Lung cancer is a most common malignant tumor of the lung and is the cancer with the highest morbidity and mortality worldwide. For patients with advanced non-small cell lung cancer who have undergone epidermal growth factor receptor (EGFR) gene mutations, targeted drugs can be used for targeted therapy. There are many methods for detecting EGFR gene mutations, but each method has its own advantages and disadvantages. This study aims to predict the risk of EGFR gene mutation by exploring the association between the histological features of the whole slides pathology of non-small cell lung cancer hematoxylin-eosin (HE) staining and the patient's EGFR mutant gene. The experimental results show that the area under the curve (AUC) of the EGFR gene mutation risk prediction model proposed in this paper reached 72.4% on the test set, and the accuracy rate was 70.8%, which reveals the close relationship between histomorphological features and EGFR gene mutations in the whole slides pathological images of non-small cell lung cancer. In this paper, the molecular phenotypes were analyzed from the scale of the whole slides pathological images, and the combination of pathology and molecular omics was used to establish the EGFR gene mutation risk prediction model, revealing the correlation between the whole slides pathological images and EGFR gene mutation risk. It could provide a promising research direction for this field.

Information-based teaching was applied in the experimental teaching of nuclear protection medicine based on its own features.The teaching content was sent to students as micro-video via an information platform before class for preview;during the class,the teaching was performed in the form of lectures by students and experiments in groups;after class,students were required to submit reports of experimental improvement or innovative experimental design.A comprehensive assessment was performed for preview,classroom operation,question answering in class,and experimental reports.The results of teaching practice showed that this teaching mode can effectively stimulate the students' interests in learning,enhance their research and innovation abilities,and improve the experimental teaching effect of nuclear protection medicine.

Objective To evaluate the safety of influenza vaccine and 23-valent pneumococcal polysaccharide vaccine (PPV23) immunized alone or in combination in elderly people and to raise the awareness of vaccine safety among the elderly. Methods From October 2014 to September 2015,454 eld-erly people who were over 60 years old and immunized with influenza vaccine and PPV23 alone or in combi-nation were recruited in this study and divided into five groups. Local and systemic reactions occurred within one month after vaccination were recorded. Results (1) Incidences of adverse reactions among all subjects and people vaccinated with influenza vaccine alone,domestic PPV23 alone,imported PPV23 alone,domes-tic PPV23 combined with influenza vaccine and imported PPV23 combined with influenza vaccine were 10.13%,5.35%,11.63 %,9.52%,17.24% and 12.63%,respectively. Local reaction,injection site pain and mild reaction were the common reactions to vaccination. All reactions occurred within seven days and most of them occurred within 30 minutes to one day after vaccination(82.61%). All subjects recovered within seven days and most of them recovered within one day (84.78%). (2) Compared with the people immunized with domestic or imported PPV23 or influenza vaccine alone,those immunized in combination had higher incidences of reactions to vaccination. Among the three single vaccination groups, domestic PPV23 group had the highest incidence of reactions,followed by imported PPV23 and influenza vaccine groups,but no significant difference was found among them(P>0.05). The incidence of responses to influenza vaccine combined with domestic PPV23 was higher than that to influenza vaccine combined with imported PPV23, but no significant difference was found between them (P>0.05). (3) In each group,women,people aged≥70 years or with chronic diseases had a higher incidence of responses to vaccination than men,people aged 60 to 69 years or without chronic diseases,respectively (P>0.05). Conclusion Immunization with influ-enza vaccine and PPV23 alone or in combination is safe and tolerable in elderly people regardless of gender, age,or whether they are suffering from chronic diseases or not. Both domestic and imported PPV23 have the feature of good safety.

Objective To evaluate the effectiveness of community?based standardized blood pressure control and lifestyle management in hypertensive patients in Jinhua. Methods The study included patients with primary hypertension from community health service centers in Yongkang, Lanxi, and an urban district in Jinhua. Electronic health record data from 2015 to 2017 were collected, and relevant indicators before and after standardized management were assessed. Rates and constituent ratios were used for statistical evaluation. Numeric data were compared using the chi square test, and means were compared using the t?test. Results Of 14 943 hypertensive patients who underwent standardized management, 8 052 were women (53.88%) and 6 891 were men (46.12%). The average age of these patients in early 2015 was 66.63 years. After 3 years of standardized management, the rate of blood pressure control increased from 42.85% to 49.50%. The difference was statistically significant (χ2=133.019, P<0.05). The mean systolic and diastolic blood pressure values (138.67 mmHg and 84.46 mmHg, respectively) (1 mmHg=0.133 kPa) after standardized management were significantly different from those (139.40 mmHg and 85.08 mmHg, respectively) before standardized management (t=7.667, P<0.05; t=6.583, P<0.05, respectively). The average body weight, number of cigarettes smoked daily, and regular exercise time (61.51 kg, 15.28 cigarettes, and 40.56 min, respectively) after standardized management were significantly different from those (61.62 kg, 15.49 cigarettes, and 40.31 min, respectively) before standardized management (t=5.015, P<0.05; t=1.848, P<0.05; t=2.455, P<0.05, respectively). The medication compliance and willingness of being managed had significantly increased. The difference was statistically significant (χ2=72.600, P<0.05; χ2=299.434, P<0.05, respectively). Conclusions Standardized community-based management of hypertension effectively improved the rate of blood pressure control and the overall health of residents.

Objective To lay foundation for the establishment of national standards of electroacupuncture devices by exploring the problems existing in their clinical application.Methods An analysis was made of the models, stimulus waveforms and complex waveform characteristics, stimulus frequencies, current intensities and pulse widths of electroacupuncture devices reported in clinical literature. The actual output frequencies of three kinds of electroacupuncture devices were measured using RM6240C multi-channel physiological signal acquisition and processing system to observe the accuracy of their actual output parameters and summarize the problems existing in electroacupuncture devices. Results The reports on electroacupuncture device parameters showed that of the five indicators analyzed statistically, the frequency of described waveforms was the highest (96.2%); the frequencies of described models (88.8%), stimulus frequencies (61.7) and current intensities (11.2%) were next; the frequency of described pulse widths was the lowest (1.8%). The electroacupuncture device most commonly used clinically was G6805 series, but the subtypes were confused because of many manufacturers. The waveform was described more frequently but complex waveform characteristics were less. The difference of frequencies of clinical application of electroacupuncture was larger. They were from 0.8-400 Hz but described less accurately. The output frequency was indicated by the range in most of the literature. The output adjusters of the three kinds of electroacupuncture devices did not correspond to their actual output frequencies. There was a larger difference between the actual range of output frequencies and the adjustable frequency range indicated in the instruction.Conclusions Electroacupuncture devices have the problems of lacking a display unit of actual output parameter values, the adjusting parameters of the knob adjustable controller being not precise enough and the actual values of output frequencies not reaching the rated range in the instruction.

BACKGROUNDAdvances in transplantation immunology show that the balance between dendritic cells (DCs) and their subsets can maintain stable immune status in the induction of tolerance after transplantation. The aim of this study was to investigate if DCs and DC subpopulations in recipient peripheral blood are effective diagnostic indicators of acute rejection following kidney transplantation.

METHODSImmunofluorescent flow cytometry was used to classify white blood cells (WBCs), the levels of mononuclear cells and DCs (including the dominant subpopulations, plasmacytoid DC (pDC) and myeloid DC (mDC)) in peripheral blood at 0, 1, 7, and 28 days and 1 year after kidney transplantation in 33 patients. In addition, the blood levels of interleukin-10 (IL-10) and IL-12 were monitored before and after surgery. Fifteen healthy volunteers served as normal controls. Patients were undertaking hemodialysis owing to uremia before surgery.

RESULTSThe total number of DCs, pDC, and mDC in peripheral blood and the pDC/mDC ratio were significantly lower in patients than controls (P < 0.05). Peripheral DCs suddenly decreased at the end of day 1, then gradually increased through day 28 but remained below normal levels. After 1 year, levels were higher than before surgery but lower than normal. The mDC levels were higher in patients with acute rejection before and 1 day after surgery (P < 0.005). There was no significant difference in IL-10 and IL-12 levels between patients with and without acute rejection.

CONCLUSIONThe changes in DCs and DC subpopulations during the acute rejection period may serve as effective markers and referral indices for monitoring the immune state, and predicting rejection and reasonably adjusting immunosuppressants.

Adolescent ; Adult ; Dendritic Cells ; immunology ; Graft Rejection ; immunology ; Humans ; Kidney Transplantation ; adverse effects ; Middle Aged ; Myeloid Cells ; immunology ; Young Adult

Objective To analyze the dynamic changes of dendritic ceils (DCs) and their subsets plasmacytoid DC (pDC) and myeliod DC (mDC) in peripheral blood of renal transplantation patients,and to confer the relationship between DCs subsets and graft rejection.Methods White blood cells (WBC) and mononuclear cells (PBMNCs) in peripheral blood of 28 renal transplantation recipients (test group) were measured before operation and at 1st,7th,28th day after operation.The number of DCs and subsets,and pDC/mDC were detected by using flow cytometry,and IL-10 and IL-12 levels were determined by using ELISA before and after operation.Ten volunteers (control group) served as controls.Results The levels of DCs,pDC and mDC before operation in test group were lower than in control group (P＜0.05),but there was no statistically significant difference in pDC/mDC ratio between two groups (P＞0.05).The number of DCs in test group was significantly decreased on the first day after operation up to the lowest level,then slowly increased,and recovered 73.7 ％ at 28th day after operation.The number of mDC and pDC was also decreased after operation,but mDC recovered faster than pDC (P＜0.05).On the day 7th after operation,the number of mDC in the recipients with graft rejection was higher than in those without graft rejection in test group (P＜0.01 ).There was no significant difference before and after operation in the levels of IL-10 and IL-12 in test group.Conclusion The number of DCs and subsets are related to the recipients' immune state,and their abnormality displays unstable immune state of recipients.The number of DCs and subsets can be used as an assistance index to diagnose graft rejection.

Objective To measure the financial burden incurred by hypertension to urban patients in Beijing, Nanjing and Hangzhou cities. Methods Two communities were sampled from the three cities randomly, and 300 hypertension patients were sampled randomly from hypertension control files in each community for questionnaire survey. Results Health expenditure of the families with hypertension patients accounts for 14. 4% of the family's income, and 18. 2% of the family's expenditure, a ratio far beyond the national average (10.6 %). However, the majority of them report the burden as affordable.The basic medical insurance for urban residents helps alleviate the financial burden of hypertension patients and the extent of such burden has a close bearing on the outcome of hypertension treatment and prevention. Conclusion Effective community-based blood-pressure monitoring and control system is key to reducing the financial burden of hypertension. The reimbursement policy for hypertensive patients within the basic medical insurance is expected to be further improved.

The present paper introduces the definition of prehypertension,summarizes the advances in prehypertensive epidemiology and focus of debate and suggests the outlook of prehypertension.

OBJECTIVETo study injury of liver and kidney among the workers exposed to terephthalic acid(TPA), ethylene glycol(EG) and(or) dowtherm A(DOW), and research for early biological monitoring indexes.

METHODSBy using the method of occupational epidemiology, an investigation of industrial hygiene in a chemical fibre corporation was carried out and the changes of the liver and kidney functions were analyzed among the workers who had been exposed to TPA, EG, DOW.

RESULTSThe values of serum gamma-glutamyl traspetidase(GGT) and total bile acid(TBA) in TPA + EG + DOW group men were (35.45 +/- 16.09) U/L, (10.29 +/- 6.76) mumol/L respectively and the values of serum alanine transaminase(ALT) and TBA in TPA + EG + DOW group women were(30.68 +/- 8.58) U/L, (9.53 +/- 6.63) mumol/L respectively, significantly higher than those in TPA, DOW and control groups(P < 0.05, P < 0.01). Compared with TPA, DOW and control groups, the values of urine N-acetyl-beta-D-glucosaminidase(NAG) and beta 2-2-microglobulim (beta 2-MG) in TPA + EG + DOW group of both men and women increased significantly(P < 0.05, P < 0.01), with(5.68 +/- 4.01) U/mmol Cr and (23.49 +/- 13.44) mg/mol Cr, and(6.68 +/- 4.68) U/mmol Cr and (22.80 +/- 13.00) mg/mol Cr, respectively. Analysis of regression indicated that both liver and renal injuries of the workers were evidently correlated with their exposure to TPA, EG and DOW after adjustment for the confounding factors such as sex, smoking, drinking, etc(P < 0.001).

CONCLUSIONBased on available knowledge, it is reasonable to assume that the joint actions should be considered on the injury of liver and kidney caused by TPA, EG and(or) DOW among the workers. Serum ALT, GGT, TBA, urine NAG and beta 2-MG should be suggested as biomarkers for liver and kidney damage.

Acetylglucosaminidase ; urine ; Alanine Transaminase ; blood ; Bile Acids and Salts ; blood ; Ethylene Glycol ; toxicity ; Female ; Humans ; Kidney ; drug effects ; Liver ; drug effects ; Male ; Occupational Exposure ; adverse effects ; Phenyl Ethers ; toxicity ; Phthalic Acids ; toxicity ; gamma-Glutamyltransferase ; blood