PRDI-BFI and RIZ homology domain containing proteins (PRDM) play a key role in cell differentiation and proliferation.Most members of the PRDM gene family are tumor suppressor genes which involved in tumorigenesis and abnormal expression in a variety of tumors.Aberrant DNA methylation often silences these genes,which may occur in the early stage of tumor,Cancer can be reversed by demethylation,which provides a new way for cancer treatment.

This paper introduces a new perspective of case choice in medical ethics teaching,which breaks through the limitations of the choice of teaching cases,chooses the hot-case analogy teaching methods out of medical field,and proves to have received good teaching results.

Objective To study the role of HMGA2 in the occurrence and the progression of uterine leiomyomas.Methods Fifty cases of uterine leiomyomas who met the inclusion criteria(aged 30-50 years old,free from hormone at least for 6 months before surgery,no other diseases,postoperative pathological diagnosis as uterine leiomyoma) admitted to our hospital from January to July 2003 were studied.The expression of HMGA2 mRNA in uterine leiomyomas and neighbour normal myometrium was detected by ISH.Results HMGA2 mRNA was strongly expressed in 30 cases of uterine leiomyomas but not expressed in neighbour normal myometrium.There was no difference in HMGA2 mRNA between proliferative stage and progestational stage.Conclusion The increased expression of HMGA2 in uterine leiomyomas may be important in the occurrence and the progression of uterine leiomyomas.

Aim To investigate the pharmacokinetics of dipfluzine hydrochloride,a novel piperazines calcium antagonist.Methods Eighteen Beagle dogs were randomly divided into three groups,which were administered with dipfluzine hydrochloride at iv single dose of 1.5,3.0 and 6.0 mg?kg-1,respectively.The blood was collected at different time.A RP-HPLC method was developed to determine the concentration of dipfluzine hydrochloride in plasma.The pharmacokinetic parameters were calculated by 3P97 software.Results The specificity,lowest limit of detection and quantification,extraction recoveries,the precision of intra-and inter-day and stability were qualified to the pharmacokinetic study.The concentration-time courses of dipfluzine hydrochloride were best fitted to a two-compartment open model at three doses.The main pharmacokinetic parameters at three doses were 24.7,24.2 and 29.6 h for T12?,0.44,1.12 and 2.86 g?min?L-1 for AUC,1.30,1.22 and 1.28 L?kg-1 for Vc,and 3.4?10-3,2.7?10-3 and 2.1?10-3 L?kg-1?min-1 for CL,respectively.Conclusions The developed RP-HPLC method for determination of dipfluzine hydrochloride in plasma can satisfy the requirement of pharmacokinetic study after iv dipfluzine hydrochloride.Analysis of plasma concentration-time curves indicates a biphasic decrease.There was a linear relationship between AUC and dosage.

Objective To investigate the value of hs-CRP in the assessment of risk stratification,coronary artery disease severity and prognosis for patients undergoing PCI with coronary heart disease.Methods A total of 150 coronary heart disease patients were recruited in the study,who had undergone PCI,and before that all the patients had undergone coronary angiography,and the levels of hs-CRP,TG,LDL-C,HDL-C,NT-proBNP and hs-cTnT were measured.Patients were divided into three groups according to the serum concentration of hs-CRP.Gemini score was used to determine the degree of stenosis.After PCI,patients were followed up for 6 months,the major cardiovascular events(MACE)were recorded.The relationships between hs-CRP and other coronary risk factors,Gemini score,vasculopathy count,MACE events were analyzed.Results The serum concentrations of hs-CRP and HDL-C, hs-cTnT were significantly correlated(r=-0.17,0.42,P <0.05).The level of hs-CRP had increasing tendency with the increase of Gensini score,and the serum concentration of hs-CRP in severe vascular lesions group was significantly higher than both mild vascular lesions group and moderate vascular lesions group(P <0.05).The serum concentration of hs-CRP in single-vessel disease patients,double-vessel disease patients and multi-vessel disease patients were (4.64±5.39),(9.86±8.75),(14.93±10.34)mg/L, there was significant difference among them(P <0.05 ).The correlation coefficients of hs-CRP and Gemini score was 0.21 (P <0.05),while hs-CRP and vasculopathy count was 0.18(P <0.05).The incidence of MACE in three groups were 18.52%,43.75%and 58.66%,which were statistically significantly difference(χ2 =13.42,P =0.001).Logistic regression showed that hs-CRP was an independent risk factor for MACE(OR =2.05,95%CI :1.24 -3.39,P =0.005).Conclusion Hs-CRP is an independent risk factor for coronary heart disease in patients with MACE after PCI,and hs-CRP was correlated with PCI patient′s vascular disease. Hs-CRP can be used as an indicator in the assessment of patient′s condition,PCI risk stratification and prognosis.

Objective To investigate the effects of extended nursing based on relationship, information and management on the self-care behaviors of patients with heart valve replacement. Methods According to admission time, 37 patients with heart valve replacement were set as the control group, which was given routine nursing intervention and another 42 patients as the study group, which received extended nursing based on the trinity of relationship, information and management 2~8 weeks after discharge. Before and after intervention, patients were evaluated by using the improved version of self-care behavior evaluation scale of heart disease (SNBAOHD). Result There were significant differences between the two groups in other items of SNBAOHD, except two items of low salt diet and medication (P<0.05). Conclusions Extended nursing after discharge based on the trinity of relationship, information and management can help the patients to be continuously cared. In this case, it is effective for the enhancement of off-hospital self-care ability and prevention of disease relapses.

Objective: To evaluate the false positive rate and false negative rate of the Chinese version of the 12-item General Health Questionnaire (GHQ-12) and the related factors in the epidemiological survey of mental ill-nesses in Zhejiang Province. Method: A total of 15000 subjects were randomly selected from the province-wide using multi-stage stratified cluster randomization. Analyses for this paper were made in the quality control sample,10% of the total 15000 subjects (1510 subjects) in which the Chinese version of Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders (SCID) was used as a golden criterion, and a cutoff score of the GHQ-12 was set to ≥ 3 to define GHQ-12 cases. Results: Totally 1449 subjects (96.0%) completed both the GHQ-12 and the SCID. Adjusted for sampling effects, the false positive and negative rates of the GHQ-12 were respective 14.6% and7.8%. Adjusted for other considered correlates and sampling effects, the adjusted odds ratios (AORs) of GHQ-12 false positive with living in less economically developed urban areas (urban type Ⅱ), with self-reportedly poor physical health, with having ever sought help because of mental problems and with being currently married/co-habited were respective 2.23 (95% CI:1.24～4.01), 2.36(1.36～4.10), 1.53 (1.10～2.14) and 0.51 (0.30～0.86) while AORs of GHQ-12 false negative with being aged 35～49 year group and living in less econom-ically developed rural areas (rural type Ⅲ) were respective 2.59 (1.18～5.67) and 2.72 (1.21～6.14). Conclusion:Factors related to the GHQ-12 false positive and negative are different. The cutoff scores of the GHQ-12 should be used based on the characteristics of subjects during identifying or screening mental illnesses.

Objective To investigate the predictive value of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) for nursing workload in emergency intensive care unit (EICU).Methods A retrospective cohort study was conducted. Critical patients except for trauma admitted to EICU of West China Hospital of Sichuan University from June 2012 to July 2016 were enrolled. APACHE Ⅱ score and therapeutic intervention scoring system (TISS-28) score were calculated in each case. The relationship between APACHE Ⅱ score and TISS-28 score was analyzed by correlation analysis and curve estimation.Results A total of 1148 patients were enrolled, including 689 male (60.0%), and age of (56±19) years old, APACHE Ⅱ score was 19 (13, 25), and TISS score was 19 (13, 25). The Spearman correlation coefficient between APACHE Ⅱ score and TISS-28 score was 0.849 (P < 0.001), and that among the linear model quadratic model, composite model, growth model, logarithm model, cubic model and exponential modelR2 were 0.669, 0.710, 0.792, 0.764, 0.765, 0.765, respectively (allP < 0.01), and the most suitable description for relationship between APACHE Ⅱ score and TISS-28 score curve was cubic model. The nursing workload was significantly increased when APACHE Ⅱ score ≥30, and it was decreased when APACHE Ⅱ score < 30.Conclusion APACHE Ⅱ was a useful score for predicting the nursing workload in EICU.

Objective:To explore the application effect of medical science competition in nursing interns whocontribute to "healthy China" , and to improve their health education awareness, ability, method and self-confidence.Methods:A total of 205 nursing interns who worked in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2019 to 2020 were selected as the research objects. They were divided into the control group (105 cases) and the experimental group (100 cases) according to whether they participated in the medical science competition. The control group learned the form and method of health education in clinical rotation according to the traditional practice teaching plan. The experimental group volunteered to participate in the medical science competition, which required the dissemination of health knowledge through various forms. Before and after the competition, the health education ability assessment scale was used for comparison.Results:Before the medical science competition, there was no significant difference in the total score of assessment, planning, implementation, evaluation and health education between the control group and the experimental group ( t values were 0.765 - 1.749, all P>0.05). After the medical science competition, the total scores of assessment, planning, implementation, evaluation and health education ability of nursing interns in the experimental group were (24.38 ± 4.72), (17.98 ± 3.98), (25.16 ± 5.36), (12.57 ± 2.96) and (80.09 ± 15.65) respectively, while those in the control group were (22.45 ± 6.29), (16.61 ± 4.77), (23.04 ± 6.55), (11.31 ± 3.46) and (73.41 ± 19.69).The differences between the two groups were statistically significant ( t values were 2.226 - 2.795, all P<0.05). Conclusions:The medical science competition can improve the health education ability of assessment, planning, implementation, evaluation of nursing interns and contribute to "healthy China" .

Objective:To investigate frailty status of the elderly patients with leukoaraiosis (LA) and to analyze the correlation between white matter hyperintensities and their frailty status.Methods:From June 2019 to September 2020, a total of 162 patients with leukoaraiosis over 65 years old were screened by cranial MRI.The Fried frailty phenotype was used to evaluate their frailty status.The Fazekas scale scoring method was used to independently assess the periventricular white matter hyperintense (PVH) and deep white matter hyperintense (DWMH) by the cranial MRI images.SPSS 22.0 software was used for statistical analysis.ANOVA test was used to compare normal distribution data between groups, and Kruskal-Wallis H test was used to compare non-normal distribution data between groups.Spearman rank correlation analysis was used to analyze the correlation between PVH and DWMH scores and Fried frailty phenotype score. Results:Among 162 elderly patients with leukoaraiosis, 46 patients (28.40%) were non-frailty, 76 patients (46.91%)were pre-frailty and 40 patients (24.69%) were frailty.There were statistically significant differences in age( F=9.382, P<0.01), number of chronic diseases( H=10.736, P<0.01), number of medication ( H=15.927, P<0.01) and mini-nutritional assessment short form (MNA-SF) scores( F=5.263, P<0.01) among older LA patients with different frailty phenotype.There was statistical difference in PVH scores in elderly LA patients with different frailty phenotype (χ 2=108.537, P<0.01), but no significant difference in DWMH scores (χ 2=4.239, P>0.05). Spearman correlation analysis showed significant positive correlation between PVH score and frailty phenotype score in elderly LA patients ( r=0.718, P<0.001). Conclusion:Elderly LA patients have a high incidence of frailty, which may be related to aging, multi-disease coexistence, multiple medication, nutritional risk and other factors.The occurrence of weakness in elderly LA patients is related to periventricular white matter lesions, and the more serious the white matter damage, the more obvious the degree of frailty.