Violent trespass against medical right dangerously harms medical staffs' health,both physically and mentally.It disarranges normal infirmary system on medical diagnosis and treatment.The research carried out in 80 hospitals covering 10 provinces indicates that presently violent trespass against medical right occurs from time to time;moreover this shows an up-growing trend.Such phenomena take place in various medical colonies and medical organizations diverse themselves obviously.This passage analyzes the causes of violence from the aspects of society,hospital and physician-patient relationship.

[ ABSTRACT] AIM:To construct a lentiviral vector for stable delivery of the ER-α36 gene and to detect its effect on SGC7901 cell growth.METHODS: The efficient RNAi targeting sequences identified for the ER-α36 gene were screened.The Oligo DNA was synthesized with target sequences and annealed to form double-stranded DNA.Then it was digested by Xho I and EcoR I and connected with GV307 vector to produce LV-ER-α36-RNAi lentiviral vector.PCR was used to screen the positive clones and sequence.The LV-ER-α36-RNAi, pHelper 1.0 and pHelper 2.0 plasmids were co-transfected into 293T cells for producing lentiviral vector and infecting SGC7901 cell line.Fluorescence microscopy, real-time PCR and Western blotting were used to detect the transfection efficiency and gene silencing effect.17β-estrodial at concentration of 1 ×10 -10 mol/L was used to stimulate the recombinant cell line, and the action on the growth of gastric cancer cells and the expression of Src, ERK1/2 and cyclin D1 were determined.RESULTS: DNA sequencing analysis confirmed the identity of recombinant shRNA expression vectors.Immunofluorescence assay demonstrated that transfection efficiency was above 80%.Transfection of LV-ER-α36-RNAi significantly knocked down the expression of ER-α36 at mR-NA and protein levels with tetracycline ( TeT) simulating as revealed by real-time PCR and Western blotting.Compared with control group, the growth of the recombinant cell line declined and the expression of Src, ERK1/2 and cyclin D1 and the activation of Src decreased (P<0.05).CONCLUSION: Lentiviral vectors that silence ER-α36 expression are con-structed successfully and can be used to study the role of ER-α36 in gastric cancer.The ER-α36 is related with many kinds of cancer cell growth, including gastric cancer cells.

Objective To explore the shape change characteristics of Oncomelania hupensis snail shell after the snails being passively migrated into Shandong intake area of the South-to-North Water Diversion Project. Methods The snails raised on the Dushan island in Weishan Lake region were captured,and 115 the first filial generation snails and 107 the second filial generation ones were selected. The length and width of shells and apertures,and the labial ridge thickness of those snails were measured,the longitudinal rib number of snail spiral was counted,and 107 parental snails were chosen as controls. Results The labial ridge thickness of the filial generation snail was significantly reduced with the increase of algebras,and the labial ridge thickness among the 3 generations had a significant difference(P<0.01). Both the length of snail shell and the width of snail apertures were de-creased,while the width of snail shell,the length of snail apertures,the multiplication product of snail aperture’s length and width and the longitudinal rib number of snail spiral were all increased. Conclusion The body size of Oncomelania snails in Weishan Lake region becomes smaller,and their shells become thinner,which indicates that the environment of the lake region is not suitable for snail breeding,and the snails have natural decay tendency with the extension of time.

Objective A suspected strain of Brucella canis isolated in Hebei Province in 2015 was identified and its genetic characteristics were analyzed.Methods After conventional identification of the bacteria strain,multiplex polymerase chain reaction (M-PCR) and multiple-locus variable-number tandem-repeat analysis (MLVA) were conducted to determine its species and genetic characteristics.Results The strain was identified as Brucella canis by conventional subtyping and M-PCR.Using Panel 1,the strain was genotype 3,using Panel 2A,the strain was genotype 28.It was closely clustered with Brucella canis,and differences of repeated numbers at variablenumber tandem-repeat (VNTR) loci Bruce04,Bruce07,Bruce09 and Bruce16 were also displayed.Conclusions The conventional subtyping and molecular methods can improve the stability and accuracy of the identification.Genetic characteristics of the strain is closely related to that of Brucella canis.

To understand the possibility of schistosomiasis transmission on the East Route Project of the South-to-North Water Diversion Project, a survey of endemic status of schistosomiasis in Weishan Lake area was conducted. A cluster sampling of 2086 boatmen were screened with DDIA Kit, and the positive ones were examined with Kato-Katz technique. Meanwhile, a questionnaire survey about schistosomiasis control was carried out to collect the data about the boatmen's general information and knowledge , attitude and practice (KAP). The results showed there were no schistosomiasis patients. However, there exist potential risk factors for schistosomiasis transmission because of the bad hygiene habits and the poor knowledge of schistosomiasis prevention in boatmen.

Medical homogenization in multi-campus hospital plays an essential role in leveraging the advantages of public hospitals, promoting the expansion of high-quality medical resources and balancing regional layout. The Second Affiliated Hospital Zhejiang University School of Medicine deeply used digital intelligence technology to build a new integrated mobile health service system consisting of internet hospital and 5G intelligent applications, which empowered medical efficiency in multi-campus hospital. This system broke the limitations of inconsistent medical resources, unbalanced discipline layout, and insufficient information connectivity in the construction of multi-campus hospitals, and achieved remarkable results in practice. It could provide reference for the multi-campus construction of other large public hospitals.

Objective To investigate the risk factors of hyperbilirubinemia in late preterm infants. Methods The clinical data of 815 late preterm infants (449 males and 366 females) from 25 hospitals in Beijing were collected from October 2015 to April 2016, including 340 cases(41.7％) with hyperbilirubinemia (hyperbilirubinemia group), and 475 cases without hyperbilirubinemia (control group). The clinical data of two groups were compared, and the maternal factors influencing hyperbilirubinemia in late preterm infants were analyzed with logistic regression. Results There were no significant differences in gender ratio (M:F 1.39 vs. 1.12, t=1.811,P=0.172)and birth weight[(2502.6±439.6)g vs. (2470.2±402.9)g,χ2=2.330,P=0.127)]between two groups. The incidence rates of hyperbilirubinemia in infants of 34 wks, 35 wks and 36 wks of gestational age were 22.9％(87/174), 35％(119/300) and 42.1％(143/341) respectively (χ2=1.218,P=0.544). The multivariate logistic regression analysis indicated that the maternal age(OR=1.044,95％ CI:1.010-1.080,P=0.011)was independent risk factor and multiple births(OR=1.365,95％CI:0.989-1.883,P=0.048), premature rupture of membranes(OR=2.350,95％ CI:1.440-3.833,P=0.001), cesarean section(OR=1.540,95％CI:0.588-4.031,P=0.014)were risk factors for hyperbilirubinemia in late preterm infants. Conclusions The incidence of hyperbilirubinemia in late preterm infants is relatively high. Maternal age, multiple births, premature rupture of membranes and cesarean section are risk maternal factors related to hyperbilirubinemia in late preterm infants.

Objective:To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods:The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group (237 cases) and the control group (722 cases) according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results:Among the 959 late-preterm babies, 530 were male and 429 were female.Two hundred and thirty-seven cases (24.7%) developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases (81 cases, 8.4%), followed by transient tachypnea (65 cases, 6.8%), amniotic fluid aspiration (51 cases, 5.3%), and respiratory distress syndrome (24 cases, 2.5%) successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups (all P>0.05). Compared with the control group, more late-preterm infants were delivered by cesarean section (73.4% vs.59.7%, χ2=14.43, P<0.001) and the 1-minute Apgar score was lower [(9.41±1.66) scores vs.(9.83±0.53) scores, t=5.40, P<0.001] in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group (66.7% vs.58.6%, χ2=4.877, P=0.027), but no difference in various complications between 2 groups was observed ( P>0.05). In the respiratory morbidity group, the most frequent complications were maternal hypertension and preeclampsia (27.8% vs.22.6%, χ2=2.728, P=0.099). There were no differences between 2 groups in gestational age, birth weight and birth length (all P>0.05). There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group (18.8% vs.14.1%, 6.3% vs.2.4%, χ2=8.960, P=0.011). The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the control group [(9.00±4.42) d vs.(6.82±4.19) d, t=6.676, P<0.001] since the infants with respiratory morbidity needed to be hospita-lized. Conclusions:Respiratory diseases occur in about 1/4 of late-preterm infants.Infants who are delivered by cesarean section and whose mothers are complicated with the maternal hypertension and preeclampsia should be monitored closely.Respiratory support should be provided for infants not appropriate for gestational age who are more likely to suffer from respiratory diseases, so that they can successfully pass through the transition period.

Objective:In general, patients with seropositive rheumatoid arthritis (RA) are considered to show an aggressive disease course. However, the relationship between the two subgroups in disease severity is controversial. Our study is aimed to compare the clinical characteristics and prognosis of double-seropositive and seronegative RA in China through a real-world large scale study.Methods:RA patients who met the 1987 American College of Rheumatology (ACR) classification criteria or the 2010 ACR/European Anti-Rheumatism Alliance RA classification criteria, and who attended the 10 hospitals across the country from September 2015 to January 2020, were enrolled. According to the serological status, patients were divided into 4 subgroups [rheumatoid factor (RF)(-) anti-cyclic citrullinated peptide (CCP) antibody (-), RF(+), RF(+) anti-CCP antibody(+), anti-CCP antibody(+)] and compared the disease characteristics and treatment response. One-way analysis of variance was used for measurement data that conformed to normal distribution, Kruskal-Wallis H test was used for measurement data that did not conform to normal distribution; paired t test was used for comparison before and after treatment within the group if the data was normally distributed else paired rank sum test was used; χ2 test was used for count data. Results:① A total of 2 461 patients were included, including 1 813 RF(+) anti-CCP antibody(+) patients (73.67%), 129 RF(+) patients (5.24%), 245 RF(-) anti-CCP antibody(-) patients (9.96%), 74 anti-CCP antibody(+) patients (11.13%). ② Regardless of the CCP status, RF(+) patients had an early age of onset [RF(-) anti-CCP antibody(-) (51±14) years old, anti-CCP antibody(+) (50±15) years old, RF(+) anti-CCP antibody(+) (48±14) years old, RF(+)(48±13) years old, F=3.003, P=0.029], longer disease duration [RF(-) anti-CCP antibody(-) 50 (20, 126) months, anti-CCP antibody(+) 60(24, 150) months, RF(+) anti-CCP antibody(+) 89(35, 179) months, RF(+) 83(25, 160) months, H=22.001, P<0.01], more joint swelling counts (SJC) [RF(-) anti-CCP antibody(-) 2(0, 6), Anti-CCP antibody(+) 2(0, 5), RF(+) anti-CCP antibody(+) 2(0, 7), RF(+) 2(0, 6), H=8.939, P=0.03] and tender joint counts (TJC) [RF(-) anti-CCP antibody(-) 3(0, 8), anti-CCP antibody(+) 2(0, 6), RF(+) anti-CCP antibody(+) 3(1, 9), RF(+) 2(0, 8), H=11.341, P=0.01] and the morning stiff time was longer [RF(-) anti-CCP antibody(-) 30(0, 60) min, anti-CCP antibody(+) 20(0, 60) min, RF(+) anti-CCP antibody(+) 30(10, 60) min, RF(+) 30(10, 60) min, H=13.32, P<0.01]; ESR [RF(-) anti-CCP antibody(-) 17(9, 38) mm/1 h, anti-CCP antibody(+) 20(10, 35) mm/1 h, RF(+) anti-CCP antibody(+) 26(14, 45) mm/1 h, RF(+) 28(14, 50) mm/1 h, H=37.084, P<0.01] and CRP [RF(-) anti-CCP antibody(-) 2.3 (0.8, 15.9) mm/L, Anti-CCP antibody(+) 2.7(0.7, 12.1) mm/L, RF(+) anti-CCP antibody(+) 5.2(1.3, 17.2) mm/L, RF (+) 5.2(0.9, 16.2) mm/L, H=22.141, P<0.01] of the RF(+)patients were significantly higher than RF(-) patients, and RF(+) patients had higher disease severity(DAS28-ESR) [RF(-) anti-CCP antibody(-) (4.0±1.8), anti-CCP antibody(+) (3.8±1.6), RF(+) anti-CCP antibody(+) (4.3±1.8), RF(+) (4.1±1.7), F=7.269, P<0.01]. ③ The RF(+) anti-CCP antibody(+) patients were divided into 4 subgroups, and it was found that RF-H anti-CCP antibody-L patients had higher disease severity [RF-H anti-CCP antibody-H 4.3(2.9, 5.6), RF-L anti-CCP antibody-L 4.5(3.0, 5.7), RF-H anti-CCP antibody-L 4.9(3.1, 6.2), RF-L anti-CCP antibody-H 2.8(1.8, 3.9), H=20.374, P<0.01]. ④ After 3-month follow up, the clinical characteristics of the four groups were improved, but there was no significant difference in the improvement of the four groups, indicating that the RF and anti-CCP antibody status did not affect the remission within 3 months. Conclusion:Among RA patients, the disease activity of RA patients is closely related to RF and the RF(+) patients have more severe disease than RF(-) patients. Patients with higher RF titer also have more severe disease than that of patients with low RF titer. After 3 months of medication treatment, the antibody status does not affect the disease remission rate.

The detection of electrocardiogram (ECG) characteristic wave is the basis of cardiovascular disease analysis and heart rate variability analysis. In order to solve the problems of low detection accuracy and poor real-time performance of ECG signal in the state of motion, this paper proposes a detection algorithm based on segmentation energy and stationary wavelet transform (SWT). Firstly, the energy of ECG signal is calculated by segmenting, and the energy candidate peak is obtained after moving average to detect QRS complex. Secondly, the QRS amplitude is set to zero and the fifth component of SWT is used to locate P wave and T wave. The experimental results show that compared with other algorithms, the algorithm in this paper has high accuracy in detecting QRS complex in different motion states. It only takes 0.22 s to detect QSR complex of a 30-minute ECG record, and the real-time performance is improved obviously. On the basis of QRS complex detection, the accuracy of P wave and T wave detection is higher than 95%. The results show that this method can improve the efficiency of ECG signal detection, and provide a new method for real-time ECG signal classification and cardiovascular disease diagnosis.
Algorithms ; Arrhythmias, Cardiac ; Electrocardiography ; Heart Rate ; Humans ; Signal Processing, Computer-Assisted ; Wavelet Analysis