Objective To detect the expression of integrin ?5?1 in restenosed human vein grafts.Methods The expression of integrin ?5?1 and ?-smooth muscle actin(?-SMA) in 30 resected restenosed human vein grafts(from Kerfuff clinical hospital of Germany) was detected by confocal immunofluorescence with specific antibodies against ?5?1 and ?-SMA.Images were processed with Silicon Graphics Octane.Results In normal veins,integrin ?5?1 expression was very weak in media smooth muscle cells and in endothelium,and ?-SMA expression was present in media smooth muscle cells.In the restenosed vein grafts,integrin ?5?1 was strongly stained in the media smooth muscle cells and intimal endothelial cells,and moderately in the intimal smooth muscle cells,?-SMA was present in media smooth muscle cells and in the intimal smooth muscle cells.Conclusion Our research reveals that integrin ?5?1 is significantly upregulated in the media smooth muscle cells and intimal endothelial cells in the restenosed human vein grafts,suggesting the participation of integrin ?5?1 in the restenosis formation of human vein grafts.

Objective To investigate the diagnosis and treatment of post-transplant lymphoproliferative disease (PTLD) after hematopoietic stem cell transplantation (HSCT).Methods Clinical data of one case of PTLD,including clinical manifestations,diagnosis and treatment,were retrospectively analyzed.And the related literatures were reviewed.Results From January 2007 to November 2012,one case developed PTLD among 196 patients who were followed up after HSCT in the First Affiliated Hospital of Chongqing Medical University.The incidence of PTLD was 0.5％.Clinical manifestations of the patient were not typical,including frequent fever,multiple lymphadenopathy and multiple pulmonary nodules.The patient was diagnosed as diffuse large B-cell lymphoma (B-DLCL) by pathological examination of the swollen lymph node.After withdrawal of immunosuppressants,the temperature returned to normal,and lymphadenopathy and pulmonary nodules disappeared completely.Conclusion PTLD is a severe complication of HSCT with distinctive morphologic and clinical characteristics.The origin of this disease may be associated with Epstein-Barr virus infection and imrnunosuppressive therapy.It needs the pathologic detection to make a definite diagnosis.Several different treatment strategies have been employed,and reduction of immunosuppressive therapy may lead to regression of PTLD.

Objective:To optimize the water extraction and alcohol precipitation technology of Xuanfei Zhike granule .Methods:Orthogonal test was used to investigate the effects of adding water , decocting time and boiling time on the water extraction , and the effects of relative density , alcohol precipitation concentration and alcohol precipitation time on the alcohol precipitation technology by taking comprehensive score including the amount of hesperidin , the amount of tectoridin and the yield of dry cream as the indices .Re-sults:The preferred water extraction technology was as follows: added 10 times water and extracted 1.5 h firstly, and then added 8 times water and extracted twice with 0.5 h for each.The preferred alcohol precipitation technology was as follows:concentrated the wa-ter extraction to a relative density of 1.05 (measured at 60℃), slowly added 95％ethanol to 80％alcohol solution and stored 18 h at low temperature .Conclusion:The optimal water extraction and alcohol precipitation technology is stable and feasible , which can pro-vide reference for the standardized production of Xuanfei Zhike granule .

Objective Animal experiment is indispensible for the progress of medicine and medical research.Experimental animals deserve basic respect and care.This paper reviewed the history and status of the experimental animal welfare nationally and internationally to identify the ethical problems existed in animal experiments,and finally discuss the establishing of ethical review system of experimental animals.Methods According to literature review,as well as summarizing the operating practice in the affiliated hospital of Chengdu university of TCM,this study analyzed the problems in the field of experimental animal welfare protection.Results Many countries,such as Britain,Germany and the United States,have legislation on the welfare of experimental animals.There are no such laws in China while departmental regulations has formulated.At present,the weak cognition of bioethics among medical personnel,lack of corresponding certification system,lack of the ethical review system of laboratory animal are still unsolved problems.This paper summarizes the principles of ethical review,the documents of review and the elements of review.Conclusions The protection of experimental animals is a systematic project,and ethical review as the first link of animal experiments can play a good role in promoting animal experiment.

Objective: To investigate the current status of occupational stress in medical staff in Shenzhen, China, and to provide a reference for developing health administrative policy and reducing occupational stress in medical staff. Methods: From January to June, 2018, a cross-sectional survey was performed in 992 medical workers who were selected from 2 municipal hospitals and 2 district hospitals by stratified random sampling. General information was collected, Occupational Stress Inventory-Revised Edition was used to investigate occupational stress, and univariate and multivariate analyses were performed based on a descriptive analysis of related results. Results: For the medical staff in Shenzhen, the scores of Occupational Role Questionnaire, Personal Stress Questionnaire, and Personal Resources Questionnaire were 185.67±17.55, 108.45±15.56, and 122.74±16.56, respectively. Age, degree of education, type of work, job title, professional title, and permanent or temporary job were influencing factors for occupational task (P<0.05) ; age, working years, type of work, and night shift were influencing factors for personal stress response (P<0.05) ; working years, type of work, professional title, and weekly working hours were influencing factors for personal coping resources (P<0.05) . Conclusion There is a high degree of occupational stress among medical staff in Shenzhen, and it is recommended to improve medical resources in Shenzhen, reduce occupational stress among medical staff, and increase coping resources.

OBJECTIVE: To investigate the current status of occupational stress and quality of life( QOL) in medical staffs of Shenzhen City. METHODS: A total of 992 medical stuffs from 4 hospitals of Shenzhen City were selected as study subjects by using the stratified random sampling method. The Occupational Stress Inventory Revised Edition and SF-36 Questionnaire were used to investigate the occupational stress and QOL. RESULTS: The rate of high occupational strain in medical staffs of Shenzhen is 48. 8%. According to the results of multivariate stepwise regression analysis,the influencing factors for physical component summary of QOL were profession,education,occupational strain,personal coping resource,length of service and work hours( P < 0. 05). The influencing factors of mental component summary of QOL were age,occupational strain,personal coping resource,length of service,work hours and gender( P < 0. 05). CONCLUSION: Occupational stress is a factor influencing the physical and mental health of medical staffs in Shenzhen City. High occupational stress and lack of coping resources can reduce the QOL.

Objective:To analyze the clinicopathological features in diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) patients, and provide reference for patients who will receive renal biopsy with diabetes mellitus complicated with chronic kidney disease.Methods:The patients with type 2 diabetes mellitus complicated with chronic kidney disease who underwent renal biopsy were collected through the database at the Nanfang Hospital of Southern Medical University from February 2002 to June 2018. According to the results of renal biopsy, they were divided into DKD group and NDKD group (including DKD+NDKD). The clinical manifestations and pathological types were compared between the two groups.Results:A total of 507 patients were eventually included in the study. There were 114 cases (22.5%) with DKD and 393 cases (77.5%) with NDKD. Pathologically, the most common pathological types of NDKD were membranous nephropathy (30.0%) and IgA nephropathy (19.1%). Among NDKD patients, 5.6% patients had DKD combing with NDKD. In term of the clinical manifestations, DKD patients had a longer history of diabetes (>1 year, 76.3% vs 36.1%, P<0.001), higher quantity of urinary protein [3.69(1.70, 6.74) g/24 h vs 2.21(0.91, 4.97) g/24 h, P<0.001], higher serum creatinine [117.5(85.8, 194.5) μmol/L vs 89.0(68.0, 143.8) μmol/L, P<0.001] than NDKD patients. But the hemoglobin [(105.07±20.85) g/L vs (124.41±25.02) g/L, P=0.002] and cholesterol [(5.69±1.87) mmol/L vs (6.43±2.75) mmol/L, P=0.001] in DKD patients were lower than those in NDKD patients. Logistic regression analysis showed that diabetes mellitus history ( OR=4.162, 95% CI 1.717-10.098, P=0.002) , higer systolic pressure (every 1 mmHg, OR=1.028, 95% CI 1.011-1.045, P=0.001) , history of antihypertensive medication ( OR=3.141, 95% CI 1.496-6.591, P=0.002), diabetic retinopathy ( OR=5.561, 95% CI 2.361-13.100, P<0.001) and higher glycated hemoglobin level (every 1%, OR=1.680, 95% CI 1.333-2.118, P<0.001) were related factors of DKD, while hematuria ( OR=2.781, 95% CI 1.334-5.798, P=0.006) and higher hemoglobin level (every 1 g/L, OR=1.022, 95% CI 1.008-1.037, P=0.002) were related factors of NDKD. Conclusions:There are differences in clinical manifestations and pathological types between DKD and NDKD. The history of diabetes, antihypertensive medication, fundus examination, higher of proteinuria and glycosylated hemoglobin may predict DKD, while hematuria and higher level of hemoglobin may have certain guiding significance for the diagnosis of NDKD. The indication of renal biopsy in patients with diabetes mellitus complicated with chronic kidney disease should include comprehensive clinical manifestations.

Objective:To observe the impact of core stability training in the sling exercise therapy pattern on the balance of stroke survivors.Methods:Sixty stroke survivors were randomly divided into a control group ( n=30) and an experimental group ( n=30). In addition to routine rehabilitation training, the control group received traditional core stability training, while the experimental group underwent core stability training applying the sling exercise therapy pattern. Before and after 4 weeks of training, the standing balance of both groups was evaluated using the Prokin balance trainer, with the length and area of motion recorded when performing the balance test with the eyes open and closed. Surface electromyography was used to record the average EMG (AEMG) values of the bilateral erector spinae and multifidus muscles during the balance testing. Results:After the 4 weeks of training the length and the area of progression of the center of the pressure were both significantly smaller for both groups than before the training with the eyes both open and closed. The average length and area in the experimental group were significantly less than among the controls. The AEMG values recorded during the balance tests were significantly higher than those before the intervention for both groups, with the multifidus muscle averages on the affected side significantly greater in the experimental group than among the controls when performing the balance test with the eyes closed.Conclusion:Core stability training in the sling exercise therapy pattern is superior to conventional core stability training because it can better improve the balance of stroke survivors.

Objective To analyze the confirmation results of initial screening positive for human immunodeficiency virus(HIV)antibodies and to investigate the rationality of the gray zone for the signal-to-cutoff(S/CO)ratio values obtained by chemiluminescence assay.Methods A total of 184 specimens with positive HIV antibody screening results were collected.Confirmation was conducted u-sing the Western blot(WB)method and viral nucleic acid testing,and the confirmation outcomes and band distribution were observed.The receiver operating characteristic(ROC)curve was employed to predict the optimal cutoff value,and the rationality of S/CO values in establishing a gray zone for HIV antibody was analyzed.Results Among the 184 HIV antibody screening positive samples,153(83.15％)were initially screened by chemiluminescence,and 31(16.85％)were screened by colloidal gold method.Male cases(57.07％)and those aged 40 years or older(75.00％)had higher proportion of initial screening positivity than females and other age groups.Supplemental WB testing revealed that 101(54.89％)cases were confirmed as HIV-1 antibody positive,56(30.43％)were negative,and 27(14.67％)were indeterminate.Of the 27 indeterminate cases,one was confirmed positive by NAT(initial S/CO value by chemiluminescence:5.60),while the remaining 26 were negative.The positive agreement rates between chemiluminescence,colloidal gold and supplemental WB tes-ting were 65.36％and 3.23％,respectively,with statistically significant difference(x2=40.191,P＜0.05).Among 27 cases with indeterminate HIV-1 antibody results,upon further nucleic acid testing for viral load,one case exhibited WB banding pattern of P24+gp160,and the nucleic acid load confirmed this case as positive.In the distribution of band patterns among indeterminate sam-ples,P24 had the highest occurrence(74.07％),followed by P66(11.11％),gp160(7.41％)as well as P17 and gp41(both 3.70％).The ROC curve predicted the optimal S/CO cutoff value to be5.15,with an area under the curve(AUC)of0.904,sensitivity and specificity of 83.30％and 76.40％,respectively,and 95％CI of 0.861 to 0.948.There was a good correlation between the WB band patterns and confirmation results for initial screening positive cases(P＜0.05),with the highest correlation found for the P24 band(r=0.910).Conclusion There is a certain rate of false positives among HIV antibody initial screening positive cases,and effective screening can be a-chieved through WB testing.Additionally,based on the current testing platform,the gray zone for HIV antibody S/CO values in the chemiluminescence assay is set at 1.00 to 5.15,which exhibits high sensitivity.

Objective To analyze the confirmation results of initial screening positive for human immunodeficiency virus(HIV)antibodies and to investigate the rationality of the gray zone for the signal-to-cutoff(S/CO)ratio values obtained by chemiluminescence assay.Methods A total of 184 specimens with positive HIV antibody screening results were collected.Confirmation was conducted u-sing the Western blot(WB)method and viral nucleic acid testing,and the confirmation outcomes and band distribution were observed.The receiver operating characteristic(ROC)curve was employed to predict the optimal cutoff value,and the rationality of S/CO values in establishing a gray zone for HIV antibody was analyzed.Results Among the 184 HIV antibody screening positive samples,153(83.15％)were initially screened by chemiluminescence,and 31(16.85％)were screened by colloidal gold method.Male cases(57.07％)and those aged 40 years or older(75.00％)had higher proportion of initial screening positivity than females and other age groups.Supplemental WB testing revealed that 101(54.89％)cases were confirmed as HIV-1 antibody positive,56(30.43％)were negative,and 27(14.67％)were indeterminate.Of the 27 indeterminate cases,one was confirmed positive by NAT(initial S/CO value by chemiluminescence:5.60),while the remaining 26 were negative.The positive agreement rates between chemiluminescence,colloidal gold and supplemental WB tes-ting were 65.36％and 3.23％,respectively,with statistically significant difference(x2=40.191,P＜0.05).Among 27 cases with indeterminate HIV-1 antibody results,upon further nucleic acid testing for viral load,one case exhibited WB banding pattern of P24+gp160,and the nucleic acid load confirmed this case as positive.In the distribution of band patterns among indeterminate sam-ples,P24 had the highest occurrence(74.07％),followed by P66(11.11％),gp160(7.41％)as well as P17 and gp41(both 3.70％).The ROC curve predicted the optimal S/CO cutoff value to be5.15,with an area under the curve(AUC)of0.904,sensitivity and specificity of 83.30％and 76.40％,respectively,and 95％CI of 0.861 to 0.948.There was a good correlation between the WB band patterns and confirmation results for initial screening positive cases(P＜0.05),with the highest correlation found for the P24 band(r=0.910).Conclusion There is a certain rate of false positives among HIV antibody initial screening positive cases,and effective screening can be a-chieved through WB testing.Additionally,based on the current testing platform,the gray zone for HIV antibody S/CO values in the chemiluminescence assay is set at 1.00 to 5.15,which exhibits high sensitivity.