Objective To investigate the effect of blood glucose level on pulmonary diffusion capacity in elderly patients with type 2 diabetes and its clinical significance.Methods Totally 132 older adults with type 2 diabetes were enrolled in this study.According to blood glucose level,the patients were divided into well-controlled group (n =57) and poor controlled group (n =75).Additionally,52 age-matched non-diabetic healthy subjects were selected as control group.Levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) and 2-hour postprandial glucose (2h PG) in the diabetic patients were detected,and homeostasis model assessment of insulin resistance (HOMA IR) was calculated.The patients with type 2 diabetes underwent urinary albumin excretion rate (UAER) detection,fundus examination and nerve conduction velocity test.pulmonary ventilation,diffusion of the lungs for carbon monoxide (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were examined in all subjects.Results Levels of FBG,2h PG,HbA1c and HOMA-IR were higher in poor-controlled group than in good glycemicwell-controlled group (all P＜0.05).Compared with the control group,body mass index (BMI) was increased in diabetic groups (both P＜0.05).The pulmonary ventilation function in the three groups had no significant differences (P＞0.05).DLCO and DLCO/VA were lower in diabetic groups than in the control group(all P＜0.05).DLCO and DLCO/VA in poor-controlled group were lower than those in well controlled group (both P＜0.05).DLCO and DLCO/VA were lower in patients with microangiopathy score ≥ 2 than those without microangiopathy (both P ＜ 0.05).Multiple liner regression analysis showed that DCLO and DLCO/VA were negatively correlated with HbA1c,HOMA-IR,duration of diabetes and microangiopathy (r=-2.51,-2.35,-2.42,-2.37,-2.41,-2.52,-2.47,-2.36,all P＜0.05).Conclusions The pulmonary diffusion capacity is significantly impaired in elderly patients with type 2 diabetes.Pulmonary diffusion capacity is negatively correlated with the blood glucose level.The lung may be one of the target organs of type 2 diabetes mellitus.

ObjectiveTo evaluate the effect of Rhubarb associated preparations (rhubarb or prescriptions of traditional Chinese medicine including rhubarb) on sepsis patients with acute gastrointestinal dysfunction (AGI).Methods The retrieval of databases from libraries including PubMed, Medline, Cochrane Central Register of Controlled Trials, CNKI, CBMdisc, Wan Fang Database, VIP database were searched to identify randomized controlled trials (RCTs) about Rhubarb associated preparations for treatment of sepsis patients with AGI from the foundation of the various databases to March 2016. And in the mean time, the references of the studies accepted were also retrieved. The retrieving and screening of literatures were performed independently by two researchers, the methodological quality and data extraction of the enrolled literatures were assessed by Jadad scale, and Cochrane Collaboration 5.3 software was used to perform Meta analyses to observe the effects of rhubarb associated preparations on gastrointestinal function score, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score and 28-day mortality in sepsis patients with AGI; the bias of published literatures was evaluated by funnel plot.Results ① Finally, 16 studies involving 1 171 patients (610 in rhubarb preparation group and 561 in the control group) were identified and enrolled. 12 studies had a Jadad score ≥ 3 and 4 studies < 3. The random method was used in classification of groups in all the studies in which the intergroup baseline data being comparable was clearly indicated. The blind method was applied in 5 contained RCTs.② The results of Meta-analyses showed that rhubarb associated preparation could improve gastrointestinal function score [mean difference (MD) = -0.52, 95% confidence interval (95%CI) = -0.55 to -0.48, P < 0.000 01], reduce the APACHEⅡ score (MD = -3.66, 95%CI = -5.00 to -2.33,P < 0.000 01) and 28-day mortality [odds ratio (OR) = 0.46, 95%CI = 0.30 to 0.71,P < 0.000 01] compared with those in the control group, the differences being statistically significant. No publication bias was seen in 16 literatures containing RCTs from the funnel plot.Conclusions Compared with the control group, the rhubarb associated preparations combined with conventional theraph can significantly improve the gastrointestinal function score, reduce APACHE Ⅱ score and 28-day mortality of sepsis patients with AGI, which suggests the rhubarb associated preparations have better efficacy. In addition, the result of sensitivity analysis has not substantially changed the results of Meta-analysis.

Objective To investigate the cross-talk between extracellular signal-regulated kinase (ERK) and nuclear factor κB (NF-κB) signal transduction pathways in A375 human melanoma cells.Methods Cultured A375 cells were randomly divided into 5 groups:control group receiving no treatment,two U0126 (a selective inhibitor of the ERK signaling pathway) groups treated with U0126 of 10 and 5 μmol/L,and two BMS-345541 groups treated with BMS-345541 of 10 and 5 μmol/L.After 24-hour treatment,Western blot and reverse transcription PCR were performed to measure the protein expressions of NF-κB P65,phosphorylated IκBα (p-IκBα),ERK1/2,as well as p-ERK1/2,and the mRNA expressions of NF-κB P65 and ERK1,respectively.One-way analysis of variance and least significant difference (LSD)-t test were carried out for statistical analysis.Results After 24 hours of treatment with U0126 of 10 and 5 μmol/L,a significant decrease was noted in the relative expression level of NF-κB p65 protein (0.60 ± 0.04 and 0.56 ± 0.06 vs.1.54 ± 0.15,both P＜ 0.01) and mRNA (0.79 ± 0.05 and 0.75 ± 0.04 vs.0.86 ± 0.05,both P ＜ 0.01),but a statistical increase in that of p-IκBα protein (0.90 ± 0.05 and 0.70 ± 0.02 vs.0.61 ± 0.03,both P ＜ 0.01) in the two U0126 groups compared with the control group; significant differences were observed in the expression level of p-IκBo protein (P ＜ 0.01) but not in that of NF-κB p65 protein (P ＞ 0.01) between the two U0126 groups.The relative expression levels of ERK1/2 and p-ERK1/2 proteins as well as ERK1 mRNA were significantly higher in the control A375 cells than those in the cells treated with BMS-345541 of 10 μmol/L (0.73 ± 0.07,0.75 ± 0.09,1.51 ± 0.02,all P ＜ 0.01),but similar to those treated with BMS-345541 of 5 μmol/L (0.94 ± 0.11,0.99 ± 0.04,1.62 ± 0.03,all P ＞ 0.05).Conclusion There is a cross-talk between ERK and NF-κB signal transduction pathways in A375 melanoma cells.

Medical education of PhD candidates is of great importance to medical personnel training in our country. With the development of society, the progress of science and technology and renewal of knowledge, cultivation of innovative talents and improvement of graduate education quality is priority nowadays. This paper reflects on the progress we’ve made on medical education of PhD candidates. Though efforts have been made to improve the innovative ability of talents in our country gradually, we still need to be more innovative, more consistent and more scientific in the future. According to the state Degree Requirements and our goal of talent training, we should combine courses with scientific research systematically, pay more attention to scientific methodology and academic training, finally form a better training mode of PhD candidates majoring in medical science.

Objective:To seek the effect of group education under the BOPPPS model(bridge-in, objective, pre-assessment, participatory learning, post-assessment, summary) on the breastfeeding competency of first gestation women, to improve the breastfeeding competency of first gestation women and promote the realization of postpartum breastfeeding.Methods:Eighty-one first gestation women were chosen from the gestation class of the First Affiliated Hospital of Shanxi Medical University, the quasi-experimental research method was adopted, 40 women from January to February 2022 were involved in the control group and 41 women from May to June 2022 were involved in the intervention group. The control group was assigned common education, while the intervention group was assigned group education based on BOPPPS model. Breastfeeding Competency Scale (BCS) and breastfeeding family support questionnaire were used to compare breastfeeding competency and family support level of the two groups before and after intervention, and the skin contact rate at 1 hour after delivery and the pure breastfeeding rate at 42 days after delivery were compared between the two groups.Results:Before intervention, there was no significant difference in breastfeeding competency and family support level between the two groups (all P>0.05). After 4 weeks of intervention, the scores of breastfeeding competency and family support were (147.59 ± 13.50), (3.16 ± 0.18) points in the intervention group, more than those in the control group (125.48 ± 16.87), (2.87 ± 0.22) points, the differences were statistically significant between the two groups ( t=-6.52, -6.30, both P<0.05). The skin contact rate at 1 hour after delivery and the pure breastfeeding rate at 42 days postpartum were 75.6%(31/41), 53.7%(22/41) in the intervention group, more than those in the control group 52.5%(21/40), 30.0%(12/40), the differences were statistically significant between the two groups ( χ 2=4.71, 4.65, both P<0.05). Conclusions:Group education based on BOPPPS model can improve the level of breastfeeding competency and family support of gestation women. It increases the skin contact rate, and plays a good role in promoting the increase of pure breastfeeding rate.

Objective: To explore the related factors of death from severe heat stroke in Shanghai from 2013 to 2017. Methods: The data of 1 152 patients with severe heat stroke who were divided into survival (n=1 037) and death (n=115) groups including gender, age and heat stroke type (heat cramp, heat exhaustion, heat apoplexy and the mixed type) were collected from meteorological bureau and case report system for high temperature heat stroke in Shanghai from 2013 to 2017. Meanwhile, the meteorological data of the onset date of severe heat stroke cases were collected, including maximum temperature, minimum temperature, daily temperature, relative humidity, air pressure, precipitation and wind speed. The differences of individual and meteorological factors between the two groups were compared, and multivariate logistic regression model was used to analyze the related factors of death from severe heat stroke. Results: Among 1 152 cases, the mean±SD of age was (56.29±18.95) years old, 843 (73.18%)were male, 962 (83.51%) were in the heat wave period; 322 cases (27.95%) were heat cramp, 170 cases (14.76%) were heat exhaustion, 533 cases (46.27%) were heat apoplexy and 114 cases (9.90%) were the mixed type. Daily average temperature ((32.81±1.99) ℃), daily maximum and minimum temperatures ((38.20±2.24) ℃ and (29.22±1.94) ℃) in survival group were lower than those in death group (all P values<0.001), which were (33.76±1.17) ℃, (39.19±1.31) ℃ and (29.72±1.66) ℃. Daily average relative humidity ((60.36±9.75)%) and daily minimum relative humidity ((41.26±9.71)%) in survival group were higher than those in death group(allP values <0.05), which were (54.59±6.89)% and (35.60±7.24)%. The results of logistic regression analysis suggested that compared with the cases with daily average humidity <60% and a mixed type heat stroke, the death OR (95%CI) values of cases with daily average humidity >60%, heat cramp, heat exhaustion and heat apoplexy were 0.31 (0.18,0.54), 0.13 (0.05,0.34), 0.68 (0.58,2.30) and 0.87 (0.48,1.58). Conclusion The temperature, relative humidity and the type of heat stroke were the main related factors affecting the prognosis of severe heat stroke.

Objective:To prepare 18F-Alfatide Ⅱ automatically based on the improved CFN-100 fluorine multifunctional module and assess its PET/CT imaging in prostate cancer patients. Methods:A certain volume (200-500 μl) of fluoride ion was separated into the reaction tube by a fluoride ion separator and reacted with the labeled precursor l, 4, 7-triazacylononane-1, 4, 7-triacetic acid-E[(polyethylene glycol) 4-cyclo(Arg-Gly-Asp- D-Phe-Tyr)] 2(NOTA-E[PEG 4-c(RGDfk)] 2) (lyophilized kit). In the aqueous phase, 18F was chelated with aluminum. After being separated and purified by C18 column, 18F-Alfatide Ⅱ was prepared automatically. The radiochemical yield and its quality were analyzed. Quality control was carried out and 18F-Alfatide Ⅱ PET/CT imaging was performed in 2 patients (72 and 66 years old)with prostate cancer. Results:18F-Alfatide Ⅱ was prepared automatically by the improved CFN-100 fluorine multifunctional module combined with a double channel-fluorine ion separation device. 18F-Alfatide Ⅱ was synthetized in about 30 min, with radiochemical yield of (28±3)% (non-decay corrected, n=6). The radiochemical purity of the product was more than 98%, the specific activity was 2.8×10 7 MBq/mmol and the nuclear purity was >99%. PET/CT imaging of 2 patients showed that 18F-Alfatide Ⅱ were highly concentrated in prostate cancer lesions with the maximum standardized uptake value (SUV max) of 35.6 and 5.0, respectively. Conclusion:18F-Alfatide Ⅱ can be prepared successfully by improved CFN-100 fluorine multifunctional module with stable synthesis method, short synthesis time and high radiochemical yield, which can be highly concentrated in prostate cancer.

Background Non-occupational carbon monoxide (CO) poisoning is a public health problem that seriously affect people’s health and lives. Objective To describe the prevalence of non-occupational CO poisoning during 2007—2018 in Shanghai, analyze its epidemiological characteristics and potential influencing factors, and explore effective prevention and control measures. Methods Daily reported non-occupational CO poisoning cases and meteorological factors from 2007 to 2018 were collected in Shanghai, epidemiological characteristics were analyzed by descriptive epidemiology methods, and a distributed lag nonlinear model was used to assess the association between temperature and non-occupational CO poisoning. Results A total of 2264 non-occupational CO poisoning events and 3866 cases from 2007 to 2018 were reported in Shanghai, including 59 death cases. More than half of the poisoning cases were female (56.3%), and young adults accounted for more cases than any other age group (54.8%). The poisoning events mainly occurred in winter (from December to next February); however, cases reported in summer increased in recent years. The peak period of the events was from 20:00 to 24:00. Households (85.2%) and restaurants (8.0%) were the common places of non-occupational CO poisoning events, and the main cause was improper use of gas water heater (36.9%). A nonlinear curve was found between daily average temperature of current day and the occurrence of non-occupational CO poisoning. Temperature was negatively associated with the risk of non-occupational CO poisoning when the temperature was lower than 9.6 ℃, while a positive association was found during 9.7-26.0 ℃. Conclusion Winter is a high season for non-occupational CO poisoning in Shanghai, rising cases reported in summer is also worthy of attention. Supervision should be strengthened to ban sales of unqualified gas water heaters, and health education on CO poisoning prevention and control should be conducted through multiple channels, in order to reduce the incidence of CO poisoning.

BACKGROUND: Venous thromboembolism (VTE) is a recognized complication in lung cancer patients with higher morbidity and mortality. The purpose of this study is to determine the incidence of lower extremity venous thrombosis (LEDVT) in lung cancer patients and to reveal the risk factors for LEDVT during admission in our center. METHODS: We first connected 231 patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from July 2017 to December 2017. All these patients underwent color ultrasound examination of lower extremity vein on admission to analyze the incidence of LEDVT. At the same time, the incidence of LEDVT in patients with benign lung diseases on admission was used as control. In order to explore the possible risk factors for LEDVT in these patients with lung cancer, we further analyze the correlations between LEDVT and their clinical features. At the same time, we also analyze the relationship between LEDVT and Plasma D-Dimmer, fibrinogen (FIB), thrombin time (TT), activated partial thrombin time (APTT), prothrombin time (PT) and platelet (PLT) in these patients with lung cancer. RESULTS: Among 231 patients with lung cancer, the incidence rate of LEDVT on admission was 5.2% (12/231), and in 77 patients with benign lung disease, there was none of patients with LEDVT on admission. This result indicated that the admitted incidence rate of LEDVT in patients with lung cancer was significantly higher than that in patients with benign lung disease (P<0.05). Further analysis in patients with lung cancer found that there was higher incidence rate of LEDVT in distant metastasis group (including N3 lymph node metastasis) compared to in non-distant metastasis group (11.29%, 7/62 vs 2.96%, 5/169) (P<0.05). In patients with lung cancer, the median value of D-Dimer in LEDVT group was 1,534 mg/L (369 mg/L-10,000 mg/L), which was significantly higher than that in the non-LEDVT group (539 mg/L, 126 mg/L-1,000 mg/L) (P<0.05). There was no statistically significant difference in FIB, TT, APTT, PT and PLT between these two groups (P>0.05). CONCLUSIONS The overall incidence of LEDVT in our central lung cancer patients was approximately 5%, significantly higher than that in patients with benign lung disease. Lung cancer patients with distant metastasis (including N3 lymph node metastasis) at admission were more likely to develop LEDVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.
Female ; Humans ; Incidence ; Lower Extremity ; Lung Neoplasms ; surgery ; therapy ; Male ; Middle Aged ; Patient Admission ; Risk Factors ; Tomography, X-Ray Computed ; Venous Thrombosis ; diagnostic imaging ; etiology