ABSTRACT
Huashan Hospital became the first Academic Medical Center Hospital accredited by Joint Commission International (JCI) in 2013. The Department of Clinical Nutrition has constantly improved internship education through the introduction of JCI standards. Based on the flexible combination of teaching and practicing modules, clinical nutrition knowledge is closely integrated with professional dietitian skills, and in-depth practical training helps students to acquire much more experience of the occupation as a dietitian. Teachers think highly of students' initiative and knowledge conversion ability, and in the recent five years, undergraduate projects have been enhanced in both quantity and quality.
ABSTRACT
Huashan Hospital became the first Academic Medical Center Hospital accredited by Joint Commission International (JCI) in 2013. The Department of Clinical Nutrition has constantly improved internship education through the introduction of JCI standards. Based on the flexible combination of teaching and practicing modules, clinical nutrition knowledge is closely integrated with professional dietitian skills, and in-depth practical training helps students to acquire much more experience of the occupation as a dietitian. Teachers think highly of students' initiative and knowledge conversion ability, and in the recent five years, undergraduate projects have been enhanced in both quantity and quality.
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Objective To explore the prevalence and possible risk factors of depressive /anxious symptoms of patients with digestive disease .Methods Totally 245 patients with digestive diseases were recruited consecutively .Face-to-face interview and the hospital anxiety and depression scale ( HADS) ,self-rating anxiety scale ( SAS) and self-rating depression scale ( SDS) were employed to collect the clinical data .The non-condition logistic regression was performed to analyze the data .Results The prevalence of depression and anxiety in patients with organic diseases in digestive system was 36.3%.Among them,the higher incidence of depression and anxiety symptoms were digestive system tumors , peptic ulcer , acute pancreatitis and cirrhosis .The educational degree was correlated with simple depression,pure anxiety,depression complicated with anxiety (χ2 =8.781,P=0.013;χ2 =7.976,P=0.018;χ2 =15.807,P=0.003),the degree of high school or above was a protective factor ,the OR values were 0.347, 0.373,0.301.The gender was also correlated with depression ,anxiety,depression complicated with anxiety (χ2 =4.343,P=0.031;χ2 =1.056,P=0.017;χ2 =2.382,P=0.03),female was the risk factor of mental illness ,the OR values were 2.72,2.438,2.671.The age was correlated with depression ,depression complicated with anxiety (χ2 =9.872,P=0.002;χ2 =15.710,P=0.031),the age of over 40 years old was the risk factor of mental illness ,the OR values were 5.137,5.731.The occupation was correlated with depression (χ2 =6.017,P=0.017),the non-physical labor was the risk factors of depression , the OR value was 2.752.Conclusion There is a higher prevalence of depression and anxious symptoms in patients with digestive organic diseases .Female,senior high school or lower ,older than 40 years,and non-manual work are the risk factors of these symptoms .
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Objective To explore the clinical effect and prognosis of plasma N -terminal probrain natriuret-ic peptide (NT -proBNP)and 6 min walk test performance (6 -MWT)in patients with chronic heart failure (CHF).Methods 100 patients with CHF were selected as observation group,and 50 healthy people were selected as control group.They were grouped by NYHA degree,28 cases were NYHA Ⅱ,56 cases were NYHA Ⅲ and 16 cases were NYHA Ⅳ.The plasma level of NT -proBNP,6 -MWT,left ventricular ejection fraction (LVEF),early diastolic peak mitral flow velocity to late diastolic peak mitral flow velocity (E /A)were measured.Results The plasma NT -proBNP level of CHF patients was positively correlated with NYHA degree (r =0.683,P <0.01);6 -MWT was neg-atively correlated with NYHA degree(r =-0.518,P <0.01).For CHF patients,significant correlation was observed between NT -proBNP and 6 -MWT (r =-0.789,P <0.05).Plasma NT -proBNP level was correlated with dias-tolic HF,systolic HF and mixed type heart failure (r =-0.678,P <0.01;r =-0.845,P <0.01;r =-0.759,P <0.01).Conclusion Plasma NT -proBNP,6 -MWT can serve as a marker for the detection and evaluation of heart failure.Meanwhile,the higher the NT -proBNP level,the shorter the 6 -MWT,the more serious the heart failure,the poorer the prognosis.
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Objective To investigate the feasibility of CT pulmonary angiography (CTPA) with 80 kVp and contrast agent of iodixanol (270 mg I/ml) by filtered back projection(FBP) reconstruction.Methods In total,52 patients who underwent CTPA were randomly divided into two equally-sized groups,control group and experimental group.The volume computed tomography dose index (CTDIvol) and dose-length product (DLP)were recorded,and the weighted computed tomography dose index (CTDIw) and effective dose (E) were calculated.The image quality was visually evaluated and measured,and statistical analyses were performed on the image quality and the radiation dose.Results The sex,age,height,weight and body mass index (BMI) had no statistical difference between two groups (P ＞ 0.05).The average iodine dosage decreased by 22.9％ in the experimental group compared with the control group.Compared with the control group,the CTDIvol,DLP,CTDIw and E decreased by 73.5％,75.1％,73.5％ and 75.8％,respectively.The differences were statistically significant (t =＜0.001,30.5,＜ 0.001,-28.7,P ＜ 0.05).The image quality of the two groups met the requirement of diagnosis and there were no significant statistic differences between visually evaluating and objectively measuring the image quality (P ＞ 0.05).Conclusions Using 80 kVp and iodixanol for CTPA,FBP reconstruction image quality can meet diagnostic requirements.At the same time the radiation dose,the contrast agent dose and the X-ray tube wastage are reduced respectively.
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Objective To summarize the clinical features of brucellosis and investigate the experience of diagnosis and treatment of the disease .Methods Data from epidemic reports and clinical characteristics from 172 ca-ses of patients with brucellosis were retrospectively analyzed .Results 130 out of 172 cases of were diagnosed as bru-cellosisaise.Of the misdiagnosed 42 cases,13 cases were misdiagnosed as lumbar spine ,10 cases as upper respiratory tract infection 8 cases as pancytopenia,5 cases as orchitis epididymitis,2 cases as hepatitis,1 case as prostatitis, 1 case as cervical disease ,1 case as myocarditis ,1 case as rheumatoid arthritis .And after treatment ,142 cases recov-ered completely,16 cases improved.The total efficiency was 100.0%.2 cases without standard treatment recurred ,an interval of 3 to 15 months.Conclusion So the clinical manifestation of brucellosis is lack of specificity that misdiag-nosis rate is high;The manipulation combined with standard antibiotic therapy may have certain effects on early -stage brucellosis .
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This review will discuss aerosol device technologies available for pulmonary vaccine deliveries.The possibilities of adopting aerosol-generation for the purpose of pulmonary immunization are described.Aerosol-generation systems might offer advantages in respect to vaccine stability and antigenicity.The noninvasive,relatively safe and low-cost net of pulmonary delivery may provide great benefits to the public health vaccination campaign.
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Objective To understand the clinical value on the detection of carcinoembryonic antigen mRNA (CEA mRNA), cytokeratin 19 mRNA (CK19 mRNA) and telomerase in blood for the monitoring of blood metastasis of lung cancer. Methods CEA mRNA and CK19 mRNA were detected by reverse transcriptase-nested primers-polymerase chain reaction, telomerase was detected by telomeric repeat amplification protocol-hybridism-enzyme-linked immunosorbent assay in peripheral blood. Results The positive rates of the three tumor markers in lung cancer group were much higher than the non-tumor group and the health group (P<0.001). The sensibility of CEA mRNA and telomerase were much higher than CK19 mRNA (P<0.01). The positive rates of the markers in TNM stages Ⅲ and Ⅳ were much higher than in stages Ⅰ (P<0.05 to P<0.01). Conclusion It had high value that detecting CEA mRNA, CK19 mRNA and telomerase in peripheral blood on the discovery of blood metastasis of lung cancer. Among them, the clinical value of CEA mRNA and telomerase are higher than CK19 mRNA, and combined assay of the markers can improve the sensibility.
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OBJECTIVE:To provide reference for the rational clinical prophylactic use of antibiotics. METHODS:The cases in whom the clinical prophylactic use of antibiotics between 2006 and 2007 in our hospital showed failure in efficacy were monitored to analyze the cause of failure,meanwhile the clinical samples were sent for culture,isolation,identification and drug susceptibility tests as well as drug resistance analysis. RESULTS:Cephalosporins,Quinolones,Penicillins,Cefhalosporins + enzyme inhibitor were more commonly used antibiotics in our hospital,with drug resistance rates at 57.21%,65.14%,68.63%,and 18.81% respectively. Among the total 240 cases monitored,the prophylactic use of antibiotics totaled 877 times,of which,388 (44.24%) were non-indicated drug use,459 (52.34%) showed drug resistance,286 (32.61%) involved improper drug choice,and 42 (17.50%) showed dual infection. CONCLUSION:The clinical prophylactic use of antibiotics in our hospital is far from perfect; therefore,it is urgent to tighten control on the standard prophylactic use of antibiotics.
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Objective: To investigate the effective methods of nutritional support, to improve the endurance for the operation and to promote postoperative recovery in patients undergoing liver transplantation. Methods: The perioperative nutritional condition and nutritional-support methods were reviewed in 33 patients with liver transplantation. In the first 3 postoperative days, parenteral nutrition (PN) was used in combination with infusion of human albumin and plasma. From the 4th to 5th day, enteral nutrition (EN) was used in combination with PN. Finally, the complete oral intake of food was applied. Results: Of 33 patients, there were 30 patients whose serum levels of total protein (TP) and albumin (ALB) were elevated, and glutamic-pyruvic transminase (GPT), total-bilirubin (T-BIL) and combined-bilirubin (D-BIL) were descended after nutrition support. Conclusion: The operative endurance and postoperative recovery were improved effectively by proper nutritional support in liver transplantation patients.
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Objective To explore the mechanism of the skin lesion induced by oxidation hair dyes Methods The effects of subjects,such as oxidation hair dyes,hydrogen peroxide (H 2O 2) and p phenylenediamine (PPD) and their mixture which were main components of oxidation hair dyes,on the proliferation of rat's keratinocytes were detected by primary culture technique of rat's keratinocytes and MTT colorimetric assay Results All of the observed groups presented a certain inhibition on proliferation of the rat's keratinocytes,except the group exposed to PPD at the lowest dose for the shorter period The OD values decreased with the increase of exposure levels and periods Dose response relationship was observed between the exposure levels and inhibition rates of cell survival(the r values after 24 h exposue: r H 2O 2 =0 981, r PPD =0 949, r PPD-H 2O 2 =0 963, r hair dyes =0 887) Conclusion The skin lesion induced by oxidation hair dyes might associated with its cytotoxicity