Objective To determine the value of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natri-uretic peptide and homocysteine in the risk stratification of patients with unstable angina pectoris;thus to provide an assessment for the condition of patients in clinic.Methods 135 patients with unstable angina were included in the disease group and subjected to risk stratification according to GRACE risk score software,70 cases of low-risk group,60 cases in the middle-risk group and 5 cases in the high-risk group.Another 145 healthy people were in the control group.The levels of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine were detected and compared.Results Between the control group and the disease group,significant difference of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocys-teine was found (P <0.05),but the difference of ischemia modified albumin was not statistically significant(P >0.05).In the dis-ease group,the levels of ischemia modified albumin,heart-type fatty acid-binding protein and homocysteine in each risk stratification showed no significant difference(P >0.05).The level of B-type natriuretic peptide in high-risk group was higher than that in the low-risk group and in the middle-risk group and the difference was statistically significant (P <0.05),while there was no statisti-cally significant difference between the low-risk group and the middle-risk group(P >0.05 ).Conclusion The detection of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine possesses certain meaning in diagnosing unstable angi-na,and the level of B-type natriuretic peptide indicates the risk degree of the disease.

Objective:To seek the possibility of using internally installed curved mandibular distractor to repair the partial mandibular curved defect.Methods:A curved mandibular defect was sectioned in each of 3 adult dogs.The distractor designed by our own group based on the steel ball conducted force was implanted.After 7 days of latency,the distraction was performed at the rate of 0.5 mm × 2 times per day,followed by 3 months consolidation period.The osteogenesis was evaluated by general observation,X-ray examination and HE staining.Results:No complication was observed after operation and during distraction.The new bone healed well into a curved shape.The X-ray examination revealed that the transport disc moved along with the predesigned rail curve.HE staining clearly showed neo bone formulation zone between the mature trabecular and connective tissue.Conclusion:The internal distractor based on the steel ball conducted force can realize the curved distraction osteogenesis of posteriormandibular.

Objective To investigate the pathogen-related genes of atmospheric polluting disease so as to clarify the biology mechanism and provide the scientific basis.Methods By using the technique of dot blot hybridization,we analyzed genes’differential expression with cloning by exposure to ≥75 μg/m3 PM2.5 in heating season and < 75 μg/m3 PM2.5 in un-heating season in WI-38 human embryo lung cells.The levels of cytokines TNF-α,IL-2, IL-6 and IL-8 were determined by radio immunity assay. Results After 24h of treatment, compared with control group,more than 100μg/mL PM2.5 significantly increased TNF-α,IL-6 and IL-8 levels,and decreased IL-2 in WI-38 human embryo lung cells (P < 0.05 ).The clear stripe was found in 350 bp in 48 gene samples with segment with differential expression of genes exposed to different concentrations of PM2.5 in WI-38 human embryo lung cells.Through the dot blot hybridization,black brown spots were found in 41 samples in Tester cDNA hybridization,and no similar spots were found in all of the same samples in Driver cDNA hybridization. Conclusion PM2.5 exposure may induce the inflammatory damage of WI-38 human embryo lung cells.Obvious genetic damage was observed in those cells exposed to ≥75 μg/m3 PM2.5 in heating season.

OBJECTIVETo compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury.

METHODSEighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups.

RESULTSThe total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P < 0.05). After treatment, the results of the VAS and ODI of the two groups were apparently declined (both P < 0.01), and those in the observation group were decreased more obviously (both P < 0.01).

CONCLUSIONThe effect of oblique inser-tion at anatomical points for sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Joint Diseases ; physiopathology ; therapy ; Male ; Middle Aged ; Sacroiliac Joint ; injuries ; physiopathology ; Young Adult

OBJECTIVETo observe the effect of different concentrations of zoledronic acid on human gingival fibroblast (HGF) cells proliferation and apoptosis, and to investigate the mechanism of bisphosphonate-related osteonecrosis of the jaw (BRONJ) caused by zoledronic acid.

METHODSDifferent concentrations (0, 0.5, l.0, 5.0, 10.0 µmol/L) of zoledronic acid acted on the HGF. After 24 hours, flow cytometry was used to detect the rate of apoptosis and methyl thiazolyl terazolium (MTT) assay used to observe the proliferation of HGF. The effect of different concentrations of zoledronic acid on cell proliferation was examined by proliferation test on day 2, 4 and 7.

RESULTSFlow cytometry showed that when the concentration of zoledronic acid was 0, 0.5, 1.0, 5.0, 10.0 µmol/L, the apoptosis rate was (0.67 ± 0.50)%, (2.13 ± 0.21)%, (3.27 ± 0.23)%, (4.17 ± 0.35)%, (9.87 ± 1.79)% respectively. The difference in HGF cells between control group and zoledronic acid groups was significant (P < 0.05) at three concentrations of zoledronic acid (1.0, 5.0, 10.0 µmol/L). The cell proliferation test showed an concentration-time dependent effect. With increase of concentration and time, the cell proliferation was significantly inhibited. There was significant difference in absorbance value among the different concentration groups (P < 0.05).

CONCLUSIONSZoledronic acid can inhibit HGF proliferation and promote its apoptosis.

Apoptosis ; drug effects ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; etiology ; Bone Density Conservation Agents ; pharmacology ; Cell Proliferation ; drug effects ; Coloring Agents ; Diphosphonates ; pharmacology ; Dose-Response Relationship, Drug ; Fibroblasts ; drug effects ; physiology ; Flow Cytometry ; Gingiva ; cytology ; Humans ; Imidazoles ; pharmacology ; Tetrazolium Salts ; Thiazoles ; Time Factors

Objective To analyze the impacts of bureaucracy management at tertiary public hospitals in Beijing on exchange modes and trust between doctors and patients, using both the bureaucracy theory and trust theory. To study the role of such management as an organizational structure for hospital operation and service, in the transition of doctor-patient trust from traditional special trust to a universal trust based on bureaucracy structure and specialized job division. Methods The purpose sampling method was used to select 94 hospital administrators, medical staff, and patients from six tertiary hospitals for a field survey. Results Bureaucracy at public tertiary hospitals keeps improving, and its systematic and refined organizational structure is changing the exchanges between doctors and patients, earmarking universal trust of the fundamental type of doctor-patient trust, aided by special trust. Rules and regulations of bureaucracy normalize medical services, and specialization enables medical workers in their clinical work against difficult and severe diseases, winning both reputation and patient trust as well. However, the specialized, professional and dehumanized characteristic of bureaucracy tend to encourage doctors to attend to diseases than patients, and separate links in medical services to decrease doctor-patient trust in the meantime. Conclusions Bureaucracy is a necessary organizational form of urban public hospitals, but it should strengthen their humanity feature and improve their communication with patients with rules and regulations. At the same time, with the use of integrated medical mode in clinical practice, bureaucracy could be improved to benefit patients and enhance trust of patients.

OBJECTIVETo explore the role of sphingomyedlin phosphodiesterase 1 (SMPD1) gene mutations in the pathogenesis of Parkinson's disease (PD).

METHODSFor 110 Chinese patients with PD, all exons of the SMPD1 gene were sequenced, and the results were compared with reference sequence from GenBank to identify possible mutations.

RESULTSA novel heterozygous mutation Ex2:c.677C>A/p.P226Q (likely pathogenic) was identified in a patient, which resulted in substitution of Glutamic acid by Proline at position 226. In addition, two known single nucleotide polymorphisms (SNPs) Ex1:c.107T>C/p.V36A (benign) and Ex6:c.1522G>A/p.G508R (benign), and three previously reported SMPD1 mutations Ex2:c.T371T>G/p.L124R (uncertain significance), Ex2:c.636T>C/P.(=)(benign) and Ex6:c.1598C>T/p.P533L (uncertain significance) were identified. The novel p.P226Q mutation and p.P533L mutation were predicted to have a possibly damaging effect on the structure and function of SMPD1 protein, which in turn may lead to PD.

CONCLUSIONThe mutation rate of the SMPD1 gene was 3.64% among Chinese PD patients. Genetic variants of SMPD1 may increase the risk of PD.

Objective:To understand the major cognition, major choice motivation and the relationship between the two of medical students, and provide references and suggestions for the selection of talents in various majors of medical schools and the effective development of enrollment work.Methods:This study selected undergraduates of Batch 2019 from Peking University Health Science Center as the survey objects, conducted a questionnaire survey on their major cognition, major choice motivation and influencing factors, and used principal component analysis and Spearman rank correlation analysis.Results:The study found that the major cognition scores of 640 undergraduates of Batch 2019 from Peking University Health Science Center were clinical medicine (3.24±0.89) > stomatology (2.89±1.00) > basic medicine (2.66±1.02) > pharmacy (2.54±0.97) > preventive medicine (2.29±0.93) > nursing medicine (2.21±0.99) > medical laboratory (1.98±0.95) > medical English (1.95±0.93). Six major motivation factors for professional choice were school and professional strength, professional learning and job prospects, own factors, Peking University sentiments and the influence of others, medical factors, school policies, and the contribution rates were 34.60%, 12.97%, 7.42%, 6.00%, 5.59% and 5.37%, respectively. Major cognition scores and major choice motivation factors were positively correlated with each other to some extent.Conclusions:At present, students' major cognition level of medical majors still has a large room for improvement, and the motivational factors of major choice are more complicated, among which "the school and professional strength" and "the prospects of study and work" are important factors. Medical schools should focus on strengthening major publicity, improving students' major cognition, attracting aspiring students to apply for medical majors from many aspects, and improving the training quality of medical professionals.

Objective:To investigate the effectiveness and safety of the coaxial needle technique in percutaneous liver biopsy for patients with coagulation function abnormalities.Methods:Clinical data of 210 patients who underwent percutaneous liver biopsy using the coaxial needle technique under ultrasound guidance from December 2018 to May 2021 in 3 centers were collected. A retrospective analysis was conducted to compare the puncture success rate, number of samples obtained, pathology qualification rate, intraoperative and postoperative bleeding rates between the group with coagulation function abnormalities and the group with normal coagulation function.Results:After propensity score matching, there were 105 patients in each group, with a puncture success rate of 100% in both groups. The pathology qualification rate was 100% for all samples.Intraoperative bleeding occurred in 78 cases (74.3%, 78/105) in the coagulation function abnormalities group and in 64 cases (61.0%, 64/105) in the normal coagulation function group, with a statistically significant difference between the two groups ( P=0.006). Postoperative bleeding occurred in 3 cases (2.9%, 3/105) in the coagulation function abnormalities group and in 0 case in the normal coagulation function group, with no statistically significant difference between the two groups ( P=0.081). Conclusions:The use of the coaxial needle technique for percutaneous liver biopsy in patients with coagulation function abnormalities not only allows for obtaining an adequate tissue sample but also demonstrates good safety.

Objective:To explore the safety, efficacy and preliminary clinical application of the single plantar approach or in combination with the dorsalis pedis approach in the treatment of Lisfranc injury with poor dorsalis pedis soft tissue, metatarsal avulsion fracture or complicated multi-column lesions.Methods:(1) Six fresh cadaveric specimens of adult foot were collected and dissected through the plantar approach in order to determine the skin incision of the plantar approach and the safe area for plate-screw internal fixation, including start-stop points and courses of plantar nerves, blood vessels, tendons and ligaments, followed by plate-screw fixation on the specimens. (2) After feasibility of the plantar approach was confirmed by our anatomical study, it was used to treat the 3 patients who were admitted to Department of Orthopedics, The Third Hospital Affiliated to Southern Medical University between September 2020 and November 2021 for Lisfranc injury with severe necrosis due to dorsalis pedis skin contusion or metatarsal base avulsion fracture. They were 2 males and one female, with an average age of 51 years (from 34 to 68 years). The preliminary clinical efficacy was evaluated in terms of visual analogue scale (VAS), midfoot score of American Orthopaedic Foot and Ankle Surgeons (AOFAS), Maryland score, Kofoed score, fracture healing at the last follow-up and postoperative complications.Results:(1) Regarding the anatomical exposure range, the metatarsal side of the first metatarsal wedge joint was exposed medially and the metatarsal side of the third metatarsal wedge joint was exposed laterally; the peroneus longus tendon, Lisfranc plantar ligament and interosseous ligament were explored. X-ray films after the simulated operation showed satisfactory plate positions. (2) As for the preliminary clinical application, all patients were followed up for 6 to 14 months (mean, 11 months). At the last follow-up, the VAS score ranged from 0 to 1 (mean, 0.5), AOFAS score from 85 to 92 (mean, 89), Maryland score from 93 to 96 (mean, 95), and Kofoed score from 92 to 95 (mean, 94). There were no early complications such as fascial compartment syndrome, skin necrosis or infection. All fractures got united, with no complications like traumatic arthritis, muscle atrophy or screw loosening.Conclusion:Testified by the anatomical study, the plantar approach can be used to treat Lisfranc injury with poor dorsalis pedis soft tissue, metatarsal avulsion fracture or complicated multi-column lesions, leading to safe, effective and satisfactory clinical outcomes.