Objective To evaluate the practical application of the Media Fill Test(MFT)in assessing aseptic compounding competency of personnel in Pharmacy Intravenous Admixture Services(PIVAS).Methods A multicenter controlled study was conducted across six tertiary hospitals(center ①-⑥)in China.Participants were divided into an inexperienced group(Group A,n=118)and an experienced group(Group B,n=118),each performing five MFT operations.Positive controls validated medium efficacy.Contamination rates and pass rates were analyzed using chi-square and Fisher's exact tests.Results Valid samples included 584 for Group A and 588 for Group B.The sample pass rate was 66.78%(390/584)in Group A and 91.67%(539/588)in Group B,while personnel pass rates were 46.15%(54/117)and 80.51%(95/118),respectively,with significant intergroup differences(both P<0.01).All centers except Center ⑥ showed significantly higher pass rates in Group B(all P<0.05).Conclusion MFT effectively differentiates technical proficiency levels and is suitable for training evaluation of novice PIVAS staff.

Objective To evaluate the practical application of the Media Fill Test(MFT)in assessing aseptic compounding competency of personnel in Pharmacy Intravenous Admixture Services(PIVAS).Methods A multicenter controlled study was conducted across six tertiary hospitals(center ①-⑥)in China.Participants were divided into an inexperienced group(Group A,n=118)and an experienced group(Group B,n=118),each performing five MFT operations.Positive controls validated medium efficacy.Contamination rates and pass rates were analyzed using chi-square and Fisher's exact tests.Results Valid samples included 584 for Group A and 588 for Group B.The sample pass rate was 66.78%(390/584)in Group A and 91.67%(539/588)in Group B,while personnel pass rates were 46.15%(54/117)and 80.51%(95/118),respectively,with significant intergroup differences(both P<0.01).All centers except Center ⑥ showed significantly higher pass rates in Group B(all P<0.05).Conclusion MFT effectively differentiates technical proficiency levels and is suitable for training evaluation of novice PIVAS staff.

Currently, the application rate of virtual reality technology in the fields of medical education and medical treatment is relatively low. In this study, based on the structure of the human stomach, virtual reality technology, sensing technology, big data technology, and cloud computing technology were integrated. A new form of medical education was established to include the online website platform for data storage and analysis and the offline VR glasses for the physical operation. Through the use of 3d Max technology, Unity3D technology, and C# language, we constructed a three-dimensional model of the human stomach to present the stomach in three dimensions. This enables the users to immerse in it to achieve true human-computer interactive learning. This study updates the concept of medical education, effectively improves the quality and efficiency of medical education, and facilitates the development of surgical programs and reduction in the risk of surgery, as well as provides experimental materials for scientific research. In the future, it can be further developed to include the three-dimensional structures of the circulatory system and other major systems in the human body.

Objective:To investigate the prevalence of hypertension and its associated factors in rheumatoid arthritis (RA) patients.Methods:Consecutive Chinese patients with RA were recruited from August 2015 to September 2019 at Department of Rheumatology, Sun Yat-sen Memorial Hospital. Demo-graphic data and clinical data were collected including indicators of disease activity, functional assessment and radiographic assessment, comorbidities and previous medications. Logistic regression analysis was used to evaluate the related factors of hypertension in RA patients.Results:There were 674 RA patients recruited with 82.3%(555/674) female and mean age (50±13) years. The prevalence rate of hypertension was 32.9% (222/674), followed by dyslipidemia (9.9%, n=67), type 2 diabetes (8.8%, n=59), hyperuricemia (8.5%, n=43), fatty liver disease (8.0%, n=54), cardiovascular disease (6.2%, n=42) and chronic kidney disease (3.3%, n=22). Compared with those without hypertension, RA patients with hypertension had advanced age with longstanding disease duration, higher disease activity indicators, worse joint destruction, and higher proportions of comorbidities. Multivariate logistic regression analysis showed that comorbidities including hyperuricemia [ OR=1.977, 95% CI(1.002, 3.900)], dyslipidemia [ OR=1.903, 95% CI(1.102, 3.288)] and fatty liver disease [ OR=2.335, 95% CI(1.278, 4.265)] were risk factors of hypertension after adjustment for age and gender. Conclusion:Hyperten-sion is the most common comorbidity in RA patients which is associated with comor-bidities including hyperuricemia, dyslipidemia and fatty liver disease. Detection and management of hyperten-sion and other cardiovascular disease related comorbidities in RA patients should be emphasized.

Objective To investigate the dynamic expression and significance of B cell lymphoma (Bcl) 6 in fibroblast-like synoviocytes (FLS) induced osteoclast differentiation and activation in rheumatoid arthritis (RA) patients.Methods RA-FLS were co-cultured with peripheral blood monocytes (PBMCs) from healthy volunteers in the medium containing M-CSF.Bcl6 protein and mRNA in osteoclasts and their precursors were determined by immunofluorescence and Real-time PCR at day 0,7,14 and 21,respectively.Osteoclasts were identified by tartrate-resistant acid phosphatase (TRAP) staining.Bone resorption activity of osteoclasts was determined by bone slices stained with toluidine blue.Kruskal-Wallis H and Bonferroni were used for statistical analysis.Results ① Immunofluorescence staining and TRAP staining showed that Bcl6 protein was mainly expressed in the nuclei of PBMCs.After co-cultured with RA-FLS for 7 days,some PBMCs differentiated into macrophages and a few differentiated to TRAP-positive multinucleated osteoclasts,and the total Bcl6 protein expression in osteoclasts and their precursors were increased.At day 14,the total Bcl6 protein expression was increased further.At day 21,the Bcl6 protein expression in nuclei of osteoclasts was decreased while PBMCs were differentiated into osteoclasts,and total Bcl6 protein expression was decreased.②Real-time PCR showed that Bcl6 mRNA expression in osteoclasts and their precursors at day 7 tended to increase than that at day 0 (x2=3.429,P＞0.05).At day 14 after co-cultured with RA-FLS,Bcl6 mRNA expression in osteoclasts and their precursors was significantly higher than that at day 0 (x2=5.333,P=0.045).At day 21,the expression of Bcl6 mRNA was significantly lower than that at day 14 (x2=6.023,P=0.038).Conclusion Bcl6 may be involved in osteoclast differentiation and activation,and may play a role in the inflammatory status in the process of differentiation from PBMCs to macrophages.Further studies are needed to establish the mechanisms.

Objective To investigate the development of the cervical cord in children by using diffusion tensor imaging.Methods Ninety healthy children were undergone with diffusion tensor imaging of the cervical cord by using single-shot spin-echo echo planar image sequence.The values of apparent diffusion coefficients (ADC), fractional anisotropy (FA), average length(Ltract) and volume of tracts(Vtract) were measured in the cervical regions.Results The measurements of each group were as follow:ADC value:0.9747 ±0.2777,0.8493 ±0.2236,0.8210 ±0.1432,0.9198 ± 0.1444,0.9048 ±0.1676;FA value:0.4117 ±0.0391,0.4712 ±0.0199,0.4944 ±0.0439,0.5608 ±0.0443,0.6169 ± 0.0551;Ltract:25.61 ±8.63,24.66 ±7.14,27.03 ±7.23,34.93 ±10.99,37.63 ±10.22;Vtract:3.07 ±1.49,3.00 ± 1.52,3.81 ±1.33,5.41 ±2.35,6.64 ±2.84.FA value, Ltract and Vtract showed significance in different age groups , while ADC value was found no difference ( P<0.001) .Post-Hoc test revealed that FA value was significantly different between age group I and Ⅱ.FA value, Ltractand Vtract presented significantly different between group ⅢandⅣ.FA value difference was also found between group Ⅳand V.FA value, Ltract and Vtract were all positively corelative with age (F=1.758, P=0.145 ) .Conclusion Development of the cervical cord shows periodicity with periodic features .Diffusion Tensor Imaging can be used as a tool to observe and evaluate development of the cervical cord in children .

Objective To investigate the effect of tumor necrosis factor (TNF)-α antagonists on liver function and reactivation of hepatitis B virus ( HBV ) in patients with inflammatory arthropathy with concurrent chronic HBV infection.Methods Patients with active rheumatoid arthritis (RA) and ankylosing spondylitis (AS) who were grouped according to serum HBV biomarkers were treated with TNF-α antagonist.The liver function and reactivation of HBV were monitored before and after anti-TNF-α therapy.Kruskal-Wallis one-way analysis of variance on ranks of continuous variables and x2 test or Fisher's exact test for categorical variables among 3 or more groups.Results Fifty patients were enrolled with 3 to 23 months of follow-up visit.The level of transaminases in chronic HBV infection group [n=11,AST (36±18) U/L,ALT (44±46) U/L] were significantly higher than that in past HBV exposure group [n=16,AST (22±6) U/L,ALT (17±9) U/L] or free of HBV infection group [n=23,AST (19±6) U/L,ALT (15±9) U/L](AST:x2=11.161,P＜0.01,ALT:x2=8.038,P＜0.01).One patient with elevated baseline HBV-DNA load was treated concomitantly with lamivudine and anti-TNF-α therapy,and the HBV-DNA load reduced about to normal 4 months later.Among the other 10 patients with normal baseline HBV-DNA load in chronic HBV infection group,one patient showed reactivation of HBV with elevated transaminases after anti-TNF-α therapy; another patient had only elevated transaminases without reactivation of HBV,and the transaminases returned to normal after withdrawal of antiTNF-α therapy,which suggested drug-induced liver injury.All patients in both past HBV exposure group and free of HBV infection group remained HBsAg negative after the therapy.Conclusion Patients with inflammatory arthropathy should be screened for HBV infection and check liver function before anti-TNF-α therapy,and carefully monitor the reactivation of HBV and liver function during treatment.Patients with concurrent chronic HBV infection should be treated conco-mitantly with anti-virus and anti-TNF-α therapy if they have elevated baseline HBV-DNA load (＞105 copies/ml,in particular) and good economic situation.

Objective To investigate the distributions of PAH gene mutation and provide guidance for gene diagnosis and prenatal diagnosis of patients with PKU in Xinjiang of China.Methods A total of 15 patients (aged from 2 to 10 years, all with blood Phe concentration over 700 μmol/L) who visited Urumqi general hospital of Lanzhou Command were clinically diagnosed as PKU and were included in this study. PCR followed by DNA sequencing was performed to analyze the promoters, all the 13 exons and their flanking introns of PAH gene in these 15 PKU patients.Results PAH gene of 15 PKU patients was amplified by PCR, and PCR products were subjected to DNA sequencing directly.Four PAH gene mutation types, including 5′- Flanking-626G > A, 5′-Flanking-480DelACT, S196fsX4 and IVS8+1G>C, were identified in each of four PKU patients.Consequently reverse DNA sequencing showed G>A at -626 site, ACT deletion at -480 position in the promoter of PAH gene, an insertion at 584 site in the coding region and G>C at the border between exon 8 and intron 8 of PAH gene, respectively. After inquirying from PAH website and international PAH database (www.pahdb.mcgill.ca), these four PAH gene mutation types were verified as novel PAH gene mutations. Additionally, four patients carrying either of these four PAH gene mutation aged 3-5 years old were characterized by typical clinical phenotypes including blood Phe levels between 1 572-1 782 μmol/L, mental retardation, yellow hair and mousy odor of hair, skin and urine. Conclusions 5′-Flanking-626G>A, 5′-Flanking-480DelACT, S196fsX4 and IVS8+1G > C are identified as four novel PAH gene mutations to cause PKU directly probably either by disrupting the normal 3-D structure and affecting enzymatic activity of PAH or depressing the transcription and translation of PAH gene.Together, our identification of four novel PAH gene mutations will provide important clues for future gene diagnosis and prenatal diagnosis of PKU.

OBJECTIVETo investigate the effect of betulinic acid (BA) on the proliferation, migration, apoptosis and cell cycle of pancreatic cancer cells (BxPC-3) in vitro and elucidate the underlying.

METHODThe effect of BA on the proliferation of BxPC-3 was measured by using sulforhodamine B (SRB) assay. Migratory ability of BxPC3 cells were detected by wound healing assay, and the morphological change was observed with light microscope. The influence of BA on cell cycle of BxPC-3 cells was tested by flow cytometry (FCM). Apoptosis was analyzed by using Hochest33342-PI double staining. Western blot technologies were applied to detect the expression of Bcl-2 and Bax.

RESULTBA exhibited significant cell proliferation and migration inhibition, as well as its potency of inducing apoptosis in BxPC-3 cells in vitro in a dose-dependent manner. The IC50 value for 72 h was 16.54 mg x L(-1). Cell migration was significantly inhibited at 5 mg x L(-1) of BA. Cells treated with BA showed increased cell population in G0 phase, with decreased G2/M phase population. The expression of Bax and Bcl-2 was up and down-regulated respectively in BA-treated BxPC-3 cells in a dose-dependent manner.

CONCLUSIONBA exerted potent effect on growth inhibition, G0 cell cycle arrest and induction of apoptosis in BxPC-3 cells in vitro, possibly associated with the down-regulation of Bcl-2 and up-regulation of Bax expression. The potent antitumor capacity of BA suggested that it could be a promising new anticancer agent in human pancreatic cancer treatment.

Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Pancreatic Neoplasms ; drug therapy ; genetics ; metabolism ; physiopathology ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Triterpenes ; pharmacology ; bcl-2-Associated X Protein ; genetics ; metabolism

Objective To evaluate the clinical value of multiple tumor marker protein chip in diagno-sis and detection of postoperative recurrence of breast cancer.Methods The serum levels of 12 tumor makers (CA199,NSE,CEA, CA2A2,Ferritin,β-HCG,AFP,f-PSA,PSA,CA125,CA153 and HGH)were measured in 70 preoperative breast cancer patients, 32 recurrence patients,52 non-recurrence patients and 76 normal con-trois.Results ①The breast cancer group had significantly higher positive rate than that of the controls (P<0.05).The positive rates and serum levels of CA199,CEA,CA242,Ferritin,CAI25 and CA153 in breast cancer patients had those of control significant differences compared with groups (P<0.05).②The recurrence group had significantly higher positive rate than that of non-recurrence group (P<0.05).The positive rates and se-rum levels of CA199, CEA, Ferritin, CA125 and CA153 in the recurrence patients had significant differences compared with those of non-recurrence patients(P<0.05).③The positive rate of recurrence group had signif-icant difference compared with that of breast cancer group(P<0.05).Moreover,The positive rate and serum level of Ferritin in the recurrence patients had significant difference compared with that of breast cancer pa-tients.Conclusion The multiple tumor marker protein chip detective system has valid value of clinical appli-cation in the diagnosis and detection of postoperative recurrence of breast cancer.The combination detection of CA199, CEA, Ferritin ,CA125 and CA153 may be the economical and effective in the diagnosis and detection of postoperative recurrence of breast cancer.