Abstract:Because of the prevalence of chronic disease, it is a major challenge in the world to effectively change bad health habits. So the article explored why habit was primary form of behavior patterns, explained how health habits were formed, then analysed the different role of rationality, consciousness and unconsciousness in changing behavior and habits, advanced how to change health habits effectively. Finally, according to the mechanism of the formation and transformation of habits, the author provided relevant recommendations and measures to effectively control the spread of chronic diseases in practice.

Abstract:Objective:To make the public satisfaction structural equation model for community traditional Chinese medicine service by referring to the customer satisfaction model, and to analyze the current situation of community traditional Chinese medicine service in the city group of Guangzhou, Shenzhen, Shantou, Huizhou and Zhanjiang in Guangdong province. Methods: Using the method of PLS, an empirical study on the public satisfaction with the community traditional Chinese medicine service in Guangdong province was conducted. Results: The study revealed that the satisfaction index model was feasible for assessing the community traditional Chinese medicine service in Guangdong province. Conclusion: The results showed that satisfaction assessments should be promoted further, the quality of traditional Chinese medicine service in community should be reformed, and the important factors that affected satisfaction should be improved.

Abstract:The reform of public hospitals is the emphasis and difficulty of China’s new medical reform. Based on the definition of the difficulty and expensiveness to see a doctor, public hospitals and its public welfare, the article expounded the main effects of public hospitals reform, and made a deep analysis of the challenges from the indistinct public welfare nature, the imperfect compensation mechanism, the weak management and internal operation mechanism, and the unbalanced medical talent allocation. Finally, some targeted suggestions were put forward.

Abstract:Animal has no moral,but this does not negate that the virtue is form the basis of human life. Baby who cannot use language,cannot give the conceptually reasoning cannot grow up into mature practitioner without person’s biological basis. Mature practitioner cannot keep the identity without the body of animal personality. Based on recognition of the biological basis of virtue,the relationship between virtue and reason should be clarified probably,and the dilemma of rationalism moral philosophy should be solved.

Abstract:Through analysing the fund operational status of new rural cooperative medical care(NCMS) in Binhai county, Jiangsu province, the authors suggested that a few effective measures should provide reference for other regions to keep operation of NCMS steady and safe, including perfect propaganda network system,sustainable and stable fund-raising mechanism, a reasonable compensation scheme,strict regulatory mechanisms and scientific and efficient information management system.

Abstract:Based on domestic health service, this article attempted to explore the strategic cooperation joint development mechanism between hospitals for direction, and put forward the innovative 3-stage model:“resources transform → incubation → benefit deepen”. Taking medical university hospital for the study, through surveys and statistical analysis, the authors advised the operation mechanism of strategic cooperation joint development between hospitals should provide theoretical support and intuitive data reference for the actual work.

Abstract:Objective:To compare the differences between medical students and non-medical students in the aspects of rates of sexual act incidence and rates of sexual act protection during the last 10 years of China,and discuss the influence of medical education for current sexual acts in order to provide foundations for developing sexual education. Methods:Domestic published documents about current sexual act situation in both medical and non-medical universities were collected from January,2002 to January,2012. The documents were evaluated according to the specific standard,and the required documents were analyzed by Meta. General statistic description was applied if data heterogeneity was too obvious to apply Meta. Results:The number of qualified documents was 15 in total. Due to the apparent heterogeneity,general statistic description was applied. In medical students the rate of sexual incidence was lower and the rate of sexual protection was higher than non-medical students apparently,and the both rate were rising year by year recently. Conclusion:The problem of sexual acts in the universities is not optimistic,and the response is necessary.

Abstract:Recent years,the rapid increase in medical espense became a heavy burden on the patiens.The high cost of getting medical service in china is a hot issue. As a standardized treatment plans,the clinical pathways are closely related to medical process control and hospital information construction. The implementation of Clinical Pathway should assure the quality of health care and lower medical expense,reduce the nonessential inspection and avoid the excessive medical service. The medical process control linked with clinical pathways will improve the medical quality.

Abstract:This article began with the public welfare of hospitals and the current situation of construction projects, analyzed the necessity and significance of the implementation of construction agent system,and proposed considerations and suggestions with regard to crucial problems arising in the course of such implementation.

Abstract:The cultural conflicts between doctors and patients are caused by differences between the traditional medicine culture and the modern medicine culture, which exist during the process of modernization in China. To deal with these conflicts, we could use the philosophic thought of “harmony generates vitality” and “harmony without uniformity” which are both from the traditional culture, accept the existence of differences, achieve the goal of integration, then promote the popularization and development of the modern medicine culture. All the efforts would certainly contribute to the resolution of these conflicts.

Abstract:The physicians and patients have confidence in each other is one of the key influential factors for a good physician-patient relationship. However, there have been serious confidence problems in Chinese hospitals for a long time, the reasons can be listed as follows: a confidence lack in whole society, unfair healthcare policy and system, a poor communication between physicians and patients, corruption of medicine professional morality, patient’s incorrect ideas and the behavior of breaking duty. We should do our best to deal with these problems, and to reconstruct a good physician -patient confidence in the end.

Abstract:With the cross-sectional method, the article studied the patients’ satisfaction and loyalty to general hospitals in Changzhou city, analyzed their relationship and the influencing factors, then provided a reference for hospitals to improve their services and patients’ loyalty and promote their sustained and sound development.

Abstract:With the development of modern scientific technology, the loss of medical humanism is becoming more and more visible. The article started from the connotation of medical humanism, analysed the current situation of the loss of medical humanism, and emphasized the importance of medical humanism. It also suggested the efficient ways to nurture medical humanism on the following three aspects: improving of humanistic quality of medical staff, assessment of humanism index and the reflection of medical humanistic care.

Abstract:Objective: To study subjective well-being and personal affecting factors among clinical college students. Methods: General well-being schedule(GWB), Beck depression inventory(BDI), Eysenck personality questionnaire(EPQ-RSC), and the self-esteem scale(SES) were used. Results: The clinical college students had a high level of subjective well-being. Extroversion was positively related to subjective well-being, and neuroticism was negatively related to subjective well-being. The self-esteem was negatively related to subjective well-being. The total score of depression and its items were negatively related to subjective well-being. Neuroticism was the most powerful and stable factor predicting subjective well-being; the depressed attitude, physical symptoms and depressed actions were also second powerful factors predicting subjective well-being, among which, feeling of exhaustion and sad mood were comparatively effective; while the self-esteem only explain a small part of subjective well-being. Conclusion: Some suggestions were proposed according to these personal affecting factors in order to enhance the subjective well-being and mental health of the medical students.

Abstract:During the period of the Republic of China, the uneven distribution of resources in medical education were very prominent, and the government put forward the university area system reform in order to change the phenomenon. Although the aim of the reform was not to adjust the distribution of medical education, it had the effect of regulation objectively. On the other hand, the government adopted a series of measures to donate money, so as to regulate the distribution of medical school. But for a variety of reasons, the regulation of distribution in medical school was not successful, uneven distribution phenomenon still existed. The analyses of this regulation had certain enlightenment function to the distribution of current medical education.

Abstract:Objective: To explore the career decision-making self-efficacy and coping styles of medical college students and analyze their correlations. Methods: 659 undergraduates of medical university were investigated by the career decision-making self-efficacy scale(CDMSE) and coping style questionnaire(CSQ). Results:① There was gender difference in medical college students’ career decision-making self-efficacy and male college students’ career decision-making self-efficacy was higher than that of female students(P < 0.05). ②Overall career decision-making self-efficacy and each of its dimensions had significant positive correlations with the problem-solving dimension of coping style(P < 0.05), and negatively correlated to self-accusation, fantasy and avoidance(P < 0.05). The self-evaluation and problem-solving of career decision-making self-efficacy had negative correlations with the rationalization of coping style(P < 0.05).③Students with high career decision-making self-efficacy usually used positive ways to deal with problems, and students with low career decision-making self-efficacy used negative coping styles. Conclusion: Certain relations existed between career decision-making self-efficacy and coping styles of medical college students. More attention should be paid to the cultivation of college students’ positive coping styles.

Abstract:Independent college has become an important component of China’s higher education, and the development of independent college needs further exploration. According to the existing unreasonable position and universal problems of personnel training, this article started with constitute elements of personnel training objectives, put forward several principles which independent college should follow, emphasized the concrete objectives and content of personnel training, then abstracted the general definition of personnel training objective of independent college.

Abstract:Surveying on the sample of 85 colleges and universities, there was a big difference in course module design, general character, main courses, elective courses, stage of development and other aspects through comparing the difference of course system design of international trade among comprehensive universities, economic colleges and medical colleges. To maintain economics nature and characteristics of international trade professionals, medical colleges should strengthen the teaching staff, deepen cross-disciplinary research, definite the school characteristics, integrate the curriculum resources and other aspects.

Abstract:Orthodontics, a discipline with great flexibility and abstraction, is famous for its complex operation procedure. How to make the students grasp the basic techniques in clinic, comprehend the ideas for proper diagnosis and treatment plan, and form a systematic thought of orthodontics in a short time are always challenges for orthodontic education. Three-dimensional simulation jaw frame system can imitate clinic treatment procedure, and with its great visualization, it is an effective and scientific mode in orthodontics continuing education to perform standardized training of clinic operation.

Abstract:The important task of epidemiological educators is to increase the teaching effect of epidemiology for non-preventive medicine and train qualified medical personnel who are adapted to the new situation. Through teaching practice, we provide several suggestions on the teaching of epidemiology for clinical medicine: connecting with clinical and prevention practice and improving students’ interest in learning epidemiology, combining classroom teaching with learning after class and developing students’ independent learning and creative thinking ability, launching “problem-based learning” model to improve teaching efficiency and strengthening the teaching practice to enhance the students’ ability to solve practical problems.

Abstract:Dominated with medicine-related subjects, medical universities and colleges were still weak in the humanistic quality of education due to its comparatively less cultural atmosphere, insufficient class hour and teachers, and unreasonable class schedule. This article made practical analysis in teaching environment, content, method and teachers of humanity education in surgical education, and the research showed that the humanistic quality of medical students was improved.

Abstract:Objective:To investigate the role of AREG in PGE2-induced proliferation of cholangiocarcinoma cells(CCLP1 cells). Methods:CCLP1 cells were treated with PGE2,EP1-4 receptor agonist,EP2 receptor antagonist H89,PKA inhibitor H89,cAMP inhibitor SQ22536. Western blot and WST were used to examine the expression of AREG protein and the cell proliferation ability in CCLP1 cells. Results:The level of AREG protein increased by 44.2%(P < 0.05) after treated with 10 μmol/L PGE2. It was previously proved that PGE2 could promote the proliferation of CCLP1 cells,however,this effect was obviously inhibited by 20% (P < 0.01) when CCLP1 cells were pretreated with the 20 μmol/L neutralizing-antibody(Mab262 and SAB1402118) of AREG. Then four selective EP receptor agonists(17-phenyltrinor Prostaglandin E2,Butaprost,Sulprostone and Prostaglandin E1 Alcohol) 10 μmol/L were used to stimulate CCLP1 cells,it were found that only EP2 agonist could induce the expression of AREG protein,increased by 20.1%(P < 0.05),whereas the other three agonists downregulated the protein expression of AREG. In agreement with this result,the expression of AREG protein improved by EP2 agonist was indeed suppressed by 20%,when CCLP1 cells were pretreated with 10 μmol/L AH6809,the EP2 antagonist. After treated with EP2 receptor agonist(10 μmol/L) for 24 h,the proliferation ability of CCLP1 cells increased by 26.5%. PKA inhibitor H89 and cAMP inhibitor SQ22536 can restrict the AREG protein increase induced by PGE2,and the AREG protein expression was downregulated by 54.4% and 46.6% respectively,compared with PGE2 treated group. It was reported that PGE2 could induce the phosphorylation of CREB in CCLP1 cells,which could bind and activate the CRE element of AREG promoter. However,H89 and SQ22536 could strikingly inhibit the phosphorylation of CREB induced by PGE2. At the same time,CMV500-DN-CREB plasmid was transfected into CCLP1 cells,resulting in a striking restriction of AREG protein expression induced by PGE2. Conclusion:Prostaglandin E2 might promote the cell proliferation of CCLP1 cells through EP2 receptor,which consequently upregulates the expression of AREG by activation of cAMP-PKA-CREB pathway.

Abstract:Objective:To investigate whether intracellular zinc depletion can actually change spermatozoa motility and the abundance of voltage-dependent anion channel(VDAC) mRNA in cultured human spermatozoa. Methods: Spermatozoa were separated from ejaculates of three donors using a discontinuous Percoll gradient centrifugation. Each spermatozoa specimen were divided into 3 groups,one was exposed to a cell membrane-permeable zinc chelator N,N,N＇,N＇-tetrakis(2-pyridylmethy1) Ethylenediamine (TPEN) (2 -滋mol/L) for 24 hours,one was to TPEN plus zinc sulfate(5 -滋mol/L) for 24 hours,and one was as control. CASA and quantitative real-time PCR(qPCR) were performed to detect sperm motility characteristics,mRNA abundance and difference of the three VDAC subtypes between three different treatment groups respectively. Results:The results of CASA demonstrated that exposure of spermatozoa to TPEN for three hours significantly decreased sperm motility compared with the control group(P = 0.049). qPCR demonstrated that VDAC3 mRNA level of TPEN group were significantly lower than that of control group,while no significant difference was found between TPEN plus zinc sulfate treatment group and control group. Co-addition of zinc partly reversed TPEN-induced alterations of sperm motility and VDAC3 mRNA abundance. Conclusion:The results of the present study implicate that zinc depletion may induce VDAC3 mRNA abundance decreasing and affect the normal function of spermatozoa.

Abstract:Objective: To investigate the effect of thymosin β4(Tβ4) on mouse hepatic ischemia-reperfusion(IR) injury and its possible mechanism. Methods: One hundred male ICR mice were randomly divided into four groups:sham group,70% IR group,saline group and Tβ4 group respectively. Serum was collected for alanine aminotrasferase(ALT) and aspartate aminotransferase(AST) measurement at 1,3,6,12 and 24 h after reperfusion. Liver tissues were divided into two parts:one part of liver was fixed for HE staining,the other part was maintained in liquid nitrogen for Western blotting and PCR. The expressions of Tβ4,AKT,p-AKT,Bad,p-Bad were performed by Western blotting;the mRNA expressions of TNF-α and IL-6 were detected by PCR. Results: During the process of liver I/R injury,the expression of Tβ4 was decreased at 1,3 h and recovered at 6 h after reperfusion. The levels of ALT and AST in Tβ4 group were lower compared with the 70% IR group and the saline group(P < 0.05),and Tβ4 group also showed alleviated I/R injury as revealed by HE staining. Meanwhile,the expressions of TNF-α and IL-6 were significantly inhibited in Tβ4 group. Furthermore,the Tβ4 group showed elevated phosphorylation levels of AKT(p-AKT) and Bad(p-Bad) at 1,3,6 h after reperfusion. Conclusion: Tβ4 can alleviate hepatic I/R injury through activating AKT-Bad pathway directly and inhibiting the expressions of inflammatory cytokines in mice.

Abstract:Objective:To investigate the expression difference of aquaporin-3(AQP3) in each stage of gastric adenocarcinoma(GAC),and the relationship with lymph node metastasis. Methods:Collecting 80 cases of gastric adenocarcinoma tissue and corresponding nontumor tissue,the AQP3 expression of mRNA and protein in each sample were detected by quantitative real time polymerase chain reaction(qPCR) and Western blot. Then,the relationship between AQP3 expression and clinicopathologic characteristics of the patients was analyzed. Results:The different expressions of AQP3 in each stage of GAC (T1,T2,T3,T4),according to UICC(2010),had effects on lymph node metastasis;The expression of AQP3 in tumor tissue with lymph node metastasis was higher than that without lymph node metastasis. Conclusion:The overexpression of AQP3 in GAC might stimulate the occurrence of lymph node metastasis. The overexpression of AQP3 can be taken as a biomarker of GAC prognosis and metastasis. AQP3 might be a therapy target of gastric adenocarcinoma.

Abstract:Objective:To investigate the roles of lipoxin A4 (LXA4) in attenuating myocardial hypoxia/reoxygenation(H/R) lesion and the possible mechanisms. Methods:The cells were randomly divided into five groups:control group,H/R group,LXA4 + H/R group,ZnPP + H/R group,LXA4 + ZnPP + H/R group. Pathological changes of cells was observed. The levels of LDH and CK in cellular supernatants were measured,and activity of HO-1 was measured. HO-1 mRNA expression was analyzed by RT-PCR. Results:Pretreatment of the cells undergoing hypoxia/reoxygenation lesion with LXA4 significantly reduced the LDH and CK levels of cells,protected cells from necrosis,and increased the HO-1 activity and the HO-1 mRNA expression as compared with those in the cells without LXA4 pretreatment. However,HO-1 inhibition by ZnPP abolished the protective role of LXA4 on the cells undergoing hypoxia/reoxygenation lesion. Conclusion:LXA4 can induce HO-1 overexpression which provide the protective role on myocardiac cells undergoing hypoxia/reoxygenation lesion.

Abstract:Objective:To explore the impact of postnatal long-term corticosteroids use on early lung development and find the relation between glucocorticoids and insulin-like growth factor binding protein 2(IGFBP-2). Methods:Total 48 neonatal rats were randomly divided into 3 groups:control group (nebulized saline),budesonide group (nebulized budesonide) and dexamethasone group (intraperitoneal injection of dexamethasone). Treatment began at 5 day of age and continued for 1 to 2 week period. At the end of treatment,body weight and lung index were investigated. Alveolar counts,alveolar septum thickness and alveolar space as morphologic markers were used to evaluate alveolar development. The expression of IGFBP-2 was detected by Western Blot. Results:①There was no significant difference in body weight between budesonide group and control group (P > 0.05). Body weight was significantly decreased in dexamethasone group compared with control group after 14 days exposure(P < 0.01). There was significant difference in lung index between budesonide group and control group(P < 0.01),but there was no statistical difference in lung index between dexamethasone group and control group after 14 days treatment(P > 0.05). ② The total number of alveoli,thickness of the alveolar wall were dramatically reduced and alveolar space increased in budesonide and dexamethasone treated groups when compared with control(P < 0.01,P < 0.05 respectively). No significant differences about the three morphologic markers were seen between budesonide group and dexamethasone group. ③ The expression of IGFBP-2 in lung tissue of budesonide and dexamethasone groups significantly increased compared with control group detected by Western Blot. Conclusion:Long-term corticosteroids use affects postnatal lung alveolization. The overexpression of IGFBP-2 in lung tissue may relate to the pathological changes.

Abstract:Objective: To investigate the effect of mildronate(MIL) on the acute lung injury(ALI) induced by LPS in mice. Methods: According to the random number table,all 50 ICR mice were randomly divided into 5 groups,of which four groups was induced ALI and were respectively divided into LPS group,MIL 50 mg/kg group,MIL 100 mg/kg group,MIL 200 mg/kg group,each contains 10 mice. ICR mice was induced ALI by instilling intratracheally with 0.1ml LPS(2 mg/kg). Saline and mildronate (50,100 and 200 mg/kg) were injected intraperitoneally daily in mice for 6 days before challenge with LPS. In addition,10 mice in the normal saline group(NS group) were administered saline also by intraperitoneal injection at the same time in the same way. Ten animals in each group were killed at 4 h after LPS administration respectively. Wet /dry weight ratios of lung,the expression of NF--资Bp65 was observed by immunohistochemistry,the levels of IL-1βand IL-6 in lung tissue were measured by ELISA,and lungs histopathology was also performed. Results: Compared with NS group,wet /dry weight ratios of lung,the expression levels of NF--资Bp65,IL-1βand IL-6 in lung tissue were significantly higher in the LPS group(P < 0.01). Alveolar edema and neutrophils infiltration were observed in LPS group. Mildronate pretreatment significantly attenuated LPS-induced pulmonary histological changes in MIL 50 mg/kg group,MIL 100 mg/kg group and MIL 200 mg/kg group(P < 0.05),and there was no significance in pulmonary histological changes among the three mildronate therapeutic groups. Conclusion: Mildronate can protect the lungs against LPS-induced acute injury by down-regulating the expression of NF--资Bp65 and inhibiting inflammatory response at all doses.

Abstract:Objective: To examine the prevalences of sexually transmitted disease and HIV,and sex behavior among female sex workers as well as the risk factors associated with the treponema pallidum (TP) and chlamydia trachomatis (CT) infections in Jiangsu province. Methods: The subjects were recruited by convenient sampling. Demographic and behavioral information was obtained using face-to-face questionnaire interview. Blood sample and cervical swab were collected for the tests of TP,HIV,CT and neisseria gonorrhoeae(NG). Data analyses were performed using SPSS13.0. Results: A total of 1 806 subjects were recruited with questionnaire information,and blood samples were collected. The median age was 25 years old. The prevalences of TP,CT,NG and HIV were 8.4%,14.7%,5.4% and 0.3% respectively. Risk factors for TP included lower education level and working in the lower class venues. Risk factors for CT included being younger,higher education level,having unprotected sex with clients during the past month. Conclusion: High STD prevalence and widespread risk behaviors are identified among female sex workers in Jiangsu province. Targeted intervention should focus on those working female sex workers.

Abstract:Objective: To investigate the behaviors at high risk of human immunodeficiency virus(HIV) infections and related factors among men who have sex with men(MSM) in Yangzhou,Jiangsu province. Methods:A cross-sectional study with snowball sampling method was conducted from May 2008. The researchers carried out face to face questionnaire about the knowledge attitude and behavior on acquired immune deficiency syndrome (AIDS) among MSM. Blood samples were collected for test of HIV and other sexually transmitted diseases (STD) infection. Results:Among 300 respondents,82.7% of them had homosexual acts in the past six months and 79.4% had multiple homosexual partners;48.7% had heterosexual sex in the past six months and 21.2% had multiple heterosexual partners. The proportion of continuely condom using in homosexual sex in the past six months was 52.0%,while the proportion in heterosexual sex was 21.2%. Laboratory test results showed that the prevalence of HIV infection was 7.3% (22/300) and the prevalence of syphilis was 22.0% (66/300),and no HCV-positive sample were found. In multivariate logistic regression model,looking for sex partners through the internet(OR = 1.93,95% CI:1.01-3.67) and having homosexual sex with regular partners(OR = 0.45,95% CI:0.25-0.79) were significantly associated with the continuely condom using in homosexual sex in the past six months;the infection of syphilis(OR = 3.17,95% CI:1.25-7.99) was significantly associated with the HIV infection. Conclusion:The unprotected sex behavior and multiple sexual partners are common among MSM in Yangzhou. Furthermore,the infection prevalences of HIV and syphilis were relatively high. Intervention on the behavior of the target population must be strengthened to reduce the HIV spread in such population to general population.

Abstract:Objective: To understand HIV infection of men who have sex with men(MSM) in Jangsu province,and to estimate the annual HIV incidence of MSM. Methods:Total 3 152 samples from 3 rounds survey in 3 cities(Nanjing,Yangzhou and Suzhou)among MSM during 2008-2009 were tested to find HIV-1 seropositive samples. HIV-1 seropositive samples were tested with BED HIV-1 IgG capture enzyme immunoassay(BED-CEIA) to find recent HIV-1 infections and to estimate the annual HIV-1 incidence of MSM. Results: There were 175 samples found to be HIV-1 seropositive,and 92 samples confirmed to be recently infected.The annual HIV-1 incidence of 3 rounds survey were 7.05%,5.18% and 3.71% in Nanjing,6.99%,2.39% and 12.27% in Yangzhou,6.73%,3.31% and 9.84% in Suzhou. Conclusion: The prevalence of HIV-1 in MSM in Jiangsu province was still at a high level. Powerful prevention and control effort must be made.

Abstract:Objective:To explore economic and efficient way to block perinatal transmission of HBV by passive-active immunoprophylaxis with different doses of hepatitis B immunoglobulin (HBIG) in newborns with HBsAg positive mothers in China. Methods:The newborns with HBsAg-positive mothers were randomly divided into 2 groups and received 100 IU and 200 IU HBIG respectively within 12 hours after birth. Meanwhile all the newborns were received 3 doses of 10 μg yeast recombinant hepatitis B vaccine (HB vaccine) according to EPI procedure. Post-vaccination tests to detect HBsAg and anti-HBs were assessed at 7 months of age. Results:The success rate of blocking perinatal transmission in newborns of 100 IU and 200 IU group were 98.3% and 98.0% respectively. The difference of blocking efficacy between the two groups was not significant,and the HBsAg positive rates between the two groups were also not significantly different when combined with analysis of mothers’ HBeAg status. Conclusion:Combined with 10 μg yeast recombinant hepatitis B vaccine,the passive-active immunoprophylaxis using 100 IU HBIG was similar to 200 IU HBIG to prevent HBV infection of infant with HBsAg positive mother.

Abstract:Objective:To explore risk factors of hand-foot-mouth disease (HFMD) in northern parts of Jiangsu province. Methods:Questionnaire survey was used to investigate the history of children with HFMD in past 3 years retrospectively in 6 counties belong to Yancheng and Huaian. Univariate analysis and multi-logistic regression analysis were used to analyze major risk factors of HFMD. Results: There were 170 HFMD cases in 1 239 study objects with incidence of 50.36/1000 person-years,with 153 outpatient and 17 inpatient cases. Univariate analysis indicated that five exposure factors were related to the occurrence of HFMD;Multivariate analysis showed that there were three risk factors and two protective factors concerned with the prevalence of HFMD,and the factors were depicted as follow:male(OR=1.60,95%CI:1.12-2.27),living in urban(OR=1.71,95%CI:1.15-2.53),children with frequent upper respiratory tract infection,diarrhea and so on (OR=1.96,95%CI:1.20-3.21),breastfeeding only for 3-6 months(OR=0.39,95%CI:0.17-0.84) and washing their hands before and after meals (OR=0.54,95%CI:0.36-0.81). Conclusion: In urban with large density of population,contact transmission was one way of HFMD infection,so reducing children to contact with the patient would be effective to control HFMD spread. In addition,developing good health habits and breastfeeding shoud protect infant and children from HFMD.

Abstract:Objective:To explore the correlation between swine and human hepatitis E virus(HEV) in Jiangsu province. Methods:Specimens collected from HEV-IgM positive people of the general population,patients with acute hepatitis E and cholecyst from swine in the same area,were detected for HEV RNA by nested reverse transcription polymerase chain reaction(RT-PCR). HEV-positive samples were further analyzed by direct nucleotide sequencing. Results:Among the HEV IgM carriers,8 positive cases were identified,and the subtype of HEV were type 1 and type 4. The majority cases of clinical sporadic HEV were type 4(95.24%). The HEV-positive rate of swine bile samples was 12.11%,and the virus genotype was type 4. The type 4 HEV of human and swine showed a high degree of homology(81%~97%). Conclusion:Both HEV-1 and HEV-4 were found in human in this area with the dominant type of HEV-4. All the swine HEV-positive samples showed HEV-4 genotype. The HEV-4 of human and swine in the Dongtai area showed a high degree of homology. These findings suggest that swine may be one of the main hosts of HEV in this region.

Abstract:Objective: To analyze the percentage of FOXP3+ regulatory T cells in peripheral blood from patients with diabetes of different types. Methods: Three groups were included:type 1 diabetes(n = 43 cases),type 2 diabetes(n = 16 cases) and healthy control (n = 19 cases). Zinc transporter 8 antibody (ZnT8A),glutamic acid decarboxylase antibody (GADA) and islet cell antibody (ICA) were detected by radioligand binding assay. The proportions of regulatory T cells,CD4+CD25+FOXP3+T cells and CD4+CD25+T cells,in peripheral blood were determined by flow cytometry. Results: ① In the peripheral blood,the percentages of CD4+CD25+T cells in CD4+T lymphocytes from patients with type 1 diabetes or type 2 diabetes were lower than those of healthy control;② In the peripheral blood,patients with type 1 diabetes showed lower ratio of CD4+ CD25+ FOXP3+ T cells compared with healthy control and patients with type 2 diabetes;③ There was no significant correlation between the duration of diabetes and the percentage of peripheral CD4+CD25+FOXP3+ regulatory T cells or CD4+CD25+T cells. Conclusion: In the peripheral blood,the FOXP3+ regulatory T cells population was deficiency in patients with type 1 diabetes. Type 2 diabetes had small influence in the percentage of FOXP3+ regulatory T cells. There was no significant relationship between the percentage of FOXP3+ regulatory T cells and duration of type 1 diabetes.

Abstract:Objective:To explore the features of coronary lesions and cardiovascular risk factors in patients with premature and mature coronary artery disease(CAD). Methods:Total 524 patients who were diagnosed with CAD by coronary angiography(CAG) were divided into pCAD (male <55 year-old,female <65 year-old) and mature CAD. Another 112 patients without CAD diagnosed by CAG were considered as the control group. The risk factors,lipid metabolism levels and the coronary angiographic characteristics among the three groups were statistically analyzed. Results:Among the three groups,the distributions of the female,age,smoking status,father’s history of CAD,mother’s history of high blood pressure,white blood cells(WBC) counts,red blood cells (RBC) counts and creatinine concentration were significantly different(P < 0.05). For the pCAD and mature CAD groups,the distributions of father’s history of CAD,WBC counts,RBC counts and creatinine concentration were significantly different(P < 0.05). Serum total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) levels in pCAD groups were significantly higher than those in mature CAD group. Most of pCAD patients had one vascular lesion,and the number of patients with serious coronary artery stenosis (>90%) in pCAD group was less than mature CAD group. Multinomial Logistic regression analysis showed that smoking was associated with the increased risk of both pCAD and mature CAD,while female and mother’s hypertension history were associated with the decreased risk of mature CAD. Conclusion:Smoking,positive family history of CAD,dyslipidemia and abnormal hemodynamics might be the possible risk factors of pCAD. The risk factors of pCAD should be prevented comprehensively,especially in female.

Abstract:Objective:To evaluate the degree of systemic inflammatory response by compare the totally thoracoscopic operation with the conventional open operation to patients with atrial septal defect(ASD). Methods:Total 40 ASD cases were divided into two groups,totally thoracoscopic group(group A,n = 20) and conventional open group (group B,n = 20). In group A,surgical procedures were performed through three lateral-right chest wall holes under thoracoscopy. In group B,the arterial septal defects were repaired in the conventional way. Cardiopulmonary bypass(CPB) time,CPB setup time,aortic artery clamping time,operation time and serum levels of tumor necrosis factor α(TNF-α),interleukin-6(IL-6),intercellular adhesion molecule 1(ICAM-1) and interleukin-10(IL-10) in the two groups were compared. Results: All operation were performed successfully without serious complication. CPB time,CPB setup time,aortic artery clamping time and operation time in group A were statistically longer than those in group B. The serum levels of inflammatory factors(TNF-α,IL-6,ICAM-1,IL-10) in two groups statistically increased after surgery. The serum levels of inflammatory factors(TNF-α,IL-6,ICAM-1,IL-10) in group A were statistically lower than those in group B. Conclusion:Repair of ASD totally under thoracoscope ameliorats systemic inflammatory response. It is technically feasible,and safe.

Abstract:Objective:Lymph node involvement may impact postoperative therapeutic decision-making and prognosis in patients undergoing esophagectomy. This article is a prospective study of the total and the reginal lymph nodes dissection methods of the two surgical approachs (Ivor Lewis and left posterolateral thoracic approach). Methods:All 121 cases of middle and lower thoracic esophageal carcinoma from July 2010 to July 2011 were randomly divided into two groups,Ivor Lewis group with 41cases and left posterolateral thoracic approach group with 80 cases. Comparison was made on the number of lymph node resected,the number of each reginal lymph nodes resected,lymph node metastasis rate and degree,operation time,the volume of introperative blood loss,postoperative chest tube drainage,postoperative hospital stay,surgical complication rate. Results:There were significant differences in the resected number and metastasis rate of superiormediastinum lymph node,operation time,the volume of introperative blood loss between the two groups(P < 0.05). But there was no significant difference between two groups in the other factors(P > 0.05). Conclusion:Ivor Lewis approach has more advantages in the resection of superiormediastinum lymph node and is able to give a accurate evaluation on the postoperative pathological stage and guide the next treatment.

Abstract:Objective:To assess the differences in cardiopulmonary functions between laparoscopic and open surgery for colorectal carcinoma complicated with primary hypertension. Methods: The clinical data of 205 patients with colorectal carcinoma complicated with primary hypertension between May 2008 and July 2010 in the Second Affiliated Hospital of NJMU were prospectively analyzed. Of all the patients,200 cases were finally included in the study,and were randomly allocated to laparoscope group (n = 102) and conventional operation group(n = 98). The HR,SBP,DBP and the results of blood gas analysis of patients at 1st day before operation,interoperation,1st day after operation were recorded,pulmonary function on the 1st day before and after operation was analyzed as well. Results: The SBP,DBP and PaCO2 during interoperation increased significantly in the laparoscopic group than that in the conventional operation group. But on 1st day before operation and 1st day after operation,the results were not different between the two groups. Pulmonary function is better preserved after laparoscopic operation than that after conventional operation on the 1st day after operation. Conclusion: With equal degree of radical resection,laparoscopic technique for colorectal carcinoma complicated with primary hypertension causes less cardiopulmonary function injury as compared with conventional operation.

Abstract:Objective: To investigate the influences of retrognathia on upper airway form and hyoid position. Methods: The patients were divided into the retrognathic group and normal group,according to ANB and SNB. CBCT and Dolphin Imaging 11.0 software were used to compare the differences of width and volume of upper airway,angle with cranial base,and the position of hyoid between two groups. Results: Compared with normal group,the measurements of LP3,VOP and VP in retrognathia group are smaller,the angles of oropharynxes are more retroclined,and hyoids positions were lower and more backwards. H-VPS is significantly correlated with LP3,VOP and VP in retrognathia group. Conclusion: The volumes and angles of oropharynxes,and the hyoid positions in retrognathic patients are abnormal.

Abstract:Objective: To investigate the serum level of S100A12 in coronary heart disease (CHD) patients and approach the effects of S100A12 in diagnosis of CHD. Methods: One hundred and twenty-eight patients who underwent CHD and sixty-one patients with normal coronary artery CTA or coronary angiography were selected in the study. Serum level of S100A12 was measured by ELISA assay. The relationship between serum level of S100A12 and the pathogenetic conditions of CHD were analyzed by logistic regression. Results: The serum level of S100A12[(43.57 ± 10.30) ng/ml] in CHD group was significantly higher than those in serum of non-CHD group[(25.63 ± 7.42) ng/ml](P < 0.001),and positively related with the coronary stenosis Gensini severity score (r = 0.391,P < 0.001). Further logistic regression analysis indicated that after ruling out the other risk factors,such as age,male,BMI overweight,high blood pressure,diabetes,and blood lipid abnormalities,S100A12 also had significant correlation with CHD (OR = 2.67,P < 0.001). Conclusion: The serum level of S100A12 may be a potential biological indicator to predict the risk for CHD.

Abstract:Objective:To investigate the relationship between obstructive sleep apnea syndrome(OSAS) and early atherosclerosis using vascular ultrasonography. Methods:Thirty-seven OSAS patients without hypertension (OSAS group) and forty normal subjects were enrolled in the study. Flow-mediated dilation(FMD) was investigated with brachial artery ultrasound examination. In addition,the arterial elastic parameters including vascular expansibility(VE),compliance coefficient(CC),stiffness index(-茁) and pulse wave velocity (PWV) through quantitative arterial stiffness (QAS) analysis were measured. The differences of the parameters between two groups were analyzed. In the OSAS group,polysomnograph(PSG) data were recorded and analyzed including apnea-hypopnea index (AHI),minimal pulse oxyhemoglobin saturation(miniSpO2). Correlations and regression were calculated between indices of oxygen saturation and FMD. Twenty patients in OSAS group underwent continuous positive airway pressure(CPAP) treatment for three months. Results:① Compared with normal control group,FMD,VE and CC in OSAS group were significantly lower,but -茁 and PWV were significantly higher(P < 0.05). ② Through pearson correlation analysis,in the OSAS group,FMD was negatively correlated with AHI,age and -茁(r = -0.325~-0.378,all P < 0.05),but positively correlated with miniSpO2(r = 0.504,P < 0.01). Through stepwise multiple linear regression analysis,miniSpO2 was a significant determinant for FMD (R2 = 0.548,P < 0.05). ③ Compared with parameters before treatment,there was a significant increase in FMD and CC,but the parameters of arterial stiffness,including PWV and -茁,were significantly lower(P < 0.05). Conclusion:Endothelial dysfunction and the arterial elasticity decrease are present in OSAS patients. Vascular ultrasonography could be performed in detection of early atherosclerosis. CPAP treatment can improve vascular elasticity and endothelium function effectively.

Abstract:Objective:To extract DNA from paraffin-embedded tissue by silica-extraction. Methods:The DNA samples were obtained via silica-extraction method from 49 cases of paraffin-embedded tumor tissues from Department of Pathology in the First Affiliated Hospital of NJMU. The 16 STR gene loci of PCR-DNA fragments were identified with Identifiler Kit. The purity of DNA extracted was analyzed by ultraviolet spectrophotometer. Results:The mean D(260 nm)/D(280 nm) of DNA extracted from gastric carcinoma was 1.84 ± 0.02,from pulmonary carcinoma is 1.85 ± 0.02,from thyroid carcinoma was 1.82 ± 0.02. There was no significant difference in D(260 nm)/D(280 nm) among three carcinoma type groups(P > 0.05). The 46/49 cases(93%) showed the full peaks of all the 16 STR gene loci of PCR-DNA fragment. Conclusion:Silica-extraction may be used to various kinds of paraffin-embedded tissues and extract DNA with high purity and high integrity.

Abstract:Objective:To analyze the concordance and correlation of the detection results of HBsAg,anti-HBs and HBeAg,which were measured by Roche Cobas e601 and Abott Architect i2000,respectively. Methods:The serum samples,including 119 for HBsAg detection,140 for anti-HBs detection and 197 for HBeAg detection,were differently measured by these two chemiluminescence immunoassay(CLIA) systems. Results:The concordance of qualitative results for HBsAg,anti-HBs and HBeAg were 99.1%,95.7% and 90.9% between these two CLIA systems,and the correlation coefficient of quantitative results were 0.566,0.863 and 0.964. But the anti-HBs concentration measured by Abott Architect i 2000 was significantly higher than that of Roche Cobas e 601 system. Conclusion:Qualitative detection results of HBV markers in serum measured by these two systems have good concordance,but anti-HBs concentrations detected were significant different between these two systems.