Objective To evaluate the safety of CT guided percutaneous lung biopsy in the elderly,and to analyze the risk factors for its complications.Methods Totally 204 elderly patients aged ≥65 years underwent transthoracic needle biopsy under CT guidance.Clinical data,complication and its risk factors were analyzed retrospectively.Results The complications included pneumothorax accounting for 15.2％ (31/204),hemoptysis 21.6％ (44/204),and no mortality was found.Logistic regression analysis showed that needle path ≥5.00 cm,lesion size ≤2.00 cm and emphysema around the lesion were the independent risk factors for postoperative pneumothorax (OR=4.05,2.54 and 3.97,all P＜0.05).Meanwhile,the enhancement degree by CT ＞40 HU,needle path ≥5.00 cm and lesion size ≤2.00 cm were the independent risk factors for postoperative bleeding (OR=2.27,2.82 and 2.33,all P＜0.05) in elderly patients undergoing lung biopsy.The sensitivity and specificity for postoperative pneumothorax and bleeding obtained by forecasting equation were 87.1％ and 49.1％,54.5％ and 80.8％ respectively.Conclusions The length of needle path,lesion size and emphysema around the lesion are correlated with pneumothroax,and length of needle path,lesion size and the CT enhancement degree are correlated with bleeding after percutaneous lung biopsy in the elderly.

Objective To explore the mechanisms of individual, social and environmental factors influencing physical activity and the relationships among the factors in patients with type 2 diabetes. Methods A survey was conducted from January to July 2015 among 225 patients with type 2 diabetes using convenience sampling. The questionnaire included 9- item Patient Health Questionnaire, the International Physical Activity Questionnaire,Perceived Social Support Scale, Chinese Walkable Environment Scale, Bandura′s Exercise Self- efficacy Scale. Results The effective questionnaire recovery rate was 98.7%(222/225). Exercise self- efficacy was a mediator of factors influencing physical activity. Exercise self- efficacy and physical activity were positively correlated (β=0.24, P<0.05). Walkable environment only affected physical activity indirectly medicated by exercise self- efficacy (β=-0.26, P<0.05). Perceived social support directly associated with physical activity (β=0.14, P<0.05). Depression not only affected physical activity directly (β=-0.28, P<0.05), but also associated with physical activity indirectly medicated by exercise self-efficacy (β=-0.32, P<0.05). Conclusions Interventions should be taken to increase the perceived social support, improve depression and walkable environment, especially to enhance exercise self- efficacy, so as to improve the physical activity level of patients with type 2 diabetes.

Objective To evaluate the effect of propofol on interleukin-1β (IL-1β)-induced increase in monolayer permeability of human umbilical vein endothelial cells (HUVECs).Methods Primary HUVECs were cultured and purified by immuno-magnetic separation.The expression of VE-cadherin in endothelial cells was determined by immunofluorescence.The HUVEC monolayer permeability was detected by the Transwell system.The cells were seeded on the upper chamber (2 × 105 cells/well) and cultured for 3 days after confluence.The cells were treated in two ways.The cells were randomly divided into 6 groups (n =36 each) and 5 of the 6 groups treated with 1,2,5,10 and 20 ng/ml IL-1β for 24 h except for control group.The cells were also randomly divided into 5 groups (n =30 each) and 4 of the 5 groups were pretreated with 0,10,50 and 100 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h except for control group.The cells were radomly divided into 3 groups (n =18 each) and 2 of the 3 groups were pretreated with 50 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h or 30 min.The expression of occludin protien,p38 mitogen activiated protienkinase (p38 MAPK) and phosphorylated p38 MAPK (p-p38 MAPK) was determined by Western blot.Results Compared with control group,5,10 and 20 ng/ml IL-1β significantly increased HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.05 or 0.01).10,50 and 100 μmol/L propofol inhibited IL-1 β-induced increase in the permeability of HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.01).IL-1β could down-regulate HUVEC occludin protein expression,and activate p38MAPK signaling pathway,and propofol inhibited IL-1β-induced down-regulation of HUVEC occludin protein expression and activation of p38 MAPK signaling pathway (P ＜ 0.01).Conclusion Propofol can alleviate IL-1β-induced increase in the permeability of HUVEC monolayer via inhibiting activation of p38 MAPK signaling pathway.

Objective:To explore the necessity and feasibility of introducing the courses of dental practice management in the undergraduate education of stomatology under the background of the undergraduate entrepreneurship education reform.Methods:In the School of Stomatology of Zhejiang Chinese Medical University, the entrepreneurial course dental practice management was set-up for the junior undergraduate students. CBL, PBL, teacher's lecture, student's lecture on the stage and PPT demonstration, role-play, and team cooperation were taken in the course. And the questionnaires were used to investigate the course setting, necessity, teaching forms and satisfaction from multiple groups. SPSS was performed for data analysis, and the teaching effect was evaluated through the data results.Results:The scores of 108 students in the study [(75.99±5.76) points] were roughly distributed as normal functions. The results of the survey showed that the number of students who planned to have their own private clinics after the course increased by 41 (37.96%) compared with that before the course. All instructors and 33 (78.57%) active dentists thought that the course was reasonable in the undergraduate courses.Conclusion:It is necessary and feasible to introduce the dental practice management course in undergraduate education of stomatology, which will have a certain guiding effect on the long-term development of dentists, and is also beneficial to the reform of innovation and entrepreneurship courses in medical universities.

Objective To investigate potential causative associations between immunophenotype traits and cervical cancer by using two-sample Mendelian randomization (MR) analysis. Methods The genetic instrumental variables (IVs) of 731 immunophenotypes of peripheral blood were obtained from the GWAS Catalog database. The GWAS summary data of cervical cancer were obtained from FinnGen database. The inverse-variance weighted (IVW), weighted mode, weighted median, and MR Egger methods were used for evaluations. The sensitivity analysis and reverse Mendelian randomization analysis were conducted to eliminate bias and reverse causality. The MR Steiger directionality test was further used to ascertain the reverse causal relationship between immune cells and cervical cancer. Results A total of 71 immune cell subtypes associated with cervical cancer were identified, of which 31 had a strong association. The majority of the B cell panel was protective factors for cervical cancer. B-cell activating factor receptor (BAFF-R) was the most frequently expressed molecule in this analysis. It is expressed on several B cell subtypes. The CD20 on IgD+ CD38+ B cell (OR=1.887, 95%CI: 1.078-3.306, P=0.026) is the risk factor for cervical cancer. In cDC panels, the CD123 expression on plasmacytoid dendritic cell (OR=2.48, 95%CI: 1.229-5.003, P=0.011), CD123 expression on CD62L+ plasmacytoid dendritic cell (OR=2.5, 95%CI: 1.231-5.077, P=0.011), CD80 expression on plasmacytoid dendritic cell (OR=2.62,95%CI:1.244-5.515, P=0.011), and CD80 expression on CD62L+ plasmacytoid dendritic cell (OR=2.641, 95%CI: 1.246-5.596, P=0.011) were positively associated with the incidence of cervical cancer. All gynecological cancers in this study have no statistically significant effect on immune cells, according to reverse MR analysis. Conclusion This study emphasized the genetically predicted causality between immune cells and cervical cancer. In clinical practice, it is important to pay attention to the screening of peripheral blood immune cells for patients with cervical cancer.

Objective: To investigate the distribution of peripheral blood lymphocyte subpopulations in 654 children aged 28 days to 7 years, and to provide a basis for establishing a normal reference range. Methods: A total of 654 healthy Han children aged 28 days to 7 years were enrolled.The children were divided into infant group(28 days-12 months)(180 cases, 27.52%), toddler group(1-3 years)(184 cases, 28.13%), and preschooler group(3-7 years)(290 cases, 44.34%). Peripheral blood samples were collected, and the percentages of lymphocyte subpopulation were detected by flow cytometry. Results: There were statistically significant differences between boys and girls in CD3⁺ CD4⁺ T cells, CD3⁺ CD8⁺ T cells percentages and the CD4⁺ /CD8⁺ ratio in infant group(Z=-2.595, 3.317, -3.492, all P<0.05); in CD3⁺ CD4⁺ T cells percentage in toddler group(Z=2.312, P<0.05); in CD3⁺ T cells, CD3⁺ CD4⁺ T cells, CD3^-CD19⁺ B cells, CD3^-CD16⁺ CD56⁺ NK cells percentages and the CD4⁺ /CD8⁺ ratio in preschool age group(Z=4.088, 4.991, 3.129, -6.949, 2.141, all P<0.05). The comparison in all age groups showed significant differences in CD3⁺ T cells, CD3⁺ CD4⁺ T cells, CD3^-CD19⁺ B cells, CD3^-CD16⁺ CD56⁺ NK cells percentages and the CD4⁺ /CD8⁺ ratio in boys(χ²=6.925, 51.543, 39.563, 87.751, 30.334, all P<0.05), in CD3⁺ CD4⁺ T cells, CD3⁺ CD8⁺ T cells, CD3^-CD16⁺ CD56⁺ NK cells percentages and the CD4⁺ /CD8⁺ ratio in girls(χ²=27.646, 44.046, 26.066, 54.238, all P<0.05). The CD3⁺ CD4⁺ T cells and CD3^-CD19⁺ B cells percentages declined with age(χ²=82.345, 40.214, all P<0.05); The CD3⁺ CD8⁺ T cells and CD3^-CD16⁺ CD56⁺ NK cells percentages increased with age(χ²=38.43, 108.302, all P<0.05). Conclusion The peripheral blood lymphocyte subpopulation values differ by gender and age.It is necessary to establish the reference range of lymphocyte subpopulations for children in Lanzhou according to gender and age.