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Objective @#To identify the factors affecting microvascular complications among patients with type 2 diabetes (T2DM), so as to provide insights into the management of microvascular complications of T2DM.@*Methods@#T2DM patients hospitalized in the Department of Endocrinology of a tertiary hospital in Weifang City, Shandong Province from January 2021 to January 2022 were enrolled, and subjects' basic information, lifestyle and medical history were collected using questionnaire surveys. Fasting insulin, fasting blood glucose and glycated hemoglobin were measured, and factors affecting microvascular complications were identified among T2DM patients using a multivariable logistic regression model and a decision tree model.@*Results@#Totally 1 003 T2DM inpatients were enrolled, including 515 men (51.35%) and 488 women (48.65%), and the prevalence of microvascular complications was 40.18%. Multivariable logistic regression analysis showed that age of 60 years and older (OR=2.510, 95%CI: 1.441-4.374), T2DM duration of 10 years and longer (OR=3.205, 95%CI: 2.242-4.581), fasting insulin of lower than 3.21 μIU/mL (OR=1.749, 95%CI: 1.239-2.469), using of agents or insulin to control blood glucose (OR=1.880, 95%CI: 1.143-3.092), glycated hemoglobin level of 7% and higher (OR=1.751, 95%CI: 1.172-2.615) as factors affecting microvascular complications among T2DM patients. Decision tree analysis identified course of T2DM as a major factor affecting the risk of microvascular complications among T2DM patients, and the prevalence of microvascular complications was 70.22% among T2DM patients with disease course of 10 years and longer and fasting insulin of lower than 3.21 μIU/mL or 16.32 μIU/mL and higher, 44.23% among T2DM patients with disease course of 5 to 10 years and at ages of 60 years and older, and 43.10% among T2DM patients with disease course of less than 5 years and fasting insulin of lower than 3.21 μIU/mL. @*Conclusion@#Advanced age, long course of T2DM, low fasting insulin and high glycated hemoglobin may increase the risk of microvascular complications among T2DM patients.
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ABSTRACT Introduction: Volleyball has become popular worldwide, and its athletic standard has risen. The skills of jumping into a net test athletes' lower limb strength and speed. Objective: Study the effects of deep jumping exercises on the explosive strength in the lower limbs of volleyball athletes. Methods: Through the experimental method, logical analysis method, and mathematical statistics method, the kinematics and the results of the practical tests on the 8 muscles of the athletes' lower limbs were studied. The training took place for 8 weeks of training intervention, and the characteristic biomechanical structure of the athletes' lower limb muscles during the deep jump was established. Results: The landing time of the athletes in the deep jump group was improved, with a change of 0.03s. The deep jump group increased in time by 0.02s, indicating that the jumping ability was significantly improved. Conclusion: The deep jump training method reduces the time spent landing, with a strong level of evidence. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: O voleibol tornou-se popular em todo o mundo, e seu padrão atlético elevou-se. As habilidades de salto em rede, testam a força dos membros inferiores e a velocidade dos atletas. Objetivo: Estudar os efeitos dos exercícios de salto profundo sobre a força explosiva nos membros inferiores dos atletas de voleibol. Métodos: Através do método experimental, método de análise lógica e método de estatística matemática, foram estudas a cinemática e os resultados dos testes práticos nos 8 músculos dos membros inferiores dos atletas. O treinamento deu-se por 8 semanas de intervenção de treinamento, e a estrutura característica biomecânica dos músculos dos membros inferiores dos atletas durante o salto profundo foi estabelecida. Resultados: O tempo de pouso dos atletas no grupo de salto profundo foi aprimorado, com uma mudança de 0,03s, o grupo de salto em profundidade teve um aumento de tempo em 0,02s, indicando que a capacidade de salto foi significativamente aprimorada. Conclusão: O método de treinamento de salto profundo reduz o tempo gasto no pouso, com forte nível de evidência. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: El voleibol se ha hecho popular en todo el mundo y su nivel deportivo ha aumentado. Las habilidades de salto en red, ponen a prueba la fuerza de los miembros inferiores y la velocidad de los atletas. Objetivo: Estudiar los efectos de los ejercicios de salto profundo sobre la fuerza explosiva en los miembros inferiores de los deportistas de voleibol. Métodos: Mediante el método experimental, el método de análisis lógico y el método de estadística matemática, se estudiaron la cinemática y los resultados de las pruebas prácticas de los 8 músculos de los miembros inferiores de los atletas. El entrenamiento se llevó a cabo durante 8 semanas de intervención, y se estableció la estructura biomecánica característica de los músculos de las extremidades inferiores de los atletas durante el salto en profundidad. Resultados: El tiempo de aterrizaje de los atletas del grupo de salto profundo mejoró, con un cambio de 0,03s, el grupo de salto en profundidad tuvo un aumento de tiempo de 0,02s, lo que indica que la capacidad de salto mejoró significativamente. Conclusión: El método de entrenamiento de salto profundo reduce el tiempo empleado en el aterrizaje, con un fuerte nivel de evidencia. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Objective To investigate the clinical distribution and resistance change of pseudomonas aeruginosa (PAE) in the four hospitals of Henan province during 2012-2015,so as to provide guidance for reasonable clinical use of antibiotics.Methods By means of disk diffusion method (K-B method) or automatic instrument,the drug susceptibility testing was performed for the clinical isolated strain which collected from the 371st Central Hospital of PLA,the Third Affiliated Hospital of Xinxiang Medical University,the 150th Central Hospital of PLA and the 153rd Central Hospital of PLA during 2012-2015,then the result were interpreted according to the criteria of Clinical and Laboratory Standards Institute 2010,and the date were analyzed by using WHONET 5.6 software.Results A total of 1 796 strains of PAE had been isolated,and mainly distributed in department of critical care medicine (32.6％) and department of gastroenterology (28.7％).The specimens mainly collected from sputum (74.6％) and wound secretion (9.6％).The drug susceptibility results showed that the antibiotic sensitive rate of PAE to polymyxin B(93.5％) was the highest,followed by the piperacillin/tazobactam(78.2％) and amikacin(76.2％).Resistance rate of PAE to piperacillin(34.4％) was the highest,followed by the ticarcillin/calvulanic acid(34.1％) and aztreonam (30.7 ％).Drug-resistance of PAE to the ceftazidime,cefepime,aztreonam,amikacin,gentamicin and polymyxin B had a downward trend,respectively.Conclusion Drug-resistance of the PAE to the most commonly used antimicrobial has a downward trend.However,the drug-resistance situation of PAE is very serious and the resistance rates still keep the high level during 2012-2015.It is necessary to investigate the clinical distribution and resistance of PAE,so as to provide guidance for reasonable clinical use of antibiotics.
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Interstitial lung diseases (ILDs) are a diverse group of pulmonary disorders characterized by various patterns of inflammation and fibrosis in the interstitium of the lung.The underlying pathogene sis of ILDs is complex and associated with multiple rheumatologic conditions,such as systemic sclerosis,rheumatoid arthritis,pollymyositis and dermatomyositis,Sjt(o)gren's syndrome,and systemic lupus erythematosus.As the disease progresses,excessive pulmonary fibrosis impairs alveolar gas exchange and damages pulmonary function.The common methods to diagnose ILDs,such as clinical manifestations,pulmonary function test,and radiological examinations are not specific for ILDs and not able to diagnose ILDs at the early stage due to their low sensitivity.So,the easy way is important to diagnose ILDs.One important biomarker for ILDs is the high-molecular-weight glycoprotein,Krebs von den Lungen-6 (KL-6).KL-6 encoded by the MUC1 gene is a mucin-like glycoprotein with high molecular weight and expressed predominantly on the cell surface of type Ⅱ alveolar epithelial cells,and is detectable in the serum of patients with ILDs.We here report a case of ILDs associated with dermatomyositis and secondary Sj(o)gren's syndrome.A 60-year-old woman was admitted to our hospital with the chief complaints of debilitation,dry mouth,dyspnea and astasia.ILDs associated with dermatomyositis and secondary Sj(o)gren's syndrome was diagnosed clinically when the following criteria were satisfied:(1) development of dyspnea within 2 months of presentation,(2) pulmonary dispersion dysfunction,(3) bilateral infiltrative shadows on chest high resolution computed tomography (HRCT).She was treated with prednisone 50 mg/d prior to admission,but the result of therapy was not good.In our hospital she was treated with intravenous methylprednisolone and cyclophosphamide and oral hydroxychloroquine sulfate.Subsequently,her serum KL-6 levels gradually decreased after treatment,pulmonary diffuse function improved,and the improvement in the clinical manifestation and HRCT findings were observed.Nevertheless,the combination treatment of glucocorticoid and cyclophosphamide had contributed to the favourable outcomes.In conclusion,detection of serum KL-6 levels in ILDs associated with connective tissue diseases may be beneficial to making a definitive diagnosis,predicting the prognosis and monitoring the disease activity,which would be of great help in clinical practice.However,a well-designed clinical study with more patients and a longer follow-up period are required to arrive at a more conclusive judgment on the role of serum KL-6 in patients with ILDs.
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Objective: To explore the relationship between the incidences of percutaneous coronary intervention (PCI) complicated depression and serum levels of brain-derived neurotrophic factor (BDNF), ghrelin in coronary artery disease (CAD) patients. Methods: A total of 90 CAD patients after PCI were enrolled. According to Hamilton depression (HAMD) scale, the patients were divided into 2 groups: Depression group, n=40 and Non-depression group, n=50. Serum levels of BDNF and Ghrelin were examined by ELISA and compared between 2 groups. Results: Compared with Non-depression group, Depression group had reduced serum levels of BDNF and Ghrelin, both P<0.05. As increased severity of depression, BDNF and Ghrelin were decreased accordingly; serum levels of BDNF and Ghrelin were negatively related to HAMD score (r=-0.711, P<0.05 and r=-0.711, P<0.05). Conclusion: Serum levels of BDNF and Ghrelin have an early warning effect on depression in CAD patients after PCI, it may reflect the severity of depression at certain degree in relevant patients.
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Objective: To preliminarily analyze the graft flow of right internal mammary artery (RIMA) in patients after coronary artery bypass grafting (CABG) using bilateral internal mammary artery (BIMA). Methods: A total of 52 patients received CABG by BIMA in our hospital from 2015-12 to 2016-07 were studied. The patients were younger than 65 years at the mean age of (56.6±6.8) years including 46 male. According to conduit grafting to left anterior descending artery (LAD), the patients were divided into 2 groups: RIMA anastomosed to LAD group, n=42 and LIMA anastomosed to LAD group, n=10. The immediate graft flow was measured by Veri Q system, surgical outcomes and graft flows were compared between 2 groups. Results: There were no operative death in all 52 patients, 1 had poor wound healing and received debridement and suturing, no one had operative complication in left 51 patients. The average LAD bridge flow in both groups were (28.7±11.5) ml/min and (31.8± 11.7) ml/min, the mean pulsation index (PI) were (2.3±0.7) and (2.0±0.4), P>0.05; the average RIMA graft flow were (28.7±11.5) ml/min and (21.1±11.0) ml/min, the mean PI were (2.3±0.7) and (2.6±1.1), P>0.05. Conclusion: Flows in RIMA-LAD graft and LIMA-LAD graft were similar; the flow of RIMA anastomosed to other target vessel was satisfactory which was an ideal graft for CABG.
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Objective To establish an experimental model of acute cerebral schistosomiasis japonica and explore the MRI manifestations of acute cerebral schistosomiasis. Methods Rabbits were divided into 3 groups with 10 rabbits in each group. The rabbits in the experimental group were directly injected with suspension fluid of Schistosoma japonicum eggs(0.9 mg,1 ml) by the cranial drilling method,those in the negative control group were given saline(1 ml)by the same method above-men-tioned,and those in the blank control group were not given any treatment. Antibiotic was given to the first two groups after the op-eration. The clinical manifestations of the 3 groups were observed,and the magnetic resonance imaging(MRI)was performed in 30 days post-operation,and then the brain tissues were taken for pathological examinations. Results All the rabbits in the ex-perimental group exhibited inappetence,various neurological symptoms including hemiplegia,and weight loss after the opera-tion;while those in the negative control group showed inappetence in 3 days after the operation,and 1 week later,the symptom disappeared;there were no adverse reactions in the blank control group. MRI of the experimental group showed nodular or patchy enhancement on T1WI enhancement,brain edema,abnormal ventricular dilatation,and needle augmentation. SWI dis-played hypointense in the abnormal enhanced nodules and flaky hypointense on the operation brain. In the negative control group,2 rabbits showed abnormal enhancement of the needle canal,and 1 showed mild dilatation of the ventricle. The blank control group showed normal manifestations. The pathological examinations showed abnormal appearances in 10 rabbits of the ex-perimental group,including 6 with S. japonicum egg granuloma nodules,nonspecific granuloma nodules coexisted with perivas-cular inflammation;no granuloma nodules were found in the negative control group,but 2 rabbits showed vascular inflamma-tion;the blank control group showed the normal brain tissue. Conclusions An experimental model of acute cerebral schistoso-miasis is successfully established in rabbits by intracranial injection of schistosome eggs. The MRI examination combined with the clinical manifestations can improve the accuracy of early diagnosis of cerebral schistosomiasis.
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Objective To understand the status of Toxoplasma gondii infections and the awareness of toxoplasmosis preven-tion and control knowledge among high-risk populations in Hangzhou City. Methods The serum anti-T. gondii antibodies were detected in 100 HIV/AIDS patients,100 cancer patients,100 pregnant women and 100 healthy controls,and the awareness of toxoplasmosis prevention and control knowledge was investigated using a questionnaire. Results The sero-prevalence of T. gon-dii infection was 31％,30％and 21％in HIV/AIDS patients,cancer patients and pregnant women,which was all significantly higher than in healthy controls(χ2 =14.68, 13.96 and 7.56,all P values<0.01). The pregnant women had a high awareness rate of toxoplasmosis prevention and control knowledge,and the healthy controls had a low awareness rate. In addition,the sub-jects had a low awareness rate regarding the questions including"Do you know the damages of Toxoplasma gondii infections?","Do you know that consumption of raw or uncooked meat may cause Toxoplasma gondii infections?",and"Do you know that con-tact with contaminated soil may cause Toxoplasma gondii infections?". Conclusions The sero-prevalence of T. gondii infection is high among the high-risk populations in Hangzhou City,including the HIV/AIDS patients,cancer patients and pregnant wom-en,and these high-risk populations have a low awareness rate of some toxoplasmosis prevention and control knowledge. There-fore,it is essential to improve the health education of toxoplasmosis prevention and control knowledge among the high-risk popu-lations,so as to effectively prevent and control human T. gondii infections.
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BACKGROUND: At present, the number of patients with arthroplasty is increasing year by year. The perioperative hemorrhage is the short-term complication, which severely affects the patient's prognosis and increasing the risk for other complications. More blood transfusions or hemostasis measures are included in the perioperative blood management programs, but with different effects and adverse reactions. OBJECTIVE: To analyze the relationship of body mass index (BMI) and blood lipid level with blood transfusion rate in the perioperative period of arthroplasty and provide evidence for perioperative blood transfusion management of total knee arthroplasty. METHODS: The patients undergoing total hip arthroplasty or total knee arthroplasty at the Changshu No. 2 People's Hospital from 2011 to 2015 were recruited in accordance with the exclusion and inclusion criteria. The basic data of the participants were collected, and all patients accepted arthroplaties. The blood transfusion rate, pre-estimated blood loss, and percentage of blood loss and postoperative complications were recorded and analyzed; the BMI and blood lipid levels were recorded. Correlation analysis and regression analysis were conducted by the statistical software. RESULTS AND CONCLUSION: (1) Totally 513 patients were included in the study, with the mean age of (76.1±9.2) years old, 124 cases in normal BMI group, 229 cases in overweight group, and 160 cases in obesity group. (2) The blood transfusion rate showed significant difference among groups (P=0.002, P=0.002). There were significant differences in the blood loss and percentage of blood loss among groups (All P=0.001), suggesting that with BMI increasing, there was a decrease in blood transfusion rate and percentage of blood loss, and a increase in total blood loss. (3) The incidence of deep infection of the incision was correlated with BMI (P=0.043), and the incidence of other complications was not related to BMI. (4) In the total hip arthropalsty, the total cholesterol level was negatively related to the blood transfusion rate and percentage of blood loss (r=-0.278, P=0.021; r=-0.329, P=0.034), and the triglyceride level was negatively related to the blood transfusion rate (r=-0.449, P=0.014). In the total knee arthroplasty, the total cholesterol level was negatively related to the blood transfusion rate and percentage of blood loss (r=-0.341, P=0.006; r=-0.489, P=0.017). (5) For the blood transfusion rate in the total hip arthroplasty, BMI, total cholesterol and triglyceride levels were the protective factors, and in the total knee arthroplasty, the protective factors were BMI and total cholesterol level. (6) In summary, the blood transfusion rate is negatively related to the BMI, total cholesterol and triglyceride levels in patients undergoing total hip or knee arthroplasty. Patients with higher BMI have a higher total blood loss, lower percentage of blood loss and higher incidence of postoperative deep infection. The above indexes can be used as predictive indexes for the perioperative blood management in joint arthroplasty.
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Objective To investigate the association of genetic polymorphisms of intercellular adhesion molecule 1 (ICAM-1) with diabetic peripheral neuropathy (DPN). Methods A total of 607 type 2 diabetes patients from the Affiliated Hospital of Weifang Medical University were enrolled in this study between June 2013 and December 2014. Rs5498 (A/G K469E) and rs1799969 (G/A R241G) in the ICAM-1 gene were genotyped by using TaqMan allelic discrimination in 295 patients with DPN and 312 subjects without DPN. The distribution of these two SNPs and the genetic influence of ICAM-1 gene polymorphisms on the development of DPN were conducted. Results Genotype distributions of both SNPs were coincided with Hardy-Weinberg equilibrium in the two groups. SNP rs1799969 (G/A R241G) in the ICAM-1 gene showed a high GG genotypic frequency at 96.8%(non DPN) and 99.0%(DPN) respectively. SNP rs5498 (A/G K469E) represented AA and AG genotypes. The values were AA 48.7%/AG 39.4%in non DPN group and AA 51.5%/AG 41.7%in DPN group. There were no significant differences in genotypic distributions and allele frequencies of SNPs rs1799969 (G/A R241G) and rs5498 (A/G K469E) between the patients with DPN group and patients without DPN group (P>0.05). The dominant(AA+AG)/GG and additive (GG/AA) models of rs5498 (A/G K469E) were associated with higher risk of DPN (ORadjusted=1.585, 1.575 respectively, P<0.05). To carry A allele was related to the susceptibility of DPN. There was no such association in genetic models of rs1799969 (G/A R241G) and DPN pathogenesis. Conclusion The present study provides evidence that SNP rs5498 E469K (A/G) in the ICAM-1 gene is associated with susceptibility of DPN, and the carrying A allele appears to be a risk of DPN.
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Objective· To establish an integrative method for the gene-panel sequencing data to automatically complete quality control, detection of gene mutation and visualization. Methods · Integrate several methods, e.g. FastQC, preprocessing and information of sequences (Prinseq) to develop an R package that can be used to visualize and control the quality of the raw sequencing reads and final mutations result. The sequencing reads mapped against to the reference genome using Burrows-Wheeler Alignment Tool (BWA)/Torrent Mapping Alignment Program (TMAP). Lofreq, Varscan2, the Genome Analysis Toolkit (GATK) and Torrent Variant Caller (TVC) were used to detect gene mutation and get the variant call format (VCF) format file. Annotate the gene mutation sites using Annovar. Results · Thirty-six cases of acute myeloid leukemia sequencing from Ion Torrent Personal Genome Machine (PGM) platform were passed by this analysis tool.Ten mutation sites of 2 demo data were found in DNMT3A,TET2,JAK2,PHF6,ASXL1,NPM1 and CEBPA which were validated by sanger sequencing. Conclusion · The analysis method that integrated and developed several tools for gene-panel sequencing data analysis can accomplish the gene-panel sequencing data analysis effectively. Besides, it can reduce the false positive ratio and improve the sensitivity of gene mutation detection that provides support for the analysis of gene-panel sequencing data.
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Objective To investigate the genetic association between Polymorphism of heat shock protein(HSP)70-hom gene+2437T/C and susceptibility to breast cancer in the Han descent population of Shaanxi Province.Methods 136 patients with breast cancer and 150 healthy controls without breast cancer were recruited to participate in the study.Genotype was determined by Polymerase chain reaction-restriction enzyme analysis for the polymorphism of the HSP70-hom gene +2437T/C.Results The distribution of HSP70-hom genotypes and allelotypes had significant difference between the patients with breast cancer and healthy controls(χ2=7.282,P=0.026;χ2=6.586,P=0.010).Stratified by immunohistochemistry, the distribution of HSP70-hom genotypes types had significant difference between the patients with triple negative breast cancer(TNBC)and healthy controls(χ2=9.047,P=0.003).However,there was no significant difference of the distribu-tion of HSP70-hom genotypes between the patients with non-TNBC and healthy controls(χ2=2.575,P=0.109).Conclu-sion For Han descent population of Shaanxi Province,polymorphism of the HSP70-hom gene +2437T/C may associate with the risk of breast cancer,especially for TNBC.
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Objective To explore the data accuracy acquired by the anesthesia information management system.Methods Totally 100 patients from two hospitals were selected randomly,whose anesthesia time was estimated more than 1 h.The vital signs data acquired by the system were compared with those by the monitor once every 5 min±30 s,and totally there were 12 times of comparison executed.SAS 9.2 software was used for statistical analysis.Results In FAS set the system had the total data accuracy being 100％,95％ credibility interval from 86.87％ to 97.30％ and the BMDL higher than 85％;in PPS set he total data accuracy was 100％,95％ credibility interval was from 92.89％ to 100％ and the BMDL was also higher than 85％.The system gained "Excellent" or "Good" grade in system response,stability,functional interface operability and the accuracy of special functions.Conclusion The system acquires and stores the vital signs data automatically and accurately,enhances anesthesia information in objectivity,authenticity and tractability,and has high values for enhancing anesthesia safety,medical safety and scientific research.
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Septic shock is a life threatening healthcare problem .Initial resuscitation based on antimicrobials therapy in early stage is vital.Of note, the recent trials show that excessive fluid resuscitation would increase mortality .Thus"appropriate"goals direct-ed resuscitation is crucial to effective therapy in septic shock .In this review, we will focus on goals of septic shock resuscitation from views of hemodynamics to cells and organs .
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Objective To investigate the standard prescription in patients with stable chronic obstructive pulmonary disease (COPD) and to provide a reference for rational drug use. Methods A total of 157 patients with COPD in our hospital were included into the study from June 2016 to January 2017. Of patients, there were 3 patients with mild airflow limitation, 18 patients with moderate airflow limitation, 39 patients with severe airflow limitation and 97 patients with extremely severe airflow limitation. The self-made questionnaire was used to understand the basic situation, complications and irrational drug use. Results Most severe and extremely severe COPD patients were male, and most of them combined with high blood pressure and cardiovascular disease. Of the 157 patients, 12 cases with moderate airflow limitation used inhaled therapy of corticosteroids/bronchodilator medications, 45 cases combined with pneumocardial disease used compound methoxyphenamine, 26 cases used leukotriene receptor antagonist, 14 cases used antibiotics for no obvious infection symptom and 11 cases used systemic corticosteroids in stable COPD. All of them belong to rational drug use. Conclusion There are some unreasonable situations of drug using in patients with stable COPD. The medical staff should strictly control indications, strengthen the education for drug use, guide rational drug use and avoid the occurrence of adverse consequences.
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Objective: To introduce the construction idea and function for establishing China Cardiovascular Surgery Registry (CCSR)database and to provide a reference for domestic congener databases. Methods: Using peer database as reference, taking current status of cardiovascular surgery registry and hardware in our country with the necessity of international communication, we worked on a variables selection, metadata instruction, logic rules, case report form develpment and finally established a web-based, multi-functional database that enabled cross-database and international merging of data, forming a national intelligent data-exchanging platform for cardiovascular surgery. Results:CCSR database has over 300 variables of multiple topics including basic information, risk factors, medical procedures and endpoint events. Taking clinical and association data exchange standards as reference, it may conduct cross-discipline data connection, record important peri-operative information in relevant patients and meanwhile, it has the functions of automatic logic check, data report, statistical study, data export and importing the electronic medical records. Conclusion:CCSR database is a national platform accord with current status of Chinese cardiovascular surgery and characteristics, meanwhile it gives consideration to international communication and data exchange; which may play a important role in improving medical care and clinical investigation.
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Objective To explore the data accuracy acquired by the anesthesia information management system.Methods Totally 100 patients from two hospitals were selected randomly,whose anesthesia time was estimated more than 1 h.The vital signs data acquired by the system were compared with those by the monitor once every 5 min±30 s,and totally there were 12 times of comparison executed.SAS 9.2 software was used for statistical analysis.Results In FAS set the system had the total data accuracy being 100％,95％ credibility interval from 86.87％ to 97.30％ and the BMDL higher than 85％;in PPS set he total data accuracy was 100％,95％ credibility interval was from 92.89％ to 100％ and the BMDL was also higher than 85％.The system gained "Excellent" or "Good" grade in system response,stability,functional interface operability and the accuracy of special functions.Conclusion The system acquires and stores the vital signs data automatically and accurately,enhances anesthesia information in objectivity,authenticity and tractability,and has high values for enhancing anesthesia safety,medical safety and scientific research.
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To analyze the epidemiology,genetic variation and genetic evolution of coxsackievirus A4 (CVA4) in patients with hand,foot and mouth disease in Fujian,the virus isolates were molecular typed and amplified the whole VP1 region by RT-PCR,then the genetic variation and evolution were studied.The results showed that 33 CVA4 cases (8.1％) were confirmed from the 407 non-EV71 non-CVA16 HFMD cases in Fujian Province during 2011 and 2014,accounting for 31 cases in 2012 and 2 cases in 2014.Compared with common characteristics of the HFMD epidemic,no specificity in the distribution of CVA4 cases was found between gender and age groups.Sequence analysis of VP1 nucleotide sequences of Fujian CVA4 isolates showed that the nucleotide and amino acid sequences similarity were 92.6 ％-100 ％ and 95.7 ％-100 ％ respectively,low similarity with the prototype (83.7％-85.4％,96.1％-99.0％) and abroad isolates (82.1％-89.1％,90.4％-99.6％) both in nucleotide and amino acid sequences,high similarity with domestic isolates both in nucleotide and amino acid sequences,with the similarity of 87.9％ 99.2 ％ and 96.1％-100 ％.The results from phylogenetic tree showed that the genetic distance between Fujian CVA4 isolates and the prototype and abroad strains was far,and the genetic distance was close to domestic isolates in China.The distribution of the phylogenetic trees of Fujian CVA4 strains showed multiple branches.Therefore,CVA4 is the major HFMD associated-pathogen other than EV71,CVA 16,CVA6,and CVA10 in Fujian Province from 2011 to 2014.CVA4 strains from Fujian Province is co-circulating and co-evolving with other domestic isolates.There is existence of multiple closely related CVA4 transmission chains in various regions of Fujian.
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Septic shock is a life threatening healthcare problem .Initial resuscitation based on antimicrobials therapy in early stage is vital.Of note, the recent trials show that excessive fluid resuscitation would increase mortality .Thus"appropriate"goals direct-ed resuscitation is crucial to effective therapy in septic shock .In this review, we will focus on goals of septic shock resuscitation from views of hemodynamics to cells and organs .
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Objective To investigate the standard prescription in patients with stable chronic obstructive pulmonary disease (COPD) and to provide a reference for rational drug use. Methods A total of 157 patients with COPD in our hospital were included into the study from June 2016 to January 2017. Of patients, there were 3 patients with mild airflow limitation, 18 patients with moderate airflow limitation, 39 patients with severe airflow limitation and 97 patients with extremely severe airflow limitation. The self-made questionnaire was used to understand the basic situation, complications and irrational drug use. Results Most severe and extremely severe COPD patients were male, and most of them combined with high blood pressure and cardiovascular disease. Of the 157 patients, 12 cases with moderate airflow limitation used inhaled therapy of corticosteroids/bronchodilator medications, 45 cases combined with pneumocardial disease used compound methoxyphenamine, 26 cases used leukotriene receptor antagonist, 14 cases used antibiotics for no obvious infection symptom and 11 cases used systemic corticosteroids in stable COPD. All of them belong to rational drug use. Conclusion There are some unreasonable situations of drug using in patients with stable COPD. The medical staff should strictly control indications, strengthen the education for drug use, guide rational drug use and avoid the occurrence of adverse consequences.