Objective To discuss the influence factors on detection of acid-fast bacilli for tubercu-lnsis patients and to seek for method to improve the quality of sputum sample. Methods A retrospective analysis was carried out in 3102 sputum sample of 1034 patients. Results The positve detection of acid-fast bacilli was found in 570 samples (18.4%). Pus sputum and bloody sputum had no evident influence on the positive detection rate(P＞0.05).The other two kinds of sputum had statistical influence on the positive detection rate (P＜0.01). Conclusions Attention to the intervention and instruction before collecting sputum sample proved to be important measure to ensure the quality of sputum sample and increase the positve detection rate of acid-fast bacilli.

Objective The aim of this study was to evaluate the outcomes of auditory perception skills after cochlear implantation in children with malformed inner ear and compare them with a group of congenitally deaf chil ‐dren implantees with a normal inner ear .Methods 21 children with inner ear malformation were retrospective stud‐ied .There were 9 cases with large vestibular aqueduct syndrome (LVAS) ,7 with Mondini abnormality ,5 with com‐mon cavity .The postoperative outcomes of these 21 cases were compared with 21 cases with normal inner ear struc‐ture .The outcomes of all the children after the surgery in 1 year were studied using the soundfield test in frequency ranging 0 .5 to 4 kHz and the auditory perception skills ,and the auditory perception skills consisted of natural envi‐ronmental sound recognition ,consonants recognition ,vowels recognition ,numeral recognition ,tone recognition , monosyllabe recognition ,disyllabe recognition ,trisyllabe recognition ,short sentences recognition ,selective hearing recognition .Results The results of soundfield test and auditory perception skills after cochlear implantation in 9 children with LVAS and 6 with Mondini abnormality had no significant difference (P > 0 .05) comparing with the control cases .Postoperative thresholds in soundfield test were 50 ~ 75 dB HL for 1 case with severe Mondini abnor‐mality ,the mean value of hearing ability score was 70 .5% ,and less than the results of control cases .Postoperative mean thresholds in soundfield test were 65 .26 ± 5 .13 dB HL for 5 cases with common cavity ,the hearing ability score was less than the results of control cases (P< 0 .05) .Conclusion The effect of rehabilitation had no difference between the children with LVAS and the cases with normal inner structure after cochlear implantation ,but was poo‐rer in children with severe Mondini abnormality and common cavity .It was necessary to evaluate the degree of mal‐formation of inner ear structure before cochlear implantation .

Objective:To investigate the expression of miR-151a-3p in peripheral blood mononuclear cells (PBMCs) of children with lupus nephritis (LN) and its correlation with activity and vascular damage.Methods:A total of 87 children with LN admitted in Hainan Women and Children′s Medical Center from January 2016 to March 2019 were enrolled, including 16 cases of type Ⅱ, 14 cases of type Ⅲ, 34 cases of type Ⅳ, 17 cases of type Ⅴ and 6 cases of type Ⅵ.Besides, additional 40 children with normal physical examination were selected as the healthy control group.The 87 children with LN were divided into the LN stable group (31 cases) and LN active group (56 cases) by using systemic lupus erythematosus disease activity index (SLEDAI) scores.According to different proportions of the medium membrane, the patients were classified into the mild group (25 cases), moderate group (34 cases) and severe group (28 cases). Real time quantitative PCR (qPCR) was used to detect the expression level of miR-151a-3p in PBMCs of each group.The correlation of the expression level of miR-151a-3p in PBMCs of LN children with the SLEDAI score and renal interstitial damage score was studied by Pearson correlation analysis. Results:The expression levels of miR-151a-3p in the LN group, LN active group and LN stable group (0.47 ± 0.06, 0.30 ± 0.04, and 0.75±0.12, respectively) were significantly lower than that in the healthy control group (1.62±0.35) (all P<0.01), and the expression level of miR-151a-3p in the LN active group (0.30±0.04) was significantly lower than that in the LN stable group (0.75±0.12) ( P< 0.01). The SLEDAI score [(14.35±4.60) points vs.(8.25±2.24) points] and renal interstitial damage score [(52.70±6.30) points vs.(34.80±4.10) points] in the LN active group were significantly higher than those in the LN stable group (all P<0.01). The expression levels of miR-151a-3p (0.18±0.02, 0.41±0.05 vs.0.83±0.16) in type Ⅴ-Ⅵ and type Ⅳ groups were significantly lower than that in the type Ⅱ-Ⅲ group (all P<0.01). The SLEDAI scores [(16.50±5.28) points, (12.36±3.74) points vs.(6.40±1.70) points] and renal interstitial damage scores [(62.70±7.40) points, (47.20±5.80) points vs.(25.80±3.50) points] in type Ⅴ-Ⅵ and type Ⅳ groups were significantly higher than those in the type Ⅱ-Ⅲ group (all P< 0.01). The expression levels of miR-151a-3p (0.20±0.02, 0.39±0.04, 0.86±0.18 vs.1.62±0.35) in severe, moderate and mild groups were significantly lower than that in the healthy control group (all P<0.01), and the expression level of miR-151a-3p decreased with the aggravation of vascular damage.The SLEDAI scores [(15.20±5.10) points, (12.85±3.90) points vs.(6.70±1.82) points] and renal interstitial damage scores [(57.30±6.80) points, (51.60±6.30) points vs.(27.20±3.60) points] in the severe and moderate groups were significantly higher than those in the mild group (all P<0.01). The expression level of miR-151a-3p in LN children was negatively correlated with the SLEDAI score and renal interstitial damage score ( r=-0.682, -0.627, all P<0.001). Conclusions:The expression level of miR-151a-3p in PBMCs of LN children is significantly decreased.The declined miR-151a-3p level is closely related to disease activity and vascular damage, and may be involved in the occurrence and development of LN.

BACKGROUND:Col agen/bioactive glass composite materials possess excellent osteogenic potential and biocompatibility, but its application in bone tissue engineering is limited by mechanical property and degradation. OBJECTIVE:To construct col agen/bioactive glass/chitosan composite scaffolds with good mechanical property, anti-degradation ability and bone repair property.
METHODS:Bioactive glass/col agen composite scaffolds with chitosan as dispersant were prepared by lyophylization. Fourier transform infrared spectroscopy, scanning electron microscope, X-ray diffraction, and dynamic biomechanical testing were used to characterize the structure and properties of the composite scaffolds. RESULTS AND CONCLUSION:Results show that charge-attractions in pre-prepared bioactive glass/chitosan solution increased the homogeneity of bioactive glass dispersed in col agen gel and the compressive modulus and strength increased significantly due to the homogeneity and intermolecular interactions between chitosan and col agen. The enzymatic degradation rate and mineralization activity in the simulated body fluid were also lower because of a high degree of embedment of bioactive glass in col agen/chitosan matrix, and entanglement of col agen in chitosan at molecular level, which decreased the exposure of bioactive glass to the simulated body fluid, and col agen to enzyme solution.

Objective To explore the perception of clinical learning environment,career maturity,and professional identity as well as their associations among 3+2 nursing undergraduates.Method Totally 198 3+2 nursing undergraduate students from two provincial medical colleges in Shandong province were enrolled.Results Mean scores for clinical learning environment,career maturity and professional identity were (3.44 ± 0.54),(3.31 ± 0.37) and (3.63 ± 0.62),respectively.Clinical learning environment and career maturity (P＜0.001) were positivelyassociated with 3+2 nursing undergraduates' professional identity.Conclusions Clinical learning environment,career maturity and professional identity of 3 +2 nursing undergraduates areat a moderate level.Interventions to facilitate clinical learning environments and career maturity will foster the growth of professional identity.

Objective to investigate the efficacy of moxibustion treatment to rheumatoid arthritis(RA) patients and the impact to blood levels of rheumatoid factor(RF) ,C reactive protein(CRP) ,and interleukin-6(IL-6) .Methods RA patients were divided in-to treatment group and comfort group .The two groups were treated by moxibustion and sham-moxibustion for 2 courses ,respec-tievely .Results Overall clinical efficacy rate was higher in treatment group than in comfort group(P<0 .01) .The arthralgia ,ar-throcele ,tenderness and its degrees ,and morning stiffness time were significant improved in both groups(P<0 .05) ,and the indexes were better in treatment group than comfort group(P<0 .05) .The blood levels of RF ,IL-6 and CRP were reduced after treatment in both groups(P<0 .05) ,and which of treatment group reduced more than those of comfort group(P<0 .05) .Conclusion Moxi-bustion treatment can significantly improve clinical outcomes of RA and markedly reduce the blood levels of RF ,IL-6 and CRP of RA patients .

OBJECTIVETo observe the repair effect of Schwann cells (SCs) modified by microgene pSVPoMcat on injured spinal cord in rats.

METHODSSemi-transection injury at the level of T(8) of spinal cord was made with cutting method on 120 Sprague Dawley (SD) rats. Then 40 rats implanted with SCs modified by microgene pSVPoMcat were taken as Group A, 40 rats implanted with simple SCs as Group B and the other 40 rats were taken as the control group (Group C). The functional recovery of the rats was observed through combined behavioral score (CBS) and cortical somatosensory evoked potential (CSEP), and the expression of the glial fibrillary acidic protein (GFAP) was measured with in situ hybridization and immunocytochemistry. At 3 months after operation, the rats were examined with magnetic resonance image (MRI), and the neurofilaments (NF) of the axons were stained with immunohistochemical method.

RESULTSGFAP expression in Group A was significantly lower than that of the other 2 groups. MRI showed that the spinal signals in the injured area recovered fundamentally in Group A, didn't recover in Group B and malacia focus was found in Group C, which was same as the results of NF staining. Wave amplitudes in incubation periods in Group A and Group B tended to recover. It recovered to the normal level in Group A, which was similar to the results of CBS.

CONCLUSIONSSCs modified by microgene pSVPoMcat can inhibit GFAP expression, improve the growth of the axons and the functional recovery of neurons after spinal cord injury.

Analysis of Variance ; Animals ; Evoked Potentials, Somatosensory ; Gene Transfer Techniques ; Genetic Therapy ; Glial Fibrillary Acidic Protein ; metabolism ; Immunohistochemistry ; In Situ Hybridization ; Magnetic Resonance Imaging ; Nerve Regeneration ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; metabolism ; transplantation ; Spinal Cord ; physiopathology ; Spinal Cord Injuries ; pathology ; physiopathology ; therapy

OBJECTIVETo study the curative effect of wilsonii injecta on severe head injury (SHI).

METHODSA total of 120 patients with SHI were divided randomly into 2 groups, the patients treated with conventional methods as Group A (n=60) and the patients treated with wilsonii injecta as Group B (n=60). The changes of neural function indexes were evaluated with Glasgow Coma Scale (GCS) before treatment and with Glasgow Outcome Scale (GOS) after treatment, simultaneously, the parameters of hemorrheological indexes (HI), brain electrical activity map (BEAM) and transcranial Doppler sonography (TCD) were observed before and after treatment.

RESULTSIn Group B, the clinical GCS, the HI, the BEAM and the prognosis GOS were improved much more than those in Group A. And the TCD parameters in Group B decreased, which had significant difference compared with that in Group A (P<0.01).

CONCLUSIONSWilsonii injecta can rapidly improve the injured p ersons' conscious states, the abnormal BEAM and the surviving quality. It suggests that the improvement of the HI is related to the relief of the vasospasm of the arterial blood vessels in the brain, which may be one of the important mechanisms of wilsonii injecta in improving the prognosis.

Adult ; Brain Injuries ; diagnostic imaging ; drug therapy ; Brain Mapping ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Injury Severity Score ; Male ; Plant Extracts ; administration & dosage ; Probability ; Reference Values ; Treatment Outcome ; Ultrasonography, Doppler

Objective To study the molecular genetic mechanism of congenital central hypoventilation syndrome ( CCHS).Method The clinical data and molecular genetics results of CCHS diagnosed in neonatology department from 2014 to 2016 were analyzed retrospectively.The relationship between genotypes and clinical phenotypes in patients of CCHS was analyzed , and the diagnostic thinkings , follow－up and prognosis were summarized.Result A total of 4 infants with CCHS were included in this study.Among them, 2 were boys and the other 2 were girls.They were all full－term neonates without asphyxia at birth , but they soon sufferd from dyspnea and cyanosis , required assisted ventilation.One case had difficult defecation. All 4 cases had difficulty in weaning.The respiratory rhythm became weak developed apnea and carbon dioxide retention was detected in blood gas analysis.All the 4 cases died after withdrawal of treatment.The results of molecular genetic testing were as follows.There was a 38bp heterozygous deletion mutation in exon 3 of gene PHOX2B ( e.756＿776 del21bp).Three cases were found small fragment insertion in exon 3 of gene PHOX2B, which attributed to polyalanine repeat expansion mutations (PARMs).One case belonged to type 20/27 and another 2 cases belonged to type 20/26.Conclusion The main manifestation of CCHS in the neonatal period is ventilator dependant , which can combined with megacolon and atypical autonomic nerve disorder.According to the literature, more than 95%of CCHS are caused by the PHOX2B mutation. The symptom is severe when it got a non－PARMs mutation.It′s useful to make a definite diagnosis with genetic diagnosis results , which could be helpful for treating and predicting.Only effective respiratory support and standardized follow－up system can improve the quality of life in patients of CCHS.

Purpose: This study explored the performance of prenatal ultrasonography in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC). Methods: Fetuses diagnosed with hepatic hilar cyst in the second trimester were included in this study. A series of prenatal ultrasound examinations were performed in the second and third trimesters. The diameter of the gallbladder (GB) and hepatic cyst were measured, as well as the wall thickness of the GB. The GB-cyst connection, visibility of the right hepatic artery (RHA), and other concomitant abnormalities were carefully evaluated. A neonatal transabdominal ultrasound examination was performed within 1 week after birth, and clinical data were followed up to 6 months after birth. Results: Between January 1, 2016 and January 31, 2020, 53 fetuses diagnosed with hepatic hilar cyst were recruited. Eight were excluded because they were lost to follow-up. Among the 45 cases included in this study, 10 were diagnosed with CBA and 35 with CC after birth. Statistically significant differences were found in GB width, wall thickness, change in GB width, change in cyst length, GB-cyst connection, and RHA visibility between the CBA and CC groups. GB width showed the best diagnostic performance with an area under the curve (AUC) of 0.899. The combination of GB width, GB wall thickness, and GB-cyst connection yielded a comparable AUC of 0.971. Conclusion The GB should be carefully evaluated in fetuses with hepatic hilar cyst. Prenatal ultrasound findings could provide suggestive parameters for the differential diagnosis of CBA from CC.