Analyzing and discriminating incorrect cases is a good method in medical statistics teaching,which can not only help students review the knowledge they have learned but also guide their self-learning.Teachers can start teaching based on the reverse thinking,propose incorrect cases with moderate difficulty and in accordance with the reality and arouse students' creativity through introducing the incorrect cases,reviewing the incorrect cases and conducting group discussion.

Objective: To analyze the current situation and characteristics of poor vision of students aged 7-18 in 26 ethnic minorities in China, and to provide scientific basis for the vision prevention and treatment measures for minority students. Methods: The 2014 national survey report on student physique and health was used to collect the data of 80 766 primary and secondary school students of poor vision selected from 26 ethnic minorities, The Chi-square test was used to compare and analyze the visual acuity of Han and Chinese students. Results: The rate of poor eyesight among primary and secondary school students of ethnic minorities was 39.17%. The girls were reported with higher rates of visual impairment than boys, and the difference was highly significant(χ2=1 127.28, P<0.01). High school girls (16-18 years old ) had the highest rate of visual impairment, reaching 63.13%. The rate of vision failure was the lowest among boys in the lower grades of primary school (7 to 12 years old), amounting to 20.50%. The detection rate of poor vision in all ethnic groups ranged from 14.68% to 62.94%. Among them, the top five groups with the highest detection rate of poor vision were Tibetan(62.94%), Zhuang(62.39%), Korean(57.92%), Hui(56.48%) and Naxi(51.35%). The five lowest ethnic groups were the aquarium(14.68%), Wa(17.96%), Kyrgyz(18.30%), Li(19.22%) and Hhani(22.30%). The differences among most ethnic groups were highly significant(χ2=7 910.34, P<0.01). Conclusion The vision level of 26 minority students in China is lower than that of the Han. But there are significant ethnic differences. While intervening in Tibet，Zhuang and other key ethnic students, we should pay attention to gender differences and strengthen the prevention and control of vision of students from all ethnic groups.

OBJECTIVETo investigate the effects of hydrogen sulfide (H₂S) on oxidative stress and endoplasmic reticulum stress (ERS) in a rat model of diabetic cardiomyopathy (DCM).

METHODSThirty male SD rats were randomly divided into control group, diabetes group and treatment group( n = 10). Intraperitoneal injection of streptozotocin was utilized to establish a rat model of DCM. The rats with DCM in treatment group were intraperitoneally injected with NaHS solution. After treated for 12 weeks, the hearts isolated from rats were perfused on a langendorff apparatus. The ventricular hemodynamic parameters were measured. The ultrastructures of myocardium were observed using electron microscopy. The content of malondialdehyde (MDA), the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in myocardial tissue were determined by spectrophotometry. The expressions of C/EBP homologous protein( CHOP), glucose-regulated protein 78 (GRP78) and Caspase 12 at mRNA level in myocardium were detected using RT-PCR.

RESULTSCompared with control group, the cardiac function and myocardial ultrastructure were damaged obviously in diabetic rats. In myocardial tissue, the content of MDA was increased, while the activities of SOD and GSH-Px were decreased. CHOP, GRP78 and Caspase 12 mRNA expressions were increased significantly. Compared with diabetes group, cardiac function and myocardial ultrastructure damage were improved in treatment group. The content of MDA was decreased, while the activities of SOD and GSH-Px were increased significantly. The mRNA levels of CHOP, GRP78 and Caspase 12 were increased.

CONCLUSIONH2S can protect myocardium in diabetic rats, maybe it is related to reduce oxidative stress damage and inhibition of the ERS-induced apoptosis pathway.

Animals ; Apoptosis ; Caspase 12 ; metabolism ; Diabetes Mellitus, Experimental ; drug therapy ; Diabetic Cardiomyopathies ; drug therapy ; Endoplasmic Reticulum Stress ; Glutathione Peroxidase ; metabolism ; Heat-Shock Proteins ; metabolism ; Hydrogen Sulfide ; pharmacology ; Male ; Malondialdehyde ; metabolism ; Myocardium ; ultrastructure ; Oxidative Stress ; Rats ; Streptozocin ; Superoxide Dismutase ; metabolism ; Transcription Factor CHOP ; metabolism

BACKGROUND:Knee society score of Peking Union Medical Col ege has been promoted and used in the 306th Hospital of PLA for 2 years and we have accumulated some clinical data.
OBJECTIVE:To analyze the stability and feasibility for suitable clinical medical practice of knee society score of Peking Union Medical Col ege.
METHODS:Fifty-five patients with osteoarthritis of the knee were included, and the patients were divided into
three groups:the preoperative group;3 months postoperative fol ow-up group;6 months postoperative fol ow-up group. The measurement results obtained by the application of the scale were compared to those of the Western Ontario and McMaster Universityies Ostroarthritis Index, visual analog scale, and hospital for special surgery
score, and then knee society score goodness-of-fit analysis was performed based on the structural equation model.
RESULTS AND CONCLUSION:Knee society score performance assessment of the signs and symptoms of
osteoarthritis of the knee patients was positively correlated with the pain severity of visual analog scale score;the overal knee society score of the patients after 6-month fol ow-up was significantly improved compared with that before treatment. The knee society score after 3-and 6-month fol ow-up was significantly higher than that before treatment, and the score was quite with the hospital for special surgery score. The overal assessment of the knee society score after treated for 3 and 6 months was improved for more than grade Ⅰ, the visual analog scale
score was decreased for more than 30%. The pain assessment items and physiological functional assessment items of Western Ontario and McMaster Universityies Ostroarthritis Index after 6-month fol ow-up were
significantly better than those before treatment (P<0.05);the visual analog scale score was poor after 3-month fol ow-up, and there was significant difference in visual analog scale score before and after treatment which was related with the pain level;the score accompanied by function and joint stiffness was significantly improved. The knee society score of Peking Union Medical Col ege obtained four dimensions of 22 assessment projects, and the
goodness-of-fit analysis showed that the scale had good goodness which had scientific nature and application value.

Objective To investigate the effects of 1,25-dihydroxyvitamin D3[1,25 (OH)2D3] on cell proliferation in hu?man glomerular mesangial cells and it′s effects on the regulation of mTOR/p70s6K signaling pathway in this cell line. Meth?ods The cultured human mesangial cells at passage 3-7 were divided into four groups:control group,VD group (addition of 10-8 mol/L of 1,25-dihydroxyvitamin D3 ),R group (addition of 5 mg/L of rapamycin) and R+VD group(addition of 5 mg/L ra?pamycin combined with 10-8 mol/L of 1,25-dihydroxyvitamin D3). Drug incubation last 48 h. The effect of mesangial cell pro?liferation was measured by CCK-8 colorimetric assay. The cell cycles were measured by flow cytometry. The expression of mTOR and p70s6K were detected by immunofluorescence. Results (1) The absorbance of A450 was higher in control group than that in VD group than that in R group than that in R+VD group. But the inhibition rate (IR) was lower in control group than that in VD group than that in R group than that in R+VD group. All comparisons were of statistic significance. ( 2) Cells in G1 phase were higher while cells in G2/M and S phases as well as proliferation rate (PI) were lower in control group than those in VD group than those in R group than those in R+VD group. All comparisons were of statistic significance except in?dexes between group R and group VD. (3) mTOR and p30s6K expressions in mesangial cells were higher in control group than those in VD group than those in R group than those in R+VD group. All comparisons were of statistic significance ex?cept indexes between group R and group VD. Conclusion 1,25-dihydroxyvitamin D3 might inhibit mesangial cell prolifera?tion significantly through mTOR/p70s6K signaling pathways.

Objective To explore the effect and the possible pathway of different concentrations of QLT0267,which was the inhibitor of the integrin-linked kinase (ILK),on the process of high glucose-induced tubularepithelial-myofibroblast transdifferentiation (TEMT) in human renal tubular epithelial cells (HK-2).Methods HK-2 cells were exposed to 30 mmol/L GS,and TEMT model was established.After excluding the effect of high osmotic in TEMT,HK-2 cells were divided into 6 groups by different concentrations of GS and QLT0267 for 48 hours.The rate of the cell proliferation was calculated by MTT.The expression of ILK and α-smooth muscle actin (α-SMA) were determined by immunofluorescence and Western blot,and the expression of protein kinase B (AKT),phosphorylated protein kinase B (p-AKT),and E-cadherin were determined by Western blot.Results (1) The expression of ILK,p-AKT,and α-SMA in HK-2 cells were unregulated and the expression of E-cadherin was downregulated for 48 hours with glucose treating vs control (P ＜ 0.05);(2) The proliferation rate in high glucose group was higher than the group which concentration of QLT0267 was greater than 5 μmol/L (P ＜ 0.05);(3) With the concentrations of QLT0267 increased,the expression of p-AKT,α-SMA was gradually decreased (all P ＜ 0.05),and the expression of E-cadherin was gradually increased (all P ＜ 0.05).Conclusions 30 μmol/L of GS can lead to TEMT in HK-2 cell.The QLT0267 with concentration greater than 5 μmol/L may prevent the activation of ILK downstream proteins,then partially inhibits cell proliferation and TEMT in HK-2 cell.

Objective To observe the effects of different concentrations of SB203580, the inhibitor of P38MAPK, in process of high glucose (GS)-induced renal tubular epithelial-myofibroblast transdifferentiation (TEMT). Methods The cultured human renal tubular epithelial cells (HK-2) were divided into control group (5.5 mmol/L GS), GS (30 mmol/L GS) group and different concentrations of SB203580 (30 mmol/L GS +5, 10, 20 and 30 μmol/L SB203580) groups. The treat?ments were for 48 hours. MTT assay was used to observe cell proliferation. The median inhibiting concentration (IC50) was cal?culated. Western blot assay was used to detect the expressions of P38MAPK, P-P38MAPK andα-smooth muscle actin (α-SMA) in control group, high-glucose group and S30 group. The expression ofα-SMA was also detected by the method of im?munofluorescence. Results 1.Compared with control group, there was no significant inhitory effect on proliferation rate in DMSO group (P>0.05). There were increased HK-2 cells in high glucose group and S5group (P<0.05). Proliferation rates were significantly decreased in S20 and S30 groups (P<0.05). Compared with high glucose group, the proliferation rates of HK-2 cells were inhibited in S5, S10, S20 and S30 groups (P<0.05). 2. The expression of P-P38MAPK was significantly higher in high glucose group and S30 group than that of control group (P<0.05). Compared with high glucose group, the ex?pression of P-P38MAPK was significantly decreased in S30 group (P<0.05), whereas no significant difference in the expres?sion of P38MAPK between the two groups (P>0.05). 3. Compared with control group, the expression ofα-SMA was signifi?cantly increased in high glucose group and S30 group (P<0.05). Compared with high glucose group, the expression of α-SMA was significantly decreased in S30 group (P < 0.05). Conclusion The 30 mmol/L GS can lead to TEMT in HK-2 cells. The more suitable inhibitory concentration of SB203580 in the process of TEMT is 30μmol/L. SB203580 can slow down the process of TEMT by inhibiting P38MAPK activation and inhibiting proliferation and the expression ofα-SAM s of HK-2 cells.

Objective:To investigate effects of hydrogen sulfide (H2S) on inducible nitric oxide synthase (iNOS) in kidneys of Type 1 diabetic rats.Methods:Thirty-two male SD rats were randomly divided into four groups:A normal control (NC) group,a diabetes mellitus (DM) group,a NaHS (NaHS+DM) group,and a NaHS control (NaHS) group (n=8 per group).Type 1 diabetes was induced by a single intraperitoneal injection of streptozotocin (55 mg/kg).After successful establishment of models,the rats in NaHS+DM and NaHS groups were injected with NaHS solution (56 μmol/kg) intraperitoneally.Eight weeks later,the activities of total nitric oxide synthase (T-NOS) and iNOS,as well as the level of nitric oxide (NO) were detected in serum and renal tissues,respectively,The activity of glutathione peroxidase (GSH-Px) was determined in renal tissues,The ultrastructures of renal tissues were observed by transmission electron microscope,The protein expression ofiNOS in renal tissues was detected by Western blot.Results:Compared with the NC group,there was no significant difference in the various indexes in the NaHS group (P＞0.05).However,in the DM group,the activities of T-NOS and iNOS,and the level of NO were all increased significantly in serum and renal tissues,while the activity of GSH-Px was decreased in renal tissues.Under the electronic microscope,the thickening of the glomerular capillary basement membrane,the proliferation of mesangial matrix,and the foot fusion were observed.The protein expression ofiNOS was increased obviously in renal tissues in the DM group (P＜0.01).Compared with the DM group,the activities of T-NOS and iNOS and the level of NO were all decreased in serum and renal tissues,while the activity of GSH-Px was increased in renal tissues in the NaHS+DM group (P＜0.01).The renal ultrastructural damages were ameliorated obviously.The protein expression ofiNOS was decreased significantly (P＜0.01).Conclusion:H2S exerts a protective effect on kidney injury in type 1 diabetic rats.The mechanism might be related to inhibition of iNOS activity and protein expression,in turn leading to reduction of NO content in renal tissues.

Objective To explore and study the effect of bundles on prevention and treatment of oral mucositis caused by chemoradiotherapy for patients with nasopharyngeal carcinoma. Methods A total of 40 patients who met the inclusion criteria from June 2014 to December 2014 were selected as the control group, who adopted routine nursing measures, 40 patients who met the inclusion criteria from January 2015 to June 2015 were assigned to the observation group. Bundles on prevention and treatment of oral mucositis caused by chemoradiotherapy for patients with nasopharyngeal carcinoma were edited using a series of evidence-based approach, and it was used to manage the patients of observation group. Results While doing 21, 28, 33 friction of radiotherapy, the oral mucositis level of 0 degree, Ⅰ degree,Ⅱ degree,Ⅲ degree and Ⅳ degree of the observation group were 8, 25, 7, 0, 0 cases;3, 11, 24, 2, 0 cases;0, 19, 13, 6, 2 cases respectively, which were lower than the control group whose degrees were 0, 31, 6, 3, 0 cases;0, 18, 11, 10, 1 cases;0, 9, 17, 9, 5 cases. The difference between the two groups was statistically significant (Z=-4.440,-3.441,-2.232, all P < 0.05 or 0.01). While doing 21, 28, 33 friction of adiotherapy, the throat pain level of 0 degree, Ⅰ degree,Ⅱ degree,Ⅲ degree of observation group were 4, 31, 5, 0; 2, 22, 14, 2; 0, 26, 12, 2 cases respectively, which were lower than the control group whose degrees were 1, 22, 16, 1 cases; 0, 10, 23, 7 cases; 0, 10, 17, 13 cases. The difference between the two groups was statistically significant (Z=-3.137,-3.326,-3.518, all P<0.01). While doing 28, 33 friction of radiotherapy, the Self Rating Anxiety Scale of the observation group scored 56.76 ± 3.19, 58.72 ± 5.41, which were lower than 60.58 ± 2.46, 63.42 ± 4.97 in the control group. The difference between the two groups was statistically significant (t=11.746, 10.561, all P <0.01). While doing 33 friction of radiotherapy, the self rating anxiety scale of the observation group was 60.56 ± 3.73, which was lower than 63.43 ± 4.77 in the control group. The difference between the two groups was statistically significant (t=-4.983, P<0.01). The following entries:swallow, sensation, eating in public, dry mouth, sticky saliva, feel sick of the quality of life questionnaire of the observation group were higher than the control group while doing 33 friction of radiotherapy. All the differences were statistically significant (t=-3.873-5.130, P<0.05 or 0.01). Conclusions The bundles could effectively prevent and treat oral mucositis caused by chemoradiotherapy for patients with nasopharyngeal carcinoma. It could release the throat pain, anxiety and depression of the patients, as well as improve the quality of life to some extent.

Objective:To summarize the midterm to long-term outcomes and experiences of endovascular treatment (ET) of spontaneous isolated superior mesenteric artery dissection (SISMAD).Methods:The clinical data of 31 SISMAD patients from Jan 2011 to Dec 2019 treated with ET was retrospectively analyzed.Results:Successful ET was achieved in 29 patients with a technical success rate of 93.5%. A total of 36 self-expandable bare stents were planted in 28 patients and plain old balloon angioplastry (POBA) was performed in 1 patient. Abdominal pain disappeared within 24 hours in 89.3% of the patients after stenting. The rate of perioperative complication was 3.2%. There was no SMA dissection rupture bleeding, nor perioperative death occurred. The mean follow-up time was 53.5 (range, 6 to 110) months. There was no dissecting aneurysm formation, no SMA rupture and bleeding, and no stent rupture during the follow-up. The post ET 1-year, 3-year, and 5-year free from reintervention rate were 100%, 100%, and 91.7%, respectively.Conclusions:ET for SISMAD is safe and effective with satisfactory perioperative and midterm to long-term outcomes.