Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.

Objective To investigate the effects of Thalidomide(THD)on transdifferentiation of human fetal lung fibroblast(HFL-F) to myofibroblast(MF) induced by Transforming Growth Factor-?1(TGF-?1) and the effects on trans differentiated MF.Methods HFL-F to MF trans-differentiation was induced with 5 ?g/L TGF-?1.The effect of 50 ?g/L THD on HFL-F to MF transdifferentiation was evaluated by measuring hydroxyproline(HYP) content with alkaline hydrolysis colorimetry,?-smooth muscle actin(?-SMA) protein with Western Blot,?-SMA and collagen Ⅲ(COL Ⅲ) mRNA with semiquantitative RT-PCR.Results THD inhibited TGF-?1 induced up-regulation of HYP and COLⅢ mRNA expressions(all P0.05).For HFL-F treated with 5 ?g/L TGF-?1 for 96 h,THD inhibited COLⅢ mRNA expression(P

Objective:To develop an evidence-based nursing program for a patient with oral complications of dysphagia due to cerebral infarction.Methods:According to the principle of PICO, and the problem of patients' clinical manifestations, using the method of combining subject words and free words, the database of Uptodate, NICE, SIGN. RNAO, medical pulse guide network, BMJ, Cochranc library, PubMed, EMbase, CINAHL, China National Knowledge Infrastructure were searched and collected the clinical guidelines, systematic evaluation and randomized controlled trial of oral complications in patients with dysphagia of cerebral infarction.Results:Totally 1 clinical decision, 5 clinical guidelines, 4 expert consensus, 2 systematic evaluations, 1 Meta-analysis, 3 randomized controlled trial (RCT) were included. Based on the search results and the patient′s condition and wishes, nurses performed swallowing function tests every two days according to the Standard Swallowing function rating Scale (SSA), raised the head of the bed 40°~45° and holded it for 1 hour. Three times a day, the teeth were brushed with chlorhexidine oral care solution under negative pressure. Sputum scab was removed by mechanical scrubbing. The back of tongue was scrubbed by 6x tongue scraping technique every night. After the infection was controlled, the teeth were washed twice a day with 0.9% sodium chloride solution. Oral condition and swallowing function were evaluated daily. High flow humidification oxygen therapy and mask spray atomization inhalation were used. Swallowing training was performed on the third day after admission. Seven days after the evidence was applied to clinical practice, the oral mucosa was moist without peculiar smell and sputum scab, and the swallowing function was changed from grade IV to grade II.Conclusion:Nursing cerebral infarction patients with dysphagia, nurses should timely assess the patient's oral cavity and swallowing function, the application of chlorhexidine and 0.9% sodium chloride solution oral care solution mechanical scrubbing method and negative pressure washing brushing method can effectively remove sputum scab, use 6x tongue scraping technology to scrub the back of tongue, can reduce micro organisms, reduce halitosis; the application of nasal mask high flow humidification oxygen therapy and spray atomization inhalation humidification effect is obvious Therefore, early swallowing training can reduce the incidence of oral complications.

Objective To detect the expression of chemokine receptors CXCR3 mRNA in the peripheral blood mononuclear cells (PBNCs) of patients with Rheumatoid Arthritis (RA) and to analyze the relationship between the expression and the disease activity. Methods mRNA was extracted from PBNCs and the expression of CXCR3 mRNA was detected by real-time fluorescence quantitative PCR (RFQ-PCR) in 51 RA patients and 32 controls. T-test, x2-test, ANOVA were used for statistial analysis. Results Comparison between the two groups had shown that the expression levels of CXCR3 mRNA in clinical active RA group were higher than those of the RA patients in remission and healthy controls (P<0.05). The expression levels of CXCR3 mRNA were positively correlated with serum levels of ESR and CRP in clinical active RA group (r=0.824, r=0.765, P<0.05). In addition, RF titer, APF, AKA, and anti-CCP had no significant correlation with the expression levels of CXCR3 mRNA in RA patients (P>0.05). Conclusion RFQ-PCR is a sensitive,reproducible and practical test. The mRNA expressions of CXCR3 are significantly elevated in RA patients,which suggest that CXCR3 may be involved in the pathogenesis of RA. The mRNA expressions of CXCR3 in active RA patients are higher than those of RA patients in remission. These results indicate that CXCR3 may play an important role in the pathogenesis and progression of RA, and CXCR3 may be considered as an indicator for disease activity, therapeutic efficacy and prognosis of RA.

Objective:To ascertain the levels of individual doses to radiation workers arising from occupationally external exposure in China in 2017, with an aim to provide basic data and scientific basis for prevention and control of occupational radiation sickness.Methods:Data on individual doses to monitored workers engaged in medical and industrial applications of radiation sources were collected through National Individual Dose Registry, with statistical analysis being carried out using Kruskal-Wallis H test, Mann-Whitney U test and Bonferroni method. Results:A total of 361 727 radiation workers were investigated in 2017, of which 81.6% was from medical application and 18.4% from industrial application, respectively. The average annual effective dose from medical and industrial applications were 0.353 and 0.270 mSv, respectively, with the former significantly higher than the latter ( Z=48.547, P<0.05). Furthermore, a statistically significant difference was seen in the average annual effective dose for each occupational category of medical application ( H=1 136.217, P<0.05), suggesting that the dose values for the monitored workers in nuclear medicine and interventional radiology were significantly higher than for other four medical categories ( Z=2.877-26.967, P<0.05). These dose values for the radiation workers was 0.361 mSv in tertiary hospitals, 0.397 mSv in secondary hospitals, and 0.308 mSv in primary and unrated hospitals, respectively. The dose values for the monitored workers in industrial radiography and well logging were significantly higher than for other five industrial categories of industrial applications ( Z=4.172-36.908, P<0.05). Conclusions:The average annual effective doses to the of monitored workers meet the relevant national standards. The exposure doses to the workers in nuclear medicine, interventional radiology, industrial radiography and well logging are relatively high. The necessary measures and devices for radiation protection should be further strengthened to reduce occupational exposure of workers.

A method of on-line solid phase extraction ( SPE )-two dimensional liquid chromatography electrospary-tandem mass spectrometric method was established for the determination of Teicoplanin concentrations in human cerebrospinal fluid. Cerebrospinal fluid samples were treated by the on-line SPE treatment, and analyzed by LC-MS/MS. The chromatographic separation was performed on a Shiseido CAPCALL-PAK C18 column with gradient elution by using 25 mmol/L ammonium acetate ( pH 6. 0 )-acetonitrile as mobile phases, and the flow rate of 1 mL/min. Detection was carried out under the selected reaction monitoring ( SRM) in positive ionization mode with scopolamine hydrobromide as internal standard. Matrix-matched calibration curves with good correlation coefficients (R2=0. 9993, n=6) were obtained in the concentration range of 25-5000 μg/L. The average recoveries varied from 100. 8% to 109. 9%. The intra-and inter-day precisions were less than 6%. The method is proved to be rapid, sensitive, accurate, and suitable to determine Teicoplanin concentrations in human cerebrospinal fluid.

Objective To explore the status of job burnout of medical staffs in minority border areas. Methods A total of 906 medical personnel from Pu'er hospitals in Yunnan Province were as-sessed with Maslach Burnout Inventory General Survey (MBI-GS) by t test, descriptive statistics, chi-square test, ANOVA and LSD-t pairwise comparison. Results ①The emotional exhaustion, cynicism and reduced personal accomplishment of medical staffs in minority border areas (1.55±1.40, 0.99± 1.29, 2.47±1.98) are significantly lower than general areas (P=0.000, 0.010, 0.000); ②emotional ex-haustion, cynicism and Maslach Burnout Inventory (MBI) total points of different levels of hospital medi-cal staff, the score of which in descending order are:municipal, county and township (town) levels (P=0.000, 0.000, 0.000); ③Female medical personnel's emotional exhaustion and cynicism are scored significantly higher than males medical staff (P=0.000, 0.025); ④The scores of emotional exhaustion, cynicism, reduced personal accomplishment and MBI total points of Bachelor medical staff are signifi-cantly higher than those of colleges as well as secondary schools and below (P=0.000, 0.000, 0.000, 0.012); ⑤The scores of reduced personal achievement of Lahu medical staff are higher than those of other ethnic groups (P=0.009). Conclusion In medical staffs in minority border areas there exists a certain extent of job burnout, which presents differences among genders, educational background, hos-pitals and ethnic groups.

Inflammation plays an important role in the occurrence, development and outcome of ischemic stroke. As one of the most sensitive indicators of inflammation, interleukin (IL)-6 is associated with the risk of ischemic stroke and plays a dual role in ischemic stroke. In-depth study on the changes and role of IL-6 level in patients with ischemic stroke may help to develop new methods to predict the outcome of ischemic stroke and promote the prevention and treatment of ischemic stroke.

Platelets play an important role in hemostasis, inflammation, tumor metastasis, wound healing and defense response, but its routine storage requires a specific temperature and the storage time is generally limited to 5 ~7 d, at the same time, platelet storage damage and bacterial breeding will limit its storage time. In addition, routine transfusion can cause serious adverse reactions such as non-hemolytic fever, allergies, circulatory overload, and transfusion-related acute lung injury. These limit the clinical application of platelet products. However, additives associated with platelet preservation can reduce the likelihood of their occurrence. Therefore, this article reviews the research status of additives related to platelet preservation in recent years, as well as improving platelet storage damage and improving platelet preservation characteristics.

Objective:To investigate secondary factors, laboratory features, treatment options, and prognosis of pure red cell aplastic anemia (PRCA) .Methods:This was a multicenter retrospective clinical study. Patients aged above 18 years newly diagnosed with PRCA between June 1, 2010, and June 1, 2019, were recruited as the main study object. A comparative analysis of remission rate and overall survival rate was made according to different treatment schemes adopted by patients and different drug reduction rates.Results:A total of 67 patients with PRCA were included in this study and the secondary PRCA group accounted for 44.8% (30/67) . The most common secondary factors were thymoma ( n=10) and T-cell large lymphocytic leukemia (T-LGLL) ( n=6) . The overall response rate of PRCA was 85.7% and the 3-year overall survival rate of PRCA was (74.3±7.5) %. The remission rate of cyclosporine A alone was slightly higher than that of oral glucocorticoid alone or combined with glucocorticoid[90.0% (36/40) vs 75.0% (12/16) , P=0.147]. After patients applied with cyclosporine A treatment reached CR/PR and remained stable for 3-6 months, the dose of cyclosporine A was reduced by 25 mg each time. The cyclosporine A reduction interval of a 25 mg/d reduction in more than 1 month significantly prolonged the median disease-free survival compared with a 25 mg/d reduction in less than 1 month [not reached vs 15 (95% CI 7-23) months, P<0.001]. There were 62.5% (10/16) of patients who responded to the initial or incremental treatment regimen after relapse. Conclusion:PRCA has features of various secondary factors, high overall survival rate, and high remission rate. Treatment with cyclosporine A alone is preferred, and cyclosporine A should be slowly tapered to reduce the risk of later relapse after it takes effect and patients reach a steady state.