Objective To review the clinical feature of Nocardia-positive patients and improve the awareness of Nocardia infection.Methods The clinical data were reviewed retrospectively for 11 patients from whom Nocardia was isolated during the period from May 2012 to December 2014 in the General Hospital of Ningxia Medical University.Results Contamination was suspected in 2 of the 11 cases.Nocardia infection was considered in the remaining 9 cases,including pulmonary infection in 6 cases,skin and soft tissue infection in 2 cases,peritoneal dialysis-related peritonitis in 1 case.Underlying diseases were documented in all the 9 patients,4 of which received corticosteroids or immunosuppressants for their underlying diseases.Conclusions Nocardia may cause infection in different body sites,especially lungs.The patients with underlying diseases,especially those receiving corticosteroids or immunosuppressants,are relatively more susceptible to Nocardia infections.

Objective:To evaluate the stability and bio-safety of warming moxibustion gel-unguentums( WMG) . Methods: With the commercially available package and at 40℃ ± 2℃, RH (75% ± 5%) for six months,the stability of WMG was inspected. Guinea pig skin sensitization test, rabbit skin irritation test and cell toxicity test were used to investigate the safety. Results:Compared to the results of 0 month, there was no difference in the sample character, containing paste percentage, adhesion, shape, weight difference and all theindices in TLC identification. Cell toxicity test showed that WMG had slight cytotoxicity. Guinea pig skin sensitization test and rabbit skin irritation test indicated that the grade of skin reaction was zero and the primary stimulus index of skin tissues was also zero. Conclusion:The quality of WMG is stable and the production preparation technology is feasible. Moreover, it is safe in transder-mal administration.

Objective To investigate the clinical features of patients with multiple sclerosis (MS) and restless legs syndrome (RLS) and to further examine relevant factors that may contribute to the co-occurrence of MS and RLS.Methods Seventy MS patients were recruited in the present study.The RLS screen was further performed in MS patients based on the diagnostic criteria for RLS.MS patients with RLS were designated as the case group and MS patients without RLS served as the control group.The clinical data including age of MS onset,MS duration and clinical disability by the expanded disability status scale (EDSS) were analyzed.Results There were 12 MS patients with RLS in total 70 MS patients and the incidence rate was 17.1％.The average age of MS onset in the RLS group was (47.6 ± 10.0) years,and (40.1 ± 10.4 ) years in the control group.The difference of average age of MS onset was found to be significant (t =2.29,P =0.030).The average history of MS in the RLS group was ( 12.6 ± 6.8 ) years,and ( 8.2 ± 6.6) years in the control group ( t =2.10,P =0.039).The average EDSS of the RLS group was 4.5 ±2.5,and 2.5 ±2.0 in the control group (t =3.02,P =0.004).There was no significant association between RLSRS and EDSS in MS patients with RLS (P =0.15).Conclusion The incidence rate of RLS in MS patients was high.Among patients with MS,RLS was associated with older age,longer MS duration,and more severe disability.

Objective To study the clinical value of capsule endoscopy for small bowel diseases in pediatric and adolescent patients.Methods Clinical data of 61 pediatric and adolescent patients who underwent capsule endoscopy from February 2007 to April 2014 was respectively analyzed.The positive diagnostic results and safety were observed.Results Of 61 patients,the CE procedures were completed successfully in 58 patients,and failed in 3 patients because of the gastric stasis.Forty-one positive lesions were found in small intestine,and the detection rate was 70.69％.Positive findings included angiodysplasias,Crohn' s disease,Meckel diverticula,ulcer,P-J syndrome,protrusion lesion and enteritis,etc.Finally,29 patients were confirmed (50％),3 (5.17％) were misdiagnosed and 1 (1.72％) was missed.Twenty-two patients underwent other small bowel examinations besides the capsule endoscopy.And the accuracy of capsule endoscopy was 81.82％.All capsules were successfully swallowed by the patients and evacuated within two weeks.No complications such as capsule retention or intestinal obstruction occurred.Conclusion Capsule endoscopy is a safe and well tolerated procedure with high diagnostic rate,which has a prospective clinical value in small bowel diseases in pediatric and adolescent patients.

Objective To evaluate the effectiveness of mini clinical evaluation exercise (miniCEX) in community rotation of general practice residency training.Methods Forty nine general practice residency trainees,who participated in community rotation during July 2012 to July 2014 in 3 community teaching bases,were randomly divided into two groups:25 trainees in intervention group received conventional teaching and additional 2 rounds of mini-CEX in one month,and 24 trainees received conventional teaching only.The changes of self-evaluation scores of clinical competence after the community rotation were evaluated.Focus group discussions of 8 trainees and 8 teachers from intervention group were also adopted in January to February 2013 to assess the effectiveness of mini-CEX.Results Three trainees withdrew in the study and the interventional group completed 232 mini-CEXs.The self-evaluation scores of clinical competence were elevated in all items in interventional group after community rotation (from 7.03 ± 0.68 to 7.30 ±0.77 in medical history,from 7.00 ± 0.83 to 7.18 ± 0.88 in physical examination,from 7.42 ± 1.20 to 7.52 ± 0.76 in humanistic qualities,from 6.79 ± 0.82 to 7.12 ± 0.70 in clinical judgment,from 6.85 ± 1.06 to 7.18 ± 0.81 in counseling skills,from 6.85 ± 1.15 to 7.12 ± 0.96 in organization,from 7.09 ±0.81 to 7.33 ±0.69 in overall competence),while in control group,scores of humanistic qualities (from 7.74 ± 0.89 to 7.60 ± 0.97),clinical judgment (from 6.94 ± 0.77 to 6.77 ± 1.10) and organization/efficiency (from 6.94 ± 0.96 to 6.80 ± 0.76) were declined.Mter adjusting self-evaluation score before rotation,the increased scores in clinical judgment(7.12 ±0.70 vs.6.77 ± 1.10,F =4.339,P =0.042) and organization (7.12 ± 0.96 vs.6.80 ± 0.76,F =4.336,P =0.042) of intervention group were significantly higher than those of control group.In focus group discussions both trainees and teachers recognized that mini-CEX would enhance clinical competence,be more comprehensive in assessing and adaptable in training program than former rotation tests.The major concerns of using mini-CEX were subjective rating process,non-unified rating standards and insufficient teaching ability.Conclusions Application of mini-CEX in community rotation of general practice residency training can enhance clinical competency of trainees.

Objective : To investigate the mental health status of the pupils from Grade Four and Five in Jiading District of Shanghai, and to provide evidence for mental health intervention. Methods : All the students from Grade Four and Five in Jiading District, Shanghai were selected as survey objects. The MHT was used to evaluate their mental health status, and the influencing factors of mental health problems were analyzed by multivariate logistic regression model. Results : A total of 3 788 questionnaires were issued, of which 3 100 ones were valid and the effective rate was 81.84%. The detection rate of mental health problems was 17.06%. The detection rates of impulse tendency, terror tendency, physical symptoms, sensitivity tendency, self-blame tendency, loneliness tendency, anxiety towards people and learning anxiety were 11.77%, 15.55%, 12.97%, 16.19%, 10.10%, 4.81%, 13.16% and 14.00%, respectively. The results of multivariate logistic regression analysis showed that female students ( OR=1.617,95%CI: 1.325-1.974 ) , poor self-rated appearance ( OR=3.683, 95%CI: 2.428-5.586 ) ,only one or two friends ( OR=1.806, 95%CI: 1.342-2.428 ) , poor academic performance ( OR=1.626, 95%CI: 1.167-2.267 ) , primary school education or below of mother ( OR=1.539, 95%CI: 1.107-2.139 ) general or poor relationship with mother ( OR=1.785, 95%CI: 1.303-2.444 ) or father ( OR=1.745, 95%CI: 1.336-2.280 ) were risk factors for mental health problems. Conclusion The fourth-to fifth-grade primary school students in Jiading District of Shanghai have high detection rate of psychological problems. Gender, the number of friends, academic performance, education level of mother and the relation with parents are associated.

Objective: To explore the survival difference of patients with colon and rectal neuroendocrine neoplasm (NEN) at different stages. Methods: We identified 8 679 patients with colorectal NEN diagnosed between 1988 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) registry, including 5 437 rectal NEN and 3 242 colon NEN ( 1 681 cecum NEN ). Survival curve was drawn by Kaplan-Meier method. Prognostic factors were analyzed by univariate analysis and multivariate Cox regression model. Results: The ratio of male patients with colon and rectal NEN was similar to female (P=0.095). Rectal NEN patients were younger (P<0.001), more highly differentiated (P<0.001), and with earlier stage (P<0.001). Survival analysis showed that the survival of rectal NEN was superior to that of colon NEN, with 10-year tumor-specific survival rates of 86.8% and 44.8% respectively (P<0.001). Multivariate Cox analysis showed that age, gender, marital status, primary tumor site, grade, stage and surgery were independent prognostic factors of colorectal NEN (all P<0.01). The most important factor was stage (HR=3.531), followed by differentiation grade (HR=1.856). Stratified analysis displayed that the survival of rectal NEN in stage Ⅰ, Ⅱ and Ⅳ were better than those of corresponding stage of colon NEN (all P<0.05), but worse in stage Ⅲ (P=0.012). While the survival of rectal NEN were significantly better than those of colon NEN within all stages after excluding 1681 cases of cecal NEN (all P<0.05). Among the patients with well-differentiated NEN, the survival of rectal NEN in stage Ⅰ, Ⅲ and Ⅳ were better than those of corresponding stage of colon NEN (all P<0.05) while there was no significant difference in stage Ⅱ(P=0.169). For poor-differentiated NEN, only the survival of rectal NEN patients in stage Ⅳ (P=0.001) was significant longer than those of colon NEN, while there was no significant difference in stage Ⅰ, Ⅱ and Ⅲ (stage Ⅰ: P=0.760; stage Ⅱ: P=0.181; stage Ⅲ: P=0.313). Conclusions The survival of NEN patients in colon and rectum is different. Cecum NEN should be considered as a separated tumor for prognostic analysis due to its special clinicopathologic characteristics.

Breast cancer is the most diagnosed cancer in women worldwide and the leading cause of most cancer-related deaths, posing a serious threat to women′s health worldwide. At present, although the prognosis of some patients with breast cancer has improved, the emergence of drug resistance and the metastasis and recurrence of breast cancer are still the main reasons for poor prognosis. CD36 is a multiligand transmembrane glycoprotein expressed on various cell types. In recent years, studies have confirmed that CD36 can reshape the lipid metabolism of cancer cells; promote the differentiation of tumor-related macrophages into M2 type and recruitment into tumor tissues; regulate the function of Treg cells, CD8+ T cells, DCs, and other immune cells, and thus promote tumor development. In addition, CD36 is also associated with breast cancer stem cells, metastasis-initiating cells, and breast drug resistant cells. Therefore, CD36 could be an important potential therapeutic target for breast cancer.

OBJECTIVETo study the effect of Lycium ruthenicum anthocyanins on atherosclerosis (AS) in mice.

METHODNormal mice were taken as the control group, and hyperlipemia mice were divided into the model group, Lycium ruthenicum anthocyanins low, medium and high dose groups, and the simvastatin drug control group. After the oral administration, blood lipid indicators were detected by enzymatic analysis. The histomorphological changes in aortas, hearts and livers were observed, and liver-related indicators were determined by using hematoxylin-eosin (HE) staining.

RESULTCompared with the high-fat group, L. ruthenicum anthocyanins low, medium and high dose groups showed significant decrease in total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and atherosclerotic index (AI) (P < 0.05). However, high-density lipoprotein cholesterol (HDL-C) level showed a trend of higher than the model group. Liver's total antioxidant capacity (T-AOC), Glutathione peroxidase (GSH-PX), lipoprotein lipase (LPL) were significantly increased (P < 0.05), malondialdehyde (MDA) was markedly decreased (P < 0.01); the percentage of aortic plaque area of each anthocyanins dose group in the total area was significantly lower than the model group (P < 0.05); severity of aorta, heart and liver were significantly lighter than the high-fat group. But the media dose group was similar with the simvastatin group.

CONCLUSIONL. ruthenicum anthocyanins can interfere the formation of AS, while lowering blood lipid levels in mice.

Animals ; Anthocyanins ; therapeutic use ; Atherosclerosis ; prevention & control ; Body Weight ; drug effects ; Glutathione Peroxidase ; metabolism ; Hypercholesterolemia ; blood ; drug therapy ; pathology ; Lipids ; blood ; Liver ; pathology ; Lycium ; chemistry ; Male ; Mice ; Phytotherapy

BACKGROUND: Insufficient bone mass in the posterior maxilla region often increases the difficulty of dental implantation. The application of maxillary sinus floor elevation successfully solves this problem. In the surgery bone grafting can be used to obtain sufficient bone mass. However, nonuse of graft materials can shorten the cycle of patient's treatment and reduce trauma and cost. OBJECTIVE: Combining the latest relevant research trends, to review the advances in the study of maxillary sinus floor elevation with and without bone grafting. METHODS: The first author searched PubMed, VIP, WanFang and CNKI databases using computer for relevant articles published from January 1985 to August 2018. The key words were "dental implant, maxillary sinus, bone augmentation, bone substitute" in English and Chinese, respectively. Finally, 78 articles were included in result analysis after screening and summarizing. RESULTS AND CONCLUSION: Ideal results can be achieved in the maxillary sinus floor elevation with or without simultaneous bone grafting In addition, the nonuse of grafting materials have the advantages of simplifying surgical procedures, shortening treatment cycles, reducing trauma and pain, reducing treatment costs, reducing complications and failure rates, thus gaining the favor of doctors and patients. Therefore, the maxillary sinus floor elevation without simultaneous bone grafting will be the primary choice of the doctors engaged in dental implantation in the future.