Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA％)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA％)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA％of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LDgrade4,middle lobe of right lung WTgrade5,upper lobe of right lung WAgrade4,middle lobe of right lung WAgrade5 and lower lobe of left lung WAgrade3 in low EOS group were all higher than those in high EOS group(all P＜0.05).Except for the upper lobe of right lung LDgrade4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P＜0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA％,a part of WT and WA were all weakly negatively correlated with blood EOS level.

The kidneys are one of the main excretory organs for drugs and when drugs are not excreted effectively, they can accumulate in the kidneys or in the interstitial tubules, leading to drug-induced kidney injury. The tubulointerstitium accounts for 80% of the volume of the kidney and is the primary site of response to various types of renal injury. This article focuses on drug-induced acute interstitial nephritis, highlighting its clinical symptoms, listing common induction drugs, analysing pathological features, and explaining its pathogenesis from the perspective of immune response, with the aim of providing a basic and clinical evidence for subsequent studies.

Objective:To better understand the current status of master of public health (MPH) cultivation, establish a better training system, and improve its training quality.Methods:The students and teachers from many universities in Fujian province, as well as the public health workers, were investigated with a questionnaire on the "training model of master of public health", and SPSS 13.0 was used for data processing.Results:The survey results showed that 51.54%(67/130) of the survey respondents liked MPH major, and their understanding of MPH gradually increased with increasing working experience. However, there was no statistical significance in terms of the correlation between the abilities cultivated by the MPH training system and the working years. And 89.23%(116/130) of the survey respondents indicated that the direction of MPH training needed to be further refined, and the net promoter score for the evaluation of the MPH training model was -53.07%.Conclusion:At present, certain achievements have been made in MPH cultivation, and the development of MPH cultivation system needs more in-depth study.

Objective:To investigate the therapeutic effects of a small interfering RNA (siRNA) targeting hypoxia inducible factor-1α (HIF-1α) on collagen-induced arthritis (CIA) in mice and to analyze the possible mechanism at the macrophage level.Methods:DBA/1 mice were injected with bovine type Ⅱ collagen to establish the CIA model. Then, they were injected with HIF-1α-siRNA adenovirus or negative control adenovirus through tail vein once a week for four weeks. This study included four groups: control group, CIA model group, negative control group and HIF-1α-siRNA group. Mouse bone marrow-derived macrophages (BMDMs) were isolated and cultured. The relative expression of CD206 and arginine (Arg) at mRNA level in mouse BMDMs was detected by RT-PCR. The proportions of F4/80 + CD16/32 + M1 and F4/80 + CD206 + M2 macrophages in spleen and thymus were detected by flow cytometry. Pathological changes in the ankle joint of mice were observed using HE staining. Immunohistochemistry was used to detect the expression of macrophages and the subsets in mouse synovial tissues. Results:(1) Compared with the control group, the CIA model group showed decreased expression of CD206 at mRNA level in BMDMs, but increased expression of Arg at mRNA level ( P<0.01). HIF-1α-siRNA increased the expression of CD206 at mRNA level ( P<0.05) and reduced the expression of Arg at mRNA level in BMDMs of mice with CIA ( P<0.01). (2) Compared with the control group, the mice in the CIA model group had increased proportions of F4/80 + CD16/32 + M1 macrophages in splenocytes and thymocytes ( P<0.05), but decreased proportions of F4/80 + CD206 + M2 macrophages in thymocytes ( P<0.05). HIF-1α-siRNA could down-regulate the proportions of F4/80 + CD16/32 + M1 macrophages in splenocytes and thymocytes ( P<0.05), and up-regulate the proportions of F4/80 + CD206 + M2 macrophages in thymocytes of CIA mice ( P<0.01). (3) CIA mice had synovial hyperplasia and macrophages infiltration, especially M1 macrophages, in the ankle joint. HIF-1α-siRNA could alleviate the synovial hyperplasia and macrophage infiltration. Conclusions:HIF-1α-siRNA could alleviate macrophage infiltration and synovial hyperplasia in CIA mice through reducing the proportions of M1 macrophages in thymocytes, BMDMs and synovial tissues and increasing the proportion of M2 macrophages, suggesting that HIF-1α-siRNA could treat CIA mice by regulating the differentiation of M1 and M2 macrophages.

To compare carbon nanoparticles with methylene blue for sentinel lymph nodes mapping in laparoscopic staging of early endometrial carcinoma.Forty five patients with stage I or stage Ⅱ endometrial carcinoma undergoing laparoscopic operation from January 2016 to January 2018 were randomly divided into two groups:methylene blue was applied in 20 cases and carbon nanoparticies were applied in 25 cases for sentinel lymph node (SLN) mapping in laparoscopic staging;and the images of two tracers were compared.The development time of nano-carbon group was shorter[(16.4±3.4) min vs.(21.0±5.9)min,t=3.26,P=0.02] and duration was longer [(73.1 ± 14.3) min vs.(54.6 ± 14.9)min,t=5.41,P=0.04] than those of methylene blue group.In lymphatic mapping,the detection rate of SLN in nano-carbon group was significantly higher than that of methylene blue group [95％ (21/22)vs.5/18].For detection of metastatic SLN,the sensitivity of methylene blue group was 1/2 and that of nano-carbon group was 4/4 (x2=66.70,P＜0.01).The results indicate that both methylene blue and Nano-carbon tracer can be used for SLN mapping in laparoscopic staging of early endometrial carcinoma,and nano-carbon tracer is recommended as the first choice to predict pelvic lymph node metastasis in endometrial carcinoma surgery.

OBJECTIVE: To analyze the clinical characteristics and genetic basis of a child affected with Glass syndrome. METHODS: Clinical manifestations and auxiliary examination results of the child were analyzed. Potential mutation was detected with next generation sequencing and validated by Sanger sequencing. RESULTS: The child has featured growth and mental retardation, delayed speech, cleft palate, crowding of teeth, and downslanting palpebral fissures. DNA sequencing revealed a de novo heterozygous missense mutation c.1166G>A (p.R389H) in exon 8 of the SATB2 gene in the child. CONCLUSION The heterozygous mutation c.1166G>A (p.R389H) of the SATB2 gene probably account for the Glass syndrome in the patient.
Abnormalities, Multiple ; genetics ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 2 ; Humans ; Intellectual Disability ; genetics ; Matrix Attachment Region Binding Proteins ; genetics ; Mutation ; Transcription Factors ; genetics

Objective To investigate the changes of serum retinol binding protein 4 (RBP4) concentration in peripheral blood of normal gravidas at different stages during pregancy and the differential expression of serum RBP4 in gravidas with fetal growth restriction (FGR) in second trimester.Methods This study enrolled 80 gravidas who received routine prenatal examination and delivered in the Beijing Luhe Hospital Affiliated to Capital Medical University from January 2014 to January 2015,Forty gravidas were classified to FGR group as the birth weight of their fetuses was below two standard deviations or below the 10th percentile for the corresponding gestationas and same sex,or less than 2 500 g after 37 weeks.The other 40 gravidas who delivered newborns with normal birth weight (2 500 g ＜ birth weight ＜ 4 000 g) were used as control group.Levels of serum RBP4,plasma albumin,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein-cholesterol (LDL-C),hemoglobin,fasting insulin and vitamin A were determined before pregnancy and at 12-16,20-24,28-32 and 36-40 weeks of gestation.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.Independent sample t test or analysis of variance,Chi-square test or Fisher exact test was used for statistical analysis.Pearson correlation was used to analyze the relationship between peripheral blood RBP4 level and neonatal birth weight at 20-24 weeks.Results (1) Serum RBP4 levels in normal gravidas were (24.65± 10.02),(29.86±23.40),(56.10± 12.28),(65.80±20.56) and (53.71 ±24.17) μg/ml before pregnancy and at 12-16,20-24,28-32 and 36-40 weeks of gestation,respectively,showing a gradually increasing trend with gestational week until a peak at 28-32 weeks and then followed by a decrease (F=14.173,P＜0.001).(2) The body mass index and placental weight of gravidas in FGR group were lower than those in control group [20.7±3.3 vs 22.9±2.1,(401.3±56.2) vs (501.3±64.7) g;t=22.590 and 2.487,both P＜0.05].(3) The fasting blood glucose,fasting insulin,HOMA-IR,RBP4 and plasma albumin in FGR group were lower than those in control group [(4.06± 0.4) vs (4.38 ± 0.4) mmol/L,(21.84± 15.2) vs (31.76 ± 1.5) μ U/ml,0.5 ± 0.2 vs 0.7±0.2,(41.78± 12.8) vs (65.80±20.5) μg/ml,(35.1 ±2.7) vs (36.5±2.3) g/L;t=3.419,2.355,3.419,6.263 and 2.462,all P＜0.05].Maternal serum RBP-4 at 20-24 weeks of normal gravidas and FGR gravidas were positively correlated with the birth weight of newborns (r=0.717 and 0.748,both P＜0.05).Conclusions Serum RBP4 of gravidas may be associated with the occurrence of FGR.

Objective: To explore and compare 4-color and 8-color fluorescence antibody panels for detecting minimal residual disease of multiple myeloma patients after therapy. Methods: One 8-color antibody panel was built including CD38 and CD138 for the identification of plasma cells (PCs) , membrane antigen CD45, CD19, CD56 and CD117, cytoplasmic Kappa (cκ) and Lambda (cλ) light chain antigen. Six tubes of 4-color panels were built, among them, membrane antigen CD45/CD19, CD56/CD117, CD19/CD56 and light chains were analyzed combined by CD38/CD138 for PCs gate in the tubes M1-3 and tube C-_κ/λ, respectively; CD19 or CD45 and cκ/cλ light chains were detected in the tube MC1-_CD38 for CD38/SSC identified PCs gate and tube MC2-_CD138 for CD138/SSC identified PCs gate separately. Twenty normal volunteer bone marrows and seventy-three specimens from multiple myeloma patients after complete remission were measured and analyzed. Results: MRD positive samples were discriminated in 82.19% of the specimen evaluated through either abnormal plasma cells (aPCs) or clonal plasma cells (cPCs) by 8-color antibody panel. Among of them, consistency was 89.04%. The median percentage of cPCs was 0.105%. The lowest sensitivity of experiment was 0.004%. Percentage of PCs identified by CD38/ SSC gate was higher than that by CD38/CD138 (P<0.001) and CD138/SSC gate (P=0.001) apparently. The lowest MRD positive rate was found in tube C (65.75%) , which lower than 8-color panel obviously (P=0.024) . The percentages of aPCs measured by tube M2-_56/117 were significantly lower than other tubes (P=0.014) . MRD positive rate determined by cPCs was higher than that by aPCs both in the tube MC1-_CD38 and tube MC2-_CD138, whose concordance rate were 68.49% and 79.45%, respectively. Compared with 8-color panel, tube MC2-_CD138 the best choice among six tubes of 4-color panels, which has the best sensitivity, accuracy and negative predicted value, higher positive predicted value and specificity. Tube M1-_45/19 was the second choice. Conclusions CD38/CD138 are the best markers for gating PCs. Membrane antigen and cκ/cλ detected simultaneously is a better method for MM MRD detection and 8-color antibody panel is an ideal approach. Two tubes of 4-color antibody combination, M1-_45/19 and MC2-_CD138 are recommended in the 4-color panels.

Objective To put forward a project of human resource management in nurses during pregnancy and lactation so as to ensure physical and mental health in in nurses during pregnancy and patient satisfaction,reduce the recessive loss of human resource and to optimize the allocation of nursing human resource.Methods The project was designed comprehensively from post setting,employment arrangements, performance management and so on according to analyzing the actual demand of in nurses during pregnancy on physical and mental health,work environment,economic returns and so on.Results After implementing the project,there were five nurses during pregnancy and one nurse during lactation returning to work. The satisfaction of front-line nurses and the head nurses in the departments with this project was 100% and 97.37%. Conclusions The implementation project of human resource management in the nurses during pregnancy and lactation can make nurses fully realize self-worth,relieve the hospital′s stress on invisible loss of human resources,ensure the relative stability of nurses,achieve the best management effects of tripartite win-win situation for the hospital,patients and nurses.

This study was aimed to evaluate the efficacy and safety of acupuncture treatment for diabetic peripheral neuropathy.MEDLINE, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang database were searched. The study endpoints included clinical total efficacy, peripheral nerve conduction velocity and adverse reactions. The Review Manager software 5.2 was used in the bias and risk assessment as well as efficacy. GRADE profiler software was used to evaluate quality of evidences. The results showed that there were 18 randomized controlled trials (RCTs) with 1158 patients included. The clinical total efficacy rate of acupuncture treatment was obviously better than the drug control group [RR: 1.38, 95%CI (1.25, 1.53),P < 0.000 01]. The sensory nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD = 2.55, 95%CI (1.23, 3.87),P = 0.000 1]; for nervus peroneus communis, the acupuncture treatment group was superior to the drug control group [MD = 3.42, 95%CI (2.56, 4.28),P < 0.000 01]. The motor nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD= 4.10, 95%CI (1.01, 7.19),P = 0.009); for the nervus peroneus, the acupuncture treatment group was superior tothe drug control group [MD = 3.09, 95%CI (1.99, 4.19),P < 0.000 01]. The adverse reactions and safety indicators were that no adverse reaction was reported in both studies with no abnormal safety indicator. The quality of evidence showed that the sensory nerve conduction velocity for nervus peroneus communis was moderate; the motor nerve conduction velocities for nervus medianus and nervus peroneus communis were low. While, the clinical efficacy rate and the quality of evidence for sensory nerve conduction velocity of nervus medianus were relatively low. It was concluded that the current clinical evidences were uncertain for the efficacy and safety of acupuncture in diabetic peripheral neuropathy treatment.