Objective To investigate awareness of hypertension prevention and treatment knowledge in physicians from hospitals at varied levels in Xinjiang. Methods In total, 150 voluntary physicians were selected randomly from hospitals at varied levels in Xinjiang for an anonymous close-book baseline survey on hypertension knowledge with questionnaire. Then, an intensive training on hypertension prevention and treatment based on Guidelines on Prevention and Treatment for Hypertension in China was offered for them.After training, another survey was conducted among them with the same questionnaire to examine improvement in their awareness of hypertension prevention and treatment knowledge and evaluate effectiveness of the training. Results At baseline, 89. 3 percent (134/150) of physicians could correctly know diagnostic criteria for hypertension, 78. 3 percent ( 18/23 ) of them from primary-care hospitals, and 52. 0 percent (78/150) could correctly know level of blood pressure under control, only 34. 8 percent (8/23) of them from primary-care hospitals. Only 67 (44. 7% ) physicians surveyed could know criteria for non-antihypertensive drug treatment, 27 of then from secondary-care hospitals and nine from primary-care ones, significant less in that among those from tertiary-care ones ( 88. 6%, 31/35 ) ( P ＜ 0. 05 ). After training, their awareness of hypertension prevention and treatment knowledge improved significantly ( P ＜0. 01). Conclusions Awareness of hypertension prevention and treatment knowledge differed considerably in physicians from hospitals at varied levels, poorer in those from primary-care hospitals, and more importance should be attached to them, especially to those from primary-care hospitals.

Objective To summarize the stomach via laparoscopic and natural orifice transluminal endoscopic surgery (NOTES) Clinical application of abdominal exploration and peritoneal biopsy unexplained ascites. Methods A retrospective analysis of our hospital clinical datum of unexplained ascites patients, 20 cases were undergone single port laparoscopic operation from January 2014 to October 2015 and 11 cases were undergone NOTES from May 2015 to July 2016. Operation time, hospitalization expenses, intraoperative bleeding, postoperative hospital stay, postoperative abdominal pain score, fever and leukocyte on the 3rd postoperation were compared in tow groups. Results Laparoscopy group 20 cases, 11 cases diagnosed as tuberculous ascites, 8 cases malignant ascites, 1 case was still unknown;NOTES group 11 cases, 9 cases diagnosed as tuberculous ascites, 1 case malignant ascites and 1 case liver cirrhosis. In two groups, 30 cases were accurate diagnosed (96.8%), tuberculous ascites 20 cases (64.5%), malignant ascites nine cases (29.0%). Laparoscopy group compared with NOTES group, operation time was longer and hospitalization expenses was more, there were statistical signiifcant differences (P<0.05);postoperative hospital stays were higher (P < 0.05); intraoperative bleeding, postoperative abdominal pain score, fever and leukocyte on the 3rd postoperation were no statistical difference (P>0.05). Conclusion The two methods were able to quickly and accurately diagnose ascites reason, in order to facilitate treatment and surgical trauma, less serious complications. Comparison of laparoscopy, NOTES may be more advantageous in ascites diagnosis.

Objective To explore the clinical value of transgastric natural orifice transluminal endoscopic surgery(NOTES)in diagnosing unexplained ascites.Methods The clinical data in 12 cases of unexplained ascites diagnosed by adopting transgastric approach NOTES and performed abdominal exploration and peritoneal biopsy in our hospital from November 2015 to July 2016 were retrospectively analyzed.The operative risk and clinical application value were evaluated by statistically analyzing the postoperative complications occurrence and the diagnosis rate of disease.Results The definite diagnosis rate reached 100％ verified by pathology after abdominal exploration and peritoneal biopsy,in which 8 cases(66.7％)were tuberculous peritonitis,2 cases(16.7％)were liver cirrhosis,1 case(8.3％)was peritoneal mesothelioma,1 cases(8.3％)was peritoneal metastatic carcinoma;2 cases appeared abdominal pain after operation,including 1 case of neutrophil ratio increase,symptoms and persistent time of abnormal laboratory indexes did not exceed 24 h,the incidence rate was 8.3％;no complications of abdominal cavity infection,incision bleeding and puncture site fistula occurred.Conclusion The transgastric NOTES for conducting abdominal exploration and peritoneal biopsy in the diagnosis of unexplained ascites has the advantages of small trauma,less complications and rapid postoperative recovery,possesses an important clinical application value.

Objective To observe the clinical efficacy of thumb-tack needling for subcutaeous embedding combined with electroacupuncture in the treatment of postoperative pain of hemorrhoids with qi stagnation and blood stasis type.Methods A total of 150 patients with postoperative pain of hemorrhoids of qi stagnation and blood stasis type were randomly divided into observation group,control group and routine group,with 50 cases in each group.The routine group was given routine anti-inflammatory and supportive treatment.The control group was given thumb-tack needling for subcutaeous embedding therapy on the basis of routine group treatment.The observation group was given electroacupuncture treatment on the basis of control group treatment.A total of six days of treatments were given.After six days of treatment,the clinical efficacy of the three groups was evaluated,and the changes of Visual Analogue Scale(VAS)of pain scores were observed before and after treatment in the three groups.The changes of 5-hydroxytryptamine(5-HT),calcitonin-related gene peptide(CGRP),norepinephrine(NE),substance P(SP)and β-endorphin(β-EP)were compared before and after treatment in the three groups.Results(1)The effective rate of the observation group was 36.00%(18/50),the control group was 14.00%(7/50),and the routine group was 4.00%(2/50).The effective rate of the observation group was significantly superior to that of the control group and the routine group,and the difference was statistically significant(P＜0.05).(2)At 6,12,24,48 hours after treatment,the VAS of pain scores of the three groups were significantly improved(P＜0.05),and the improvement of VAS pain score in the observation group was significantly superior to that in the control group and the routine group,the difference was statistically significant(P＜0.05).(3)After treatment,the levels of serum NE,5-HT,CGRP,SP and β-EP in the three groups were significantly improved(P＜0.05),and the levels of serum NE,5-HT,CGRP,SP and β-EP in the observation group were significantly superior to those in the control group and the routine group,the differences were statistically significant(P＜0.05).Conclusion Thumb-tack needling for subcutaeous embedding combined with electroacupuncture in the treatment of postoperative pain of hemorrhoids of qi stagnation and blood stasis type can significantly improve the pain symptoms of patients.The levels of serum 5-HT,CGRP,NE,SP and β-EP were significantly improved,and the curative effect was significant.

Objective To develop the National Norms of Negligence (NNN) for rural children aged 0 to 35 months.Methods According to multi-stage stratified cluster sampling principle,10 provinces or municipalities (Jilin,Shaanxi,Shanxi,Beijing,Anhui,Jiangsu,Hunan,Hubei,Yunnan,Chongqing) in China were selected.A national research group was formed collaboratively.A questionnaire was designed by ourselves.According to several statistical analysis methods,such as item,factor and reliability analysis etc.we determined the norm.The evaluation criteria of the scale were determined by percentile method.Finally,the reliability and validity of the norm were evaluated.Results In total,2310 children were surveyed,in which the effective sample were 2227,with an effective rate as 96.4％.The scale consisted of 6 neglected dimensions and 65 items in total.The total Cronbach's α coefficient of the scale was 0.903,with the split-half reliability coefficient as 0.829,the parallel reliability as 0.720 and the re-test reliability as 0.678,respectively.The total neglect cut-off score of this scale was 139.Conclusion The scale seemed to have perfect stability and reliability and all the statistical indicators met the psychometric demands.

OBJECTIVETo investigate over-expression of wild-type alpha-synuclein inducing the aberrant aggregation of alpha-synuclein in HEK293 cell in vitro.

METHODSThe cDNA encoding the human alpha-synuclein without the stop code was cloned into PGEM T-easy vector. Using enzyme map and DNA sequencing analyzed and determined the recombinant plasmid, and then sub-clone the alpha-synuclein cDNA fragment into pEGFP-N1 vector. The recombinant plasmids alpha-synuclein-pEGFP were transfected into HEK293 cells by lipofectamin 2000. The aberrant aggregation of alpha-synuclein was measured by EGFP fluorescence, anti-alpha-synuclein immunocytochemistry. The inclusions in the cultured cells were identified with HE staining.

RESULTSThe restriction enzyme map suggested that eukaryotic expression vector for human wild-type alpha-synuclein gene was constructed successfully. By EGFP fluorescence, anti-alpha-synuclein immunocytochemistry, it could be observed that the alpha-synuclein protein could aggregate in cytoplasm and the Lewy body-like inclusions found in cytoplasm of cultured cells.

CONCLUSIONThe over-expression of wild-type alpha-synuclein can induce protein aberrant aggregation and Lewy body-like inclusions formation in cytoplasm of HEK293 cell in vitro.

Cells, Cultured ; Gene Expression ; Humans ; Immunohistochemistry ; Inclusion Bodies ; metabolism ; Lewy Bodies ; metabolism ; Parkinson Disease ; genetics ; metabolism ; alpha-Synuclein ; genetics ; metabolism

Objective To explore the clinicopathological features of adrenocortical oncocytic carcinoma and protein expression , gene mutation , and gene copy number alteration of epidermal growth factor receptor ( EGFR) in this carcinoma .Methods We reviewed the clinical and histomorphological features of 9 adrenocorti-cal oncocytic carcinoma cases who received surgical resection in the period of January 2000 to December 2009 in Peking Union Medical College Hospital , and 9 adenoma cases were included as control .EGFR protein expres-sion , EGFR gene mutation and EGFR gene copy number alteration in both groups were detected by immunohisto -chemistry , Scorpion Amplification Refractory Mutation System ( ARMS ) , and fluorescence in situ hybridization ( FISH) , respectively . Results The 9 cases of adrenocortical oncocytic carcinomas included 2 cases of Cushing's syndrome and 7 cases of nonfunctional cortical carcinoma .All cases were followed up for 6 to 56 months, and 2 patients with adrenocortical oncocytic carcinomas lost to follow -up, and 6 died.In the adrenocorti-cal oncocytic carcinoma patients , EGFR overexpression was found in 77.8%(7/9), and EGFR FISH was posi-tive in 55.6%(5/9).In contrast, only 22.2% (2/9) of the adrenocortical adenoma patients showed EGFR weak expression and none had positive FISH result .No EGFR gene amplification or mutation was found in the 2 groups of patients .Conclusions Adrenocortical oncocytic carcinoma is rare .EGFR overexpression and chromo-some 7 polysomy are frequent abnormality in the adrenocortical oncocytic carcinomas , which may be used in the differential diagnosis .Also, an investigation of the gene status of EGFR should facilitate the identification of a target therapeutic regimen for carcinoma patients .

OBJECTIVETo develop the national neglect norms for rural children aged 3 to 6 years, which are suitable for Chinese situations.

METHODSAccording to the multi-stage stratified cluster sampling principle, 84 towns of 10 provinces or municipalities were selected in China. Children aged 3 to 6 years were surveyed in November 2010, the sample of analysis were 3240 (of whom males were 49.6% (1608/3240) and the Han nationality were 93.3% (3023/3240)). Questionnaire was designed by authors and deleted items that did not meet the requirements through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norm. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm completed.

RESULTSAfter deleting inappropriate items by statistical processing, finally, the scale consisted of 57 items, and included 6 neglected dimensions (physical neglect, emotional neglect, educational neglect, safe neglect, medical neglect and social neglect). Its item loadings ranged from 0.359 to 0.789, which met the statistical requirements. The scale's total Cronbach α coefficients 0.904, the total split-half reliability coefficients were 0.820, the 6 neglect dimensions' Cronbach α coefficients ranged from 0.620 to 0.815, the 6 neglect dimensions' split-half reliability coefficients ranged from -0.034 to 0.789, the scale's parallel reliability were 0.785 and it's re-test reliability were 0.613. After construct validity, external validity and content validity testing, the result showed that this scale could effectively reflect the real neglected status of children investigated. The total neglect cut-off score of this scale were 121.

CONCLUSIONThe scale has good stability and reliability. And it adapts Chinese conditions and it's convenient to operate.

Child Abuse ; diagnosis ; prevention & control ; Child, Preschool ; China ; Female ; Humans ; Male ; Psychological Tests ; Reproducibility of Results ; Rural Population ; Sampling Studies ; Surveys and Questionnaires ; standards

BACKGROUNDAndrographolide has been shown to have anticancer activity on diverse cancer cell lines representing different types of human cancers. The aim of this research was to investigate the anticancer and apoptotic effects of andrographolide on the BGC-823 human gastric cancer cell line.

METHODSCell proliferation and IC50 were evaluated using MTT assay, cell-cycle analysis with flow cytometry apoptotic effects with Annexin-V/propidium iodide double-staining assay, and morphologic structure with transmission electron microscopy. Immunohistochemistry and reverse-transcription PCR was used to analyze Bcl-2, Bax, and caspase-3 expressions.

RESULTSAndrographolide showed a time- and concentration-dependent inhibitory effects on BGC-823 cell growth. Compared to controls, the number of cells in the G0-G1-phase increased significantly, S and G2-M-phase cells decreased after 48 hours of treatment with andrographolide, and both early and late apoptotic rates increased significantly compared to the controls, all in a concentration-dependent manner. Bax and caspase-3 expressions were markedly increased, and Bcl-2 expression was decreased.

CONCLUSIONSAndrographolide inhibits BGC-823 cell growth and induces BGC-823 cell apoptosis by up-regulating Bax and caspase-3 expressions and down-regulating Bcl-2 expression. Andrographolide may be useful as a potent and selective agent in the treatment of human gastric cancers.

Apoptosis ; drug effects ; Caspase 3 ; analysis ; genetics ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Diterpenes ; pharmacology ; Dose-Response Relationship, Drug ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Stomach Neoplasms ; drug therapy ; pathology ; bcl-2-Associated X Protein ; analysis ; genetics

Objective:To analyze the associations between prenatal and 1-year-old exposure to antibiotics and allergic symptoms in children aged 6-11 months and 18-23 months.Methods:In this study, a prospective birth cohort study was adopted. A total of 2 122 pregnant women were enrolled in Maternal and Child Health Care Center of Ma′anshan from June 2015 to June 2016, and they were followed up from the beginning of pregnancy to children′s 24 months of age. Excluding 564 pairs of mothers and children who were lost to follow-up or with incomplete information on the use of antibiotics and children′s allergic symptoms, a total of 1 558 pairs of mothers and children were included in the analysis of this study. The parents and children′s general demographic information, early-life antibiotic exposure and other data were collected, the information about allergic symptoms in children aged 6-11 months and 18-23 months were investigated by reference to the "International Study of Asthma and Allergies in Childhood (ISAAC)". The univariate and multivariate binary unconditional logistic regression model was used to was used to estimate associations between the effects of early-life antibiotic exposure on allergic symptoms in 2-year-old children.Results:The antibiotic usage rate of pregnant women during pregnancy was 3.4% (53), and the antibiotic usage rates of children between 0 to 2 months, 3 to 5 months, and 6 to 11 months were separately 15.2%(237), 15.5%(242) and 17.3%(269). The total prevalence of allergic diseases in children aged 6 to 11 months was 24.1% (375 children), and the total prevalence of allergic diseases in children aged 18 to 23 months was 22.0% (342 children). After adjust parental (maternal) education level, family monthly income per capita, parental (maternal) allergy history, parental (maternal) age at pregnancy, mother′s Body Mass Index (BMI) before pregnancy, exposure to second-hand smoke during pregnancy, delivery method, child gender, birth weight, preterm birth, the use of antibiotics when children were 3-5 months old ( RR=1.61,95% CI:1.19-2.17) and 6-11 months old ( RR=1.43,95% CI:1.06-1.93) were the risk factors for allergic symptoms at 6-11 months of age; and the use of antibiotics when children were 0-2 months old (RR=1.41, 95% CI: 1.03-1.95), 3-5 months old ( RR=1.54, 95% CI: 1.12-2.11) and 6-11 months old ( RR=1.58, 95% CI: 1.17-2.14) were the risk factors for allergic symptoms at 18-23 months of age. Conclusion:Children′s exposure to antibiotics within 1 year of age was a risk factor for allergic symptoms in children aged 6-11 months and 18-23 months, children should avoid unnecessary antibiotic use in infancy.