Objective To investigate the dynamic change of T-lymphocyte subpopulations in the patients with SARS to understand the pathogenesis of SARS,and to find the specific early diagnostic and warning indexes for SARS.Methods T-lymphocytes in the peripheral blood were labelled by specific fluorescein antibodies and examined by flow cytometry in 252 cases of patients with SARS.The relationship between the dynamic change of T-lymphocyte subpopulations and the clinical progression was analyzed.Results The CD 3 +,CD 4 + and CD 8 + T cells,especially CD 4 + T cells decreased at the fist two-week of the disease course and reached to the lowest level at the second week,and began to increase from the third week in all patients.The change pattern of CD 3 +,CD 4 + and CD 8 + T cells in the severe type of SARS was the same as that of the mild type of SARS,but with more serious extent and longer time.The CD 4 + cell amount of the first,second and third weeks in the mild type of SARS was 515?444/?l,421?350/?l and 600?389/?l respectively,and was up to normal level at the fourth week.The CD 4 + cell amount of the first,second,third and fourth weeks in the severe type of SARS was 312?158/?l,255?187/?l,435?343/?l and 539?394/?l respectively,and still lower than normal level at the fourth week.There was a significant difference in the CD 3 +,CD 4 + and CD 8 + cell amount among the different weeks of disease course in both types.NK cell amount also decreased during the course of disease.The CD 4 +/CD 8 + ratio did not change much and was within the normal range.Conclusions The decrease of CD 3 +,CD 4 + and CD 8 + T cells is a sensitive index for early diagnosis of SARS.The continuous decrease of them may indicate the severe condition of the patients with SARS.

Objective To investigate the serum concentration of adiponectin(apM1)in patients of Han population with type 2 diabetes(T2DM), impaired glucose tolerance(IGT)and normal glucose tolerance(NGT)in Liaoning Province,and explore its correlation with T2DM process. Meth-ods Unrelated 278 subjects in Liaoning Province were enrolled for the study,including 97 newly diagnosed T2DM subjects,88 IGT subjects,and 93 cases with NGT. Serum apM1,fasting and post-glucose load glucose and insulin,blood lipids,blood pressure,calculate HOMA-IR and HOMA-B,height,weight,waist,hips were measured;body mass index(BMI)and waist hip ratio(WHR)were calculated. Three groups were divided into obese overweight and non-obese overweight subgroups with BMI≥25 kg/m2 as the boundary point. Then central and peripheral obesity was distin-guished using WHR(male≥0.90,female≥0.85 as the boundary point). Results Reduced apM1 levels was first observed in obese NGT stage. Accompanied by elevated levels of insulin resistance,apM1 levels showed a gradual decline trend paralleled with the NGT-IGT-T2DM model. Se-rum apM1 in T2DM was significantly lower than that in NGT(P<0.001). Negative correlations were found between apM1 and WHR,fasting plas-ma glucose,HOMA-IR and triglyceride. Stepwise multiple regression analysis indicated that,HOMA-IR and triglyceride were independent factors for serum apM1 levels. Conclusion Reduced apM1 levels were first appeared in obese NGT stage;apM1 is closely related to insulin resistance and T2DM process. Low level of apM1 can be used as a predictor of early intervention of IGT outcome and T2DM process.

OBJECTIVE:To know the residual characteristics of organochlorine pesticides and 5 kinds of heavy metals (Cu, As,Cd,Hg and Pb) in Panax notoginseng. METHODS:P. notoginseng samples with 3 years were collected from Baiyi Town, Songming County and Liushao Township,Xundian County of Yunnan Province in Apr. 2013. 60 strains of P. notoginseng and 1 kg rhizosphere soil samples were also collected. The organochlorine pesticide residues and 5 kinds of heavy metals on its various parts and soil samples were detected. Pesticide residues determination method in Chinese Pharmacopoeia(2010 edition,volumeⅠ)was conducted to determine the organochlorine pesticides and 5 kinds of heavy metals (Cu,As,Cd,Hg and Pb). RESULTS:There was pentachloronitrobenzene in different parts of P. notoginseng from Baiyi Town,Songming County,and the contents were root bark>fibrous≥notches>ribs>leaves;there were pentachloronitrobenzene only in the root bark and fibrous of P. notoginseng from Liushao Township,Xundian County,and the contents were root bark>fibrous. No Hg was detected in any part of P. notoginseng samples,and the other heavy metals were highest in root bark;As and Pb were relatively high in soil,the contents of As and Pb in samples were far lower than in soil. CONCLUSIONS:The contents of pesticide residues and heavy metals in different parts of P. notoginseng are different,and those in root bark are relatively high. P. notoginseng sample contains organochlorine pesticides, which is mainly pentachloronitrobenzene;P. notoginseng sample has relatively strong accumulation of Cd.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.

OBJECTIVE:To provide reference for medication and chemotherapy in patients with colorectal cancer. METH-ODS:Through retrospective study,case histories and doctor’s advice of the colorectal cancer patients receiving chemotherapy in our hospital during 2011-2014 were consulted to analyze the chemotherapy,medication and irrational drug use. RESULTS:A total of 593 cases of colorectal cancer patients with chemotherapy frequency of 1 940 times were collected to analyze the choice of che-motherapy regimen mainly from the following aspects:indications of chemotherapy,choice of chemotherapy regimen,chemothera-py process and chemotherapy period. There was 409 cases of irrational drug use according to the analysis of drug dosage,selection of solvents and drug concentration,the unqualified rate was 21.08% . CONCLUSIONS:The medication and chemotherapy in pa-tients with colorectal cancer in our hospital are basically rational,but there are still certain problems and shortcomings. In future clinical applications,the medication and chemotherapy need to be improved.

Objective: To investigate the effect of chrysotile exposure on ribosomal DNA (rDNA) copy number and DNA damage response, so as to provide insights into the mechanism of asbestos-induced carcinogenesis. Methods: Human pleural mesothelial MeT-5A cells were treated with chrysotile suspensions at doses of 1.25, 2.5 and 5 μg/cm2 (low-, medium-, high-dose group), while PBS served as controls. MeT-5A cells were harvested 6, 24, 48 and 72 h post-treatment, and the rDNA copy numbers and the BIRC5, HRAS, GINS4 and RRM2 mRNA expression were determined using a quantitative real-time PCR (qPCR) assay. The apoptosis of MeT-5A cells and DNA damage were detected using Muse cell analyzer. The rDNA copy numbers, DNA damage responses and BIRC5, HRAS, GINS4 and RRM2 mRNA expression were compared in MeT-5A cells treated with different doses of chrysotile suspensions. Results: There were significant differences in 45S rDNA copy numbers among low-, medium-, high-dose groups and the control groups 6, 48 and 72 h post-treatment with chrysotile suspensions, and significantly lower 45S rDNA copy numbers were measured in low-, medium- and high-dose groups than in the control group 6 h post-treatment, while significantly higher 45S rDNA copy numbers were found in the high-dose group than in low- and medium-dose groups 48 and 72 h post-treatment (all P<0.05). There were significant differences in 5S rDNA copy numbers among low-, medium-, high-dose groups and the control groups 24, 48 and 72 h post-treatment with chrysotile suspensions, and significantly lower 5S rDNA copy numbers were measured in medium- and high-dose groups than in the control group 24 and 48 h post-treatment, while significantly lower 5S rDNA copy numbers were found in medium- and high-dose groups than in the low-dose group 24, 72 h post-treatment (all P<0.05). There were significant differences in the overall apoptotic rate of MeT-5A cells among groups at different time points, and the overall apoptotic rate of MeT-5A cells were significantly higher in medium- and high-dose groups than in the control group (all P<0.05), with late-stage apoptosis predominantly detected. There were significant differences in the rates of ATM activation and DNA double-strand break in MeT-5A cells among groups 72 h post-treatment, and higher rates of ATM activation and DNA double-strand break were measured in medium- and high-dose groups than in the control group (all P<0.05). In addition, there were significant differences in the relative mRNA expression of BIRC5, HRAS, GINS4 and RRM2 genes among groups 24 and 48 h post-treatment, and significantly lower BIRC5, HRAS, GINS4 and RRM2 mRNA expression was quantified in medium- and high-dose groups than in the control group (all P<0.05). Conclusion Exposure to chrysotile may induce rDNA copy number variations and altered expression of nucleolar proteins in human pleural mesothelial cells, which may be involved in the regulation of DNA damage responses.

Objective : To analyze the survival of patients with malignant mesothelioma, so as to provide insights into the management of malignant mesothelioma. Methods : Totally 36 patients with malignant mesothelioma admitted to Cixi Third People’s Hospital from October 2012 to January 2021 were enrolled, and the demographic features, exposure to asbestos, and diagnosis and treatment were retrospectively reviewed. The survival rate and median survival time were calculated with the life-table method, and the factors affecting the survival rate of malignant mesothelioma were identified using the Kaplan-Meier estimate and log-rank test. Results : The 36 patients with malignant mesothelioma included 6 men ( 16.67% ) and 30 women ( 83.33% ), and had a median age of 61 ( interquartile range, 14 ) years. There were 30 cases with pleural malignant mesothelioma ( 83.33% ) and 6 cases with peritoneal malignant mesothelioma ( 16.67% ), 32 cases ( 88.89% ) with a history of occupational exposure to asbestos, and 26 cases ( 72.22% ) receiving palliative treatment. The 1-, 2- and 3-year cumulative survival rates were 30%, 15% and 3%, respectively, and the median survival time was 0.71 years. In addition, there were no significant differences in the survival period among patients with malignant mesothelioma in terms of gender, age, route of asbestos exposure, duration of asbestos exposure, pathogenic site and treatment regimens ( P>0.05 ). Conclusion The 36 patients with malignant mesothelioma had a median survival period of 0.71 years, and no association was found between the survival period and asbestos exposure or pathogenic site.

Objective:To explore the effect of handicraft training administered over the Internet on sensation disorders and on the mental status and life quality of stroke survivors.Methods:A total of 75 stroke survivors in the sequelae stage and with sensory disturbance were randomly divided into a general training group of 26 (group A), a handicraft training group of 26 (group B), and a handicraft training group of 23 using Internet instruction (group C). In addition to 40 minutes of routine physical and sensory training rehabilitation every morning, groups A and B were given traditional training and handicraft training, while group C was given handicraft training delivered over the Internet for 40 minutes every afternoon, five days a week for 4 weeks. The traditional training involved inserting wooden boards, plate grinding, as well as sorting beans. The handicraft training involved digital painting, making non-woven flowers, silk screening flowers and paper-rolling. Before and after the 4 weeks of treatment, all of the subjects were assessed using the Fugl-Meyer sensory assessment (FMA-S), the Hamilton Anxiety Scale (HAMA), the Modified Barthel Index (MBI), and the physical component summary scale (PCS) and mental component summary scale (MCS) of the 36-item short-form health survey.Results:After the treatment, significant improvement was observed in their average scores of all three groups in all of the assessments. Groups B and C showed significantly greater improvement in the average FMA-S, HAMA and MBI scores than group A. And the average HAMA and MCS scores of group C were significantly better than those of group B.Conclusion:Handicraft training delivered over the Internet can improve the sensory functioning, mental status and life quality of stroke survivors in the sequelae stage with sensory disturbance.

Objective:To explore the intervention effect of motivational interviews based on timing theory on self-efficacy, negative affect and coping styles of parents with infantile spasms children.Methods:Cluster sampling was used to select 82 parents of infantile spasms hospitalized in the Department of Neurology of a children’s hospital, a three-A hospital from January 2019 to October 2019. They were divided into control group and observation group with 41 cases each according to random number table. The control group received routine health education, and the observation group received five motivational interviews based on timing theory interventions on the basis of routine care. The effect of the intervention was evaluated by General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), and the Chinese version of Coping Health Inventory for Parents (CHIP) before intervention, on the day of discharge, and 3 months after discharge.Results:Before the intervention, there was no significant difference in the scores of GSES, HADS and CHIP scales between the parents of the two groups ( P>0.05). After intervention, The GSES scores of the observation group on the day of discharge and 3 months after discharge were (19.63±0.87) and (22.58±1.28) points, which were significantly higher than (18.92±0.74) and (19.46±1.25) points of the control group. The difference between both groups was statistically significant ( t values were -3.865, -10.926, P<0.01). HADS-A/HADS-D scores of the observation group on the day of discharge and 3 months after discharge were (12.50±0.82), (10.50±0.87) and (9.78±0.80), (8.63±0.87) points, respectively. The HADS-A/HADS-D scores of the control group on the day of discharge and 3 months after discharge were (12.92±0.74), (11.72±0.99) and (10.23±0.78), (9.38±1.04) points, respectively. The difference was statistically significant ( t values were 2.412-5.764, P<0.05 or 0.01). The observation group scores on CHIP subscales on the day of discharge and 3 months after discharge are higher than the control group, the difference was statistically significant (t values were -7.93--2.490, P<0.05 or 0.01). Conclusions:Motivational interviews based on timing theory can enhance parents’ self-efficacy, improve their negative emotions and family coping styles, and thereby promote the recovery of children.

Objective: To explore the changes in ribosomal DNA copy number in peripheral blood among patients with pneumoconiosis and its influencing factors, so as to provide insights into prevention and treatment of pneumoconiosis. Methods: Eighty-eight patients with pneumoconiosis who visited a designated hospital and 71 community residents with no history of pneumoconiosis or dust exposure were selected as the pneumoconiosis group and control group, and age, smoking history, drinking history and cumulative years of exposure to dust were collected through questionnaire surveys. The copy number of 45S rDNA and 5S rDNA was detected using real-time fluorescence quantitative PCR, and the differences between the two groups were compared. Factors affecting the copy number of 45S rDNA and 5S rDNA were identified by a multiple linear regression model. Results: The pneumoconiosis group had a median age of 56.00 (interquartile range, 15.25) and a mean cumulative dust exposure duration of (12.40±8.08) years, with 56.82% smoking and 62.50% drinking. The control group had a median age of 64.00 (interquartile range, 37.00) years, with 32.39% smoking and 26.76% drinking. The median copy number of 45S rDNA in the pneumoconiosis group was 1.29 (interquartile range, 0.59), which was lower than 2.10 (interquartile range, 1.88) in the control group; the median copy number of 5S rDNA in the pneumoconiosis group was 5.33 (interquartile range, 0.85), which was higher than 4.66 (1.34) in the control group (both P<0.05). Multiple linear regression analysis identified age (β=-0.034) and pneumoconiosis (β=-1.595) as factors affecting 45S rDNA copy number, age (β=-0.013) as a factor affecting 5S rDNA copy number, and age (β=0.018) as a factor affecting 5S rDNA copy number in the pneumoconiosis group (all P<0.05). Conclusions Compared with community residents with no history of pneumoconiosis or dust exposure, the copy number of 45S rDNA in peripheral blood among patients with pneumoconiosis is reduced and the copy number of 5S rDNA is increased.