Objective:To improve the clinical recognition of hereditary fibrinogen deficiency.Methods:The diagnosis and treatment process of a patient with acute promyelocytic leukemia (APL) complicated with hereditary fibrinogen deficiency who was admitted to the second Affiliated Hospital of Anhui Medical University in December 2018 was retrospectively analyzed, and the relevant literature was reviewed.Results:The patient was initially diagnosed as APL, and the complete remission was obtained after dual-induction therapy of all-trans retinoid acid and arsenous acid. During the first consolidation treatment, repeated reviews of fibrinogen fluctuated between 1.0-1.5g/L, and further improving the fibrinogen gene sequencing to diagnose APL combined with hereditary fibrinogen deficiency.Conclusion:For APL patients in remission who have decreased fibrinogen for many times and patients with hereditary fibrinogen deficiency who have significantly decreased fibrinogen in a short period, bone marrow biopsy and genetic testing should be further conducted to determine the pathogenesis.

Chinese materia medica(CMM) industry is one of the most national identity in China′s industries.According to the development situation in recent years,putting forward some reasonable ideas will promote better and faster development of the CMM industry.In this paper,through the literature review combined with CMM industry development status,the current structure of CMM industry was analyzed.And based on the concept of the industrial chain,the CMM industry chain structure was analyzed and described.The proposal of building a harmonious CMM industry chain was put forward clearly,which will conform to the requirements of the CMM industry development.Above all,this article has provided some constructive ideas for future development of CMM industry.

Objective To summarize the nursing experience of 1 case of very low birth weight infant decannulation difficult in PICC. Methods The nursing key points included: full assessment analysis decannulation difficult reason, consult the PICC catheter outpatient health nurses, give magnesium sulfate hydropathic compress, mucopolysaccharide polysulfate cream local besmear outside, sanyrene outside, at the same time give low-molecular-weight heparin calcium injection subcutaneous injection such as anticoagulant active treatment and nursing. Results After 7 days ,the infant left axillary mass dispel, PICC pull out smoothly. Conclusions Decannulation difficult of very low birth weight infant requires full evaluation, multidisciplinary cooperation and specialist consultation, can give targeted personalized nursing safety smooth tube drawing, is worthy of reference for clinic.

OBJECTIVE: To investigate the individual external dose level of medical radiation staffs in Guangzhou City.METHODS: The medical radiation staffs of Guangzhou City who conducted individual dose monitoring at Guangdong Province Hospital Center for Occupational Diseases Prevention and Treatment from 2008 to 2014 were selected as study subjects by convenient sampling method.Their individual dosage monitoring data were analyzed.RESULTS: A total of 17 754 person-times were monitored in 7 years.The annual collective effective dose was 10 621.1 person·mSv and the median per capita annual effective dose was 0.21 mSv/a.The per capita annual effective dose in 2008-2012 showed an increasing trend each year( P < 0.05),peaked in 2012,and then decreased in 2013 and 2014( P < 0.05).The per capita annual effective dose of radiology staffs in level Ⅱ medical institutions was higher than that of level Ⅲ medical institutions,level Ⅰ medical institutions and those below level Ⅰ( P < 0.01).The per capita annual effective dose of radiation staffs in level Ⅲ medical institutions was higher than level Ⅰ medical institutions and those below level Ⅰ( P <0.01).The effective monitoring rates of radiation staffs monitored for 4 cycles every year increased with time from 2008 to 2014( P < 0.01).The effective monitoring rate increased with the hospital level( P < 0.01).The per capita annual effective dose of the staffs in radiological diagnosis department was lower than that of clinical nuclear medicine,radiotherapy and interventional radiology( P < 0.01).CONCLUSION: The radiation dose of medical radiation staffs in Guangzhou City was within the national standard limit.Protection should be focused on the the staffs in secondary hospitals,clinical nuclear medicine,radiotherapy and interventional radiology.

Objective:To investigate the synergistic antitumor effect of pyrotinib in combination with 5-fluorouracil(5-Fu)on human epidermal growth factor receptor 2(HER2)positive breast cancer cells and its underlying molecular mechanism. Methods:HER2 positive breast cancer cells were screened by Western blotting.HER2 positive SKBR-3 and BT474 cells were treated with pyrotinib and 5-Fu individually or in combination for the following experiments.MTT assay was used to assess the effect of different drugs on the proliferation of the treated cells,and the combination index(CI)values were calculated using Combidrug software.Colony formation assay was used to evaluate the effect of different drugs on the colony-forming ability of the treated cells.FCM assay was used to analyze the effect of different drugs on the apoptosis rate and cell cycle of the treated cells.Western blotting was used to examine the effect of different drugs on the expression levels of proteins in the proliferation-and apoptosis-related signaling pathways.SKBR-3-cell-based tumor xenograft model was established using BALB/c nude mice.After treatment with pyrotinib and 5-Fu individually or in combination,the growth profiles of the xenograft tumors were recorded and the expression levels of proteins in the proliferation-and apoptosis-related signaling pathways were examined in the tumor tissues. Results:HER2 positive breast cancer cell lines SKBR-3 and BT474 were selected for further experiments after screening.The proliferation SKBR-3 and BT474 cells could be inhibited after treatment with pyrotinib and 5-Fu individually or in combination(all P＜0.05).Compared with pyrotinib or 5-Fu single drug treatment,pyrotinib in combination with 5-Fu had higher inhibition rate on the proliferation of SKBR-3 and BT474 cells with a Cl value of＜1,indicating the synergistic effect of pyrotinib and 5-Fu.In addition,in contrast to pyrotinib or 5-Fu single drug treatment,there was a further decrease in the number of colonies formed,increase in apoptosis rate,and increase in the percentage of G0/G,cells in SKBR-3 and BT474 cells after treatment with pyrotinib in combination with 5-Fu(all P＜0.01).Animal experiment results showed that the growth rate of xenograft tumors in mice treated with pyrotinib in combination with 5-Fu was significantly slower than that of the single-drug treated mice(P＜0.05).Western blotting analysis showed that the expression levels of HER2,HER4,AKT and phosphorylated ERK were significantly decreased after treatment with pyrotinib in combination with 5-Fu both in vitro and in vivo(all P＜0.01),indicative of the blockage of proliferation-related signaling pathways.Meanwhile,analysis of the apoptosis-related proteins revealed a decrease in the expression levels of caspase 3,poly ADP-ribose polymerase(PARP),and Bcl-2(all P＜0.01),while an increase in the expression levels of cleaved-caspase 3,cleaved-PARP,and p21(all P＜0.01). Conclusion:Pyrotinib and 5-Fu had synergistical antitumor effect on HER2 positive breast cancer cells,and the underlying mechanism may be related to the blockage of proliferation-associated signaling pathways and the induction of apoptosis and cell cycle arrest.

Objective: To systematically analyze the risk factors for urinary tract infection (UTI) in children with primary nephrotic syndrome (PNS), in order to provide scientific evidence for clinical prevention. Methods: Eight databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang Database, Chinese Science and Technology Periodical Database and Chinese Biological Medical Literature Database were retrieved for the case-control studies on PNS complicated with UTI in children.According to the inclusion and exclusion criteria, eligible studies were selected for meta-analysis by using RevMan 5.3 software. Results: Finally, 12 case-control studies were included, 917 children in the case group and 2 784 children in the control group.Compared with children without UTI, statistically significant difference existed in children with UTI of elevated 24-hour urine protein [standardized mean difference (SMD)=0.45, 95% CI: 0.02-0.88], decreased serum albumin (SMD=-1.06, 95%CI: -1.14--0.97), elevated serum cholesterol [weighted mean difference (MD)=2.28, 95%CI: 1.61-2.95], elevated serum low density lipoprotein (SMD=0.57, 95%CI: 0.37-0.77), decreased plasma IgG (SMD=-0.76, 95%CI: -0.94 to-0.58), elevated plasma IgM (MD=0.28, 95%CI: 0.11-0.46), high-dose hormone (MD=0.75, 95%CI: 0.58-0.92), and long time hormone use[<15 d odds ratio (OR)=-0.20, 95%CI: 0.10-0.42; ≥15 d OR=5.00, 95%CI: 2.38-10.50]. Conclusions Massive proteinuria, hypoalbuminaemia, hypercholesterolemia, high level of low density lipoprotein, decreased plasma IgG, high-dose hormone and long time hormone use are risk factors for UTI in children with PNS.

OBJECTIVE: To investigate the effects of subacute systemic inhalation exposure of 1,2-dichloroethane(1,2-DCE) on learning and memory in NIH mice. METHODS: Forty-five specific pathogen free healthy 7-week-old NIH mice were randomly divided into control,low-dose and high-dose groups with 5 female mice and 10 male mice in each group. The mice were exposed to 1,2-DCE at dosages of 0. 00,100. 00 and 350. 00 mg/m3 for 6 hours per day for consecutive 28 days by dynamic systemic inhalation. The neurobehavioral tests of mice were performed before and after the first to fourth weeks of exposure using the Morris water maze test. RESULTS: There was no significant difference in body weight and swimming speed among the three groups of mice( P > 0. 05). The navigation experiment results showed that the escape latency of mice in both low-and high-dose groups were longer than that of the control group at the same time point(P < 0. 05) during 1-4 weeks after exposure. In the control group,the escape latency was shorter than that of the same group before exposure( P < 0. 05). The escape latency of high-dose group prolonged with the increase of exposure time,and in the 4 th week the escape latency was significantly higher than that of the same group before exposure( P < 0. 05).The experiment results of space exploration indicated that the first time of crossing platform in low-and high-dose groups were longer than that of the control group at the second to the fourth week( P < 0. 05). The target quadrant retention time and the number of crossing the platform in the low-and high-dose groups were lower than those in the control group( P <0. 05). CONCLUSION: Subacute inhalation exposure of 1,2-DCE can impair the learning and memory ability of NIH mice.The high-dose exposure may reduce learning ability in mice in a time-effect manner.

The construction and operation of the hospital-wide radiation protection management information system is of great significance for improving the efficiency and quality of radiation protection management. A hospital has built a hospital-wide radiation protection management system, which consisted of four modules: radiation staff management module, protection items management module, site and equipment management module, and self-inspection module. The system adopted B/S mode, carried the lightweight J2EE framework-SpringBoot framework, and used mybatis, which was flexible and practical, as the persistence layer of the system, to store the data completely in the SQLServer database.Java language was used as the system development language, and the front and back-end separation architecture was used. Each of the four modules implemented the management responsibility departments and responsible personnel to carry out the all-round management of radiation protection, and realized the integrated, information-based and standardized management of radiation protection management in the hospital.

OBJECTIVE: To explore the association of interaction of noise exposure and superoxide dismutase( SOD) gene polymorphism on the susceptibility of occupational noise-induced hearing loss( ONHL) in Chinese Han population.METHODS: A simple random sampling method was used to select 2 400 Han workers as study subjects.These workers were exposed to 75.0-120.0 dB( A) of normalized continuous A-weighted sound with pressure level equivalent to a 40 hworking-week( L_(EX,W)) in Guangzhou City.A model method was set up to define 201 sensitive workers( sensitive group)and 202 resistant workers( resistant group) by combining results with hearing pure tone threshold test and the cumulative noise exposure( CNE).The genomic DNA was extracted from peripheral blood cells.The single nucleotide polymorphisms analysis of SOD was carried out by using the TaqMan probe with chemical fluorescence allelic identification test.Binary logistic regression method was used to analyze the interaction of noise exposure and SOD.RESULTS: After adjusting confounding factors such as gender,heavy metal exposure,dust exposure and high temperature exposure,the risk for ONHL in individuals interactively carry rs2040724 AG or GG and rs4880( CC + CT) was significantly higher than that in individuals interactively carry rs2040724 AA and rs4880 TT( P < 0.05).The risk for ONHL in individuals interactively carry rs10432782 GT or GG and rs4880( CC + CT) was significantly higher than that in individuals interactively carry rs10432782 TT and rs4880 TT( P < 0.05).The risk for ONHL in individuals exposed to L_(EX,W)≥85 dB( A) and interactively carried with rs2040724 GG and rs4880( CC + CT) was significantly higher than that in individuals exposed to L_(EX,W)< 85 dB( A) and interactively carry rs2040724 AA and rs4880 TT( P < 0.01).The risk for ONHL in individuals exposed to L_(EX,W)≥85 dB( A) and interactively carry rs10432782 GT or GG and rs4880( CC + CT) was significantly higher than that in individuals exposed to L_(EX,W)< 85 dB( A) and interactively carry r10432782 TT and rs4880 TT( P < 0.05).CONCLUSION: In Chinese Han population,noise exposure intensity and SOD1( rs2040724,rs10432782),SOD2( rs4880)gene polymorphism had interacting effects on ONHL susceptibility.

OBJECTIVE: To screen the optimal fitting model for the change trend of the number of new cases of occupational diseases in Guangdong Province by using linear and nonlinear regression models. Method The number of new cases of occupational diseases in Guangdong Province from 2003 to 2017 was used as the dependent variable(■) and the year(time) as the independent variable(x).Eleven mathematical models including linear regression, cubic function, quadratic function, composite function, growth function, exponential function, logistic function, power function, logarithmic function, S-type function and inverse function were used to fit the data, and the best-fit model was selected to describe and verify the change of new occupational diseases. RESULTS: Among the 11 mathematical models, the determination coefficient of fit results of cubic curve regression model was the highest(0.94, P<0.01), and the fit effect was the best. The fitting curve was ■. The cubic curve regression model was used to fit the number of new cases of occupational diseases in Guangdong Province from 2003 to 2019. The results showed that the measured value of new cases in all those years, except 2011, was within 95% confidence interval of the fitting value. The median(25 th, 75 th percentile) of absolute relative deviation between the fitting value and the actual value was 8.9%(4.3%, 14.7%). CONCLUSION: The regression model based on cubic curve can better fit the incidence of occupational diseases and can be used to describe the occurence of occupational diseases.