Epidemiology is a traditional subject mainly based on principles and concepts, and its teaching method needs further improving to meet the requirement of the new trend of education reform. Lecture-based teaching, problem-based teaching, case-based teaching, and internet based teaching, such as flip class, massive open online course and micro-lecture, all have its own unique merits in the practice of epidemiology teaching. So the combination of traditional teaching and online teaching is the most promising mode. "Rain class" , a mixed mode, is an efficient tool to present the epidemiology case more actually in class. Thus, teaching design and application of "rain class" are worth research.
Computer-Assisted Instruction ; Epidemiology/education* ; Humans ; Internet ; Online Systems ; Research ; Teaching

OBJECTIVETo search for a better therapy for early postoperative inflammatory small bowel obstruction (EPISBO).

METHODSTwo hundred and forty cases were divided into four groups according to admitting order, 60 cases in each group. Routine treatments in western medicine were used in group A including gastrointestinal decompression, parenteral nutrition, anti-infection, supportive therapy and so on. Group B was treated with electroacupuncture in Zusanli (ST 36), Shangjuxu (ST 37) etc. in addition to those given in group A. Group C was treated with acupoint injection with Neostigmine in Dachangshu (BL 25), Zusanli (ST 36) etc. in addition to the treatment used in group A. Group D was treated with all of the treatments used in group A, B and C.

RESULTSThe total effective rate was 93. 3% in group A, 96. 7% in group B, 100.0% in group C and group D. There was no significant difference among the four groups (P>0. 05). The average recovery time of bowel sound was (11. 512. 9) days in group A, (9. 3 +/- 2.5) days in group B, (5.6 +/- 3.5) days in group C and (2. 2 +/- 1.7) days in group D. The average anal exsufflation time was (12. 5 +/- 3. 1) days in group A, (10. 7 +/- 3.6) days in group B, (7. 2 +/- 3. 1) days in group C and (2. 5 +/- 1. 5) days in group D. Group D was superior to those of other three groups obviously, and there were significant differences between them (all P<0. 01).

CONCLUSIONElectroacupuncture combined with acupoint injection has a satisfied therapeutic effect for treatment of EPISBO.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Injections ; Intestinal Obstruction ; immunology ; surgery ; Male ; Middle Aged ; Neostigmine ; administration & dosage ; Postoperative Complications ; drug therapy ; immunology ; therapy ; Treatment Outcome

OBJECTIVETo verify the efficacy of electroacupuncture (EA) and acupoint injection on early postoperative intestinal obstruction and explore its mechanism.

METHODSOne hundred and sixteen cases were divided randomly into two groups. In control group (56 cases), the conventional western medicine was applied, including gastrointestinal decompression, parenteral nutrition (PN), anti-inflammation and supporting therapy. In observation group (60 cases), on the basis of the treatment as control group, EA and acupoint injection with Neostigmine were supplemented. Zusanli (ST 36), Shangjuxu (ST 37)/Xiajuxu (ST 39) and Dachangshu (BL 25) were selected as main points. Before treatment and after 3 days treatment, the levels of plasma interleukint (IL-6), tumor necrosis factor-alpha (TNF-alpha) and motilin (MOT) were determined.

RESULTSIn observation group, the mean recovery time of bowel sound and the mean frequency of passing gas were less than those in control group (both P < 0.01). After treatment, in either group, the levels of IL-6 and TNF-alpha were down-regulated as compared with those before treatment (all P < 0.01). After treatment, in observation group, IL-6 level was (15.2 +/- 4.1) pg/mL and TNF-alpha level was (18.3 +/- 6.5) pg/mL. They were (35.5 +/- 7.2) pg/mL and (52.7 +/- 12.3) pg/mL respectively in control group, indicating significant difference in statistics between two groups (both P < 0.01). In either group, MOT level increased after treatment as compared with that before treatment (both P < 0 01). After treatment, in observation group, the increase of MOT level was superior to that in control group [(190.7 +/- 48. 5 ) pg/mL vs (114.6 +/- 36.9) pg/mL, P < 0.01].

CONCLUSIONElectroacupuncture and acupoint injection are significantly effective in the treatment of early postoperative intestinal obstruction. This therapy may inhibit the release of inflammatory factors to reduce intestinal wall edema and it may promote MOT secretion to increase intestinal peristalsis. As a result, the recovery of gastrointestinal function is promoted.

Acupuncture Points ; Adult ; Aged ; Cytokines ; blood ; Electroacupuncture ; Female ; Humans ; Inflammation ; therapy ; Injections ; Intestinal Obstruction ; therapy ; Male ; Middle Aged ; Motilin ; blood ; Postoperative Complications ; therapy

Objective: To explore the relationship between meat consumption and metabolic syndrome (MS) in Chinese adults aged ≥18 years. Methods: The data were obtained from 2010- 2012 National Nutrition and Health Survey. A total of 34 923 subjects who completed the dietary survey, the physical examination and had the testing results of blood sugar and blood lipid levels were enrolled in this study. MS was defined according to the diagnostic criteria of China Diabetes Society 2013. The prevalence ratios of MS and each form of MS and related 95%CI were calculated after post stratification weight according to the population data (2009) released by the national bureau of statistics. Results: The average meat intake among subjects was 94.8 g/d. People who had meat consumption between 100 g/d and 199 g/d had the lowest prevalence of MS, abdominal obesity and hyperglycemia. As the meat consumption increased, the prevalence of MS in men increased. Men who had meat consumption of ≥300 g/d had a higher risk of MS than those who had low level of meat consumption, with prevalence ratio equaled to 1.46 (95%CI: 1.14~1.87). Similar trend was not observed in women. Conclusion: Moderate intake of meat is associated with reduced risk of MS in Chinese adults.
Adolescent ; Adult ; China/epidemiology* ; Diet ; Female ; Humans ; Male ; Meat ; Metabolic Syndrome/ethnology* ; Obesity, Abdominal/ethnology* ; Prevalence ; Risk Factors

Objective: To investigate the effect of heterogeneous nuclear ribonucleoprotein K (hnRNP K) and its interaction with human papillomavirus 16 (HPV16) on cervical intraepithelial neoplasia (CIN). Methods: The participants included 67 women with normal cervix (NC), 69 women with CINⅠ and 68 women with CINⅡ/Ⅲ in a community cohort of pathologically diagnosed women established in Jiexiu of Shanxi province, from June 2014 to June 2015. A structured questionnaire was used to collect the demographic data of the subjects and the related factors of cervical lesions. Cervical exfoliated cells and cervical tissues from biopsy or surgery were selected. The infection status of HPV16 was detected by flow-through hybridization. The protein expression levels of hnRNP K were evaluated by Western blot. SPSS 23.0 software was used to collate and analyze the data. To study the differences in demographic characteristics, related factors, hnRNP K protein and HPV16 infection among NC, CINⅠand CINⅡ/Ⅲgroups, χ(2) test, trend χ(2) test, and Kruskal-Wallis H test were conducted. Multiple comparisons of hnRNP K protein in three groups were completed by using the Bonferroni method. The OR and its 95%CI of hnRNP K, HPV16 and CIN were calculated by using the unconditional logistic regression models. Two-way interactions between hnRNP K protein and HPV16 infection on CIN were analyzed by using additive model and related indicators. Results: HPV16 infection rates were 10.4% in women with normal cervix, 14.5% in women with CINⅠ and 41.2% in women with CINⅡ/Ⅲ, respectively. The differences among three groups were significant (P<0.001). Moreover, the infection rates of HPV16 gradually increased with the increasing severity of CIN (trend χ(2)=18.512, P<0.001). The differences in protein expression of hnRNP K among three groups were significant (H=48.138, P<0.001) and the expressionincreased with the development of cervical lesionss (trend χ(2)=21.765, P<0.001). Results from the interaction analysis indicated that there were additive effects between high expression of hnRNP K protein and HPV16 in CINⅡ/Ⅲ group compared with normal group (API=0.639, 95%CI: 0.083-1.196). In contrast, no such additive effect was found in CINⅠ group. Conclusions: HPV16 infection and over-expression of hnRNP K protein were associated with the increased risk of cervical intraepithelial neoplasia. There might be interaction between hnRNP K protein overexpression and HPV16 infection existed on the progress of CINⅡ/Ⅲ.
Case-Control Studies ; Disease Progression ; Female ; Gene Expression Regulation, Neoplastic ; Heterogeneous-Nuclear Ribonucleoprotein K/metabolism* ; Human papillomavirus 16 ; Humans ; Papillomavirus Infections ; Uterine Cervical Neoplasms/virology* ; Uterine Cervical Dysplasia/virology*

Objective: To compare the time and spatial distribution of hepatitis C and HIV/AIDS cases and its correlation, in China from 2012 to 2017. Methods: Data on reported hepatitis C and HIV/AIDS cases was gathered from the Direct Reporting System of Infectious Diseases Information Network in China, 2012 to 2017 while annually collected provincial data was based on the date of review and current address. Correlation of the data was analyzed, using both simple correlation and linear regression methods. Results: The number of reported cases of hepatitis C remained stable in China, in 2012-2017, with the number of annual reported cases as 201 622, 203 155, 202 803, 207 897, 206 832 and 214 023, respectively. The number of reported cases on HIV/AIDS showed a steady growing trend, from 82 434, 90 119, 103 501, 115 465, 124 555 to 134 512. However, the numbers of hepatitis C and HIV/AIDS cases were in the same, top six provinces: Henan, Guangdong, Xinjiang, Guangxi, Hunan and Yunnan. Results from the simple correlation analysis indicated that there was a positive correlation (r>0.5, P<0.01) existed between the above-said two kinds of cases at the provincial level in China, in 2012-2017. Again, results from the linear regression analysis also showed that the correlation coefficient r(s) and year was strongly correlated (r=0.966) while r(s) had been linearly increasing with time. Conclusions: Our data showed that there were temporal and spatial correlations existed between the reported cases of hepatitis C and HIV/AIDS at the provincial level, suggesting that relevant prevention and control programs be carried out in areas with serious epidemics. Combination of the two strategies should be encouraged, especially on prevention and treatment measures related to blood transmission.
Age Distribution ; China/epidemiology* ; Epidemics ; HIV ; HIV Infections/ethnology* ; Hepatitis C/ethnology* ; Humans ; Linear Models ; Spatial Analysis ; Spatio-Temporal Analysis ; Young Adult

BACKGROUNDThe difference in clinical outcome between paclitaxal-eluting stents (PES) and sirolimus-eluting stents with bio-degradable polymer (SES-BDP) for bifurcation lesions remains unclear. The present study aimed to investigate the one-year clinical outcome after DK crush stenting using PES (Taxus(TM)) vs. SES-BDP (Excel(TM)) from our database.

METHODSA total of 275 patients (90 from the DKCRUSH-I and 185 from the DKCRUSH-II study) were studied. The primary endpoint was the occurrence of major adverse cardiac events (MACE) at 12 months; including cardiac death, myocardial infarction (MI), or target vessel revascularization (TVR). The rate of binary restenosis and stent thrombosis served as secondary endpoints.

RESULTSAt follow-up, minimal luminal diameter (MLD) in the Taxus group was (2.11 ± 0.66) mm, with resultant increased target lesion revascularization (TLR) 12.2% and TVR 14.4%, significantly different from the Excel group; (2.47 ± 0.56) mm, P < 0.001, 3.2%, P = 0.006, 4.9%, P = 0.019, respectively. As a result there was a significant difference in MACE between the Taxus (20.0%) and Excel (10.3%, P = 0.038) groups. Overall stent thrombosis was monitored in 11 patients (4.0%), with five in the Excel group (2.7%) and six in the Taxus group (6.7%). All stent thrombosis in the Excel group was classified as early, and all were defined as late in the Taxus group.

CONCLUSIONThe Excel stent had lower rate of stent thrombosis, TLR, TVR, and composite MACE at 12-month after an indexed stenting procedure, compared to the Taxus stent.

Absorbable Implants ; Aged ; Coronary Artery Disease ; therapy ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Paclitaxel ; therapeutic use ; Polymers ; Sirolimus ; therapeutic use

BACKGROUNDThe predictive value of bifurcation angle (BA) for worse events after stenting bifurcation lesions remains to be unknown. The present study was to investigate the dynamic change of BA and clinical relevance for patients with coronary bifurcation lesions treated by drug-eluting stent (DES).

METHODSBA was calculated by 3-D quantitative coronary analysis from 347 patients in DKCRUSH-II study. Primary endpoint was the occurrence of composite major adverse cardiac events (MACE) at 12-month, including cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR). Secondary end points were the rate of binary restenosis and stent thrombosis at 12-month.

RESULTSStenting was associated with the reduction of distal BA. The cut-off value of distal BA for predicting MACE was 60°. Distal BA in < 60° group had less reduction after stenting ((-1.96 ± 13.58)° vs. (-12.12 ± 23.58)°, P < 0.001); two-stent technique was associated with significant reduction of distal BA (Δ(-4.05 ± 14.20)°), compared to single stent group (Δ + 1.55 ± 11.73, P = 0.003); the target lesion revascularization (TLR), TVR and MACE rate was higher in one-stent group (16.5%, 19.0% and 21.5%), compared to two-stent group (3.8%, P = 0.002; 7.5%, P = 0.016; and 9.8%, P = 0.024), respectively. Among patients in ≥ 60° group, there were no significant differences in distal BA, stent thrombosis (ST), MI, MACE, death, TLR, TVR between one- and two-stent groups; after stenting procedure, there was only slight change of distal BA in left anterior descending (LAD)-left circumflex (LCX) subgroup (from (88.54 ± 21.33)° at baseline to (82.44 ± 31.72)° post-stenting), compared to either LAD-diagonal branch (Di), or LCX-obtuse marginal branch (OM), or RCA distal (RCAd) (all P < 0.001).

CONCLUSIONTwo-stent technique was associated with significant reduction of distal BA. DK crush stenting had reduced rate of MACE in patients in < 60° group, compared to one-stent technique.

Adult ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Female ; Humans ; Male ; Prospective Studies ; Young Adult

Objective: To investigate the clinical, imaging, histological, and molecular features and the differential diagnosis of radiation-associated sarcomas of bone and soft tissue. Methods: Forty-six cases of radiation-associated sarcomas of the bone and soft tissue in Beijing Jishuitan Hospital from January 2010 to January 2022 were retrospectively analyzed; and the imaging, histological features and immunophenotype were examined. Results: There were 33 females and 13 males, aged from 18 to 74 years, with a mean of 52 years. The most common site of radiation-associated sarcomas were the limbs and spine (15 cases), followed by the chest (9 cases). The primary diseases included epithelial tumors (15 breast cancer, 6 cervical cancer, and 5 bowel cancer), hematolymphoid tumors, bone and soft tissue tumors and infectious lesions. The latent period of radiation-associated sarcomas ranged from 2-22 years, with an average of 11.6 years. Histopathologically, the morphology was divergent from the primary tumor. The most common malignant tumor type was undifferentiated sarcoma (22 cases), followed by osteosarcoma (16 cases). The immunophenotype of radiation-related sarcoma was almost the same as the corresponding soft tissue sarcoma. Conclusions: Radiation-induced sarcoma has a wide range of primary tumor types and its imaging, morphology and immunohistochemical features are similar to those of the primary sarcoma of bone and soft tissue. Clinical correlation is often recommended for the differential diagnosis.
Male ; Female ; Humans ; Retrospective Studies ; Sarcoma/pathology* ; Osteosarcoma/diagnostic imaging* ; Soft Tissue Neoplasms/pathology* ; Bone Neoplasms/pathology*

Coal ; Coal Mining ; Dust/analysis* ; Humans ; Male ; Miners ; Occupational Diseases ; Occupational Exposure/adverse effects*