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ObjectiveTo construct and validate a clinical prediction model for diabetic kidney disease （DKD） based on optical coherence tomography angiography （OCTA）. MethodsThis study enrolled 567 diabetes patients. The random forest algorithm as well as logistic regression analysis were applied to construct the prediction model. The model discrimination and clinical usefulness were evaluated by receiver operating characteristic curve （ROC） and decision curve analysis （DCA）， respectively. ResultsThe clinical prediction model for DKD based on OCTA was constructed with area under the curve （AUC） of 0.878 and Brier score of 0.11. ConclusionsThrough multidimensional verification， the clinical prediction nomogram model based on OCTA allowed for early warning and advanced intervention of DKD.
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Objective To investigate the role of Bcl-2 adenovirus/E1B 19kD interacting protein 3 (BNIP3) in oligodendrocyte apoptosis after diffuse axonal injury (DAI) in rats. Methods Seventy-seven male adult Sprague-Dawley rats were randomly divided into sham group (n = 11), DAI group (n = 33), and intervention group (n = 33). DAI model was made referring to modified Marmarou method and the rats in intervention group received intracerebroventricular injection of BNIP3 inhibitor, necrostatin-1 (Nec-1, 30 g/L, 2 μl) immediately after injury. Tested the BNIP3 protein expression, oligodendrocyte apoptosis and myelin histopathology before and after the intervention of Nec-1. Results Compared with the sham group, DAI rats upregulated BNIP3 levels and had positive correlation with cell apoptosis in brainstem. Nec-1 significantly inhibited BNIP3 expression, then decreased the number of apoptotic oligodendrocytes, increased the average absorbance of luxol fast blue (LFB) staining and myelin basic protein (M BP) levels, and alleviated the myelin ultrastructure of DAI rats. Conclusion BNIP3 participate in the DAI-induced apoptosis of oligodendrocytes, and inhibition of BNIP3 can protect oligodendrocytes and myelin sheath from DAI injury.
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Objective The effects of dynamic prediction table in ICU were discussed based on the theory visualization management. Methods A self-designed dynamic prediction table of critical patients is used to record the monitoring points and precautions of patient's situation, and evaluating the application effect after 6 months. Results The incidence of unclear shift, missed shift, misplaced shift and accumulated defective shift of observation group was 7.64％(11/144), 3.47％ (5/144), 3.47％ (5/144) and 14.58％(21/144), which was lower than 21.53％(31/144), 12.50％(18/144), 9.72％(14/144)and 43.75％(63/144) of control group(χ2=11.150, 7.986, 7.564, 29.647, P<0.05);nurses on the mastery condition of critically ill patients of observation group was (91.17±3.96), which was higher than(27.83±3.66)of control group(t=-4.813, P<0.01);the satisfaction of doctors with nurses of observation group was(32.22±2.71), which was higher than(23.86 ± 2.76) of control group(t=-12.98, P<0.01); the satisfaction of family members of patients with nurses of observation group was(33.77 ± 2.31), which was higher than(25.42 ± 4.43) of control group(t=-18.326,P<0.01); nurses have a good experience with the new methods. Conclusions Application of dynamic prediction table in ICU can promptly remind nurses work priorities, enhance their awareness of risk warning, strengthen the information communication of department and help to improve the quality of nursing care.
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Objective: To investigate the chemical constituents in the whole herbs of Cardamine leucantha. Methods: The chemical constituents were isolated and purified via silica gel, polyamide, D-101 macroperous resin, and Sephadex LH-20 column chromatography. Their structures were determined on the basis of spectral analysis and physicochemical properties. Results: Fourteen compounds were isolated and identified, covering three simple indoles: indole-3-carboxylic acid (1), 6-hydroxyindole-3-carboxylic acid (2), and 6-hydroxyindole-3-carboxylic acid-6-O-β-D-glucopyranoside (3); two coumarins: esculetin (4) and esculin (5); seven steroids: 3-O-(p-coumaroyl)-β-sitosterol (6), β-sitosterol (7), 5α, 8α-epidioxyergosta-6, 22-dien-3β-ol (8), 5α, 8α-epidioxyergosta-6, 9 (11), 22-trien-3β-ol (9), sitost-5-ene-3β, 7α-diol (10), β-sitosteryl-3β-glucopyranoside-6'-O-palmitate (11), and daucosterol (12); and two phenolic compounds: p-hydroxybenzoic acid (13) and vanillic acid (14). Conclusion: All the compounds are isolated from the plants in Cardamine L. for the first time.
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<p><b>OBJECTIVE</b>To discuss the diagnostic value of cardiac enzyme and troponin in acute organophosphorus pesticide poisoning (AOPP).</p><p><b>METHODS</b>A retrospective study was performed in the document published in domestic journals and PubMed from 1979 to 2010. The data of the cardiac enzyme and troponin were collected. Statistical analysis was conducted with one-way ANOVA and rank sum test. 2129 cases with AOPP were enrolled.</p><p><b>RESULTS</b>The levels of creatine kinase (CK), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) in milder, moderate and severe poisoning groups were significantly elevated compared by the healthy control group (P < 0.05). The differences were also dramatic among three patients groups (P < 0.05). The ratios of CK-MB to CK in both moderate and severe groups were significantly lower than in healthy controls (P < 0.05). The levels of CK, CK-MB and cTnI were higher especially in patients with intermediate myasthenic syndrome (IMS) than patients without IMS. Meanwhile, the levels of CK and CK-MB were elevated in patients with respiratory failure compared by non-failure ones, but decreased in the ratios of CK-MB to CK (P < 0.05).</p><p><b>CONCLUSIONS</b>The elevation of CK and CK-MB in serum could not be judged as the criteria of myocardial damage in AOPP, the ratio of CK-MB to CK were more valuable; the value of cTnI in myocardial damage was still in suspect. CK, CK-MB and cTnI could be used as auxiliary criteria of AOPP classification.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Cardiomyopathies , Diagnosis , Creatine Kinase , Blood , Creatine Kinase, MB Form , Blood , Myocardium , Metabolism , Pathology , Organophosphate Poisoning , Metabolism , Troponin I , Blood , Troponin T , BloodABSTRACT
<p><b>OBJECTIVE</b>To discuss the effectiveness of severe and acute organophosphate poisoning (AOPP) treated with plasma exchange in China.</p><p><b>METHODS</b>Researches about effectiveness of severe AOPP treated with plasma exchange were analyzed by Review Manager 4.2 and fixed effect model of meta-analysis method were used.</p><p><b>RESULTS</b>Six trials including 433 patients were identified. Treatment group including 211 patients adopted traditional physician therapy plus plasma exchange, and control group including 222 patients received physician therapy only. The case-fatality rate of the treatment group was lower than the control one [RR=0.30, 95%CI (0.19-0.49), P<0.01].</p><p><b>CONCLUSION</b>Plasma exchange can improve the cure rate of severe AOPP.</p>
Subject(s)
Humans , Organophosphate Poisoning , Therapeutics , Pesticides , Poisoning , PlasmapheresisABSTRACT
In order to improve the efficacy of vibration expectoration and prevent secondary injury in patients with chest trauma,the body surface marking method was used in vibration expectoration.The exact injured locations and areas were identified via CT ot X-ray results.Then,the restricted and focused areas of expectoration were marked with red and green colors,which could guide the machines to avoid the fracture sites,reduce pain,prevent secondary injury and administrate effective expectoration in the areas of sputum and atelectasis.However,the dynamic CT or X-ray results must be used for reference to ensure the accuracy of the body surface marking.
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<p><b>OBJECTIVE</b>To observe the treatments on the patients with acute methamidophos dichlorvos (DDV) and omethoate poisoning and provide the reliable basis for the rational treatments on these three organophosphorus pesticides poisoning.</p><p><b>METHODS</b>101 patients with AOPP in 7 hospitals were divided into three groups: Group A, 59 patients with acute methamidophos poisoning, Group B, 32 patients with acute DDV/dipterex (DEP) poisoning, Group C, 10 patients with acute omethoate/dimethoate poisoning. The levels of erythrocyte AChE and the therapeutic efficacies of pralidoxime chloride (PAM-Cl) were compared among the three groups.</p><p><b>RESULTS</b>The AChE activities of all the three groups were inhibited on level of (9.12 +/- 7.99) U/g Hb (group A), 7.32 +/- 4.62 U/g Hb (group B) and (12.01 +/- 9.53) U/g Hb (group C), among which no significant difference was found (P > 0.05). All the patients recovered from acute cholinergic excitation or crisis after the treatment of PAM-Cl. The erythrocyte AChE activities were obviously reactivated in group A three hours later after admission to hospital, each on level of (11.37 +/- 8.67) U/g Hb, (12.51 +/- 6.98) U/g Hb, (15.90 +/- 7.31) U/g Hb, (18.33 +/- 4.78) U/g Hb and (18.91 +/- 7.00) U/g Hb at the 12th, 24th, 48th, 72nd hour and discharge (P < 0.05), and the upgrade tendency was continuous. AChE activities in group B were also reactivated after treatment, each on level of (8.91 +/- 5.89) U/g Hb, (1.31 +/- 6.61) U/g Hb, (13.00 +/- 7.55) U/g Hb, (14.22 +/- 7.80) U/g Hb, (12.78 +/- 7.07) U/g Hb and (16.87 +/- 7.06) U/g Hb at the 3rd, 12th, 24th, 48th, 72nd hour and discharge, but the upgrade tendency turned slowly after 12 hours, the inhibited AChE activities were not reactivated in group C from the beginning to the end.</p><p><b>CONCLUSION</b>After the treatment of PAM-Cl, the AChE activities of the patients with acute methamidophos poisoning could be continuously reactivated, the AChE activities of the patients with acute DDV/DEP poisoning could also be reactivated in 12 hours, and then keep stable, but the AChE activities of the patients with acute omethoate/dimethoate poisoning could not be reactivated. However, PAM-Cl has therapeutic efficacy against acute toxicity of all the three organophosphorus pesticides. Oximes should be vigorously used in the treatment of AOPP, including acute omethoate/dimethoate poisoning.</p>