{L-End}Objective To establish the construction of intelligent management system for equipment and supplies of medical rescue teams for provincial nuclear and radiation accidents, based on modern Internet+ Internet of Things. {L-End}Methods The current status and requirements of emergency equipment and supplies allocation and management of medical emergency teams for provincial nuclear and radiation accidents were analyzed. Utilizing technologies such as Internet of Things, low-power Bluetooth, and radio frequency identification, an intelligent management system for medical rescue teams, its equipment and supplies for provincial nuclear and radiation accidents was designed. {L-End}Results The intelligent management system for medical rescue teams, its equipment and supplies for nuclear and radiation accidents was able to perform the inventory warning, expiration date warning, maintenance alert, and warning for emergency personnel health status, based on dynamic management of rescue personnel, equipment and supplies. It provided an effective support for on-site commanders in making emergency decisions. {L-End}Conclusion The use of Internet+Internet of Things technology can achieve intelligent management for medical rescue teams and its equipment and supplies can effectively improve the level of personnel and equipment support for the rescue of nuclear and radiation accidents at the provincial level.

Objective:To investigate and compare the value of cross-sectional area measurement and width measurement by high frequency ultrasound in the diagnosis of congenital adrenal hyperplasia (CAH) in infants.Methods:The abdominal ultrasound images of 20 infants who were diagnosed as CAH in Tianjin Children′s Hospital and clinical diagnosised from November 2013 to August 2018 were analyzed retrospectively. The maximum cross-sectional area of adrenal gland and the maximum width of single limb were measured respectively to assess the size of adrenal gland. Fifty normal full-term infants were selected as control group at the same period. The differences of maximum cross-sectional area of adrenal gland, the maximum width of single limb between CAH group and control group were compared. ROC curve was plotted to compare the diagnostic values of cross-sectional area measurement and width measurement.Results:①There was significant difference in maximum cross-sectional area of adrenal gland between infants with CAH and normal infants[(129.47±37.39)mm 2 vs (54.42±20.85)mm 2; t=10.004, P<0.001]. There was significant difference in maximum width of adrenal gland between infants with CAH and normal infants [(4.56±1.20)mm vs (3.25±0.66)mm; t=5.445, P<0.001]. ②The area under ROC curve(AUC) of cross-sectional area measurement was 0.966, the best cutoff value was 87.5 mm 2, the sensitivity was 95.0%, and the specificity was 92.5%. AUC of width measurement was 0.817, the best cutoff value was 5.25 mm, the sensitivity was 90.0%, and the specificity was 62.5%. The difference of AUC between cross-sectional area measurement and width measurement was 0.149, which was statistically significant ( Z=2.309, P=0.021). Conclusions:Both cross-sectional area measurement and width measurement by high frequency ultrasound have diagnostic values for CAH in infants, with the former more valuable than the latter.

A 74-year-old male patient was treated with pemetrexed on the basis of erlotinib for lung adenocarcinoma. For the first time, pemetrexed 800 mg dissolved in 0.9% sodium chloride 100 ml was given by intravenous injection. On the 3rd day after the treatment, the patient developed generalized skin rash, and then ulceration of oral mucosa and skin ulceration of perianal and scrotal area gradually appeared. The patient was diagnosed with exfoliative dermatitis. On the 6th day after the treatment, the patient developed diarrhea, which was gradually aggravated with the increased frequency from 3 to 4 times to 10 to 12 times daily. On the 9th day, after the treatment the patient developed myelosuppression (grade IV), with white blood cell count (WBC) 0.6×10 9/L, neutrophils count 0.1×10 9/L, red blood cell count (RBC) 2.04×10 12/L, hemoglobin (Hb) 65 g/L, and platelet count (PLT) 77×10 9/L. Despite the active treatments with anti-allergy, antidiarrheal, and blood cell regeneration stimulating drugs, the patient′s myelosuppression was aggravated. On the 15th day after the treatment, laboratory tests showed WBC 0.1×10 9/L, neutrophil count 0, RBC 2.53×10 12/L, Hb 80 g/L, and PLT 1×10 9/L. The patient′s treatment was given up at the request of his family members and the patient died on the 18th day after the treatment.

A 74-year-old male patient was treated with pemetrexed on the basis of erlotinib for lung adenocarcinoma. For the first time, pemetrexed 800 mg dissolved in 0.9% sodium chloride 100 ml was given by intravenous injection. On the 3rd day after the treatment, the patient developed generalized skin rash, and then ulceration of oral mucosa and skin ulceration of perianal and scrotal area gradually appeared. The patient was diagnosed with exfoliative dermatitis. On the 6th day after the treatment, the patient developed diarrhea, which was gradually aggravated with the increased frequency from 3 to 4 times to 10 to 12 times daily. On the 9th day, after the treatment the patient developed myelosuppression (grade IV), with white blood cell count (WBC) 0.6×10 9/L, neutrophils count 0.1×10 9/L, red blood cell count (RBC) 2.04×10 12/L, hemoglobin (Hb) 65 g/L, and platelet count (PLT) 77×10 9/L. Despite the active treatments with anti-allergy, antidiarrheal, and blood cell regeneration stimulating drugs, the patient′s myelosuppression was aggravated. On the 15th day after the treatment, laboratory tests showed WBC 0.1×10 9/L, neutrophil count 0, RBC 2.53×10 12/L, Hb 80 g/L, and PLT 1×10 9/L. The patient′s treatment was given up at the request of his family members and the patient died on the 18th day after the treatment.

Objective: To investigate the association of iron with stress hormones and insulin resistance in patients with gestational diabetes mellitus (GDM). Methods: Seventy-five pregnant women diagnosed as GDM during 24-28 weeks were collected from January to November 2015 in Yantai Yuhuangding Hospital, and 75 normal pregnant women were used as control group. Blood glucose, insulin, stress hormones and iron metabolism related indexes were detected. Homeostasis model assessment for insulin resistance (HOMA-IR) was used to evaluate insulin resistance, and the correlation of iron metabolism with stress hormones and insulin resistance was analyzed. Results: Compared with control group, norepinephrine (NE) and epinephrine (E) levels were higher in GDM group (both P<0.05), but there was no significant difference in cortisol level between two groups (P>0.05). Serum ferritin (SF), serum iron, and transferrin saturation levels were higher in GDM group than those in control group(all P<0.01). Multivariate logistic analysis showed that cortisol, E, and NE levels were positively correlated with SF level in GDM group (all P<0.05). Cortisol and E levels were positively correlated with transferrin saturation (both P<0.05). SF and transferrin saturation were positively correlated with HOMA-IR in two groups (P<0.05 or P<0.01). Conclusion Iron overload may involve in dysfunction of stress adaptation and insulin resistance in patients with GDM. (Chin J Endocrinol Metab, 2018, 34: 563-566)

OBJECTIVE: To analyze the characteristics of newly diagnosed pneumoconiosis in gem processing industries in Guangdong Province from 2006 to 2016.METHODS: Data from Direct Reporting System for Occupational Disease Network in the gem processing industries in Guangdong Province from 2006 to 2016 were collected and analyzed according to pneumoconiosis disease category, regions, industry and enterprise characteristics.RESULTS: There were 202 new diagnosed pneumoconiosis cases in gem processing industry in Guangdong Province from 2006 to 2016,which showed a general decline trend after peaking in 2008.Among 202 cases,192 cases( 95.0%) were silicosis,9 cases( 4.5%) were other pneumoconiosis,1 case( 0.5%) was welder pneumoconiosis; 143 cases( 70.8%) were stage Ⅰ pneumoconiosis,44 cases( 21.8%) were stage Ⅱ pneumoconiosis,15 cases( 7.4%) were stage Ⅲ pneumoconiosis; 196 cases( 97.0%)were male and 6 cases( 3.0%) were female.The mean age for diagnosis was( 36.3 ± 0.4) years,and the median dust exposure duration was 9.6 years.There was 86.1% of cases centered at the Pearl River Delta region and 94.6% of cases working in jewelry and related goods manufacture industry,which were more commonly from Hong Kong,Macao,Taiwan and private own economy enterprises( 94.1%),as well as large and small enterprises( 72.2%).There was 38.2%( 21/55) of the enterprises reporting 2 or more cases,of which 3 enterprises had more than 10 new cases.The job titles of these cases were mainly drilling,cutting,sculpturing and stone cutting.CONCLUSION: The prevalence of pneumoconiosis in gem processing industries in Guangdong showed a decreasing tendency, but there is a potential risk of group onset of pneumoconiosis.The prevention and control procedures for dust hazard should be strengthened in gem processing industries.

Objective: To study the effects of metastasis associated 1 (MTA1) on biological characteristics such as migration, invasion and proliferation of gastric cancer (GC) cells. Methods: pSilencer3.1-MTA1-siRNA vector was used to establish human gastric cancer BGC-823 cell lines with constitutive MTA1-knockdown. Boyden, wound healing, clony forming assay and 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) assay were performed to identify the effects of MTA1-deficiency on the biological behaviors of BGC-823 cells in vitro. Simultaneously, MTA1 overexpressed BGC-823 cell line was established by pcDNA3-MTA1 plasmid transfection for reverse verification. In addition, the role of MTA1 in the tumorigenicity of gastric cancer BGC823 cells in vivo was examined by subcutaneous injection of BGC-823 cells expressing different MTA1 levels into nude mice. Reverse transcription-polymerase chain reaction (RT-PCR) and western blot were used to detect the expression levels of integrin β1, cyclin D1 and uPAR in pSilencer3.1-MTA1-siRNA, pcDNA3-MTA1 transfected cells and control cells. Results: MTA1 knocked down or upregulated BGC-823 cell lines were successfully generated by transfecting pSilencer3.1-MTA1-siRNA or pcDNA3-MTA1 vector with lipofectamine 2000, respectively. The Boyden and wound healing experiments showed metastasis and invasion ability in MTA1 knocked down cells (25±2, 12±1) were significantly decreased when compared with those of control (78±2, 50±2) and MTA1-overexpressed groups (218±2, 269±3; P<0.05). The results of MTT assay and colony forming assay were significantly decreased when compared with those of showed that MTA1 overexpressed cells grew more rapidly and formed more colonies in vitro and induced worse malignant tumors in vivo, while MTA1 knocked down cells presented the reversed phenotype[control group (1 482.41±511.90) mm^3, (1.39±0.29)g; MTA1 overexpressed group [(3 158.73±1 823.22) mm^3, (2.23±0.51)g; MTA1-downregulated group (711.32±284.30)mm^3, (0.87±0.21) g ; P<0.05)]. In addition, RT-PCR result showed that the expression level of MTA1 was positively correlated with the known metastasis-related genes (integrinβ1, cyclinD1, uPAR). Conclusions MTA1 promotes the invasion, migration and proliferation of human gastric cancer BGC-823 cells. On the contrary, down-regulation of MTA1 significantly inhibits tumorigenicity of BGC-823 cells and induces favorable phenotypes. MTA1 may promote the malignant phenotype of BGC-23 cells via regulating the expressions of integrinβ1, cyclinD1 and uPAR.

Objective To investigate the radiobiological effects of VPA-BSANPs on C6 and U87 glioma cells in vitro.Methods C6 and U87 glioma cells were treated with different concentrations of VPA and VPA-BSANPs for 12 h and 24 h,and MTT assay was used to determine cell viability.C6 and U87 cells were treated with different concentrations of VPA and VPA-BSANPs conbined with X-ray irradiation (0,2,4,6,and 8 Gy),and colony formation assay was used to determine plating efficiency (PE).C6 and U87 glioma cells were treated with different concentrations of VPA and VPA-BSANPs for 12 h,followed by X-ray irradiation (0,4,and 8 Gy),and flow cytometry using Annexin V-FITC/PI staining was used to examine cell apoptosis.Western blot was used to evaluate the effects of VPA and VPA-BSANPs on radiation-induced apoptosis protein expression.One-way ANOVA was used for comparison of means with homogeneity of variance between multiple groups,and the t-test was used for comparison of means between two groups.Results Without irradiation,VPA and VPA-BSANPs had no significant inhibitory effects on the proliferation of C6 and U87 cells (P=0.328,0.920).The PE of cells treated with VPA-BSANPs combined with irradiation was significantly lower than that of cells treated with VPA combined with irradiation (P=0.000).In C6 and U87 cells,VPA-BSANPs combined with irradiation increased the expression of p53 and Bax (P =0.000,0.000 and P =0.010,0.002),but reduced the expression of Bcl-2 (P =0.008,0.000).Active caspase-3 fragments were only found in the cells treated with VPA-BSANPs combined with irradiation and VPA combined with irradiation,but were less in the former cells than in the latter cells (P=0.004).The active fragments of peroxisome proliferator-activated receptor were only found in the cells treated with VPA-BSANPs combined with irradiation.Conclusions VPA-BSANPs can increase the radiosensitivity of C6 and U87 glioma cells in vitro,possibly by promoting the apoptosis of tumor cells induced by radiation.

Objective To understand the current situation of knowledge and attitude on depression in nurses in psychiatric and general hospitals of partial regions nationwide so as to provide targeted training on relevant knowledge for nurses.Methods A totals of 5497 nurses (2902 in psychiatric hospitals, 2595 in general hospitals) from 8 provinces were investigated with the adapted questionnaire of knowledge and attitude on depression.Results The scores of knowledge and attitude of nurses in psychiatric hospitals were (13.55±3.58) and (95.34±12.69), which were higher than those [(10.81±2.97), (89.02±15.31)] of nurses in general hospitals with significant differences (t=30.636, 16.824;P<0.01). The single factor analysis showed that there were statistically significant differences in the score of knowledge on depression of nurses between different departments, ages, marriages, educational background and working years (t=30.952, 23.217, 23.266, 40.065, 23.266, 40.065;P<0.05). Besides, there were statistically significant differences in the score of attitude on depression of nurses between different departments, ages, marriages, positional titles, educational background and working life (t=16.656,19.127,17.228,17.894,10.713,17.894;P<0.05). The regression analysis revealed that the influencial factors on knowledge were the property of department, educational background, positional titles and working years; the influencing factors for attitude were the property of department, educational background.Conclusions Clinical nurses are with low awareness of knowledge on depression along with negative attitudes with patients. Managers should draw up a training plan based on the property of department, educational background, positional titles, working years and so on for the nurses to strengthen the training on knowledge of disease and humanities, thus improving their service ability for patients with depression.

Objective To investigate the postoperative complication and nursing experience of hand-assisted laparoscopic J-type ileal pouch-anal anastomosis (IPAA) in familial adenomatous polyposis (FAP). Methods A total of 36 patients with FAP who had undergone hand-assisted laparoscopic J-type ileal pouch- anal anastomosis (IPAA) were analyzed retrospectively. Results The postoperative complication included ileal pouch bleeding in 2 cases, urinary retention in 3 female patients, external hemorrhoids swelling in 3 cases, and anastomotic fistula in 2 cases. Six cases had ileum pouch inflammation during the postoperative follow- up. All the complications were relieved after conservative medical therapy. Conclusions IPAA operation puts forward high technical requirements with more postoperative complications. Therefore, it is important to strengthen nursing of the patients, reduce postoperative complication and increase quality of life of FAP.