BACKGROUND:Increasing evidence suggests that N6-methyladenosine(m6A)regulators are closely associated with osteoarthritis and are considered to be a new direction in the prevention and treatment of osteoarthritis,but their specific mechanism of action is unknown. OBJECTIVE:To conduct a bioinformatics analysis of the osteoarthritis gene microarray dataset in order to explore the role of m6A in osteoarthritis and analyze the pathogenesis of osteoarthritis. METHODS:The m6A regulators associated with osteoarthritis and their expression were first extracted from the GSE1919 dataset in the GEO database using R software,and then the results were analyzed by gene difference analysis and GO and KEGG enrichment analyses.Subsequently,the results of protein-protein interaction network topology analysis and machine learning results were intersected to obtain the m6A Hub regulators,which were validated by in vitro cellular experiments. RESULTS AND CONCLUSION:A total of 16 osteoarthritis-related m6A regulators were extracted and 11 m6A differential regulators,including ZC3H13,YTHDC1,YTHDF3 and HNRNPC,were obtained by differential analysis.GO enrichment analysis showed that osteoarthritis-related m6A differential regulators played a role in the biological processes such as mRNA transport,RNA catabolism,and regulation of insulin-like growth factor receptor signaling pathway.(3)KEGG enrichment analysis showed that the differential regulators were mainly involved in the p53,interleukin-17 and AMPK signaling pathways.The combined protein-protein interaction network topology analysis and machine learning results obtained the m6A Hub regulator-YTHDC1.(5)The results of in vitro cellular experiments showed that there was a significant difference in the expression of m6A key regulator between the control and experimental groups(P<0.05).To conclude,YTHDC1 is closely related to the development of osteoarthritis,which is expected to be a molecular target of m6A for the treatment of osteoarthritis.

OBJECTIVE: To explore the genetic mechanism underlying a case with para-Bombay phenotype. METHODS: The ABO and Lewis phenotype were identified with serological methods. The coding regions of exons 6 and 7 of the ABO and FUT1 genes were amplified with PCR and directly sequenced. Haploid sequence analysis was carried out on the variant sites of the FUT1 gene. RESULTS: Serological analysis confirmed that the proband has a rare para-Bombay phenotype. Direct sequencing revealed that he was a B.01/O.01.02 heterozygote for the ABO gene, and had heterozygous deletion for the 768 and 881-882 sites of the FUT1 gene. Further haploid analysis showed that the c.881_882delTT deletion has occurred in one haploid while c.768delC was present in the other haploid. The proband was therefore determined as a FUT1*01N.13/01N.20 heterozygote, which have resulted in frameshift in polypeptide chain p.Phe294Cysfs*40 and p.Val257Phefs*23, respectively. CONCLUSION A rare bi-allelic heterozygous deletion of para-Bombay phenotype has been identified in a blood donor. The c.881_882delTT and c.768delC deletions may decrease the activity of α-1,2-fucosyltransferase.
Animals ; Male ; ABO Blood-Group System/genetics* ; Alleles ; Fucosyltransferases/genetics* ; Genotype ; Heterozygote ; Mutation ; Phenotype ; Humans

Based on the latest results of international researches, combining with the experiences of our team in the simulation of acute dyspnea, Xiangya Hospital Central South University has summarized 7 characteristics, procedures and methods of debriefing, including that immediate feedback happens after simulation; feedback is provided by a trained instructor with clinical experience; feedback time is at least longer than the simulation time; various international methods of feedback can be used; the content of feedback is the learning objective; oral feedback is preferred; video can be used to review the details. The study aims to provide a theoretical basis for debriefing in domestic scenario stimulation teaching, and finally improve the effectiveness of the scenario stimulation teaching.

Objective:To develop a new kind of efficiency-based hospital ranking based on existing major hospital rankings with reference to hospital input data.Methods:DEA method was called into play and built five models for hospital ranking according to the efficiency value so calculated. The hospital beds available and the number of employees of 59 general hospitals in 2018 were used as the input indicators, and China′s Best Hospitals ranking by Fudan University′s Hospital Management Institute(Fudan ranking)and the total scoring and individual items evaluation from China Hospital STEM ranking by the Medical Information Institute of the Chinese Academy of Medical Sciences were used as the output indicators.Results:The correlation coefficients between hospital beds and the scores from Fudan-rankings and STEM-ranking were 0.08 and 0.09 respectively( P>0.05), and the correlation coefficients between personnel and scores from the two rankings were 0.34 and 0.39 respectively( P<0.01). The correlation coefficients of the efficiency values of the five super-efficiency DEA models and the beds were 0.37, -0.61, -0.71, -0.61 and-0.61 respectively( P<0.01), and the correlation coefficients of personnel were-0.17, -0.37, -0.60, -0.39 and -0.39( P<0.01)respectively. Compared with the original ranking, the ranking of the efficiency value of the super-efficiency DEA model found the average ranking of hospitals in Beijing and Shanghai rose by 6.38 places, and the ranking of hospitals in non-Beijing and Shanghai areas dropped by 4.37 places on average. The difference was statistically significant( P=0.02), and other differences in the ranking of different types hospitals were not statistically significant. Conclusions:Thanks to the super-efficiency DEA efficiency value which is added with such input indicators as hospital beds and personnel, the ranking becomes more scientific and comprehensive. The research results can provide references for more rational patient flow and encourage hospitals onto a more healthy development pathway.

Objective:To explore the effects of perianesthesia position nursing model based on enhanced recovery after surgery (ERAS) in patients undergoing thoracoscopic surgery.Methods:Totally 100 patients undergoing thoracoscopic pulmonary surgery in Huzhou Central Hospital between July and December 2019 were selected by convenient sampling and divided into the control group and the experimental group according to the random number table, with 50 cases in each group. Patients in the experimental group received perianesthesia position nursing, while patients in the control group received conventional position nursing. The time of position placement, number of placement personnel, intubation time, comfort and pain were compared between the two groups.Results:There were statistically significant differences in the placement time and number of placement personnel between the two groups ( P<0.05) . The GCQ score of the experimental group was higher, while the VAS score was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The perianesthesia position nursing model based on ERAS can shorten the time of posture placement, reduce the pain, and improve the comfort in patients undergoing thoracoscopic surgery.

Objective? To explore the effect of rehabilitation nursing based on 5E concept in patients after SuperPath minimally invasive total hip replacemen(t THR). Methods? From February 2016 to February 2018, 194 patients who underwent THR through SuperPath approach in Huzhou Central Hospital of Zhejiang Province were selected as the study subjects. The patients were randomly divided into observation group (n=97) and control group by coin flipping method. The control group was given routine nursing care while the observation group was given the rehabilitation nursing based on 5E concept on the basis of that in the control group. The degree of pain, hip function score, incidence of complications and compliance of functional exercise were compared between the two groups. Results? The Harris score of the patients in the observation group was (65.25±5.29) at 1 month, (87.69±6.47) at 3 months and (93.85±8.66) at 6 months after operation, while that of the control group was (55.84±4.14), (77.48±5.89), (82.45±7.69). There were significant differences between the two groups (t=13.767, 11.511, 9.465;P＜ 0.05). The incidence of postoperative complications was 4.12% (4/97) in the observation group and 27.84% (27/97) in the control group (χ2=20.310, P＜ 0.05). The total compliance rate of functional exercise was 95.88% (93/97) in the observation group and 87.63% (85/97) in the control group, the difference was statistically significant (χ2=4.359,P＜ 0.05). The nursing satisfaction of patients in the observation group was 96.91% (94/97) and 81.44% (79/97) in the control group. The difference was statistically significant (χ2=12.015,P＜0.05). Conclusions? The application of comprehensive rehabilitation nursing based on 5E concept in SuperPath minimally invasive THR can effectively promote the recovery of hip function, reduce the occurrence of complications after operation, enhance the compliance of patients with functional exercise, and significantly improve the satisfaction of patients with nursing.

Objective To investigate the protective role of dexmedetomidine in rats with endotoxin-induced acute lung injury (ALI).Methods Forty-eight adult male SD rats were divided into four groups (n=12 each) according to the random number table: control group, lipopolysaccharide (LPS) group, dexmedetomidine (DEX) treatment group and DEX pretreatment group.ALI was induced in rats by femoral intravenous injection of LPS (8 mg/kg).Rats in DEX treatment group was given DEX (50 μg/kg) for 2 minutes via the femoral intravenous injection 0.5 hour after LPS injection, followed by maintenance pump injection of DEX (5 μg·kg-1·h-1).Analogously, rats in DEX pretreatment group was given DEX (50 μg/kg) for 2 min via the femoral intravenous injection 0.5 hour before LPS injection, followed by maintenance pump injection of DEX (5 μg·kg-1·h-1).By contrast, control group received the same amount of normal saline intravenously.All rats were sentenced to death and their carotid blood samples were collected6 hours after all injections.Superior lobe of the right lung was examined under light microscope and the histologic findings were tested using the difusse alveolar damage (DAD) score.Middle lobe of the right lung was used to calculate the lung tissue wet/dry weight (W/D) ratio.Samples of collected carotid blood were taken to measure levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6.Bronchoalveolar lavage fluid (BALF) obtained from bronchoalveolar lavage was collected to measure levels of TNF-α and IL-6.Results Lung tissue injury was obvious after LPS injection and DAS score was improved as well.However DEX therapy reduced the lung damage as well as the DAD score, especially obvious in DEX pretreatment group (P<0.05).W/D ratio was obviously increased in other three groups compared to control group, but further comparison showed that W/D ratio was lowered in DEX treatment and pretreatment groups compared to LPS group, especially obvious in DEX pretreatment group (P<0.05).Levels of TNF-α and IL-6 were higher in other three groups than control group, but further comparison showed that levels of TNF-α and IL-6 were decreased in DEX treatment and pretreatment groups compared to LPS group, especially obvious in DEX pretreatment group (P<0.05).Levels of TNF-α and IL-6 in BALF were higher in LPS and DEX treatment groups than control group and were higher in LPS group than DEX treatment(P<0.05).Further comparison showed level of TNF-α in BALF similar between DEX treatment and pretreatment groups (P>0.05), but IL-6 in BALF was significantly lower in DEX pretreatment group than DEX treatment group (P<0.05).Level of total protein in BALF was increased in LPS group compared to control group and was decreased in DEX treatment and pretreatment groups compared to LPS group, but there were no significant differences between DEX treatment and pretreatment groups (P>0.05).Conclusion Either preoperative injection of DEX or DEX treatment has protective effect in rats with LPS-induced ALI, while preoperative injection of DEX has been proved to be more effective.

OBJECTIVETo explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.

METHODSAccording to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.

RESULTSThe duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).

CONCLUSIONSIn patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; drug therapy ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Incidence ; Induction Chemotherapy ; Lung Neoplasms ; drug therapy ; Neutropenia ; chemically induced ; epidemiology ; prevention & control ; Polyethylene Glycols ; Recombinant Proteins ; administration & dosage ; Taxoids ; administration & dosage ; adverse effects

Objective To evaluate the value of detecting HCMV-DNA in urine in the diseases of newborn babies ,by comparing the result between HCMV-DNA in urine and HCMV-IgM antibody in blood in different diseases of the newborn babies .Methods The urine and blood samples were collected from 1 520 infants who were in hospital of the neonate department from January 2013 to December 2014 .The HCMV-DNA in urine was examined by fluorescence quantitative polymerase chain reaction(FQ-PCR) .And HCMV-IgM antibody in blood was examined by the method of chemiluminescence(ECL) .Results In the 1 520 cases ,153 had de-tectable HCMV-DNA in their urine samples with a positive rate 10 .07% ,while only 4 cases were positive of the HCMV-IgM anti-body in blood with a positive rate 0 .27% .The two groups was statistically significant difference (P<0 .05) .In the infant diseases of 1 520 cases ,the positive rate of HCMV-DNA in urine was 82 .6% of the hepatitis syndrome while the positive rate of HCMV-IgM antibody in blood was 3 .85% .The positive rate of HCMV-DNA in urine was 8 .95% in the jaundice symptoms ,while the posi-tive rate HCMV-DNA in urine was 4 .62% in the pulmonary infection .Each group of disease was statistically significant difference in the positive rate of HCMV-DNA (P<0 .05) .Conclusion The detection of HCMV-DNA in urine is more beneficial to the diag-nosis of HCM V infection of infants than the detection of HCM V-IgM antibody in blood ,especially in hepatitis syndrome ,neonatal jaundice and pulmonary infection .

Objective To analyze clinical features of and hypertrophy-related factors in patients with hypertrophic port-wine stains (PWS). Methods Patients with PWS were enrolled into this study from Anhui Provincial Hospital and the First Affiliated Hospital of Anhui Medical University between January 2010 and August 2014. Clinical features of hypertrophic PWS were investigated. The factors related to hypertrophy in PWS were analyzed by univariate and multivariate unconditional logistic regression analyses. Results A total of 262 patients with PWS were enrolled, 82 (30 males and 52 females)of whom had hypertrophic PWS with a median age of 32.5 years (range, 18 - 54 years). Among the 82 patients, 66(80.48%)had plaque-like hypertrophic PWS, 9(10.98%)had papular or nodular type, and 7 (8.54%)had mixed type; 56.10% (46/82)were aged ≥ 30 years, 41.46% (34/82)varied from 11 to 30 cm2 in lesional area, and 85.36% (70/82)showed purple lesions. There was a significant difference between patients with hypertrophic PWS and those with flat PWS in the distribution of age, lesional area and color(χ2 = 25.559, 10.580, 90.630, respectively, all P < 0.05), while gender, Fitzpatrick′s skin type, lesional site and distribution were unrelated to hypertrophy in PWS (all P > 0.05). Multivariate unconditional logistic regression analysis revealed that an age ≥ 30 years(OR = 2.889, 95%CI: 1.459 - 5.721)and purple lesions(OR = 19.984, 95% CI: 5.704 - 70.023)were factors related to skin hypertrophy in PWS. Conclusion An age ≥ 30 years and purple lesions seem to be hypertrophy-related factors in PWS.