Objective:To define doctors professional risk connotation , the scientific judgment doctors profes-sional risk fact , seek medical professional risk guard against and dissolve the long -term mechanism , maintaining safety and legitimate rights and interests of the doctor′s body and mind .Methods:Using doctor -patient relation-ship as the research background , adopts the questionnaire survey , through the survey data analysis of the correla-tion between the doctor-patient relationship and the doctor professional risk , on the basis of the young workers , for example , the empirical research doctors professional risk existing conditions and the reality .Results:The doctor-patient relationship nervous career anxiety and unease , doctor of job burnout and the harm done by the profession itself, complicated medical environment cannot effectively solve the doctor occupational safety crisis , institutional arrangements and the prevention and control mechanism is not reasonable career crisis .Conclusion:The govern-ment should strengthen the professional risk management system design and the prevention and control institutions and hospitals to strengthen the construction of professional risk management and prevention and control system , the doctor should promote occupational consciousness of risk prevention and control and doctor -patient communication ability, the society should strengthen professional risk management and the prevention and control of environmental regulation .

Objective To investigate the construction of compound membrane with corneal stromal cells and collagen-chitosan by tissue engineering technique and its biocompatibility.Methods Rabbit and human corneal stromal cells were separated and seeded into collagen-chitosan membrane.The compound membrane was transplanted into rabbit corneal stroma.Then the growth condition of keratocytes,the effect on normal keratocytes and degradation of compound membrane were detected by corneal confocal microscope,anterior OCT and histological and immunohistochemical methods ex vivo 1,2,4 weeks after grafting.Results The rabbit and human corneal stromal cells grown well in collagen-chitosan scaffold.The compound membrane degradated gradually after grafting.There was no necrosis and dissolvation.Corneal epithelium,stroma and endothelial cells were all normal.Conclusion Collagen-chitosan can be used as a biological scaffold for construction of corneal stroma.Corneal confocal microscopy and anterior OCT are new methods to observe the biological activity of constructed corneal stroma.

Objective To discuss the characteristics of multiple blood supplies and the significance of multiple intra-arterial embolization in massive hemoptysis. Methods Forty-four patients with massive hemoptysis underwent digital subtraction angiography (DSA) and intra-arterial embolization after ineffective medical treatment. The characteristics of blood supply of lesions,the methods of intra-arterial embolization and the clinic efficacy were retrospectively analyzed. Results All the patients, one artery was embolized in 9 patients,2 arteries were embolized in 18,3 in 14 and 4 in 3. The hemoptysis decreased or ceased immediately after intra-arterial embolization in 43 patients and recurrence within lweek in 2,which were controlled with additional emblization. 1 patient died in surgery. Conclusion The lesions of massive hemoptysis had complicated blood supplies,and multiple intra-arterial embolization was very important.

Objective To investigate the effects of chronic renal failure rabbit serum on proliferation and nuclear factor kappa B (NF-κB) activation of rabbit arterial smooth muscle cells (ASMCs) and to explore the possible mechanism. Methods Rabbit model of chronic renal failure was established by the ligation of renal arterial branches. ASMCs were incubated in the media with various concentrations of chronic renal failure serum cultured in vitro. Cell proliferation was assessed by MTT. Cell apoptosis was detected by Hoechst33342 staining. NF-κB p65 nuclear translocation was analyzed by immunofluorescence. Expression of proliferating cell nuclear antigen (PCNA) and NF-κB p65 proteins in response to chronic renal failure serum in ASMCs was determined by Western blotting. Results Lower concentrations of chronic renal failure serum (≤ 10%) could significantly promot the proliferation of ASMCs in a dose- and time-dependent manner. Higher concentrations of chronic renal failure serum (＞10%) could significantly inhibit the proliferation and induce apoptosis of ASMCs compared to the normal control (P＜0.05). Under the stimulation of lower concentrations of chronic renal failure serum, the expression of PCNA and NF-κB p65 increased significantly compared to the normal control (P＜0.01), while decreased markedly under the stimulation of higher concentrations of chronic renal failure serum compared to the normal control (P＜0.01). Under the stimulation of 10% chronic renal failure serum, nuclear translocation of NF-κB p65 in ASMCs was found. Conclusions Different concentrations of chronic renal failure rabbit serum can effectively induce ASMCs proliferation or apoptosis. The mechanism of promoting proliferation may be mediated by activating NF-κB, which will be useful for the treatment of accelerated atherosclerosis in chronic renal failure.

OBJECTIVE:To determinate vitamin B1 and vitamin B6 in Gengnianling capsules by HPLC simultaneously .METHODS: The separation was performed on Hypersil-ODS C18 column, methanol - sodium hexanesulfonate solution(20 : 80) was used as mobile phase with a flow rate of 0.8ml/ min and detection wavelength of 280nm.RESULTS: Linear correlations with peak area scores were achieved when the sample size of vitamin B1 and vitamin B6 were with a range of 0.884?g-2.652?g (r = 0.9 999) and 0.714?g-2.142?g(r = 0.9 999) .respectively, the average recovery of which were 95.87%(RSD = 0.82%) and 101.96% (RSD = 0.86%), respectively .CONCLUSION: The method is simple, accurate and it can be used for quality control of Gengnianling Capsule.

Objective To discuss the significance of platelet rich plasma in promoting bFGF and VEGF expression in would healing of rabbit buns .Methods The 24 rabbits were randomly divided into control group and experimental group .The sulfadiazine silver paint to the wound for control group and the platelet rich plasma gel evenly spread to the wound for experimental group .At 7th ,10th ,14th day ,4 rabbits of each group were randomly selected to sacrificed after anesthesiaed ,wound healing rate was compare in 2 groups ,HE staining and testimmunohistochemistry were conducted in each group .Results At 7th ,10th ,14th day ,the wound healing rate of experimental group were higher than those of control group .At 7th d ,the focal granulation ,cells and vessels inten-sive were more significant in experimental group than in control group ,at 10th day ,the wound fibroblast cells and capillary number are more significant in experimental group ,and at 14th day ,the most of fibroblasts translate into fiber cell and the capillary number decreased ,the fibroblasts proliferation was still active and fiber cell was less in the control group .At 7th ,10th day ,the expression of bFGF and VEGF were both higher ,but experimental group is obvious higher than control group(P<0 .05) ,but at 14th day ,the ex-pression of bFGF and VEGF were gradually declined and was not obvious statistics differences in the two group (P>0 .05) .Conclu-sion The platelet rich plasma could promote the big white rabbit scald wound healing ,while the main mechanism maybe the ex-pression of bFGF and VEGF increased in the early .

OBJECTIVE: To test droplet digital PCR for species identification and absolute quantification of biological sample. METHODS: Specific primers and probes for human mtDNA encoding gene ND4 and 16S rRNA were designed, and the species-specificity was assessed on DNA samples derived from human and common animals. To determine the sensitivity and stability of droplet digital PCR for species identification and absolute quantification, gradient dilution series of recombinant plasmid and 16 human DNA samples were analyzed. RESULTS: Human recombinant plasmid FAM (ND4) could be used in detecting the samples of human. And the results of detecting were consistent with all levels of diluted concentrations. Droplet digital PCR was able to detect low and single copy of target DNA. CONCLUSION Droplet digital PCR, with high sensitivity and specificity, is fully amenable for species identification and absolute quantification of biological samples, also it can be applied on routine forensic examination.
Animals ; DNA ; DNA Primers/genetics* ; DNA, Mitochondrial/genetics* ; Humans ; NADH Dehydrogenase/genetics* ; Polymerase Chain Reaction/methods* ; RNA, Ribosomal, 16S/genetics* ; Sensitivity and Specificity ; Species Specificity

Objective To analyze the clinical and laboratory phenotypes of Duchenne muscular dystrophy(DMD)in a retrospective study of 96 cases and to evaluate therapeutic efficacy of glucocorticosteroid.Methods The clinical phenotype,laboratory examinations resuhs and the records in the follow-up in 96 patients with DMD were collected.The level of serum creatine kinase(CK)and motor ability before and after glucocorticosteroid therapy were analyzed by statistical analysis.Their myocardium impairments and intelligence conditions were also assessed.Results(1)The level of serum CK (mmol/L)had three peaks at the age of ≤ 3 years old(16 547.9 ±770.9),5 years old(14 371.9 ± 696.7)and 8 years old(13 089.8 ± 877.6).The CK level significantly decreased after dexamethasone (5-10 mg,iv)treatment for 10-15 days,but increased again after prednisone acetate(0.50-0.75 mg · kg-1 · d-1,oral)administration for one month(F =6.758,P =0.003).(2)The motor ability improved in 51 DMD cases with long-term oral admission of prednisone,including 24 cases receiving repeated dexamethasone,iv.(3)The myocardial perfusion imaging in 37 DMD cases showed remarkable uneven “spotted like” radionuclide distribution in ventricle.(4)The intelligence quotients in 24 DMD were lower than normal population.Conclusions There are high CK hyperlipidemia and myocardial damage in the sub-clinical stage of DMD and myocardium impairment is positively correlated with age.Glucocorticosteroid therapy has an important effect on the protection of motor and cardiac functions,with recommendation of using in early stage of disease.

Objective:To evaluate the predictive value of the quick sequential organ failure assessment(qSOFA) score in septic shock after percutaneous nephrolithotomy(PCNL).Methods:309 patients who underwent PCNL at the First Affiliated Hospital of Soochow University between May 2018 and October 2019 were retrospectively reviewed. Among them, there were 192 men and 117 women, whose mean age was (51.4±12.8)years (range from 20 to 79 years). There were 82 cases(26.5%) of hypertension and 23 cases(7.4%) of diabetes. There were 88 patients(28.5%) with positive preoperative urine culture.102 patients(33.0%) were diagnosed with staghorn calculi by abdominal CT and urinary tract abdominal plain film(KUB).78 patients(25.2%) had a history of urinary surgery. The qSOFA and SIRS were evaluated to all patients within 24 h after PCNL and the best diagnostic criteria was considered as qSOFA≥2 and SIRS≥2. Receiver operating characteristic(ROC) curves were constructed and the areas under the curve(AUC) were calculated to compare the discriminatory ability of qSOFA and SIRS with the post-PCNL septic shock. A univariate logistic regression analysis was used to identify the covariates associated with post-PCNL sepsis. Then adjusted multivariate analysis was used to identify the predictive value of positive qSOFA and SIRS for the postoperative clinical outcomes including postoperative hospitalization days, postoperative blood transfusion, postoperative re-intervention, residual stone, planned readmission within 30 days and unplanned readmission within 30 days.Results:Among the 309 patients who underwent PCNL, 23 patients(7.4%) met the positive qSOFA criterion while 84 patients(27.2%) developed to SIRS. 7 patients(2.3%) were admitted to ICU after operation and were eventually diagnosed as septic shock, among which 6 patients met the criteria of qSOFA and SIRS. 8 patients(2.6%) underwent multi-channel operation. The median operative time of 309 patients was 85(56, 115) min. Postoperative calculus composition analysis showed that 64 patients(20.7%) were infectious calculi. Postoperative KUB showed residual calculi in 179 patients (57.9%). The median postoperative hospital stay was 7(6, 9) days. 10 patients(3.2%) received blood transfusion. 9 patients(2.9%) received re-intervention after surgery. There were 41 patients (13.3%) of planned readmissions and 16 cases (5.2%) of unplanned readmissions within 30 days. The AUC of qSOFA and SIRS was 0.900 and 0.799 respectively. The qSOFA had a higher specificity, positive likelihood ratio and positive predictive value(94.4%, 15.23, 26.1%)than that of SIRS(74.2%, 3.32, 7.1%)for septic shock. In univariate logistic regression analysis significant associations were observed between positive urine culture, stone size, staghorn stones, struvite stones, surgery history, operation time and sepsis after PCNL. Multivariate logistic regression analysis revealed that postoperative length of stay( OR=1.237, 95% CI 1.048-1.459, P=0.012) and postoperative transfusion( OR=8.265, 95% CI 1.409-48.481, P=0.019) were closely associated with qSOFA after adjusting for covariates shown to be related to post-PCNL sepsis mentioned above. Conclusions:The qSOFA could be superior to SIRS in predicting septic shock after PCNL.

Objective To explore the sensitivity of Enterococcus f aecium and Enterococcus f aecalis isolated from 2011 to 2013 and provide reference for anti-infection therapy .Methods The identification and drug sensitivity test of clinical isolates were carried out by using VITEK2 Compact system .Results The ratio of Enterococcus f aecium to Enterococcus f aecalis isolates was 1 .93 and it was increasing year by year .No vancomycin ,linezolid and tigecycline resistant Enterococcus f aecium and Enterococcus f aecalis i-solates was detected .The rates of Enterococcus f aecium sensitive to quinupristin-dalfopristin and tetracycline were higher than En-terococcus f aecalis(P<0 .05) ,and the rates of Enterococcus f aecium sensitive to nitrofurantoin ,ampicillin ,penicillin G ,moxifloxa-cin ,levofloxacin and ciprofloxacin were lower than that of Enterococcus f aecalis(P<0 .05) .Conclusion The detection rates of En-terococcus was shifting to Enterococcus f aecium ,and the trends became obvious year after year .The drug sensitivity of Enterococcus f aecium and Enterococcus f aecalis is different ,and doctors should choose the proper therapy according to their specific drug resist-ance .At present ,vancomycin ,linezolid and tigecycline are preffered for the treatment against infection caused by Enterococcus f aeci-um and Enterococcus f aecalis .