The integrated course centered on organ system has been implemented for several years in Huazhong university of science and technology.Basic medicine courses were divided into three modules.Medical introduction Ⅰ was the first one which integrated nine basic medicine courses.Reform on teaching methods,teaching content,teacher training and experiment teaching were conducted and initial results were achieved.

Objective To study the effects of IFN-?on expression of B7 molecules in human lung adenocarcinoma cell line cultured in vitro.Methods Human lung adenocarcinoma SPC-A-1 cells were incubated in the medium with IFN-?respectively.Cell proliferation effect was measured by MTT assay;apoptosis was detected with flow cytometry assay;expression of B7-1 and B7-2 mRNA was determined by RT-PCR.Results Compared with those of control group,MTT shows that IFN-?could reduce the SPC-A-1 cell proliferation.FCM shows the apoptosis rate in the IFN-? group was significantly higher,but there is no different changes in each concentration group.Compared with the control group,expression of B7-1 and B7-2 significantly increased in the IFN-?group,and the expression was not correlated with the concentration of IFN-?in each control group.Conclusion IFN-?can inhibit cell proliferation and induce apoptosis in SPC-A-1 cell line.IFN-?markedly enhance the expression of B7-1 and B7-2 in SPC-A-1 line.The apoptosis may be mediated by up-expression of gene B7-1 and B7-2.

Aimed at the decontamination of protective clothes used for high level biosafety laboratory,infectious sickroom and field sampling,a kind of chemical spray sterilization device adopting PLC and touch screen technology is developed,which has the advantages of being safe,reliable,easy to operate and adjustable for parameters.The experimental results show that the decontamination effect of the device is reliable,and the device runs stable and highly-automatized,and the effect of the spray is satisfactory.The device has great practical value in the areas of biosafety,inspection & quarantine and medical facility.

Objective To investigate the predictive value of metabolic syndrome (MS) on new-onset cholelithiasis.Methods The retrospective cohort study was conducted.The data of 89 553 subjects who participated health examination at the Kailuan General Hospital Affiliated to the North China University of Science and Technology,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Jinggezhuang Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from June 2006 to December 2015 were collected.According to the diagnostic criteria of MS published by International Diabetes Federation,all the patients were divided into 4 groups,including 70 657 without MS in the normal group,14 075 corresponded with 3 diagnostic criteria of MS in the MS-3 group,4 556 corresponded with 4 diagnostic criteria of MS in the MS-4 group and 265 corresponded with 5 diagnostic criteria of MS in the MS-5 group.Health examinations were applied to all subjects by the fixed team of doctors at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) comparisons of clinical characteristics among the 4 groups;(2) incidence of cholelithiasis in the 4 groups;(3) risk factors analysis affecting new-onset cholelithiasis.Measurement data with normal distribution were represented as (x) ± s and comparisons among groups were analyzed using the one-way ANOVA.Pairwise comparison and homogeneity of variance were done using the LSD test.Heterogeneity of variance was done using the Dunnett's T3 test.Measurement data with skewed distribution were described as M (Q) and comparisons among groups were analyzed using the nonparametric Kruskal-Wallis test.Comparisons of count data were analyzed by the chi-square test.The incidence of cholelithiasis in the 4 groups were calculated by the Kaplan-Meier method and comparisons of incidence were done by the Log-rank test.The COX proportional hazards model was used to analyze the hazard ratios (HR) and 95％ confidence interval (95％ CI) of MS on new-onset cholelithiasis.Results (1) Comparisons of clinical characteristics among the 4 groups:age,sex (male),systolic blood pressure (SBP),diastolic blood pressure (DBP),waistline,triglyceride (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),fasting blood glucose,BMI,cases with hypertension,diabetes,drinking,smoking and physical exercise were (50± 12) years,52 895,(127 ± 20) mmHg (1 mmHg =0.133 kPa),(81 ± 11) mmHg,(85±9)cm,1.14 mmol/L (range,0.83-1.56 mmol/L),(4.9±1.1) mmol/L,(1.56±0.39)mmol/L,(5.2± 1.3)mmol/L,(24.5±3.3) kg/m2,24 016,7 696,11 636,20 689,10 245 in the normal group and (54± 11)years,12905,(142±19)mmHg,(90±11)mmHg,(94±8)cm,2.08 mmol/L (range,1.51-3.04 mmol/L),(5.1±1.3)mmol/L,(1.50±0.42)mmol/L,(6.3±2.1)mmol/L,(27.1±3.2) kg/m2,10 031,5 737,3 090,4 762,2 353 in the MS-3 group and (54±10)years,4 556,(146±19)mmHg,(92±11)mmHg,(97±7)cm,2.57 mmol/L (range,2.03-3.80 mmol/L),(5.2± 1.4)mmol/L,(1.44±0.45)mmol/L,(7.2±2.4)mmol/L,(28.1±3.1)kg/m2,3 696,2 971,1 091,1 699,867 in the MS-4 group and (56±11)years,265,(146± 17)mmHg,(92±11)mmHg,(98±6)cm,2.60 mmol/L (range,2.06-3.91 mmol/L),(4.9±1.1)mmol/L,(0.86±0.14) mmol/L,(7.7± 2.9) mmol/L,(28.7 ± 2.9) kg/m2,221,196,62,93,78 in the MS-5 group,respectively,with statistically significant differences among the 4 groups (F =481.40,x2 =3 359.07,F =3 551.06,3 280.16,5 915.20,x2 =18 358.71,F=211.30,473.42,4 168.34,3 909.75,x2 =9 829.51,14 449.74,375.78,225.14,145.73,P ＜ 0.05).(2) Incidence of cholelithiasis in the 4 groups:89 553 subjects were observed for (8.0± 1.1) years,and 4 313 had new-onset cholelithiasis with a cumulative incidence of 4.8％.The cumulative incidences of cholelithiasis in the normal,MS-3,MS-4 and MS-5 groups were respectively 4.5％,5.6％,6.3％ and 13.2％,with a statistically significant difference among the 4 groups (x2 =89.96,P＜ 0.05).There were statistically significant differences in the cumulative incidences of cholelithiasis among the normal,MS-3,MS-4 and MS-5 groups (x2=28.56,29.25,43.48,17.13,35.75,16.82,P＜0.05).(3) Risk factors analysis affecting new-onset cholelithiasis:results of COX proportional hazards model showed that hazard of the new-onset cholelithiasis in the normal group was increased compared with that in the MS-3,MS-4 and MS-5 groups with adjustment for sex,age,high-sensitivity C-reactive protein,smoking,drinking and physical exercise (HR=1.16,1.33,2.68,95％CI:1.07-1.26,1.17-1.51,1.92-3.74,P＜0.05).Conclusion MS is an independent risk factor of new-onset cholelithiasis,and the increased incidence risk of new-onset cholelithiasis is consistent with subjects corresponded with diagnostic criteria of MS.

Objective To investigate the predictive value of cumulative body mass index (cumBMI) on new-onset cholelithiasis.Methods The retrospective cohort study was conducted.The data of 31 794 subjects who participated health examination at the Kailuan Hospital,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Jinggezhuang Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital in 2006,2008,2010,2012 and 2014 were collected.All the subjects were allocated into 4 groups according to squartiles of cumBMI:7 949 with cumBMI＜ 140.81 kg/m2 ×year in the Q1 group,7 946 with 140.81 kg/m2×year≤ cumBMI＜ 159.69 kg/m2 ×year in the Q2 group,7 949 with 159.69 kg/m2×year≤cumBMI＜ 180.49 kg/m2 ×year in the Q3 group and 7 950 with cumBMI ≥ 180.49 kg/m2×year in the Q4 group.All the subjects received respectively the five health examinations in 2006,2008,2010,2012 and 2014 at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) incidence of cholelithiasis in the 4 groups;(2) risk factors analysis affecting newonset cholelithiasis:sex,age,cumBMl,BMI,drinking,smoking,physical exercise,hypertension,diabetes,C-reactive protein (CRP),triglyceride (TG) and total cholesterol (TC).Measurement data with normal distribution were represented as-x±s and comparisons among groups were analyzed using the one-way ANOVA.Pairwise comparison and homogeneity of variance were done using the LSD test.Heterogeneity of variance was done using the Dunnett's T3 test.Measurement data with skewed distribution were described as M (Q) and comparisons among groups were analyzed using the nonparametric test.Count data were analyzed by the chi-square test.The incidence of cholelithiasis in the 4 groups were calculated by the Kaplan-Meier method and comparisons of incidence were done by the Log-rank test.The univariate analysis and multivariate analysis were done using the COX regression model.Results (1) Incidence of cholelithiasis in the 4 groups:31 794 subjects were observed for (2.1 ± 0.4) years,and 236 had new-onset cholelithiasis with an incidence of 7.42‰.Incidences of cholelithiasis in the Q1,Q2,Q3 and Q4 groups were respectively 4.03‰,7.17‰,7.93‰ and 10.57‰,with a statistically significant difference among the 4 groups (x2 =72.39,P＜0.05).(2) Risk factors analysis affecting new-onset cholelithiasis:results of univariate analysis showed that sex,age,cumBMI,BMI,hypertension and CRP were independent risk factors affecting new-onset cholelithiasis of subjects [HR =1.61,1.75,1.64,1.36,1.39,1.39,95％ confidence interval (CI):1.23-2.10,1.49-2.05,1.45-1.86,1.21-1.53,1.07-1.79,1.18-1.62,P＜0.05].Results of multivariate analysis showed that female,age between 50 years and 60 years,age≥60 years,140.81 kg/m2×year ≤cumBMI ＜159.69 kg/m2×year,159.69 kg/m2×year≤cumBMI＜ 180.49 kg/m2 ×year,cumBMI ≥ 180.49 kg/m2 × year were independent risk factors affecting new-onset cholelithiasis of subjects (HR=1.59,1.78,2.33,2.04,2.42,3.66,95％CI:1.21-2.09,1.31-2.44,1.63-3.34,1.29-3.24,1.47-3.95,2.15-6.25,P＜0.05).Conclusion Female,advanced age and increasing cumBMI are independent risk factors affecting new-onset cholelithiasis,and the incidence of cholelithiasis rises as cumBMI increases.

To get the information about civil attitudes and main affecting factors of cadaver donation in Zhengzhou.Make stochastic visits to part of dwellers in Zhengzhou urban districts and then study the statistical data.The main affecting factors are traditional ideas and unsound legal system.So,in order to have a good effect,we should strengthen the dissemination of cadaver donation,renovate ideas,and strengthen relevant legislation for cadaver donation.

Objective:To investigate the therapeutic effect of different prone position ventilation (PPV) on patients with severe acute respiratory distress syndrome (ARDS) at high altitude.Methods:The severe ARDS patients who met the Berlin standard admitted to the department of intensive care unit (ICU) of Qinghai Provincial People's Hospital from January 2017 to January 2020 were enrolled. The patients with classic PPV treatment (i.e. alternate prone supine position, about 16 hours per day) were included in the discontinuous PPV group; the patients with modified PPV treatment (i.e. alternate left and right prone positions 20°-30°, every 4 hours and continuous treatment for 24 hours per day) were included in the continuous PPV group. The oxygenation index (PaO 2/FiO 2), mechanics of breathing, ventilator parameters before treatment and 72 hours after treatment, and mechanical ventilation time, the length of ICU stay, and related complications between the two groups were analyzed. Results:Eighteen cases were treated with continuous PPV and 20 cases were treated with discontinuous PPV. There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), PaO 2/FiO 2, lung compliance, driving pressure (ΔP) and positive end expiratory pressure (PEEP) before treatment between the two groups. Compared with before treatment, PaO 2/FiO 2 in discontinuous PPV group and continuous PPV group was increased significantly after 72-hour treatment [mmHg (1 mmHg = 0.133 kPa): 99.7±15.4 vs. 55.5±6.3, 121.8±25.3 vs. 55.1±7.1, both P < 0.05], lung compliance was improved significantly (mL/cmH 2O: 36.8±2.4 vs. 28.0±2.0, 43.4±6.7 vs. 27.7±2.1, both P < 0.05), and ΔP was decreased significantly [cmH 2O (1 cmH 2O = 0.098 kPa): 10.5 (10.0, 12.0) vs. 13.0 (12.3, 14.0), 10.0 (8.0, 12.0) vs. 13.0 (12.0, 14.0), both P < 0.05], PEEP was also decreased [cmH 2O: 12 (12, 14) vs. 14 (13, 14), 10 (8, 10) vs. 14 (12, 15), both P < 0.05], and the indexes in continuous PPV group were improved more significantly than those in discontinuous PPV group [PaO 2/FiO 2 (mmHg): 121.8±25.3 vs. 99.7±15.4, lung compliance (mL/cmH 2O): 43.4±6.7 vs. 36.8±2.4, ΔP (cmH 2O): 10.0 (8.0, 12.0) vs. 10.5 (10.0, 12.0), PEEP (cmH 2O): 10 (8, 10) vs. 12 (12, 14), all P < 0.05]. The duration of mechanical ventilation and the length of ICU stay in the continuous PPV group were significantly shorter than those in the intermittent PPV group [days: 6.0 (5.0, 7.3) vs. 8.0 (7.0, 9.0), 9.7±1.5 vs. 12.1±2.2, both P < 0.01]. During the PPV treatment, there were 3 cases of cheek skin damage and 2 cases of ear skin damage in the continuous PPV group, and 3 cases of facial skin damage in the intermittent PPV group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.321, P = 0.571). All patients were repaired normally after PPV, without adverse consequences. Conclusion:Continuous PPV is more effective than discontinuous PPV in the treatment of severe ARDS patients at high altitude, and the related complications are did not increased in prolonged time of PPV.

Background Patients often suffer from a few complications of neurological and psychiatric problems after traumatic brain injury including damage of cognition, mental disorders and behavior problems. Damage of cognition is a common sequela in traumatic brain injury. Numerous researchers were focus on the cognition changes of patients with mild brain injury. But their conclusions are debatable. Executive function is one of the important components of cognition. In this study,we tried to find out the executive functional alterations of the patients with mild brain injury.Methods 159 patients with brain injury caused by transportation events and 68 normal controls were assessed executive function. The executive function tests included the block design in WAIS, the Stroop test, the verbal fluency and the modified version of Wisconsin card sorting test (M-WCST). These tests were applied to compare the scores of traumatic brain injury patients with various severities including mild, moderate, and severe and with different CT/MRI results.Results Patients with mild head injury got significantly lower scores on all tests than normal controls ( P＜0.01 ). But there was no significant difference between mild and moderate brain injury group. Except Stroop test and WCST categories, patients with mild brain injury got significantly lower scores on all other tests than those with severe brain injury ( P ＜0.05). In the brain injury cases with damage signs on CT/MRI, there was no significant difference on scores of all tests except block design tests among brain injury patients with various severities. Among the brain injury cases without any damage signs on CT/MRI, there was no significant difference on scores of all tests among brain injury patients with various severities. The correlation analysis showed that scores of block design and verbal fluency test were negatively related to the severity of brain injury( P＜0.05). The age and the education level of the patients had negative and positive correlation, respectively, to executive function.Conclusions The executive function of patients with mild brain injury was impaired when the medication was terminated. We should pay more attention to patients with mild brain injury by performing various tests for assessment of disability.

Objective To observe the changes in microcirculation after induction of anesthesia in patients in plateau region. Methods Ten patients of both sexes, aged 35-58 yr, weighing 52-87 kg, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, were enrolled in this study. Anesthesia was induced with intravenous etomidate 0. 3 mg∕kg, sufentanil 0. 75 μg∕kg and vecuronium 0. 10 mg∕kg. Me-chanical ventilation was performed after tracheal intubation. Fluid was replaced by intravenously infusing lactated Ringer′s solution 500 ml over 30-45 min after completion of anesthesia induction. At 5 min before anesthesia induction, 5 min after induction and after the end of fluid replacement, the hemodynamic pa-rameters such as heart rate (HR), SpO2and mean arterial pressure (MAP) were recorded, and microcir-culatory indices such as total vascular density (TVD), perfused vessel density (PVD), proportion of per-fused small vessels (PPV) and microvascular flow index (MFI) were measured. Results Compared with the baseline value before anesthesia induction, HR was significantly increased, SpO2and MAP were de-creased, TVD, PVD, PPV and MFI were decreased at 5 min after anesthesia induction (P＜0. 05). Com-pared with the baseline value at 5 min after anesthesia induction, HR was significantly decreased, and SpO2and MAP were increased immediately after fluid replacement (P＜0. 05), and no significant change was found in TVD, PVD, PPV or MFI immediately after fluid replacement (P＞0. 05). Conclusion Mi- crocirculatory disturbance is obvious after induction of general anesthesia in patients undergoing operation in plateau region, and no marked improvement is found in microcirculation after rapid fluid replacement, which may be the main cause of metabolic disorders such as acidosis after operation.

In December, the outbreak of a novel coronavirus (2019-nCoV) in Wuhan, China, has attracted extensive global attention. On January 20, 2020,the Chinese health authorities upgraded the coronavirus to a Class B infectious disease in the Law of the People's Republic of China on the Prevention and Treatment of Infectious Diseases, and considered it as Class A infectious diseases in disease control and prevention. On January 22, 2020, the 2019-nCoV nucleic acid detection test was listed as the diagnostic criteria in the "guidelines for diagnosis and treatment of pneumonia due to 2019-nCoV (Trial Version 2)" . Therefore, standardizing the operation process of the 2019-nCoV nucleic acid detection in clinical laboratories has become a top priority. It is of paramount importance to establish standard protocols for detection of the 2019-nCoV nucleic acids in clinical laboratories to improve the reliability of the results and ensure the biosafety of laboratory personnel.