Objective To explore the value of serum ischemia modified albumin (IMA) level in assessment of disease severity for patients with chronic obstructive pulmonary disease (COPD).Methods A total of 81 cases of patients with COPD treated in our hospital from September 2015 to March 2016 were selected (COPD group),including 51 cases of patients with acute exacerbation of COPD and 30 cases of patients with stable of COPD.Meanwhile,30 volunteers without COPD were collected as control group.Serum levels of IMA were detected and compared among different groups.Correlations between serum level of IMA and serum level of myoglobin (MYO),troponin T (TNT) and C reactive protein (CRP),and white blood cell (WBC) count were analyzed respectively.A receiver operating characteristic (ROC) curve was also plotted to investigate the diagnostic value of serum IMA level for diagnosing COPD.Results Serum level of IMA in the COPD group was higher than that in the control group [84.1 (79.1,88.5) U/L vs.73.1 (70.2,75.1)U/L],serum level of IMA in patients with acute exacerbation of COPD was higher than that of patients with stable of COPD [85.5 (82.3,89.4)U/L vs.78.1 (75.9,83.0)U/L],serum levels of IMA in patients with acute exacerbation and stable of COPD both were higher than that in the control group,there were statistically significant differences (P＜0.05).The serum level of IMA was positively related with serum level of MYO in patients with COPD (r=0.554,P =0.00).ROC curve indicated when the cutoff value was set as 76.55 U/L,the sensitivity and specificity of serum level of IMA for diagnosing COPD was 88.5％ and 80.0％ respectively,and area under the ROC curve was 0.88.Conclusion Serum level of IMA could be a valuable indicator for clinically assessing disease severity of patients with COPD,which deserves further study through expanding samples size.

BACKGROUND: Measurement uncertainty characterizes the dispersion of the quantity values attributed to a measurand. Although this concept was introduced to medical laboratories some years ago, not all medical researchers are familiar with it. Therefore, the evaluation and expression of measurement uncertainty must be highlighted using a practical example. METHODS: In accordance with the procedure for evaluating and expressing uncertainty, provided by the Joint Committee for Guides in Metrology (JCGM), we used plasma glucose (Glu) as an example and defined it as the measurand. We then analyzed the main sources of uncertainty, evaluated each component of uncertainty, and calculated the combined uncertainty and expanded uncertainty with 2 budgets for single measurements and continuous monitoring, respectively. RESULTS: During the measurement of Glu, the main sources of uncertainty included imprecision, within-subject biological variance (BVw), calibrator uncertainty, and systematic bias. We evaluated the uncertainty of each component to be 1.26%, 1.91%, 5.70%, 0.42%, and -2.87% for within-run imprecision, between-day imprecision, BVw, calibrator uncertainty, and systematic bias, respectively. For a single specimen, the expanded uncertainty was 7.38% or 6.1+/-0.45 mmol/L (kappa=2); in continuous monitoring of Glu, the expanded uncertainty was 13.58% or 6.1+/-0.83 mmol/L (kappa=2). CONCLUSIONS: We have demonstrated the overall procedure for evaluating and reporting uncertainty with 2 different budgets. The uncertainty is not only related to the medical laboratory in which the measurement is undertaken, but is also associated with the calibrator uncertainty and the biological variation of the subject. Therefore, it is helpful in explaining the accuracy of test results.
Blood Chemical Analysis/methods/standards ; Clinical Chemistry Tests/*methods/standards ; Glucose/*analysis/standards ; Humans ; Models, Statistical ; Quality Control ; *Uncertainty

BACKGROUND: Measurement uncertainty characterizes the dispersion of the quantity values attributed to a measurand. Although this concept was introduced to medical laboratories some years ago, not all medical researchers are familiar with it. Therefore, the evaluation and expression of measurement uncertainty must be highlighted using a practical example. METHODS: In accordance with the procedure for evaluating and expressing uncertainty, provided by the Joint Committee for Guides in Metrology (JCGM), we used plasma glucose (Glu) as an example and defined it as the measurand. We then analyzed the main sources of uncertainty, evaluated each component of uncertainty, and calculated the combined uncertainty and expanded uncertainty with 2 budgets for single measurements and continuous monitoring, respectively. RESULTS: During the measurement of Glu, the main sources of uncertainty included imprecision, within-subject biological variance (BVw), calibrator uncertainty, and systematic bias. We evaluated the uncertainty of each component to be 1.26%, 1.91%, 5.70%, 0.42%, and -2.87% for within-run imprecision, between-day imprecision, BVw, calibrator uncertainty, and systematic bias, respectively. For a single specimen, the expanded uncertainty was 7.38% or 6.1+/-0.45 mmol/L (kappa=2); in continuous monitoring of Glu, the expanded uncertainty was 13.58% or 6.1+/-0.83 mmol/L (kappa=2). CONCLUSIONS: We have demonstrated the overall procedure for evaluating and reporting uncertainty with 2 different budgets. The uncertainty is not only related to the medical laboratory in which the measurement is undertaken, but is also associated with the calibrator uncertainty and the biological variation of the subject. Therefore, it is helpful in explaining the accuracy of test results.
Blood Chemical Analysis/methods/standards ; Clinical Chemistry Tests/*methods/standards ; Glucose/*analysis/standards ; Humans ; Models, Statistical ; Quality Control ; *Uncertainty

Objective To enhance the management in identifying the surgical sites to comply with national standards.Methods A nurse-physician collaboration management team was set up to investigate the current identification of surgical sites in every operating room which violates regulations,with the causes analyzed and countermeasures proposed.Working hand in hand,doctors and nurses figured out the management details for preoperatively identifying the surgical sites and reengineering of the surgical process.With the responsibilities clarified and training enhanced,the surgeons,anesthesiologists,ward nurses and operating room nurses were held responsible for the process and improvements of identifying the surgical sites.The number of patients with unreasonable identification of surgical sites was calculated before and after establishment of nurse-physician collaboration management team.Results The reasonable identification rates of surgical sites were 37.94% before the reform and 80.94% after;incorrect use of all types of the surgical site identification can be minimized in the reform.Conclusion The management of nurse-physician collaboration is conducive to enhancing the reasonable identification rate of surgical sites,thus improving the quality of care and correctness of operations.

Objective:To analyze the expression of LETM2 in KYSE150 and ECA109 cell lines and its effect on the proliferation, migra-tion, and invasion of esophageal squamous cell carcinoma (ESCC). Methods:The expression level of the LETM2 protein in 90 paired hu-man ESCC tissues and matched adjacent normal tissues was determined through immunohistochemistry. The expression level of LETM2 in ESCC cell lines was detected by real-time PCR and Western blot. The expression levels of LETM2 in KYSE150 and ECA109 cell lines were knocked down using lentivirus. MTT assays were performed to examine the effect of LETM2 on the proliferation of ESCC cells. Colony formation assay was used to detect the colony formation ability. Flow cytometry was performed to analyze the cell cycle. The effect of LETM2 depletion on the migration and invasion of ESCC cells was determined by Transwell assay. Results:LETM2 expres-sion was frequently upregulated in the ESCC tissues than in the adjacent normal tissues. The suppressed exogenous expression of LETM2 led to the inhibition of cell proliferation and colony formation. However, cell migration and invasion were not affected. The re-sults on the cell cycle distribution revealed that LETM2 knockdown acts as a negative regulator of the cell cycle at the G1 to S phase transition. Conclusion:LETM2 acts as a tumor-driven gene in the development and progression of ESCC. This finding suggests that LETM2 can be used as an efficient prognosis biomarker and a potential therapeutic target for ESCC.

Objective:To explore the application of web problem-based learning (WPBL) + case-based learning (CBL) combined with clinical pathways in dermatological nursing teaching.Methods:A total of 120 nurses who practiced in the dermatology department of The First Affiliated Hospital of Air Force Medical University from July 2018 to June 2020 were selected as the research objects. According to the nurse practice period, they were divided into a control group and a study group, with 60 people in each group. The control group used traditional teaching, and the study group used WPBL+CBL combined with clinical pathways for teaching. After the teaching, the two groups of practical nurses were assessed for their theoretical and clinical operational abilities, and the comprehensive abilities of the two groups of practical nurses and their satisfaction with teaching were assessed through questionnaire surveys. SPSS 22.0 was used for t test and χ2 test. Results:The theoretical and clinical performance assessment results of the study group were better than those of the control group, and the difference was statistically significant ( P<0.001). The research group was better than the control group in assessment of improving clinical operation ability, independent problem-solving ability, cultivating teamwork ability, improving self-learning ability, improving ability of presenting and analyzing problems, improving comprehensive analysis ability, cultivating clinical thinking ability and comprehensive ability, with statistical significance ( P<0.001). The satisfaction rate of the trainee nurses in the study group was 93.33%, and the satisfaction rate of the trainee nurses in the control group was 31.67%, with statistically significant differences. Conclusion:WPBL+CBL combined with clinical pathways teaching can significantly improve the theoretical and clinical operation ability of dermatology practice nurses, and improve their comprehensive ability and clinical teaching satisfaction rate, which is worthy of application and promotion in clinical nursing teaching.

OBJECTIVETo study the applicability of MultiCalc software to prenatal screening of Down's syndrome in Jiangsu province, China.

METHODSThe gestational age-specific median of maternal serum marker was calculated by means of regression method. Regression functions for adjustment of Multiple of the Median (MoM) by weight were established for our own population.

RESULTSBefore the adjustment by weight, the average level of alpha fetal protein(AFP) was 16% higher and the free beta-human chorionic gonadotrophin (beta-hCG) was 14% higher than those of the Caucasian in MultiCalc software respectively. But when the AFP and free beta-hCG results were converted to weight-adjusted MoM levels, the values were 0.99 and 1.02 respectively. The median of MoM of AFP and the free beta-hCG were 1.00 through the regression model of gestational age and weight adjustment.

CONCLUSIONThere was no difference of average weight-adjusted MoM levels between the Jiangsu population and the Caucasian, and the MultiCalc software was applicable to maternal serum screening for Down's syndrome of Jiangsu.

Adolescent ; Adult ; Body Weight ; China ; Chorionic Gonadotropin ; blood ; Down Syndrome ; diagnosis ; Female ; Fetal Diseases ; diagnosis ; Gestational Age ; Humans ; Middle Aged ; Mothers ; Pregnancy ; Pregnancy Trimester, Second ; blood ; Prenatal Diagnosis ; methods ; Reference Values ; Regression Analysis ; Software ; alpha-Fetoproteins ; metabolism

Corona virus disease 2019 (COVID-19) patients with trauma are at high risk of venous thromboembolism (VTE), which must be taken seriously in the therapeutic processes. Hypercoagulable state is induced by 2019 novel coronavirus (2019-nCoV) in many ways, such as increasing the level of inflammatory factors and fibrinogen, and inducing endothelial cell injury. The venous wall injuries from trauma and operation directly or indirectly trigger off the exogenous coagulation pathway and the microcirculation can be damaged at the same time, which may initiate the exogenous pathway of VTE. Immobilization of limbs and forced bed rest during the treatment of traumatic patients will slow venous blood flow. Chronic non-communicable diseases such as diabetes in the elderly were independent risk factors for VTE. Furthermore, the persistent fever, severe lung disease, respiratory failure, sepsis and invasive technology application add the risk of VTE and the difficulty of treatment. In order to help effective prevention VTE of for COVID-19 patients with trauma, the authors put forward relevant technical suggestions for prevention and nursing of VTE to provide basis for nursing work during pandemic of COVID-19.

Sanggenon C is a kind of flavonoid compound mainly extracted from the traditional Chinese medicine Morus alba. The pharmacological effects and mechanisms of sanggenon C are systematically reviewed and summarized， and it is found that this component can improve pulmonary fibrosis by regulating transforming growth factor-β1 and nuclear factor-κB； it can exert anti- tumor effects by inhibiting the proliferation of tumor cells and inducing the apoptosis of tumor cells； it can exert cardioprotective， neuroprotective and hepatoprotective effects by regulating multiple signaling pathways， such as calcineurin/nuclear factor of activated T cells 2， peroxisome proliferators-activated receptor α， and Ras homolog gene family member A/Rho-associated coiled- coil containing protein kinase， enhancing autophagy， reducing inflammatory response and reducing the level of oxidative stress； it can treat osteoporosis by inhibiting osteoclast uptake and promoting osteoblast formation； it has certain inhibitory effect on many enzymes； it can exert anti-inflammatory effects by regulating nuclear factor-κB signaling pathway； it can exert antioxidant effects by scavenging free radicals. However， researches on the pharmacological effects of sanggenon C mostly focus on the cellular and animal field， and the specific mechanism of action is not yet clear. In the future， basic research and clinical trials are still needed to explore and verify.

Objective: To explore the expression of FAT1 in esophageal squamous cell carcinoma (ESCC) tissues, and its effect on cell proliferation. Methods: The expression levels of FAT1 protein in human ESCC tissues and matched adjacent normal tissues were determined by immunohistochemistry (IHC). Lentivirus based knockdown of FAT1 was carried out in YSE2 and Colo680N cell lines and 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) assays was performed to examine the effect of FAT1 on the proliferation of these ESCC cells. Colony formation assay was used to detect the colony formation ability. Flow cytometry was performed to analyze the cell cycle and apoptosis. The expression levels of cell cycle markers in FAT1 knock out ESCC cell lines were detected by real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR) and Western blot. Results: The relative expression of FAT1 in ESCC tissues was 66.97±21.53, significantly lower than 78.13±16.76 of adjacent normal tissues(P<0.05). Knockdown of FAT1 promoted cell proliferation and colony formation. In YSE2 cell, the division time in negative control (NC) group was (1 570±51) min, significantly longer than (1 356±31) min in shFAT1 group. In Colo680N cell, division time in NC group was (1 532±53) min, significantly longer than (1 290±30) min in shFAT1 group (P<0.05). Knockdown of FAT1 promoted G1-to S-phase transition and resulted in the upregulation of CDK4/CDK6/CCND1. Conclusion FAT1 inhibits the proliferation and G1-to S-phase transition of ESCC cells through regulating the protein expression of CDK4/CDK6/CCND1 complex.