BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. METHODS: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. RESULTS: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. CONCLUSION: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.
Asian Continental Ancestry Group* ; Body Mass Index ; Costs and Cost Analysis ; Cough ; Delivery of Health Care ; Dyspnea ; Health Expenditures ; Hospitalization ; Humans ; Linear Models ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Smoke ; Smoking ; Sputum

Objective: To investigate the clinicopathologic and prognostic features of Claudin-low breast cancers (CLBC). Methods: Tissue microarray sections were scored semiquantitatively for the immunohistochemical expression of claudin-1, -3, -4, -7 and -8 in 233 cases of invasive breast cancers collected from Qingdao Central Hospital from January 2010 to December 2011. Results: The expression rate of Claudin-3 (72/212, 33.9%) and -4 (56/212, 45.2%) was most similar, and Claudin-4 showed the highest expression. Twenty one cases (21/212, 9.0%) were diagnosed as CLBC, with triple-negative breast cancer (TNBC) accounted for the highest proportion (11/21, 52.4%). Among the CLBC cases, the invasive carcinoma no special type (66.7%, 14/21) and metaplastic carcinoma (14.3%, 3/21) were mostly seen, while metaplastic squamous carcinoma did not show Claudin-low pattern. Compared to the non CLBC in this cohort, CLBC had higher proportion of histologic grade 3 and tumors larger than 2 cm, and the proportions were slightly lower than TNBC. Patients with CLBC had lower 5 year disease-free(P>0.05) and overall survival rates(P=0.018). Conclusion CLBC shows distinct clinicopathologic and prognostic features comparing to other subtypes, and is associated with poor prognosis.

Objective To investigate preventive measures and pathogenic related factors of periodontitis. Methods A total of 138 patients with periodontitis from August 2012 to March 2014 in our department were selected as the experi-mental group. Meanwhile 138 healthy cases matched with the patients within 2 years age difference in the same regions were selected as the control group. Questionnaire survey was used to inquire the basic information, educational status, economic income, acquisition of knowledge in periodontal disease, brushing habits, negative life events and so on. The differences in results between two groups were compared. Results Among 138 patients with periodontitis, there was 1087 disease parts on maxillaries, 872 parts on mandibles, 1243 parts on molars, and 876 parts on anterior teeth and bicuspids. According to Amaitage standard, 138 patients with periodontitis, the rate of mild to moderate periodontitis patients was 81.16% (112 cases), and the rate of severe periodontitis was 18.84% (26 cases). Acquisition of knowledge in periodontal disease, smoking, the frequency and sustained time of brushing per day, negative life events and mouth care between two groups showed statistical significance(P<0.05). There was no significant difference between two groups in age, gender and educational status(P>0.05). Non conditional Logistic regression results showed that: independent pathogenic risk factors of periodontitis included acquisition of knowledge in periodontal disease, the frequency and sus-tained time of brushing per day, negative life events and regular mouth care, and regular mouth care ranked first among these factors(the odds ratio=3.102, P<0.05). Conclusion Periodontitis is the result of interaction of multiple risk factors, therefore, comprehensive measures especially regular mouth care should be adopted to prevent the occurrence of peri-odontitis.

【Objective】 Tostudy the effect of ABO blood group on the FⅧ∶C and Fib content in human plasma, so as to provide the oretical guidance for the quality control of fresh plasma products and the establishment of relevant quality standards. 【Methods】 Samples determined included fresh plasma collected and fresh plasma separated manually. The FⅧ∶C and Fib content were determined by coagulation method. The exon6 of ABO gene was amplified and sequenced to determine the genotype. 【Results】 The FⅧ∶C in fresh plasma collected was (147.421±45.773)%, and that in fresh plasma separated manually was (119.083±35.130)%, showing significant differences(P<0.05). The Fib content in fresh plasma collected was (2.252±0.381)g/L, and that in fresh plasma separated manually was (2.324±0.470)g/L, with no significant differences observed (P>0.05). The FⅧ∶C in non-O type (A, B, AB type) fresh plasma collected and fresh plasma separated manually were (167.048±40.862)% and (129.251±33.503)%, respectively, significantly higher than that in O type fresh plasma collected and fresh plasma separated manually as(121.386±38.632)% and (91.589±22.328)%, respectively. The Fib contents in non-O type fresh plasma collected and fresh plasma separated manually were (2.242±0.385)g/L and (2.329±0.472)g/L, respectively. The Fib contents in O type fresh plasma collected and fresh plasma separated manually were (2.287±0.370)g/L and (2.307±0.462)g/L, respectively, and no significant difference was noticed (P>0.05). 【Conclusion】 There was no significant correlation between Fib content and ABO blood group, while FⅧ∶C was significantly correlated with ABO blood group. In the preparation and quality control of FⅧ related blood products, the effect of ABO blood group on the FⅧ∶C should be considered, and the quality standard of FⅧ in plasma products should be established based on the ABO blood group.

Objective The expression and prognosis significance of CD59 in pancreatic cancer were analyzed by bioinformatics.Methods Gene expression profiling interactive analysis 2(GEPIA2)and human protein atlas(HPA)databases were used to compare the expression of CD59 between pancreatic cancer tissues and adjacent tissues;Kaplan-Meier plotter database was used to evaluate the effect of CD59 on prognosis;String and Cytoscape3.9.1 were used to analyze the CD59 protein interaction network;DAVID6.8 performed gene enrichment and pathway enrichment analysis of CD59 with key interacting genes.Results Compared with normal tissues,the expression of CD59 in pancreatic cancer tissues was significantly up-regulated(P<0.05),and the overall survival time(HR=2.3,95%CI:1.52-3.50)and recurrence free survival(HR=4.31,95%CI:1.57-11.83)of pancreatic cancer patients with CD59 high expression was shorter than CD59 low expression patients.Protein interaction network analysis revealed that CD59 is closely related to several molecules such as CD55,GOLGA2,LMAN1,TMED2 and SERPINA1.Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis indicated that CD59 was mainly involved in pathways such as complement activation,innate immune response and coronavirus-COVID-19.Conclusion CD59 is highly expressed in pancreatic cancer tissue and is affected by several immune-related genes.It is associated with poor prognosis of patients and can be used as one of biomarkers for early diagnosis and prognosis prediction of pancreatic cancer.

【Objective】 To explore the application effect of traditional teaching combined with problem based learning (PBL) in the teaching of transfusion medicine taking the chapter of Human Leukocyte Antigen System and Testing in Clinical Blood Transfusion Testing Technique as an example. 【Methods】 Firstly, practical problems in chapter Human Leukocyte Antigen System and Testing were analyzed. Then, in response to the key and difficult points in the teaching of this chapter, examples were given to illustrate the practical application of traditional teaching combined with PBL in the teaching of Clinical Blood Transfusion Testing Technique from the aspects of teaching objectives, teaching processes, course implementation and implementation effects. The teaching effectiveness was evaluated through a questionnaire. 【Results】 Traditional teaching combined with PBL helped students grasp important knowledge and techniques, break down thinking barriers, grasp internal connections and characteristics, simplify the learning process, stimulate interest in learning and enhance team collaboration. Meanwhile, students' exploration and innovation abilities could be further cultivated through extracurricular expansion by teachers, thus achieving ideal teaching effect. The questionnaire showed that over 90% of the students consider that combining traditional teaching with PBL was beneficial for improving teaching effect. 【Conclusion】 In the teaching of transfusion medicine, adopting traditional teaching combined with PBL according to the textbook content can improve the teaching effect, which is beneficial for the cultivation of comprehensive talents.