Objective To investigate the predictive significance of Septin9 gene methylation(mSEPT9)in peripheral blood in the diagnosis of colorectal adenoma.Methods A total of 52 subjects were included,31 patients with colorectal adenomas were collected as the experimental group in the Department of Pathology and 21 subjects with negative colonoscopy in the gastroenterology outpatient clinic were used as the control group from October 2020 to May 2022.mSEPT9 was detected in the two groups,and the results of CEA level in peripheral blood were collected.All the results were statistically analyzed using the Receiver Operating Characteristic(ROC).Results The area under the curve(area of the ROC:AUC)of mSEPT9detectionto predict the development of adenoma was 0.7205(P<0.05),And the cut-off value(CT value)was 39.55,the corresponding sensitivity was 90.91%and the specificity was 56.67%.The AUC of CEA detection for predicting adenoma was 0.5333(P>0.05).Conclusions The detection of mSEPT9 is better than that of CEA tumor marker detection in peripheral blood for screening colorectal adenomas with good sensitivity and relative specificity.Invasive colonoscopy for people with positive mSEPT9 screening results can be easier to accept by the general population.

Blinding is an important means to control and reduce measurement bias in clinical research， and blinding assessment is the main method to measure the success of the blinding method. By summarizing the current situation of blinding assessment in randomized controlled trials （RCT） of acupuncture， it was found that the report rate of blinding assessment by acupuncture RCT was relatively low， and the studies reporting blinding assessment had several problems， such as incomplete assessment individuals， unreasonable assessment questionnaires， and unscientific analysis methods， and the setting of the assessment time point is controversial. Given the above problems， this paper discussed the key elements of blinding assessment individuals， assessment questionnaires， assessment time points， and analysis methods. It is suggested that blinding assessment should be carried out on all blinded participants and personnel in the study； the assessment questionnaire should be designed by direct inquiry， with responses designed using three or more categorical options that include an "unclear" option； the early stage of the trial should be taken as the mandatory time point for assessment， integrating the evaluation index of the James blinding index and the Bang blinding index， in order to standardize the application of blinding assessment in acupuncture RCT and improve the quality of acupuncture clinical research.

Humans ; Adult ; Serum Albumin, Human ; Consensus ; Cardiac Surgical Procedures ; Thoracic Surgery

OBJECTIVE To establish a method for the determination of fourteen fluorescent whitening agents in cosmetics by HPLC-MS/MS. METHODS Samples were extracted on a Waters ACQUITY UPLC ®BEH C18(2.1 mm×50 mm, 1.7 μm) column after ultrasonic extracted by DMF with the mobile phase consisted of methanol-0.1% ammonia water solution by gradient elution. The flow rate was 0.3 mL·min-1. The column temperature was 40 ℃. MS was performed using triple quadrupole mass spectrometry. Electrospray ionization source was operated in the positive/negative mode using multiple reaction monitoring scanning mode. RESULTS The results showed that there were good linear relationships for the fluorescent whitening agents in a certain concentration range with correlation coefficients(r) greater than 0.99. The limits of quantification were 0.01-20 μg·g-1 and the limits of detection were 0.004-8 μg·g-1. The average recoveries at three spiked levels were in the range of 85.4%-108.9%, and the relative standard deviation were in the range of 0.3%-7.2%. CONCLUSION The method has high sensitivity, strong specificity, simple and convenient operation, and is suitable for the detection of fourteen fluorescent whitening agents in cosmetics.

Objective To analyze the screening results and risk assessment of common malignant tumors among female residents in Deyang from 2017 to 2019, so as to provide basis for cancer prevention and control. Methods Women who underwent physical examinations and completed the survey of common malignant tumors related risk factors from 2017 to 2019 were selected. The high risk rate, screening rate and detection rate of common malignant tumor among female urban residents in Deyang were analyzed. Results From 2017 to 2019, a total of 49,871 female urban residents completed the survey of common malignant tumor related risk factors. The risk rates of breast cancer, lung cancer, cervical cancer and colorectal cancer were 13.24%, 7.65%, 12.92% and 5.53%, respectively. Among all the age groups, women at the age of 50~59 years old were at the highest risk of breast cancer, lung cancer, cervical cancer, colorectal cancer; The screening rates of breast cancer, lung cancer, cervical cancer and colorectal cancer were 24.68%, 11.72%, 34.62% and 14.15%, respectively; The screening rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among women with different educational levels showed significant difference (P<0.05). The screen rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among high risk groups were 24.68%, 11.75%, 26.56% and 14.35%, respectively; The detection rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among the screening groups were 9.33%, 2.68%, 9.82%, and 2.02%, respectively (P<0.05). Conclusion Female residents in Deyang from 2017 to 2019 have high risk and detection rates of breast cancer and cervical cancer, so active screening of malignant tumors among urban female residents can effectively improve the residents' quality of life, and is of vital importance for the early diagnosis and treatment of malignant tumors.

Objective:To evaluate the effect of airway driving pressure (ΔP) guided sedation strategy on the prognosis of patients with mechanical ventilation.Methods:Patients who needed invasive mechanical ventilation and admitted to the department of intensive care unit (ICU) of Jiangxi Provincial People's Hospital from January 2017 to December 2018 were enrolled. The patients were divided into study group and control group according to the random number table. After informed consent of patients or their families, both groups received routine treatment in ICU. The control group was treated with light sedation strategy, the Richmond agitation sedation score (RASS) was performed every 4 hours, and the target was RASS > -3. ΔP in the study group was measured once a day, and the sedative target of patients with low driving pressure (ΔP ≤ 14 cmH 2O, 1 cmH 2O = 0.098 kPa) was RASS > -3, while the patients with high driving pressure (ΔP > 14 cmH 2O) was RASS ≤ -3. The evaluation was conducted at 28 days after admission to ICU, and the patients were followed up to 60 days. The main outcome was days without mechanical ventilation in 28 days. The secondary outcomes were the rate of extubation, discharge outcome, incidence of ventilator associated pneumonia (VAP) and delirium, and 60-day survival rate. Results:A total of 60 patients with respiratory failure due to various reasons were recruited, 30 in each group. There was no significant difference in gender, age, primary disease, severity of disease or ΔP between the two groups. The days without mechanical ventilation within 28 days in the study group were significantly more than that in the control group [days: 20 (0, 23) vs. 12 (0, 16), P = 0.018], and the incidences of VAP (3.3% vs. 16.7%, P = 0.045) and delirium (0% vs. 10.0%, P = 0.038) were significantly lower than that in the control group. There were no significant differences in the rate of extubation (73.3% vs. 66.7%, P = 0.273), discharge outcome [improvement (cases): 24 vs. 21, unhealed (cases): 2 vs. 5, deaths (cases): 4 vs. 4, P = 0.506] and 60-day survival rate (83.3% vs. 76.7%, P = 0.519) between the study group and control group. Conclusion:Compared with light sedation strategy, ΔP directed sedation strategy can effectively shorten the duration of mechanical ventilation and reduce the incidence of VAP and delirium in the ICU patients.

A 13-year-old male patient presented with skin abnormalities for more than 10 years and slow growth in body height for more than 5 years. Since the age of 6 months, erythema and scales had occurred on the extremities, and gradually spread to the trunk and face; brown pigmentation and punctate depigmentation appeared after subsidance of the erythema and scales, accompanied by dental caries, thickened palms and soles, nail thickening and peeling. Since the age of 6 years, the patient had presented with slow growth in body height, gonadal dysgenesis, sparse eyebrows and eyelashes, flat cheekbones and lameness in walking. In the past 10 years, neutrophil count had been found to be continuously lower than the normal reference value. Blood routine examination showed a neutrophil count of 1.1 × 10 9/L and a neutrophil proportion of 0.345; serum level of testosterone in the patient (< 0.087 nmol/L) was lower than normal levels. DNA was extracted from the peripheral blood of the patient and his parents, and gene mutation analysis was carried out by using whole-exome sequencing technology. Genetic testing showed compound heterozygous mutations in the USB1 gene of the patient, including the c.450-2A>G mutation inherited from his mother and the c.335de1G mutation inherited from his father, and the c.335de1G mutation had not been reported in China and other countries.

Objective To explore the integration of the digital imaging medical records system and the hospital information system ( HIS), for a hospital-wide information platform for digital medical records management. Methods All the medical records were classified as " to copy and not to copy" by sampling, and an item corresponding table was developed for both HIS medical record files and imaging records copying types. The imaging copying system for paper-based medical records only covers those must-copy ones, while those medical record files without need to be copied were directly transcoded via the interface to the imaging medical records system from the HIS system. This makes digital imaging medical records complete. Results The digital imaging medical record system is thus integrated, and the cost of making imaging medical records was sizably reduced without compromising the quality and integrity of medical records. Conclusions Imaging medical records produced by copying paper-based ones are integrated with those directly sent via the interface to the imaging medical records system, forming complete digital imaging records, at a much lower cost.

Objective To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) during aortic arch surgery in the adult patients,to offer the evidence for the detection of which temperature provides best brain protection in the subjects who accept the great aortic surgery.Methods A total of 109 patients undergoing the surgery of aortic arch were divided into the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.We recorded the characters of the patients and their cardiopulmonary bypass time,aortic clamping time,cerebral perfusion time and postoperative recovery time,tracheal intubation time,time of intensive care unit (ICU) and postoperative cognitive dysfunction.Results Patients' characteristics were similar in two groups.All the patients were cured.There were no significant differences in aortic clamping time of each group [(111.4 ± 58.4) min vs.(115.9 ± 16.2) min];selective cerebral perfusion time [(27.4 ± 5.9) min vs.(23.5 ±6.1) min] of the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.There were significant differences in the cardiopulmonary bypass time[(207.4 ± 20.9) min vs.(263.8 ± 22.6) min],the postoperative recovery time [(19.0 ± 11.1) h vs.(36.8 ± 25.3) h],intubation time [(46.4 ± 15.1) h vs.(64.4 ± 6.0)h];length of ICU [(4.7 ± 1.7) d vs.(8.± 2.3) d],and postoperative cognitive dysfunction of the two groups.Conclusion Compared to the deep hypothermic circulatory arrest,the moderate hypothermic circulatory arrest can provide better brain protection and achieve good clinical results.

Objective To develop a quality evaluation index system of simulation teaching in nursing. Methods Delphi technique was used to formulate the quality evaluation indicators of simulation teaching through a two-round expert consultation among 27 experts. Results The questionnaire recovery rates were 96. 43% and 100% in two rounds, and the experts′ authority coefficient was 0. 89. Finally the teaching quality evaluation index system of nursing simulation was determined, including 5 first level indicators, 14 secondary level indicators and 62 tertiary level indicators. The primary index was CV 0. 00-0. 08, and the coordination coefficients of secondary and tertiary indexes were 0.515 and 0.589. Conclusions The quality evaluation index system of nursing scene simulation teaching is scientific and reliable, which could provide nursing educators with systematic and objective tool of simulation teaching quality evaluation.