OBJECTIVE To know more clearly about the situation of Hepatitis B virus markers in clinical medical workers and take further interventional strategies to protect high risk medical workers.METHODS Hepatitis B virus markers in doctors,nurses and medical checkers who have contacted with patients′ blood,body fluid,or other occupational hazard situation,were detected by of ELISA.RESULTS Among the 587 medical workers detected,311 were with deficiency of active immunity(52.98%),196 were HBV infectors(33.39%).CONCLUSIONS Medical workers are in high risk groups of HBV infection.Medical institutions should attend to their self-protection and encourage them to take HBV vaccine to prevent iatrogenic transmission.

Objective To investigate the relationship between the plasma IL-6,ACE level and DVH parameters radiation pneumonitis,and to evaluate its clinical value on the prediction of radiation pneumonitis.Methods 60 patients with locally advanced non-small cell lung cancer patients with unresectable or unwilling to surgical resection routinely received three-dimensional conformal radiation therapy.Before radiotherapy,radiotherapy beginning 1 week,2 weeks,3 weeks,4 weeks,5 weeks,6 weeks,8 weeks and 12 weeks,enzyme-linked immunosorbent assay (ELISA) was used to detect IL-6 and ACE content.The evaluation of radiation pneumonitis was accordance with the RTOG acute radiation pneumonitis grading standards.The patients with radiation pneumonitis were included in observation group,otherwise as control group.IL-6,ACE and DVH parameters in two groups were analyzed.The DVH parameters includes V20,V20,MLD and NTP.Results Among all the 60 patients,16 cases were diagnosed as radiation pneumonitis,among whom 5 cases occurred in radiotherapy,10 cases occurred within one month after radiotherapy,1 case occurred in two months after radiotherapy,including the 11 cases of grade Ⅱ and the other 5 cases of grade Ⅲ.In the observation group and the control group,expression level of the IL-6 had statistical significance before and after radiotherapy,ACE had significant difference in 2rd,3rd,4th,5th,6th week after radiotherapy (all P ＜ 0.05).V20,V30 and MLD differences were statistically significant between the observation group and control group [(46.2±4.5) ％ vs (30.5±7.5) ％,(37.5±5.6) ％ vs (20.5±5.6) ％,(20.4±2.3) Gy vs (15.5±3.5) Gy,(25.2±8.2) ％ vs (9.9±4.5) ％,all P ＜ 0.05].Conclusion Plasma IL-6,ACE levels,V20,V30,the MLD,and NTP are related to the occurrence of radiation pneumonitis.

Objective To observe the therapeutic effect of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets for chronic functional constipation. Methods Sixty patients with chronic functional constipation were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was treated with Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets orally, and the control group was treated with oral administration of Prucalopride Succinate Tablets alone. The therapeutic effects on traditional Chinese medicine (TCM) symptoms and constipation, and the follow-up therapeutic effect of the two groups were evaluated after treatment. During the three months after the completion of treatment course, the recurrence of constipation was monitored. Results (1) The cure rate of the treatment group was 90.0％ and that of the control group was 60.0％, indicating that the therapeutic effect on TCM symptoms in the treatment group was stronger than that of the control group(P < 0.05).(2) In respect of the relief of constipation, the markedly effective rate was 93.3％ in the treatment group and was 50.0％ in the control group, and the overall effective rate was 100.0％ in the treatment group and was 73.3％ in the control group, the difference being significant between the two groups(P<0.05 or P<0.01).(3) During the treatment, the percentage of patients with weekly completely spontaneous defecation frequency ≥3 was 86.7％ in the treatment group, and was 53.3％ in the control group, the difference being significant (P < 0.05). (4) The results of 3-month follow-up after the completion of treatment course showed that one case from the treatment group had the recurrence of constipation, and the recurred cases from the control group were 6, the difference being significant (P < 0.05). Conclusion Oral use of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets exerts certain therapeutic effect for chronic functional constipation, which is effective both on relieving constipation symptoms and on reducing recurrence rate.

Through several years of exploration in Shanghai Chongming region, the team from Chongming Branch of Xinhua Hospital has established the initial multidisciplinary diagnosis and treatment model of cancer pain, which includes the department of oncology, anesthesiology, pain, rehabilitation, psychology and so forth. By means of medical informationization, they take cancer pain management as the starting point and have initially real-ized a new model of the real-time assessment and treatment of cancer pain, which has helped patients effectively reduce the physical and psychological suffering, improved the quality of life, developed a healthy self-manage-ment of patients, and has reference significance to palliative care.

Objective:To investigate the role of Akt signaling pathway in the regulation of breast cancer bone metastasis induced pain behavior in rat.Methods:Model rats were randomly divided into three groups:Model group,Model+GSK690693 group and Model+ Saline group.On PID 13,14 and 21,Model+GSK690693 group rats were intrathecally injected with GSK690693,a specific inhibitor of Akt.Model+Saline group were injected with saline instead.The pain related behaviors were respectively recorded on PID 0,7,14 and 21.The expression ofp-Akt in DRG used for western bloting were examed on PID 21.Results:After the injection of Akt specific inhibitor GSK690693 by intrathecal,In the Model+GSK690693 group,the threshold value of mechanical contraction reflex was increased,the spontaneous pain behavior and the expression of p-Akt in DRG decreased.On PID 14 d and 21 d,the pain behavior of rats in Model+GSK690693 group was significantly different from that of Model+Saline group and Model group (P＜0.01);On PID 21 d,There was significant statistical significance (P＜0.01) on the expression of p-Akt and Model in the ipsilateral Model+GSK690693 of DRG group,which was statistically significant (P＜0.05) compared with the Model+Saline group.Conclusion:Intrathecal injection of Akt specific inhibitor GSK690693 inhibits rat pain related behaviors induced by bone metastasis in rat breast cancer.

OBJECTIVE To study the role of ciliary neurotrophic factor(CNTF) in the generation of facial nerve.METHODS Twenty adult New Zealand rabbits' bilateral super buccals of facial nerves were transected and connected with silicone tube.CNTF was injected into a random side of silicone tube and normal saline in the other.At four and eight weeks after the operation, both the CNTF group and the SAL group underwent electrophysiology test and histopathology as well as quantity analysis.RESULTS Four weeks later, both CNTF and SAL group failed in eliciting muscular excitement upon stimulation; T-test showed a signifi-cant difference(P

Orthopedic,as an important subject of medical system,is complementary and common progress with young orthopedic surgeon.So,strengthening the standardized training of clinical and scientific research ability for young orthopedic is the primary task in department of orthopedics in our country.Unfortunately,the development of the professional career of Chinese young orthopedic surgeon is presently entrapped in a dilemma due to the diverse contents of the orthopedic subject and the abstract structure of the bone science,and the short time for college education and practice training.In practice,we focus on the ability cultivation based on problem oriented clinical practice,and integrate reasonable and standardized assessment mechanism referring to the international excellent physician training mode.We also integrate the comprehensive development of medicine,teaching and research to promote the improvement of the professional ability of the young doctors in the department of orthopedics.

Objective:To evaluate the clinical and echocardiographic characteristics of valvular involvement in SLE patients and its predictive value for valvular outcome.Methods:A retrospective study included 58 adult SLE patients with valvular involvement diagnosed for the first time by echocardiography in the First Affiliated Hospital of Wenzhou Medical University. According to gender and age, 1∶2 SLE patients without valvular involvement were selected as the control group. Clinical and echocardiographic data within 24 hours after initial admission were collected. The predictive factors were analyzed using cox parametric regression analysis.Results:①Among 58 patients,significant valve lesions were detected by echocardiography in 50 and presented as valve thickening with regurgitation. The mitral valve was the most commonly affected, followed by the aortic valves. ②Compared with the non-valvular involvement group, the percent of CRP, SLC-R, IgA、aCL-IgG were higher in the valvular involvement group [CRP:60.3% vs 30.4%, χ2=10.54, P=0.001; SLC-R: 63.8% vs 19.8%, χ2=33.08, P<0.001; IgA:27.6% vs 22.4%, χ2=16.04, P<0.001; aCL-IgG: 27.6% vs 2.6%, χ2=24.84, P<0.001]. ③Cox parametric regression analysis showed that CRP [ HR (95% CI)=2.641(1.499, 4.654), P=0.001,SLC-R HR(95% CI)=3.234(11.776, 5.888), P<0.001], and aCL-IgG[ HR(95% CI)=2.166 (1.148, 4.087) , P=0.017] were independent predictors of valvular involvement. Conclusion:SLE patients with increased levels of CRP、SLC-R、IgA and aCL-IgG have a high risk of valvular involvement. CRP、SLC-R and aCL-IgG are independent predictors of valvular involvement.

OBJECTIVETo observe the influence of Niupo Zhibao pellet (NZP) on transforming growth factor-beta1 (TGF-beta1) and its receptor's expression.

METHODSEndotoxic shock model was established by intravenous injection of lipopolysaccharide (LPS) 1.5 mg/kg and intraperitoneal injection of D-galactosamine 100 mg/kg, and intervened by NZP, TGF-beta1 and its receptor's expression in lung tissue were detected by immunohistochemical method.

RESULTSNZP could enhance the TGF-beta1 and its receptor's expression in endotoxic shock lung tissue, and reduce the injury of lung.

CONCLUSIONThe mechanism of NZP in reducing endotoxic shock lung injury is possibly related with its effect in enhancing the TGF-beta1 and its receptor's expression in lung tissue.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Galactosamine ; Lipopolysaccharides ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Transforming Growth Factor beta ; biosynthesis ; Respiratory Distress Syndrome, Adult ; etiology ; metabolism ; Shock, Septic ; chemically induced ; complications ; metabolism ; Transforming Growth Factor beta ; biosynthesis ; Transforming Growth Factor beta1

Objective To evaluate the effectiveness and associated factors of prevention of motherto-child human immunodeficiency virus (HIV) transmission in Hubei Province,and to provide a reference for prevention of mother-to-child transmission of HIV.Methods In this prospective cohort study,HIV-positive pregnant women who were in some counties and cities of Hubei Province from January 2004 to December 2016 were enrolled.Prevention of mother-to-child transmission of HIV was conducted for these HIV-positive pregnant women and their infants,and their clinical data were collected.Descriptive analysis and x2 test were used to analyze the general characteristics of HIV-positive pregnant women and their infants.Logistic regression analysis was adopted to explore the associated factors of mother-to-child HIV transmission.Results In total,536 HIV-positive pregnant women (628 pregnancies) were found,among which,334 pregnant women and 345 infants were enrolled in this study.Twenty-four infants were HIV-positive,which was 6.96％ in all infants (95％CI:4.27％-9.64％).The rates of mother-to-child HIV transmission without prevention,formula feeding only,infant medication plus formula feeding,mother and infant medication plus formula feeding were 35.71％ (95％CI:21.61％-51.93％),8.82％ (95％CI:2.08％-15.57％),7.41％ (95％CI:0.92％-24.22％),and0.48％ (95％CI:0.01％-2.64％),respectively.No antiretroviral medications during delivery (OR =14.484,95 ％CI:1.740-120.577,P=0.013),breastfeeding (OR=6.542,95％CI:2.416-17.713,P=0.000),and CD4-T lymphocyte count＜200 cells/μL during delivery (OR=3.060,95％CI:1.076-8.703,P=0.036) were independent risk factors of mother-to-child HIV transmission.Conclusions The rate of mother-to-child HIV transmission without prevention is high in Hubei Province,which can be significantly reduced by comprehensive interventions (mother and infant medication plus formula feeding).Thus,we should diagnose HIV-positive pregnant women as early as possible,and should give pregnant woman antiretroviral therapy plus infant medication and formula feeding to further reduce the rate of mother-to-child HIV transmission.