Objective To explore the feasibility and clinical significance of combined detection of human plasma and feces expression level of microRNA-92a-1 (miRNA-92a-1) as colorectal tumour screening marker.Methods From August to October in 2011,the feces and plasma samples of 60 colorectal cancer (CRC) patients,23 colorectal adenoma (CRA) patients and 30 healthy controls were collected.The expression level of miRNA-92a-1 was determined by quantitative reverse transcription-polymerase chain reaction.Mann-Whitney's U test was applied for the difference test between groups.Then,according to the receiver operating characteristic (ROC) curve analysis the cut-off point was determined and the sensitivity and specificity were analyzed.Results Compared with healthy controls,the expressions of miRNA-92a-1 in plasma of CRC and CRA patients increased (U=288.5 and 151.0,both P＜0.01).Compared with healthy controls,the expression of miRNA-92a-1 in feces of CRC patients increased (U=627.5,P=0.0199).According to ROC curve analysis,when the cut-off point was ＞1.22,the sensitivities of plasma miRNA-92a-1 in CRC patients and CRA patients were 85.0％ (51/60) and 73.9％ (17/23) respectively.The specificity of healthy controls was 76.7％ (23/30).When the cut-off point was ＞1.14,the sensitivities of feces miRNA-92a-1 in CRC patients and CRA patients were 31.7％(19/60) and 26.1％(6/23) respectively.The specificity of healthy controls was 90.0 ％ (27/30).Combined the detection results of plasma and feces,the sensitivities of miRNA-92a-1 in CRC patients and CRA patients was 88.3％ (53/60) and 82.6％ (19/23) respectively.The specificity in healthy controls was 73.3％ (22/30).The sensitivity was higher than that of single sample testing.Conclusions The sensitivity and specificity are high in the combined detection of plasma and feces miRNA-92a-1 expression level in CRC patients and CRA patients,miRNA-92a-1 may be a potential CRC screening marker.

Objective To explore the current status and influencing factors of spiritual well-being and hope among malignant lymphoma patients.Methods From May 2012 to May 2015, we selected 90 malignant lymphoma patients treated in Xijing Hospital by convenience sampling. All of the patients were investigated with the Functional Assessment of Chronic Illness Therapy-spiritual Well-being Scale (FACIT-Sp) and the Herth Hope Index (HHI).Results The score of FACIT-Sp and HHI of malignant lymphoma patients was (25.34±12.06) and (26.08±11.87) respectively. Logistic regression analysis showed that the influencing factors of spiritual well-being of patients included the degree of education, social support and tumor stage (P<0.05); the influencing factors of hope of patients included the degree of education, social support, level of income and tumor stage (P<0.05).Conclusions The level of spiritual well-being and hope of malignant lymphoma patients are usually low. They have similar influencing factors.

Objective:To discuss the relationships between occupational stress, career calling and occupational burnout among primary school teachers, and test whether career calling moderates the relationship between occupational stress and occupational burnout.Methods:399 teachers from public primary schools were recruited as participant. Their occupational stress and burnout, and career calling were assessed via online questionnaire in the period between March and August 2018. Hierarchical multiple regression was used to test the moderating role of career calling.Results:The score of occupational stress was (3.59±0.85) , the score of career calling was (3.15±0.69) and the score of occupational was (3.26±0.88) . Occupational stress was significantly and positively related to occupational burnout ( r=0.42, P<0.01) , while career calling was significantly and negatively related to occupational stress ( r=-0.30, P<0.01) and occupational burnout ( r=-0.32, P<0.01) . Career calling moderated the relationship between occupational stress and occupational burnout. Conclusion:Career calling as a personal resource buffers the positive relationship between occupational stress and occupational burnout. School leaders can promote teachers' career calling by endowing educational work with more meaning, which leading to lower level of occupational burnout.

Objective:To discuss the relationships between occupational stress, career calling and occupational burnout among primary school teachers, and test whether career calling moderates the relationship between occupational stress and occupational burnout.Methods:399 teachers from public primary schools were recruited as participant. Their occupational stress and burnout, and career calling were assessed via online questionnaire in the period between March and August 2018. Hierarchical multiple regression was used to test the moderating role of career calling.Results:The score of occupational stress was (3.59±0.85) , the score of career calling was (3.15±0.69) and the score of occupational was (3.26±0.88) . Occupational stress was significantly and positively related to occupational burnout ( r=0.42, P<0.01) , while career calling was significantly and negatively related to occupational stress ( r=-0.30, P<0.01) and occupational burnout ( r=-0.32, P<0.01) . Career calling moderated the relationship between occupational stress and occupational burnout. Conclusion:Career calling as a personal resource buffers the positive relationship between occupational stress and occupational burnout. School leaders can promote teachers' career calling by endowing educational work with more meaning, which leading to lower level of occupational burnout.

Objective To investigate the clinical significances ofvasculogenic mimicry (VM) and Ki-67 expression in human gliomas.Methods Sixty-three specimens of human gliomas with adequate clinical and pathological data,collected in our hospital from January 2008 to December 2012,were chosen.VM in the glioma samples was determined by dual staining of periodic acid-Schiff (PAS) and endothelial marker CD34,and Ki-67 protein expressions by SP immunohistochemical staining.The association between VM and clinical characteristics of the patients were analyzed.Results VM channels were found in 13 specimens of human gliomas (20.63％),and it was correlated with tumor grade and tumor recurrence (P＜0.05):high incidence of VM in high-grade gliomas (WHO Ⅲ,19％; WHO Ⅳ,33.3％) was noted as compared with that of lower-grade gliomas (WHO Ⅱ,6.7％); patients with VM were more prone to tumor recurrence (28.6％) as compared with those without VM (4％).A positive relationship between Ki-67 expression and VM was revealed (r=0.531,P=0.000).Kaplan-Meier survival analysis showed that both progression-free survival and overall survival of VM-positive group were significantly shorter than those of VM-negative group (P＜0.05).Cox proportional hazards model analysis indicated that VM was an independent prognostic factor of human gliomas (P=0.020).Conclusion The presence of VM in human gliomas tissues is proved; combined detection of VM and Ki-67 expression can contribute to evaluate the risk of tumor recurrence,and simultaneously be some new indicator of predicting the prognosis of human gliomas.

Objective To explore the value of retrievable inferior vena cava (IVC) filter placement for prevention of perioperative pulmonary embolism (PE) in patients with lower extremity/pelvic fracture with deep vein thrombosis (DVT).Methods Clinical data of 1 891 lower extremity/pelvic fracture patients combined with DVT were retrospectively analyzed.Totally 411 patients with permanent filters were excluded,and the other patients were divided into filter group (n=843) and control group (n=637) according to whether receiving retrievable IVC filter placement or not.The incidence of perioperative symptomatic PE and mortality were compared between the two groups.Results In filter group,Optease nonpermanent filters were inserted in 218 patients,and the mean indwelling time was (14.3±3.6) days.Celcet filters were inserted in 625 patients,and the filters were successfully removed in 566 out of 578 patients who underwent filter removal surgery (97.92％,566/578),and the mean indwelling time was (15.8±4.1) days.The incidence of PE in filter group (0.12％[1/843]) was significantly lower than that in control group (1.57％ [10/637],P＜0.05).Among the patients who received chemical anticoagulant therapy,the incidence of PE in filter group and control group was 0.14 ％ (1/700) and 1.47％(9/612),respectively (P＜0.05).Conclusion Retrievable IVC filter placement is a safe and effective method for preventing perioperative symptomatic and fatal PE in lower extremity/pelvic fracture patients with DVT.

Objective:To investigate the pathogenesis, precaution and treatment of neonatal congenital complete heart block (CCHB) in twins.Methods:The clinical data of a case of premature twins with neonatal CCHB from the Department of Neonatology, the First Affiliated Hospital of Xinxiang Medical University were retrospectively analyzed and related literature was reviewed.Results:(1)Case review: the 37-year-old gravida had no symptoms.Fetal ultrasound cardiogram(fUCG)at 23 weeks of gestation indicated bradycardia and CCHB.Then, the mother was diagnosed with undifferentiated connective tissue disease.After treatment with human immunoglobulin, dexamethasone and hydroxychloroquine, fUCG at 31 weeks of gestation still suggested CCHB.An emergency cesarean section was performed on the diagnosis of threatened preterm labor.With weakly positive neonatal antinuclear antibody (ANA), and positive Ro60 and Ro52 autoantibodies, twins were diagnosed with CCHB by 24 hour-Holter monitors.One of the twins was discharged with CCHB (ventricular rate of 80-90 times/min) after systemic therapy, but the weight increased to 2 200 g. The other one of the twins suffered from the sudden decrease of heart rate and blood pressure and finally died of sudden cardiac arrest.(2) Literature search: two cases in Chinese and 9 cases in English were reviewed.Among them, 9 cases were sjogren syndrome type A (SSA)/Ro and sjogren syndrome type B(SSB)/La related CCHB, and 2 cases were idiopathic CCHB.Conclusions:The placental transfer of anti-SSA or anti-SSB is an important mechanism of neonatal CCHB in twins, and other factors may also be involved.Current treatments are unsatisfactory.Most patients need pacemaker implantation.Early diagnosis and prenatal management can improve the prognosis.

OBJECTIVETo develop a standard Neglect Evaluation Scale which is suitable for rural primary school students in China.

METHODSAccording to the principle of multi-stage stratified cluster sampling, a field investigation was conducted among primary school students in 28 counties from 7 provinces and 2 municipalities. The questionnaires were self-designed, and determined by multiple rounds of pilots and revisions. Among 5 862 students, 2 792 (6-8 years' old) and 3 070 (9-11 years' old) were investigated by using two kinds of Neglect Evaluation questionnaires, respectively. After project analysis, factor analysis, reliability and validity analysis, the reliability and stability of the scale were tested. Then percentile method was used to determine the evaluation standard to develop and finalize the formal scale.

RESULTSThe numbers of the remaining items for 6-8 year-old group and 9-11 year-old group is 69 and 58, respectively, both of which contain six levels of neglect, including body, emotion, health care, education, security, and society. 4 times of factor analysis were conducted in both of the two groups. The factor loadings in these two groups were 0.290-0.700 and 0.276-0.729 respectively. Reliability test results showed that the two kinds of scales' Cronbach alpha coefficient were 0.924 and 0.929 respectively, split-half reliability were 0.891 and 0.904 respectively, the retest reliability were 0.559 and 0.892 respectively, the differences were statistically significant (P < 0.05). The retest reliability among 6-8 year-old group in medical neglect level had no statistical significance, but was close to the cut-off point (P = 0.054). The test results of external validity indicated that both of the two scales could reflect the neglect status of the subjects (P < 0.05), but the subjective and objective evaluation towards neglect were not consistent. The cut-off points for judging whether the children were neglected or not among 6-8 year-old and 9-11 year-old groups were 159 and 137 respectively; and the adjusted values were 160 and 135 respectively.

CONCLUSIONThe two norm scales developed by this study showed good discriminability, reliability, validity, and stability. The norms developed on the basis of the scales was suitable for the situation of rural students in primary schools in China.

Child ; Child Abuse ; China ; Factor Analysis, Statistical ; Humans ; Reproducibility of Results ; Rural Population ; Schools ; Students ; Surveys and Questionnaires

OBJECTIVE：To management recheck and sorting weight for finished intravenous solutions in PIVAS ，to provide reference for reducing dispensing error and improving the safety and quality of intravenous infusion therapy. METHODS ：The weight analysis method was used to determine the weight of main drug and solvent in the finished intravenous solutions and infusion bottle . The weight maintenance information was added in PIVAS information management system ，and the marked weight of finished intravenous solutions was calculated for the verification of finished intravenous solutions. Average daily check quantity of finished product ，checking time ，average checking time of finished products per bag ，detection rate of dispensing error ，external error and timeliness of finished infusion batch were compared before （Mar.-May，2019，n＝83 006）and after （Jun.-Aug.，2019， n＝83 173）management. The effects of weighting recheck management were evaluated. RESULTS ：Compared with before the implementation of weighting recheck management ，there were no significant differences in the average daily check quantity of finished products ，the detection rate of dispensing errors caused by wrong labeling of liquid ，or the times of delayed drug delivery batches after the implementation of weighting recheck management （P＞0.05）. The checking time of finished products ，average checking time of finished products per bag ，the number of bags added or subtracted error ，detection rate of dose dispensing error ， total error detection rate prolonged or increased significantly （P＜0.05），and the number of external error was decreased significantly（P＜0.05）. CONCLUSIONS ：The weighting recheck management improves the accuracy and safety of PIVAS preparation，effectively improves error detection rate ，reduces the occurrence of external error ，but prolongs the time of checking ， which are urgent to be solved by information and automation means.

Objective To investigate the prevalence of iron deficiency(ID)and iron deficiency anemia (IDA) in pregnant women in urban areas of China. Methods The study was a national cross-sectional survey conducted from September 19th, 2016 to November 20th, 2016. According to the classification of the National Bureau of Statistics, all survey sites were set up in 6 regions of the country. Pregnant women were continuously selected using multistage stratified sampling. A total of 12 403 pregnant women were collected and examined for serum ferritin and hemoglobin levels. Results The median serum ferritin level during pregnancy was 20.60 μg/L(11.78-36.98 μg/L), the hemoglobin level was(118±12)g/L. With the progress of pregnancy, the levels of serum ferritin and hemoglobin decreased gradually. The median serum ferritin levels in the first, second trimester and third trimester were 54.30 μg/L(34.48-94.01 μg/L), 28.60 μg/L(16.40-50.52 μg/L), and 16.70 μg/L(10.20-27.00 μg/L)respectively(P<0.01). The mean hemoglobin levels were(127 ± 10)g/L,(119 ± 11)g/L and(117 ± 11)g/L respectively(P<0.01). The prevalence of ID in urban pregnant women was 48.16%(5 973/12 403), and IDA prevalence was 13.87% (1 720/12 403). The prevalence of IDA in the first, second trimester and third trimester were 1.96% (20/1 019), 8.40%(293/3 487)and 17.82%(1 407/7 897), respectively(P<0.01). The prevalence of standardized ID and IDA were significantly different in various regions of China(P<0.01). The standardized prevalence of ID were relatively higher in East China and Northeast China, 57.37% and 53.41% respectively, while it was the lowest in Southwest China, 30.51%. The standardized prevalence of IDA in South Central, Northwest, and East China were relatively high, 21.30%, 16.97% and 17.53% respectively, and the standardized prevalence of IDA in Southwest China was the lowest, 5.44%,the differents in various regions were significant(all P<0.01). Conclusion The current phenomenon of ID and IDA in pregnant women is still very common,and nutrition and health care during pregnancy should be strengthened.