Objective To study the intervention effectiveness of intensive training in medical interns’occupational exposure protection.Methods Medical interns in seven colleges and universities in Wuhan between 2011 and 2015 were chosen and divided into control group (675 medical interns in 2011 - 2013,comprehensive training about healthcare-associated infection control was conducted for once before internship )and intervention group (682 medical interns in 2014 - 2015,hospital-department-tutor three steps of intensive training was conducted),the occurrence of occupational exposure and exposure knowledge awareness between two groups were compared. Results The awareness rate of knowledge about occupational exposure protection and the implementation rate of protective measures in intervention group were both higher than control group (all P <0.05).Incidence of occupa-tional exposure in intervention group was lower than control group (21 .70%[n=148]vs 65.33%[n=441 ],χ2 =262.91 ,P <0.01);percentage of interns who conducted active serological virus detection and intensified vaccination of hepatitis B virus were both higher than control group (14.66%[n=100]vs 2.96%[n=20];11 .73%[n=80]vs 2.67%[n=18],respectively).Occupational exposure before and after intervention occurred most frequently when interns were preparing medicine,occupational exposure reporting rate in intervention group was higher than control group (72.97%[108/148]vs 50.11 % [221/441 ],χ2 =52.78,P <0.01 ).Conclusion The intensive training of occupational exposure protection among medical interns can improve the awareness and skills of occupational protec-tion,and reduce the occurrence of occupational exposure.

Studies have shown that pregnant women due to their specificity and social factors during pregnancy, maternal mortality and postpartum serious complications were significantly higher. Taking effective measures to control maternal mortality and ensuring the safety of pregnant women is an urgent problem to be solved.The first measure to ensure the safety of pregnant women is to use appropriate assessment tools, accurate, dynamic and comprehensive risk assessment of pregnant women. At present, with the start of a comprehensive two-child policy,research related to obstetric early warning scores has become the focus of research in the field of obstetric care.Therefore,this article through the"obstetrics","maternal","risk warning","risk score"as the key word,search Wanfang database,Chinese Journal full-text database(CNKI),Chinese biomedical literature database(CBM);foreign language literature,such as PubMed,Web of Science,Springer,EBSCO and other databases,with"early warning score","risk score","risk score system","Obstetric","Obstetric care"Word for retrieval.So that to provide a comprehensive analysis of the status quo of the use of early risk assessment tools at home and abroad,and to summarize the contents of the assessment tools,and further point out the problems in the current research.

Health education during pregnancy can reduce the incidence of maternal and child disease and improve their health level. As the implementation of the " universal two-child policy" and the change of the national fertility view, the number of maternal, especially the number of the advanced maternal age, is faster increase.While the health manpower in our country is short, so we need a convenient, fast and safe informationalizedway for maternal health education.This article comprehensive analyze the status of application health education about the form and content in the China and overseas,and discuss the advantages and limitations, in order to establish a scientific, effective, propagable and new model of maternity information health education, to provide experience and enlightenment for our clinical works.

Objective:To understand the reasons for non-adherence of pulmonary rehabilitation exercise in patients with acute exacerbation of COPD, and in order to provide theoretical and practical basis for improving patient adherence.Methods:Using qualitative phenomenological research methods, eighteen patients of non-adherence with exercise were conducted deeply semi-structured interviews, and the Colaizzi analysis was used for data analysis and extracting themes.Results:Seven themes were extracted: effect of subjective and objective symptoms, limited by comorbidity, negative mood disturbance, lack of perception effect, material environment in ward, cultural environment in ward and inappropriate form of exercise.Conclusions:Health care providers should value these obstacles and implement targeted measures, in order to achieve the goal of improving exercise adherence, so that more patients would complete pulmonary rehabilitation exercise.

OBJECTIVETo explore the role of HIF1α gene in prostate cancer cell line DU145 by knocking it out with a novel gene-editing tool CRISPR/cas9 system.

METHODSA CRISPR/cas9 system with two sgRNAs targeting exon 1 of the HIF1α gene was constructed for the knock out experiment. CCK8 assay and transwell experiment were carried out to assess the effect of the knock out on the proliferation, migration and invasiveness of DU145 cells.

RESULTSThe efficiency of gene-targeting was measured through a T7E1 assaying and sequence analysis, which confirmed that the partial knock out was successful and has led to a significant decrease in the expression of HIF1α and inhibition of cell proliferation, migration and invasiveness.

CONCLUSIONA CRISPR/cas9 system for the knock out of HIF1α has been successfully constructed, which could inhibit the proliferation and migration of DU145 cells. The system can facilitate further studies of the HIF1α gene and its roles in tumorigenesis.

CRISPR-Cas Systems ; genetics ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Gene Editing ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; physiology ; Male ; Neoplasm Invasiveness ; Prostatic Neoplasms ; pathology

Objective: To investigate the status and prognostic significance of TERT and IDH1/2 genes mutations in diffusely infiltrating gliomas. Methods: Hot spot mutations of TERT and IDH1/2 genes were detected by DNA sequencing in 236 cases of gliomas at West China Hospital from 2012 to 2016, including pilocytic astrocytoma (WHO grade Ⅰ, 16 cases), diffuse astrocytoma and oligodendroglioma (WHO grade Ⅱ, 89 cases), anaplastic astrocytoma and oligodendroglioma (WHO grade Ⅲ, 72 cases) and glioblastoma (WHO grade Ⅳ, 59 cases). The prognostic significance of TERT and IDH1/2 hot spot mutations was evaluated. Results: No IDH or TERT mutations were detected in pilocytic gliomas. TERT promoter mutation frequency was higher in patients aged ≥40 years(60.8%, 93/153) than in patients aged <40 years (32.8%, 22/67; P<0.01). TERT promoter mutation rate was also significantly higher in oligodendroglioma (87.5% , 56/64) than that in astrocytoma(37.8%, 59/156; P<0.01). Young age (<40 years), oligodendroglioma and IDH1 mutation were favorable prognostic factors for diffusely infiltrating astrocytic and oligodendroglial tumors. TERT mutation alone was not of prognostic significance. Diffusely infiltrating astrocytic and oligodendroglial tumors were divided into four molecular subtypes according to TERT and IDH1 mutation status: IDH(+ )/TERT(+ ), IDH(+ )/TERT(-), IDH(-)/TERT(-) and IDH(-)/TERT(+ ). There was significant prognostic difference among the 4 subtypes. Conclusions Combined IDH and TERT gene mutation analysis may be useful for prognostic subgrouping. Notably, IDH1 wild-type cases can be further subdivided into TERT(+ ) or (-) subgroups with significant prognostic difference.

From the two aspects both at home and abroad endowment institutions the elderly family support commonly used assessment tool, this paper introduces the process of development of tools, dimensions, scoring method, and analyze the reliability and validity of the advantages and disadvantages of various assessment tools, aimed at the elderly family support for localization development of our country endowment institutions provide reference for the development and application of assessment tools.

Objective To construct an early warning model of fall risk for the elderly based on six kinds gait parameters. Methods A digital field was used to collect parameters from six kinds of gait for the elderly with or without the history of falls, and the binomial logistic regression analysis was used to establish a regression equation for predicting the fall risks in the elderly, and an early warning model was constructed. Results The regression equations constructed according to the parameters from six kinds of gait were statistically significant. The overall correct rate was predicted from high to low: walking forward with closed eyes (97.1%), walking backward with open eyes (92.9%), walking backward with closed eyes (88.6%), walking forward with open eyes (87.1%), turning head up and down with open eyes (85.7%), turning head left and right with open eyes(82.9%). The constructed early warning model for fall risk of the elderly mainly included five steps, namely, judgment, test, extraction, calculation and early warning, which was suitable for gait testing and evaluation of the elderly in the laboratory. Conclusions Parameters from six kinds of gait could predict the fall risk of the elderly. Among them, walking forward with closed eyes was best to predict the fall risk in the elderly. The established early warning model of fall risk for the elderly could be used to predict the fall risk of 65-75 year old people within one year, which could provide early warning based on the probability of falling, playing a positive effect on preventing falls in the elderly.

ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome types and influencing factors of protein-energy wasting （PEW） in chronic kidney disease （CKD） undergoing maintenance hemodialysis （MHD）. MethodsAccording to diagnostic criteria， 164 patients with MHD were divided into PEW group and non-PEW group. The clinical data of all patients were collected， including general information such as gender， age， height and weight， disease characteristics such as course， cormobidity， and haemodialysis duration， laboratory indicators such as blood routine， liver function， renal function， electrolyte， blood lipid， grip strength， and the four examinations. Logistic regression analysis was used to find the influencing factors of PEW by taking the clinical indicators with significant differences between the two groups （P＜0.05） as the independent variables， diagnosis of PEW as the dependent variable， and normal values as the reference. ResultsOut of 164 patients with MHD， there were 96 （58.5%） cases in PEW group and 68 cases （41.5%） in non-PEW group. Compared to the non-PEW group，PEW group had increased age， ratios of bedrest， deep vein preservation， edema， and low grip strength， percentages of comorbidities type 2 diabetes， cardiovascular and cerebrovascular diseases，infections and anemia， and levels of alanine aminotransferase and permine amin aminotransferase， as well as decreased body mass index， self-care ratio，internal arteriovenous fistula， red blood cell count， hemoglobin， serum total protein， serum albumin levels （P＜0.05）. The PEW group had significantly higher frequency of poor appetite and digestion， abdominal distension， fear of cold and preference of warmth， weak breathing and fatigue， poor appetite， oliguria， nausea and vomiting than non-PEW group （P＜0.05）. The incidence of both yin and yang deficiency syndrome and damp-turbidity syndrome were significantly higher in the PEW group than the non-PEW group， while that of liver-kidney yin deficiency syndrome and stirring of wind syndrome were lower （P＜0.05）. Logistic regression analysis showed that low BMI （＜22 kg/m²）， inability to take care of oneself， low grip strength，low serum albumin （＜38 g/L）， infection， older age， fear of cold and cold limbs，and poor appetite were the risk factors of PEW in patients undergoing MHD （P＜0.05）. ConclusionThe root syndrome of MHD-PEW patients is both yin and yang deficiency， concurrent with damp-turbidity syndrome. Low BMI， low serum albumin， infection and older age may be the influencing factors of PEW in patients undergoing MHD.