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Objective:To compare the value of Caprini, Padua and Autar risk assessment models in the risk assessment of venous thromboembolism in hospitalized stroke patients.Methods:A retrospective case-control study were used to collect hospitalized stroke patients in the neurology department of Xiangya Hospital from January 1, 2018 to June 30, 2020. 75 patients with venous thromboembolism (VTE) were VTE group and 75 patients without VTE were control group. The risk of thrombosis was assessed by Caprini risk assessment model, Padua risk assessment model and Autar risk assessment model respectively. The predictive value of each model on the risk of VTE formation in stroke patients was analyzed by receiver operating characteristic (ROC) curve and area under the curve (AUC).Results:The areas under the curve of Caprini, Padua and Autar risk assessment models for predicting the risk of VTE formation in stroke patients were 0.768±0.039, 0.746±0.040 and 0.710±0.042 respectively. The sensitivity, specificity and accuracy were 81.3%, 61.3%, 71.3%(Caprini), 72.0%, 72.0%, 72.0%(Padua), 66.7%, 68.0% and 67.3%(Autar) respectively. There was no significant difference in the prediction value of the three models on the formation risk of stroke VTE (all P>0.05). The technique for order preference by similarity to ideal solution (TOPSIS) method was used to comprehensively evaluate the AUC, sensitivity, specificity and accuracy of the three risk assessment models. Padua risk assessment model was the best, followed by Caprini risk assessment model and Autar risk assessment model. Conclusions:The Caprini, Padua, and Autar risk assessment scales can well predict the risk of VTE in stroke patients. The Caprini scale has the highest sensitivity and the Padua scale has the highest specificity. There is no significant difference in the predictive value of the three scales. Comprehensive evaluation of predictive value: Padua risk assessment scale is the best.
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Objective:To investigate risk factors for infection of biofilm-forming Klebsiella pneumonia and prognosis of patients. Methods:The clinical data of 125 patients with Klebsiella pneumoniae bloodstream infection admitted in Tianjin Medical University General Hospital from January to December 2019 were analyzed retrospectively. According to the presence of Klebsiella pneumoniae biofilm, patients were divided into biofilm positive group ( n=81) and biofim negative group ( n=44). In biofilm positive group 17 patients died (fatal group) and 64 survived (survival group) during 3-month follow-up. The antimicrobial resistance of the strains was analyzed, and multivariate logistic regression analysis was used to investigate the risk factors of biofilm-forming Klebsiella pneumoniae infection and the risk factors of death in biofilm positive group. Results:A total of 125 strains of Klebsiella pneumoniae were isolated from 125 patients, of which 81(64.80%) strains were biofilm positive. Antimicrobial resistance analysis showed that the resistance rate of biofilm positive group to aztreonam, amikacin, ciprofloxacin and levofloxacin was significantly higher than that in the biofilm negative group ( χ2=5.94, 4.03, 5.05 and 4.15, P<0.05). Multivariate logistic regression analysis showed that endotracheal intubation ( OR=3.460, 95% CI 2.890-14.445, P<0.05) and administration of immunosuppressants ( OR=6.945, 95% CI 1.160-21.567, P<0.05) within 3 months before infection were independent risk factors for biofilm-forming Klebsiella pneumoniae bloodstream infection. The use of tegacycline ( OR=4.886, 95% CI 1.123-21.263, P<0.05) within 3 months before death was independent risk factors for the death of biofilm-positive Klebsiella pneumoniae bloodstream infection. Conclusions:In order to reduce the incidence and fatality of biofilm-forming Klebsiella pneumoniae bloodstream infection, antibiotics should be used rationally and invasive procedures should be minimized.
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CDIO is a new education model composed of Conceive, Design, Implement and Operate modules. In order to meet the needs of social development, this paper discusses the construction of the training system of applied innovative talents in ophthalmology of integrated traditional Chinese and western medicine guided by CDIO concept. Combing with practice, this paper puts forward teaching reform strategies from such five aspects as teaching purpose, curriculum system, construction of the teaching team, evaluation system, and practice effect, providing a new thought for the cultivation of applied innovative talents in ophthalmology.
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In order to satisfy the social and medical demands for optometric talents, the education model combining "medicine, teaching, research and prevention" was established, fully integrated with various resources like talents, facilities, equipment from the affiliated eye hospital, institute of ophthalmology and prevention and treatment center for juvenile myopia. Cultivation of high-quality applicative talents which integrated "knowledge, skills and accomplishment" were taken as the main line, Cultivation goal was established in accordance with requirement of talent. The curriculum system was optimized on the basis of competence. The teaching mode was reformed to "2+2" mode, "double-position teachers" became the requirement for the teaching staff and professional education comprehensive practice platform of "one entity, two wings" was constructed, with good effectiveness being achieved.
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Objective@#To explore the relationship of discrimination perception and social anxiety of the left-behind children, focusing on the moderating effect of trait gratitude.@*Methods@#Totally 588 left-behind children were investigated with discrimination perception questionnaire, gratitude questionnaire and Liebowitz social anxiety questionnaire. Data were analyzed by independent t test, correlation analysis and regression analysis.@*Results@#There was a significant difference in group discrimination between the only child (2.11±0.98) and the non-only child (2.28±0.93) (t=-2.11, P<0.05). Correlation analysis showed that trait gratitude (4.93±0.89) was negatively correlated with individual discrimination (2.53±1.03) and group discrimination (2.22±0.95) (r=-0.55, r=-0.56, both P< 0.05), furtherly negatively correlated with fear of negation (0.85±0.47) and social avoidance (0.81±0.53) dimensions of social anxiety (r=-0.47, r=-0.48, both P<0.05). Additionally, discrimination perception was positively correlated with social anxiety (r=0.61, P<0.05). Regression analysis showed that discrimination perception could significantly predict social anxiety (β=0.44, P<0.01), and trait gratitude could significantly moderate this effect (β=-0.75, P<0.01).@*Conclusion@#Discrimination perception can positively predict social anxiety, and trait gratitude can moderate this effect.
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Objective To explore the relationship of discrimination perception and social anxiety of the left-behind children,focusing on the moderating effect of trait gratitude. Methods Totally 588 left-be-hind children were investigated with discrimination perception questionnaire, gratitude questionnaire and Liebowitz social anxiety questionnaire. Data were analyzed by independent t test,correlation analysis and re-gression analysis. Results There was a significant difference in group discrimination between the only child (2. 11±0. 98) and the non-only child (2. 28±0. 93) (t=-2. 11,P<0. 05). Correlation analysis showed that trait gratitude (4. 93± 0. 89) was negatively correlated with individual discrimination ( 2. 53 ± 1. 03) and group discrimination (2. 22±0. 95) (r=-0. 55,r=-0. 56,both P< 0. 05),furtherly negatively correlated with fear of negation (0. 85±0. 47) and social avoidance (0. 81±0. 53) dimensions of social anxiety ( r=-0. 47,r=-0. 48,both P<0. 05). Additionally,discrimination perception was positively correlated with so-cial anxiety (r=0. 61,P<0. 05). Regression analysis showed that discrimination perception could significant-ly predict social anxiety (β=0. 44,P<0. 01),and trait gratitude could significantly moderate this effect (β=-0. 75,P<0. 01). Conclusion Discrimination perception can positively predict social anxiety,and trait gratitude can moderate this effect.
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In order to satisfy the social and medical demands for optometric talents, the education model combining "medicine, teaching, research and prevention" was established, fully integrated with various resources like talents , facilities , equipment from the affiliated eye hospital , institute of ophthalmology and prevention and treatment center for juvenile myopia . Cultivation of high-quality applicative talents which integrated "knowledge, skills and accomplishment" were taken as the main line, Cultivation goal was established in accordance with requirement of talent . The curriculum system was optimized on the basis of competence. The teaching mode was reformed to "2+2" mode, "double-position teachers" became the requirement for the teaching staff and professional education comprehensive practice platform of"one entity, two wings"was constructed, with good effectiveness being achieved.
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Objective To discuss the clinical application value of serum procalcitonin(PCT) in patients with Candida bloodstream infection.Methods The data of 783 hospitalized patients of Tianjin Medical University General Hospital including blood culture and serum PCT test were retrospectively analyzed,and the medical records of patients with Candida or bacterial bloodstream infection were evaluated by univaxiate and multivariate logistic regression analysis.The comparison of PCT value were carried out among the different blood culture groups using the Mann-Whitney U test.A receiver operating characteristic(ROC) curve was used to determine the diagnostic performance of the PCT.Results The PCT was 0.21 (0.06,1.02) ng/mL in the 510 patients with negative blood culture,but in 121 patients with Candida infection and 152 patients with bacteria infections,the PCT levels were 1.15 (0.38,6.85) ng/ mL and 2.34 (0.77,15.12) ng/mL,respectively.There were statistically significant differences in PCT levels among three groups(P＜0.05).According to ROC,when the value of PCT was 0.355 ng/mL,the sensitivity was 76.9％,and the specificity was 60.8％ with 0.726 area under the curve (AUC) (P＜0.01) for the identification of Candida infection by blood cultures.Conclusions Serum PCT levels have a certain diagnostic value for Candida bloodstream infection.In critically ill patients with factors associated with candidemia,the combination of clinical symptoms with PCT as an adjuvant diagnostic marker and other laboratory findings can be used to make a prompt and effective initiation of antifungal therapy.
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BACKGROUND AND PURPOSE: The objective of this study was to determine the prevalence of and risk factors for dementia in residents aged 65 years and older in a Chinese nursing home. METHODS: A cross-sectional study was carried out in a nursing home located in Hangzhou, Zhejiang Province, China. Cognitive status, including the presence of dementia and mild cognitive impairment (MCI), was measured using a combination of medical history and objective cognitive assessments. Logistic regression analysis was conducted to predict the associated risk factors. RESULTS: In total, 943 residents (334 males and 609 females) aged 84.00±6.67 years (mean±SD) were included. Dementia was diagnosed in 420 (44.5%) residents, and MCI was diagnosed in 195 (20.7%). Mild, moderate, and severe dementia were present in 20.3%, 14.0%, and 65.7% of those in the dementia group, respectively. Logistic regression analysis revealed that dementia was associated with a low education level (p=0.000), an advanced age (p=0.010), and a history of stroke (p=0.023). CONCLUSIONS: Our study found a high prevalence of dementia in a Chinese nursing home, and a high prevalence of patients with severe dementia. Risk factors for dementia included a low educational level, an advanced age, and a history of stroke. Appropriate interventions need to be applied to this population.
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Humans , Male , Asian People , China , Cross-Sectional Studies , Dementia , Education , Logistic Models , Cognitive Dysfunction , Nursing Homes , Nursing , Prevalence , Risk Factors , StrokeABSTRACT
Objective To investigate the occurrence and severity of behavioral and psychological symptoms of dementia(BPSD)in elderly dementia patients,and to explore the relationship of the degree of dementia and the severity of BPSD with the burden of caregivers in pension agency.Methods Using a convenient sampling method,the Clinical Dementia Rating (CDR) scale,neuropsychiatric scale (NPI)and Zarit caregiver burden scale(ZBI)were used to evaluate 145 patients with Alzheimer's disease and caregiver burden in Hangzhou.Results The incidence rate of BPSD was 51.8 ％ (72 cases),with a higher incidence rate of delusions of 22.3％ (31 cases),a higher severity of sleep disorder/nocturnal behavior [NPI symptom score (5.95 ± 4.60) points].The symptom making a greatest burden on the caregivers was delusion [ZBI score (32.81 ± 17.66) points].There were positively correlations of the burden of caregivers with the degree of dementia and the severity of BPSD (r=0.434,0.710,all P＜0.01)in patients with senile dementia.Conclusions The incidence rate of BPSD in dementia patients is higher,and the occurrence of BPSD is associated with the severity of mini mental state examination(MMSE)and dementia,which increases the burden of caregivers.More attention should be paid to BPSD in patients with senile dementia.And the social support system serving patients with senile dementia and their caregivers should be further improved.
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To foster interdisciplinary talents with the highly fusion of clinical skills and the capacity for scientific research, a preliminary exploration of teaching for the cultivation of scientific innovation ability was carried out for clinical postgraduate students. In the cultivation of clinical post-graduate students' innovation consciousness and innovative spirit, we focused on the transformation of attaching more importance to the clinical skills than to the capacity for scientific research to establish the foundation of the competitive compound talents. Then in the early stage of medical project writing, basic knowledge learning and exchange, we stressed clinical postgraduate students' solid grasp of basic knowledge of medical science to consolidate the way of enhancing the scientific research ability. Furthermore , under the guidance of the second research supervisors allocated by the department , we strengthened the clinical postgraduate students' writing of scientific research project bid and pro-fessional paper to promote the organic combination of the clinical practice and scientific research innovation and enhance their scientific research ability.