Objective:To develop an online interactive cytopathological training program, and to evaluate it for improving the cytopathological diagnostic ability of endoscopists in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreas.Methods:A total of 5 500 cytopathological images were collected from 194 patients with pancreatic solid mass who underwent EUS-FNA in Nanjing Drum Tower Hospital from August 2018 to August 2019. The cell type in each cytopathological picture was labeled by senior cellular pathologists, which was used to build a learning and testing platform for online interactive cytopathological training. Five endoscopists without cytopathological background were invited to participate in this training. Sensitivity, specificity, positive predictive value and negative predictive value of endoscopists in differential diagnosis of cancer and non-cancer before and after training were compared to evaluate the effect of the online interactive cytopathological training program on improving the ability of endoscopists in diagnosis of cytopathology.Results:A cytopathological training platform for endoscopists to learn and take online test was successfully built. Before training, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis of cancer and non-cancer for endoscopists were 0.55 (95% CI: 0.53-0.58), 0.32 (95% CI: 0.30-0.35), 0.43 (95% CI: 0.41-0.45), 0.44 (95% CI: 0.41-0.47) and 0.43 (95% CI: 0.42-0.45), respectively. After training, the above indicators were 0.96 (95% CI: 0.95-0.97), 0.70 (95% CI: 0.68-0.73), 0.74 (95% CI: 0.72-0.76), 0.95 (95% CI: 0.94-0.96) and 0.81 (95% CI: 0.80-0.83), respectively, which were significantly improved compared with those before ( P<0.001). Conclusion:The online interactive cytopathological training program can improve the understanding and diagnostic ability of endoscopists in pancreatic cytopathology, help to implement rapid on-site evaluation in the process of EUS-FNA, and improve the diagnostic efficiency of EUS-FNA.

Environmental monitoring technologies competition can effectively improve the comprehensive quality and technical skills of technical personnel by means of professional theory exams and on-site practical assessment. In view of the undertaking work of the Second National Competition of Professional and Technical Personnel in Ecology and Environment Monitoring (special competition for radiation monitoring), this paper summarized the experience and gains in the aspects of preliminary preparation, field implementation, achievement generation, etc., analyzed the problems in national radiation environmental monitoring through the achievements of the special competition for radiation monitoring, and put forward recommendations for the next step, in order to provide reference for undertaking similar major events in the future and provide ideas and directions for national radiation environmental monitoring.

  Objective  To discuss the significance of genetic diagnosis of children with syndromic hearing loss by using whole-exome sequencing.  Methods  The clinical data of 34 children with sensorineural hearing loss were collected and the whole exons of genome of the children and their parents were sequenced and analyzed.  Results  Genetic causative gene and mutations have been identified in 19 children, including 4 genes (HARS2, USH2A, GATA3, MITF) related to rare syndromic hearing loss. Fifteen children were diagnosed with non-syndromic hearing loss related gene, including 8 cases with GJB2 mutation, 5 cases with SLC26A4 mutation and 2 cases with MYO15A mutation. Mutations of c.435_437del(p.K147del) and c.1403G > C (p.G468A) in gene HARS2, c.11389+1del in gene USH2A, c.1327delA(p.M443Wfs*33) in gene GATA3, c.627C > A(p.C209X) in gene MITF and c.8033_8057delinsG(p.N2678_D2686delinsS) in gene MYO15A were first reported.  Conclusions  Whole-exome sequencing helps the accurate diagnosis of causes of hearing loss, especially for the rare syndromic hearing loss with atypical clinical manifestations. Information from genetic testing may highlight further recommended exams of structure and functions of related organs.

Genome-wide physical protein-protein interaction(PPI)mapping remains a major chal-lenge for current technologies.Here,we reported a high-efficiency BiFC-seq method,yeast-enhanced green fluorescent protein-based bimolecular fluorescence complementation(yEGFP-BiFC)coupled with next-generation DNA sequencing,for interactome mapping.We first applied yEGFP-BiFC method to systematically investigate an intraviral network of the Ebola virus.Two-thirds(9/14)of known interactions of EBOV were recaptured,and five novel interactions were discovered.Next,we used the BiFC-seq method to map the interactome of the tumor protein p53.We identified 97 interactors of p53,more than three-quarters of which were novel.Furthermore,in a more complex background,we screened potential interactors by pooling two BiFC libraries together and revealed a network of 229 interactions among 205 proteins.These results show that BiFC-seq is a highly sensitive,rapid,and economical method for genome-wide interactome map-ping.

Objective:To investigate the clinical effect of recombinant human growth hormone (rhGH) in the treatment of children with growth hormone deficiency and its effect on thyroid function.Methods:From June 2016 to June 2018, 81 children with growth hormone deficiency in Da Jiangdong Hospital of Hangzhou were selected.The rhGH was given 1 time before bedtime, and the treatment course was 6 months.The growth and development, bone metabolism and thyroid function were compared before treatment, 3 months and 6 months after treatment.Results:The height and growth rate at 3 months after treatment [(131.76±2.28)cm, (10.40±0.87)cm/year] and at 6 months after treatment [(134.83)cm, (11.74±0.72)cm/year] were higher than those before treatment [(127.32±3.49)cm, (4.32±1.08)cm/year] ( F=7.973, P=0.000, F=12.314, P=0.000), which at 6 months after treatment were higher than those 3 months after treatment (height: t=9.586, 16.405, growth rate: t=39.457, 51.448, P=0.000). There was no statistically significant difference in BMI among before treatment [(17.21±4.28)kg/m 2], 3 months after treatment [(17.86±5.14)kg/m 2] and 6 months after treatment [(18.01±4.35)kg/m 2] ( F=0.762, P=0.391). The serum levels of BGP and ALP at 3 months after treatment [(7.19±0.38)ng/mL, (129.34±8.97)U/L] and at 6 months after treatment [(7.94±0.63)ng/mL, (154.67±10.42)U/L] were higher than those before treatment [(6.38±0.57)ng/mL, (108.49±6.51)U/L] ( F=8.971, P=0.000, F=15.427, P=0.000), and the levels of BGP and ALP at 6 months after treatment were higher than those 3 months after treatment ( t=9.175, P=0.000, t=16.581, P=0.000). There were no statistically significant differences in serum FT3, TSH and FT4 levels before treatment, 3 months after treatment and 6 months after treatment ( F=0.893, P=0.287, F=0.472, P=0.517, F=1.084, P=0213). Conclusion:rhGH has significant clinical effects on children with growth hormone deficiency, and has no significant effect on thyroid function, which is worthy of clinical reference.

Objective To evaluate the role of c-Jun N-terminal kinase (JNK) in activation of astrocytes in midbrain periaqueductal gray (PAG) of rats with neuropathic pain.Methods A total of 72 pathogen-free male Sprague-Dawley rats,aged 9 weeks,weighing 160-200 g,were divided into 4 groups using a random number table:control group (group C,n =8),neuropathic pain group (group NP,n =40),dimethyl sulfoxide control group (group DS,n =12) and JNK inhibitor SP600125 group (group SP,n=12).Neuropathic pain was produced by chronic constriction injury (CCI).At 14 days after CCI,10 nmol JNK inhibitor SP600125 0.5 μl was intraperitoneally injected into the PAG in group SP,and 10％ dimethyl sulfoxide 0.5 μl was given instead in group DS.Eight rats were selected in group C,before CCI and at 3,7,14 and 21 days after CCI in group NP,and in DS and SP groups,and the mechanical pain threshold was measured before CCI,before administration on 14 days after CCI and at 30,45,60,75 and 90 min after administration.The rats in group C were sacrificed after the end of measurement of the mechanical pain threshold,and brains were removed for determination of phosphorylated JNK (p-JNK) and glial fibrillary acidic protein expression (by Western blot) in PAG region.The rats in group NP were sacrificed after the end of measurement of the mechanical pain threshold at each time point,and brains were removed for detection of p-JNK expression in PAG region.Four rats in DS and SP groups were sacrificed after the last measurement of the mechanical pain threshold at 45 min after administration,and brains were removed for determination of glial fibrillary acidic protein expression in PAG region.Results Compared with group C,the mechanical pain threshold was significantly decreased at each time point after CCI,and the expression of p-JNK was up-regulated at 7-21 days after CCI in group NP (P＜0.01).Compared with group DS,the mechanical pain threshold was significantly increased at 30 min after administration,and GFAP expression was down-regulated at 45 min after administration in group SP (P＜ 0.01).The mechanical pain threshold was significantly higher at 30-75 min after administration than before administration in group SP (P＜0.01).Conclusion The mechanism underlying activation of astrocytes in PAG is related to activating JNK in the rats with neuropathic pain.

Objective To evaluate the clinical application of TCM nursing therapies and identify the problems during the therapy implementation, in order to explore the countermeasures to promote its clinical improvement. Methods A descriptive cross-sectional study was conducted,and a self-designed questionnaire was employed to investigate 218 nurses from 148 grade A class three TCM hospitals in China. Results 25 TCM nursing therapies were implemented in these hospitals. Ear acupressure therapy was the most frequently implemented,accounting for 83.5%(182/218);while wax therapy was the least implemented, accounting for 7.8%(17/218). The implementation frequency of these technologies varied significantly, 0~860 times a week. The top three of them were acupoint application therapy, hot compression of Chinese medicine and ear acupoints therapy.TCM nursing therapies were considered to be the most frequently used in insomnia, headache, edema, arthralgia, cold, epigastric pain, hypochondriac pain and fever.Storage of TCM nurses,lacking of TCM knowledge and inapposite therapy implementation were the main problems in the application. Conclusions Scientific and rational allocation of human resources, cultivation of the TCM-specific nursing professional, enhancement of nurses'awareness of Chinese medicine, establishment of a reasonable charging standard, and strengthening the risk management in implementation will promote its clinical development.

Objective Our purpose was to investigate the pathogenic gene mutation of a Han Chinese family with vitreous amyloidosis.Methods The 9 individuals(proband,1 affected member and 7 unaffected members) of the family were selected and their DNA was extracted from peripheral blood.The 4 exons of transthyretin(TTR) gene were amplified by polymerase chain reaction(PCR) technique.The amplified products of TTR gene were sequencing by Sanger technique.We also selected 100 unrelated healthy individual as the control group.Results By DNA sequencing,a heterozygous mutation was found in 4 of the 9 subjects from the family.The transition of adenine to cytosine(AAG ＞ ACG) was detectable in exon 2 of TTR,which changed the amino acid composition at codon 35 (Lys35Thr).This mutation did not presented in control group.Conclusion The heterozygosis mutation of TTR gene Lys35Thr should be a pathogenic mutation for the family with vitreous amyloidosis.

Objective To investigate the effects of club mode of health education on social support of breast cancer patients and their spouses.Methods A total of 100 breast cancer patients who underwent modified radical mastectomy and their spouses in Suzhou Municipal Hospital from May 2012 to March 2013 were randomly divided into the intervention group and the control group with 50 cases respectively. Patients and spouses in the intervention group were involved in the club, while in the control group patients and spouses received routine nursing care. Perceived social support scale (PSSS) and social support ratings scale (SSRS) were used in the questionnaires for patients before the intervention and at the 1st month, 3rd month, 6th month after the intervention.Results In the intervention group, the score of the support on the patients out of family was (29.80±5.77) at the 1st month after the intervention; the total score of perceived social support was (57.22±5.26) at the 3rd month after the intervention; the score of support from family was (26.59±2.51) at the 6th month after the intervention. All of those scores were significant higher than those in the control group (F=6.391, 0.304, 7.435;P<0.05). At the 3rd month after the intervention, the score of the social support on the spouses were (45.02±6.40) in the intervention group and (39.17±7.77) in the control group. The difference between the two groups was statistically significant (F=1.250,P<0.05).Conclusions The club mode of health education can effectively improve the social support status for breast cancer patients and their spouses.

Objective To compare the effect of GammaTM wet wipes and 75% alcohol on the disinfection of X-ray protective clothing,and provide reference for choosing rational disinfection methods.Methods 62 pieces of X-ray protective clothing were selected,30 were from operating rooms,32 from catheterization room.Protective clothing were randomly divided into trial group and control group,each had 31 pieces.Trial group disinfected clothing with GammaTM wet wipes,control group disinfected clothing with 75% alcohol,disinfection effect,drying time,and cost between both groups were compared.Results Average bacterial colony counts in trial group and control group before disinfection were 2.38 CFU/cm2 and 2.36 CFU/cm2 respectively,qualified rates were 80.64% and 83.87%respectively.Bacteria were not detected in both groups after disinfection.The average drying time in trial group was shorter than control group([352.35±9.93]s vs[676.13±10.62]s,t=123.98,P <0.01).The cost of disinfecting X-ray protective clothing in trial group was 29.60% less than control group.Conclusion Effect of GammaTM wet wipes and 75% alcohol on disinfecting X-ray protective clothing are both reliable,compared with 75% alcohol, GammaTM wet wipes are without corrosion,have shorter drying time,and save more cost.