Objective:To investigate the relationship between prolonged PR interval and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 537 middle-aged and elderly inpatients with T2DM in the Southern Branch of the Sixth People′s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research objects. Color Doppler ultrasound was used to detect bilateral carotid artery intima-media thickness(CIMT). The subjects were divided into carotid atherosclerosis group(CAS group, n=352)and non-carotid atherosclerosis group(NCAS group, n=185). The difference in the PR interval of ECG between the two groups was compared. Pearson or Spearman rank correlation analysis was used for evaluating the correlation of PR interval and CAS lesions with various clinical index. The relationship between PR interval and CAS lesions was adopted by multivariate logistic regression analysis. Results:The average PR interval of middle-aged and elderly patients with T2DM was(164.57±23.02)ms. The average PR interval in CAS group was significantly higher than that in NCAS group [(169.76±24.28) vs (154.70±16.42)ms, P<0.01]. The results of multifactorial logistic regression analysis showed that age, low density lipoprotein-cholesterol, serum osteocalcin, and PR interval were independent factors influencing the development of CAS lesions in middle-aged and elderly patients with T2DM( OR=1.079, 1.936, 0.879, 1.039, respectively, P<0.05 or P<0.01)where each 1 ms increase in PR interval was associated with a 3.9% increase in the risk of CAS in middle-aged and elderly patients with T2DM( OR=1.039, 95% CI 1.006-1.073, P=0.020). Multivariate logistic regression analysis showed that middle-aged and elderly type 2 diabetic patients with PR interval≥158 ms were 4.072 times more likely to have CAS lesions than those with PR interval<158 ms( OR=4.072, 95% CI 1.417-11.702, P<0.01). Conclusion:The PR interval of electrocardiogram is correlated with CAS lesions in middle-aged and elderly patients with T2DM. Middle-aged and elderly type 2 diabetic patients with significantly prolonged PR interval should be reminded to screen for CAS lesions early.

Objective:To investigate chromosomal aberrations in peripheral blood lymphocytes of underground miners, in order to explore the influencing factors involved in chromosomal aberration levels of non-uranium metal mines.Methods:Totall 135 workers were recruited from an iron mine and a gold mine located in different cities of Henan province, where 69 workers worked aboveground and 66 miners worked underground in the metal mines. The radon concentration in the mines was measured by solid-state nuclear track detectors. Chromosomal aberrations in peripheral blood lymphocytes from the subjects were detected using conventional analysis method, and the influence factors of chromosomal aberrations were analyzed.Results:Radon concentration was 30-2 943 Bq/m 3 in the aboveground workplace of the mines, and 62-28 314 Bq/m 3 in underground. The age of the underground group was obviously lower than that of the aboveground group( t=2.12, P<0.05), but the frequencies of dicentrics, translocation, acentric fragment, and total chromosome-type aberrations in the underground group were significantly higher than those in the aboveground group ( χ2=10.49, 16.74, 8.15, 29.50, P<0.01). Consistent results were obtained when only male workers were regarded as object of observation ( χ2=8.44, 11.63, 4.94, 20.81, P<0.05). The frequency of translocation ( χ2=8.44, P<0.05) was dependent on the length of service in the underground group. Poisson regression analysis indicated that the aboveground and undergroud grouping partly affected the levels of dicentrics, translocation, acentric fragment, and total chromosome-type aberrations (the underground group IRR=3.25, 2.69, 1.97, 2.18, P<0.05). Conclusions:The radon exposure in the underground workplace of the metal mines may be the main factor resulting in the increase of chromosome-type aberrations of miners. The occupational health and safety of the miners who may be exposed to high radon levels are worthy of great attention.

Objective:To evaluate biological dose and retrospective biodosimetry of a case of large area back skin injury caused by suspected interventional procedure.Methods:Peripheral blood from the patient was collected at about 7 months after interventional procedure, and the chromosomal aberrations in peripheral blood cells were analyzed to evaluate the retrospective biodosimetry using the correction factor of dose estimation, Dolphin′s model and Qdr method, respectively. Results:Based on the amounts of semi-automated dic and manually detected dic plus ring, the whole-body average absorbed dose of the victim was estimated to be 0.68-0.95 Gy by four different dose response curves. Over dispersion of dic or dic plus ring was also detected, and the efficiency of dose assessment was obviously increased using dic semi-automatic detection. Based on three different retrospective biodosimetry models, the estimated average absorbed dose was further corrected to be between 1.80-2.86 Gy, which was consistent with clinical diagnosis of degree Ⅳ radiation skin injury.Conclusions:A case of suspected radiation skin injury was confirmed by chromosomal aberration analysis and it’s biodosimetry was reconstructed, suggesting that the unstable chromosomal aberration analysis may be applicable to assess the retrospective biodosimetry of non-uniform local radiation exposure.

Objective:To understand the etiological characteristics of an acute gastroenteritis outbreak.Methods:Real-time polymerase chain reaction (PCR) and bacteria cultures were performed for the samples, including stool samples from patients and cooks, environmental swabs, raw food material (chicken meat), collected during the outbreak. Pulsed-field gel electrophoresis, antibiotics susceptibility test and whole-genome sequencing were performed for the Campylobacter jejuni isolates. Results:Four stool samples from patients were positive for Campylobacter jejuni by real-time PCR, in which 1 Campylobacter jejuni strain was isolated from a case who had no antibiotic treatment. Twelve Campylobacter jejuni and 7 Campylobacter coli isolates were obtained from 4 raw chicken meat samples. The Campylobacter jejuni strain isolated from the case was resistant to nalidixic acid, ciprofloxacin, chloramphenicol, florfenicol and tetracycline. The MLST analysis with the whole-genome sequences confirmed that the Campylobacter jejuni isolate from the case belonged to ST10075. Antimicrobial resistance genes cmeABCR, tetO/M and blaOXA-61 were found in the genome of the isolate from the patient by the whole-genome sequencing. No mutation in 23S rRNA was found and the C257T mutation in gyrA was identified in this isolate. Conclusion:Laboratory analysis indicated that Campylobacter jejuni infection might be the major cause of this gastroenteritis outbreak.

Multidrug resistance (MDR) has been considered as a huge challenge to the effective chemotherapy. Therefore, it is necessary to develop new strategies to effectively overcome MDR. Here, based on the previous research of -(2-hydroxypropyl)methacrylamide (HPMA) polymer-drug conjugates, we designed an effective system that combined drug-efflux circumvention and mitochondria targeting of anticancer drug doxorubicin (Dox). Briefly, Dox was modified with mitochondrial membrane penetrating peptide (MPP) and then attached to (HPMA) copolymers (P-M-Dox). Our study showed that macromolecular HPMA copolymers successfully bypassed drug efflux pumps and escorted Dox into resistant MCF-7/ADR cells endocytic pathway. Subsequently, the mitochondria accumulation of drugs was significantly enhanced with 11.6-fold increase by MPP modification. The excellent mitochondria targeting then resulted in significant enhancement of reactive oxygen species (ROS) as well as reduction of adenosine triphosphate (ATP) production, which could further inhibit drug efflux and resistant cancer cell growth. By reversing Dox resistance, P-M-Dox achieved much better suppression in the growth of 3D MCF-7/ADR tumor spheroids compared with free Dox. Hence, our study provides a promising approach to treat drug-resistant cancer through simultaneous drug efflux circumvention and direct mitochondria delivery.

Objective To understand effects of the interventional operation on thyroid,peripheral blood indexes and chromosomal aberrations (CA) of peripheral lymphocyte of children with congenital heart disease (CHD).Methods Follow-up studies were conducted in 70 child patients undergoing cardiac catheterization and 23 with open heart surgery as control from 2010 to 2013.Postoperative follow-up examinations included thyroid ultrasound,blood routine indexes and analyses of CAs.Results Difference in thyroid ultrasound abnormality rate was not statistically significant between children with cardiac catheterization and control group (40.0％ vs.43.5％,P ＞ 0.05).There was no significant difference in white blood cell (WBC) count between interventional group and control group (P ＞ 0.05).The effects of disease type and operation time on thyroid ultrasound and WBC count were not observed (P ＞ 0.05).The frequency of chromosome aberrations,including acentric fragment,dicentrics and translocation in interventional group [(0.76 ± 0.07) ％],was higher than in control group [(0.25 ± 0.07) ％,(Z =-3.631,P ＜ 0.05],and the rates of acentric fragment and translocation were also higher in interventional group (Z =-2.531,-2.397,P ＜ 0.05).Conclusions Effect of intervention therapy on thyroid structure and WBC count in children with CHD was not observed,but the genotoxic effects remain in children with cardiac catheterization.

Objective To explore the influence of long-term low-dose ionizing radiation on 8-hydroxy-2-deoxyguanosine(8-OHdG) level in the serum of radiation workers in hospitals.Methods 307 age-and sex-matched hospital radiation workers were recruited by stratified random sampling method.After deleting the subjects without dosage information,230 individuals were divided into four groups according to their job title [including diagnostic radiology (n =75),radiotherapy (n =60),nuclear medicine (n =41) and interventional radiology (n =54)].Serum 8-OHdG level was measured by ELISA assay.Results According to the statistical analysis,there was significant difference in the serum 8-OHdG level among four groups (F =9.071,P ＜ 0.05),and the content of serum 8-OHdG was significantly higher in the interventional radiology group than that in the groups of diagnostic radiology,radiotherapy and nuclear medicine (t =-4.473,-3.011,-2.189,P ＜ 0.05).There were significant differences in serum 8-OHdG level among different dose groups and working period groups(F =7.659,3.058,P ＜ 0.05).The serum 8-OHdG levels significantly increased along with exposure dose and working period (r =0.300,0.142,P ＜ 0.05).Conclusions Serum 8-OHdG may be a potential biomarker of oxidative DNA damage in radiation workers exposed to low-dose ionizing radiation.

Objective To discuss the influence of hierarchical management mode on psychological empowerment and innovation behavior of nurses in intensive care unit (ICU). Methods From April 2016 to April 2017, hierarchical management mode was applied among 41 ICU nurses in Shanxi Provincial People's Hospital for 12 months. The levels of psychological empowerment and innovation behavior were compared before intervention, on the 6th and the 12th month after intervention. Results Before the intervention, the score of the psychological empowerment was (3.07±0.46), which was at a middle level. Meanwhile, the score of innovation behavior was (2.91±0.40), which was at a low level. With the implementation of hierarchical management mode, the differences in the scores of each dimension and the total score of psychological empowerment were statistically significant (F=11.463, 27.192, 13.700, 36.609, 45.733;P<0.001). The differences in the scores of each dimension and the total score of innovation behavior were statistically significant (F=43.149, 106.489, 21.836, 80.586;P< 0.001). Conclusions ICU nurses' psychological empowerment is at a moderate level, and individual innovative behavior is at a weak level. Hierarchical management mode helps to improve ICU nurses' psychological empowerment and personal innovative behavior level.

Objective To select the risk factors and focus on the pathogenesis of anterior ischemic optic neuropathy (AION) after cataract surgery.Methods A retrospective review of all patients with phacoemulsification surgery referred to the Ophthalmology Divisions,the First Affiliated Hospital,Zhengzhou University,from September 1,2010 to September 1,2016 was performed.Eligible patients were 11 206 cases(13 320 eyes),30 cases (30 eyes) were complicated with AION after cataract surgery (AION group),and 90 cases (90 eyes) were selected as control group according to the ratio of 1 ∶ 3 by random sequence.Factors of small cup disc ratios,previous surgery history,cardiac disease,diabetes,hypertension,hyperlipemia,smoking,carotid disease and intraocular pressure (IOP) were collected,x2 test,Logistic regression and t test were performed to analyze risk factors for AION.Results Small cup-disc ratios,diabetes,hypertension,hyperlipemia,carotid disease were influencing factors of AION after cataract surgery.Hyperlipemia and carotid disease were risk factors of AION after cataract surgery.There was no significant difference in preoperative intraocular pressure between two groups(all P ＞ 0.05).The intraocular pressure at postoperative 1 day and 7 days in AION group were higher than those in control group (all P ＜ 0.05).Conclusion Hyperlipemia and carotid artery disease are risk factors for AION after cataract surgery,and high intraocular pressure may be the inductive factor of AION.

Objective To establish a homothermal and fast detecting method on pathogenic bacteria by combining recombinase-aid amplification (RAA) with molecular beacon.Methods The establishment of the methodology.Staphylococcus aureus specific primers were designed from the relative region of the staphylococcal protein A (SPA).Asymmetry amplification was optimized by adjusting the primer concentration ratios.The results of amplification and hybridization were visualized and analyzed by agarose gel electrophoresis and fluorescence detection.The sensitivity was identified by detecting dilute positive plasmids.And the specificity was determined using RAA method by detecting 72 pathogenic bacteria,including Staphylococcus aureus and other Staphylococcus spp.from the Department of Clinical Laboratory of Daping Hospital in December 2016.Besides,the Kappa analysis and the clinical diagnosis efficiency were investigated by analyzing 39 extra strains in the laboratory in December 2016.Results When the concentration ratio of restrictive and non-restrictive primer was 1:20,the yield efficiency of single-stranded DNA (ssDNA) reached the peak.And as for the hybridization efficiency,the asymmetry amplification was higher than symmetry amplification.Twenty copies/μl was proposed as the limits of detection by testing dilute plasmids.And the RAA hybridization method could distinguish Staphylococcus aureus with other Staphylococcus spp.Comparing with traditional detection methods with a Kappa index of 0.860,this method shows a good consistency.By analyzing the 111 bacteria,the sensitivity of the method is 92.5％ (37/40),the specificity is 97.2％ (69/71),the positive predictive value is 94.9％ (37/39),the negative predictive value is 95.8％ (69/72),the positive likelihood radio is 33.04,the negative likelihood radio is 0.077,the Youden index is 0.897 and the Kappa index is 0.902.Conclusion Through the combination of asymmetry recombinase-aid amplification optimization and molecular beacon probe,a new method of detecting bacteria DNA with RAA hybridization technique is established,providing the foundation for its clinical application.