Objective To study the gene mutation characteristics of patients with spinocerebellar ataxias(SCA) in Ningxia region.Methods The SCA3/Machado-Joseph disease(MJD)trinucleotide CAG repeat number was detected by polymerase chain reaction(PCR),capillary gel electrophoresis(CGE) and DNA sequencing in 6 patients with SCAs and 4 normal kindreds from a family in Ningxia region.Results All patients and 1 kindred were positive for SCA3/MJD;other 3 kindreds were negative for SCA3/MJD.The CAG repeat number was expanded to 66～81 in the patients with SCA3/MJD and a kindred,and 22～33 in other 3 kindreds.Conclusion There is SCA3/MJD in the patients with SCAs of Ningxia region.Gene examining has the great significance for definite diagnosis in the patients with SCAs.

The PBL teaching and the case teaching have begun to be applied to the course of health economics, which has strong adaptability to the two teaching methods. Two teaching methods not only have the same characteristics, such as diversified teaching, outstanding students as the main body, paying atten-tion to the theory and practice, emphasizing on the comprehensive use of knowledge, but also have different characteristics, such as teaching idea, applied range and points of focus. These similar characteristics and differences are reflected in the development of health economics course. Based on the differences and simi-larities of the two teaching methods and further integration of the characteristics of health economics, this paper puts forward the countermeasures to optimize the application of the two teaching methods in health economics course.

Objective To verify whether early growth response-3(EGR3) gene is targeted by microRNA-181b using molecular biology methods so as to provide guidance for the subsequent study on microRNA-181b`s role in the molecular mechanisms of schizophrenia.Methods Bioinformatic methods predicted that EGR3 gene is targeted by microRNA-181b.PCR methods amplified the fragment in EGR3 gene 3`UTR including the putative microRNA-181b binding site.Then the sequence was cloned into the pmirGLO luciferase vector.The DNA sequences of the amplified fragments were identified by restriction enzyme digestion and sequencing, and were consistent with the reference sequence from UCSC.This constructed vector was marked as pmirGLO-EGR3 vector.Finally, the pmirGLO vector, the pmirGLO-EGR3 vector, microRNA-181b mimics and negative control (NC) were divided into 5 groups and transfected into HEK393T cells;the luciferase activity was tested by dual luciferase reporter gene assay.Results The results of restriction enzyme digestion and sequencing demonstrated that the PCR fragmentwas successfully cloned into pmirGLO vector.The transfection results showed that the recombinant plasmid was successful transfected into HEK293T under the fluorescence microscope, with transfection efficiency being about 90％.The results of dual luciferase activity assay demonstrated that microRNA-181b significantly decreased the reporter gene`s activity compared with the NC.Conclusion At the cellular level, the schizophrenia susceptibility gene EGR3 was verified to be targeted by micorRNA-181b, which provides a new clue for the subsequent study on microRNA-181b`s role in the molecular mechanisms of schizophrenia.

Objective:To investigate the turnover intention and its influencing factors in rural general practitioners in southwest Shandong province.Methods:In May 2020, a survey with self-designed questionnaire was conducted among 2 805 rural general practitioners in southwest Shandong province selected by multi-stage sampling method. Pearson chi square test (χ2) and binary logistic regression were used to analyze the factors influencing the turnover intention of rural general practitioners.Results:A total of 2 805 questionnaires were sent out, 2 693 were collected and 2 272 were valid, with an effective rate of 84.4%. Among 2 272 participants, 1 076 (47.4%) had medium to high level turnover intention. Binary logistic regression showed that part-time job ( OR=1.443, 95% CI: 1.105-1.884, P<0.01), average monthly night shifts ≥20 times ( OR=1.340, 95% CI: 1.106-1.623, P<0.01), daily working time ≥13 hours ( OR=1.358, 95% CI: 1.107-1.666, P<0.01), insomnia ( OR=2.075, 95% CI: 1.755-2.454, P<0.01), feeling depressed at work ( OR=2.987, 95% CI: 2.516-3.546, P<0.01), degree of emotional exhaustion ( OR=3.801, 95% CI: 3.188-4.533, P<0.01) and degree of de-personalization tendencies ( OR=2.493, 95% CI: 2.086-2.981, P<0.01) were the significant factors influencing the turnover intention of rural general practitioners. Conclusions:Rural general practitioners in southwest Shandong have a high-level turnover intention, part-time jobs, average number of night shift per month, working time, insomnia, depression and job burnout are the main factors affecting the turnover intention. Necessary measures should be taken by relevant departments to enhance the stability of rural general practitioners.

To explore the differences in cognitive function between different subtypes of chronic insomnia，including the diferences of incidence of cognitive dysfunction and the cognitive domain of each subtype. Methods To collect patients diagnosed as chronic insomnia in the neurology department of Cardiovascular and Cerebrovascular Hospital of Ningxia Medical University from January 2018 to December 2018（65 cases in total）. Polysomnography（PSG） was used to classify patients with insomnia objectively. 14 cases were sleep difficultly，12 cases were awakened early，16 cases were difficult to maintain，and 23 cases were mixed. On the morning of the completion of PSG，to evaluate the cognitive function of patients with the Montreal Cognitive Assessment（MoCA）. Results （1）The incidence of cognitive impairment in different subtypes of chronic insomnia was different（χ2=8.004，P<0.05），and the mixed group was more prone to cognitive dysfunction. （2）The delayed recall scores of patients with different subtypes of insomnia were different（H=13.239，P<0.05），and the scores of the mixed group were lower than other groups（P<0.05）. Conclusion The incidence of cognitive dysfunction among different subtypes of chronic insomnia was different，the mixed type was more prone to cognitive impairment. The delayed recall ability varied among different types，the mixed type was worse.

OBJECTIVETo compare the long-term survival and postoperative complications of distal gastric cancer patients between Billroth I((BI() and Billroth II((BII() reconstruction.

METHODSClinicopathological data of 992 patients with distal gastric cancer who underwent D2 curative gastrectomy in our department from May 2008 to April 2015 were recorded, including 207 patients of BI( reconstruction and 785 of BII( reconstruction, were retrospectively analyzed. Patients presenting a previous history of cancer, gastric resection or cytotoxic chemotherapy, and those presenting liver or intraperitoneal tumor dissemination or unresectable infiltration into contiguous organs were excluded. Patients in BI( and BII( group were selected using gmatch methods based on age (±10 years), gender, tumor size (±1 cm), differentiated degree and depth of invasion in order to reduce the selection bias of clinicopathological characteristics. The final number of patients matched was 191 respectively.

RESULTSCompared with BII( group, the BI( group had a significantly shorter operation time (181.7 min vs. 220.7 min, P=0.000) and a shorter postoperative hospitalization stay (7.6 days vs. 8.1 days, P=0.046). The postoperative complications including anastomotic leakage, wound dehiscence, wound infection, intraperitoneal hemorrhage, intestinal obstruction, duodenal stump fistula, pulmonary infection and fever had no significant difference(P>0.05). Three-year survival between two groups was comparable (82.9% vs. 78.7%, P=0.379).

CONCLUSIONSCompared with BII(, BI( reconstruction is more suitable for patients with distal gastric cancer.

Gastrectomy ; Gastroenterostomy ; Humans ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery

BACKGROUND:Currently,the verification of the precision of personalized bone models is usually performed by methods such as paired t-tests or intraclass correlation coefficient,but such methods often require the production of large batches of models,which do not satisfy the need for immediate use of personalized models. OBJECTIVE:To study the feasibility of establishing the equivalent model to verify the precision of the personalized bone model rapidly. METHODS:Bone CT images of three adults were randomly obtained for reconstruction.3D printing was used to create personalized bone models,and then the personalized bone models were scanned using CT and reconstructed.Mimics was used to compare the reconstructed models of bone CT images with the bone CT images.Geomagic Studio was used to analyze the fitting deviation between the reconstruction model of personalized bone model CT image and the reconstruction model of skeletal CT image.The 3D-printed personalized bone model was measured against the measurement positions and dimensions marked on the reconstruction model of skeletal CT image,and the error was calculated. RESULTS AND CONCLUSION:(1)By comparing the reconstructed bone CT image model with the bone CT scan image,the two were compatible in terms of anatomical structure and morphology,and the contours almost overlapped.(2)By fitting bias analysis,the standard bias was 0.176,0.226,and 0.143 mm in order,and all the results were<0.25 mm.(3)By measuring and calculating the model,the mean relative errors were 0.44%,0.21%,and 0.13%,and all the results were within 5%error.(4)The constructed equivalent model was in line with the basic conditions for making personalized bone models.The established equivalent model met the clinical needs and design requirements,and it was feasible to use the method of the equivalent model to verify the precision of the personalized bone model quickly.(5)This method could provide a targeted and rapid way to verify the precision of personalized bone models.It could achieve the goal of providing immediate clinical use without the need to produce large batches of models compared to conventional methods such as paired t-tests or intraclass correlation coefficient.

Objective　To explore the correlation between cerebral microbleeds and cognitive dysfunction as well as the risk factors affecting the occurrence of cognitive dysfunction.Methods　A total of 113 patients with no abnormalities by transcranial magnetic resonance imaging scans admitted to our hospital from May 2018 to June 2019,clinical risk factors were recorded.MoCA was tested for cognitive function assessment.MoCA score≥26 was divided into normal cognitive function group,MoCA score<26 was divided into cognitive dysfunction,and both groups were scanned with susceptibility weighted imaging.Analyze the clinical risk factors that affect the MoCA score and the relationship between the number,incidence, anatomic location and MoCA score of cerebral cerebral microbleeds.Results　There was a statistical difference in the years of education between the two groups of patients (P<0.05).The number of cerebral microbleeds lesions and the positive of cerebral microbleeds lesions were negatively correlated with the MoCA score (P<0.05).There was a negative correlation between basal ganglia microbleeds and MOCA score (P<0.05).Conclusion　Few years of education may be an independent risk factor for cognitive dysfunction,and cerebral microbleeds are closely related to the occurrence of cognitive dysfunction.