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The inconsistency of diagnostic criteria for malnutrition has confused clinicians since the 1980s. After the implementation of disease diagnosis related group payment (DRG) in China's public hospitals, the diagnosis of malnutrition and the correct documentation of nutrition-related diagnosis on the front sheet of medical records are related to the correct classification of the disease group and the medical insurance payment. Therefore, the reliable diagnostic criteria for malnutrition, especially disease-related malnutrition, is urgently needed in clinical practice. In September 2018, The global leadership Iinitiative on malnutrition (GLIM) diagnostic criteria consensus was launched. GLIM aimed to provide the explicit and unified diagnostic criteria for malnutrition in adult hospitalized patients. However, GLIM criteria was based on the voting by nutritional experts and was merely a consensus in nature. The clinical validity of GLIM criteria needs prospective verification, i.e., to demonstrate that patients with malnutrition as per GLIM criteria could have improved clinical outcomes with reasonable nutritional interventions. In November 2020, the article titled Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002 was published on the journal Nutrition. It was the first study comparing nutritional risk screening 2002 (NRS 2002) and GLIM malnutrition diagnostic criteria among Chinese patients for the indication of nutritional support therapy. The clinical effectiveness of the two tools was retrospectively verified as well. Here we discussed the key points of this retrospective study, including the critical research methods, to inform the currently ongoing prospective validation of the GLIM malnutrition diagnostic criteria (the item of reduced muscle mass not included).
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It is common that families of cancer patients ask physicians to non-disclose the diagnosis from the patients for purpose of protecting their emotion and quality of life (QOL), but it is conflicted with patients’ increasing demands for right to know in China. Therefore, it is urgent to verify whether non-disclosure (or disclosure) of the diagnosis is more beneficial to patients’ QOL, and provide research evidence for solving the dilemma of non-disclosure or disclosure in medical decision-making. 300 hospitalized patients with early/middle stage liver cancer were recruited, including 162 patients in the disclosure group and 138 patients in the non-disclosure group. The patients’ QOL scale were evaluated at the time of admission, 1 month, 3 months, and 6 months after discharge. The social support scale, trait coping style and trait anxiety/depression scale were assessed at admission. The results showed that 91.30% of the patients in the non-disclosure group knew of the diagnosis of liver cancer by their own way after discharge. The scores of emotional functioning and overall QOL were significantly higher in the disclosure group than those in the non-disclosure group at first month after discharge (P<0.01). At six months after discharge, among the 52 patients with cancer recurrence, the scores of emotional functioning and overall QOL were higher in the disclosure group than those in the non-disclosure group (P<0.05). Additionally, the multivariate analysis showed that, in the presence of age, trait anxiety/depression, social support and other influencing factors, disclosure of diagnosis was positively correlated with the overall QOL at 1 and 6 months after discharge (P<0.05). It indicated that disclosure of cancer diagnosis during hospitalization is more beneficial to improve the QOL of patients with early and middle stage cancer.
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OBJECTIVE Aryl hydrocarbon receptor (Ahr) is thought to be a crucial factor that regulates immune responses, which may be involved in the pathogenesis of autoimmune inflammation including rheumatoid arthritis (RA). The results of our group in recent years have shown that CP-25, a novel ester derivative of paeoniflorin, has a good effect on improving RA animal models. However, whether the anti-arthritis effect of CP-25 is related to Ahr remains unclear. METHODS CP-25 treatment ameliorated adjuvant-induced arthritis (AA), a mouse model of RA, by inhibiting Ahr-related activities in fibroblasts like synoviocytes (FLS). AA rats were treated with CP-25 or paroxetine from day 17 to 33 after immunization. RESULTS CP-25 alleviated arthritis symptoms and the pathological changes, decreased the expression of Ahr in the synovium and FLS of AA rats. Besides, treatment with CP-25 reduced the proliferation and migration of MH7A caused by Ahr activation. In addition, we also demonstrated that CP-25 down-regulated the co-expres?sion and co-localization of Ahr and G protein-coupled receptor kinase 2 (GRK2) in MH7A. CONCLUSION The data pre?sented here demonstrated that CP-25 suppressed FLS dysfunction in rats with AA, which were associated with reduced Ahr activation and the interaction between Ahr and GRK2.
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Objective@#To compare the clinical characteristics of simple testicular yolk sac tumor (YST) in children with those in adults so as to improve the diagnosis and treatment of the malignance.@*METHODS@#This study included 75 cases of simple testicular YST pathologically confirmed between May 2008 and July 2018, which were divided into groups A (aged <18 years, n = 64) and B (aged ≥18 years, n = 11). We analyzed the clinical data on all the cases and compared the clinical manifestations, laboratory results, pathological findings, clinical stages, treatment methods and prognostic outcomes between the two groups of patients.@*RESULTS@#The patients of group A ranged in age from 6 months to 5 years (［1.38 ± 0.89］ yr), with the tumor diameter of 0.9－6.0 (2.48 ± 1.12) cm, while those of group B from 25 to 49 years (median 34 years), with the tumor diameter of 3.5－6.3 (5.16 ± 1.32) cm, most presenting with a painless scrotal mass, 4 (6.2%) in group A and 5 (45.5%) in group B with testis pain. There were statistically significant differences between the two groups in the tumor diameter and initial manifestations (P < 0.05). All the patients were treated by radical high-level spermatectomy and orchiectomy and, in addition, 1 in group A and 3 in group B by retroperitoneal lymph node dissection (RPLND), 24 in the former and 5 in the latter group followed by chemotherapy. Elevated levels of serum alpha-fetoprotein (AFP) were observed in all the cases. Sixty-five of the patients were followed up for 10－78 (52.00 ± 23.78) months, during which 2 cases of simple metastasis, 3 cases of simple relapse, 3 cases of relapse with metastasis and 5 cases of death were found in group A, and 5 cases of simple metastasis, 1 case of simple relapse, 1 case of relapse with metastasis and 4 cases of death in group B.@*CONCLUSIONS@#There are significant differences in the clinical manifestation, biological behavior, treatment and prognosis of testicular YST between children and adults. In children, most of the testicular YST cases are at clinical stage I and preferably treated by radical high-level spermatectomy and orchiectomy with favorable prognosis. In adults, however, the tumor is highly malignant, with high incidences of recurrence and metastasis and poor prognosis, for the treatment of which the first choice is radical high-level spermatectomy and orchiectomy combined with RPLND and chemotherapy.
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OBJECTIVE@#To investigate the technique, mechanism and clinical efficacy of manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations.@*METHODS@#From January 2016 to December 2017, 181 patients with anterior glenohumeral dislocations were treated with our manual reduction, including 71 males and 110 females, ranging in age from 19 to 94 years old, with a mean age of(61.1±16.3) years old; 68 cases of subglenoid type, 93 cases of subcoracoid type and 20 cases of subclavian type. Constant score was used to evaluate limb function while the external fixation was removed.@*RESULTS@#One hundred and fifty-seven patients achieved reduction at the first attempt and 23 patients achieved at the second time. There was no vascular damage, nerve damage or iatrogenic fracture accmpanied. The Constant score ranged from 75 to 100, with a mean score of 92.1±4.3. One hundred and sixty-eight patients were followed up, and the duration ranged from 12 to 24 months, with an average of (16.1±3.2) months, no recurrent dislocation occurred during the follow up period.@*CONCLUSIONS@#The manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations has high success rate and low complication rate, which is scientific, safe, standardized, easy to learn and worth promoting.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Manipulation, Orthopedic , Schools, Medical , Shoulder Dislocation , Therapeutics , Shoulder Fractures , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical effects between open reduction internal fixation and three-dimensional reduction with external fixation under analgesia in treating fresh thoracolumbar fractures, and explore the simple and effective method for thoracolumbar fractures.</p><p><b>METHODS</b>The clinical data of 40 patients with thoracolumbar fractures who met the inclusion and exclusion criteria in the department of orthopaedics affiliated to Suzhou Hospital of Nanjing University of Chinese Medicine from February 2013 to August 2017 were retrospectively analyzed. According to therapeutic methods, the patients were devided into treatment group and control group, 20 cases in each group. Treatment group was treated by three-dimensional reduction method and external fixation devices under analgesia, and control group was treated by open reduction and common spinal fixation system. In treatment group, there were 9 males and 11 females, aged from 26 to 68 years old with an average of (52.8±11.3) years; and in control group, there were 10 males and 10 females, aged from 26 to 64 years old with an average of(50.6±8.8) years. Anterior vertebral body compression(AVBC), Cobb angle and visual analogue scale(VAS) were measured and compared in two group.</p><p><b>RESULTS</b>All 40 patients finished follow-up. The follow-up time in treatment group was 5 to 37 months with average of (16.1±8.8) months, in control group was 5 to 29 months with an average of(17.3±6.0) months. There was no significant difference between two groups(>0.05). AVBC, Cobb angle, VAS score were obviously improved in all patients after treatment(<0.05), but there were no significant difference between two groups(>0.05).</p><p><b>CONCLUSIONS</b>Clinical effect of two methods was similar in treating thoracolumbar fractures, but three-dimensional reduction and external fixation devices under analgesia has advantage of easy operation, smaller trauma and no need secondary surgery for removed internal fixation.</p>
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<p><b>OBJECTIVE</b>To investigate clinical effects of percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures.</p><p><b>METHODS</b>From May 2013 to October 2016, 53 patients with closed calcaneal fractures were analyzed, and were divided into treatment group and control group. There were 33 patients in treatment group including 25 males and 8 females, aged from 15 to 82 years old with an average of(44.7±14.2) years old; 17 cases were type II and 16 cases were type III according to Sanders classification; treated by percutaneous poking reduction with bone grafting and limited internal fixation. There were 33 patients in control group, including 20 males aged from 25 to 62 years old with an average of (42.2±11.3) years old; 8 cases were type II and 12 cases were type III according to Sanders classification; treated by open reduction and internal fixation. Imaging indicators, hospital stays and preoperative waiting time were observed and compared, Maryland scoring were applied to evaluate foot function.</p><p><b>RESULTS</b>Fifty-three patients were followed up, and treatment group was followed up from 8 to 40 months with an average of (19.9±7.2) months; while control group was followed up from 12 to 40 months with an average of (21.7±7.7) months, and there were not significant differences between two groups in follow-up time (>0.05). There were no obvious meaning in Böhler angles, Gissane angles between two groups (>0.05). There were significant differences in hospital stays and preoperative waiting time(<0.01). There were no significant differences in Maryland score between treatment group(90.45±5.76) and control group(89.10±6.16).</p><p><b>CONCLUSIONS</b>Percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures could obtain satisfied effects, and has advantages of less trauma and complications, rapid recovery and good clinical effects.</p>
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Background More and more evidences suggest that the interaction of retinal progression of retinal diseases.Objective Present study was to investigate the primarily cultured and digested using explant culture method and trypsas acidic protein(GFAP) staining,S-100 staining and cytokine-18 staining co-cultured under the normoxia and hypoxia using transwell chamber,and the proliferation and migration of cultured RPE cells were examined using MTT and compared with only RPE cells cultured group at 3, 6, 24 and 48 hours.Results Over 90% of primarily cultured RPE cells showed the positive response for S-100.The proliferation and migration of RPE cells were significantly increased in hypoxia condition compared with normoxia condition (P＜0.01).In hypoxia group,amount of proliferation and migration of RPE cells in co-culture group were higher than the only RPE cells cultured group(P＜0.01).Conclusion Hypoxia appear to aggravate the proliferation and migration of RPE cells under the hypoxia status.
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<p><b>OBJECTIVE</b>to explore effects of airborne fine particulate matter exposure on human respiratory symptoms and pulmonary function.</p><p><b>METHODS</b>one hundred and seven field traffic policemen were recruited as airborne fine particulate matter high-exposure group and one hundred and one male residents as common exposure group. The individual sampler was used to measure fine particulate matter exposure levels of the two groups. To obtain personal information, especially respiratory symptoms such as cough, sputum, etc. a questionnaire survey was used. The pulmonary ventilation function was detected: forced expiratory vital capacity (FVC), the first 1 second forced expiratory volume (FEV1.0), FVC/FEV1.0% and peak flow values (PEF), and the difference of fine particulate matter exposure level and respiratory function of the two groups was compared.</p><p><b>RESULTS</b>24 h individual average fine particulate matter exposure concentration of traffic police and residents were respectively (115.4 ± 46.17) microg/m(3) and (74.94 ± 40.09) microg/m(3), the traffic police PM2.5 exposure levels were significantly higher than the residents. In the incidence of respiratory symptoms, compared with high-exposure group and common exposure group, coughing, expectoration, throat unwell, asthma, short of breath and nose discomfort, traffic police group was higher than residents group (P < 0.05). The abnormal rate of lung ventilation function indexes, such as FVC and FEV1.0 was 25.23% and 12.15% respectively in high-exposure group, 11.88% and 2.97% in common exposure group, there was no statistical difference between two groups. Besides, the abnormal rate of FVC and FEV1.0, showed rising trend in high-exposure group with seniority.</p><p><b>CONCLUSION</b>long-term higher levels of airborne fine particulate matter exposure, may impact respiratory health and impair pulmonary function.</p>
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Adult , Humans , Male , Middle Aged , Air Pollutants , Occupational Exposure , Particle Size , Particulate Matter , Police , Pulmonary Ventilation , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To apply the bioinformatics tools for analyzing the differentially expressed genes in oral submucous fibrosis (OSF) to obtain the implied biological significance.</p><p><b>METHODS</b>By using DAVID and Onto-express bioinformatic tools, 865 differentially expressed genes in OSF were analyzed and the analysis of chromosome location, gene ontology (GO) and genetic-association diseases were performed.</p><p><b>RESULTS</b>A majority of the differentially expressed genes were located on chromosome 1,2,5,6,7,11,12 (P < 0.01). GO classification of the differentially expressed genes identified the biological process subgroups, including genes involved in immune response, defense response and so on. The cellular component subgroups were associated with extracellular matrix, cytoskeleton and membrane, molecular function subgroups related to protein binding, extracellular matrix structural constituent and signal transducer activity. The diseases genetically associated with these genes included infection, immune and cardiovascular diseases.</p><p><b>CONCLUSIONS</b>Bioinformatics can provide the quick and parallel analysis of massive data got from gene microarrays and enable the function classification of the differentially expressed genes, which provides new ideas on the research of pathogenesis and epidemiology of OSF.</p>
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Humans , Computational Biology , Methods , Gene Expression Profiling , Oligonucleotide Array Sequence Analysis , Oral Submucous Fibrosis , Genetics , SoftwareABSTRACT
An FPGA-Based Image Guided Surgery Hardware Platform has been designed and implemented in this paper. The hardware platform can provide hardware acceleration for image guided surgery. It is completed with a video decoder interface, a DDR memory controller, a 12C bus controller, an interrupt controller and so on. It is able to perform real time video endoscopy image capturing in the surgery and to preserve the hardware interface for image guided surgery algorithm module.
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Algorithms , Endoscopy , Methods , Equipment Design , Software , Surgery, Computer-AssistedABSTRACT
OBJECTIVE@#To culture human gingival epithelia in vitro, and to construct the tissue engineered gingiva with the acellular dermal matrix (ADM).@*METHODS@#Human gingival epithelia were isolated from the gingival tissue, and the cells were cultured and seeded onto the surface of ADM. After 7 days of submerged incubation, an air-liquid interface culture was performed for 7, 14, and 21 days. The complex constructed above was taken for histological examination.@*RESULTS@#Human gingival epithelia could proliferate well on the surface of ADM, and form multilayer structure. But the superficial epithelium was partially keratinized.@*CONCLUSION@#Tissue engineered gingiva may be constructed with human gingival epithelia and ADM in vitro.
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Humans , Acellular Dermis , Cells, Cultured , Connective Tissue , Epithelial Cells , Cell Biology , Gingiva , Cell Biology , Skin, Artificial , Tissue Engineering , MethodsABSTRACT
<p><b>AIM</b>The simplified preparative method and formulation for atenolol monolithic osmotic pump tablets were investigated.</p><p><b>METHODS</b>The core tablets with an indentation were compressed by the punch with a needle. Osmotic pump tablets were prepared by coating the indented tablets. Similarity factor was used to evaluate formulation of osmotic pump tablets.</p><p><b>RESULTS</b>The formulation of core tablets and the composition and thickness of coating membrane showed marked effects on drug release. Orifice size of core tablets in the range of 1.00 - 1.14 mm scarcely affected drug release.</p><p><b>CONCLUSION</b>The preparation of osmotic pump tablets was simplified with the exempting of laser drilling. The atenolol monolithic osmotic pump tablets could deliver drug constantly for 24 h.</p>
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Adrenergic beta-Antagonists , Chemistry , Atenolol , Chemistry , Delayed-Action Preparations , Drug Carriers , Osmosis , Polyethylene Glycols , Chemistry , Tablets , Technology, Pharmaceutical , MethodsABSTRACT
This paper introduces the application and role of data mining technology in the hospital management.
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Humans , Databases, Factual , Efficiency, Organizational , Hospital Administration , Methods , Hospital Information Systems , Information Storage and Retrieval , Methods , Medical Informatics Applications , Medical Records Systems, ComputerizedABSTRACT
<p><b>OBJECTIVE</b>Data on traffic accident from year 2000 to 2002 were collected and testified. Epidemiological study was carried out to find the main risk factors of traffic accident.</p><p><b>METHODS</b>The spatial distribution was conducted by means of Geographic Information System (GIS) and were marked on Shanghai digitalized map with different layers by different colors.</p><p><b>RESULTS</b>Results showed that during 2000, 2001 and 2002, 69,669 , 68,894, and 47,088 traffic accident episodes occurred in Shanghai, resulting in 1747, 1724, 1557 deaths respectively with direct economic lost: 2.1, 2.4, 3.0 billion RMB. The main risk factors causing traffic accident deaths would include drinking alcohol before driving, fatigue and speeding. The leading causes of death were head injury and complex injury of body. GIS showed that there was a homocentric circle with more traffic accidents in downtown city, but more deaths in the urban city. Disease burden caused by traffic accident was very heavy.</p><p><b>CONCLUSION</b>In Shanghai, traffic accident has great impact on social and economic issues thus should be controlled effectively. Focus should be layed on control of traffic accident in downtown area and to decrease the number of deaths related to traffic accident in the urban area.</p>
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Female , Humans , Male , Accidents, Traffic , Age Factors , China , Epidemiology , Risk Factors , Sex Factors , Wounds and Injuries , EpidemiologyABSTRACT
We discuss in this paper some kinds of image acquiring methods, particularly under the current domestic hospital environment.
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Humans , Artificial Intelligence , Hospital Administration , Image Processing, Computer-Assisted , Information Storage and Retrieval , Internet , Magnetic Resonance Imaging , Radiology Information Systems , Tomography, X-Ray Computed , Video RecordingABSTRACT
OBJECTIVE@#To study the depletion of cardiac troponin T in Rats of early myocardial ischaemia.@*METHODS@#Immunohistochemical method (LSAB) was used and the depletion area of CTnT in myocardial ischaemia were measured by the computer image analysis.@*RESULTS@#There is obviously depletion of CTnT after 15 min in myocardial ischaemia of rats, the mean of CTnT depletion of myocardial ischaemic group is significant difference compared with that of the control group (P < 0.01), and the depletion area increased with the prolongagtion of ischaemic time.@*CONCLUSION@#The depletion of CTnT is one of sensitive signs of early myocardial ischaemia.