It is important that the oral hospital establish a guarantee system of medical graduation clinical practice quality. Having experienced clinical education for many years,the hospital has formed a system in order to achieve objective management and process management organic unification,which can gradually promote the clinical practice quality.

Objective To study the default mode network (DMN) of mild cognitive impairment (MCI) related to leukoaraiosis (LA) with resting-state functional magnetic resonance imaging (rs-fMRI). Methods 31 LA patients (Clinical Dementia Rating of 0.5) and 27 normal controls (Clinical Dementia Rating of 0, and matched in age, gender and lever of education) were scanned with the rs-fMRI. The data was analyzed with SPM5 software, using independent component analysis. The differences between the both groups were compared with two-sample t-test. Results The DMN during resting-state of normal controls was posterior cingulate cortex/precuneus, bilateral medial frontal cortex, bilateral middle temporal gyrus, bilateral inferior parietal gyrus, angular gyrus, bilateral hippocampus. The DMN of MCI group was consistent with the normal controls, but the activation decreased in anterior cingulate cortex/left medial frontal lobe, right parahippcampus/ uncus, right inferior temporal gyrus, left deep frontal white matter/head of caudate nucleus; and increased in the left caudate nucleus/anterior cingulate cortex, left frontal lobe, and left superior temporal gyrus/inferior parietal gyrus. Conclusion Activation of resting-state functional network is disorder in LA, which may relate to cognitive impairment.

Objective To investigate the epidemiology of viral infection in elderly patients to contract acute exacerbations of chronic obstructive pulmonary disease (AECOPD)in Minhang district of Shanghai from 2010 to 2012,and to study the relationships between viral infection and clinical features.Methods The elderly patients (age >70 year old)with AECOPD admitted from September 2010 to November 2012 were enrolled for study.The patients who couldn't complete lung function test were excluded.The pharyngeal swabs (PS)were taken from each patient within the first 24 h after admission.Nine respiratory viruses and their subtypes from pharyngeal swabs were detected by the nested multiplex polymerase chain reaction (PCR)method,including influenza virus A (FluA),2009 influenza A (H1N1 )virus (09FluH1 ), influenza virus B (FluB),respiratory syncytial virus A (RSVA)and B (RSVB),human coronavirus-229E (hCOV-229E),human coronavirus-NL63 (hCOV-NL63 ),human coronavirus-OC43 (hCOV-OC43 ), human coronavirus-HKU1 (hCOV-HKU1),human parainfluenza virus 1-4 (hPIV1-4),human adenovirus (hAdV),human boca virus (hBoV),human metapneumo-virus (hMPV)and human rhinovirus (hRV). According to the PCR results,all patients were divided into positive viral infection group and negative viral infection group.The relationships between viral infection and clinical features were analyzed.Results Sixty patients were eligible for study.Of them,14 patients were found to be positive for virus infection including a triple infected patient (FluB,hRV and hROV)and 46 patients were negative for virus infection.The viral pathogens detected in the positive viral group were:9 cases of hRV (15.00%),2 cases of hPIV (3.33%),2 cases of hCOV (3.33%),2 cases of FluB (3.33%)and 1 cases of RSV (1.67%).The mortality in the positive viral group was higher than that in the negative viral group.However,the other clinical characteristics between the two groups had no significant differences. Conclusions Human rhinovirus was the most common viral pathogen in elderly patients with AECOPD.Viral infection might be associated with the prognosis.However,the patients with viral infection are lack of specific clinical characteristics,therefore,the prompt diagnosis before careful study would be difficult.

Objective , To investigate the influence of blood pressure variability on cerebral infarction in older men. Methods Ambulatory blood pressure was measured in 1527 elderly men ( older than 65 yrs) with atherosclerosis. All cases were divided into 2 groups: Six hundred and seven patients with cerebral infarction ( group A)and 920 patients without cerebral infarction ( group B). Smooth curve method was used to analyze each patient's ambulatory blood pressure data and the trend of each patient's blood pressure curve was portrayed. The differences between the actual blood pressure and the blood pressure on the curve was defined as blood pressure variability,and the blood pressure variability between the 2 groups was compared. Results The systolic blood pressure variability in 24 hours in group A was significantly higher than that in group B( [8.4'±2. 2]mm Hg vs [ 8.0 ± 2. 0 ] mm Hg, P ＜ 0. 01 ), especially for the systolic blood pressure variability in daytime( [ 8. 2 ± 2. 2 ] mm Hg vs [ 7. 8 ± 2. 1 ] mm Hg, P ＜ 0. 01 ). However, the systolic blood pressure variability at night was not significantly different between the 2 groups( [ 8.9 ± 3. 9 ] mm Hg vs [ 8. 7 ± 3.7 ] mm Hg,P ＞ 0. 05 ). There were no significant difference between the diastolic blood pressure of 24 hours( [5. 5 ± 3.8 ] mm Hg vs [5.5 ± 1.5 ]mm Hg,P ＞0. 05),during daytime([5.4 ± 1.5]mm Hg vs [5.3 ± 1.4] mm Hg,P ＞0.05)and nighttime ( [ 6. 1 ± 2.7 ] mm Hg vs [ 6. 1 ± 2. 6 ] mm Hg, P ＞ 0. 05 ). Conclusion In elderly men with atherosclerosis,cerebral infarction was closely related to systolic blood pressure variability,but independent of nighttime systolic blood pressure and diastolic blood pressure variability.

Objective　To investigate the protective effect of complement C5a receptor 1 (C5aR1) antagonist on cerebral ischemia-reperfusion （CIR） in mice.Method　Mice were randomly divided into sham operation group,cerebral ischemia-reperfusion group (model group) and C5aR1 antagonist （PMX53）group.At 3 h before,24 h after and 48 h after cerebral reperfusion timepoint,the PMX53 group was given with PMX53,the sham group and the model group were given same volume of saline by intraperitoneall injection.At 72 h after cerebral reperfusion timepoint,neurological deficits score of mice were evaluated by the modified Longa method,the infarcted brain volume was calculated after TTC staining,the cerebral tissue water content of the ischemic hemisphere was calculated by dry and wet weight method,the mRNA expression of inflammatory factors in the ischemic hemisphere were detected by real-time PCR,and the relative expression of ZO-1 in cerebral tissue of the ischemic hemisphere was calculated by Western blot.Results　At 72 h after cerebral reperfusion,compared with the model group,neurological deficits function score,cerebral water content,cerebral infarction volume and inflammatory cytokines (IL-1β,TNF-α) were significantly decreased in the PMX53 group (all P<0.05),ZO-1 expression was significantly higher in the PMX53 group (P<0.05).Conclusion　C5aR1 antagonist can improve the neurological function score after CIR,reduce the volume of cerebral infarction,reduce the degree of cerebral edema and inflammatory response,and has a protective effect on the blood-brain barrier.

Objective:The results of the two interferon-gamma release assay tests were compared, so as to provide reference for the laboratory to choose the detection method.Methods:Double blood samples of 96 suspected TB patients hospitalized in Civil Aviation General Hospital from July 2018 to December 2019 were collected, providing for TB specific antigen stimulation test by QIAGEN kit and Autobio kit respectively. ELISA and chemiluminescence were used to detect interferon-gamma, and the results were determined according to the manufacturer′s instructions. Based on the clinical or bacteriological evidence for diagnosis of tuberculosis, the consistency of the two kits was compared, and the diagnostic efficacy of tuberculosis was evaluated. At the same time, 60 samples of plasma stimulated by TB specific antigen in QIAGEN kit were randomly selected to detect interferon-gamma by ELISA and chemiluminescence respectively, and the consistency between the two interferon-gamma detection systems was compared. The Kappa coefficient were used to measure the consistency of the results. The ordinary linear regression and Bland-Altman plots were performed to show the differences of IFN-γ data between assays.Result:In 96 samples, the sensitivity and specificity of QIAGEN test were 81.82% (18/22) and 74.32% (55/74), and that of Autobio test were 72.73% (16/22) and 70.27% (52/74), respectively. The results of the two systems were consistent, Kappa value was 0.847, P<0.05. The area under ROC curve of QIAGEN test for diagnosis of tuberculosis was 0.807 (95% confidence interval: 0.702-0.911), while that of Autobio test was 0.765 (95% confidence interval: 0.640-0.889). Comparing the results of two systems for detecting interferon-gamma in the same plasma, the results of two systems were in good agreement ( R2=0.97, P<0.05); but there were significant differences in the levels of interferon-gamma in the same patient sample after stimulation with different negative and positive tubes ( R2=0.41, P<0.05). Conclusion:The results of γ-interferon release assay test of Autobio system and QIAGEN system are in good agreement, and the results of γ-interferon release assay test of the two systems are also in good agreement. Different amount of antigen coating, titer and test system may be responsible for the different release of interferon-gamma.

Objective:To investigate the expression of promyelocytic leukemia zinc finger (PLZF) in human peripheral blood with asthma and its clinical significance.Methods:Forty patients with stable asthma from May 2021 to October 2021 in the Department of Respiratory Medicine of the Shanghai Fifth People's Hospital were enrolled, and forty healthy controls were recruited in the study. The levels of cytokines in serum were measured by enzyme-linked immunosorbent assay (ELISA). Quantitative real-time PCR (qPCR) was used to detect the expression of PLZF mRNA in plasma. The level and distribution of PLZF+ cells in PBMCs were detected by flow cytometry after isolating peripheral blood mononuclear cells (PBMCs). Independent sample t test, Mann-Whitney U test, χ 2 test, ROC curve and Logistic regression were used to analyze the results with SPSS 26.0 and Graphpad Prism 7.0. A P<0.05 was considered statistically significant. Results:The levels of cytokines IFN-γ, IL-2, IL-4, TNF-α and IL-17 in human peripheral blood from the asthma group were obviously higher than those in the control group ( P<0.05), whereas there was no significant difference in the level of cytokine IL-10 between the two groups. The level of PLZF mRNA in PBMCs from the asthma group was significantly up-regulated compared to that in the control group [(3.40%±2.52%) vs. (1.23%±0.78%), P<0.05]. CD8+PLZF+ and Vβ11+PLZF+T cells in the asthma group were significantly outnumbered than those in the control group ( P<0.05). Logistic regression and ROC curve analysis showed that PLZF expression in PBMC was a risk factor for the development of asthma ( OR =3.67, AUC=0.87, P<0.05). Conclusions:The high expression of PLZF in peripheral blood may play an important role in the development of asthma, which needs to be further confirmed by large sample studies.