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Objective:To identify the clinical characteristics and adverse events of patients with giant cell arteritis (GCA).Methods:Patients who were hospitalized and diagnosed with GCA in Zhongshan Hospital, Fudan University, from December 2009 to November 2020 were enrolled into a retrospective study analysis. Baseline data and follow-up data were collected. Adverse events were defined as one of the following events: relapses, ischemic complications and death. Patients with adverse events were analyzed in clinical features and risk factors by univariate and multivariate analysis. Associations with adverse events were assessed using ROC curve and survival curves.Results:A total of 69 patients with GCA were included in this study, with the male: female ratio of 1∶1.03. Fatigue and headache were common symptoms. Finally, 61 patients were followed up at the end of May in 2021. Over the mean follow-up time of (35±20) months, adverse events occurred in 16 cases (26.2%). Patients with adverse events had significantly lower levels of platelet and globulin at baseline than those without adverse events [(325±142)×10 9/L vs (238±112)×10 9/L, t=2.22, P=0.030]; [(31±6) g/L vs (26±6) g/L, t=2.74, P=0.008]. Red cell volume distribution width-coefficient of variation (RDW-CV) was considered an independent risk factor for adverse events [ OR (95% CI)=0.32 (0.14,0.74), P=0.008]. Further, patients especially with RDW-CV<14.75% were prone to have adverse events, which occurred in 2.6%, 20.5%, 25.6%, 33.3%, 41.00% in 1, 2, 3, 5, 10 years. Its risk increased significantly after 2 years ( P=0.042, P=0.021, P=0.002, P=0.001). The incidence of adverse events was much higher in patients with RDW-CV<14.75%(95% CI=0.002). Conclusion:Adverse events are common in patients with GCA. RDW-CV is an independent risk factor for having adverse events. Low level of RDW-CV predicts an increased risk of adverse events by the following years.
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Objective To evaluate the value of detecting HCMV-DNA in urine in the diseases of newborn babies ,by comparing the result between HCMV-DNA in urine and HCMV-IgM antibody in blood in different diseases of the newborn babies .Methods The urine and blood samples were collected from 1 520 infants who were in hospital of the neonate department from January 2013 to December 2014 .The HCMV-DNA in urine was examined by fluorescence quantitative polymerase chain reaction(FQ-PCR) .And HCMV-IgM antibody in blood was examined by the method of chemiluminescence(ECL) .Results In the 1 520 cases ,153 had de-tectable HCMV-DNA in their urine samples with a positive rate 10 .07% ,while only 4 cases were positive of the HCMV-IgM anti-body in blood with a positive rate 0 .27% .The two groups was statistically significant difference (P<0 .05) .In the infant diseases of 1 520 cases ,the positive rate of HCMV-DNA in urine was 82 .6% of the hepatitis syndrome while the positive rate of HCMV-IgM antibody in blood was 3 .85% .The positive rate of HCMV-DNA in urine was 8 .95% in the jaundice symptoms ,while the posi-tive rate HCMV-DNA in urine was 4 .62% in the pulmonary infection .Each group of disease was statistically significant difference in the positive rate of HCMV-DNA (P<0 .05) .Conclusion The detection of HCMV-DNA in urine is more beneficial to the diag-nosis of HCM V infection of infants than the detection of HCM V-IgM antibody in blood ,especially in hepatitis syndrome ,neonatal jaundice and pulmonary infection .
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Objective To understand the trend of HIV infection in Guangxi region ,and to provide a reference basis for related sections .Methods A retrospective analysis were done to the data of HIV screening from 2007 to 2014 in the HIV screening labora‐tory of Guangxi Zhuang autonomous region people′s hospital .Results The positive rate of HIV antibody was 0 .50% (2007 ,121/24 890 ) ,0 .41% (2008 ,125/30 305 ) ,0 .40% (2009 ,157/40 466 ) ,0 .29% (2010 ,129/44 125 ) ,0 .31% (2011 ,151/48 914 ) ,0 .33%(2012 ,187/56 653) ,0 .30% (2013 ,191/63 581) ,0 .30% (2014 ,206/69 164) ,respectively .The population of HIV antibody positive came from farmers and freelancers who were low education and aged from 20 to 40 .It was given priority to the Zhuang and Han na‐tionality in the region of Guangxi ,Infection was mainly through sexual transmission .Conclusion The trend of HIV infection in Guangxi region has decreased ,but there was higher infection rates in Guangxi .
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Objective:To investigate hypoxia location in condylar cartilage in the early growth stage of rats.Methods:40 Sprague-Dawley rats were breastfed from 1 4 d to 21 d of age.1 0 rats were sacrificed at 1 2,24,48 and 96 h respectively after initiation of normal food at 21 d of age.The rats were administered pimonidazole hydrochloride (HP-1 )at a dose of 60 mg/kg by intraperitoneal injection 2 h before sacrifice.The expression of HP-1 in the whole condylar cartilage was detected by immunohistochemical staining.Results:HP-1 was mainly expressed in the chondrocytes of the fibrous and proliferative layer of cartilage,primarily concentrated in the weight-bearing area of joint-anterior aspect of the condyle and posterior aspect of the articular eminence at all time points.The highest expres-sion was observed at 24 h after initiation of normal food (P <0.01 ).Conclusion:In the early growth stage of rats,dietary loading may directly induce hypoxia in uper layer of condylar cartilage,the hyoxia level may change with time of dietary loading.
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Objective To analyze the distribution and antimicrobial resistance situation of pathogens isolated from blood culture to provide the scientific basis for the accuratel use of antibacterial drugs and preventing and controlling nosocomial acquired blood‐stream infection .Methods The US BACTEK‐FK automatic blood culture instrument and the French VITEK 2 COMPACT auto‐matic bacteria identification/susceptibility system were used to conduct the culture ,identification of blood culture isolated bacterial strains and drug susceptibility test .The results of drug susceptibility test were judged by adopting the 2011 criteria of the Clinical Laboratory and Standards Institute(CLSI) .Results The main isolated bacteria from blood culture for the recent three years were E coli ,staphylococcus aureus and klebsiella pneumonia bacteria ,coagulase negative staphylococcus(CNS) ,etc .The proportions of hos‐pital‐acquired bloodstream infections during these period were 42 .2% ,46 .9% and 54 .1% respectively .The detection rate of methi‐cillin‐resistant staphylococcus aureus (MRSA) was 18 .8% ,which of multiple drug resistant acinetobacter baumannii (MDRAB) was 42 .9% ,which of producing extended spectrum beta lactamase (ESBLs) in E .coli and klebsiella pneumoniae were 71 .8% and 69 .8% respectively .Conclusion The bloodstream infections pathogens in this hospital are mainly Enterobacteriaceae bacteria ,the proportion of hospital‐acquired bloodstream infections increases year by year ;the detection rate of multi‐drug resistant Acinetobact‐er baumanni (MDRAB) is higher ,clinic should pay more attention to the change of blood culture pathogens and their drug resist‐ance trend ,meanwhile nosocomial bloodstream infection should be prevented and controlled .
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<p><b>OBJECTIVE</b>To assess the association of genetic polymorphisms of CYP2C19*2,*3,*17 with the recurrence risk of ischemic stroke during clopidogrel prevention in ethnic Han Chinese from Fujian Province.</p><p><b>METHODS</b>Clinical data of 985 patients with acute ischemic stroke was collected. After 1 year postdischarge follow-up evaluations, only 114 patients with persistence of clopidogrel were enrolled. CYP2C19 genetic polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)and direct sequencing ,then we analysis the correlation between polymorphisms and the recurrence of stroke.</p><p><b>RESULTS</b>Among the 114 patients, 23 had a second onset whilst receiving clopidogrel treatment. During the antiplatelet therapy with clopidogrel, carriers of CYP2C19 poor metabolizer (CYP2C19*2/*2 or *2/*3) had a higher rate of recurrent stroke compared with extensive metabolizers (CYP2C19*1/*1) (OR=4.71, 95%CI: 1.18-18.80, P<0.05). Carriers of CYP2C19 *2 mutant allele had increased recurrence compared with those carrying none loss-of-function allele (OR=2.31, 95%CI: 1.20-4.46, P<0.05). The rate of recurrent stroke in those carrying homozygous mutant *2 allele (CYP2C19*2/*2) was 6.14 times greater than the rate of wild-type homozygotes (CYP2C19*1/*1) (95%CI: 1.54-24.54, P<0.05). Patients with previous stroke history had increased risk of recurrence (OR= 4.146, 95%CI: 1.259-13.655, P<0.05). However, CYP2C19*17 was not detected in the group.</p><p><b>CONCLUSION</b>For ethnic Han Chinese patients receiving clopidogrel treatment, carriers of poor metabolizer or homozygous mutant *2 allele (CYP2C19*2/*2) have a higher risk of recurrent stroke. The CYP2C19 *2 allele is an independent risk factor for recurrent stroke. Those with previous history of stroke are more prone to the recurrence.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Alleles , Asian People , Genetics , Brain Ischemia , Ethnology , China , Cytochrome P-450 CYP2C19 , Genetics , Gene Frequency , Genetic Predisposition to Disease , Ethnology , Genetics , Genotype , Linkage Disequilibrium , Logistic Models , Platelet Aggregation Inhibitors , Therapeutic Uses , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Polymorphism, Single Nucleotide , Recurrence , Risk Factors , Sequence Analysis, DNA , Stroke , Ethnology , Genetics , Ticlopidine , Therapeutic Uses , Time FactorsABSTRACT
Objective To observe effect of using ambroxol to humidify of airway during mechanical ventilation to treat severe pneumonia in infants,and to explore dynamic changes of respiratory mechanics.Methods Sixty-five infants with severe pneumonia need ventilator treatment according the diagnosis criterion were divided into 2 groups by random digits table method:experimental group (33 cases) and control group (32 cases).Experimental group was used ambroxol and control group was used 0.9％ sodium chloride,each 2 ml intratracheal instillation,and then took the balloon pressurized oxygen 30 s,followed by ventilator,after 24 h.Changes of respiratory mechanics indexes were observed before and after treatment,including:mean airway resistance,lung dynamic compliance,work of breathing,airway plateau pressure.Respiratory mechanics values were recorded before and after treatment.Results After treatment for 24 h,the index in experimental group were better than those in control group.Mean airway resistance were (0.68 ± 0.04) cmH2O/ (L·s) and (0.57 ± 0.05) cmH2O/ (L·s),1 cmH2O =0.098 kPa,lung dynamic compliance were (3.17 ± 0.81) ml/kPa and (2.56 ± 0.69) ml/kPa,work of breathing were (0.54 ± 0.08) J/L and(0.41 ± 0.06) J/L,airway plateau pressure were (2.23 ± 0.58) cmH2O and (2.12 ± 0.63) cmH2O.There were significant differences (P ＜ 0.05).The mechanical ventilation time in experimental group was significantly shorter than that in control group [(64.08 ± 13.92) h vs.(79.57 ± 19.64) h] (P ＜0.05).Conclusion Airway humidification using ambroxol can better treat severe pneumonia,reduce airway resistance and improve alveolar ventilation,shorten time on the machine.
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Making dental impressions and models is a part of daily routine work for dental nurses in the orthodontic department in China. This paper analyzes the common problems encountered in the process of making dental impressions and models, and emphasizes the importance of quality control and supervision during this process. A method of combining real-time monitoring and periodic inspection based on nurse-doctor cooperation was put forward to ensure the quality of dental impressions and models. Firstly, the nurses should be well trained with the instruction of doctors before on duty; Secondly, the head nurse should be responsible for implementing real-time monitoring and periodic inspections to find the problems and take measures in time. Also, the doctors should check the dental impressions and models in time, especially for those models with special demands, and help the nurses to improve their skills constantly.
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OBJECTIVE To investigate the nosocomial infection knowledge nurses in graduating class. METHODS 286 nurses of graduating class were investigated by questionnaires. RESULTS The students were lacked of knowledge about nosocomial infection and 61.70% nurses of graduating class had never participated in the training of nosocomial infection knowledge (the average score only 58.67). They were interested in the disinfection and sterilization of infection diseases. And they wanted to get it through clinical infection control group (81.56% students selected this educational methods). CONCLUSIONS It is necessary to strengthen the training and education of nosocomial infection. And adjust the training mode and content according object.
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OBJECTIVE To study the germicidal efficacy and germicidal mechanism of compound ortho-phthalaldehyde(OPA) against Bacillus subtilis var.niger spores.METHODS Suspension quantitative germicidal test was used to observe the germicidal efficacy of compound OPA against B.subtilis var.niger spores.The germicidal mechanism of compound OPA was studied in transudation of protein and DNA and ultra-microstructure.RESULTS The results showed that at(20?1)℃,the logarithm mean reduction was greater than 5.00,after B.subtilis var.niger spores had been exposed to compound OPA for 30min.Some protein leaked from B.subtilis var.niger spores treated with compound OPA for some time,but there wasn′t DNA.The ultrastructure showed that the shape was amorphic,the electronic density of the coat was unequal,the core leaned to one side or appeared the transmission area.CONCLUSIONS Compound OPA can effectively kill B.subtilis var.niger spores.Its mechanisms are that in accordance with benzolkonium bromide(Bromogeramine) the compound OPA can change the osmotic pressure of cell and increase cell permeability,then it can easily penetrate to their target sites within the cell.