Objective To investigate the relationship between CRP and CK-MB among acute and stable patients with COPD in Nanjing city. Methods Using case-control design, 81 COPD patients and 71 normal controls were selected. Both fasting venous and arterial blood samples were collected for COPD patients at the acute and the stable stage separately, while fasting venous blood samples were collected for controls during medical examination. The concentrations of CRP, CK-MB or PaO2 of all blood samples were examined. Results The concentration of CRP and CK-MB were significantly higher among stable COPD patients (7.18?5.62, 10.92?5.33; respectively) than those among controls(3.00?0.91, 3.11?1.46; respectively), while acute patients (51.22?24.53,30.06?16.68; respectively) got much higher concentration of CRP and CK-MB than stable patients did. However, PaO2 was significantly higher among stable COPD patients than that among acute patients. For acute COPD patients, the concentration of CK-MB positively correlated with CRP, while PaO2 negatively correlated with CRP and CK-MB separately. Conclusions CRP and CK-MB were sensitive predictors of COPD status to the transition from stable to acute stage of COPD, and both negatively correlated with PaO2 among these sample COPD patients.

Objective To investigate the prevalence and influencing factor of metabolic syndrome(MS)in rural elderly population. Methods With randomized cluster sampling,investigations including questionnaires,physical examination,fasting plasma glucose,blood lipids were performed in rural population aged over 60 years in Changzhou city in 2004-2005. Results A total of 4976 elderly people were enrolled in the study.The prevalence of MS was 24.1%,and 10.3%in men,34.3%in women by international diabetes federation(IDF)2005 definition.86.2%individuals had one or more of the metabolic disorders.Logistic regression analysis showed that sex,smoking,sweetmeat,family history of essential hypertension(EH)and tea drinking were influencing factors of MS. Conclusions The prevalence of MS is high in rural elderly population,especially in females.

Objective To analyze the projects on the infectious disease epidemiology sponsored by the National Natural Sci?ence Foundation of China(NSFC),explore the hotspot and development trend,and offer a reference for researchers in this field. Methods Based on the NSFC database,the projects on the infectious disease epidemiology(H2609)sponsored from 1987 to 2014 were analyzed. The changes of fund numbers,amounts and research fields were described. Results During the study period,NSFC sponsored 373 projects,including 228 general projects(61.1%),78 youth projects(20.9%)and 67 other projects(18.0%). The average amount of the grant was 358.2 thousand Yuan(20 thousand?8 million). The main sponsored re?search fields were mechanisms of pathogen and immunity(36.2%)and population?based epidemiological studies(33.0%). The top three diseases were hepatitis,HIV/AIDS and tuberculosis. Conclusion The amount of funding on researches of infectious disease epidemiology has increased continuously,which has played an important role in training scientific talents in the field of prevention and control of infectious diseases.

Objective To establish a discriminant method based on clinical and laboratory data and common examinations for early predicting the severity of pediatric infection. Methods Consecutive hospitalized patients diag-nosed as septic shock were included who were admitted between June 2014 and May 2015 retrospectively. Gender (male - female ratio:1. 25∶ 1. 00)and age(1 month to 6 years old)were matched in all of 18 patients with septic shock,and 27 patients diagnosed as systemic inflammatory response syndrome(SIRS),sepsis and severe sepsis on ad-mission were included respectively in order of sequential admission number during the same period. Additional 36 gen-der - and age - matched children with common infection(non - SIRS)were enrolled as controls. The clinical and labo-ratory examination data of all the included patients were collected and then the pediatric critical illness scores(PCIS) were made according to the worst condition within 24 hours of hospitalization. The parameters correlated with the severi-ty of infection were evaluated by rank correlation and Logistic regression analysis. The discriminant models were estab-lished based on κth - nearest - neighbor analysis and evaluated with clinical diagnosis by interrater agreement test. Results Except for platelet count,the other indexes including PCIS,neutrophil count,C - reactive protein,procalcito-nin(PCT),international normalized ratio of prothrombin time,activated partial thromboplastin time,thrombin time,fi-brinogen,fibrin/ fibrinogen degradation product(FDP)and D - dimer(D - D)all had differences among groups with varying infection severity(all P ﹤ 0. 001). The Spearman's coefficient ρ of PCIS,PCT,D - D and FDP correlated to in-fection severity were - 0. 837,0. 680,0. 679 and 0. 648,respectively(all P ﹤ 0. 001). Multivariate cumulative odds Lo-gistic regression analysis showed PCIS,D - D and PCT were related to infection severity(all P ﹤ 0. 05). The total error rate of discriminant models based on 3 - index combination(Mahalanobis transformation,k = 2)was 0. 091 that was lower than any models based on 2 - index combination or single - index. Using the discriminant model based on three -index combination,the infection severity of 26 patients admitted during June 2015 were predicted with a high interrater a-greement(weighted Kappa coefficient:0. 670,P ﹤ 0. 001)compared to clinical diagnosis. Conclusion The discriminant model based on combination of PCIS,D - D and PCT could assist predicting the severity of pediatric infection earlier.

Objective To investigate the biosafety-related knowledge level of teachers,technicians and graduate students of medical colleges in Jiangsu province and to explore policy for management of laboratory biosafety in medical colleges.Methods In total of 550 teachers,technicians and graduate students from 5 full-time medical colleges were enrolled using a multiple-stage stratified random sampling method.Each subject was asked to complete questionnaire consisting of laboratory biosafety rules,safety consciousness,route of transmission,waste management and biosafety training,etc.Results The general awareness rate was 54.38%.The percentage of awareness in laboratory biosafety rules,safety consciousness,route of transmission were 27.58%,27.68% and 10.23%,respectively.The awareness rate in reagents toxicity was the lowest(7.21%).However,the awareness rate in protecting rules and waste management were as high as 83.77% and 76.90%,respectively.About 96.30% of the respondents considered that it would be necessary to launch a biosafety course in medical colleges.Conclusions The results showed that the awareness in laboratory biosafety among teachers and students of medical colleges still need to be improved.Propaganda and training of laboratory biosafety should be performed regularly to improve the general awareness and strengthen management.

OBJECTIVE To acquaint pathogen distribution of infection and present drug-resistance conditions of the commonly encountered pathogens.METHODS The statistics of the antimicrobial susceptibility testing of all the clinical isolates from Jan to Nov 2006 in our hospital was condncted.RESULTS Totally 1850 bacteria strains were isolated.From them 620(33.51%) were Gram-positive bacteria,1230(66.49%) were Gram-negative bacteria,25.8% of which were Escherichia coli,8.1% of which were Staphylococcus epidermidis,7.5% were Klebsiella pneumonice and 7.2% were MSSA;Statistics of drug sensibility test suggested,Gram-positive cocci isolated from the clinical issue be highly sensitive to vancomycin,teicoplanin and nitrofurantoin.They were still sensitive to rifampicin.and lower sensitive to other antibiotics.Gram-negatives were high sensitive to imipenem.They were still sensitive to piperacillin/tazobactam and the third-generation cephalosporins.CONCLUSIONS The drug resistance of the isolates is severe.It is suggested that there be ungent need for surveillance of bacterial resistance and rational use of antimicrobial agents be emphasized during clinical therapy.

Objective　To investigate the association betwee n the β3-adrenergic receptor gene (β3-AR) and obesity. Methods　147 patients with obesity and 106 controls were selected. Genotype of the β 3-AR was determined by polymerase chain reaction (PCR) and restriction fragme nt length polymorphism methods (RFLP). Body mass index (BMI) was detected. Results　The frequency of Arg64 allele of β3-AR gene in the obesit y g roup (20.3%) was significantly higher than those in the control group (10.2%) ( P=0.001) . The distribution of Trp64Arg and Arg64Arg genotype in the patient group (38.7% and 0.9%) were both higher than that in the control group (19.0% and 0.7%). In the female subj ects, the Trp64Arg mutation and frequency of Arg64 allele of the β3-AR gene in the obesity group(40.6% and 20.3%) were also higher than those in control (16 . 7% and 9.5%)(P<0.01). Conclusions　These results suggest th at the Trp64Arg mutation of the β3-adrenergic-receptor gene may be associat ed with increased body fat.

Objective To survey on satisfaction degree of preventive medicine undergraduates on tutorial system and to improve the effects of tutorial system.Methods Totally 73 students of preventive medicine,who would graduate in 2012,were asked to fill the questionnaires by themselves.Main contents of questionnaires include effects,satisfaction score,expectations and reality benefits,requirements for the tutors and problems of the tutorial system.Chi-square was used to test the differences between expectations and reality benefits and the significance level was set as P ＜ 0.05.Results More than half of the students thought that the effect of tutorial system was general while 43.8％students thought good and excellent.Percentages of satisfaction score over 50,over 80 and over 90 were 75.3％,41.1％ and 12.3％,respectively.Statistical analysis shown that the real benefits from research activities were more than expectation (P ＜ 0.001),while the real benefits from tutor's academic encouragement,job guidance and life values were lower than expectation (P =0.026,P =0.003,P =0.010).Students expected to have more opportunities with the professors in the future.However,there were 17.8％ students hardly attended the activities of tutorial system,in which lack of understanding of tutorial system was the main reason and without enough time was another reason.Conclusions Students basically satisfies with tutorial system and the satisfaction degree needs to be improved.Roles of tutorial system should be fully strengthened by the management department,tutors and students.

Lung cancer is among the most frequently diagnosed cancers worldwide and the leading cause of cancer death in both males and females. Screening for lung cancer coupled with earlier intervention has long been studied as an approach to mortality reduction. However, minimal progress was achieved until recently, when lowdose spiral computed tomography (LDCT) screening demonstrated a 20% reduction in mortality from lung cancer in a randomized controlled trial (RCT), the National Lung Screening Trial, from the United States. On the basis of this finding, LDCT has been recommended for lung cancer screening in high-risk populations by several clinical guidelines. However, results from the following independent RCTs in Europe failed to show consistent conclusions. In addition, intractable problems gradually emerged with the progress of LDCTscreening. This paper summarizes and discusses the main observations and challenges of LDCT screening for lung cancer. Before spreading implementation of LDCTscreening, challenges, including high false-positive rates, overdiagnosis, enormous costs, and radiation risk, must be addressed. Complementary biomarkers and technical improvement are expected in the field of lung cancer screening in the near future.
Early Detection of Cancer ; methods ; Humans ; Lung Neoplasms ; diagnostic imaging ; mortality ; Mass Screening ; methods ; Radiation Dosage ; Randomized Controlled Trials as Topic ; Risk Factors ; Tomography, X-Ray Computed

Objective: Methylotropic yeast pichia pastoris system was used to express recombinant human soluble 4 1BBL protein with biological activity. Methods: According to the nuclear acid sequence coding human soluble 4 1BBL, we cloned the genes with PCR from XG 4 1BBL transfection cell line,then the gene fragment for extracellar domain was subcloned into the PUCm T vector and sequence of s4 1BBL cDNA was confirmed by sequencing. The s4 1BBL gene was inserted into the pPICZ?A , which was transformed into Pichia pastoris GS115 by linearized electroportion.The recombinant protein was identified by the assay of SDS PAGE and Western blot. Costimulating activity of rhs4 1BBL on T cell proliferation in vitro was evidenced by 3 H TdR incorporation assay. Results: The s4 1BBL cDNA was successfully obtained and insected into pPICZ?A. The protein molecular weight of hs4 1BBL in the yeast supernamant was about 21 kD by SDS PAGE analyses,and the specificitity was identified by western blot. Finally, rhs4 1BBL protein could costimulate the proliferation of T cells in vitro. Conclusion: The rhs4 1BBL protein was efficiently expressed in Pichia pastoris (GS115)and showed natural biological activities. And it may provide a valuable materials for further study of 4 1BB/4 1BBL.