Objective:To evaluate the effectiveness of a family physician-integrated "Pulmonary Health Home" (PHH) grid management model for community-based prevention and management of chronic obstructive pulmonary disease (COPD).Methods:A randomized controlled trial (RCT) was conducted in Machong Town of Dongguan City from October 1st 2021 to September 30th 2024. The PHH platform was established, screening high-risk populations using the COPD Screening Questionnaire (COPD-SQ). Individuals scoring ≥16 underwent confirmatory pulmonary function tests (post-bronchodilator FEV?/FVC<0.7). A total of 120 clinically stable COPD patients were randomized to either the intervention group (PHH platform management) or control group (routine care). Outcomes including smoking behavior, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea scale scores, frequency of acute exacerbations, and other indicators were assessed before the preintervention and after one year of management.Results:Among 4 572 screened individuals, 345 COPD cases were confirmed (detection rate: 7.55%), representing a 259% increase from the pre-intervention baseline (96 cases). After one year, compared to controls, the intervention group showed: significantly lower annual cigarette consumption (165.8±61.3 vs. 321.3±70.2, t=12.856),greater reduction in CAT scores (16.06±5.92 vs. 19.25±5.24, t=3.182), fewer acute exacerbations (0.71±0.32 vs. 2.46±0.48 times/year, t=24.503), higher patient satisfaction (87.9%(51/58) vs. 62.5%(35/56), χ2=10.203), better mastery of inhalation technique (82.4% (48/58) vs. 48.2%(27/56), χ2=13.843), increased clinician-patient interactions (13.5±3.2 vs. 4.2±1.5 times/year, t=19.876) (all P<0.05). Conclusion:The family physician-integrated PHH grid management model significantly enhances community-based COPD outcomes.

Objective:To evaluate the effectiveness of a family physician-integrated "Pulmonary Health Home" (PHH) grid management model for community-based prevention and management of chronic obstructive pulmonary disease (COPD).Methods:A randomized controlled trial (RCT) was conducted in Machong Town of Dongguan City from October 1st 2021 to September 30th 2024. The PHH platform was established, screening high-risk populations using the COPD Screening Questionnaire (COPD-SQ). Individuals scoring ≥16 underwent confirmatory pulmonary function tests (post-bronchodilator FEV?/FVC<0.7). A total of 120 clinically stable COPD patients were randomized to either the intervention group (PHH platform management) or control group (routine care). Outcomes including smoking behavior, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea scale scores, frequency of acute exacerbations, and other indicators were assessed before the preintervention and after one year of management.Results:Among 4 572 screened individuals, 345 COPD cases were confirmed (detection rate: 7.55%), representing a 259% increase from the pre-intervention baseline (96 cases). After one year, compared to controls, the intervention group showed: significantly lower annual cigarette consumption (165.8±61.3 vs. 321.3±70.2, t=12.856),greater reduction in CAT scores (16.06±5.92 vs. 19.25±5.24, t=3.182), fewer acute exacerbations (0.71±0.32 vs. 2.46±0.48 times/year, t=24.503), higher patient satisfaction (87.9%(51/58) vs. 62.5%(35/56), χ2=10.203), better mastery of inhalation technique (82.4% (48/58) vs. 48.2%(27/56), χ2=13.843), increased clinician-patient interactions (13.5±3.2 vs. 4.2±1.5 times/year, t=19.876) (all P<0.05). Conclusion:The family physician-integrated PHH grid management model significantly enhances community-based COPD outcomes.

Objective To explore the value of DWI and ADC in differential diagnosis of benign prostatic hyperplasia (BPH)and prostatic cancer(PCa).Methods The data of 43 patients with BPH or PCa proven by histopathology were retrospectively reviewed. There were 21 patients with PCa and 22 patients with BPH.All of the patients were examined by DWI at 1.5T MRI.On the DWI,signal intensities in ROI were measured at the b value of 800 s/mm2 and 1 600 s/mm2 ,respectively.On the ADC map,ADC values in ROI were measured.The differences of the ADC values and the signal intensities of DWI were compared between the benign BPH and the PCa by using independent sample tGtest.Diagnostic efficiency of the signal intensity and the ADC value for PCa were analyzed by using ROC curve.Results There were statistically significant differences of the ADC values and the signal intensities of DWI at the b value of 800 s/mm2 and 1 600 s/mm2 between the BPH and the PCa (P＜0.05).The ADC at the b value of 1 600 s/mm2 had the highest diagnostic efficiency,the DWI at the b value of 1 600 s/mm2 took a second place,and the DWI at the b value of 800 s/mm2 was worst.Conclusion DWI and ADC are helpful for the diagnosis of PCa,and ADC at b value of 600 s/mm2 has the highest diagnostic efficiency.

Objective To explore clinical features and antimicrobial resistance of lower respiratory tract infection (LRTI)with Streptococcus pneumoniae (S .pneumoniae)isolated from children in Nanjing.Methods Clinical data of children with confirmed S .pneumoniae LRTI through sputum culture at a children’s hospital in Nanjing between July 2013 and June 2014 were analyzed retrospectively,S .pneumoniae strains were performed antimicrobial susceptibility testing through K-B method and minimum inhibitory concentration (MIC)testing.Results Among 197 children with S .pneumoniae infection,72.59% were <3 years old,63.96% occurred in autumn and winter, 57.87% had elevated leukocyte count,cough and fever were the most common clinical symptoms,complications of digestive and circulatory system were also common.The resistance rates of S .pneumoniae to azithromycin, penicillin,and erythromycin were 94.92%, 92.98%, and 88.83% respectively; the sensitivity rates to vancomycin,chloramphenicol,meropenem,ceftriaxone,and ofloxacin were all > 90%,vancomycin was up to 98.98%.Conclusion The percentage of S .pneumoniae LRTI is high in children < 3 years old,most occur in autumn and winter,resistance rates to azithromycin,penicillin,and erythromycin are all high,antimicrobial agents should be selected for the treatment of infection according to antimicrobial susceptibility testing.

Objective:To explore the efficacy of combination drug therapy for chronic prostatitis .Methods:According to National Institute Health Chronic Prostatitis Syndrome Index (NIH‐CPSI) combined with the pre‐ and post‐ massage test (PPMT) and expressed prostatic secretion (EPS) routine examination ,the NIH classification and efficacy evaluation was conducted for 253 patients with chronic prostatitis .All the 253 cases were administered quinolone antibiotics for 2 to 4 weeks , and meanwhile were administered alpha blocker and prostat for 4 to 6 weeks .Results:According to NIH‐CPSI ,there were 23 (9 .1% ) cases of type Ⅱ ,109(43 .1% ) cases of type Ⅲ A and 121(47 .8% ) cases of type Ⅲ B among the 253 patients .After 6 weeks of treatment ,the patients were evaluated by CPSI and the results showed that the curative rate ,the remarkable effective rate ,the improving rate ,the ineffective rate ,the total effective rate was 18 .6% ,45 .5% ,14 .6% ,21 .3% ,and 77 .7% , respectively .The average WBC count in EPS was (5 .4 ± 1 .6)/HP after the treatment ,while it was (24 .6 ± 3 .8)/HP before the treatment .And the difference was statistically significant (P< 0 .05) .After the treatment ,23 patients with chronic bacterial prostatitis underwent bacterial culture by using PPMT ,19 of which turned negative with a turning negative rate of 82 .6% .Conclusions:NIH‐CPSI is a reliable method for efficacy evaluation .The combination of drugs ,including quinolone , alpha blockade and prostat ,shows satisfactory effect for the treatment of chronic prostatitis .

Objective To investigate the application of the Healthcare Failure Mode and Effects Analysis ( HFMEA) system to reduce occupational exposure of HIV for surgical staff.Methods Based on the method of HFMEA system utilization, the occupational exposure prevention team for surgical medical staff had been set up to analyze the failure mode and the causes of potential risks,and to calculate the Risk Priority Number ( RPN) .In this study some improvement measures had been carried out, aiming at the failure mode and priority problems.We counted and implemented circumstances of exposure before and after the HFMEA implementation, and evaluated the appraisement of surgical staffs for the implementation of HFMEA.Results Before administration of HFMEA,twenty two HIV-infected patients were admitted in our institution,of which six patients caused occupational exposure, five cases of blood-borne exposure, and one cases of mucous membrane exposure.After administration of HFMEA,thirty HIV-infected patients were admitted, of which only one patient caused occupational exposure, for blood-borne exposed type.The exposure rate before and after HFMEA administration had statistical significance (χ2 =4.36, P <0.05 ).Surgical staffs rendered a positive appraisement for HFMEA administration and 32 (100) staffs recommended it to enhance the recognition of HIV patients contact safety protection and minimize HIV occupational exposure.Conclusions Could reduce occupational exposure rate for surgical medical staff by usage of HFMEA to evaluate and reduce occupational exposure of HIV patients, safe injection, personal protective equipment and medical waste management.

PURPOSE: Synuclein-gamma (SNCG), which was initially identified as breast cancer specific gene 1, is highly expressed in advanced breast cancers, but not in normal or benign breast tissue. This study aimed to evaluate the effects of SNCG siRNA-treatment on breast cancer cells and elucidate the associated mechanisms. METHODS: Vectors containing SNCG and negative control (NC) siRNAs were transfected into MDA-MB-231 cells; mRNA levels were determined by real-time polymerase chain reaction. Cell proliferation was evaluated using the MTT assay, cell migration was assessed by the Transwell assay, apoptosis and cell cycle analyses were conducted with the flow cytometer, and Western blot analysis was performed to determine the relative levels of AKT, ERK, p-AKT, and p-ERK expression. RESULTS: SNCG mRNA levels were significantly reduced in MDA-MB-231 cells transfected with SNCG siRNA. Our results indicate that in SNCG siRNA-treated cells, cell migration and proliferation decreased significantly, apoptosis was induced, and the cell cycle was arrested. Western blot analysis indicated that the protein levels of p-AKT and p-ERK were much lower in the SNCG siRNA-treated groups, than in the control and NC groups. CONCLUSION: SNCG siRNA could decrease the migration and proliferation of breast cancer cells by downregulating the phosphorylation of AKT and ERK.
Apoptosis ; Blotting, Western ; Breast ; Breast Neoplasms ; Cell Cycle ; Cell Migration Assays ; Cell Movement* ; Cell Proliferation ; Extracellular Signal-Regulated MAP Kinases ; Phosphorylation* ; Proto-Oncogene Proteins c-akt ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; RNA, Small Interfering ; Synucleins*