and 131I-PDA-PEG-PpⅨ group were significantly different ((72.18±6.57)% vs (86.07±5.17)%, (59.31±9.06)% vs (80.85±4.21)%, (42.90±1.30)% vs (72.99±5.73)%; t values: 3.71, 4.82, 11.46, P values: 0.006, 0.001, <0.001). The 131I-PDA-PEG-PpⅨ+ PTT+ SDT combination therapy had a better killing effect on 4T1 tumor cells than the combination of 131I-PDA-PEG-PpⅨ+ PTT and 131I-PDA-PEG-PpⅨ+ SDT (cell viabilities: (10.09±2.50)% vs (16.04±2.63)%, (28.65±4.72)%; F=351.66, P<0.001). In vivo imaging showed that 99Tc m-PDA-PEG-PpⅨ was stable in mouse models and could be effectively enriched in tumors. Conclusions:A multifunctional nanoprobe based on PDA is successfully prepared. The radionuclide labeling method is simple and effective, with a good stability. 131I-PDA-PEG-PpⅨ can kill 4T1 cells efficiently. 99Tc m-PDA-PEG-PpⅨ has an obvious tumor concentration effect in mouse models.

Objective To verify the effectiveness and safety of domestic neurosurgery medical robot Remebot for the biopsy of intracranial lesions.Methods Thirteen patients with intracranial lesions having comparatively difficulty in diagnosis in our hospital from January 2016 to May 2016 were randomly selected to robot operation group (n=6) and frame stereotactic group (n=7).In the robot operation group,four marks were pasted to the patient's head for the stereotaxy without frame,while in the frame stereotactic group,the frame should be fixed to the patient's head for the operation.The targets were set at the central of the lesions and the biopsies were performed through targets to the whole lesions.The specimens were sent for pathologic examinations with immunohistochemical staining.Results The confirmed diagnostic rate of robot operation group was 6/6:glioblastoma multiforme in 3,oligodendroglioma in one,non-Hodgkin's lymphoma in one and focal cortical dysplasia in one;the confirmed diagnostic rate of the frame stereotactic group was 6/7:glioblastoma multiforme in 2,grade Ⅱ-Ⅲ astrocytoma in 2,follicular thyroid carcinoma in one and cerebellum ganglion glioma in one,and the one without confirmed diagnosis was intracranial multiple cystic lesion.The positional accuracy in the robot operation group was 1.48±0.62 (accuracy error:0.66-2.47 mm) and that in the frame stereotactic group was 1.06±0.49 (accuracy error:0.50 mm-l.90 mm).Conclusions The domestic neurosuregery medical robot Remebot is characteristic by minimal invasive and high positional accuracy.It is quite suitable for frameless stereotactic intracranial lesion biopsy.The surgical planning could be made according to the shape of lesions and the positional accuracy is reached to the requirement of biopsy.Since the procedure of operation could be performed without fixing the frame on patients' head,the pain and fear of patients are reduced in a great deal and the operation is quite easy to be performed.Thus,it's more suitable for the biopsy ofintracranial lesions.

OBJECTIVES: The development and validation of the specific health literacy assessment tool for older adults is the basis for conducting the research on health literacy among older adults. The existing health literacy assessment scale for older adults in Chinese mainland has some limitations, such as too many items and poor compliance during the survey. It is necessary to develop or introduce simplified assessment tools to support large-scale surveys in the future. This study aims to modify the brief health literacy assessment scale compiled by Taiwan scholars, and to conduct the test for the reliability, validity and the measurement equivalence across gender in the older population in mainland China. METHODS: From March to April 2021, 508 older adults from Jinan, Shandong Province, China were selected by cluster sampling method to conduct a questionnaire survey using the brief health literacy assessment scale and health-promoting lifestyle profile. After 4 weeks, 83 of them were selected for retesting. SPSS 25.0 statistical software was used for descriptive analysis, item analysis, exploratory factor analysis, correlation analysis, and reliability test, and Mplus 8.0 was used for confirmatory factor analysis and gender measurement equivalence test. RESULTS: Each item of the scale had good discrimination, and there were significant differences in the scores of each item between high score and low score groups (P<0.05), and the coefficient of correlation between the scores of each item and the total score was between 0.721 and 0.891. Exploratory factor analysis extracted a factor with a characteristic root greater than 1, and the cumulative variance interpretation amount was 67.94%. The confirmatory factor analysis showed that the single factor structure fit was good [χ2/df was 2.260, the Tucker-Lewis index was 0.973, the comparison fit index (CFI) was 0.982, and the root mean square error of approximation (RMSEA) was 0.071]. The multi-group confirmatory factor analysis results showed that the brief health literacy assessment scale's configural equivalence, weak equivalence, and strong equivalence models were all accepted. The comparison results of measurement equivalence models showed that the changes of RMSEA were less than 0.015, and the changes of CFI were less than 0.01, indicating that the brief health literacy assessment scale had measurement equivalence between different gender groups. Cronbach's α coefficient was 0.945, and the test-retest reliability was 0.946. The correlation coefficient between health literacy and health-promotion lifestyles was 0.557 (P<0.05). CONCLUSIONS The brief health literacy assessment scale has good reliability, validity, and measurement equivalence across gender, and can be used as an effective measurement tool for the health literacy of the older people in Chinese mainland.
Humans ; Aged ; Reproducibility of Results ; Health Literacy/methods* ; Psychometrics ; Surveys and Questionnaires ; Asian People ; China ; Factor Analysis, Statistical

Objective To observe the outcomes of seizure control by three different surgical approaches,hippocampal transection,anterior temporal lobectomy and selective amygdalo-hippocampectomy,for the treatment of intractable medial temporal epilepsy,and explore their influences in the impairments of cognitive and memorial functions.Methods Twenty-nine patients with intractable medial temporal epilepsy,admitted to our hospital from January 2012 to October 2015,were chosen in our study;8 patients accepted hippocampal transection,10 accepted anterior temporal lobectomy and 11 accepted selective amygdalo-hippocampectomy.Seizure controls after treatment with these 3 approaches were compared and results of neuropsychological examinations (verbal intelligence quotient [VIQ],performance intelligence quotient [PIQ],full intelligence quotient [FIQ] and memory quotient [MQ]) were compared before and after operation.Results The effective rates of seizure controls were all higher than 80％ and seizure free rate was about 60％ in the 3 groups;Engel grading showed no significant differences among the three groups (P＞0.05).Results of all the neuropsychological examinations in the hippocampal transection group before and after operation had no significant differences (P＞0.05);however,all results in the anterior temporal lobectomy group after operation were significantly declined as compared with those before operation (P＜0.05);and PIQ,FIQ and MQ scores in the selective amygdalo-hippocampectomy group after operation were significantly lower as compared with those before operation (P＜0.05).Conclusions Hippocampal transection will not cause significant damage in intelligence and memory functions.As compared with both anterior temporal lobectomy and selective amygdalo-hippocampectomy,hippocampal transection can have good seizure control and preserve memory function.

OBJECTIVE: To explore the genotype distribution of 5,10-methylenetetrahydrofolate reductase (MTHFR) and 5-methyltetrahydrofolate-homocysteine methyltransferase reductase (MTRR) among Chinese Han women in Zhengzhou. 
 METHODS: A total of 1 253 women were recruited from Zhengzhou city. The genotype of MTHFR C677T, A1298C and MTRR A66G was detected to analyze the distribution of gene polymorphisms and to compare them with the published data from other Han women.
 RESULTS: The frequency of the MTHFR 1298CC genotypes (1.3%) in Zhengzhou was lower than that in Xiangtan (4.8%), Yanbian (3.8%), Zhenjiang (3.5%), Jingzhou (3.2%), Kunming (2.7%), Deyang (6.3%), Huizhou (7.2%) and Wulumuqi (3.4%) (all P<0.05). The difference in allele frequency was significant compared with that in Yantai, Yanbian, Wulumuqi, Zhenjiang, Jingzhou, Kunming, Dezhou, Xiangtan or Huizhou (all P<0.05). The frequency of the MTRR 66GG genotypes (5.4%) in Zhengzhou was lower than that in Deyang (8.2%) (P<0.01) and allele frequency between them was significant difference (P<0.05). 
 CONCLUSION The gene polymorphism of MTHFR A1298C and MTRR A66G among the Han women in Zhengzhou is statistically different from that in some regions of China.
Alleles ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Ferredoxin-NADP Reductase ; genetics ; Gene Frequency ; Genotype ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Polymorphism, Genetic

OBJECTIVE: To analyze the characteristics of BK polymavirus (BKV) infection and the optimal time window for intervention in kidney transplant recipients (KTRs). METHODS: We retrospectively analyzed the clinical data and treatment regimens in 226 KTRs in our center between January, 2013 and January, 2018. Among the recipients, 157 had a urine BKV load ≥1.0×10 copy/mL after transplantation, and 69 had a urine BKV load below 1.0×10 copy/mL (control group). RESULTS: Among the 157 KTRs, 60 (38.2%) recipients were positive for urine BKV, 66 (42.0%) had BKV viruria, and 31(19.7%) had BKV viremia. The incidence of positive urine occult blood was significantly higher in BKV-positive recipients than in the control group ( < 0.05). The change of urine BKV load was linearly related to that of Tacrolimus trough blood level (=0.351, < 0.05). In urine BKV positive group, the average estimated glomerular filtration rate (eGFR) was below the baseline level (60 mL·min·1.73 m) upon diagnosis of BKV infection reactivation, and recovered the normal level after intervention. In patients with BKV viruria and viremia, the average eGFR failed to return to the baseline level in spite of improvement of the renal function after intervention. CONCLUSIONS Positive urine occult blood after transplantation may be associated with BKV infection reactivation in some of the KTRs. BKV infection is sensitive to changes of plasma concentration of immunosuppressive agents. Early intervention of BKV replication in KTRs with appropriate dose reduction for immunosuppression can help to control virus replication and stabilize the allograft function.
BK Virus ; physiology ; Humans ; Kidney Transplantation ; Polyomavirus Infections ; virology ; Retrospective Studies ; Transplant Recipients ; Tumor Virus Infections ; virology ; Viral Load ; Virus Replication