Objective To explore the changes of blood gas, plasma fibrinogen and D-dimmer levels in neonates with severe hyaline membrane disease (HMD). Methods Forty - three neonates with severe HMD(treated by mechanical ventilation) ,26 neonates with mild HMD( without treated by mechanical venti-lation) and 31 controls were studied. The blood gas,plasma fibrinogen and D-dimmer levels were measured. Results Compared with other two groups, the levels of blood pH, PaO2 and FBG decreased significantly in neonates with severe HMD (P<0.01). The levels of PaCO2 and D-dimmer increased significantly (P<0.01). The blood pH was negatively correlated with plasma D-dimmer level,but it was positively correlated with plasma FBG level in neonates with severe HMD. Conclusion There are coagulation abnormalities in neonates with severe HMD. Hypoxemia and acidosis have close relationship with the coagulation abnormali-ties.

Background:Personality characters will influence the future career planning and development of medical students.Therefore,it will be important in the field of medical education to survey their personalities.Study design:The personality questionnaire was developed according to the Big-Five characters.The content validity and consistent reliability were assessed.A total of 124 undergraduate medical students participated in this 44-item self-evaluation about their personalities.Results:The inter-item consistency reliabilities of the 44-items of Big-Five personality questionnaire were analyzed and discordant items were deleted(Crobach's Alpha from 0.484~0.782 before selection to 0.67~0.82 after selection).The content validity of this five dimensions ranged from 0.8 to 0.9(P

Objective To investigate the value of prenatal ultrasound in diagnosis and treatment of twin reverse arterial perfusion (TRAP) syndrome. Methods A retrospective study was performed in 5 TRAP cases, including ultrasound images, clinical data and pregnancy outcomes. The sonographic characteristics were summarized. Results Five TRAP cases were diagnosed during 13 to 28 weeks' gestation and confirmed after birth. Color Doppler unltrasonography revealed retrograde umbilical artery perfusion towards acardiac twin. Two of 5 cases ended up in induced abortion, 1 in spontaneous abortion, 1 was delivered at 37 weeks' gestation after ultrasound-guided feticide of the acardiac twin and 1 was monitored closely with ultrasound and delivered alive at 32~(+4) weeks' gestation. Conclusion Prenatal ultrasonography has great applicative value for TRAP syndrome in early diagnosis, choosing optimal treatment and prognosis assessment.

Objective To evaluate the clinical significance of the detection of the Human Papilloma Virus (HPV) DNA typing in therapy of cervical diseases. Methods 780 cases have been studied. These cases which showed HPV-DNA positive and were diagnosed by biopsy as cervical cancer or cervical intraepithelial neoplasia( CIN Ⅰ-Ⅲ) were treated by operation or physical therapy. And 6 months and 12 months after the treatment,TCT and HPV DNA test were carried out. Results The prevalence of HPV-DNA types among the 780 cases descended from HPV 16 to 52,58,18,33 and 31. Detection rates of HPV-52 and 58 were highest among the patients with CIN Ⅰ. In patients with CIN Ⅱ,CIN Ⅲ,carcinoma in situ and invasive carcinoma,the positive rate of HPV-16 was obviously higher than other genotypes,and the difference was significant (P＜0. 01 ). 520 cases were followed-up after treatment,we found that HPV-DNA subsided within 3 months to 1 year in 432 cases. 88 cases still showed the HPV-DNA positive, among this group 48 cases were cytology diagnosed as normal or inflammation,but 14 cases were ASC-US,22 cases were LSIL and 4 cases were HSIL. Cytology abnormal cases were mere often detected in patients with persistent HPV-positive than in patients with HPV-negative. Conclusion Referring patients with cervical diseases the common HPV genotypes are 16,52,58,18,33 and 31. Especially HPV-16 are closely related with cervical cancer and high-level cervical intraepithelial neoplasis. HPV-DNA turn negative in most patients in 12 months after treatment. Persistent infection of HPV-DNA is related with the pathological changes persist.

Objective To study the effect of hand-assisted laparoscopic anterior resection for rectal cancer(RC).Methods The clinical data of 28 cases of RC operated with hand-assisted laparoscopy were analyzed retrospectively. Results The operations in all the 28 cases were successfully performed, and no intra-or post-operative complications were observed.The number of resected lymph nodes and the resected margins from the tumor were sufficient.After operation,the patients felt less pain, recovered quicker and bowel movement recovered early;first postoperative flatus was appeared at 32 hours after operation;average postoperative hospital stay was 7 days.All the patients were followed-up for 8 to 19 months,and no trocar port tumor implantation or local recurrence occurred.Conclusions The results demonstrate that hand-assisted laparoscopic anterior resection in the treatment of RC have many advantages,such as safe,less trauma,the patients recover quicker,resection of the tumor more complete etc,so it can be used extensively.

Objective To investigate the present situation on therapy and secondary prevention of coronary heart disease (CHD) in the elderly,and to improve treatment and secondary prevention.Methods Cross sectional,non-intervention and multicenter survey was used in this study.All 7962 effective interviewed cases were with aged ≥60 years from 116 hospitals of 21 provinces and cities during April and July of 2011.Among them,male was 63.4％,aged (73.0±7.9) years,24.1％cases were aged ≥80 years.The current treatment and risk factors of elderly CHD were investigated by questionnaire including basic information,health check,types and severe degree of CHD,its therapy and prevention,and control of the risk factors.Results (1) All cases were received drugs and percutaneous coronaryintervention (PCI) or surgery,27.5％ cases of PCI,2.6％ of coronary artery bypass grafting(CABG),70.4％ cases of expectant treatment.(2) The ratio of cases with angina pectoris and myocardial infarction was 76.5 ％,the attack of angina pectoris ≥3 times/weeks in recent month was 48.3％,Canadian Cardiovascular Society(CCS) Ⅱ scores and over was 79.3％.(3) The utility ratio of prevention drugs recommended by the guidelines were 70.3％ antiplatelet drug,54.9％ lipid regulating agents,47.5％ BB,29.0％/22.2％ ACEI/ARB.(4)The situation of risk factor control was as followed:among all the cases,38.9％ of them with active smoking≥1 counts/day,28.4％ of them with passive smoking,57.6％ of them with BMI ≥24,46.4％ of male with waistline ≥90 cm,41.1％ of female with waistline≥85 cm.In our cases,67.6％ of them with hypertension and 56.6％ achieved the level of blood pressure＜140/90 mm Hg; 23.4％ with diabetes mellitus and 49.5％ achieved the level of HbA1c ＜7.0％; 33.2％ with Lipids disorder and 26.6％ achieved the level of TC＜4.1 mmol/L,27.5％ of LDL-C＜2.6 mmol/L.(5) The analysis showed that there were more attacks of angina pectoris in the groups of male than female(P=0.0050),those HbA1c ≥7.0％ than those ＜7.0％ (P=0.019),and those LDL-C≥2.6 mmol/L than those ＜2.6 mmol/L (P =0.044),and that there were less attacks in those with CABG than without it (P＜0.001) and in those with PCI than without it (P＜0.001).Conclusions Inadequate control of symptom,insufficient utility ratio of prevention drugs and control of risk factors appear in elderly CHD.Coronary revascularization,drug use of guidelines recommend and control of high risks are the key points of high curative effect of elderly CHD.

Objective To evaluate the values of prenatal surveillances of ultrasonography in twin pregnancies with amniotic fluid discordance. Methods Two hundred and seventy cases of diamniotic twins were included. Both postnatal outcomes and prenatal amniotic fluid discordant variations were analyzed,and the incidences of amniotic fluid discordance were compared between the monochorionic-diamniotic(MCDA)and dichorionic-diamniotic (DCDA) gruop. Results Twenty four cases of twins with amniotic fluid discordance were found in the study. The incidence of amniotic fluid discordance in MCDA group was much higher than that in DCDA group (28.9% vs 5.6%, P ＜0. 001 ) ,and 24 cases of twin-to-twin transfusion syndrome (TTTS) were diagnosed in the former group and none were found in the latter group. Downward tendency of amniotic fluid discordance was shown in non-TTTS cases of MCDA group. Compared with TTTS cases, the postnatal outcomes of non-TTTS cases with amniotic fluid discordance were much better in MCDA group ( P ＜0.001 ). Conclusions TTTS and MCDA twins with amniotic fluid discordance may overlap each other in the early stage. Serial surveillances of ultrasonography are necessary for prenatal differentiating twin pregnancies complicated by amniotic fluid discordance,and providing strong support to clinical treament.

Objective:To understand the oral health status of urban and rural residents in China,the Fourth National Oral Health Epidemiological Survey (FNOHES) was conducted in 2015.Materials and methods:Based on the principles of multi-stage,stratified,equal capacity,and random sampling,the subjects included five groups of residents aged 3-5,12-15,35-44,55-64,and 65-74 years in all 31 provinces,municipalities,and autonomous regions except Hong Kong,Macao,and Taiwan.The total sample size was 172,425.The survey covered two areas,namely oral health status and knowledge,attitude and oral health behavior.Results:Residents in China had serious caries and poor periodontal condition.The prevalence of caries was above 50％ in all age groups,subjects without periodontal disease accounted for ＜50％,and fewer than 50％ of subjects brushed their teeth twice a day.Based on the results of the FNOHES,the following suggestions were proposed for improving the oral health in China in the future:to establish and improve the comprehensive prevention and control system for oral diseases,implement a comprehensive prevention and control strategy for priority groups,strengthen the oral health education for all people to improve oral health literacy,enhance dynamic monitoring to scientifically evaluate oral health status,and coordinate multi-party resources to establish and improve the oral health service security system.Conclusion:The oral health status of Chinese residents and their oral health behavior habits need to be improved.With the support of the administrative departments of the government and unremitting efforts of the oral health staff,all sectors of society must be coordinated to strengthen oral health education for the whole population.Furthermore,comprehensive prevention and control measures must be implemented for priority groups.

To evaluate the estimation of prevalence ratio (PR) by using bayesian log-binomial regression model and its application,we estimated the PR of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea in their infants by using bayesian log-binomial regression model in Openbugs software.The results showed that caregivers' recognition of infant's risk signs of diarrhea was associated significantly with a 13％ increase of medical care-seeking.Meanwhile,we compared the differences in PR's point estimation and its interval estimation of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea and convergence of three models (model 1:not adjusting for the covariates;model 2:adjusting for duration of caregivers' education,model 3:adjusting for distance between village and township and child month-age based on model 2) between bayesian log-binomial regression model and conventional log-binomial regression model.The results showed that all three bayesian log-binomial regression models were convergence and the estimated PRs were 1.130(95％CI:1.005-1.265),1.128(95％CI:1.001-1.264)and 1.132(95％CI:1.004-1.267),respectively.Conventional log-binomial regression model 1 and model 2 were convergence and their PRs were 1.130(95％ CI:1.055-1.206) and 1.126(95％ CI:1.051-1.203),respectively,but the model 3 was misconvergence,so COPY method was used to estimate PR,which was 1.125 (95％CI:1.051-1.200).In addition,the point estimation and interval estimation of PRs from three bayesian log-binomial regression models differed slightly from those of PRs from conventional log-binomial regression model,but they had a good consistency in estimating PR.Therefore,bayesian log-binomial regression model can effectively estimate PR with less misconvergence and have more advantages in application compared with conventional log-binomial regression model.

Objective:To screen out the differentially regulated metabolites by the analysis of serum metabolic fingerprints, and to provide potential biomarkers for diagnosis of lung cancer.Methods:A total of 228 subjects were enrolled in Changhai Hospital from January 27, 2021 to June 4, 2021, including 97 newly diagnosed lung cancer patients and 131 healthy individuals. Serum samples were collected from the enrolled cohort according to a standard procedure, and the enrolled cohort was divided into a training set and a completely independent validation set by stratified random sampling. The metabolic fingerprints of serum samples were collected by previously developed nano-assisted laser desorption/ionization mass spectrometry (nano-LDI MS). After age and gender matching of the training set, a diagnostic model based on serum metabolic fingerprints was established by machine learning algorithm, and the classification performance of the model was evaluated by receiver operating characteristic (ROC) curve.Results:Serum metabolic fingerprint for each sample was obtained in 1 minute using a novel nano-LDI MS, with consumption of only 1 μl original serum sample. For the training set, the area under ROC curve (AUC) of the constructed classifier for diagnosis of lung cancer was 0.92 (95% CI 0.87-0.97), with a sensitivity of 89% and specificity of 89%. For the independent validation set, the AUC reached 0.96 (95% CI 0.90-1.00) with a sensitivity of 91% and specificity of 94%, which showed no significant decrease compared to training set. We also identified a biomarker panel of 5 metabolites, demonstrating a unique metabolic fingerprint of lung cancer patients. Conclusion:Serum metabolic fingerprints and machine learning were combined to establish a diagnostic model, which can be used to distinguish between lung cancer patients and healthy controls. This work sheds lights on the rapid metabolic analysis for clinical application towards in vitro diagnosis.