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Objective:To evaluate the prognostic value of sepsis-induced coagulopathy (SIC) in patients with sepsis.Methods:From January 2019 to December 2021, patients with sepsis admitted to the Intensive Care Unit of our hospital were retrospectively classified into the SIC group and non-SIC group according to SIC diagnostic criteria. The baseline clinical data, severity score, total length of hospital stay, length of ICU stay and 28-day survival were compared between the two groups. Kaplan-Meier was used to compare the 28-day survival of patients with sepsis between the two groups. Cox proportional hazard regression model was employed to analyze the risk factors of prognosis in patients with sepsis.Results:Totally 274 patients with sepsis were included in the analysis, including 139 patients in the SIC group and 135 patients in the non-SIC group. The two groups were compared in the perspectives of the Platelet count (PLT), prothrombin time (PT) , procalcitonin (PCT), D dimer, hematocrit, red blood cell distribution width, hemoglobin, acute kidney injury (AKI), the use of continuous renal replacement treatment (CRRT), the use of vasoactive drugs, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEⅡ) score were compared between the two groups and the difference were statistically different (all P<0.05). Kaplan-Meier analysis showed that the 28-day mortality rate in the SIC group was significantly higher than that in the non-SIC group (32.4% vs. 14.1%, P<0.05). COX proportional hazard model showed that SIC score ( HR= 2.17, 95% CI: 1.15-3.91, P<0.05), APACHEⅡ score ( HR= 1.13, 95% CI: 1.09-1.17, P<0.05) and the use of vasoactive drugs ( HR=3.66, 95% CI: 1.53-8.75, P<0.05) were independent influencing factors for 28-day death in patients with sepsis. Conclusions:Patients with sepsis and SIC have more severe disease and increased mortality risk. SIC score exhibits good clinical value in predicting the prognosis of patients with sepsis.
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Objective@#To investigate the creation of smoke-free environments in public places in Hangzhou City, so as to provide insights into effective implementation of the tobacco control policy. @*Methods@#The party and government administrations at each level, medical institutions, educational places, restaurants and entertainment places, and open public places were enrolled. The creation of smoke-free environments was investigated in these places through undercover investigation with field observations and concealed photography by a third-party professional investigation company from November to December, 2022. The building of smoke-free environments (totally 60 scores) and no smoking indoors (totally 40 scores) were evaluated according to the Criteria for Scoring of Smoke-free Organizations in Hangzhou City. @*Results@#Totally 909 places were investigated, and the comprehensive score of smoke-free environment building was (82.83±14.13) points. There were 285 party and government administrations with a comprehensive score of (84.19±12.85) points, 65 medical institutions with a comprehensive score of (90.35±6.95) points, 65 educational places with a comprehensive score of (83.43±16.81) points, 403 dining and entertainment places with a comprehensive score of (80.68±14.75) points, and 91 open public places, with a comprehensive score of (82.34±14.77) points. There were 397 places with standardized tobacco control tips at entrances (43.67%), 308 places with tobacco control signs posted as required (33.88%), 707 places that set outdoor smoking areas correctly (77.78%), 68 places with smoking paraphernalia (7.48%), 28 places with tobacco sales (3.08%). There were 732 places without signs of indoor smoking (80.53%), 850 places without indoor smoking (93.51%) and 24 places without dissuading from smoking (2.64%).@*Conclusion @#The indoor no-smoking is overall satisfactory in public places in Hangzhou City; however, standardizing no-smoking tips at entrances, standardizing the posting of no-smoking signs and assignment of tobacco control materials remain to be improved.
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As one of the common benign gynecological diseases, endometriosis (EM) can have a serious impact on the physical and mental health and quality of life of women of childbearing age. Studies have shown that the risk of ovarian cancer in patients with EM is significantly higher than that in the general population. EM is closely related to the occurrence of some types of ovarian cancer, and this kind of ovarian cancer is named endometriosis-related ovarian cancer (EAOC). The incidence rate, pathogenesis, treatment and prognosis of EAOC are summarized in order to better understand it.
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Objective@#To assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT). @*Materials and Methods@#This prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15.3 [range, 18–87] years) between September 1, 2018, and January 31, 2021. All participants had parathyroid lesions causing PHPT, proven biochemically and through imaging. The imaging features of the PHPT nodules, including the shape, margin, size, composition, and location, were evaluated before treatment. Serum intact parathyroid hormone, calcium, and phosphorus levels; parathyroid nodule volume; and PHPT-related symptoms were recorded before and after treatment. We calculated the technical success, biochemical cure, and clinical cure rates for these patients. Complications were evaluated during and after the ablation. @*Results@#Complete ablation was achieved in 38 of the 39 nodules in the 39 enrolled participants. All the patients were treated in one session. The technical success rate was 97.4% (38/39). The mean follow-up duration was 13.2 ± 4.6 (range, 6.0–24.9) months. At 6 and 12 months post-RFA, the biochemical cure rates were 82.1% (32/39) and 84.4% (27/32), respectively, and the clinical cure rates were 100% (39/39) and 96.9% (31/32), respectively. Only 2.6% (1/39) of the patients had recurrent PHPT. At 1, 3, 6, and 12 months after technically successful RFA, 44.7% (17/38), 34.3% (12/35), 15.8% (6/38), and 12.5% (4/32) of participants, respectively, had elevated eucalcemic parathyroid hormone levels. Recurrent laryngeal nerve paralysis occurred in 5.1% (2/39) of the patients, who recovered spontaneously within 1–3 months. @*Conclusion@#US-guided RFA was effective and safe for PHPT patients. RFA may be an alternative treatment tool for patients who cannot tolerate or refuse to undergo surgery.
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Objective @#To investigate the establishment of smoke-free environments in medical and healthcare institutions in Zhejiang Province, so as to provide the evidence for improving the implementation of the tobacco control policy in medical and healthcare institutions.@*Methods@#Health administrative sectors and public health institutions at provincial, city and county levels, secondary and tertiary medical institutions, and community health service/township health centers in Zhejiang Province were enrolled. The status of institutional establishment of smoke-free environments was investigated through concealed photography and consulting medical service guides by the assigned the third-party professional investigation company in 2021. The layout of smoke-free environments and indoor smoking were assessed according to the Criteria for Scoring Smoking-free Medical and Healthcare Institutions.@*Results@#Totally 547 medical and healthcare institutions were enrolled in this undercover investigation, including 102 health administrative sectors, 209 public health institutions, 146 secondary and tertiary medical institutions, and 90 community health service/township health centers. The gross mean scores of establishment of smoke-free environments were 83.41±12.19 among all medical and healthcare institutions, 82.02±10.73, 85.56±9.70 and 83.18±12.59 among province-, city- and county-level medical and healthcare institutions, respectively, and the gross mean scores of establishment of smoke-free environments were 82.60±12.27, 85.79±10.74, 80.89±13.85, 82.27±11.62 scores among health administrative sectors, public health institutions, secondary and tertiary medical institutions and community health service/township health centers, respectively. There were 315 institutions with no smoking signs at entrances (57.59%), 255 institutions posting no smoking signs ( 46.62% ), 245 institutions assigning two and more types of health education materials for tobacco control ( 44.79% ), 110 institutions with outdoor smoking areas ( 51.16% ), 66 secondary and tertiary medical institutions with smoking cessation clinics ( 45.20% ) and 354 institutions with carpet smoking bans in indoor places ( 64.72% ).@*Conclusions@#The overall establishment of smoke-free environments is satisfactory among medical and healthcare institutions in Zhejiang Province. Nevertheless, improving the coverage of no smoking signs and health education of tobacco control, promoting the standardized construction of smoking cessation clinics and establishing a long-action tobacco control mechanism are still needed.
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Objective:Based on the theory of planned behavior (TPB), the exercise intervention program for breast cancer patients undergoing chemotherapy was constructed, and its application effect was preliminarily explored.Methods:A total of 116 patients receiving chemotherapy in the department of breast surgery from June to December 2021 in Shanxi Provincial Cancer Hospital were selected by purpose sampling method. The subjects were randomly divided into control group and experimental group by flipping a coin. The control group was given routine nursing, and the experimental group was given routine nursing on the basis of exercise intervention based on the theory of planned behavior. After three cycles of chemotherapy, the effects of the intervention were evaluated by piper Revised Fatigue Scale (RPFS), Exercise Self-efficacy Scale and Quality of Life Core Scale (EORTC QLQ-C30).Results:In the intervention stage, there were 2 cases in the experimental group and 3 cases in the control group lost. After the intervention, the total score and all dimensions (behavioral, emotional, sensory and cognitive) of cancer-induced fatigue in the experimental group were (2.30 ± 0.58), (2.21 ± 0.85), (2.32 ± 0.70), (2.66 ± 0.71) and (2.03 ± 0.58), which were lower than those in the control group (2.84 ± 0.44), (2.79 ± 0.60), (3.04 ± 0.75), (3.04 ± 0.60) and (2.53 ± 0.56), the differences were significant ( t values were 3.05-5.23, all P<0.05). The total scores of exercise self-efficacy and the dimensions of physical, psychological and social environment were higher than those of the control group ( t values were -7.63 - -3.31, all P<0.05). The scores of overall quality of life, physical function and emotional function were higher than those of the control group ( t = -3.48, -3.14,-2.34, all P<0.05), while the scores of fatigue and insomnia symptoms were lower than those in the control group ( t = 5.13, 3.14, both P<0.05). Conclusion:The exercise program based on the theory of planned behavior can improve the exercise self-efficacy of breast cancer patients undergoing chemotherapy, reduce cancer-related fatigue and improve their quality of life.
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@#Objective To predict the molecular mechanism of Dihuang (Rehmanniae Radix) in the treatment of diabetic nephropathy (DN) complicated with depression based on network pharmacology. Methods The components of Dihuang (Rehmanniae Radix) were identified from the Integrated Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP), Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and relevant literature. The component targets were detected by combining the SwissTargetPrediction and PubChem databases. Disease targets were collected from the Therapeutic Target Database (TTD), DisGeNET, and Ensembl databases with “diabetic nephropathy” and “depression” as keywords. The disease-component targets were mapped using Venny 2.1.0 to obtain potential targets. A protein-protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database and Cytoscape 3.7.2. The co-expression genes of the key targets were collected based on the COXPRESdb 7.3. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed for potential targets using R language. Target-component docking was verified and evaluated using Discovery Studio 4.5. Results According to the databases and literature reports, Dihuang (Rehmanniae Radix) contained 65 active components, and had 155 related targets for the treatment of DN complicated with depression. PPI screening showed that the key targets included serine/threonine protein kinase 1 (AKT1), signal transducer and activator transcription 3 (STAT3), interleukin 6 (IL-6), mitogen-activated protein kinase 1 (MAPK1), and vascular endothelial growth factor A (VEGFA), etc. GO enrichment analysis mainly involved biological processes, such as lipid metabolism, protein secretion regulation, cell homeostasis, and phosphatidylinositol 3 kinase activity. KEGG pathway enrichment analysis included the role of the AGE-RAGE signaling pathway in diabetic complements, insulin resistance (IR), neurotrophin signal path, Toll-like receptor signaling pathway, relaxin signaling pathway, epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), etc. Molecular docking showed that the target had high affinity for stachyose, manninotriose, verbascose, nigerose, etc. Conclusion Based on network parmacology, this study preliminarily predict the effects of Dihuang (Rehmanniae Radix) in treating DN complicated with depression by regulating inflammation, glucose metabolism, nution nerve, etc.
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OBJECTIVE：To optimize the formulation of Curcumin （CUR）transethosomes（CUR-TEs）. METHODS ：The contents of CUR in CUR-TEs were determined by HPLC. CUR-TEs were prepared by injection method. Using comprehensive score of encapsulation efficiency and drug loading as index ，based on signal factor test ，Box-Behnken design-response surface method was used to optimize and validate the formulation. The property of CUR-TEs prepared by the optimal formulation was investigated. RESULTS：The optimal formulation of CUR-TEs was as follows as lecithin of 4％，CUR of 0.13％，1，2-propylene glycol of 25％，tween-80 of 1％. Results of validation test of optimal formulation showed that comprehensive score of encapsulation efficiency and drug loading of CUR-TEs was 93.04±2.16，relative error of which to predicted value （91.19）was 2.03％. The encapsulation efficiency of CUR-TEs prepared by optimal formulation was （91.17±1.35）％，and its drug loading was （0.94± 0.02）％. The particle size was （190.64±15.97）nm with polydispersity index of 0.086±0.007，and Zeta potential was （－12.74± 1.60）mV. CONCLUSIONS ：The optimized formulation of CUR-TEs is stable ，feasible and repeatable ，with good stability.
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Objective:To investigate the serum endothelial cell specific molecule-1 (ESM-1) level and its clinical significance in patients with hypertensive disorders complicating pregnancy (HDCP).Methods:Three hundred pregnant women with HDCP (HDCP group) and 300 pregnant women undergoing health check-ups (healthy control group) from January to December 2019 in Maternity and Child Health Hospital of Wenling City of Zhejiang Province were selected. In HDCP group, hypertension during pregnancy was in 94 cases, mild preeclampsia was in 131 cases, and severe preeclampsia was in 75 cases. The serum ESM-1, serum uric acid and 24-hour urine protein levels were detected. The incidences of neonatal asphyxia, fetal distress, cesarean section, polyhydramnios, premature rupture of membranes and postpartum hemorrhage in the HDCP group were recorded.Results:The serum ESM-1, serum uric acid and 24-hour urine protein in HDCP group were significantly higher than those in healthy control group: (0.42 ± 0.05) μg/L vs. (0.33 ± 0.04) μg/L, (262.34 ± 23.18) mmol/L vs. (212.37 ± 22.16) mmol/L and (0.36 ± 0.07) g vs. (0.11 ± 0.03) g, and the differences were statistical significant ( P<0.01). The correlation analysis results showed that the serum ESM-1 was positive correlation with serum uric acid and 24-hour urine protein in HDCP pregnant women ( r = 0.497 and 0.512, P<0.01). The serum ESM-1 in pregnant women with mild preeclampsia and severe preeclampsia were significantly higher than that in pregnant women with hypertension during pregnancy: (0.44 ± 0.05) and (0.51 ± 0.06) μg/L vs. (0.38 ± 0.04) μg/L, the serum ESM-1 in pregnant women with severe preeclampsia was significantly higher than that in pregnant women with mild preeclampsia, and the differences were statistical significant ( P<0.05). With the median serum ESM-1 (0.41 μg/L) as the boundary, pregnant women with HDCP were divided into high ESM-1 group (154 cases) and low ESM-1 group (146 cases). The incidences of neonatal asphyxia, fetal distress, cesarean section, polyhydramnios, premature rupture of membranes and postpartum hemorrhage in high ESM-1 group were significantly higher than those in low ESM-1 group: 14.94% (23/154) vs. 6.16% (9/146), 26.62% (41/154) vs. 9.59% (14/146), 46.10% (71/154) vs. 29.45% (43/146), 25.32% (39/154) vs. 3.42% (5/146), 23.38% (36/154) vs. 4.11% (6/146) and 20.13% (31/154) vs. 7.53% (11/146), and the differences were statistical significant ( P<0.01). Conclusions:Serum ESM-1 level is elevated in pregnant women with HDCP . Serum ESM-1 level is closely related to the severity of HDCP and pregnancy outcomes.
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Nonalcoholic fatty liver disease (NAFLD) is a typical chronic liver disease closely associated with gut dysbiosis, and dietary factor may be the most important driving factor affecting the composition and function of intestinal bacteria. Based on the concept of enterotype, this article summarizes the effect of diet on enterotype-related gut microbiota in NAFLD, including Firmicutes/Bacteroidetes ratio, Bacteroides, Prevotella, Ruminococcus, Proteobacteria, Actinobacteria, and other bacteria. It is pointed out that improving diet to regulate gut microbiota is one of the important strategies for the prevention and treatment of NAFLD and has a good prospect, which needs further mechanism and clinical research.
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In order to solve the problems of insufficient stimulation channels and lack of stimulation effect feedback in the current electrical stimulation system, a functional array electrode electrical stimulation system with surface electromyography (sEMG) feedback was designed in this paper. Firstly, the effectiveness of the system was verified through
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Female , Humans , Male , Electric Stimulation , Electrodes , Electromyography , Feedback , NeurofeedbackABSTRACT
Objective:To investigate the effect of magnesium sulfate combined with nifedipine on coagulation function, vascular endothelial function and pregnancy outcome in patients with pregnancy induced hypertension.Methods:From January 2019 to January 2020, 142 cases of pregnancy hypertension admitted to Wenling Maternal and Child Health Hospital were divided into observation group(71 cases) and control group(71 cases) according the random digital table method.The control group was treated with magnesium sulfate injection, and the observation group was treated with nifedipine sustained-release tablets on the basis of the control group.The course of treatment in both two groups was 10 days.The therapeutic effect, blood pressure, coagulation function, endothelial function and pregnancy outcome of the two groups were compared before and after treatment.Results:The total effective rate of the observation group(92.96%) was higher than that of the control group(77.47%)(χ 2=6.762, P<0.05). The systolic blood pressure [(126.52±7.97)mmHg] and diastolic blood pressure [(76.98±3.65)mmHg] in the observation group were lower than those in the control group [(137.83±10.23)mmHg and (85.21±5.12)mmHg] ( t=7.349, 11.029, all P<0.05). After treatment, the PT[(11.81±0.34)s] and APTT[(32.62±0.47)s] in the observation group were longer than those in the control group[(12.32±0.21)s and (31.45±0.58)s], while the FIB [(3.17±0.41)g/L] was lower than that in the control group [(3.83±0.36)g/L], and the difference was statistically significant between the two groups( t=10.753, 13.206, 10.193, all P<0.05). The level of serum NO [(69.32±4.26)mg/L] in the observation group was higher than that in the control group [(60.29±6.15)mg/L], while ET-1 [(62.15±6.78)mg/L] was lower than that in the control group [(74.39±10.29)mg/L] , and the difference was statistically significant between the two groups( t=10.170, 8.370, all P<0.05). The incidence of cesarean section(36.62%), fetal respiratory distress(5.63%), postpartum hemorrhage(4.23%) and premature rupture of membranes(8.45%) in the observation group were lower than those in the control group(53.52%, 25.35%, 26.76% and 22.54%)(χ 2=4.096, 10.542, 13.770, 5.379, all P<0.05). Conclusion:Magnesium sulfate combined with nifedipine can improve the coagulation function and vascular endothelial function of patients with pregnancy induced hypertension, and reduce adverse pregnancy outcome.
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Objective@#To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS.@*Methods@#Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software.@*Results@#A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ2=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children’ hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ2=14.47, P<0.001 in stool specimen; χ2=31.99, P<0.001 in throat swab; χ2=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases.@*Conclusions@#Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.
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Objective@#To explore the method of replanting severed piercing finger micro tissue blocks.@*Methods@#From February, 2001 to October, 2016, 16 cases of severed piercing finger micro tissue blocks were replanted with debridement. The trunk or branch of proper palmar digital artery was anastomosed. Vascular collocations were used such as venous arterialization when there was no anastomotic artery available. Regular postoperative followed-up was performed to observe the recovery of tissue survival, appearance, sensation of flap, and joint function.@*Results@#One case had partial epidermal necrosis, and healed after change of dressing. The finger-disconnected micro tissue blocks of other 15 cases survived well. After 6 months to 2 years of follow-up, the replanted micro tissue blocks were ruddy in color and recovered from S3 to S4. The appearance of the 16 fingers was good, and the function of joints was restored.@*Conclusion@#The finger-disconnected micro tissue blocks should be actively replanted. With skilled microsurgical techniques, the anastomosis of the arterial or venous artery will ensure the success of replantation and survived, as well as to restore good function and appearance.
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Objective@#To evaluate the effect of a tobacco control intervention for college students under the advocate-promoting model, and to provide evidence for methods to improve smoking control and health decisions.@*Methods@#Four colleges were selected from the list of colleges that participated in a survey of college student tobacco use in Zhejiang Province in 2015, and we conducted a tobacco control intervention with them under the advocate-promoting model for two years. A total of 1 007 students were selected using a random sampling method and surveyed before intervention, and 991 students were selected using a random sampling method and surveyed after the intervention. A chi-square test was used to compare the differences between tobacco use, second-hand smoke exposure, and tobacco knowledge among students before and after the intervention.@*Results@#After the tobacco control intervention, the attempted smoking rate among students in the four colleges dropped from 34.36% to 22.30%, the current smoking rate dropped from 12.12% to 7.87%, the second-hand smoke exposure rate decreased from 75.47% to 70.53%, the difference was statistically significant (χ2=37.73, 9.99, 6.18, P<0.05). After intervention, the proportion of students who had seen tobacco advertisements in the past 30 days decreased from 60.38% to 54.4%, the proportion of students who "saw smoking scenes in video media" decreased from 25.02% to 19.58%, and the proportion of students who "learned smoking control knowledge in class" increased from 14.20% to 18.16%, the difference was statistically significant (χ2=7.08, 8.55, 5.79, P<0.05).@*Conclusion@#The advocate-promoting model of "advocacy alliance" can help colleges to establish a smoke-free campus environment and improve college students’ tobacco knowledge and reduce their attempted and current smoking rates.
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Objective@#To develop a scientific oncology missed nursing care self-rating scale suitable for hospital culture background in China, and to test its validity and reliability.@*Methods@#The initial scale was formulated by literature review, qualitative interview and delphi expert consultation. A total of 388 clinical nurses from Shanxi Province were selected by convenience sampling. Item analysis was used to filtrate items. The validity was evaluated by using evaluation scale of construction and content validity, and the reliability was tested by using internal consistency, split-half reliability and retest reliability.@*Results@#Oncology missed nursing care self-rating scale consisted of 33 items and 4 dimensions including nursing assessment, nursing plan, basic nursing and nursing intervention. Exploratory factor analysis (EFA) revealed that 4 factors accounted for 63.664% of the accumulated variances. The scale-level content validity index (S-CVI) was 0.904. The Cronbach α coefficient was 0.948, the spilt-half reliability coefficient was 0.786, and the retest reliability coefficient was 0.833.@*Conclusion@#Oncology missed nursing care self-rating scale has good validity and reliability, which can be used as a measuring tool for oncology missed nursing care.
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Objective To estimate the serotype and age-specific hospitalization burden associated with hand,foot and mouth disease (HFMD) in Anhua county of Hunan province,between October 2013 and September 2016.Methods We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals,and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua.Combined with the results of virological surveillance,the serotype-specific hospitalization burden of HFMD in Anhua,was estimated.Results During the three years,it was estimated that 3 541 clinical diagnosed HFMD cases,including 3 146 laboratory-confirmed HFMD cases,were hospitalized in Anhua,but only one was diaguosed as being severe.The estimated average hospitalization rate was 723/100 000(95％C1:699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95％ CI:620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016.The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000),Cox A10 (38/100 000) and other enterovirus (64/100 000),and the difference was statistically significant (P＜0.001).HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000),and then decreased with age.Compared with the hospitalized HFMD caused by EV71 and Cox A16,Cox A6-associated hospitalizations mainly occurred in younger age groups (P＜0.001).Conclusion Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71,Cox A16,Cox A6 and Cox A10,especially in young children,in Anhua.
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Objective To estimate the serotype and age-specific hospitalization burden associated with hand,foot and mouth disease (HFMD) in Anhua county of Hunan province,between October 2013 and September 2016.Methods We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals,and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua.Combined with the results of virological surveillance,the serotype-specific hospitalization burden of HFMD in Anhua,was estimated.Results During the three years,it was estimated that 3 541 clinical diagnosed HFMD cases,including 3 146 laboratory-confirmed HFMD cases,were hospitalized in Anhua,but only one was diaguosed as being severe.The estimated average hospitalization rate was 723/100 000(95％C1:699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95％ CI:620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016.The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000),Cox A10 (38/100 000) and other enterovirus (64/100 000),and the difference was statistically significant (P＜0.001).HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000),and then decreased with age.Compared with the hospitalized HFMD caused by EV71 and Cox A16,Cox A6-associated hospitalizations mainly occurred in younger age groups (P＜0.001).Conclusion Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71,Cox A16,Cox A6 and Cox A10,especially in young children,in Anhua.
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Objective To investigate the clinical effect of alprostadil in the treatment of coronary heart disease and its effect on myocardial microcirculation and hemorheology.Methods From January 2015 to October 2017,100 patients with coronary heart disease admitted to the First People's Hospital of Wenling were randomly divided into two groups according to the digital table,with 50 cases in each group.The control group was treated with routine therapy.The observation group was treated with alprostadil on the basis of routine treatment.The clinical efficacy,myocardial microcirculation index and hemorheology index were compared between the two groups.Results The total effective rate of the observation group was 96％ (48/50),which was higher than 82％ (41/50) of the control group,and the difference between the two groups was statistically significant (x2 =5.005,P ＜ 0.05).After treatment,the cardiac troponin Ⅰ and myocardial troponin T in the observation group were (0.023 ±0.014)μg/L,(0.012 ±0.006)μg/L,respectively,which in the control group were (0.037 ± 0.015) μg/L,(0.019 ± 0.008) μg/L,respectively,the differences between the two groups were statistically significant (t =4.825,4.950,all P ＜ 0.05).The erythrocyte hematocrit,plasma viscosity,erythrocyte sedimentation rate,erythrocyte electrophoresis time in the observation group were (25.69 ± 3.87) ％,(293.42 ± 12.73) s,(15.21 ± 4.59) mm/h,(1.29 ± 0.37) mp/s,respectively,which in the control group were (32.54 ± 4.52) ％,(326.17 ± 18.65) s,(21.85 ± 5.93) mm/h,(1.76 ± 0.43) mp/s,respectively,the differences between the two groups were statistically significant (t =8.140,10.256,6.261,10.256,all P ＜ 0.05).Conclusion Alprostadil in the treatment of coronary heart disease can improve the clinical efficacy and improve the patients'myocardial microcirculation and hemorheological indicators.
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Objective To explore the method of replanting severed piercing finger micro tissue blocks. Methods From February, 2001 to October, 2016, 16 cases of severed piercing finger micro tissue blocks were re鄄planted with debridement. The trunk or branch of proper palmar digital artery was anastomosed. Vascular collocations were used such as venous arterialization when there was no anastomotic artery available. Regular postoperative fol鄄lowed-up was performed to observe the recovery of tissue survival, appearance, sensation of flap, and joint function. Results One case had partial epidermal necrosis, and healed after change of dressing.The finger-disconnected micro tissue blocks of other 15 cases survived well.After 6 months to 2 years of follow-up, the replanted micro tissue blocks were ruddy in color and recovered from S3 to S4. The appearance of the 16 fingers was good, and the function of joints was restored. Conclusion The finger-disconnected micro tissue blocks should be actively replanted. With skilled microsurgical techniques, the anastomosis of the arterial or venous artery will ensure the success of replantation and survived, as well as to restore good function and appearance.