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Objective:To investigate the predictive value of mechanism Glasgow age blood pressure score (MGAPS), revised trauma score (RTS) and modified rapid emergency medicine score (mREMS) in predicting the mortality risk of patients with acute traumatic brain injury (TBI) within 24 hours.Methods:A case control study was performed for clinical data of 1 156 patients with acute TBI admitted to Affiliated Hospital of Nantong Hospital from January to December of 2020, including 745 males and 411 females; aged 18-100 years [(59.9±15.1)years]. Glasgow coma score (GCS) was 3-15 points [15(9, 15)points]. The patients were divided into death group ( n=87) and survival group ( n=1 069) according to death or not within 24 hours. Vital signs, general data, MGAPS, RTS and mREMS were documented at emergency visit. Differences in the specific scores and severity levels of the patients using the three scoring systems were compared between the two groups. Receiver operating characteristic (ROC) curve was plotted for the three scoring systems based on the specific scores and severity levels of the patients. While the area under the curve (AUC), sensitivity, specificity, optimal threshold and Youden index were determined to estimate the value of the three scoring systems in predicting death risk in patients with acute TBI within 24 hours. Results:Death group showed significantly decreased scores in MGAPS [17(12, 19)points] and RTS [5.0(4.1, 6.0)points] and significantly increased score in mREMS [9(7, 12)points] when compared with survival group (all P<0.01). The proportion of moderate- and high-risk patients for MGAPS and proportion of high-risk patients for RTS and mREMS in death group were significantly higher than those in survival group (all P<0.01). As indicated by the ROC curve plotted based on the specific scores, mREMS had the maximum AUC (0.88), followed by MGAPS (0.86) and RTS (0.86); the sensitivity of mREMS, MGAPS and RTS was similar (80.5%, 86.2% and 82.8%, respectively), while mREMS showed the highest specificity (83.4%) compared to MGAPS (78.0%) and RTS (82.3%); the optimum threshold of mREMS, MGAPS and RTS, was 6 points, 6.08 points and 20 points; the Youden index of MGAPS, RTS and mREMS was 0.64, 0.64 and 0.65. As indicated by the ROC curve plotted based on the injury severity, MGAPS had the highest AUC (0.84), followed by RTS (0.70) and mREMS (0.59); MGAPS also had the highest sensitivity (92.0%), higher than RTS (47.1%) and RTS (18.4%); when mREMS showed the highest specificity(98.8%) compared to RTS (93.7%) and MGAPS (68.8%); the optimal threshold of MGAPS, RTS and mREMS was 22 points, 4 points and 13 points; the Youden index of MGAPS, RTS and mREMS was 0.61, 0.41 and 0.17. Conclusions:MGAPS, RTS and mREMS can be predictive in assessing the mortality risk of patients with acute TBI within 24 hours. mREMS has the highest prediction value, with an optimal threshold of 6 points when the risk assessment is made in accordance with specific scores of the patients. MGAPS has the highest prediction value when the risk assessment is assessed by the injury severity.
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Purpose To investigate the expression of cell cycle related protein including Cyclin D1,CDK4,p16 and IgH/CCND1 fusion gene in mantle cell lymphoma (MCL) and their relationship with each other.Methods The expression of cell cycle related protein including Cyclin D1,CDK4,p16 and IgH/CCND1 fusion gene were detected on the 40 cases of MCL (expreimental group) and 20 cases of reactive hyperplasia (control group) by using the combined detection of fluorescence in situ hybridization (FISH) and immunohistochemistry of EnVision two methods.40 cases of MCL were confirmend by using gene rearrangement technique and immunohistochemistry.The threshold of IgH/CCND1 fusion gene of MCL was established in the control group.Results In the experimental group,Cyclin D1 protein positive expression rate was 100％,the positive expression of CDK4 protein rate was 87.50％,p16 protein positive expression rate was 17.50％.Positive rate of IgH/CCND1 fusion gene of 100％.These cell cycle related protein and IgH/CCND1 fusion gene were negative in the control group.Conclusion In MCL,Cyclin D1-CDK4-p16 pathway is consistent with the principle of tumor cell cycle regulation.The establishment of threshold value of IgH/CCND1 fusion gene by FISH technique may provide the basis for the judgement of FISH of the IgH/CCND1 in China.
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Purpose To investigate the corre1ation of the epiderma1 growth factor receptor( EGFR)gene mutation and amp1ification and protein expression with occurrence and deve1opment of non-sma11 ce11 1ung cancer( NSCLC),and to exp1ore the re1ationship be-tween the mutation and amp1ification of EGFR gene and other c1inica1 patho1ogica1 parameters. Methods qRT-PCR,FISH and immu-nohistochemistry were used to detect EGFR gene(exons 18,19,20 and 21)mutation,amp1ification and protein expression in paraf-fin-embedded tissues of NSCLC. Results EGFR gene(exons 18,19,20 and 21)mutation rate was 58. 18%(32/55)in NSCLC with qRT-PCR techno1ogy,in which the occurrence rate of exon 19 de1etions and exon 21 mutation of L858R was 87. 50%(28/32). EGFR gene mutation rate was significant1y different in gender,smoking history and patho1ogica1 type(P0. 05). EGFR gene amp1ification rate was 23. 64%(13/55)and its protein expression rate was 70. 91%(39/55). Both EGFR gene mutation and amp1ification was c1ose1y corre1ated(P0. 05). Conclusion EGFR gene mutation with high pro-tein expression of NSCLC is common1y found in fema1e,no-smoking and adenocarinoma patients,who are main candidates of a tyrosine kinase inhibitor( TKI)screening. EGFR gene mutation and amp1ification is typica11y corre1ated,but their consequence is unknown, which needs to be further investigated. EGFR gene mutation and amp1ification is not consistent with protein expression,its under1ying machanism is to be determined.
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Objective To investigate the status quo of new allocated nurses to master relevant knowledge of blood specimen collection.Methods 197 new allocated nurses and young nurses within 5 working-years were included and the new allocated nurses accepted knowledge training of blood specimen collection.Differences in training effect between nurses with different work experience and education background were analyzed.Results Average score of new allocated nurses before training was lower than young nurses,while after training,there was no difference between them.The training score of new allocated nurses did not correlate with their background before and after training.Conclusions In order to improve the quality of testing and prompt development of new nurses,the department of clinical nursing should strengthen the relevant training about knowledge of blood specimen collection in new allocated nurses.
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Objective To investigate the expressions of RUNX3 and CyclinDl in pancreatic carcinoma and their significance. Methods Expressions of RUNX3, CyclinD1 in 47 cases with pancreatic carcinoma, 18 cases with cystadenoma of pancreas and 12 normal pancreas cases were detected by immunohistochemistry, and the relationship between their expressions and clinicopathological parameters was analyzed. Results The positive expression rates of RUNX3 in pancreatic carcinoma, cystadenoma of pancreas, normal pancreas cases were 57.4％ (27/47), 94.4％ (17/18), 100％ (12/12); the positive expression rates of CyclinD1 in pancreatic carcinoma, cystadenoma of pancreas, normal pancreas cases were 72.3％ (34/47), 44.4％(8/18), 8.3％ (1/12). RUNX3 expression was not related to the age and sex, but it was negatively associated with clinical staging, lymph node metastasis, the differentiation degree (P ＜0.05 ). CyclinD1 expression was not related to the age and sex, but it was positively associated with clinical staging, lymph node metastasis, the differentiation degree (P ＜0.05 ). The expression of RUNX3 and CyclinD1 was negatively associated (r = - 0.375, P = 0.009). Conclusions The expression of RUNX3 is decreased in pancreatic carcinoma. The expression of CyclinD1 is increased in pancreatic carcinoma. They may play an important role in the carcinogenesis and progression of pancreatic carcinoma.
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Objective To investigate the expression of histone acetylated H3 and H4, methylated H3K4 and H3K9 in diffuse large B-cell lymphoma (DLBCL). Methods The expression of histone acetylated H3 and H4, methylated H3K4 and H3K9 were examined by SP immunohistochemistry technique in lymphoid tissue of 40 cases with DLBCL and 16 cases with proliferative lymphadenitis. Results The expression of histone acetylation of H3 and H4 were lower than that in proliferative lymphadenitis. Histone methylated H3K4 was lower in expression and H3K9 was in higher expression. There was a positive correlative expression between the global histone acetylation of H3 and H4, the global histone acetylation of H3, H4 and histone methylation of H3K4. Conclusion Improper modification of histone acetylations and methylations may play an important role in pathogenesis in DLBCL.
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Objective To explore the effect of general intervention in improving the psychological condition of healthy pregnant women. Methods Totally 96 pregnant women who made prenatal visits in our obstetrics and outpatient department were divided into the control and the intervention group stochasti-cally. The intervention group started from first prenatal visit. The general intervention measures included cognitive intervention, the behavioral intervention, family coping intervention and psychological intervention with self-designed relaxation exercises. While conventional prenatal visit, propaganda and nursing were im-plemented to the control group.Self-made general questionnaire and symptom checklist 90 (SCL-90)were used to survey and analyze the results. Results Post-natal depression and anxiety of the control group was obviously higher than that of the prenatal. The Post-natal obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility, terror and bigotry in the intervention group were greatly alleviated. Com-pared with the control group, obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility and terror of the intervention group were significantly different (P<0.05). The depression improved while the difference was not evidently differenL Conclusions Delivery had great influence on the psychological status of women,especially anxiety and depression. General intervention measures like psychological relax-ation exercises can improve the psychological condition of healthy pregnant women obviously,especially de-pression.