Objective:To evaluate the performance of rural practitioners of endoscopic cleaning and disinfection participating in the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers and to analyze the influencing factors.Methods:The questionnaires for skill assessment were designed based on the skill scheme and clinical practice of the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China, and the App Early diagnosis, Early treatment was used as the examination platform. The practitioners in 539 county hospitals from 25 provinces participating in the program in 2019 were assessed for techniques and skills for endoscopic cleaning and disinfection and the excellence rate was calculated. Multivariate logistic regression model was used to analyze the influencing factors for the examination. Results:A total of 1 671 endoscopic cleaning and disinfection practitioners participated in the assessment with the score of 73.41±16.60. The passing rate was 85.82%, and the excellence rate was 44.94%. Among all questions, the correct rate of "opportunistic screening flow chart" was the highest (98.21%), and that of "the evaluation index for mass screening" was the lowest (57.89%). The multivariate logistic regression analysis showed that the excellence rate was high in practitioners who had a bachelor degree or above ( OR=1.627,95% CI:1.319-2.007, P<0.001), the career for 5 to <15 years (5 to <10 years: OR=1.329,95% CI:1.045-1.689, P=0.020; 10 to <15 years: OR=1.384,95% CI:1.026-1.867, P=0.033), working in eastern and central regions (eastern regions: OR=3.476,95% CI:2.368-5.103, P<0.001;central regions: OR=4.028,95% CI:2.679-6.057, P<0.001) and with full understanding of the screening scheme ( OR=1.547,95% CI:1.246-1.921, P<0.001) . Conclusion:Practitioners on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China have mastered the basic screening scheme and skills for endoscopic cleaning and disinfection. The education background, duration of the career, area and understanding of screening scheme are influencing factors for the excellence rate of endoscopic cleaning and disinfection.

Objective:To clarify the clinical significance, diagnostic and prognostic values of circular RNA circ_0141633 and circ_0008234 in peripheral blood of pancreatic cancer, and analyze their impact on the biological function of pancreatic cancer cells.Methods:The peripheral blood samples of 97 pancreatic cancer patients and 71 healthy controls were collected, and the expression of circ_0141633 and circ_0008234 was analyzed by real-time quantitative polymerase chain reaction (qRT-PCR). The relationships between the expression of circ_0141633 and circ_0008234 and clinicopathological characteristics and prognosis of pancreatic cancer were analyzed by chi-square test, K-M survival curves and Cox proportional hazards regression model. The area under curve (AUC), sensitivity and specificity of circ_0141633 and circ_0008234 in the diagnosis of pancreatic cancer were analyzed by receiver operating characteristic (ROC) curve. The effects of circ_0141633 and circ_0008234 on the proliferation, migration, invasion and epithelial mesenchymal transformation (EMT) of Bxpc-3 cells were analyzed by methyl thiazolyl tetrazolium (MTT) method, cell scratch test, Transwell invasion and Western blot.Results:The expression of circ_0141633 and circ_0008234 in peripheral blood of pancreatic cancer patients was higher than those of healthy controls (all P<0.05). High expression of circ_0141633 and circ_0008234 was associated with higher clinical stage, lymph node metastasis and venous invasion, and were independent risk factors for poor prognosis in pancreatic cancer (all P<0.05). The overall survival rate of patients with high expression of circ_0141633 and circ_0008234 was significantly lower than that of patients with low expression of circ_0141633 and circ_0008234 (all P<0.05). The AUC of circ_0141633, circ_0008234, the combination of circ_0141633 and circ_0008234, CA19-9 in the diagnosis of pancreatic cancer was 0.70, 0.67, 0.88 and 0.82, with sensitivity of 64.32%, 60.79%, 78.22% and 73.97%, respectively. The specificity was 68.54%, 65.46%, 81.65% and 79.41%, respectively. The diagnostic efficiency of combination was superior to CA19-9, circ_0141633 and circ_0008234 alone (all P<0.05). Interfering with circ_0141633 and circ_0008234 alone could inhibit the proliferation, migration, invasion and EMT of Bxpc-3 cells, and the above inhibitory effect was more obvious after interfering with both of circ_0141633 and circ_0008234 (all P<0.05). Conclusions:The high expression of circ_0141633 and circ_0008234 in peripheral blood could be used as potential diagnostic and prognostic biomarkers of pancreatic cancer, and could promote the progression of pancreatic cancer.

Objective:To investigate the clinical features of adenoviral encephalitis (AE), and to provide reference for clinical diagnosis and treatment of adenoviral encephalitis.Methods:From January 2012 to December 2020, 1 185 cerebrospinal fluid (CSF) samples of hospitalized children with suspected central nervous system infection in the Second Affiliated Hospital of Shantou University Medical College were collected for the detection of 22 common respiratory pathogens and common pathogens for encephalitis by polymerase chain reaction. Records of patients with adenovirus positive in CSF were reviewed and relevant clinical manifestations, laboratory tests and imaging examination results were collected for analysis.Results:Among 1 185 CSF samples, 242 samples were positive for viral nucleic acid, with detection rate of 20.4%, including 1.9%(23/1 185) of adenovirus. As for 23 children diagnosed with AE, 18 were male, five were female, with the age of (44.8±35.9) months, ranging from two months and 19 days to 10 years. Of 23 children, 21(91.3%) presented with fever, followed by convulsions (16 cases, 69.6%), headache (four cases, 17.4%), vomiting (11 cases, 47.8%), consciousness change (11 cases, 47.8%) and emotion disturbance (three cases, 13.0%). Among 23 children, eight cases had white blood cell counts (WBC) of (6 to <10)×10 9/L, 10 cases had WBC of (10 to 20)×10 9/L and the white blood cell classification was mainly neutrophils (21 cases, 91.3%), and C reactive protein of 20 cases (87.0%) was in the normal range. Cerebrospinal fluid examination showed that WBC were less than 15×10 6/L in 20 cases (87.0%), and WBC ≥15×10 6/L in three cases, which were up to 500×10 6/L; the protein of 19 cases was in the normal range, the glucose of 15 cases was in the normal range, and the chloride of 19 cases was in the normal range. Among 16 cases with brain magnetic resonance imaging examination, eight cases did not show abnormality, six cases with local meningeal linear enhancement, one case with small intracranial malacia, and one case with extensive intracranial lesions. For 13 cases who received electroencephalogram (EEG) test, seven cases showed normal EEG or marginal state, four cases showed extensive medium and high amplitude slow wave, one case showed spike wave or spike slow wave and one case had both of the above two changes. Among 23 children, 22 cases recovered including one case had secondary epilepsy, and the remaining one case had severe brain dysfunction and was unable to suck when discharged, with an indwelling gastric tube and accompanied by secondary epilepsy. Conclusions:The clinical manifestations and auxiliary examinations of children with AE have no obvious specificity. Most children with AE have a good prognosis, but a small number of them may have serious sequelae.

OBJECTIVE: To explore the effects of taurolithocholic acid (tLCA) and chenodeoxycholic acid (CDCA) on the expression of aorexigenic neuropeptide in mouse hypothalamus GT1-7 cells. METHODS: Mouse hypothalamic GT1-7 cells were treated with culture medium containing 10% FBS (control group, =3) or with 10 nmol/L, 100 nmol/L, 1 μmol/L and 10 μmol/L tLCA (tLCA group, =3) or CDCA (CDCA group, =3) for 12, 24 or 48 h. Real-time PCR was performed to determine the expression levels of proopiomelanocortin (POMC) mRNA in the cells, and the production levels of α-melanocyte-stimulating hormone (α-MSH) were assessed using an ELISA kit. Signal transduction and activator of transcription 3 phosphorylation (p-STAT3), threonine kinase phosphorylation (p-AKT), suppressor of cytokine signaling 3 (SOCS3), G protein-coupled bile acid receptor-1 (TGR5) and farnesoid X receptor (FXR) protein were detected by Western blotting. RESULTS: Western blotting results showed that mouse hypothalamic GT1-7 cells expressed two bile acid receptors, TGR5 and FXR, whose expressions were regulated by bile acids. Real-time PCR showed that the expression of POMC mRNA was significantly increased in the cells after treatment with 10 μmol/L tLCA or CDCA for 24 h. POMC-derived anorexigenic peptide α-MSH increased significantly in GT1-7 cells after treatment with 10 μmol/L tLCA or CDCA for 24 h. Treatment of the cells with tLCA or CDCA significantly increased the expressions of intracellular signaling proteins including p-STAT3, p-AKT and SOCS3. CONCLUSIONS Mouse hypothalamic GT1-7 cells express bile acid receptors TGR5 and FXR. Bile acids tLCA or CDCA can promote the expression of POMC mRNA and increase the production of the anorexigenic peptide α-MSH. The intracellular signaling proteins p-AKT, p-STAT3 and SOCS3 are likely involved in bile acid-induced anorexigenic peptide production.
Animals ; Cell Line ; Chenodeoxycholic Acid ; pharmacology ; Gene Expression Regulation ; drug effects ; Hypothalamus ; cytology ; Mice ; Neuropeptides ; genetics ; metabolism ; Pro-Opiomelanocortin ; genetics ; RNA, Messenger ; genetics ; STAT3 Transcription Factor ; metabolism ; Signal Transduction ; drug effects ; Suppressor of Cytokine Signaling 3 Protein ; metabolism ; Taurolithocholic Acid ; pharmacology ; alpha-MSH ; genetics

OBJECTIVE: To explore the effects of taurolithocholic acid (tLCA) and chenodeoxycholic acid (CDCA) on the expression of aorexigenic neuropeptide in mouse hypothalamus GT1-7 cells. METHODS: Mouse hypothalamic GT1-7 cells were treated with culture medium containing 10% FBS (control group, =3) or with 10 nmol/L, 100 nmol/L, 1 μmol/L and 10 μmol/L tLCA (tLCA group, =3) or CDCA (CDCA group, =3) for 12, 24 or 48 h. Real-time PCR was performed to determine the expression levels of proopiomelanocortin (POMC) mRNA in the cells, and the production levels of α-melanocyte-stimulating hormone (α-MSH) were assessed using an ELISA kit. Signal transduction and activator of transcription 3 phosphorylation (p-STAT3), threonine kinase phosphorylation (p-AKT), suppressor of cytokine signaling 3 (SOCS3), G protein-coupled bile acid receptor-1 (TGR5) and farnesoid X receptor (FXR) protein were detected by Western blotting. RESULTS: Western blotting results showed that mouse hypothalamic GT1-7 cells expressed two bile acid receptors, TGR5 and FXR, whose expressions were regulated by bile acids. Real-time PCR showed that the expression of POMC mRNA was significantly increased in the cells after treatment with 10 μmol/L tLCA or CDCA for 24 h. POMC-derived anorexigenic peptide α-MSH increased significantly in GT1-7 cells after treatment with 10 μmol/L tLCA or CDCA for 24 h. Treatment of the cells with tLCA or CDCA significantly increased the expressions of intracellular signaling proteins including p-STAT3, p-AKT and SOCS3. CONCLUSIONS Mouse hypothalamic GT1-7 cells express bile acid receptors TGR5 and FXR. Bile acids tLCA or CDCA can promote the expression of POMC mRNA and increase the production of the anorexigenic peptide α-MSH. The intracellular signaling proteins p-AKT, p-STAT3 and SOCS3 are likely involved in bile acid-induced anorexigenic peptide production.
Animals ; Bile Acids and Salts ; Chenodeoxycholic Acid ; Hypothalamus ; Mice ; Neuropeptides ; Phosphorylation ; STAT3 Transcription Factor ; Signal Transduction ; Suppressor of Cytokine Signaling 3 Protein

Objective:To assess the relationship between body mass index (BMI) and death risk of cardiovascular disease (CVD) in rural male population.Methods:22 282 men aged 40 years older in Tanghe county and Fenghuang county from the cohort of the "Prospective Study on Adult Behavior and Health Risk Factors in China" were selected as subjects of this study. Cox regression model was used to calculate the hazard ratios ( HRs) of the death of CVD during the follow-up period with different BMI groups at baseline. Results:The average follow-up period in the two counties was (19.1±8.7) years and 10 828 (48.6%) people died during the follow-up period. 4 504 deaths were attributed to CVD. Among the deaths of CVD, 1 279 cases died of ischemic heart disease (IHD), ischemic stroke (IS) died in 1 201, cases died of died of 1 317 hemorrhagic stroke (HS), other 707 cases. Compared to population with BMI<18 kg/m 2, Cox regression model (adjusting factors of region, age, nationality, education level, occupation, smoking, drinking, blood pressure, blood pressure, etc.) showed that people with BMI between 20-22 kg/m 2 had the lowest risk of CVD death ( HR=0.95, 95 %CI: 0.83-1.09). But the difference was not statistically significant among each BMI group ( P>0.05). The risk of IHD death was the lowest in the population with BMI between 20-22 kg/m 2 ( P<0.05) ( HR=0.64, 95 %CI: 0.52-0.80). There was no statistically significant difference between the risk of IHD death in the population with BMI≥24 kg/m 2 and that in the population with BMI<18 kg/m 2 ( P>0.05). There was no statistically significant difference between the risk of IS death and BMI ( P>0.05). The death risk of HS in the population with BMI between 18-24 kg/m 2 was higher than that in the population with BMI<18 kg/m 2 ( P<0.05). The death risk of the population with BMI between 26-28 kg/m 2 was the highest ( HR=1.88, 95 %CI:1.18-2.99). Conclusions:The mortality risk of CVD and IHD was the lowest in lean or normal weight group, and HS was higher in overweight group. Maintaining a reasonable weight can reduce the risk of death in patients with CVD.

Objective To investigate the prevalence of healthcare-associated infection(HAI)in a tumor hospital,and provide evidence for prevention and control of HAI.Methods According to requirement of cross sectional survey of nationwide HAI monitoring network,prevalence rates of HAI in hospitalized patients at a tumor hospital in 2013-2015 were surveyed,surveyed results were statistically analyzed.Results A total of 3 515 hospitalized patients were investigated from 2013 to 2015,24(0.68%)had HAI.The prevalence rates of HAI from 2013 to 2015 were 0.79%,0.54%,and 0.76%respectively,difference was not statistically significant(x2=0.65,P>0.05).The main infection site was lower respiratory tract,accounting for 45.83%.The main pathogens causing HAI were gram-negative bacilli,accounting for 47.37%,followed by fungi(26.32%).Conclusion The prevalence rate of HAI in tumor patients is low,targeted monitoring should be carried out according to the current situation,the prevention and control of lower respiratory tract infection should be focused on,fungal infection should be paid attention.

Objective To investigate the feasibility of low dose dual phase contrast-enhanced chest CT with iterative mod el reconstruction (IMR) technique.Methods Totally 130 patients with suspected pulmonary occupying lesions underwent dual phase contrast-enhanced chest CT,who were randomly assigned into 2 groups (group A and group B,each n=65).Patients in group A were scanned with 100 kV,DoseRight technique with dose right index 10,and images were reconstructed with the hybrid iterative reconstruction (iDose4).While patients in group B were scanned with 80 kV,DoseRight technique with dose right index 8,and images were reconstructed with iterative model reconstruction (IMR).The objective image quality,subjective image scores and the excellence rate of vascular visualization were compared in both pulmonary artery (PA) and bronchial artery (BA) phases.The radiation dose was also calculated.Results The effective dose was (3.30 ±0.89)mSv in group A and (1.27 ±0.19)mSv in group B.Compared to group A,the effective dose reduced 61.52％ in group B (P＜0.001).Lower image noise and greater CNR were obtained in group B compared to group A in both PA and BA phases (all P＜0.001).No significant difference was found in subjective image scores of lung and mediastinal setting and the excellence rate of vascular visualization in both groups (all P＞0.05).Conclusion Using IMR,dual phase contrast-enhanced chest CT allows for a radiation dose reduction up to 61.52％,meanwhile,ensures the image quality and meets the diagnostic requirements.

Objective To evaluate the clinical effect of tibial plateau bone defects repair using osteotomy and bone grafting with autogenous bone gain way in total knee arthroplasty.Methods From Mar.2011 to Mar.2015,28 knees of 20 patients with bone defects in medial tibial plateau were in total knee arthroplasty,the bone defects were repaired into horizontal steps,then with autogenous bone grafting by osteotomy.Results The bone defects could be repaired effectively to support the knee joint prosthesis,all the patients were followed-up through outpatient from 1 year to 4 years with the average of 2.6 years,the HSS kness score increased from (20.9 ± 1.2) before opearation to (87.6 ± 1.6) after operation.Hss score were paired t test,there was statistically significant difference (P ＜ 0.05).The location was good and there was no bone defect image,no bone resorption and no joint dislocation under X-ray.Conclusions To repair the bone defects in total nkee arthroplasty,it can use the autogenous bone by osteotomy reasonably,achieve good repair defect site,reserve the bone mass maxium,reconstrust the balanced mechanical support of tibia.

Objective To investigate the drug-resistant status of Acinetobacter baumannii in clinical strains isolated from our hospital,and get to know the distribution of integrons carried by Acinetobacter baumannii,analyze the correlation between integron and drug-resistant of Acinetobacter baumannii..Methods Collected 85 Acinetobacter baumannii isolated in our lab,the drug-sensitivity tests were completed by the method of KB,the integrase genes were amplified by polymerase chain reaction(PCR),and identified the type of integron..Analyzed the correlation between the drug-resistant and integron in Acinetobacter baumannii..The open reading frame of integron were amplified by PCR,the polymorphism of integron was identified,and sequenced the PCR products.Results Except for Imipenem and Cefoperazone/ sulbactam(drug resistant rate less than 10%),the drug resistant rate of other 15 antibacterial was no more than 30% among the 85 Acinetobacter baumannii isolated in our lab..66.1 %(57/85) stains carried the integrons I,we didn't find out the integron Ⅱ and Ⅲ.The drug-resistant rates of Acinetobacter baumannii with integron were higher than that of Acinetobacter baumannii without integron.The length of amplified products in variable region of open reading frame of integron varied from 03 to 25kb,.The sequencing results confirmed the integron included multidrug resistant gene code.Conclusion In our hospital,the drug-resistant rate of Acinetobacter baumannii was high,and the majority were multidrug resistant strains.The drug-resistant rate of Acinetobacter baumannii was enhanced with integron,The multidrug resistant of Acinetobacter baumannii was associated with integrons.