Objective To compare the efficiency and safety of intracoronary transplantation of peripheral blood stem cells (PBSC) between elderly and younger patients with heart failure after myocardial infarction (MI). Methods Twenty-five patients with heart failure after MI were divided into aged group(≥60 years,n=13) and non-aged group (＜60years,n=12) to receive intracoronary PBSC transplantation (PBSCT) following bone marrow cells mobilized by granulocyte colony-stimulating factor (G-CSF). Clinical data including coronary lesion characteristic, left ventricular shape, infarct region area and cardiac function, as well as adverse side effects between the two groups were compared. Left ventricular function was evaluated before and 6 months after the treatment by single photon emission computed tomography (SPECT). Results At 6 months, the left ventricular ejection fraction (LVEF) and 6 minute walk test (6MWT)distance increased, while the left ventricular diastolic diameter (LVDd) decreased significantly in both groups. There were no significant difference between the two groups in absolute change in the cardiac function parameters. Conclusions The present study demonstrated that autologous intracoronary PBSCT might be safe and feasible for both old and younger patients with heart failure after MI and left ventricular function is significantly improved.

Objective To investigate the significance of procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC) and other inflammatory markers in the diagnosis of pediatric patients with HFMD.Methods 138 cases of pediatric patients with foot and mouth disease(study group)and 50 cases of healthy children(control group)were recruited in the study.Procalcitonin (PCT),white blood cell(WBC),neutrophil count(NC),lymphocyte count(Ly),immunoglobulins,C-reactive protein and other indi-cators were determined and compared.Results PCT,CRP,WBC,NC,Ly% and IgM levels were higher in study group than those in control group,the differences were all statistically significant(P <0.05 );IgG,IgA levels in control group were lower than that in control group,the differences were statistically significant(P <0.05).Conclusion PCT,WBC,NC,Ly,CRP and IgA,IgG,IgM can provide experimental evidence for diagnosis of children with hand foot and mouth disease.

Background and purpose:The quality of life and psychological status of the advanced cancer patients has been widely valued. This study aimed to analyze the psychological status of the advanced cancer patients and its influence factors.Methods:The patients who were hospitalized in the palliative care department of Fudan University Cancer Center from Sep. 2011 to Mar. 2013 were included in this study. Self-rating anxiety scale(SAS), self-rating depression scale (SDS), EORTC QLQ-C30, social support revalued scale and symptom checklist 90 (SCL-90) were recorded and analyzed.Results:Fifty-six patients were included in this study, 18 were depression and 24 were anxiety while 16 of them were depression together with anxiety. The patients were divided into 2 groups according to their psychological status. There’s no signiifcant difference between the age and the social support between the two groups, while the mental disorders group have lower scores on body function, role function, emotional function and social function. The mental disorders were positive correlated with the symptoms score while negative correlated with the quality of life.Conclusion:There’s a high ratio of mental disorders in advanced cancer patients, the symptom scores and quality of life are related to mental disorders. We should pay more attention to the patients who were suffered more from the illness or had lower QOL scores.

Objective To assess the continuing medical education (CME) and training needs for gereral practitioners (GPs) in urban and suburb of Shanghai.Methods Gereral practitioners in urban (n =710) and suburb (n =843) of Shanghai attending two municipal training programs were interviewed with self-designed questionnaire during July 2011 to May 2012.Results Urban group included 710 GPs whose mean age were (36.7 ± 6.8) y and 33.0％ were male.Suburban group had 843 GPs whose mean age were (36.6 ± 5.1) y and 33.2％ were male.The survey showed that 84.6％ of urban group and 85.6％ of suburban group had attended CME before.There was no statistical difference in the overall satisfaction of CME between two groups (Z =-0.895,P =0.371).The propotion of satisfied and very satisfied was 45.1％ and 13.8％ in urban groupt,while it was 49.5％ and 9.1％ in suburb group.The overall satisfaction rates of enhancing basic theories (Z =-2.296,P =0.022) and skills (Z =-2.013,P =0.044) and CME textbooks (Z =-2.819,P =0.005) were higher in suburban group than those in urban group.Both of them agreed that the contents of CME were divorced from reality of practice (60.3％ vs.65.2％,x2 =3.213,P =0.082).The percentages of complain of insufficient training time (19.7％ vs.11.0％,x2 =18.045,P ＜ 0.05) and contents (7.5％ vs.4.3％,x2 =5.747,P =0.019),and weak leadership commitment (14.3％ vs.6.5％,x2 =19.95,P ＜ 0.05) were higher in suburban group than those in urban group.On the contrary,the delivery of repeated contents (24.8％ vs.34.8％,x2 =15.327,P ＜0.05) and long training time (16.4％ vs.28.2％,x2 =26.055,P ＜ 0.05) were lower in suburban group than those in urban group.Using case study in the teaching was the common choice of both groups (73.3％ vs.78.0％,x2 =0.635,P =0.426).Compared to urban group,suburban group was more likely to choose lecture of theory (63.6％ vs.50.8％,x2 =6.712,P =0.010) rather than problem based learning (43.1％ vs.51.9％,x2 =4.273,P=0.010).Conclusions Both urban and suburban GPs in Shanghai are generally satisfied with the CME programs.There are some discrepancies in training needs of CME between urban and suburben area in Shanghai,indicating that the CMB programs need to be designed according to the needs of trainees in urban or suburb areas.

Objective To investigate the training needs of general practioners (GPs) in Shanghai and to analyze the related factors.Methods A questionnaire survery on the training needs was conducted among 428 GPs who attended a municipal training program of clinical compentance in Shanghai during July 2011 to February 2012.Results Among 428 GPs receiving the survey,23.9％ (102/427) expressed great willingness for training; 40.2％ ( 169/421 ) preferred part-time and 41.3％ ( 174/421 ) preferred on-job training; 31.7％ (377/1188) wished to have case analysis method of teaching.In the aspect of training contents,common clinical skills were ranked the first,accounting for 32.1％ (1376/4280) of the choices,on the other hand,health care for women,children and the elderly in community was ranked the last,accounting for 18.9％ (485/2568) of the choices.Logistic regression showed that the gender (OR =2.194,P=0.010),age (OR=0.435,P=0.011) and education levels of GPs (OR=0.293,P=0.006) were related factors of training needs.Conclusion The survay reveals that training needs of GPs are strong in Shanghai and GPs prefer short-term training in real clinical situations.

Objective To analyze the epidemiologieal features and treatment of brain injury in Chinese Wenchuan earthquake so as to provide the experiences for improving treatment level. Methods A total of 685 patients with earthquake-induced brain injury in the City of Deyang were collected to ana-lyze age, injury type, injury localization and treatment characteristics. Results Of large number of earthquake victims, the number of the patients with brain injury ranked the second place, mainly minor and moderate brain injuries involving scalp laceration for the most and skull fracture and extradural hema-toma for the next. As for the age distribution of the patients, young and middie-aged patients accounted for the most, for they were at school or at work when the earthquake happened. Obvious position distribu-tion features were found in depressed fracture of skull and extredural hematoma but not in the scalp lacera-tion. Depressed fracture of skull occurred mostly at forehead and occiput while extradural hematoma could be most seen at froutotemple. Most brain injuries were combined with other injuries. Mainly extremity and pelvic fractures. Conclusions Self-protection sense and measures during earthquake are very important for decreasing incidence and severity of brain injuries. The management of rospimtory tract in prehospital care should be strengthened to avoid asphyxia and hence raise the success rate of treatment.

Gene knockout by ZFNs (zinc-finger nucleases) is efficient and specific, and successfully applied in more than 10 organisms. Currently, it is unclear whether this technology can be used for knocking-out enhanced green fluorescent protein (EGFP) gene in transgenic goats. Here we constructed and used ZFN-coding plasmids to produce genetic knockouts in the cells of cloned fetus produced from donor cells by microinjection of EGFP gene. Following introduced plasmids into caprine primary cultured fetus fibroblasts by electroporation, targeting of a transgene resulted in sequence mutation. Using the flow cytometric analysis, we confirmed the disappearance of EGFP expression in treated cells. Sequence from PCR products corresponding to targeted site showed that insertion of a G into the exon of EGFP resulted in frame shift mutation. These results suggest that ZFN-mediated gene targeting can apply to caprine fetus fibroblasts, which may open a unique avenue toward the creation of gene knockout goats combining with somatic cell nuclear transfer.
Animals ; Base Sequence ; Cloning, Organism ; Electrophoresis ; Endonucleases ; genetics ; metabolism ; Fetus ; Fibroblasts ; metabolism ; Gene Knockout Techniques ; Gene Targeting ; methods ; Goats ; Green Fluorescent Proteins ; genetics ; Molecular Sequence Data ; Mutation ; Zinc Fingers

Objective To study insulin sensitivity and first-phase insulin secretion in obese subjects with impaired glucose regulation (ICR) in Shanghai. Methods A total of 129 subjects [38 lean controls and 91 obese subjects with ICR including 64 isolated impaired glucose tolerance (IGT) ,8 isolated impaired fasting glucose (IFC) and 19 IFC + ICT] underwent 75 g oral glucose tolerance test and insulin-modified reduced sample number (n = 12) of Bergman's minimal model method with frequently sampled intravenous glucose tolerance test (FSIGTT). Insulin resistance was determined from the insulin sensitivity index (S1) of the FSIGTT. Insulin secretion was determined during the FSIGTT by the acute insulin response to glucose (AIRg). The disposition index (DI) , the product of AIRg and S1, was used to determine whether AIRg was adequate to compensate for insulin resistance. Results (1) Compared with normal controls, the value of S1 was significantly decreased in 3 groups with ICR (all P

Objective To explore the value of mammogram texture analysis in prediction of metastasis of axillary lymph nodes for breast carcinoma.Methods Mammograms and clinical data of 171 patients with breast carcinoma confirmed by pathology were retrospectively analyzed,and all patients underwent axillary lymph node dissection (ALND).Then the patients were divided into axillary lymph node metastasis group and non-metastasis group according to the result of ALND.The texture features of these lesions were statistically analyzed,including gray-level histogram texture parameters (mean value,standard deviation,skewness,kurtosis and variance) and gray-level co-occurrence matrix texture parameters (energy,entropy,correlation,inertia,inverse difference moment and contrast).Results In all of 171 breast cancer patients,96patients had axillary lymph node metastasis,while 75 patients had no metastasis.Mammograms showed negative axillary lymph nodes in 119 patients and positive axillary lymph nodes in 52 patients,and the sensitivity and specificity of mammograms in the diagnosis of positive axillary lymph nodes was 48.96％ (47/96) and 93.33％ (70/75),respectively.Mammogram texture analysis showed the values of energy,entropy,inverse difference moment and correlation in axillary lymph node metastasis group were higher than those in non-metastasis group,while the values of inertia and contrast in the axillary lymph node metastasis group were lower than those in non-metastasis group (all P＜0.05).The rest texture parameters had no significant differences between two groups (all P＞0.05).Area under curve (AUC) for texture parameters of energy,entropy,inertia,inverse difference moment,correlation and contrast was 0.610,0.610,0.374,0.599,0.612 and 0.421 (all P＜0.05),respectively.AUC of mammography,mammogram texture features,and the combination of mammography and texture features was 0.711,0.676 and 0.787 (all P＜0.05),respectively.The sensitivity and specificity of mammogram texture features,the combination of mammography and texture features in diagnosis of axillary lymph nodes metastasis was 62.5％ and 64.6％,66.7％ and 82.7％,respectively.Conclusion Mammogram texture parameters are helpful for predicting axillary lymph node metastasis,and the combination of mammography and texture features can improve diagnostic efficiency of axillary lymph node metastasis.

Objective To investigate the current perioperative management of geriatric hip fractures in China.Methods The survey was performed between 15th to 21st of November,2017.An electric questionnaire was delivered to the orthopedic surgeons attending the 12th International Congress of Chinese Orthopedic Association (COA) and the orthopedic fellows attending grand round at Department of Orthopaedic Trauma,Beijing Jishuitan Hospital.The questionnaire addressed the current perioperative management of geriatric hip fractures (≥ 65 years) at the departments where the participants worked,covering preoperative examination and preparation,postoperative rehabilitation and multidisciplinary collaboration.Results 171 valid questionnaires were collected for this study.Of the 171 orthopedic surgeons from 28 provinces in China,106 (62.0％) came from a tertiary hospital and 65 (38.0％) from a secondary hospital.In 74.3％ (127/171) of the hospitals,more than 100 geriatric hip fractures were treated annually.63.2％ (108/171) of the hospitals treated 100 to 500 cases annually,5.9％ (10/171) 500 to 1,000 cases and 5.3％ (9/171) more than 1,000 cases.Multidisciplinary collaboration was not established in most hospitals (71.9％,123/171) for geriatric hip fractures.Pulmonary function test (61.4％,105/171),Holter (38.0％,65/171) and ambulatory blood pressure monitoring (53.8％,92/171) were indicated as routine preoperative investigations.In 56.3 ％ (96 / 171) of the hospitals,traction was performed before operation.In 80.1％ (137 / 171) of the hospitals,the interval between admission to surgery was more than 48h for the patients.In 36.3％ (62/171)of the hospitals,patients were allowed to ambulate within one week after surgery.In 4.1％ (7/171) of the hospitals,patients were allowed full weight-bearing within one week after surgery.Conclusion Significant gaps exist in perioperative management of geriatric hip fractures between current practice in China and worldwide guidelines and consensus.