Objective To construct a multi-disciplinary treatment(MDT)gridding vessel catheter-associated infection(VCAI)management and control system.Methods On the basis of evidence-based theory,using Delphi expert correspondence method to construct MDT gridding VCAI management and control system.The knowledge of VCAI was compared before and after the application of this system.Results After two rounds of expert correspondence consultation,the management and control system of theoretical knowledge,practical ability and professional development ability of preventing VCAI was constructed and improved.Using this management and control system to train medical staff can significantly improve their mastery of VCAI related knowledge(P<0.05).Conclusion MDT gridding VCAI management and control system based on evidence-based theory can effectively ensure patient safety.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Objective To explore the clinical effect of free postnatal delivery in the second stage of labor, and to provide evidence for clinical midwifery. Methods From March 2016 to November 2017, 120 maternity patients from the First People′s Hospital of Hefei were selected and divided into research group and control group, using simple random grouping and the method of random number table, with 60 cases in each group. At the second stage of delivery, the research group used free body position at different stages, while the control group took the position of supine bladder lithotomy position. The delivery outcome, duration of the second stage, postpartum vaginal bleeding within two hours, newborn asphyxia rate, degree of perineal laceration, perineum incision rate, delivery comfort and satisfaction and midwives job satisfaction were compared. Results The vaginal delivery rate of the research group was 96.7％(58/60), which was higher than that of the control group 86.7％ (52/60). The difference was statistically significant (χ2=3.93, P<0.05). The duration of the second stage in the research group was (31.97 ± 9.85) minutes, and that of the control group was (39.50 ± 12.19) minutes. There was a statistically significant difference between the two groups (t=-3.357, P<0.05). There was no significant difference in neonatal asphyxia rate and the amount of postpartum vaginal bleeding within 2 hours between the two groups (P>0.05). The perineum integrity rate in the research group was 10.4％(6/58), higher than that in the control group, which was 0. Perineal side cut rate in the research group was 0, lower than that in the control group, which was 21.1％(11/52). The difference was statistically significant (χ2=11.31, 13.63, P<0.05). Deliverycomfort, delivery satisfaction and midwives job satisfaction in the research group were 91.7％ (55/60), 100.0％ (60/60) and 100.0％ (60/60) respectively, while delivery comfort, delivery satisfaction and midwives job satisfaction in the control group were 38.3％(23/60), 83.3％(50/60) and 76.7％(46/60). The differences were statistically significant (χ2=37.51, 10.91, 15.85, P<0.05). Conclusion The second labor stage free position is effective safe childbirth way of delivery, which can improve the natural births, shorten the labor, lighten the perineal injury, improve the puerpera childbirth comfort and satisfaction, it also raised the midwives job satisfaction, and had no adverse effect on maternal and infant outcomes, so the method has clinical application and dissemination value.

To synthesize 5-fluorouracil-nicotinamide (5-FU-NCT) cocrystal and to investigate its physicochemical and biological properties. The cocrystal of 5-Fu-NCT was prepared through the cooling technology. PXRD, NMR, FTIR and DSC were used to characterize the structure of 5-FU-NCT cocrystal. Solubility was measured by HPLC method. Drug resistant human liver cancer BEL-7402/5-FU cells were treated with 5-FU-NCT cocrystal, the inhibition effect was tested by MTT and HE staining, and cancer cell migration was determined by scratch test. According to PXRD, NMR, FTIR and DSC results, the cocrystal of 5-Fu-NCT had been synthesized successfully. The characteristic diffraction peaks (2θ/°) of the cocrystal were 16.4, 20.4, 22.3, 27.9 and 30.1. The solubility of 5-FU-NCT was 13.5 g/L as measured by HPLC. The antitumor activity tests showed that 5-FU-NCT cocrystal enhanced anticancer effect of 5-FU, and the IC50 of 5-FU and 5-FU-NCT was 129.6 μg/mL and 42.6 μg/mL, respectively. 5-Fu-NCT cocrystal have been synthesized successfully through the cooling technology and it shows an enhanced anticancer effect in comparison to 5-FU on BEL-7402/5-FU cells.
Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Survival ; drug effects ; Crystallization ; Fluorouracil ; chemistry ; Humans ; Liver Neoplasms ; Niacinamide ; chemistry ; Solubility

Objective:To synthesize 5-fluorouracil-nicotinamide (5-FU-NCT) cocrystal and to investigate its physicochemical and biological properties.Methods:The cocrystal of 5-Fu-NCT was prepared through the cooling technology.PXRD,NMR,FTIR and DSC were used to characterize the structure of 5-FU-NCT cocrystal.Solubility was measured by HPLC method.Drug resistant human liver cancer BEL-7402/5-FU cells were treated with 5-FU-NCT cocrystal,the inhibition effect was tested by MTT and HE staining,and cancer cell migration was determined by scratch test.Results:According to PXRD,NMR,FTIR and DSC results,the cocrystal of 5-Fu-NCT had been synthesized successfully.The characteristic diffraction peaks (2θ/°) of the cocrystal were 16.4,20.4,22.3,27.9 and 30.1.The solubility of 5-FU-NCT was 13.5 g/L as measured by HPLC.The antitumor activity tests showed that 5-FU-NCT cocrystal enhanced anticancer effect of 5-FU,and the IC50 of 5-FU and 5-FU-NCT was 129.6 μg/mL and 42.6 μg/mL,respectively.Conclusion:5-Fu-NCT cocrystal have been synthesized successfully through the cooling technology and it shows a more enhanced anticancer effect in comparison to 5-FU on BEL-7402/5-FU cells.

Objective To observe the ultrastructure of blood-brain barrier in the nude mouse model of brain me-tastases from lung cancer by transmission electron microscopy using lanthanum nitrate tracing.Methods PC-9 cells (1 × 106/0.1 mL) in logarithmic phase were respectively injected into six nude mice ( model group) selected from eight nude mice randomly via the left ventricle, the other two mice without any treatment as the control group.The general status of the mice was observed after implantation.In the fourth week all the mice were sacrificed and brain tissue samples were taken and prepared for transmission electron microscopic observation using lanthanum nitrate tracing.besides, the lung and brain were removed and stained with HE to detect the presence of tumor metastasis.Results Mice in the model group began to lose weight almost simultaneously in the third week and became moribund slowly, and were all sacrificed at the fourth week when showing clear signs of cachexia.At autopsy, the thoraxes were clear, with normal lungs.Histology showed evidence of brain metastasis in all the six mice.The electron microscopy showed that lathanum nitrate tracer was escaped from the capillaries and diffusely or sparsely distributed in the brain tissues of the model group mice, however lathanum nitrate tracer was still confined in the capillary lumen in the mice of control group.Conclusions The diffuse lathanum nitrate tracer in the brain parenchymal tissue indicates the impairment of blood-brain barrier in the nude mouse model of lung cancer brain metastasis and the formation of these metastases is accompanied with the destruction of blood brain barrier.

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re?sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re?gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.

Objective To study the relationship between serum retinal binding protein 4 (RBP4) level and acute cerebral infarction,and to analyze the correlation between RBP4 level and the related risk factors of acute cerebral infarction.Methods One hundred and sixty patients with acute cerebral infarction were chosen as observation group,and 80 cases of contemporaneous healthy examined people were selected as control group.The levels of serum RBP4,body mass index (BMI),fasting blood glucose (FBG),fasting serum insulin (FINS),glycosylated hemoglobin (HbA1c),total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and blood pressure after admission of each group were measured.Statistic analysis was processed between the level of serum RBP4 and acute cerebral infarction or related risk factors.Results The level of serum RBP4 in observation group was increased compared with that in control group [(41.68 ± 5.12) mg/L vs.(23.84 ± 3.26) mg/L],and there was significant difference (P ＜ 0.01).The Pearson relative analysis showed positive correlation between the level of serum RBP4 and related risk factors of acute cerebral infarction FBG,FINS,LDL-C,BMI,systolic pressure.The Logistic stepwise regression analysis suggested that BMI,LDL-C and age were independently associated with the level of serum RBP4.Conclusion RBP4 plays an important role in the incidence of acute cerebral infarction,high RBP4 level may be one of the dangerous factors of acute cerebral infarction patients and could provide reference to prevents the cerebral infarction.

Laboratory of electron microscopy is representative of large instruments laboratories in medical research.And the operation and management in this kind of laboratory are different.Case of forty years of operation and management in the medical laboratory of electron microscopy,this paper analyzed and summarized its successful experiences in the research management system,personnel system and the aspect of equipment maintenance management.Provide a management reference for medical research institutions with the laboratory of similar large-scale instruments.