Objective To establish a safety culture evaluation model to conduct empirical research with regard to the assessment of both the radiation safety culture and management at different levels of health institutions.Methods Delphi method is used to develop a model to define the effectiveness and operational practice of safety culture system in hospitals.Results The research had achieved good reliability assessment,with Cronbach coefficient α of all indicators higher than 0.60.There were 16 hospitals with scores less than 75 (61.54％),at the primary stage of radiation safety culture,and 9 hospitals among 75-95 (34.62％),at the middle stage,only 1 hospital with score of 95.48 (3.85％),at the high grade stage.Conclusions At present,the level of radiation safety culture in medical institutions is lower as a whole.The evaluation model established in the present research is practicable to some extent and can provide reference for strengthening radiation safety management.

AIM To study the role of survivin on the apoptosis of lung cancer cell line induced bycisplatin (DDP) and etoposide (VP16). METHODS The lung adenocarcinoma cell line A549 was chosen in this experiment. The inhibitory effects of chemotherapeutical drugs on A549 cell line were assayed with MTT test. Cultured cells was divided into 3 groups: DDP, VP16 and control. Both DDP and VP16 group were divided into high concentration group and low concentration group, respectively. Expression of survivin gene were detected by reverse transcriptase PCR. Apoptosis was deterinined by flow cytometry. RESULTS Both DDP and VP16 obviously inhibited the lung cancer cell growth with dose and time dependent. Apoptosis and inhibitory rate of survivin gene expression induced by chemotherapeutical drugs was higher than that of control group. The effects also were time dependent. CONCLUSION The inhibition of survivin gene expression may play a critical role on the lung cancer cell apoptosis induced by DDP and VP16.

To evaluate the efficacy and safety of Azithromycin in the treatment of the bacterial infections. Method s: 94 patients with lower respiratory tract infection were randomly d ivided into 2 groups(47 for each gruop). The treated group were given Azithrom ycin 500mg in 5% glucose injection 500mL, iv drip, bid, for 5-7 days. Another 12 patients (including 4 patients with pelvic inflammatory disease and 8 patients with lower respiratory tract infection) were treated with Azithromycin as the op en group. Results: The treated group yielded a recovery ra te 61.7%, aeffective rate 91.5% and abacterial clearance rate 95.8%, which wer e higher than the controlled group [31.9%, 70.2%, and 76.6% (P＜0.01)]0,res pectively. The total response rate and the cure rate in 59 patients treated with Azithromycin were 93.2% and 62.7%, respectively. The incidence of clinical adve rse drug reactions in the treated group was 12.8%, being lower than 34.0% in the controlled group (P＜0.05). Conclusion: Azithromycin is an effective agent in the treatment of the acquired lower respiratory tract infection, urogenital and urogenital tract infection with slight adverse reaction .

Objectives:To evaluate lung injury mechanism in SD rat with nitrogen dioxide(NO2) exposure. 　Methods:In the test-control study, pulmonary malondialdehyde(MDA),glutathione(GSH) and total-antioxidant content(T-AOC) were determined in 10 SD rats with long-term NO2 exposure,10 SD rats with short-term NO2 exposure and 10 SD rats with fresh air as control. 　Results: Pulmonary MDA content was increased and T-AOC was decreased significantly in SD rat exposed to NO2. Pulmonary GSH was decreased significantly in long-term NO2 exposure group as compared with short-term NO2 exposure group and control group. 　Conclusions: Imbalance between oxidant and antioxidant was an important mechanism in the pathogenesis of oxidizing lung injury in SD rat with NO2 exposure.

Objective To observe the clinical therapeutic effect of Astragalus injection combined with sub-hibernation therapy for treatment of patients with severe craniocerebral injury.Methods A retrospective research method was conducted, and 89 cases with severe craniocerebral injury admitted to the Department of Critical Care Medicine of the First People Hospital of Baiyin in Gansu Province from January 2010 to December 2016 were enrolled. Astragalus injection combined with sub-hibernation was applied for treatment of 45 patients in the observation group, and for another 44 cases assigned in the control group, simply conventional treatment was used. The Glasgow coma score (GCS), coma time, ratio of cripple, mortality, incidences of pulmonary infection and urinary tract infection were compared between the two groups.Results After treatment, GCS scores were significantly higher than those before treatment in both groups, but the degree of increase was more marked on the 30 days after treatment in the observation group than that in the control group (13.15±2.53 vs. 8.79±1.59,P < 0.05). Compared with the control group, coma time was obviously shorter (days: 5.79±1.89 vs. 13.65±2.73), ratio of cripple [13.33% (6/45) vs. 22.73% (10/44)] and mortality [17.78% (8/45) vs.31.82% (14/44)] were significantly lower in observation group (allP < 0.05); the incidences of pulmonary infection [22.44% (11/45) vs. 31.82% (14/44)] and urinary tract infection [28.89% (13/45) vs. 36.36% (16/44)] were lower in the observation group, but the differences between the two groups were not statistically significant (bothP > 0.05).Conclusions The treatment of Astragalus injection combined with sub-hibernation treatment can significantly improve the coma degree, shorten the time of coma, reduce the mortality and disability rate of patients with severe craniocerebral injury.

Objective To investigate the effects of rehabilitation intervening in different stage on activities of daily living of old stroke patients. Methods 74 old cases were divided into 3 group according to the time from onset of stroke to rehabilitation intervention: group A (＜3 months), group B (3～6 months), and group C (>6 months). They were treated with routine rehabilitation for 2 months and assessed with Barthel Index before and after rehabilitation. Results All the patients improved their ADL significantly after rehabilitation (P=0.000), and those in group A improved more than in group C (P<0.05). There was no significant difference between group A and B, and group B and C (P>0.05). Conclusion The rehabilitation can effectively improve the ADL of old stroke patients. The early the rehabilitation intervenes, the better the ADL is.

Objective To explore the combined detection of B‐type natriuretic peptide (BNP) and glycosylated antigen 125 (CA125) in differential diagnosis of dyspnea .Methods BNP and CA125 were detected and compared among 106 cases with cardiac dyspnea ,56 cases with pulmonary dyspnea and 60 healthy subjects .Results BNP and CA125 levels of dyspnea patients were higher than healthy subjects ,and those of cardiac dyspnea patients were higher than pulmonary dyspnea patients (P<0 .05) .With the ag‐gravation of heart failure ,BNP and CA125 levels gradually increased .Combined detection of BNP and CA125 were with higher diag‐nostic sensitivity and specificity (P<0 .05) .After treatment ,BNP and CA125 levels significantly decreased (P<0 .05) .Conclusion Combined detection of BNP and CA125 could be with high specificity and sensitivity ,helpful for identifying cardiac or pulmonary dyspnea and dynamic observation of the disease .

Objective:To evaluate the pregnancy outcomes of fetal tethered cord (TC) prenatally diagnosed by MRI.Methods:Clinical data of 38 fetuses diagnosed as having TC by MRI, including 36 singletons and two fetuses who were both one of dichorionic diamniotic twins, were retrospectively collected and analyzed in the Obstetrics and Gynecology Hospital of Fudan University from January 2015 to August 2019. According to whether conus medullaris was located above the bladder or reached the lower edge of the bladder, all cases were divided into high or low groups. Pregnancy outcomes were compared between the two groups using Fisher's exact test and Student's t-test. Results:(1) The gestational age at MRI was (25.5±4.7) weeks. Among the 38 cases, 14 (36.8%) were isolated TC, 24 (63.2%) were complicated by other anomalies. The meningocele was responsible for the most (39.5%, n=15). The results of the ultrasound were consistent with those of MRI in 24 cases (63.2%). While in the other 14 cases (36.8%), the ultrasound only showed vertebral body's abnormal morphology, after which further MRI examination revealed a tethered cord. (2) Twenty-nine women (76.3%) chose to terminate the pregnancy. One patient (2.6%) underwent fetal reduction at 23 gestational weeks (one normal twin was delivered prematurely), and one (2.6%) was lost to follow-up. Seven (18.4%) cases continued the pregnancies to delivery. The postnatal follow-up period was 8.1 months (4.0 to 54.9 months). Two infants without comorbidities showed normal growth and development. Another three cases underwent surgeries after birth, and two cases died in the neonatal period. (3) The average width of the medullary cone was (2.5±0.8) cm. There was no significant difference in the spinal cord width between the high [(2.5±0.8) cm, n=34] and low group [(2.7±1.1) cm, n=4]. Six pregnancies (17.6%) in the high group was continued to delivery, and one of the neonates died of severe hydrocephalus. One patient in the low group (1/4) was delivered, while the baby died of neonatal asphyxia. Conclusions:Fetuses with isolated TC are prone to have a good prognosis. Further study should focus on the relation between the high or low position of the conus medullaris and pregnancy outcomes.

Objective To investigate the eating problems of outpatient infants,preschool age children(1 to 7 years old) enrolled in the Department of Child Health Care,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University,and to analyze its correlation with children's physical development,so as to establish strategies for preventing abnormal eating habit in children.Methods A toll of 2458 children met the criteria,and caregivers (mothers) completed the Children's Eating Behavior Questionnaires (CEBQ) in Department of Child Health Care,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University were selected and the children's sociodemographic data and the morbidity of children eating problems were investigated.The correlation between children's body mass index(BMI) with children's eating problems was determined by using Chi-square test and multiple regression analysis.Results About 66.2％ (1627/2458 cases) had normal weight,and 10.8％ (257/2458 cases) and 8.5 ％ (210/2458 cases) were overweight (BMI ＞ P85-P95) or obese (BMI ≥ P95),respectively.The prevalence of eating behavior problems was detected during 25-36 months.For 1-to-7-year-old children,the highest detection rate of eating problems was inattention and eating at non-permanent locations,occupying 64.7％ (1590/2458 cases)and 50.5％ (1241/2458 cases),respectively;the prevalence rate of preferring to junk food was the lowest,accounting for 19.3％ (474/2458 cases).The children's eating problems had a high association with the children's BMI.Among them,children with eating problems,such as difficultly in accepting the varying food stuff[at the age of 12 month,odds ratio(OR)=11.50,95％ confidence interval(CI):1.84-72.16] and eating at non-permanent locations(at 25-36month,OR=1.77,95 ％ CI:1.11-2.83),were prone to be wasting away;children with eating problems,such as preferring to junk food (at 12 month,OR=5.08,95 ％ CI:1.43-18.00;13-18 month,OR=2.17,95 ％ CI:1.06-4.44),rarely eating vegetables or fruit (19-24 month,OR=4.06,95％CI:1.46-11.31) and inattention (12 month,OR=3.85,95 ％ CI:1.52-9.79),were associated with overweight or obesity (all P＜0.01).Conclusions There was a high prevalence of eating problems in children between 12-84 month(1-7 years old) in Nanjing.Improper children's eating behaviors can increase the risks of wasting away or children's overweight/obesity.

Objectives: To identify any craniofacial morphological changes induced by a mandibular-repositioning oral appliance (MRA) and to explore the possibility of predicting the treatment response to MRA by cephalometric analysis in patients with obstructive sleep apnea (OSA). Methods: Seventy OSA patients [male/female: 63/7; age: (50.5±11.6) years; BMI: (27.6±4.6) kg/m2; AI: (34.9±21.3) episodes/hour; and oxygen saturation nadir: (66.3±16.5) %] were enrolled. MRA was fabricated individually for each patient after the consultation by a dentist. Polysomnographic (PSG) examination was repeated with MRA in place 3 months after the initiation of the MRA therapy. For cephalometric analysis, a pair of cephalograms of each patient was obtained, one with and another without MRA. Results and Conclusions: After 3 months' treatment, AI was (156±19.2) episodes/hour, significantly reduced compared with the pre-treatment average AI (34.9±21.3 episodes/hour,P<0.000 1). Oxygen saturation nadir improved from (66.3±16.5)% (pre-treatment) to (74.1±15.5)% (with MRA) (P<0.001). A reduction of AI≥50% was achieved in 42 patients. Insertion of MRA led to anterior shift of the mandible, increase in upper airway width and area and decrease in upper airway length. Those with evident retrognathia and longer anterior upper facial height were more likely to benefit from the MRA management.