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Objective:To investigate the correlation of endoscopy findings with symptoms in patients undergoing gastroscopy.Methods:Patients who underwent gastroscopy for the first time in Renji Hospital of Shanghai Jiao Tong University School of Medicine from January to December 2017 were included in the questionnaire survey. The participants were asked to report their main symptoms of the digestive tract in details, and gastroscopy was completed within 2 weeks. Final gastroscopic diagnosis was made based on both gastroscopy and pathology, then patients were divided into the major-lesion (peptic ulcer and malignancy) group and the non-major-lesion (chronic gastritis, reflux esophagitis and others) group. The correlation of gastrointestinal symptoms with gastroscopic findings was analyzed. The risk for major gastroscopic lesions (peptic ulcer and malignant tumors) was assessed by multivariate Logistic regression analysis.Results:A total of 5 885 patients completed the questionnaire, 5 496 (93.4%) of whom completed gastroscopy. The detection rates of peptic ulcer were 12.3% (373/3 028), 12.6% (52/412), 17.9% (49/273), 9.5% (64/675) and 9.2% (102/1 108) in patients with dyspepsia, reflux, alarm, other symptoms and no symptoms, respectively, the detection rates of malignant tumors were 1.2% (36/3 028), 0.7% (3/412), 7.7% (21/273), 0.7% (5/675) and 0.4% (4/1 108), respectively in these patients. The most common symptoms was dyspepsia, accounted for 58.3% (373/640) and 52.2% (36/69) patients with peptic ulcer and malignant tumors, respectively. Alarm symptoms were found in 30.4% (21/69) patients with malignant tumors, and 15.9% (102/640) peptic ulcer patients and 5.8% (4/69) malignant tumor patients had no gastrointestinal symptoms. Compared to asymptomatic individuals, patients with dyspepsia ( P<0.001, OR=1.52, 95% CI: 1.21-1.92) and those with warning symptoms ( P<0.001, OR=2.87, 95% CI: 2.02-4.08) had significantly increased risk for major lesions (peptic ulcer and malignant tumors) detected by gastroscopy. Conclusion:Although dyspepsia and alarm symptoms are positively associated with upper gastrointestinal malignancy and peptic ulcer, they are of limited predictive value for upper gastrointestinal diseases.
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Objective To accurately assess the condition of trauma patients at the emergency department (ED),the risk factors of in-hospital death were explored. Methods A total of 86 emergency trauma patients were retrospectively investigated. They were divided into survival and non-survival groups,in the First Hospital of China Medical University,from August 2016 to February 2017. Clinical parameters,such as sex,age,heart rate,oxygen saturation,mean arterial pressure,white blood cell count,serum creatinine,urea nitrogen, prothrombin time,activated partial thromboplastin time,hemoglobin,platelet count,serum albumin,fibrinogen,glutamic-pyruvic,total bilirubin,Glasgow coma scale (GCS),sequential organ failure assessment (SOFA) score,and injury severity score were evaluated and recorded. The parameters which were significantly different (P < 0. 1) between the two groups were analyzed using the logistic regression analysis to determine the independent risk factors of death at the ED. Receiver-operating characteristic curves were drawn to evaluate their prognostic abilities. Results GCS and SOFA score were the independent risk factors of in-hospital death in trauma patients (P < 0. 05). Conclusion Organ function,especially that of the brain,is closely related to the prognosis of adult trauma patients.
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Objective To analyze the effects of valproic acid(VPA),a histone deacetylase(HDAC)inhibitor,on macrophage polarization in?duced by paraquat(PQ)or lipopolysaccharide(LPS). Methods Mouse RAW264.7 cells were cultured at 37℃with 5%CO2,passaged,and then given one of the following treatments:(1)PQ;(2)PQ+VPA(classⅠandⅡa HDAC inhibitor);(3)PQ+apicidin(classⅠHDAC inhibitor);(4)PQ+MC1568(classⅡa HDAC inhibitor);(5)LPS;(6)LPS+VPA;(7)LPS+apicidin;(8)LPS+MC1568. The cells and culture supernatants were harvested after 8 h of treatment. RT?PCR,ELISA,and flow cytometry were conducted to assess the expression levels of macrophage phenotyp?ic markers. Results Both PQ and LPS skewed the macrophage functional polarity toward proinflammatory phenotype. VPA,apicidin,and MC1568 all inhibited PQ?and LPS?induced macrophages polarizing toward pro?inflammatory phenotype ,but the inhibitory effects were different in some ways. Conclusion VPA inhibits the proinflammatory function of macrophages induced by PQ and LPS ,but the effect of VPA on PQ?and LPS?induced macrophages has its own characteristics.
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Objective To develop a predictive model for pulmonary embolism(PE)based on the related clinical symptoms,signs,and the labo-ratory index,so as to improve the positive rate of CTPA. Methods The model was developed from a database of 119 patients with suspected PE. The risk factors of suspected PE were analyzed by logistic regression analysis ,which included significant differences in the prevalence of PE be-tween non-diseased and non-diseased groups. Receiver operating characteristic(ROC)curves was draw to determine the cut-off value of the clini-cal probability. It was validated in an independent sample of 106 patients with suspected PE. Results According to the univariate analysis ,17 of 51 variables show a significant difference between PE and non-PE patients. The model comprised 4 variables:age,dyspnea,D-dimer and unilater-al leg swelling. The area under the ROC curve is 0.776,and the cut-off value is supposed to be 0.38. In the validation sample,27% patients had PE confirmed by CTPA. The prevalence of PE was 54%when the clinical probability was above 0.38. Conclusion The proposed predictive mod-el in this study can improve the positive rate of CTPA ,simplify the diagnosis process of suspected PE patients.
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The development of translational medicine requires knowledgeable and capable talents.In this study, by systematic analysis on scientific literatures published openly during 2010 till 2014, we comprehensively described basic circumstances pertinent to talent cultivation during global translational medicine development, and analyzed diathesis requirements for qualified talents, as well as cultivation strategies from employers perspectives, in terms of knowledge, skill, social roles, values, self-concept, trait and motive characteristics, with the aim to explore the premium cultivation paths for such talents.
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As a new cross disciplinary study, translational medicine is expected to promote modern biomedical research to a new stage. In recent years, establishment of research structure of translational medicine has been completed or initiated in some areas where medicine is comparatively well developed, though this conduct is still at an exploratory stage. Referencing abroad experience,This paper discusses the innovative mechanisms and strategies for organization of traslational medicine with referrence to foreign expericences.
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An HPLC-UV method has been developed for the determination of valibose, miglitol, voglibose and acarbose, the four anti-diabetic drugs. The separation was accomplished successfully by using reversed phase chromatography (Prevail carbohydrate column, 250 mm x 4.6 mm, 5 microm) with a gradient acetonitrile-phosphate buffer solution (pH 8.0) at a wavelength of 210 nm. Furthermore, the method of a high-performance liquid chromatography coupled with ESI-MS in positive ionization mode has been established. These two methods were successfully applied to the assay and qualitative detection of four alpha-glucosidase inhibitors in the potential counterfeit anti-diabetic drugs.