Objective To study the role of beta endorphin (?-EP) in the pathogenesis of vitiligo. Methods Radioimmunoassay (RIA) was used to measure the levels of ?-EP in plasma from 40 patients and tissue fluid of lesional and non lesional skin from 33 patients with vitiligo. Results Plasma levels of ?-EP were significantly higher in patients with generalized(11.74?3.47 pmol/L), local(8.31?2.57) and segmental(8.61?2.61) vitiligo than those in normal controls(6.69?1.46). Tissue fluid levels of ?-EP were significantly higher in lesional skin (9.25?4.49 and 10.24?4.37) than those in non lesional skin (5.50?2.84 and 6.12?1.61) from patients with local and segmental vitiligo. Increased levels of ?-EP were observed in tissue fluid from both lesional and non lesional skin in patients with generalized vitiligo, however, no significant difference of ?-EP levels was found between the two kinds of skin tissue. Conclusion It is suggested that ?-EP might play a role in the pathogenesis of vitiligo.

Objective To study the protective effects of mild hypothermia on cerebral and levels of serum levels of anti -brain antibodies after severe traumatic brain injury.Methods Severe traumatic brain injury were selected as the Ⅰ group (n=60),also select healthy as the Ⅱgroup (n=30),the Ⅰgroup was divided into group A (n=30)and group B (n=30)according to a random number table.The patients of group A was given hypothermia and the patients of group B were treated with temperature treatment,the levels of anti-brain antibodies in serum of each group were determined in ELISA assay,changes in cerebral blood flow before and after treatment of group A and group B were observed in Doppler,and observed Glasgow Outcome Score (GOS )of group A and group B.Results The level of anti-brain antibodies in serum of theⅠgroup was (0.59 ±0.02)U/mL significantly higher than that ofⅡ group (0.38 ±0.01)U/mL,the difference was statistically significant(t=9.192,P=0.029);the level of anti-brain antibodies in serum after treatment of group A was (1.58 ±0.03)U/ml significantly lower than that of group B (1.82 ±0.04)U/mL,the difference was statistically significant(t=10.042,P=0.019);the average flow velocity, pulse index and GCS score after treatment of group A were (54.20 ±0.23)cm/s,(0.51 ±0.02),(10.03 ±1.03) points significantly better than those of group B[(40.03 ±0.04)cm/s,(0.72 ±0.02),(8.12 ±0.02)points],the difference was statistically significant (t=9.892,10.041,9.189,P=0.021,0.018,0.026).Conclusion The lev-els of anti-brain antibodies in serum can significantly increase after severe traumatic brain injury,Hypothermia can reduce the serum levels of anti-brain antibodies,can increase cerebral blood flow.

BACKGROUND: Brain trauma can stimulate the proliferation of neural stem cells (NSCs) to some extent, while progesterone can ameliorate the learning and memory function following brain trauma, which can also promote the neurofunctional recovery after brain trauma by stimulating the proliferation of NSCs.OBJECTIVE: To observe the effects of progesterone on the proliferation of NSCs after diffuse brain injury (DBI).DESIGN: Randomized control animal experiment.SETTING: Xinxiang Medical College.MATERIALS: Forty-eight healthy male SD rats at 4-5 months with the body mass of 280-330 g were selected.METHODS: The experiment was conducted in Xinxiang Medical College from September 2004 to January 2005. Forty-eight rat models of Marmarou DBI were selected and randomly divided into 4 groups with 12 rats in each group: ①Sham-operation group: rats were cut open the scalp and then sutured.②Brain trauma group: rats were made into animal models of brain trauma.③Dimethyl sulphoxide (DMSO) group: rats were given intraperitoneal injection of DMSO at the same volume as progesterone group at one hour after brain trauma and then the same administration was performed daily. ④Progesterone group: rats were intraperitoneally injected with 4 mg/kg progesterone at one hour after brain trauma and then the same administration was performed daily. Rats were executed respectively at 3 and 6 days after sham operation or brain trauma operation, and hematoxylin-eosin staining was conducted to observe the morphological changes of cortical neurons in brain. The expressions of nestin in dentate gyrus and hippocampus were detected with immunohistochemical staining.MAIN OUTCOME MEASURES: Observation of histomorphological changes of neurons and detection of the expressions of nestin in hippocampus and dentate gyrus.RESULTS: ①There was no injury in cortical neurons in the sham-operation group, while obvious neuronal injury and loss in cortex of rats were found in the 3-day and 6-day brain trauma groups, and the neuronal injury was significantly severer in brain trauma than in 3-day and 6-day progesterone groups. ②The expressions of nestin in hippocampal CA4 region or dentate gyrus of sham-operation group were in low level or little, and the expression of nestin could be seen occasionally in hippocampal CA4 region. The expressions of nestin in hippocampal CA4 region and dentate gyrus of the brain trauma group significantly increased (P ＜ 0.05), while those in the progesterone group increased more than the brain trauma group remarkably (P ＜ O.05).③There were no differences in neuronal injury and nestin expression between braintrauma group and DMSO group(P ＞ 0.05).CONCLUCION: Progesterone for brain trauma may be related with its promoting effects on the proliferation of NSCs.

A new method was established for the direct, rapid and quantitative analysis of pesticide residues, dimethoate chlorothalonil and malathion by low temperature plasma ( LTP) ionization miniature ion trap mass spectrometer. The LTP ionization probe and sample inlet of ion trap mass spectrometry were enclosed in a metal cavity. With non-contact heating, the samples placed on the sample platform were desorbed into gaseous phase and ionized by LTP ionization probe. The results showed that closed ionization had an edge over the opened ionization. The quantitative analysis of 3 pesticides within the range of 0. 5-10 mg/L was realized by optimizing heating time and flow rate of air, and the relative standard deviations of signal intensity is less than 11%. LODs of pesticide, which were obtained within 5 s, were as low as several hundred pictograms. The results showed that the method could be used for the analysis of pesticide residue on green and organic fruits or vegetables.

Purpose To investigate the mutations of ID3,TCF3 and MYC genes in Chinese Burkitt lymphoma and discuss their significance.Methods Total DNA was extracted from tumor tissues of 32 patients with Burkitt lymphoma,then the DNA was amplified by polymerase chain reaction (PCR),and the products of PCR were sequenced directly with Sanger sequencing methods.Results The mutation rates of ID3 and TCF3 genes were 35.5％ (11/31) and 18.8％ (6/32) respectively.The mutation rate of MYC was 50％.The mutation rates of MYC exon 1,MYC exon 2 and MYC exon 3 were 3.3％ (1/30),50％ (15/30) and 7.7％ (2/26) respectively.Conclusion Recurrent mutations of the ID3,TCF3 and MYC genes in Chinese Burkitt lymphoma were identified by Sanger sequencing.For TCF3 gene,a novel mutation c.2202G ＞ C p.L569V was found in three cases.In two cases,a novel mutation of c.1070A ＞G p.G182D was found in MYC gene.

Objective:To understand the views of various relevant personnel on the standardized training mode of resident doctors after the implementation of Beijing′s medical education synergy policy, so as to provide references for further improvement of China′s medical education synergy policy.Methods:From January to May 2019, a semi-structured interview method was used to investigate the resident training students, clinical teachers(professional postgraduate tutors and resident training trainees′ guiding doctors)as well as resident training managers in 35 resident training bases in Beijing. The original data of the interviews were sorted out, coded and analyzed by taking root theory and main frame method descriptive analysis.Results:A total of 687 valid interview results were received, of which 71.86% of the resident training managers thought that the mode was more reasonable and the advantages outweighed the disadvantages; 38.07% of the resident training students and 45.45% of the graduate supervisors mentioned that the mode effectively shortened the training time of clinical talents; however, 31.98% of the resident training students and 22.92% of the resident training students′ guiding physicians mentioned it was difficult to balance courses, scientific research and clinical work under this mode, 61.62% of graduate supervisors pointed out that the students were lack of time and energy to engage in scientific research.Conclusions:The training mode of the integration of the standardized training of resident doctors and the postgraduate training of master′s degree in clinical medicine, given its necessity and institutional advantages, is found with room of improvement in its mode setting, arrangement of scientific research courses and clinical rotation, supervision and assessment of the process.

Objective: To explore the associations between parental marital status with bullying and self injurious behavior among primary and secondary school students, and to provide intervention support for the prevention of self injurious behavior of primary and secondary school students. Methods: A total of 11 107 primary and secondary school students in Nanyang, Anyang and Xinxiang city from central China were selected using multistage clustering sampling method. A questionnaire survey regarding bullying was administered. Results: Report rate of bullying in boys (18.1%) was higher than that in girls (9.8%), while report rate of self injurious behavior in girls (3.9%) was higher than that in boys(3.2%)( χ 2=155.56, 4.64, P <0.05). The severity of bullying ( r =0.44) and types of bullying ( r =0.42) were positively correlated with self injurious behaviors( P <0.01), while parental marital status was negatively correlated with self injurious behavior( r=-0.11, P <0.01). Parental marital status negatively moderated the relationship between severity of bullying( β =-0.01), types ( β =-0.05) with self injurious behavior( P <0.01). Conclusion Parental marital status plays a moderating role in the association between bullying and self injurious behavior among primary and middle school students.The lower parental marital status, the higher rate of self injurious behavior among bullied children. Comparison of bullied rates among primary and secondary school students with different characteristics.

Objective:Upper gastrointestinal bleeding (UGIB) is a common gastrointestinal disease in the emergency department. Identifying low-risk patients suitable for outpatient treatment is the focus of clinical and research. A simple predictive model was developed to identify patients with UGIB who could safely avoid hospitalization, thus providing a feasible basis for triage by emergency physicians.Methods:A retrospective cohort study was conducted on patients with UGIB treated at Zhongda Hospital Southeast University from January 2015 to December 2020. Baseline demographic data and clinical parameters at the initial presentation were recorded. Multivariate logistic regression model was performed to identify predictors of safe discharge.Results:Six hundred and twelve patients (45.9%) were not safely discharged. There were significant differences in age, Charlson comorbidity index, systolic blood pressure, pulse rate, hemoglobin, albumin, blood urea nitrogen, creatinine and international normalized ratio between the safe discharge group and the non-safe discharge group ( P<0.05). Using multivariate logistic regression analysis, a total of 7 variables were included in the clinical prediction model of UGIB risk stratification: Charlson comorbidity index > 2, systolic blood pressure < 90 mmHg, hemoglobin < 10 g/dL, blood urea nitrogen ≥6.5 mmol/L, albumin <30 g/L, pulse ≥100 beats/min and international normalized ratio ≥1.5. The sensitivity, specificity, positive predictive value, and negative predictive value for predicting unsafe discharge were 98.37%, 24.10%, 52.3%, and 94.6%, respectively, with the best cutoff value ≥1. The area under the receiver operating characteristic (AUROC) curve was 0.822, which was significantly higher than Glasgow Blatchford score (GBS) 0.786 (95% CI: 0.752-0.820, P< 0.01) and AIMS65 0.676 (95% CI: 0.638-0.714, P< 0.01). Conclusions:The predictive model has a reliable predictive value, which can provide references for emergency medical staff to triage patients with UGIB, thereby reducing medical expenses and having certain social and economic benefits.

Health manpower is key to the functioning of the health system. There exists a general need to strengthen health human resources in countries at large as they achieve universal health coverage. Through the systematic collection and sorting out of the declarations, initiatives, guidelines in the world and topics at the World Health Assemblies on health manpower-related issues since 2000, this paper summarized and analyzed the key issues and trends on health manpower planning, education and training, international migration, and compensation management, in order to provide reference for China′s health manpower management and practice.

Objective To explore the influence of longitudinal and oblique hollow lag screw internal fixation on interphalangeal range of motion,metacarpal range of motion and complications in patients with transverse fractures of proximal phalanges.Methods Retrospective analysis was performed on 102 patients with transverse fractures of proximal phalanges admitted to department of orthopedics of our hospital from June 2021 to February 2022.According to treatment methods,the patients were divided into longitudinal group and oblique group.The longitudinal group was given longitudinal hollow lag screw internal fixation while the oblique group was treated with oblique hollow lag screw internal fixation.The baseline data of the enrolled subjects were excluded from the influence of confounding factors according to the propensity matching scoring method(caliper value=0.02),and 51 patients with comparable baseline data were obtained in each group.The surgical status(surgical time and healing time),ranges of motions of interphalangeal and metacarpal joints,excellent and good rate of hand function(total active movement,TAM)and complications at 18 months after surgery were compared between the two groups.Results All patients successfully completed the surgery,and at least 18 months of follow-up data were obtained.There was no statistical significance in the surgical time or follow-up time between the two groups(P＞0.05).The healing time in oblique group(6.57±1.22)weeks,was significantly shorter than that in longitudinal group(7.82±1.54)weeks(P＜0.05).At 18 months after surgery,the interphalangeal range of motion was significantly higher in oblique group(82.62±3.41)° than that in longitudinal group(77.45±7.46)°(P＜0.05),but there was no statistical difference in metacarpal range of motion between the two groups(P＞0.05).The excellent and good rate of hand function in oblique group(94.12％)at 18 months after surgery was significantly higher than that in longitudinal group(80.39％)(P＜0.05).The incidence of complications revealed no statistical significance between oblique group(1.96％)and longitudinal group(3.92％)(P＞0.05).Conclusion In the hollow lag internal screw fixation treatment of patients with transverse fractures of proximal phalanges,both longitudinal and oblique screw methods have good effects,but the oblique screw method is more beneficial to the recovery of hand function.