Objective To evaluate the dietary risk factors and rational nutritonal intervention for gout and hyperuricemia.Methods PubMed,EMBASE,OVID,Cochrane Library,China National Knowledge Infrastructure (CNKI),and Chinese Wanfang Database were searched for literature related to dietary risk factors and medical nutritonal intervention for gout/hyperuricemia from January 2000 to December 2015.Strict screening of the searched literature was performed based on inclusion and exclusion criteria.The bias risk evaluation tool recommended by the Cochrane Handbook and the Newcastle-Ottawa Scale (NOS) scale were used to assess the quality of included literature.With odds ratios (OR) of gout/hyperuricemia for subjects with different dietary preferences as the main effect indicator,a meta-analysis was conducted,with data collected from literature and summarized by RevMan 5.1 software.Results Nine studies were included eventually.Compared with subjects with lowest intake of red meat,seafood,alcohol,sweented soft drinks or natural juice,the OR for gout/hyperuricemia among subjects with highest intake of these foods was 1.39 (95％ CI:1.18-1.63,P ＜0.0001),1.59 (95％ CI:1.33-1.90,P＜0.00001),3.14 (95％ CI:2.17-4.53,P＜0.00001),1.69 (95％ CI:1.17-2.43,P =0.005),and 1.46 (95％ CI:1.18-1.80,P =0.000 5),respectively.In contrast,compared with subjects with lowest intake of dairy products,vegitables (containing purine-rich vegetables) or coffee,the OR for gout/hyperuricemia among subiects with highest intake of these foods was 0.50 (95％ CI:0.40-0.64,P＜0.00001),1.01 (95％ CI:0.85-1.19,P=0.95),0.48 (95％ CI:0.30-0.78,P =0.003),respectively.Conclusions Patients with gout or hyperuricemia should avoid or restrict the intake of high-purine animal foods (especially red meat and seafood),alcohol,high fructose or corn syrupsweetened foods,while abstinence of purine-rich vegetables is not required.Regular intake of dairy products and coffee is recommended for such patients.

Objective To analyze the current dietary application of medium-chain triglycerides (MCT) in hospitalized patients,and clarify the appropriate indications and the role of MCT in clinical practice through evidence-based evaluation.Method A retrospective analysis was conducted on 46 cases of hospitalized patients who were administered dietary MCT between January,2012 and December,2013 in Peking Union Medical College Hospital.Results Dietary MCT were utilized in a small but increasing number of patients,who distributed in departments of gastroenterology,pediatrics,pneumology,general internal medicine,and general surgery.37.0％ of the patients had malnutrition,while 56.5％ had hypoalbuminemia.The leading indications of MCT therapy were gastrointestinal dysfunction (21 cases) and lymph circulation disorder (15 cases),while dyslipidemia (5 cases),exocrine pancreatic insufficiency (4 cases),and intractable epilepsy (1 case) served as other indications of MCT administration.Conclusions The indications of current dietary MCT application are approximately consistent with evidence from literature.However,given the scarcity of relevant researches and limited clinical application,further clinical researches with larger samples on dietary MCT are needed to provide more high-quality evidences for guidance of clinical practice.

Objective To survey the influence of nursing intervention on cognition level for pressure sores and psychological state among accompany family members of patients with cerebral injury. Methods 123 accompany family members of patients with cerebral injury were selected and took part in the investigation about cognition level for pressure sores, besides, SDS and SAS were also adopted to evaluate their psychological state. Later nursing intervention was given to increase their cognition level for pressure sores, then another evaluation was carried out. Results before and after the intervention were compared. Results The accompany family members lacked knowledge of pressure sore, showed serious anxiety and depression for nursing pressure sore before intervention. But their cognition level for pressure sore improved and anxiety and depression lightened after intervention. Conclusions Nursing intervention is effective to alleviate cognition level for pressure sore and psychological state among accompany family members of patients with cerebral injury, which is worthy of clinical application.

41 cases of infant thrush in observation group were treated by 10% rhubarb decoction wipe on the affected area followed by pow-dered “alum 3 +goldthread 2 +borneol 1”coating;41 cases in the control group were treated by 1% ~2% baking soda scrub on the affect-ed area followed by glycerol wipe containing 50 000 to 100 000 units/ml of nystatin.The efficiency was 95.12%(39 /41)and 75.61%(31 /41)in observation and control groups respectively(P <0.05).The external use of chinese medicine is effective in the treatment of in-fant thrush.

Objective To investigate effect of standardized nutritional assessment, intervention, and monitoring on nutritional status of patients with cystic fibrosis (CF).Methods We recruited 6 consecutive patients with CF diagnosed from June 2005 to June 2015 in Peking Union Medical College Hospital, all given nutritional assessment and intervention.The clinical data and nutritional status of the patients were analyzed.Four cases were followed up, and their compliance and effect of nutritional intervention on their nutritional status were evaluated.Results The mean age of diagnosis of the patients was (19 ± 6) years.All the patients had recurrent onset of pulmonary infection and hypoxemia with varying degrees.The nutritional status was impaired in all the cases to different extent, with body mass index (BMI) of 3 patients under 20 years of age being lower than the third percentile of the standard growth curve for adolescents of the same age and sex.Mild microcytic hypochromic anemia existed in 2 cases, hypoalbuminemia in 2 cases (serum albumin ＜ 35 g/L in absence of liver or renal dysfunction), and decreased prealbumin level in 4 patients.The serum concentrations of Na, Cl, K, and Ca were approximately normal in all the 6 cases.Vitamin D level was detected in only 2 cases, all revealing vitamin D deficiency.High energy and high protein diet was suggested to all the patients, plus prescription of oral nutritional supplements for 5 patients.Diagnostic pancreatic enzyme replacement therapy (PERT) was performed in 3 patients who were suspected with exocrine pancreatic insufficiency (PI), together with fatsoluble vitamins supplementation including vitamin D3.Four CF patients were followed up for 11 to 39 months, of whom 1 was lost to follow-up after 11 months.During the follow-up period, 3 patients had progressive weight loss or growth retardation, and the other one patient failed to increase body weight.Dietary review of the 3 patients with available follow-up data revealed that actual energy intake and protein intake were only 46.1％-65.9％ and 44.1％-63.2％ of recommendation levels, respectively.By enhancing dietary education and guidance in follow-up, nutritional status of the patients was improved.Conclusion Intensive nutrition management, standardized nutritional intervention and monitoring, dietary guidance or enteral nutrition adjustment may constitute critical measures for improving nutritional status of CF patients.

Celiac disease (CD) is a chronic autoimmune gastrointestinal disorder induced by ingestion of gluten-containing foods.In the past CD was thought prevalent only in Western countries,whereas it has been found common throughout the world and increasing numbers of Chinese patients has been reported recently.However,there are still many deficiencies in management of patients with CD in China and either the diagnosis or the treatment of CD is lacking evidence-based clinical pathway.We report a case of a young woman with CD presenting with chronic diarrhea,abdominal distention,and weight loss,whose outcome was improved by following evidence-based guidelines of medical nutrition therapy.Diagnosis and treatment of the patient was analyzed with review of foreign and domestic literature to provide readers reference of the standardized nutritional intervention of CD.

Synthetic pesticides-pyrethroids have been widely used in agriculture and in households. Most of them are the environmental hormone substances. Pyrethroids have toxic effects on animals and humans,inducing teratogenicity,carcinogenicity and mutagenicity. In the present paper,the typical animals-fish,mice and rats were choosen for the health risk assessment,and the research progresses on adverse effects of pyrethroids in nervous toxicology,physiological and biochemical toxicology,reproductive toxicology were summerized,as well as the effects of the animal enzymes and immune system.

OBJECTIVEThis study aims to determine the awareness oral medical interns about occupation safety protection of knowledge and to present a scientific basis for perfecting the occupation safety education system and standard protection behavior.

METHODSA self-designed questionnaire that used a retrospective questionnaire survey on 425 stomatological interns, scoring, and statistical analysis of the survey were performed. The questionnaire included occupation safety prevention knowledge, behavior cognitive, and protective behavior, among others.

RESULTSThe questionnaire recovery rate was 100%, and the average scores of the prevention knowledge and behavior cognitive were 4.55 ± 0.91 and 4.40 ± 1.05, respectively. More than 90% interns can conduct the conventional protection, and less than 40% can perform special protection. For the item "occupation safety protection knowledge", the scores of three grade III hospitals were higher than that of stomatological hospitals and second level of first-class hospitals; the difference was statistically significant (P < 0.001). For the items "behavior cognition" and "protective behavior", the scores of the second level of first-class hospitals were lower than those of grade III hospitals and stomatolgical hospitals (P < 0.001). The second level of first-class hospitals was relatively poor in safety protection knowledge, behavioral cognitive, and protection behavior. The average score was higher for than for boys in the three contents, and the average score of interns accepting pre-job training was higher than those rejected; the difference was statistically significant (P < 0.001).

CONCLUSIONThe occupation safety knowledge of oral medical interns is not sufficient, and the protective behavior is poor. Schools and hospitals should strengthen the intern occupation safety and protection education and improve the status of occupation safety behavior.

Clinical Competence ; Humans ; Internship and Residency ; Occupational Health ; Occupations ; Oral Medicine ; education ; Retrospective Studies ; Surveys and Questionnaires ; Universities

ABSTRACT:Objective To prepare polymeric nanomicelles capable of simultaneously loading doxorubicin (DOX) and Bcl‐2 small interfering RNA (Bcl‐2 siRNA ) , and to explore their in vitro cytotoxicity and cellular uptake in MCF‐7 human breast cancer cells .Methods Copolymer poly (ethylene glycol )‐g‐polyethylenimine‐g‐poly(γ‐benzyl‐L‐glutamate) was synthesized by the combination of reductive amination and carbodiimide methods , and its chemical structure was verified by 1 H NMR .Empty and drug‐loaded copolymeric nanomicelles were prepared by dialysis method and characterized by transmission electron microscope and dynamic light scattering .The ability of the nanomicelles to compress Bcl‐2 siRNA was measured by by agarose gel electrophoresis method . The release profiles of DOX and Bcl‐2 siRNA from the nanomicelles were explored by means of fluorescence spectrometry and dialysis method .The in vitro cytotoxicity and cellular uptake of DOX and Bcl‐2 siRNA co‐loaded nanomicelles in MCF‐7 human breast cancer cells were characterized by MTT assay and confocal laser scanning microscopy , respectively .Results The critical micelle concentration of the copolymer was about 4 mg/L ,and the sizes of self‐assembled empty and drug‐loaded nanomicelles were smaller than 200 nm .The drug‐loading efficiency and drug‐loading content of DOX in the nanomicelles were 88 .7% and 15 .1% ,respectively .The DOX‐loaded nanomicelles could efficiently compress Bcl‐2 siRNA when an N/P ratio was ≥64 .The zeta potential of DOX and Bcl‐2 siRNA co‐loaded nanomicelles was +30 mV .The release behavior of the cargoes from the nanomicells was pH‐sensitive , and the release of Bcl‐2 siRNA was more sensitive to acidic pH than that of DOX . The nanomicelles could simultaneously deliver DOX and Bcl‐2 siRNA into MCF‐7 cells , and the co‐delivered DOX and Bcl‐2 siRNA significantly increased the cytotoxicity of DOX (P<0 .05) .Conclusion The polymeric nanomicelles can co‐load DOX and Bcl‐2 siRNA and deliver them into MCF‐7 cells , and DOX in combination with Bcl‐2 siRNA can synergistically inhibit the growth of MCF‐7 cells and promote cell apoptosis ,suggesting that the nanomicells may be a promising carrier for the co‐delivery for chemotherapeutics and genes .

Objective To investigate and eompare the diagnostic values of linear reference region model (LRRM) and Extended Tofts model in quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis of benign and malignant breast lesions under different temporal resolutions.Methods Eight five suspicious breast cancer women underwent bilateral DCE-MRI exam, 37 patients were benigns and 48 patients were malignants.Among those, 31 patients(15 malignant, 16 benign) were scanned with 18 s per phase, and 54 patients(33 malignant, 21 benign) were scanned with 7 s per phase, and they were assigned into breast cancer group, benign lesion group and healthy gland group proven by surgery or biopsies.For the same model, Ktrans values of the three groups under different time resolution were first analyzed using Kruskal-Wallis H rank sum test.Receiver operator curve (ROC) was used to analyse the diagnostic efficiency of K values.Results Under high and low temporal resolutions, K values of the healthy group were (0.048 ±0.022) and (0.090±0.040)/min for extended Tofts model,(0.301 ±0.197) and (0.287±0.225)/min for LRRM model respectively.K values of the benign group were (0.289±0.163) and (0.211 ± 0.080)/min for extended Tofts,(0.624 ± 0.358) and (0.593 ± 0.165)/min for LRRM respectively.K values of the malignant group were (0.959±0.451) and (0.524±0.285)/min for extended Tofts,(1.576±0.935) and (0.956±0.180)/min for LRRM respectively.There were significant differences among the three different groups(P＜0.05).Area under the ROC to differentiate benign and malignant breast lesions for Extended Tofts in high temporal, LRRM in high temporal, Tofts in low temporal and LRRM in low temporal were 0.941, 0.876, 0.850 and 0.933, with Ktrans cutoff values of 0.304, 0.917, 0.252 and 0.789/min,and sensitivity of 93.9％, 80.0％,80.0％, 80.0％;specificity of 85.7％, 90.5％, 81.2％, 87.5％ respectively.Conclusion Under low temporal resolutions, Ktrans of LRRM model had better sensitivities and specificities in differentiation of benign and malignant breast lesions than Extended Tofts model, which was the opposite in high temporal resolutions.