The use of immune checkpoint inhibitors (ICIs) has changed the clinical outcome of non-small cell lung cancer (NSCLC), with the widespread application of ICIs, immune-related adverse events (irAEs) have also appeared. Immune checkpoint inhibitor pneumonitis (CIP) is a serious adverse event of ICIs treatment that needs attention. Therefore, early identification of high-risk groups of CIPs and early intervention can reduce the occurrence of permanent drug withdrawal and severe CIPs, thereby improving patients′ prognosis.

ObjectiveTo investigate the feasibility and importance of the application of simulation ward in medical practice between classes.MethodsTo divide the interns into two groups:the experimental group of 30 and the control group of 30. Both groups apply the simulation ward to practice between classes and both are assessed at the end of the practice.ResultsTo compare the final score of the experimental group and the control group,and significant differences are found in the following aspects:humanistic care,history taking,physical examination,medical record analysis,the theoretical knowledge examinations with the data of P ＜0.05.ConclusionThe application of simulation ward in medical practice between classes can improve the quality of clinical teaching.

Objective To investigate the expression of GFAP in rat hypothalamus after acute heat stress. Methods The rats were caged in a experimental incubator for 60 minutes,the temperature within the incubator was adjusted to 24℃,34℃,38.5℃ or 42℃,the humidity was 60%.Single anti-GFAP immunohistochemical(ABC) method and anti-Fos and GFAP double immunohistochemical method were used to observe the expression of GFAP in hypothalamus in different ambient temperatures after heat stress. Results The GFAP-positive cells were rare in hypothalamus at 24℃,however it was increased in many nuclei(anterior hypothalamic area,paraventricular nucleus,arcuate nucleus,suprachiasmatic nucleus and supraoptic nucleus)at 34℃ and peaked when ambient temperature was 38.5℃,and then decreased.However,Fos/GFAP-IR double labelled astrocytes were observed at 42℃.Conclusion Astrocytes participate in the pathophysiological process of heat stress.

To investigate the upregulated genes associated with cold acclimation, a cold acclimation model was established based on Balb/C mouse. mRNA of muscle and liver were isolated, and the upregulated genes of these tissues were studied by representational differential analysis (RDA). The upregulated genes then were sequenced and searched by Blast software in GenBank database. The results showed that some genes were upregulated and possibly associated with cold acclimation. Three of these genes, transferrin, fibrinogen B-beta-chains and a new gene fragment (Genbank ID: AF454762), were confirmed to be upregulated by RNA slot-blot analysis. The finding of these genes might contribute to further understanding of the molecular mechanisms of cold acclimation.
Acclimatization ; genetics ; Animals ; Cold Temperature ; Gene Expression ; Liver ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Muscle, Skeletal ; metabolism ; Transcriptome ; Up-Regulation

Background Qiang minority is minority groups of China with the special habits and customs and living condition. So whether the spectrum of disease and bacteria spectrum in conjunctiva are similar with Han nationality is worth paying attention. Objective Present survey was to obtain the data about bacterial species in conjunctival sac in Qiang minority population with the age 40 years old and more and the compare with matched Han nationality population. Methods This survey study was performed as the standardized training and protocol. A total of 212 eyes of 106 individuals from Qiang minority in Beichuan county and 640 eyes of 320 subjects from Han nationality in Mianyang city received questionnaire survey and ophthalmological examination. The secretion of the inferior palpebral conjunctival sac was embrocated and inoculated on blood plate for 48-72 hours. The bacteria was separated and identified. This study was approved by the Ethic Committee of Sichuan Provicial People' s Hospital. Orally informed consent was obtained before the medical procedure. Results All the examinee finished the survey and examination with a good compliance. No significant difference was found in the demography between these two groups of population. The multiple bacterial positive rate in conjunctival sac was 59. 4% in Qiang minority and that of Han people was 66. 3% with a considerably difference between them (χ2 = 2. 27,P = 0. 13). The multiple bacterial species were simultaneously detected in 26.2% in Qiang minority population and 11.88% Han people, showing evidently difference (χ2 = 106. 40, P = 0. 00 ) . The positive rate of corynbaccterium in conjunctival sac of Qiang minority was statistically lower than that of Han people (20. 7% versus 45. 0% ,χ2 =31. 75 ,P = 0. 00) ,but there was no statistical difference in the positive rate of staphylococcus epidemics between two groups (χ2 = 1. 89 ,P = 0. 17). Conclusion The bacteria positive rate in conjunctiva sac is resemble in the population over 40 years in both the Qiang minority and Han nationality. The simple bacterial species is found in majority people in two groups of subjects. The positive rate of multiple bacterial strains coexistence is more in the Qiang minority. The bacterial strains is different between Qiang minority and Han nationality.

Objective To investigate the association of activating transcription factor 6(ATF6)gene Ala145Pro(GCG→CCG)variant with glucose and lipid metabolism in Chinese.Methods The genotypes were determined by PCR-RFLP in 689 Chinese in Shanghai.Among them,361 subjects showed normal glucose regulation,250 cases were newly-diagnosed diabetic patients without taking any drug and 78 cases were probands of early-onset type 2 diabetes pedigrees.The following phenotypes were measured:body height and weight to calculate BMI;waist,hip and femoral circumference to calculate waist-to-hip ratio and waist-to-femoral ratio;blood pressure;plasma glucose levels obtained at 0 and 120 minute during 75 g oral glucose tolerance test;fasting serum lipid profile including total cholesterol,triglyceride,high density lipoprotein-cholesterol and low density lipoprotein-cholesterol;body fat percentage and distribution.Results(1)The frequency of C allele is significantly lower in probands from early-onset type 2 diabetes patients compared with subjects with normal glucose regulation(P=0.035).(2)In subjects with normal glucose regulation,the CC+CG genotype had a significantly lower level of high density lipoprotein cholesterol as compared with GG genotype(P=0.014).(3)In type 2 diabetic patients,the CC+CG genotype had a significantly higher level of low density lipoprotein-cholesterol as compared with GG genotype(P=0.041).Conclusion These findings suggest that variant of ATF6 plays a role in glucose and lipid metabolism in Chinese.

Objective To describe the prevalence of deliberate self-harm (DSH) and suicidal behaviors (SIB) as well as the relationship between them in a college student population.Methods A total of 4063 medical students were selected under the cluster sampling method in Anhui province.Data were analyzed by Pearson Chi-square and logistic regression.Results A total of 4063 ( 13.4％ )students reported that they had deliberately harmed themselves during the past 12 months.The acts of DSH with 1 and more than or equal to 2 times occurrence accounted for 3.7％ and 9.6％ among all the respondents.The act of DSH was significantly higher among boys than that among girls.Rates of suicide ideation,suicide plan,attempted suicide and SIB in the last year were 4.5％,1.4％,0.6％ and 4.9％,respectively.However no statistically significant difference was found in different sex.Students in the DSH group that with SIB were found to have lower positive coping levels (OR=0.5,95％CI:0.3-0.8),getting less support from fricnds (3-5 vs.less than or equal to 2:OR=0.6,95％CI:0.3-0.9;more than or equal to 6 vs.less than or equal to 2:OR=0A,95％CI:0.2-0.8),with higher negative coping levels (OR=2.1,95％CI:1.2-3.7),having more serious depressive symptoms (OR=2.9,95％ CI:1.6-5.2) and anxiety symptoms (OR=2.2,95％ CI:1.2-3.8),having more serious sleeping problems (OR=1.7,95％CI:1.1-2.8 ) and perceived fat (fat vs.moderate:OR=2.0,95％CI:1.1-3.6) than the DSH group without SIB.The rates of SIB in students with DSH behavior were significantly higher than those in students without those behaviors (OR=4.7,95％ CI:3.5-6.4).Psyehosocial variables could attenuate the relationship between the DSH status and suicidal events (OR=3.3,95％CI:2.4-4.5).The DSH frequency exhibited a curvilinear relationship to SIB (OR=3.1-10.0) and psychosocial variables also attenuated this relationship (OR=2.4-5.9).Conclusion It was well known that SIB was not a suicidal gesture but our findings suggested that the presence of DSH might trigger the suicidal attempts.

Objective To investigate the relationship between various types of social support and suicide ideation, and whether the relationship varies by gender. Methods A total of 4 799 students in cluding freshmen and sophomores were recruited by stratified cluster sampling from 2 medical colleges in Anhui Province. We assessed demographic indicators, social support and suicidal ideation, etc. Logistic regression was used to analyze their gender differences and the relationship between social support and suicidal ideation. Results The prevalence of suicidal ideation was 6.2%, and no gender difference was found ( 2=1.224，P=0.269). The rate of suicidal ideation was higher with the decreasing of social support. Low levels of social support had independent effects on suicidal ideation among total samples and females respectively after controlling for confounding factors (all P<0.05), while low levels of social support, subjective social support and support availability increased the risk of suicidal ideation among males (P value was 0.049，0.002，0.031, respectively). In adolescents with low levels of social support, objective social support and various sources of social support, females versus males had higher risk to have suicidal ideation. Conclusions Low level of social support increased the risk of suicidal ideation among students in medical college, especially for girls. Groups at highest risk of suicidal ideation in relation to certain types of social support should be targeted with interventions accordingly.

Objective To investigate the status of clinical nurses' professional self-concept and analyze its influencing factors. Methods A total of 572 clinic nurses were investigated by using Professional Self-concept of Nurses Instrument. Results Indicators including married status, education background, age, nursing experiences, professional title and position were influencing factors of professional self-concept.Conclusions Clinical nurses below 30 years old or under 10 years nursing experiences or lower professional title or no position or single should emphasize on professional self-concept.