Objective: To develop a quality of life instrument for hepatitis B patients(QOL-HBV) and examine it's reliability and validity.Methods:The item analysis, construct validity, content validity, criteria validity, reliability and discriminate were assessed by a survey on 134 HBV patients with QOL-HBV.Results:Item analysis showed that QOL-HBV had satisfactory item discrimination. Eight common factors were extracted by exploratory factor analysis and they can be reduced to three domains. The ?2/DF was 1.310, GFI was 0.972 and AGFI was 0.967 by the confirmatory factor analysis. The coefficients of Cronbach's ? of the instrument and all domains were above 0.80. In comparison with SF-36, there was good correlation among corresponding domains.Conclusion:QOL-HBV is a good scale in testing the quality of life, which has good reliability and validity.

Objective To understand the distribution of anaerobes in gingivitis infection, and anaerobes sensitivity to ? lastams Methods 44 specimens were taken from the gingival crevicular fluid of gingivitis. The anaerobic bacteria were cultured and identified Minimal inhibitory concentrations (MIC) were measured by using agar dilution method Results Among all samples, the isolation of anaerobes was 100%, the isolation of P.melaninogenica was 86.4%, P.intermedia was 56.8%, B.forsythus was 52.3%, P.gingivalis was 65.9%, F.mucleatum was 63.6%, P.micros was 52.3%, Actinomyces ssp was 38.6% and Capnocytophaga ssp was 9.1% respectively. The anaerobes are sensitive to ? lastams. Conclusion In gingival crevicular fluid, the infection rates of P.melaninogenica, P.intermedia, B.forsythus, P.gingivalis, F.mucleatum, P.micros, and Actinomyces ssp were significantly higher than those of the other anaerobes. ? lastams can be used for the treatment of anaerobes infected gingivitis.

Objective To investigate the effects of 5-azacytidine on radiation-induced epithelialmesenchymal transition in rat alveolar type Ⅱ epithelial cell line (RLE-6TN) and explore their working mechanisms,and to provide experimental evidence for the potential drug-based treatment of radiationinduced pulmonary fibrosis.Methods RLE-6TN cells were cultured in vitro and divided into four groups according to the experimental purposes:control group (C),radiation group (R),5-azacytidine group (A),and radiation followed by 5-azacytidine group (R + A).The microstructural changes in cells were determined by transmission electron microscopy.Inverted phase-contrast microscopy revealed the morphological changes in cells.The mRNA expression levels of E-cadherin and α-SMA were measured by quantitative real-time polymerase chain reaction (qRT-PCR).The protein expression levels of E-cadherin,GSK3 β,and p-GSK3 β (Ser9) were measured by Western blot.The one-way analysis of variance was used for pairwise comparison.Results The cells in group R became spindle-like.Similar morphological changes were not observed in cells in group R + A.Osmiophilic lamellar bodies disappeared at last in cells in group R.RT-PCR results showed that compared with group C,group R had a significantly lower mRNA expression level of E-cadherin ((0.23 ± 0.06) vs.(1.00 ± 0.00),P =0.002)) and a significantly higher mRNA expression level of α-SMA ((2.91 ± 0.01) vs.(1.00 ± 0.00),P =0.000)).However,compared with group R,group R + A had a significantly higher mRNA expression level of E-cadherin ((0.47 ± 0.05) vs.(1.00 ± 0.00),P =0.024)) but a significantly lower mRNA expression level of α-SMA ((2.50 ± 0.02) vs.(1.00 ±0.00),P =0.037)).The results of Western blot showed that the protein expression level of Ecadherin was significantly reduced ((0.07 ± 0.01) vs.(0.48 ± 0.02),P =0.028)),while the protein expression level of p-GSK3β was significantly increased in Group R than in Group C ((0.85 ± 0.04) vs.(0.23 ± 0.03),P =0.031)).However,compared with group R,group R + A had a significantly lower protein expression level of E-cadherin ((0.25 ± 0.00) vs.(0.07 ± 0.01),P =0.024)) and significantly less up-regulation of the protein expression level of p-GSK3β ((0.39 ± 0.03) vs.(0.85 ± 0.04),P =0.014)).Conclusions X-ray radiation can induce the epithelial-mesenchymal transition in epithelial cells.5-azacytidine suppresses radiation-induced epithelial-mesenchymal transition by inhibition of the activity of p-GSK3β in RLE-6TN cells.

Objective To develop a new type of locating rod with easy installation and high reliability for radiotherapy.Methods The locating rod was composed of a joining beam,two clamping buckles and buckle holders.The joining beam had the length being 530+03 mm.One of the buckles was put at one end of the beam,and the other slided along a stool.An eccentric wheel drove the sliding buckle to determine the space between two buckles,and a returning spring was involved in to enhance the compliance of the sliding buckle.Results The rod gained easy installation and operation,and was compatible with the bed board with the width of 5300 mm.There was no sideslip occurred after locking the rod,and the sideslip shift was not more than 1 mm in case of 20 kgf (1 kgf=9.8 N) lateral traction.Conclnsion The rod has high performances and meets clinical requirements.

Objective To explore the effect of 1a,25(OH)2 D3 on circadian clock gene expressions in cardiac myocytes.Methods Cultured cardiac myocytes isolated from 7 -day -old Sprague -Dawley(SD)rats were identified by immunofluorescence.The medium including 1a,25 (OH)2 D3 (final concentrations were 0 nmol/L,1 nmol/L, 10 nmol/L,50 nmol/L and 100 nmol/L)were added to primary myocardial cells to culture for 2 h and then total RNA was extracted.Real -time polymerase chain reaction (RT -PCR)was applied to analyze myocardial cells circadian clock gene (Bmal1,Per2,Rev -erba)transcript levels to determine optimum concentration of 1a,25(OH)2 D3 .Then, the primary myocardial cells cultured for 72 h were divided into 3 groups:the control group was of serum -free culture medium;serum shock group was of DMEMcontaining 50%volume fraction of horse serum cultured 2 h;1a,25(OH)2 D3 treatment group receiving 1a,25 (OH)2 D3 at optimal concentration cultured 2 h.The cells were collected at 7 time points (0 h,4 h,8 h,12 h,16 h,20 h,24 h)and then total RNA was extracted.RT -PCR was applied to analyze circa-dian clock gene (Bmal1,Per2,Rev -erba)transcript levels in the myocardial cells.Results In the presence of 50 nmol/L 1 a,25(OH)2 D3 ,the Bmal1 mRNA expression showed the highest level,but the Per2 and Rev -erba mRNA expression levels were minimum.Compared with the control group,both 1a,25 (OH)2 D3 treatment group and serum shock group caused day -cycle rhythmic oscillation in circadian clock genes(Bmal1,Per2,Rev -erba)in the cardiac myocytes.And the expressions pattern of Bmal1 and Per2 genes were in the opposite phase.While Bmal1 gene expres-sion appeared at peak at 12 h,Per2 gene expression appeared in a trough.Expression of Rev -erba gene trend began to rise at 8 h,and the highest expression level appeared at 12 -16 h.Conclusions 1a,25(OH)2 D3 can affect Bmal1, Per2 and Rev -erba mRNA expressions of circadian clock genes in the cardiac myocytes.

Objective To construct the teaching model of medical statistics in universities of TCM through the questionnaire of knowledge,attitude and practice structure.Methods Medical statistics KAP questionnaire survey was conducted among postgraduates using proportional stratified sampling according to the grade.It describes the present situation and calculates the knowledge loss coefficient,knowledge demand index and behavioral application intensity of medical statistics.The Chi-square test was used to analyze the differences among different grades.Results 109 questionnaires were withdrawn.The recovery was 83.84％.45 cases (41.3％) were first year postgraduate,33 cases (30.3％) were 2nd year postgraduate,and 31 cases (28.4％) were 3rd year postgraduate.At the knowledge level,the knowledge loss coefficient of the second year postgraduates was 0.635,and there was no statistical difference (P=-0.651) vs the first year postgraduate (0.638).At the attitude level,Knowledge demand index had no statistical significance difference (P=0.213)between postgraduates in grade two (96.87％) and grade three (75.00％).Most medical postgraduates held positive attitudes toward medical statistics,hoping to strengthen the training of their application ability such as medical statistics in design and research thinking (29.18％),the statistical methods selection and the interpretation of the results (31.53％) and the statistical software operation (36.07％).At the practice level,the percentage of application intensity with statistical methods of third-year postgraduates (100.00％) was higher than the second-year postgraduates (37.50％),and the second-year postgraduates higher than the first-year postgraduates (20.45％).And with the growth of year,the percentage of application intensity was gradually increasing (P=O.O03).Among them,published scientific papers accounted for 16.5％,and 58.6％ paper grade concentrated in the core journals.Conclusion Application development should be enhanced by modularization teaching with practical issues.

This article compares and analyzes the content and theoretical structure of the concept of pathogenesis from the national textbooks of Basic Theory of Chinese Medicine and Diagnostics in Chinese Medicine from the first to the ninth version.The authors consider the mechanism as the main content of pathogenesis concept in contemporary Chinese medicine.During the construction of this concept,the concept of pathology has a profound influence,wh ich differs a lot from the emphasis on key in ancient pathogenesis content,mainly reflected in clinical diagnosis and treatment ideas transferring from dealing with key issues to dealing with abstract concept.This change is associated with the impact of western medicine on modern Chinese medicine,emphasizing the mechanism and so on,so that the ancient Xiang (象) concept is marginalized.

In mass casualty incidents (MCI), the number of casualties can far exceed the capacity of medical emergency units to treat and transport in a very short period of time. A rapid MCI triage according to the severity of their injuries, can not only effectively use limited medical resources, but also improve the survival rate of injured patients. With the emergence of artificial intelligence (AI) and augmented reality (AR), smart glasses have been developed and used in different scenarios, and have achieved remarkable results in the medical field. This article focuses on the role and advantages of smart glasses in the triage of MCI, while proposing the problems in the application of smart glasses. At the same time, we elaborate on the development status of smart glasses in the triage, and discuss the application trend and development direction of smart glasses in the triage of pre-hospital injuries.

Objective To evaluate conventional ultrasound combined with real-time elastography in differential diagnosis of metastatic axillary lymph nodes of breast cancer with a logistic regression model.Methods Conventional ultrasound and real-time elastography were performed in 112 breast cancer patients with 113 axillary lymph nodes.All the cases were confirmed with pathological examinations after surgery. A binary logistic regression model based on ultrasonographic features was developed.A receiver operator characteristic ( ROC) curve was constructed to assess the performance of the model.Results There were 28 nodes with no metastasis and 85 with metastasis in a total of 113 axillary lymph nodes.Three ultrasonographic features including the elastic strain ratio(SR), elastic score and shape were finally selected into the logistic regression model .The correct rate of the logistic regression model for predicting axillary lymph node metastasis was 93.8%, and the area under ROC curve was 0.962.Conclusion The binary classification logistic regression model has a good diagnostic efficacy in the diagnosis of benign and malignant axillary lymph nodes,while real-time elastography can improve the accuracy of conventional ultrasound in the diagnosis of axillary lymph nodes.

Objective To compare the influence of hemodialysis (HD) and peritoneal dialysis (PD) on early outcome of patients underwent kidney transplantation from donation after cardiac death (DCD).Methods Patients admitted in the First People's Hospital of Foshan with DCD kidney transplant from January 1st,2011 to June 30th,2016 were analyzed retrospectively.Recipients were grouped into HD group (n=61) and PD group (n=28) according to their pre-transplant dialysis modality.Their short-term outcomes after DCD kidney transplant were compared,including recovery of renal function,short-term complications and laboratory data.Results Patients had longer dialysis duration and lower hemoglobin,serum albumin and phosphorus in PD group than those in HD group (all P ＜ 0.05),but no significant difference shown in age,gender,body mass index,primary disease,blood pressure,and hepatitis B infection (all P ＞ 0.05).HD patients with 6.00(4.00,11.00) d recovery time of renal function,18.00(17.00,21.50) d hospital time,had 24.59％ the delayed graft function (DGF),3.28％ acute rejection and 16.39％ infection during hospitalization.While for PD patients the recovery time of renal function was 4.00(3.75,7.00) d;hospital time was 19.00(15.00,21.75) d;the incidence rate of DGF was 14.29％;acute rejection was 3.57％;and infection during hospitalization reached 17.86％.Above indexes were not significantly different between HD and PD groups (all P ＞0.05).Repeated measure ments showed that,compared with those before transplant surgery,after 1 month,3 months and 6 months HD and PD groups had decreased creatinine and phosphorus,and increased hemoglobinserum albumin and calcium;Serum albumin and calcium were different between the two groups (P ＜ 0.001,P=0.040),whereas creatinine,hemoglobin and phosphorus did not show difference (all P ＜ 0.05).After transplantation the trends of creatinine,hemoglobin,calcium and phosphorus were not different between the two groups (P values were 0.295,0.310,0.501 and 0.063,respectively).Conclusions No significant difference of the recovery regarding renal function,anemia,nutrition status and mineral metabolites was found between pre-transplant HD and PD modality in patients who underwent DCD kidney transplantations.