Volume overload or hidden lung congestion is emerging as a pervasive problem in end-stage renal disease (ESRD) patients on hemodialysis,which will lead to cardiovascular complications and impact the patients' life quality and survival time,so how to improve volume control in patients on hemodialysis is a urgent research hotspot.Recently,the ap plication of lung ultrasound for semi-quantitative assessment pulmonary congestion in patients on hemodialysis has received general concern.Lung ultrasound not only can detect excessive extravascular lung water in the early period of pulmonary congestion,but also can predict cardiac events and mortality in ESRD.Lung ultrasound is an effective,sensitive,real-time and non-invasive tool beside.The application and progresses of lung ultrasound in evaluation of pulmonary congestion in hemodialysis patients were reviewed in this article.

Adult ; Aged ; Female ; Fistula ; surgery ; Humans ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVEThis study aimed to improve students' ability in practical and theoretical courses of oral health education and to promote students' learning interest and initiative.

METHODSFourth-year students of the oral medical profession from 2006 to 2008 at Weifang Medical University were chosen as research objects for oral health education to explore the experimental teaching reform. The students were divided into test and control groups, with the test group using the "speak out" way of teaching and the control group using the traditional teaching method. Results of after-class evaluation of the test group, as well as final examination and practice examination of the two groups, were analyzed and compared.

RESULTSAfter-class evaluation results of the test group showed that the "speak out" teaching method was recognized by the students and improved students' ability to understand oral health education. The final examination and practice examination results showed that the score of the test group was higher than that of the control group (P < 0.01).

CONCLUSION"Speak out" teaching methods can improve students' ability for oral health education, in accordance with the trend of teaching reform.

The medical service payment system reform is one of core issues in medical and health system reform.The payment system can directly affect behavior of stakeholders and indirectly affect medical expense,quality of care,efficiency of medical services and efficiency of medical insurance funds.Through behavior analysis of stakeholders in fee for service,DRGs-PPS,global budget,DRGs-PPS is the best payment system that can control the irrational increase of medical expenses and ensure the level of health service and meets interest of stakeholders among three payment systems.In DRGs-PPS,stakeholders continuously make progress in filling in the front sheet of medical records,clinical pathway,construction of information system,cost calculation and restructure costs.

Micro- and integrated biosensor provides a powerful means for cell electrophysiology research. The technology of electroplating platinum black on the electrode can uprate signal-to-noise ratio and sensitivity of the sensor. For quantifying analysis of the processing method of electroplating process, this paper proposes a grid search algorithm based on the Monte-Carlo model. The paper also puts forward the operational optimization strategy, which can rapidly implement the process of large-scale nanoparticles with different particle size of dispersion (20-200 nm) attac- hing to the electrode and shortening a simulation time from average 20 hours to 0.5 hour when the test number is 10 and electrode radius is 100 microm. When the nanoparticle was in a single layer or multiple layers, the treatment uniformity and attachment rate was analyzed by using the grid search algorithm with different sizes and shapes of electrode. Simulation results showed that under ideal conditions, when the electrode radius is less than 100 /m, with the electrode size increasing, it has an obvious effect for the effective attachment and the homogeneity of nanoparticle, which is advantageous to the quantitative evaluation of electrode array's repeatability. Under the condition of the same electrode area, the best attachment is on the circular electrode compared to the attachments on the square and rectangular ones.
Algorithms ; Biosensing Techniques ; Electrodes ; Models, Theoretical ; Monte Carlo Method ; Nanoparticles ; Particle Size ; Platinum

Objective To evaluate the relationship between MEK/extracellular signal-regulated kinase (ERK) signal transduction pathway and CX3CR1 in the spinal dorsal horns in a rat model of bone cancer pain (BCP).Methods Fifty female Sprague-Dawley rats,weighing 150-180 g,were randomly divided into 5 groups (n =10 each):sham operation group (group Ⅰ),BCP group (group Ⅱ),sham operation + U0126 group (group Ⅲ),BCP+ 5％ dimethyl sulfoxide (DMSO) group (group Ⅳ),BCP + U0126 (MEK inhibitor) group (group Ⅴ).BCP was induced by inoculating Walker 256 mammary gland carcinoma cells into the medullary cavity of the left tibia.In Ⅲ and Ⅴ groups,U0126 10 μg/10 μl was injected intrathecally once a day starting from day 10 after inoculation to day 12 after inoculation,while the equal volume of 5％ DMSO was injected in group Ⅳ.Mechanical paw withdrawal threshold (MWT) was measured at 1 day before inoculation (baseline),3,6,9,and 10 days after inoculation,and after administration on 11 and 12 days after inoculation.The rats were sacrificed after administration on day 12 after inoculation and the L4.6 segments of the spinal cord were removed for determination of CX3CR1 expression in spinal dorsal horns (by Western blot and immunohistochemistry).Results Compared with Ⅰ and Ⅲ groups,MWT was significantly decreased at 6-12 days after inoculation,and the expression of CX3CR1 in spinal dorsal horns was up-regulated in Ⅱ,Ⅳ and Ⅴ groups (P ＜0.01).Compared with Ⅱ and Ⅳ groups,MWT was significantly increased at 10-12 days after inoculation,and the expression of CX3CR1 in spinal dorsal horns was down-regulated (P ＜ 0.01).Conclusion MEK/ERK signal transduction pathway in the spinal dorsal horns is involved in the development and maintenance of BCP in rats possibly through regulating the expression of CX3CR1.

Objective: To construct siRNA plasmid expression vector in order to knockdown E2F-3 activity. Methods: Sixty-four base-pair oligos for hairpin RNA expression, which targeted E2F-3 gene, were chemically synthesized and annealed. The pRNAT-U6.1/Neo vector was linearized with Bam HI and HindⅢ. Finally, the annealed oligos were inserted into the lined pRNAT-U6.1/Neo to construct RNAi plasmid(pRNAT-U6.1-E2F-3/Neo). The reconstructed RNAi plasmids were i-dentified by electrophoresis after digestion with BamHI and Hind Ⅲ, and were confirmed by sequencing analysis. Results: The recombinant pRNAT-U6.1-E2F-3/Neo vector was identified by polymerase chain reaction, and confirmed by sequencing analysis. The results demonstrated that 64 bp had been inserted into the expected site. Furthermore, the insertion sequence was exactly correct and no mutation site was found. Conclusion: The pRNAT-U6.1-E2F-3/Neo RNAi system was constructed successfully. This will facilitate the study of E2F-3 in bladder cancer cell lines.

Objective To explore the associations between interferon induced helicase C domain 1 (IFIH1) gene single nucleotide polymorphism (SNP) rs1990760 C >T and polymyositis/dermatomyositis (PM/DM) in Chinese Han patients from Jiangsu area. Methods A total of 183 PM/DM patients and 400 healthy controls were included. SNP typing was performed by Taqman MGB probe method. The distributions of genotypes and alleles and Hardy-Weinberg equilibrium (HWE) were examined by χ2 tests or Fisherˊs exact tests. Results The distribution of IFIH1 rs1990760 genotypes of all patients group and the control group were consistent with HWE. The frequencies of T and C alleles were not significantly different between the PM/DM group (20.8% and 79.2%, respectively), the DM group (20.9% and 79.1%, respectively), the PM group (20.5%and 79.5%, respectively) and control group (18.0%and 82.0%, respectively). In recessive model (TT vs CT+CC) and additive model (TT vs CC), the frequencies of TT genotype in PM/DM group (6.6% vs 2.8%; χ2=4.8 and 4.54, respectively; both P=0.03) and in DM with interstitial lung disease (ILD) group (8.3% vs 2.8%;χ2=4.84 and 4.41, respectively; P=0.03 and 0.04, respectively) were significantly higher than those in the control group.In recessive model (TT vs CT+CC), the frequency of TT genotype in PM without ILD group was significantly higher than that in the control group (9.8% vs 2.8%, χ2=5.56, P=0.04). The genotype and allele distributions of rs1990760 were not significantly different between the anti-MDA5 positive group and control group. Conclusion The rs1990760 TT genotype of IFIH1 gene may be associated with the susceptibility of PM/DM in Jiangsu Han Chinese population, and the associations may differ based on the ILD status.

Objective To explore the clinical and serological features of patients with pneumomdiastinum (PNM) and dermatomyositis associated interstitial lung disease (DM-ILD).Methods A total of 145 polymyositis/dermatomyositis (PM/DM) patients hospitalized in our department from March,2010 to December,2012 were recruited.The sera,clinical and laboratory data were collected.Anti-aminoacyl-tRNA synthetase (anti-ARS) and anti-melanoma differentiation-associated gene 5 (MDA5) antibodies were detected by RNA-immunoprecipitation (RNA-IP) and ELISA,respectively.Anti-NXP2,anti-TIF1γ,anti-SRP,anti-SAE and antiMi2 antibodies were detected by immunoprecipitation-Western blotting.Variables were compared between DM patients with and without PNM,as well as between DM-ILD patients with and without PNM.Chi square test,Fisher's exact test,t test,Mann-Whitney U test and a multivariate logistic regression model were used for statistical analysis.Results A total of 11 DM patients (10 patients positive for anti-MDA5 and 1 patient positive for anti-Mi2) developed spontaneous PNM.No PM patient developed PNM.No differences of sex,age at the onset of DM,serum ferritin levels and C reactive protein (CRP) levels was observed between DM patients with and without PNM.Compared with DM patients without PNM,DM patients with PNM had significantly higher frequencies of rapidly progressive ILD (RP-ILD) (63.6％ vs 24.4％,x2=7.25,P=0.01),anti-MDA5 antibodies (90.9％ vs 52.4％,x2=5.86,P=0.02),clinically amyopathic DM (CADM) (63.6％ vs 22.0％,x2=8.57,P=0.007) and cutaneous ulcers (36.4％ vs 11％,x2=5.20,P=0.04),but significantly lower creatine kinase (CK) levels [58.5 (30.5,394.3) U/L vs 284 (73.0,917.0) U/L,t=207.5,P=0.04].The logistic multivariate analysis indicated that cutaneous ulcer was the only independent risk factor for the occurrence of PNM in DM [OR=5.98,95％ confidence interval (CI) (1.12,31.98),P=0.037].In the comparisons between DM-ILD patients with and without PNM,a higher frequency of CADM was observed in the PNM group (63.6％ vs 27.9％,x2=5.37,P=0.03),but no significant difference of the frequencies of RP-ILD,anti-MDA5 antibodies,cutaneous ulcers and CK levels was found in these two groups.All patients with PNM were treated with corticosteroids and immunosuppressants.During the follow-up period,6 patients died of respiratory failure.Conclusion Spontaneous PNM is a refractory complication with poor prognosis,and tends to occur in DM patients with RP-ILD,anti-MDA5 antibody,CADM diagnosis and low CK level,especially in patients with cutaneous ulcers.

Objective To explore the incidences of ventilator-associated pneumonia (VAP)in intensive care units (ICUs)in China.Methods From October 2013 to September 2014,46 hospitals in 12 provinces and cities were se-lected to participate in the study,all patients admitted to ICUs were included,the incidences of VAP were surveyed and compared with data from the U.S.National Healthcare Safety Network (NHSN).Results A total of 17 358 patients were surveyed,the total patient-days were 176 096 d,the total catheter-days were 91 448 d,813 patients developed VAP,the incidence of VAP was 8.89/1 000 catheter-days,VAP mainly occurred in general ICUs (76.74%);the incidences of VAP were varied with patients in different types of ICUs,ranging from 4.50/1 000 catheter-days to 32.79/ 1 000 catheter-days.Conclusion The incidence of VAP in patients in ICUs at 46 hospitals in China is significantly higher than that reported by NHSN,even higher than the P90 .