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【Objective】 To evaluate the underreporting of death cases and related factors in disease surveillance system of Xi’an. 【Methods】 Multi-stage cluster random sampling was used, and 733 villages (neighborhood committees) were selected from 44 townships or streets in Xi’an. All the death cases of the residents in the sampled areas from 2018 to 2020 were collected through a variety of channels and checked with those registered in the Disease Surveillance System. Then the missing cases were investigated and verified. The underreporting rate was calculated, the Excel software was applied for statistical processing and Chi square analysis, and the related factors of underreporting were analyzed by using Logistic regression method. 【Results】 A total of 37650 death cases were investigated from 2018 to 2020; the average mortality was 650.59/105, and 2 901 cases were underreported. From 2018 to 2020, the underreporting rate was 9.89%, 6.95%, and 6.24%, respectively (χ2=133.525, P<0.001), with the average underreporting rate of 7.71%. The underreporting rate in the 44 sampled areas ranged from 0.90% to 42.07%. Multivariate Logistic regression analysis showed that compared with that in rural areas (9.87%), the underreporting rate was lower in urban areas (5.91%, OR=0.567, 95% CI:0.525-0.613), and higher in children under 5 years old (31.20%, OR=5.494, 95% CI:3.732-8.090) and people aged 15-44 years old (11.85%, OR=1.541, 95% CI:1.284-1.846) compared to people over 65 years old (7.44%), and higher in 2018 (9.89%, OR=1.702, 95% CI:1.551-1.869) and 2019 (6.95%, OR=1.148, 95% CI:1.038-1.271) compared to the year 2020 (6.24%). There were 2901 cases reported missing, and the proportion of those who died at home was the highest (81.39%). Underreporting of death more easily occurred in heart diseases (36.80%) and cerebrovascular diseases (27.08%) than others. 【Conclusion】 The reporting completeness of disease surveillance system increased in Xi’an. The overall underreporting rate of death causes decreased with year from 2018 to 2020. The underreporting rates in age group under 5 years old and in rural population were still high. Therefore, the reporting and management of death information should still be strengthened to minimize the underreporting rate.
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Attention deficit and hyperactivity disorder(ADHD) is a common neurodevelopmental disorder in children.Studies have shown that dietary nutrition is the basis of children′s growth and development.Nutrients affect children′s behavior, cognition and learning by participating in the processes of brain neural development, neurotransmitter function and inflammation in vivo.Clinical investigations have shown that unbalanced diet or nutrient deficiency is related to ADHD, and supplementation of nutrients or balanced diet can improve the symptoms of ADHD children.In this paper, the effects of dietary nutrients on children with ADHD and their related mechanisms are reviewed to provide theoretical support for the nutritional management of children with ADHD.
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Objective? ?To?analyze?the?risk?factors?of?delirium?in?patients?in?cardiac?surgery?intensive?care?unit?(CSICU).? Methods? A?prospective?observational?study?was?performed.?Patients?admitted?to?CSICU?of?Fujian?Medical?University?Union?Hospital?from?March?to?August?in?2017?were?enrolled.?The?combination?of?the?Richmond?agitation?sedation?scale?(RASS)?and?the?ICU-confusion?assessment?method?(CAM-ICU)?were?used?to?evaluate?delirium.?The?patient?was?assessed?on?the?second?day?after?CSICU?admission,?twice?a?day,?the?evaluation?was?stopped,?and?the?follow-up??observation?was?terminated?after?the?patient?was?discharged?from?CSICU.?The?patients?were?divided?into?two?groups?according?to?whether?delirium?occurred?in?CSICU.?The?general?and?clinical?treatment?data?(including?condition,?operation,?anesthesia?and?CSICU?treatment)?of?the?two?groups?were?compared.?The?related?factors?of?delirium?were?identified?by?univariate?analysis?and?multifactor?Logistic?regression?analysis.? Results? A?total?of?318?cases?were?included?in?this?study.?Among?them,?93?cases?had?delirium?and?the?incidence?of?delirium?was?29.2%.?It?was?shown?by?univariate?analysis?that?age,?history?of?hypertension,?type?of?surgery,?surgical?procedure,?American?Society?of?Anesthesiologists?(ASA)?anesthesia?classification,?usage?of?propofol,?plasma?transfusion,?red?blood?cells,?platelet?transfusion,?blood?loss,?operative?time,?cardiopulmonary?bypass?(CPB)?time,?myocardial?block?time,?acute?physiology?and?chronic?health?evaluation?Ⅱ?(APACHEⅡ),?duration?of?mechanical?ventilation,?the?length?of?intensive?care?unit?(ICU)?stay,?postoperative?usage?of?diazepam,?midazolam,?fentanyl,?morphine,?chlorpromazine,?etc.?which?were?related?to?delirium,?and?occupation?? (on-the-job?or?self-employed),?medical?insurance?(city?or?provincial?medical?insurance),?education?(primary?to?junior?high?school,?high?school?or?above)?could?reduce?the?risk?of?delirium.?Colinearity?diagnosis?was?performed?on?variables?with?statistically?significant?differences,?and?variables?with?variance?expansion?factor?(VIF)?<?3?were?included?in?multivariate?Logistic?regression?analysis.?The?results?showed?that?age,?education?level,?type?of?surgery,?ASA?classification,?CPB?time,?APACHEⅡ,?ICU?mechanical?ventilation?time,?and?post?operation?usage?of?midazolam?were?independently?related?to?delirium?[age:?odds?ratio?(OR)?=?1.625,?95%?confidence?interval?(95%CI)?=?1.303-2.026;?education?level:?OR?=?0.293,?95%CI =?0.171-0.504;?type?of?surgery:?OR?=?2.194,?95%CI =?1.052-4.576;?ASA?classification:?OR?=?1.916,?95%CI =?1.032-3.559;?CPB?time:?OR =?2.125,?95%CI =?1.105-4.088;?APACHEⅡ:?OR =?2.091,?95%CI =?1.005-4.349;?ICU?mechanical?ventilation?time:?OR =?1.943,?95%CI?=?1.269-2.975;?midazolam:?OR =?2.653,?95%CI =?1.328-5.299;?all?P?<?0.05],?among?which,?high?education?level?has?a?good?protective?effect?on?delirium.? Conclusions? Age,?type?of?surgery,?ASA?classification,?CPB?time,?APACHEⅡ,?ICU?mechanical?ventilation?time,?post?operation?usage?of?midazolam?were?independent?risk?factors?for?delirium,?and?high?education?level?had?a?good?protective?effect.?Among?them,?the?educational?level,?CPB?time,?duration?of?mechanical?ventilation,?and?midazolam?are?intervention?factors.?In?clinical?treatment,?not?only?the?risk?factors?should?be?identified,?but?also?intervention?should?be?taken?to?prevent?the?occurrence?of?delirium.
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Neuroplastin 65 (Np65) is an immunoglobulin superfamily cell adhesion molecule involved in synaptic formation and plasticity. Our recent study showed that Np65-knockout (KO) mice exhibit abnormal cognition and emotional disorders. However, the underlying mechanisms remain unclear. In this study, we found 588 differentially-expressed genes in Np65-KO mice by microarray analysis. RT-PCR analysis also revealed the altered expression of genes associated with development and synaptic structure, such as Cdh1, Htr3a, and Kcnj9. In addition, the expression of Wnt-3, a Wnt protein involved in development, was decreased in Np65-KO mice as evidenced by western blotting. Surprisingly, MRI and DAPI staining showed a significant reduction in the lateral ventricular volume of Np65-KO mice. Together, these findings suggest that ablation of Np65 influences gene expression, which may contribute to abnormal brain development. These results provide clues to the mechanisms underlying the altered brain functions of Np65-deficient mice.
Subject(s)
Animals , Affective Symptoms , Metabolism , Brain , Diagnostic Imaging , Metabolism , Pathology , Cognition Disorders , Metabolism , Gene Expression , Magnetic Resonance Imaging , Membrane Glycoproteins , Genetics , Physiology , Mice, Knockout , Microarray Analysis , Organ Size , Real-Time Polymerase Chain Reaction , Wnt3 Protein , MetabolismABSTRACT
Objective To investigate the effects of reverse transcription loop-mediated isothermal amplifica-tion(RT-LAMP)method and RT-PCR method for detecting Mycobacterium tuberculosis(MTB)in cerebro-spinal fluid(CSF)to provide a basis for its rapid diagnosis and clinical pharmacodynamic evaluation.Methods Eighty-five cases of CSF sample in the Bethune International Peace Hospital of PLA from December 2015 to April 2017 were selected for conducting the study and divided into the tuberculous meningitis(TBM)group(46 cases),suspected TBM group(25 cases)and control group(16 cases).The 16S rRNA region of MTB was used to design the specific primers.Then RT-LAMP and RT-PCR detection technological systems were estab-lished.Then the detection results by using the these two methods was analyzed.Results The positive detec-tion rates of the TBM group were 97.8% and 75.0% respectively,which of the suspected TBM group were 76.0% and 40.0% respectively,and which of the control group were 0.0% and 12.0% respectively,the posi-tive detection rate of each group in the RT-LAMP method was higher than that in the RT-PCR method,the difference was statistically significant(P<0.01);in the control group,adopting RT-PCR detection found non-specific amplification,while which was not found by adopting RT-LAMP method,indicating that the specifici-ty of RT-LAMP method was stronger than that of RT-PCR;the sensitivity of RT-PCR was 10.0 CFU/mL, which was higher than 1 CFU /mL of RT-LAMP.Conclusion RT-LAMP has the advantages of simpleness,sensitivity,rapidness and detecting viable bacteria,compared with PCR,which has strong specificity,easy op-erating,low cost and short time-consuming,is expected to be a routine detection tool of basic level and field medical institutions and developing countries.
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Objective To evaluate combination therapy effects of ornidazole and pefloxacin on chronic periodontitis.Methods 200 cases of chronic periodontitis were chosen from the Stomatological Hospital of Hangzhou as study subjects.100 cases in observation group were treated with ornidazole and pefloxacin combination treatment, while another 100 cases in control group were treated with ornidazole.The treatments lasted 7 days.The effects and inflammation -related perimeters (including hs -CRP,IL -4,IL -6,IFN -γ)in patients'serum were measured. Results Probing depth,attachment loss and inflammation -related perimeters of the observation group were improved significantly,and even were much better than the control group (probing depth:t =2.113,P <0.05;attachment loss:t =1.894,P <0.05,hypersensitive C -reactive protein:t =2.001,P <0.05;IL -6:t =1.953,P <0.05;interferon -γ:t =1.976,P <0.05).And the total effective rate of the observation group was also better than that of the control group (χ2 =24.335,P <0.01).Conclusion Combination treatment of ornidazole and pefloxacin is more effective than single treatment of ornidazole,which is worthy of widely promoted in clinical.
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Objective To study the relationship between the clinical imaging manifestations and the judgement of benign and malignant of solitary pulmonary nodules (SPN) .Methods A retrospective analysis of 146 patients with SPN which confirmed by pathological diagnosis .According to SPN diameter all SPN were divided into three groups ,the number of SPN which diameter smal-ler than 0 .8 cm were 16 case ,> 0 .8 - 1 .5 cm were 41 cases ,> 1 .5 - 3 .0 cm were 89 cases .Collect patients′ age ,sex ,smoking his-tory ,clinical symptoms and imaging data ,and analyze its relationship with pathological results .Results All the 146 patients were pathological diagnosis ,benign in 52 cases (35 .6% ) ,malignant in 94 cases (64 .4% ) .As the diameter increases ,the malignant rate increased .There was statistical significance in benign and malignant lesions with smoking history and clinical symptoms (P< 0 . 05) .Whether SPN boundary is clear ,have lobulation ,burr ,pleural indentation syndrome and vessel convergence in benign and ma-lignant lesions were statistically significant (P< 0 .05) .Conclusion The feature size and imaging performance of SPN has important reference value for the judgement of benign and malignant .The positive intervention to SPN have great significance on improve sur -vival rate of lung cancer .
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Objective To study the expression of c -Met protein in gastrointestinal stromal tumor(GIST) and to evaluate its clinicopathological significance.Methods The immunohistochemical technique,EnVision method was used to evaluate the expression of c -Met in 105 cases of GISTs.Results c -Met protein positive rate in GISTs was 9.52%(10 /105),its expression rate was significantly higher in GISTs with >10 /50HPF mitotic activity(P 5cm,moderate or high -risk,or mass located outside the stomach,but the difference was not statistically significant(P >0.05 ).Conclusion c -Met protein expression may related with risk of GISTs.We think that c -Met is worthy of further study for its potential usage as a evaluation indicators of GISTs clinicobiological behavior.
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Objective To investigate the histopathological characteristics of colonoscopic biopsy specimens from AIDS patients .Methods A total of 310 clinically confirmed AIDS patients with abdominal pain, diarrhea or tenesmus were enrolled from Guangzhou NO .8 People’s Hospital during 2010 and 2014. All patients underwent colonoscopic examination , and the biopsy specimens were collected .Conventional HE staining, special stainings including Gomori’s methenamine silver ( GMS), Periodic Acid-Schiff stain (PAS), acid-fast staining, and immunohistochemical staining of cytomegalovirus (CMV) were performed. Results The biopsy specimens showed mucosa chronic inflammation (93.9%), epithelial degeneration and necrosis;the local erosion and ulcer formation were observed in severe cases .Among 310 patients, the infective pathogens were identified in 139 ( 44.8%) cases, including 47 ( 15.2%) cases with CMV infections, 36(11.6%) cases with mycobacterium infections , 21(6.8%) cases with penicillium marneffei infections, 10(3.2%) cases with Cryptococcus infections, 3(1.0%) cases with candida infections, 2(0.6%) cases with cryptozoite infections and the rest 20(6.5%) cases were with uncertain pathogens . Conclusion Chronic inflammatory lesions are common in patients with AIDS , and colonoscopic mucosal biopsy can help to identify the pathogens of intestinal opportunistic infection .
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Human infection with avian influenza A H7N9 virus has emerged in China with high morbidity rates. Patients usually present with severe and rapidly progressive pneumonia. Therefore, radiological findings are important to diagnose and evaluate disease severity. The clinical characteristics of three new cases of H7N9 virus infection were analyzed, especially the radiological findings, and previously published studies regarding H7N9 virus infection were summarized. Ground-glass opacification and areas of consolidation were the most common image features. Although drug resistance has been found in some H7N9 viruses, oseltamivir administration is still recommended as soon as possible. Moreover, timely epidemiological surveillance is needed, and a new vaccine is expected for the management of avian influenza
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Objective To explore the attachment of children with emotional disorder,and provide a theoretical basis for mental intervention.Methods A total of 70 outpatients with emotional disorder and their parents and 140 normal children and their parents were enrolled.All the children and their parents were assessed with Adolescent Attachment Inventory and Experiences in Close Relationships Inventory and General demographic information inventory.Results There were statistical significances in family proximity((12.76 ± 3.69) vs (15.47 ±3.05)),friend proximity ((14.23 ± 3.84) vs (15.82 ± 3.06)) and family negativity ((12.84 ± 3.42) vs (10.46 ± 2.94)) of two groups (all P ＜ 0.05).There were statistical significances in maternal attachment avoidance ((3.60 ± 0.70) vs (3.84 ± 0.63)) and anxiety ((3.23 ± 0.77) vs (3.37 ± 0.79)) of two groups (all P ＜0.05).In emotional disorder group,there was a significantly negative relation (P ＜ 0.01) between parental anxiety dimension and friend dependence factor.Conclusion The attachment of children with emotional disorser is low family and friends proximity,higher family negativity.
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Objective To study the relationship between reactive oxygen species (ROS) as well as total antioxidant capacity ( TAC ) within follicle fluid and body mass index ( BMI ) in patients with polycystic ovary syndrome (PCOS).Methods All patients enrolled in this study were infertile women receiving in vitro fertilization-embryo transfer (IVF-ET) treatment.55 PCOS patients were divided into over-weight group ( n =23 ) and non-over-weight group ( n =32 ).Another 55 age-matched non-PCOS women were also divided into control group ( n =30) and overweight group ( n =25 ).Plasma sex hormone,triglycerides,and total cholesterol were determined.On oocyte retrieval day after ovarian stimulation,ROS and TAC in follicular fluid were assayed.Results Subjects in over-weight and PCOS over-weight groups had higher triglycerides than those in control and PCOS non-over-weight groups [ ( 1.9 ±1.1,1.7 ± 0.9,1.0 ± 0.5,1.2 ± 0.7 ) mmol/L,respectively,all P＜0.05],so did total cholesterol [ ( 4.8 ± 1.2,5.2 ± 1.1,4.0 ± 0.6) mmol/L,respectively,all P＜0.05].In PCOS over-weight group,ROS and ROS/TAC within follicular fluid were ( 35.4 ± 6.7 ) RLU/S and 39.8 ± 22.0,both were higher than those in the other 3 groups ( all P＜0.05).TAC [ (0.8 ± 0.5 ) Mm] was lower in PCOS over-weight group than that among the other 3 groups( all P＜0.05 ).ROS/TAC was higher in PCOS non-over-weight group than that of control group ( 26.5 ± 14.5 vs 14.2 ± 12.5,P＜0.05 ).Univariate analysis showed that both ROS and ROS/TAC within follicular fluid in PCOS patients were positively correlated with BMI ( r =0.34 and r =0.32,both P＜0.05 ).Conclusion Abnormal oxidative stress exists in follicular fluid of PCOS patients,and the oxidative stress parameters show positive correlation with BMI.
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Objective To explore the effect of narrative therapy on family environment and values in adolescents with emotional disorder.Methods 35 adolescents with emotional disorder and their parents from Affiliated Brain Hospital,Nanjing Medical University were enrolled and treated by narrative therapy.Family environment was assessed using Family Environment Scale-Chinese Version (FES-CV)and was compared between pre-and posttherapy.Results 28 adolescents with emotional disorder and their parents completed therapy.The cohesion,independence,intellectual orientation,active-recreation orientation and organization in FES-CV showed higher scores at post-therapy than at pre-therapy ((6.89 ± 2.56) vs.(4.21 ± 3.21) ; (5.54 ± 1.35) vs.(4.68 ± 1.51) ;(4.75±2.07)vs.(3.50±2.12);(4.07±2.65)vs.(2.50±2.32);(3.68±1.77)vs.(2.50±1.62)respectively).The contradict in FES-CV showed lower scores at post-therapy than at pre-therapy ((2.75 ± 2.44) vs (5.25 ± 2.50)).The values of adolescents with emotional disorder and their parents had a positive change after narrative therapy.Conclusion Narrative therapy is effective on the positive change of FES-CV and values of adolescents with emotional disorder and their parents.
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Objective To investigate the angiogenesis effects of Salvia miltiorrhiza in heterotopically grafted frozen-thawed mouse ovaries. Methods The ovaries thawed after cryopreservation were xenografted into the donated kidney capsules of 8- to 12-week adult male mice. The mice were divided into two groups, saline and Salvia miltiorrhiza groups, the mice either in the saline or in Salvia miltiorrhiza groups were administered I.p. Daily either saline(0.5ml) or Salvia miltiorrhiza(0.5g)respectively, from the day prior transplantation. The two groups were sacrificed 1 day,2 days and 7 days after transplantation respectively, the grafts from thawed,1 day,2 days,7 days were removed for follicle counting, immunohistochemical studying and detecting of the mRNA expression of vascular endothelial growth factor(VEGF). Results The number of follicles and survival rates in grafts after transplantation of Salvia miltiorrhiza group were more than that of saline group (P<0.05);the expression of VEGF increased after transplantation,peaked on day 7,there was no difference between the two groups (P>0.05);the apoptosis index of Salvia miltiorrhiza group was less than that of saline group (P<0.05), the mRNA expression of VEGF188 and VEGF164 of Salvia miltiorrhiza group was more than that of saline group on 48 hours after transplantation(P<0.05). Conclusion Salvia miltiorrhiza may provide benefits for folliculogensis and decreasing the apoptosis index of follicles. Nevertheless,a increase in the VEGF188 and VEGF164 isoform in the Salvia miltiorrhiza group may suggest the positive effect of exogenous Salvia miltiorrhiza therapy in the early stage of angiogenesis.
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Objective To investigate the clinical characteristics, risk factors and prevention measures of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection. Methods Thirty-nine cases whose CRKP isolation and culture were positive and who were confirmed with nosocomial infection in 2nd affiliated hospital medical school of Zhcjiang University between July 2006 and July 2008 were retrospectively investigated. Results There were 22 (56.4%) sputum specimens among CRKP samples. The average age of the patients was 64.0 years old and the average length of staying in hospital was 80.8 days. There wcre 36 patients who had been in intensive care unit (ICU) within 2 weeks and 26 were conscious disturbance,38 received urethral catheterization, 34 inserted with central venous catheter, 32 received tracheal intubation and 30 assisted with mechanical ventilation. There were 27 (69. 2 % ) patients who were co-infected with other bacteria and 8 were co-infccted with fungi. The mortality was 46. 2% in patients with CRKP infection. Before CRKP-positive culture, 27 (69.2%)experienced ＞4 kinds of antibiotics with the majority of β-lactams/β-lactamase inhibitors and carbapenems.Conclusions CRKP infection frequently occurrs in elder and patients who prolonged stay in hospital,especially patients in ICU. Invasive procedures could increase the infection opportunities.
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Objective To evaluate the value of the thumper cardiopulmonary resuscitator in the emergency cardiopulmonary resuscitation(CPR).Methods Fifty cardiac mspiratory sudden stop patients with thumper cardiopulmonary resuscitator from January 2004 to December 2007 were recruited into treatment group,and 80 cardiac respiratory sudden stop patients with barehanded CPR from May 2000 to December 2003 were recruited into control group.The SBP and blood oxygen saturation 5 to 10 minutes after the resuscitation was compared.The rate of restoration of spontaneous circulation(ROSC),hospitalization and the complication in the two groups was compared.Results The treatment group was better than the control group in improving the SBP and blood oxygen saturation(P＜0.05).The rates of ROSC and hospitalization in the treatment group were higher than those in the control group(44%,40%and 25%,21%).P＜0.05.The rate of complications had no significant difference between the two groups.Conclusions Thumper cardiopulmonary resuscitator Can surmount the factors of medical staff or patients.It can make the CPR more standard andmore effective.MeanwhileitCan raisethe SBP,strokevolume and blood supplv to the heart and brain,and then mcrease the successful rate of CPR.