Objective Medical statistics is an important tool in scientific research and practice.The article was to evaluate the current knowledge, learning needs and related influencing factors of medical statistics among medical doctoral students to provide references for the optimization in the teaching mode of medical statistics. Methods A questionnaire was used to investigate Grade 2014 doctoral students who took medical statistics course before and after the teaching in a medical university. Results The knowl-edge of doctoral students were at different levels and they had different learning requirements.More than 81.4% of the respondents have difficulty in the choice of scientific and reasonable design and the scientific design.Over 50%students had insufficient knowledge of advanced statistics and poor software application ability.They had the demands for more practical cases explanation in theory course, more software teaching hours and some short term specialized courses. Conclusion The university and teachers should carry out teaching reform according to the particularity of doctoral students and teach in small sections according to their knowledge levels of sta-tistics and learning requirements.It is suggested that the teaching should be combined with the students'own research projects in order to improve the teaching effect and improve the students'ability in sta-tistical design and solving the practical problem in scientific research statistics.

Objective To investigate the value of ankylosing spondylitis(AS)disease activity score (ASDAS)and the Bath AS disease activity index(BASDAI)in evaluating disease activity in AS.Methods ASDAS and BASDAI were used to evaluate disease activity in patients with AS,taking the patients' global scores,physician global scores and treatment decision as the “gold standard” for disease activity.According to the “gold standard”,the patients were divided into low and high disease activity groups.Statistical analysis included descriptive statistics,linear correlation and regression and ROC curve.Results A total of 227 patients with AS were included.ASDAS and BASDAI showed good correlation with disease activity as reflected by the patients' global score[r for BASDAI,ASDAS based on ESR(ASDAS-ESR)and ASDAS based on C-reactive protein(ASDAS-CRP)were 0.713,0.698 and 0.725,respectively,P =0.000]and the physician global score(r for BASDAI,ASDAS-ESR and ASDAS-CRP were 0.771,0.782,0.847,respectively,P =0.000).Both scores showed good discriminative ability for high and low disease activity states.ASDAS-CRP had the highest sensitivity.Conclusion ASDAS is a promising tool for evaluating disease activity in AS patients.

Objective To explore the diagnosis, treatment and prognosis of testicular benign tumors in children.Methods The clinical data of 26 boys ( aged between 17 days to 12 years and average age was 2.5 years) with testicular benign tumors treated in our center between January 2008 and December 2015 were retrospectively analyzed.The tumors were on the left side in 17 cases, on the right side in 9 cases. Twenty patients presented with painless scrotal mass.3 with cryptorchidism, 2 cases with hydrocele, and 1 case with varicocele.These boys underwent ultrasound or CT examination, results the enlarged tests with space-occupying lesions in 20 cases,3 cases were presented as scrotal empty,3 cases were showed as cystic masses.Twenty-four boys had taken tumor marker detection,which including 3 cases of AFP rised, 2 cases of Neuron-specific enolase slightly higher, 1 case of Ferritin increased.26 patients were performed surgical treatment, 23 cases have taken testicular tumor resection, and 3 cases underwent orchiectomy because of abnormal morphology, according to the intraoperative findings and quick frozen pathological examination results.Results Postoperative pathological diagnosis showed of maturity teratoma in 14 cases, not maturity teratoma in 3 cases, gonadoblastoma in 3 cases, interstitial cell tumor in 2 cases, epidermoid cyst in 2 cases, fibrocellular tumor and testicular inflammatory granuloma in 1 case respectively.The 23 cases were followed up for 3-70 months.All respondents children were alive, and no complications were found such as residual tumor atrophy or tumor recurrence and metastasis.Conclusions Early diagnosis and treatment is the key to obtaining a good effect of testicular tumors. Detailed specialist examination, preoperative ultrasound, CT and determination of tumor markers are important ways to diagnose testicular cancer; rapid intraoperative frozen check may manifest nature of the tumors.For pediatric testicular benign tumor, testis-sparing surgery should be considered.

Objective To investigate the dynamic changes of interleukin-1 receptor-associated kinases (IRAK-4) in hypoxic neurons and explore their role in regulation of inflammatory reaction. Methods The B35 cells exposed to hypoxia of 3% O2,5% CO2 and 92% N2 were cultured for 1,3,6, 12,24,48,72 and 96 hours respectively. Then, mRNA and protein expressions of IRAK-4 were detected by RT-PCR and Western blot, the expression of IRAK-4 in the cells were observed by laser scanning con-focal microscope (LSCM), and the concentration of IL-6 was measured by ELISA method. Results After hypoxia, the mRNA and protein expressions of IRAK-4 were increased at one hour, reached the peak at six hours (P<0.05), kept at a high level at 12 hours (P<0.05) , but decreased gradually to the normal oxygen level at 24 hours (P < 0.05) and to below the normal oxygen level at 48 hours (P < 0.05). Immunofluorescence results showed that the fluorescence intensity of IRAK-4 was gradually increased with time. The changes of IL-6 in the supernatant were positively correlated with protein expression of IRAK-4 (r =0.84, P < 0.05 ). Conclusions Hypoxia can increase the expression of IRAK-4 at transcription and translation levels in a certain period of time, which may participate in down-stream inflammatory reaction and lead to increase of IL-6 expression.

Objective: To observe whether an Xingnaojing 醒脑静 injection could improve the prognosis of patients, by increasing rifampicin penetration through the blood-brain barrier. Methods: Patients with severe tuberculous meningitis were enrolled in this study. The concentrations of Xingnaojing in cerebrospinal fluid and blood in patients treated with Xingnaojing and control were determined by high performance liquid chromatography. The changes in cerebrospinal fluid and the improvement of clinical symptoms and signs, were evaluated two weeks after admission. The long-term prognosis of the patients in the two groups were evaluated by the Glasgow Outcome Scale (GOS). Results: The concentration of rifampicin in cerebrospinal fluid was significantly higher in the Xingnaojing group (1.77±0.17 μg/mL), than in the control group (1.27±0.16 μg/mL, p<0.05). The difference in concentration of rifampicin in the blood was not significant (P>0.05). The short-term effective rate of the Xingnaojing group was 92.5% (37/40), which was significantly higher than that of the control group (80%, 32/40, p<0.05). After 6 months, 75% (30/40) of the Xingnaojing group had good prognosis according to the GOS score, whereas that of the control group was 50% (20/40) showing significantly better long-term treatment effect of the Xingnaojing group compared to the control group (P<0.05). Conclusion: Xingnaojing injection improved rifampicin penetration into the central nervous system. The increase in rifampicin concentration in cerebrospinal fluid improved outcomes in patients with severe tuberculous meningitis.

Objective To investigate the clinical efficacy of hemocoagulase for severe hemorrhagic cystitis (HC) following allogeneic hemotopoietic stem cell transplantation (HSCT). Methods Twenty patients undergoing allogeneic HSCT developed severe HC with an onset time of 14 to 70 days, all patients received the treatment of hemocoagulase (1 U ivgtt q12 h × 5 d). The urine speciments reserved before and after hemocoagulase were examined by naked eye and microscope to evaluate the efficacy. Results Twenty patients received the treatment of hemocoagulase. The HC was cured in 18 patients, improved in 1 patient and uncontrolled in 1 patient. For the patients with response, macroscopic hematuria disappeared at a median of 28 days (4-127 days) after the treatment. All procedures were tolerated well and no severe adverse effect was observed. Conclusion Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.

Objective:To detect the expression level of long non-coding RNA (lncRNA) nuclear receptor subfamily 2 group F member 2-antisense RNA 1 (NR2F2-AS1) and microRNA-129-5p (miR-129-5p) in glioma tissues and to explore its clinical significance.Methods:The glioma tissues of 103 patients with glioma who underwent surgical treatment in the neurosurgery department of Shanxi Provincial People′s Hospital from January 2015 to September 2016 and 50 normal brain tissues removed due to craniocerebral surgery in the same period were selected as the research objects. Real time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression levels of lncRNA NR2F2-AS1 and miR-129-5p in tissue samples. The correlation between the two indexes and the relationship between the expression changes of the two and clinicopathological parameters of glioma patients were analyzed. Kaplan Meier curve was used to analyze the 5-year cumulative survival rate of glioma patients with different expression levels of lncRNA NR2F2-AS1 and miR-129-5p. Cox regression analysis was used to analyze the factors affecting the poor prognosis of glioma patients.Results:Compared with normal brain tissue, the relative expression of lncRNA NR2F2-AS1 in glioma was higher and the relative expression of miR-129-5p was lower (all P<0.05). There was significant negative relationship between the relative expression of lncRNA NR2F2-AS1 and miR-129-5p in glioma ( r=-0.756, P<0.05). The expression of lncRNA NR2F2-AS1 and miR-129-5p in glioma was related to World Health Organization (WHO) grade and tumor length (all P<0.05). The 5-year cumulative survival rate of patients in lncRNA NR2F2-AS1<2.89 group was higher than that in lncRNA NR2F2-AS1≥2.89 group, and the 5-year cumulative survival rate of patients in miR-129-5p<0.55 group was lower than that in miR-129-5p≥0.55 group (all P<0.05). Multivariate analysis showed that high expression of lncRNA NR2F2-AS1, low expression of miR-129-5p, WHO grade Ⅲ-Ⅳ and tumor length were the risk factors affecting the prognosis of patients with glioma (all P<0.05). Conclusions:The increased expression of lncRNA NR2F2-AS1 and the decreased expression of miR-129-5p in glioma tissues are involved in the clinical biological progress of glioma and are closely related to the prognosis of patients.

OBJECTIVETo realize propensity score matching in PS Matching module of SPSS and interpret the analysis results.

METHODSThe R software and plug-in that could link with the corresponding versions of SPSS and propensity score matching package were installed. A PS matching module was added in the SPSS interface, and its use was demonstrated with test data.

RESULTSScore estimation and nearest neighbor matching was achieved with the PS matching module, and the results of qualitative and quantitative statistical description and evaluation were presented in the form of a graph matching.

CONCLUSIONPropensity score matching can be accomplished conveniently using SPSS software.

Objective To analyze the efficacy and safety of glimepiride treatment as initial monotherapy in newly diagnosed patients with type 2 diabetes mellitus (T2DM).Methods This was a subgroup analysis of the GREAT study,which investigated the efficacy and safety of glimepiride as initial monotherapy in Chinese patients with T2DM.This analysis was performed in 209 patients with disease duration less than 6 months and never received any anti-diabetic drugs.The change of HbA1C,fasting plasm glucose (FPG),2 h postprandial blood glucose (2hPPG),homeostasis model assessment for β-cell function index (HOMA-β),homeostasis model assessment for insulin-resistance index(HOMA-IR),the percentage of patients with HbA1C ＜ 7.0％ at endpoint and the incidence of hypoglycemia were evaluated after 16-weeks treatment.Results After 16-weeks glimepiride treatment,HbA1C value reduced significantly from baseline to endpoint,the reduction was statistically significant (9.21％ ± 1.65％ to 6.69％±0.83％,P＜0.001),69.7％ of the patients achieved HbA1C ＜7.0％ at study endpoint.Glimepiride-treated patients also achieved a significant improvement in FPG [from (10.15 ± 2.13) mmol/L to (7.23 ± 1.50) mmol/L,P＜0.001] and 2hPPG [from (17.21 ±4.14) mmol/L to (11.62 ± 3.34) mmol/L].HOMA-β was improved from 17.21± 15.19 [11.62 (2.90,115.8)] to 41.13 ± 44.12 [28.00 (5.1,360.00)],and HOMA-IR was reduced from 2.32± 1.90 [1.76 (0.60,12.80)] to 2.07 ± 1.74 [1.63 (0.4,12.3)].The incidence of all reported symptomatic hypoglycemia was 18.2％,and the incidence of confirmed hypoglycemia was 3.8％.Conclusion This analysis showed that glimepiride treatment as an initial mono-therapy could effectively improve blood glucose control in newly diagnosed patients with T2DM,and the treatment may improve islet β cell function,and the safety profile is reasonably good.

Objective:To externally validated the intra-aortic balloon pump (IABP) shockⅡ score and CardShock score for predicting in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) and compared them with the Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score.Methods:According to the inclusion and exclusion criteria, patients admitted to the cardiac care center (CCU) of our center from December 2010 to May 2019 were enrolled in this study. Patients’ baseline characteristics, in-hospital interventions, and outcomes were collected. The APACHEⅡ score was calculated during hospitalization by clinicians and collected by researchers. Two researchers independently calculated the IABP-ShockⅡ score and CardShock score; any disagreement was discussed with the third researcher. The performance of risk scores was evaluated by discrimination and calibration. The discriminative ability of risk scores was evaluated using the area under the receiver operating characteristic curve (AUC) and compared by the Delong method. The calibration of these risk scores was examined by the Hosmer-Lemeshow goodness-of-fit test. The calibration plot was also built.Results:A total of 150 patients enrolled in our study, and the in-hospital mortality was 60%. According to the IABP-ShockⅡ score, patients scored as low risk (0-2), moderate risk (3-4), and high risk (5-9) had in-hospital mortality of 29%, 68%, and 80%, respectively. According to the CardShock score, patients scored as low risk (0-3), moderate risk (4-5), and high risk (6-9)had in-hospital mortality of 21%, 57%, and 82%, respectively. According to the APACHEⅡ score, patients scored<20, 20-30, and >30 had in-hospital mortality of 19%, 69%, and 93%, respectively. For predicting the in-hospital mortality, the APACHEⅡ score demonstrated excellent discrimination (AUC=0.90, 95% CI: 0.84-0.95). The IABP-ShockⅡ score and CardShock score showed good discrimination (AUC=0.76, 95% CI: 0.68-0.83 and AUC=0.79, 95% CI: 0.72-0.85). The discriminative ability did not significantly differ between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05), but both of which were significantly lower than the APACHEⅡ score (0.76 vs 0.90, P<0.05, and 0.79 vs 0.90, P<0.05). At the same time, it was not significantly different between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05). All of these three scores were adequately calibrated according to the Hosmer-Lemeshow goodness-of-fit test ( P>0.05).The calibration plot showed accurate calibration of these three scores. Conclusions:Although less accurate than the APACHEⅡ score, the IABP-ShockⅡ score and CardShock score can show accurate prediction for in-hospital mortality of AMI-CS patients.