Objective To retrospectively analyze the clinical manifestations of coronary artery ectasia and its angiographic characteristics. Methods Twenty-five patients who underwent coronary angiography were diagnosed as coronary artery ectasia from January 2005 to December 2007. 25 cases of coronary artery atheresclerosis were also included and 25 cases with normal coronary arteriography in the same period were taken as control. Results Most of the patients were male (72%). Only three patients had diabetes and thirteen patients had hypertension. All the patients with coronary artery ectasia were admitted for chest pain. Nine of them showed abnormal ST changes and four elevated ST in ECG. Coronary artery ectasia was associated with slow coronary flow in 9 patients and coronary stenosis in 4 patients. The frequency of arterial involvement, in descending order, was right coronary artery in 76%, left anterior descending artery in 60%, left circumflex artery in 48% and left main artery in 8%. Ectasia affected only one major vessel was found in 44%, and all three vessels in 36%. As compared with the patients with coronary artery atherosclerosis and patients with normal coronary artery, patients with CAE had a lower prevalence of diabetes (12%), and there were no other significant statistics in clinical demography and other risk factors such as hypertension and dyslipidemia. Conclusions Coronary artery ectasia was prevalent in males and diabetes was less frequent. The RCA was the most commonly affected vessel and most of the patients had single vessel involvement.

In current health care management of floating population pregnant women, health care utilization rate does not reach the ideal level.Push service has been used as a key business in development and utilization of information resources for knowledge service institution, with initiative, customized, personalized, intelligent, dynamic and integrated characteristics.On the basis of analysis of cur-rent situation about the health care management of floating population pregnant women, the paper discussed the applications of push serv-ice.New thinking of application of push service to the health care management is put forward, The right aged women can be early linked through integrated mobile phone SMS, micro message interaction, email, channel type push and other means, and broad cover and whole course service management can be achieved, leading to the enhanced care utilization rate of floating population pregnant women.

Objective To investigate the expression and significance of keratinocyte growth factor-1(KGF-1) in the kidneys of septic rats.Methods Eighty male Wistar rats were randomly divided into the sepsis group and sham operation group.Either group was divided into 3-hour,6-hour,12-hour,24-hour and 36-hour subgroups,with 8 rats in each.Sepsis models were established by cecum ligation perforation (CLP).The kidney and blood samples were respectively taken for pathological study.Serum creatinine (Cr) and blood urea nitrogen (BUN) level determination and leukocyte counting were performed.KGF-1 protein was detected by immunohistochemical method and the expression of KGF-1 genes by real time PCR.Results The renal tubules in sepsis group were injured most at 24h after operation,which were infiltrated by considerable neutrophilic granulocytes,leukomonocytes and mononuclear cells,with vacuolar degeneration,focal hemorrhage and necrosis under the light microscopy.Serum Cr and BUN increased from 6h after operation,and reached the peak at 24h after operation in sepsis group,which were significantly different in those of sham operation group (P< 0.01).Compared with sham operation group,the expression of KGF-1 protein and genes of sepsis group increased significantly and reached the peak at 6h after operation.KGF-1mRNA was positively correlated with BUN and Cr (r=0.504,P<0.01;r=0.382,P<0.05).Conclusion KGF-1 was also expressed in normal kidneys,mainly in tubule epithelial cells of renal medulla and also in that of renal cortex.The expression of KGF-1 in sepsis group was obviously higher than that of sham operation group,and was positively correlated with the degree of kidney damage after infection.KGF-1 was speculated to be one of the protective factors affecting the repair of impaired kidneys caused by infection.

Objective To investigate the relationship between inflammatory factors, coronary artery dilation, and their clinical significance. Methods The cases undergone coronary angiography in our hospital last year were collected and divided into three groups: the first one included 11 patients whose angiography showed coronary artery dilation, the second group included 35 cases of atherosclerosis, and the third includes 24 cases with normal angiography. sES, MMP9 and TIMP1 were measured by ELISA method. Results Patients with coronary artery dilation were found to have significantly higher sES and MMP-9 level in comparison with atherosclerosis group and normal group[(153.7?152.7)ng/L,(90.1?54.2)ng/L,(76.5?37.2)ng/L, respectively](P

In this study,we analyzed the data of hemorrhagic fever with renal syndrome (HFRS) and host animals monitoring in Zhangzhou City,Fujian Province,China,2006-2015,in order to find out the epidemic situation and risk factors,and provide a scientific basis for the prevention and control strategy.A total of 171 HFRS cases,including 1 death,were reported in Zhangzhou in this decade.The incidence rate of 0.352/105 showed an upward trend (xtrend2 =58.60,P＜0.01).And 70 villages and towns in 11 counties have affected,accounting for 56.00％ of the counties in Zhangzhou City.The cases were mainly reported in some towns of Huaan,Nanjing and Zhaoan countries.The cases mainly occurred in countryside,which reported 142 cases.The cases in farmers accounted for the highest proportion (79.58 ％),and pig farming staff accounting for 23.01％ in farmer cases.Most cases were reported in municipal hospitals (86.55 ％).The common clinical manifestations of those cases were fever,nausea,vomiting,backache,headache,pain,oliguria or anuria,eyelid edema and so on,with 72.67％ of thrombocytopenia and of 83.09 ％ proteinuria positive.Compared with the proportion (80.49 ％) of mice in patients' house from 2006 to 2010,that (45.83％) from 2011 to 2015 decreased obviously;however,the proportion of mice or mice droppings in workplaces were rising from 60.98％ to 73.33％.Mean rodent density was 6.40％ and total infection rate in rats was 7.42％.The main kind of rats with virus infection was Rattus norvegicus,carrying Seoul virus Ⅱ.Results of this study indicate that Zhangzhou is one of the foci of HFRS rodent,and the epidemic is rising in recent years,the overall in the highly distributed,while some counties showed a rising trend year by year.Thus,monitoring and control efforts in prone areas should be increased,and to carry out clinics training of HFRS in primary health care institutions.

Adolescent ; Bone Neoplasms ; complications ; Humans ; Male ; Osteoma, Osteoid ; complications ; Scapula ; pathology ; Shoulder Joint ; pathology ; Synovitis ; complications

Objective Few researches are reported on the association of integrinαvβ6 with vaginal mucous infection and de-fense.This study aimed to investigate the effects of IL-6, TGF-β, and IFN-γon the expression of integrinαvβ6 in the vaginal epithelial cell line VK2/E6E7. Methods Immortalized human vaginal epi-thelial cells (VK2/E6E7) were cultured in vitro and treated with gra-dient concentrations of IL-6 (1, 10, 50, and 100 ng/mL), TGF-β(0.1, 1, 10, and 100 ng/mL), and IFN-γ(50, 500, 2500, and 5000 U/L) , respectively.After 48 hours, the cells were collected and total RNA extracted by the Trizol method to be reversely tran-scribed to cDNA. The expressions of integrin αand β6 subunit mRNA were detected by real-time quantitative PCR. Results In the IL-6-treated VK2/E6E7 cells, the integrin αand β6 subunit mRNA expressions were significantly lower in the 1 ng/mL and 10 ng/mL groups but remarkably higher in the 100 ng/mL group (1.14 ±0.12 and 1.37 ±0.25) than in the blank control (1.00 ±0.09) (P<0.05), and only the expression ofβ6 subunit mRNA was elevated in the 50 ng/mL group (P<0.05), with the expressions increased in a concentration-dependent manner.In the TGF-βtreated VK2/E6E7 cells, the expressions of integrinαandβ6 subunit mRNA were significantly lower in the 0.1 ng/mL and 1 ng/mL groups but remarkably higher in the 100 ng/mL group than in the blank control (1.00 ±0.09) (P<0.01), and only the expression ofβ6 subunit mRNA was elevated in the 10 ng/mL group (4.31 ±0.78, P<0.01), with the expressions increased in a concentration-dependent manner.In the IFN-γtreated VK2/E6E7 cells, the expressions of both integrinαandβ6 subunit mRNA were significantly lower in the 50 U/L, 500 U/L, 2500 U/L, and 5000 U/L groups than in the blank control (all P<0.01). Conclusion IL-6 and TGF-βhave an inhibitory effect the expression ofαvβ6 in VK2/E6E7 cells at low concentrations, which gradually diminishes with the increased concentration of inflammatory factors.In the early stage of inflammation, IFN-γcan effectively suppress the expression ofαvβ6 at a high concentration.However, with the progression of inflammation and decrease of its concentration, IFN-γloses its inhibi-tory effect and therefore does not help inflammation control.

OBJECTIVETo detect pathogenic mutations in Marfan syndrome (MFS) using an Ion Torrent Personal Genome Machine (PGM) and to validate the result of targeted next-generation semiconductor sequencing for the diagnosis of genetic disorders.

METHODSPeripheral blood samples were collected from three MFS patients and a normal control with informed consent. Genomic DNA was isolated by standard method and then subjected to targeted sequencing using an Ion Ampliseq(TM) Inherited Disease Panel. Three multiplex PCR reactions were carried out to amplify the coding exons of 328 genes including FBN1, TGFBR1 and TGFBR2. DNA fragments from different samples were ligated with barcoded sequencing adaptors. Template preparation and emulsion PCR, and Ion Sphere Particles enrichment were carried out using an Ion One Touch system. The ion sphere particles were sequenced on a 318 chip using the PGM platform. Data from the PGM runs were processed using an Ion Torrent Suite 3.2 software to generate sequence reads. After sequence alignment and extraction of SNPs and indels, all the variants were filtered against dbSNP137. DNA sequences were visualized with an Integrated Genomics Viewer. The most likely disease-causing variants were analyzed by Sanger sequencing.

RESULTSThe PGM sequencing has yielded an output of 855.80 Mb, with a > 100 × median sequencing depth and a coverage of > 98% for the targeted regions in all the four samples. After data analysis and database filtering, one known missense mutation (p.E1811K) and two novel premature termination mutations (p.E2264X and p.L871FfsX23) in the FBN1 gene were identified in the three MFS patients. All mutations were verified by conventional Sanger sequencing.

CONCLUSIONPathogenic FBN1 mutations have been identified in all patients with MFS, indicating that the targeted next-generation sequencing on the PGM sequencers can be applied for accurate and high-throughput testing of genetic disorders.

Base Sequence ; Computational Biology ; Fibrillin-1 ; Fibrillins ; Genomics ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Marfan Syndrome ; diagnosis ; genetics ; Microfilament Proteins ; genetics ; Mutation ; Semiconductors

Objective:To explore the core competency of doctors in tertiary public hospitals in regions of different income levels in China, and provide reference for promoting such competency and related policy formulation.Methods:Using multi-stage stratified cluster sampling method, 195 tertiary public hospitals in 16 provinces of China were selected from November 2021 to March 2022. 200 doctors were sampled from each hospital. A self-designed questionnaire was used to investigate the status of doctors′ core competencies, as well as the status of their postgraduate medical education and continuing medical education. According to the per capita gross regional product of each province in China Statistical Yearbook 2022, each province was divided into high, middle and low income regions, and the questionnaire data were descriptively analyzed, while χ2 test was used to compare the differences between groups. Results:A total of 32 673 valid questionnaires were collected. There were 12 135 doctors (37.14%) in China who had received comprehensive education and training of core competency in all dimensions. Among the dimensions of self-rated core competency of the surveyed doctors, there were 10 019 doctors (30.66%) with insufficient teaching ability and 438 (1.34%) with insufficient professional quality, and there was no significant difference between regions ( P>0.05). There were 2 385 (27.08%), 2 528 (27.55%) and 3 646 (24.82%) doctors in high-, middle- and low-income regions with insufficient lifelong learning ability, respectively. The proportion of doctors in middle- and high-income regions was higher than that in low-income ones ( P<0.05). There were 1 317 (15.57%), 1 290 (14.06%) and 2 719 (18.51%) doctors with insufficient knowledge and skills in high-, middle- and low-income areas, respectively. The proportion of doctors in low-income regions was higher than that in middle- and high-income regions ( P<0.05). The proportion of doctors who did not receive any kind of postgraduate medical education or continuing medical education in low-income regions was 7.33% (1 077 people), higher than that in high-income and middle- income ones ( P<0.05); 50.44% (4 442 people) of surveyed doctors in high-income regions believed that for standardized training of resident physicians (hereinafter referred to as residential training), the clinical teachers were " overworked to take this job", which was higher than that in middle- and low-income regions ( P<0.001); In middle-income regions, 46.16% (4 235 people) and 43.46% (3 987 people) believed that the salary residents and specialized physicians in standardized training (hereinafter referred to as specialized training) was too low, while 42.47% (3 897 people) and 30.44% (2 793 people) believed that the clinical practice opportunities of students were limited, both of which were higher than those in high-income and low-income regions ( P<0.001); 34.91% (5 128 people) of surveyed doctors in low-income regions believed that the investment was insufficient for training bases of residential training, 27.81% (4 085 people) of those held that training bases for specialized training were unevenly distributed, and 33.19% (4 876 people) of those held that continuing medical education was plagued by " insufficient promotion coverage, and insufficient opportunities for primary doctors", all of which being higher than those in high- and middle-income regions ( P<0.001). Conclusions:There is an obvious need to improve the core competence of doctors in the teaching ability dimension of tertiary public hospitals in China, especially in middle- and high-income regions for lifelong learning, and in low-income regions for knowledge and skills; There are differences between postgraduate medical education and continuing medical education systems in regions of different income levels in China. It is necessary to improve the competency oriented postgraduate medical education and continuing medical education systems.

Objective:Previous studies have shown an association between programmed death-ligand 1 expression(PD-L1)in non-small cell lung cancer(NSCLC)and clinical factors and that PD-L1 is positively correlated with TNM staging.This study aimed to explore the prognostic significance of PD-L1 and its correlation with the maximum standardized uptake value(SUVmax).Methods:Clinicopath-ological data and the follow-up information of the 122 de novo primary NSCLC patients were analyzed.PD-L1 expression was detected by immunohistochemistry in this 122 surgically resected non-small cell lung carcinoma tissues.Survival outcomes were analyzed using the Kaplan-Meier method and multivariate Cox proportional hazards model.Correlation between SUVmax and PD-L1 expression was analyzed using Spearman's rank correlation analysis.Results:Multivariate analysis revealed that PD-L1 expression(HR=4.518,95% CI:1.176-17.352,P=0.028)and tumor size(HR=1.404,95%CI:1.020-1.933,P=0.037)were independent risk factors for overall survival(OS) in early NSCLC patients.Sex,age,pathological type,CEA level,and SUVmax group had no obvious effect on OS(P 0.05)in early NSCLC patients.In univariate analyses,sex,pathological type,tumor size,and SUVmax group affected OS in stageⅢ-ⅣNSCLC patients.How-ever,age,CEA level,and PD-L1 expression had no effect on OS.PD-L1 expression was not an independent risk factor for OS in stageⅢ-ⅣNSCLC patients.The SUVmax group had no association with PD-L1 in all patients.Conclusions:PD-L1 expression is an independent risk factor for OS in early NSCLC patients but not in stageⅢ-Ⅳpatients.