ABSTRACT
Objective:To analyze the status quo of bystander cardiopulmonary resuscitation (BCPR) for out-of-hospital cardiac arrest (OHCA) in Qinhuangdao area and its influence on the prognosis of cardiopulmonary resuscitation (CPR).Methods:Based on the Utstein model CPR database of Qinhuangdao, data of 1 162 OHCA patients admitted to the Health Emergency Dispatch Center of Qinhuangdao City from January 2018 to January 2019 were collected, and they were divided into two groups according to whether BCPR was performed or not. The patients' demographic parameters (gender, age), precardiac arrest parameters (location of cardiac arrest), the parameters of the CPR (first aid response time before hospital, initial diagnosis of causes of cardiac arrest, initial cardiac rhythm) and the parameters of the CPR results [whether to achieve on-site restoration of spontaneous circulation (ROSC) and 30-day survival rate] were collected. Multivariate Logistic regression analysis was performed for the relationship between BCPR and on-site ROSC rate. The social characteristics of bystanders implementing BCPR, including gender, age, occupation, educational background, and acquisition method of CPR knowledge, were analyzed.Results:Among the 1 162 OHCA patients, the patients witnessed by professional medical personnel in nursing homes, hospitals and other places and pre-hospital emergency personnel were excluded. 852 OHCA patients were enrolled, among which only 24 patients obtained BCPR (2.8%), and the remaining 828 patients did not obtain BCPR (97.2%). There were no statistically significant differences in gender, age, location of cardiac arrest, pre-hospital emergency response time, primary diagnosis of cardiac arrest causes and initial cardiac rhythm between the two groups. Compared with the non-BCPR group, the on-site ROSC rate and the 30-day survival rate of the BCPR group were significantly increased [on-site ROSC rate: 16.7% (4/24) vs. 5.2% (43/828), 30-day survival rate: 8.3% (2/24) vs. 1.3% (11/828), both P < 0.05]. Multivariate Logistic regression analysis showed that BCPR [odds ratio ( OR) = 32.132, 95% confidence interval (95% CI) was 11.129-65.471], location of cardiac arrest ( OR = 0.080, 95% CI was 1.212-3.125) and response time during pre-hospital emergency treatment ( OR = 0.121, 95% CI was 0.174-0.816) were important factors for on-site ROSC of OHCA patients (all P < 0.01). A total of 30 bystanders participated in the implementation of OHCA patients' BCPR, excluding 2 bystanders of lost follow-up, 28 bystanders with effective return visit. The 28 bystanders of BCPR practitioners were mainly male (85.7%), the age was mainly 18-40 years old (57.1%), the occupation was mainly in the tourism service industry (21.5%), students (17.9%), soldiers (14.3%) and bus drivers (10.7%), and the education background was mainly junior college or above (85.7%), the methods of acquiring CPR knowledge mainly included APP and new media (42.9%) and lectures (21.4%). Conclusions:The BCPR implementation rate of OHCA in Qinhuangdao was only 2.8%. BCPR can improve the success rate of pre-hospital CPR and the 30-day survival rate of OHCA patients. Targeted selection of tourism service industry, students, military personnel and bus drivers as CPR training targets may obtain more significant social benefits.
ABSTRACT
Objective@#This study aimed to evaluate the validity and predictive value of different methods for myopia screening, and to provide the most effective method of myopia screening.@*Methods@#A total of 7 441 students of grade 1-12 selected from 36 primary and middle schools in 12 counties in Jiangsu Province were enrolled in this study for ophthalmological examination, and uncorrected visual acuity (UCVA, Plan A), noncycloplegic autorefraction (NCAR, Plan B) and combination of UCVA and NCAR (Plan C) were included in the examination. Receiver operating characteristics (ROC) curve was performed to determine the cut-off values (The gold standard is cycloplegic refraction: SE≤0.5 D), and positive predictive value, sensitivities, specificities and other indicators of three screening tests were compared and calculated.@*Results@#The AUC of the combination test for uncorrected visual acuity(UCVA) and noncycloplegic autorefraction (NCAR) was nearly 1(0.91, 95%CI=0.90-0.92), and the sensitivity, specificity, Yoden index, diagnostic coincidence rate, positive predictive value and negative predictive value were 92.4%，89.5%，0.82，91.1%，91.3%，90.8%, respectively, but the index of the younger pupils in primary schools was relatively low. The result of screening plan A for students of middle and high school students was the closest to that of myopia diagnosis.@*Conclusion@#Combination test, which was recommended by China National Health Commission, can be a practical solution for school students for myopic screening. Under the condition of no mydriatic refraction, Plan A could be considered for myopia screening especially for middle and high school students. For the younger pupils, it is suggested to use the internationally recommended myopia screening strategy, that is, SE ≤ 0.50D after mydriasis.
ABSTRACT
Objective To assess the reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test (AUDIT) among medical students in China and to provide correct way of application on the recommended scales.Methods An E-questionnaire was developed and sent to medical students in five different colleges.Students were all active volunteers to accept the testings.Cronbach's α and split-half reliability were calculated to evaluate the reliability of AUDIT while content,contract,discriminant and convergent validity were performed to measure the validity of the scales.Results The overall Cronbach's α of AUDIT was 0.782 and the split-half reliability was 0.711.Data showed that the domain Cronbach's α and split-half reliability were 0.796 and 0.794 for hazardous alcohol use,0.561 and 0.623 for dependence symptoms,and 0.647 and 0.640 for harmful alcohol use.Results also showed that the content validity index on the levels of items I-CVI)were from 0.83 to 1.00,the content validity index of scale level (S-CVI/UA) was 0.90,content validity index of average scale level (S-CVI/Ave) was 0.99 and the content validity ratios (CVR) were from 0.80 to 1.00.The simplified version of AUDIT supported a presupposed three-factor structure which could explain 61.175％ of the total variance revealed through exploratory factor analysis.AUDIT semed to have good convergent and discriminant validity,with the success rate of calibration experiment as 100％.Conclusion AUDIT showed good reliability and validity among medical students in China thus worth for promotion on its use.
ABSTRACT
Objective To assess the reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test (AUDIT) among medical students in China and to provide correct way of application on the recommended scales.Methods An E-questionnaire was developed and sent to medical students in five different colleges.Students were all active volunteers to accept the testings.Cronbach's α and split-half reliability were calculated to evaluate the reliability of AUDIT while content,contract,discriminant and convergent validity were performed to measure the validity of the scales.Results The overall Cronbach's α of AUDIT was 0.782 and the split-half reliability was 0.711.Data showed that the domain Cronbach's α and split-half reliability were 0.796 and 0.794 for hazardous alcohol use,0.561 and 0.623 for dependence symptoms,and 0.647 and 0.640 for harmful alcohol use.Results also showed that the content validity index on the levels of items I-CVI)were from 0.83 to 1.00,the content validity index of scale level (S-CVI/UA) was 0.90,content validity index of average scale level (S-CVI/Ave) was 0.99 and the content validity ratios (CVR) were from 0.80 to 1.00.The simplified version of AUDIT supported a presupposed three-factor structure which could explain 61.175％ of the total variance revealed through exploratory factor analysis.AUDIT semed to have good convergent and discriminant validity,with the success rate of calibration experiment as 100％.Conclusion AUDIT showed good reliability and validity among medical students in China thus worth for promotion on its use.
ABSTRACT
OBJECTIVE:To observe clinical efficacy of urinary kallidinogenase in the treatment of acute cerebral watershed in-farct (WSI). METHODS:128 patients with WSI were randomly divided into control group and treatment group,each of the 64 cases. Control group was given Shuxuening 15 ml added into 0.9% Sodium chloride 250 ml,ivgtt,qd;treatment group received urinary kallidinogenase 0.15 PNA added into 0.9% Sodium chloride 100 ml,ivgtt,qd. Both groups were treated for consecutive 14 days. Neurologic impairment score(NIHSS)and clinical efficacy were observed in 2 groups before treatment and 3,7 and 14 days after treatment. The blood specimens were collected after 7 and 14 days treatment,to determine serum levels of TCC. RESULTS:After treatment,NIHSS and total effective rate of treatment group were significantly higher than those of control group,with statis-tical significance(P0.05);7 days af-ter treatment,TCC level of 2 groups increased significantly,to 14 days,and a declive;the treatment group was higher than the control group,with statistical significance (P<0.05). CONCLUSIONS:Urinary kallidinogenase can improve clinical efficacy of WSI significantly,and promote neurologic impairment symptom and TCC levels.
ABSTRACT
Objective The paper focused on teaching status of evening college among different ma-jors, and tried to provide data support and suggestion for teaching reform of evening college in medical university. Method Using methods of questionnaires and interviews, the investigators analyzed five aspects of students in Peking University Health Science Center, which were the influences on study from family and work, and the evaluation on teaching, etc. The investigators entered data with Epidata 3.1 software and de-scribed it with SPSS 20.0 statistical software, with which they also did chi-square and nonparametric rank sum test. Results 38.2% (63/165) of clinical medicine students, 45.8% (27/59) of laboratory medical sci-ence students and 43.0%(71/165) of nursing students regarded hard work and limited energy as their major difficulty from jobs. Limited time for study was treated as the biggest problem for students of clinical medicine (58.2%, 96/165), laboratory medical science (46.5%, 27/58) and nursing (66.5%, 105/158). 41.9%(70/167) of clinical medicine students tended to receive traditional face-to-face teaching; 39.0%(23/59) of laboratory medical science students preferred partial face-to-face teaching with partial network teaching; while 37.2% (68/183) of nursing students tended to partial face-to-face teaching with partial self-study. 58.4%(97/166) of clinical medicine students, 55.9%(33/59) of laboratory medical science students and 64 . 8% ( 118/182 ) of nursing students preferred examination of both memorization and application . Conclusion Results showed that students in different majors presented similar opinions on teaching status, but also with a few dif-ferences. There were the same characteristics between students of clinical medicine and nursing, both with high satisfaction. While students in the laboratory medical science showed the special characteristics, with low satisfaction.
ABSTRACT
OBJECTIVE:To investigate the role of clinical pharmacists in the treatment for patients with chronic renal failure. METHODS:Clinical pharmacists participated in the treatment process for a patient with chronic renal failure during uremia period;assisted physicians to optimize and improve therapy plan from correcting anemia,controlling blood pressure,improving heart func-tion and regulating ion disorder,etc.;suggested adding dosing frequence of Felodipine sustained-release tablet,Metoprolol tartrate tablet and Shenqiong glucose injection,and giving Benazepril hydrochloride tablet and Isosorbide 5-mononitrate sustained-release tablet. They also suggested adjusting the dosage of rhEPO and the dosage form of ferralia,increasing the dosage of Calcitriol cap-sule and Calcium carbonate tablet,decreasing dosing frequence of 5% Glucose injection and Levocarnitine for injection,and giv-ing Vitamine B12 tablet. Therapeutic efficacy and ADR should be observed closely during treatment,and medication education should be performed for the patient. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient was im-proved and discharged from hospital with drugs 28 days later. CONCLUSIONS:Clinical pharmacists participate in the individual-ized treatment for patients with chronic renal failure and assist physicians to optimize therapy plan,which promote the clinical effec-tiveness and safety of drug treatment.
ABSTRACT
Objective To explore the relationship between excessive gestational weight gain and the risk of macrosomia. Methods Three databases were systematically reviewed and reference lists of relevant articles from January 2001 to December 2014 were checked. Meta-analysis of published epidemiological studies (cohort and case-control studies) was done. The odds ratio (OR) was used to evaluate the relationship of excessive gestational weight gain and macrosomia delivery. Results Twelve relevant articles were included to analyze, including 4 cohort studies and 8 case-control ones. The values of OR and 95%CI of macrosomia in pregnant women with excessive and non-excessiveweight gain were 1.66 (1.49, 1.83). Conclusion The risk of macrosomia in pregnant women with excessive gestational weight gain is much higher than those with normal gestational weight gain.
ABSTRACT
Objective To observe the clinical efficacy of Honggui capsule combined with chemotherapy in the treatment of lung cancer. Methods 61 cases of lung cancer patients were randomly divided into group A of 30 cases, treated with Honggui Capsule and chemotherapy, and group B of 31 cases treated with chemotherapy only by the envelope method. After both groups were treated for 21 days, the clinical effect, life quality improvement, improvement of TCM symptoms and the incidence of toxic and side effects in 2 groups were compared. Results After treatment, there was significant difference between group A and B in the tumor response rate (26.7% vs. 3.2%; χ2=4.927, P=0.026), Karnofsky (23.3% vs. 3.3%; χ2=5.410, P=0.020), and improvement of TCM symptoms (13.3% vs. 0.0%; χ2=4.423, P=0.035). During treatment, there was significant difference between group A and B in bone marrow suppression (33.3% vs. 58.1%; χ2=4.778, P=0.029), and gastrointestinal disturbance (16.7% vs. 58.1%; χ2=11.124, P=0.001). Conclusion Honggui capsule combined with chemotherapy has an enhanced efficacy and a detoxicating effect, besides it improves clinical symptoms and reduces the side effects of chemotherapy.
ABSTRACT
Objective To investigate and analyze the mental health status of the students from poor families and non-poor students by comparative study.Methods Conducting the cluster sampling methods,the author investigated 885 medical students with questionnaires.We input data with Epidata 3.0 software and described it with SPSS 11.0 statistical software,which also did the nonparametric rank sum test.Results 92.7％(667/719) students from poor families considered their economic status among the general level or much lower level.There were 41.9％(294/702) students from poor families who thought families' financial difficulties had positive effects on mental health.92.3％(664/719) students from poor families were never afraid that people around knew they were in work-study program.87.5％(629/719) students from poor families were satisfied with their life.Facing psychological problems,there's no difference with dissatisfaction in daily life and recourses for help between students from poor families and non-poor students except psychological consultation center and lovers P＞0.05).Conclusion Compared with non-poor students,the mental health of students from poor families in medical universities is good.The universities are supposed to pay more attention to the mental health of students who are neither poor nor non-poor and few students from poor families who are negatively impacted by their families' financial difficulties.
ABSTRACT
ObjectiveTo know urban-rural differences of reference factors for the identification of students from poor families in order to provide references for identifying index system.Methods Questionnaires were used among 708 students from poor families.ResultsThere were 78.9％ urban and 89.1％ rural families whose average earnings were lower than 410 RMB per month.The number of majority urban and rural family (58.8％,75.4％ ) was 4 - 6 ; 77.0％ ( 86.3％ ) urban and 97.3％ (97.9％) rural fathers' ( mothers' ) education levels were high school or below; 8.6％ ( 23.1％ ) urban and 82.3 ％ ( 85.1％ ) rural fathers ( mothers ) were farmers.The proportion of students having computers was 87.2％ (urban) and 7 1.9 ％ (rural) ; 54.9％ urban and 63.9％ rural students' life was not frugal; 85.2％ urban and 79.1％ rural students thought campus cards shouldn't be monitored.ConclusionsThere are significant urban-rural differences of reference factors for the idenffication and family residence is the key indicator which should have higher weights.
ABSTRACT
Objective To know the problems of reference factors,and then provide evidences for scientific and specific identifying index system for students from poor families.Methods Questionnaires were used among 719 students from poor families.Results There were 86.0％ families whose earnings were lower than 410 RMB per month.57.2％ families depended on agriculture.70.1％ students were from the rural areas.Family member number was 4～6 for the majority ( 70.7％ ).91.2％ ( 94.5％ ) fathers'( mothers' ) education levels were under high middle school.64.0％ ( 67.3％ )fathers ( mothers ) were farmers.The proportion of students having computers was 76.1％.61.2％ students' life was not frugal.There were 80.9％ students who thought campus cards shouldn't be monitored.Conclusion Family economic situation should be the key indicator.Most of the basic family information could be reference factors.Basic situation of students at school was inappropriate to be reference factors.
ABSTRACT
Objective:To investigate the application value of adnephrin in TACE on the apud -advanced liver cancer. Methods:144 patients with apud -advanced liver cancer were randomly divided into two groups,In treatment group of 72 cases,patients were injected small dose of epinephrine prior to the chemotherapy drugs and lipiodol emulsion ; In control group of 72 cases,patients were treated with conventional chemotherapy and embolism,which the chemotherapy drugs and lipiodol ultra liquid were the same basically. Results:The efficiency of the treatment group was 61.1%,36.1% for the control group.The changes of intrahepatic tumor、postoperative liver function and the quality of life had a significant deviation in two groups between pretherapy and post-treatment (P
ABSTRACT
BACKGROUND: Uncoupling of major histocompatibility complex (MHC) is the main cause for transplantation rejection, and it is the best way to prevent transplantation rejection by induce immunological tolerance of the recipient to the donor organ. Self-tolerant T cells can be obtained by negative selection in thymus, whether the intrathymic injection of allogenic antigen can get the immunological tolerance to the antigen?OBJECTIVE: To observe the effects of intrathymic injection of allogenic antigen on inducing immunological tolerance in nerve transplantation.DESIGN: A comparative observation.SETTINGS: Department of Immunology, Harbin Medical University; Department of Orthopaedics, Fourth Clinical Hospital of Harbin Medical University.MATERIALS: Thirty donor C57BL/6 mice (H-2b), male, aged from 6-8 weeks, weighing 18-22 g, were purchased from the Veterinarian Institute of Heilongjiang Province; While 60 recipient Balb/c mice (H-2b) female, aged from 6-8 weeks, weighing 18-22 g, from Beijing Experimental Animal Center. MHC (H-2b) antigen was prepared by the Department of Immunology, Harbin Medical University, and the concentration of protein was 4.4 g/L.METHODS: The experiments were carried out in the Department of Immunology, Harbin Medical University from June to November 2002. The recipient Balb/c mice were randomly divided into four groups: intrathymic injection group, syngenic transplantation group, allogenic transplantation group and immunosuppressant drug group. MHC (H-2b) antigen was extracted from splenic cells of donor C57BL/6 mice and injected intrathymically into recipient Balb/c mice (H-2d). Two weeks later, the sciatic nerve was transplanted to the recipient mice. Mixed lymphocyte reaction and delayed-type hypersensitivity (DTH) were detected at 3 weeks after transplantation.MAIN OUTCOME MEASURES:The differences of mixed lymphocyte reaction and DTH were compared among the groups.RESULTS: All the 30 donor C25BL/6 mice (H-2b) and 60 recipient Balb/c mice (H-2d) were involved in the analysis of results.①Results of mixed lymphocyte reaction: The cell proliferations in the syngenic transplantation group and intrathymic injection group were obviously lower than that in the allogenic transplantation group [(546.1±75.1), (2 668.3±533.8), (3 101.3±429.1), (4 312.3±534.1) minutes-1, P＜0.05].②Results of DTH: The thicknesses difference between two pads in the syngenic transplantation group and intrathymic injection group were obviously lower than that in the allogenic transplantation group [(41.1±3.7), (72.1±5.1), (57.6±11.3), (86.2±13.2)μm, P＜0.05].CONCLUSION:The intrathymic injection of donor H-2b antigen could induce immunological tolerance of nerve transplantation.
ABSTRACT
OBJECTIVE To probe the risk factors of the secondary lung infection in patients of postoperative(cranio)-(cerebral) trauma as well as the ways to control them.METHODS A prospective and review study was carried out in 718 cases with cranio-cerebral trauma admitted in our hospital for operation from Jan 2002 to Dec 2004.RESULTS Among 718 cases,39(5.43%) developed lung(infection),occupied 65% of the total number of the hospital(infection) in the neurosurgery.After an integrated(total and systemic) treatment,the cure rate was(69.23%(27 cases);) effective: 15.3%(6);improved: 7.7%(3); died: 7.7%(3).CONCLUSIONS Oxygen(inhalation,) nasal(feeding),sputum drawing out,(cannular) tracheotomy,and use of respirator after operation are the causes of the lung infection and it can be controlled effectively if keeping the surroundings clean,keeping strict ness in disinfection-isolation institution,improving the mangement of respiratory tract and the care of oral cavity,proper use of antibiotics,and improving immunity.
ABSTRACT
Objective:To investigate the effect of intrathymic injection of allogenic antigen to sciatic nerve transplantation.Methods:C57BL/6(H-2b) mice were used as donors and BALB/c(H-2d) as recipients. The recipients were divided into four groups: auto-transplantation group, allogenic transplantation group, allogenic transplantation and using immunosuppressive drugs,intrathymic injection group: 3 mol/L KCl MHC antigen extractions were injected into the recipients’ thymus before two weeks before the sciatic nerves were transplanted. In the third week all the recipients underwent immunological detections for IL-2R,TNF-?,mixed lymphocytes culture and apoptosis.Results:All the detections indicated that it was of significant difference between intrathymic injection group and those in allogenic transplantation group.Conclusion:The immunological rejection of allogenic peripheral nerve transplantation can be somewhat inhibited by intrathymic injection of allogenic MHC antigen.
ABSTRACT
Objective:To study the effects of intrathymical injection allogenic antigen on the establishment of donor specific transplantation immunotolerance.Methods:H 2 antigen extracted from splenic cells of donor C56BL/6 mice was intrathymically injected to recipients adult Balb/c mice, one week later,donor C57BL/6 or C3H skingrafts were transplanted,observing transplanted skin survival times ,meanwhile MLC?CML ?DTH was detected.Results:the median survival time (MST) of transplanted skin allografts was over 70 days in tolerance recipients while the skin MST graft in the control group was 12.6?1.69 days,tolerance recipients normally rejected the donor C3H skin grafts (MST 13.4 ? 1.42 days), MLC detection showed that tolerance recipient splenocyte responded to C57BL/6 stimulator significant reduction ,but in normal reaction to donor C3H stimulator,the CML and DTH of tolerance recipient splenocyte to target cell of donor C57BL/6 was inhabited.The results suggested that slpecific tolerance might be induced by intrathymic injection. Conclusion:The intrathymic injection of donor H 2 antigen extracted from C57BL/6 splenic cells could induce recipients specific tolerance to skin transplantation.
ABSTRACT
Objective:To study the effect of injection bovine retinal soluble antigen (S-Ag)into anterior chamber(AC)in inducing immunological tolerance.Methods:S-Ag was extracted from fresh bovine retina and inoculated into the AC of Wistar rats,One week later,the S-Ag mixed with complete fruend's adjuvant(CFA)was injected into footpad intradermaly.The clinical symptoms and the pathological changes were observed.The IL-4 and IFN-? concentrations in the supernatant of splenic cell culture were measured by ELISA.Results:The incidence of EAU in pretreated group(group A) was markedly higher than that of positive controls(gropu B).There were histopathological changes in all rats with clinical symptoms.The IL-4 level of splenic cell culture in group A were significantly higher than those in group B ( P
ABSTRACT
AIM To analyze the effects of glycyrrhetic acid (GA) on c-fos expression and cell proliferation in rat vascular smooth muscle cell (VSMC), and to figure out the mechanisms of binding GA to angiotensin Ⅱ(AⅡ) receptor. METHODS Primary cell culture of rat VSMC, Northern blot, TdR incorporation DNA assay and MTT assay were used in this study. RESULTS ① GA at both low (1?10 -9 mol?L -1) and high concentration (1?10 -5 mol?L -1) quickly induced c-fos expression in VSMC. Sar-AⅡ(1?10 -5 mol?L -1)inhibited both GA induced and AⅡ (1?10 -5 mol?L -1) induced c-fos expression. GA enhanced AⅡ induced c-fos expression at both low and high concentration in VSMC. ② Low level of GA stimulated the proliferation of VSMC. This stimulatory effect decreased with increasing GA concentration, and changed to be inhibitory at high concentration of GA. Not only did Sar-AⅡ eliminate the stimulatory effect of low concentration of GA on cell proliferation, it also eliminated the inhibitory effect of high concentration of GA. Low concentration of GA enhanced the stimulation of AⅡon cell proliferation, while the inhibitory effect of high concentration of GA on cell proliferation was relieved by adding 1?10 -7 mol?L -1 AⅡ. CONCLUSION This study suggests that GA activates transcription factor c-fos and promotes the proliferation of VSMC. GA may exert its effects on cells through AT 1 receptor since it induces similar changes as AⅡ and its effects can be inhibited by AT 1 receptor antagonist.