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Objective:To explore the risk factors for cognitive impairment 3 months after an ischemic stroke and their predictive value.Methods:A retrospective case-control study considered the records of 856 elderly patients who had survived an ischemic stroke. All had been evaluated using the Montreal Cognitive Assessment scale (MoCA). They were divided according to their MoCA scores into a group without cognitive impairment (the PSNCI group) and an impaired (PSCI) group. The subjects′ demographic and clinical laboratory data were compiled. All had been assessed using the National Institutes of Health stroke scale (NIHSS), the Barthel Index (BI), and the Hamilton depression scale (HAMD). Univariate and multivariate logistic regressions were evaluated and a receiver operator characteristics (ROC) curve was computed.Results:There were significant differences between the two groups in terms of gender distribution, age, hypertension and heart disease history, family history of dementia and education level. Moreover, significant differences were observed in the groups′ average total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), urinary neurofilament protein (AD7c-NTP), NIHSS scores, BIs and ADL scores. Logistic regression showed that a history of heart disease, urinary AD7C-NTP level and HAMD score were significant independent predictors of cognitive impairment 3 months after a stroke. A high BI was an independent protective factor. The area under the ROC curve for urinary AD7C-NTP was the largest (0.875) and had significant predictive value with a cut-off value of 2.43, sensitivity of 0.94 and specificity of 0.75.Conclusion:Age, sex, education, smoking, drinking, body mass index, a history of heart disease or stroke, a family history of dementia and elevated AD7C-NTP, TC or TG are risk factors for cognitive impairment after a stroke. A high BI suggests a better prognosis. Urinary AD7c-NTP is a useful predictor of PSCI 3 months after a stroke.
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Gastroesophageal reflux disease (GERD) is one of the most common digestive diseases with high incidence, complicated clinical symptoms, difficulties in standard treatment, and heavy medical burden. At present, some GERD-relevant clinical practice guidelines (CPGs) have been issued by different countries and academic organizations, but some recommendations were inconsistent, which has caused some problems for the current clinical whole-course management of GERD. To summarize the relevant evidence among the CPGs on GERD and formulate the whole- course management strategies, we included GERD-relevant CPGs published or updated after 2010 by searching websites of guidelines, relevant professional societies, and electronic databases. We extracted the recommendations and summarized the evidence from the aspects of symptoms, epidemiology, diagnosis and treatment, which was presented in the form of evidence mapping. We included 24 CPGs, including three in Chinese and 21 in English. The clinical practice management strategies of GERD were formulated based on the evidence from the aspects of clinical symptoms, diagnostic methods, medical treatment, anti-reflux surgery and endoscopic treatment, psychological treatment, and traditional Chinese medicine treatment.
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Humans , Gastroesophageal Reflux/therapyABSTRACT
Objective:To explore the significance of multidisciplinary team for the diagnosis and treatment of congenital band syndrome.Methods:Five children with congenital circular band syndrome admitted in the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Medical University from January 2017 to January 2020 were retrospectively analyzed.They were diagnosed, treated and followed up by a multidisciplinary team including the department of obstetrics and gynecology, ultrasound, and orthopedics from the fetal stage.Results:One case was found with gradually aggravated ring band that affects the blood circulation of distal limbs during fetal examination, who was promptly performed with partial band release under fetoscopy.All cases had Patterson type Ⅰ ring bands at birth, and distal limbs did not have obvious deformity.They were performed with selective annular band resection, and postoperatively followed up for an average of 10.6 (8-13) months.The annular depression of the skin disappeared, and the appearance and function recovered satisfactory.According to the monitoring of side effects scale (Moses), 4 cases were excellent, 1 case was good, and the excellent and good rate was 100%.Conclusions:The multidisciplinary team for the diagnosis and treatment of congenital band syndrome can maximize the professional advantages of physicians with diffe-rent specialties, make early diagnosis and treatment, minimize the compression of the ring band on the limbs, and avoid serious limb deformities.It is worthy of clinical application.
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OBJECTIVE@#To establish quantitative surface plasmon resonance (SPR) assay for antibodies against human platelet antigen-1a (HPA-1a).@*METHODS@#Recombinant protein was fixed on the chip surface by amino coupling method. SPR assay was used to detect the standard antibodies against HPA-1a at different conceatration. The optimal experimental parameters were determined, and standard curves were constructed with linear regression. Moreover, the sensitivity, specificity, accuracy and precision of the assay were evaluated.@*RESULTS@#The quantitative SPR assay for HPA-1a antibodies was established. The determination ranges were 0-20 IU, with accuracy (recovery rate) was 97.75%-103.08%. The intra-assay precision [coefficients of variation (CV)] was 3.53%-4.29%, and the inter-assay precision (CV) was 2.08%-4.40%. For specificity test, several kinds of monoclonal and human antibodies against platelet membrane protein were tested and no positive result was observed.@*CONCLUSION@#The established quantitative SPR assay for HPA-1a antibodies shows good sensitivity, specificity, accuracy and precision, and this rapid and simple method provides a new reference method for scientific research and clinical antibody detection.
Subject(s)
Humans , Antigens, Human Platelet , Blood Platelets , Isoantibodies , Surface Plasmon ResonanceABSTRACT
With the development of China's economy and aging of the population,patient's demands for nursing are increasingly high,thus it is very important to cultivate high-end and practical nursing personnel.This paper analyzes the necessity and feasibility of the development of Nurse Practitioner in China,and explores the qualifications and management of Nurse Practitioner,the job content of Nurse Practitioner,and the training of Nurse Practitioner.
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Objective To compare patients'satisfaction and comfort associated with automated breast volume scanner(ABVS),handheld ultrasound(HHUS)and mammography(MMG).Methods Five hundred and twenty-eight women who performed ABVS examination and previously had undergone MMG and HHUS were enrolled.BMI,bra size,with or without lesion,lesion size,pain score of MMG,ABVS and HHUS were documented and analyzed.Results The pain score of MMG was significantly higher than that of ABVS[4.0(2.0,6.0)vs 2.0(1.0,4.0)](P <0.05).92.4% of the cases were preferred for the ABVS examination,which was higher than that for the MMG(45.5%),and was similar to HHUS(94.7%).Bra size,BMI,with or without lesion and lesion size could affect the pain degree of ABVS.Conclusions Routine use of ABVS will be well tolerated by patients than MMG.
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Porous carbon nanoparticles ( NPC) were prepared by ZnCl2 activation and carbonization using citrus waste as carbon source. A sample pretreatment method with NPC as dispersive solid phase extraction (d-SPE ) absorbent was established for the determination of organophosphorus pesticides in fruits and vegetables by gas chromatography. The NPC was characterized by scanning electron microscopy (SEM), X-ray diffraction ( XRD), FT-IR spectra, Raman spectroscopy, Brunauer, Emmett and Teller surface area(BET). Those results showed that the NPC was an amorphous porous carbon material with pore size in the range of 0-15 nm. Its specific surface area and pore volume were 1243 m2 / g and 1. 28 cm3 / g, respectively. The analysis conditions, including the amount and clean up time of adsorbent, were optimized by analysis of 14 kinds of oranophosphorus pesticides in fruits and vegetables with gas chromatography-flame photometric determination(GC-FPD). Moreover, the comparison for NPC with commercial materials of PSA, C18 and GCB was investigated in this study. The results indicated that the purification time was only 2 min using 0. 01 g NPC. The cost of NPC was about 25% of C18 , 21% of PSA and 16% of GCB. Because of the porous structure of NPC, the purification efficiency was significantly higher than the three commercial materials mentioned above. Under the optimum conditions, the calibration curves of the 14 organophosphorus pesticides were linear in the range of 0. 02-1. 00 mg / L with good correlation coefficients (R2>0. 99) and detection limits (S / N=3) of 0. 63-5. 30 μg / kg. The recoveries of the pesticides at three spiked levels ranged from 71. 3% to 114. 7%with the relative standard deviations (RSDs) of 0. 9% -12. 9% . The method is simple, rapid, sensitive, and low cost, and can satisfy the requirements of detection of organophosphorus pesticide residues in fruits and vegetables, displaying a good application prospect.
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To observe the expression of N - cadherin and fibronectin in retinal pigment epithelium ( RPE) cells in vitro under high glucose conditions, furthermore, to explore the effects of high glucose on epithelial -mesenchymal transition (EMT) in RPE cells. ●METHODS: Human RPE (hRPE) cells were cultured in vitro. Containing a final concentration of 60mmol/ L glucose was used for high glucose treatment. The cells were divided into normal glucose group (5. 5mmol/ L, NG) and high glucose group (24, 48 and 72h) respectively. The expression of N - cadherin and fibronectin in hRPE cells were evaluated by immunofluorescence and real -time PCR. ●RESULTS:RPE cells became disorganized and swollen over time under high glucose conditions, especially in 72h subgroup. lmmunohistochemical analysis revealed that the expression of N - cadherin in RPE cells under high glucose conditions was decreased compared with that in the control group, while the expression of fibronectin was increased. Real - time PCR results showed that the expression of N - cadherin mRNA in high glucose group was decreased at 24h compared with that in the control group, and declined markedly at 72h ( F = 12. 252, P =0. 000). There were no significant differences between the control group and the high glucose group at 24h, while the differences between the control group and the high glucose group (48 and 72h) were significant respectively (P ●CONCLUSlON: The expression of epithelium marker N-cadherin is down - regulated under high glucose conditions in hRPE cells in vitro. Meanwhile, the expression of mesenchymal maker fibronectin is induced and appeared to EMT changes. Results of this study will enrich our growing understanding in proliferative diabetic retinopathy and hopefully lead to novel insights for the pathogenesis and therapeutic treatments.
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Objective To investigate the correlation between virtual touch tissue quantification (VTQ) and the pathological grading of liver fibrosis in chronic hepatitis B.Methods 64 chronic hepatitis B patients (the chronic hepatitis group) and 40 healthy volunteers (the controlled group) were collected.The patients in the chronic hepatitis group were underwent liver biopsy.According to the hepatic fibrosis degree,the patients in the test group were classified into stage 0,1,2,3 and 4.The liver shear wave velocities (SWV) of all the participant were measured by VTQ.The cut-off values were determined by an analysis of receiver operating characteristic (ROC) curve.Results The mean SWV was (1.04± 0.13)m/s in the controlled group.The SWV in stages 0,1,2,3,and 4 were (1.17 ± 0.08)m/s,(1.33 ± 0.32)m/s,(1.53 ±0.32) m/s,(2.09 ± 0.54) m/s,(2.18 ± 0.70) m/s,respectively.There was a significantly difference in SWV between the controlled group and the chronic hepatitis group (F =34.97,P =0.00).The SWV were significantly different not only between stages 0-2,and 3,but also between 0-2 and 4 (F =8.87,P =0.00).A positive correlation was observed between the liver fibrosis and the SWV in the chronic hepatitis group (r =0.67,P =0.00).When a cut off value was set at 1.43 m/s,area under ROC curve was 0.875.The sensitivity and specificity were 100 ％ and 62.5 ％.Conclusions SWV has a better correlation with liver fibrosis.VTQ can make an accurate assessment for stage 3 and stage 4 of the chronic hepatitis B.Therefore,VTQ can be used as a noninvasive and reliable diagnostic indicator for chronic hepatitis B.
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ObjectiveTo observe the pathogenic relationship and the mechanisms between the first molars and the temporomandibular disorders(TMD) by getting epidemiology data.MethodsThe oral examinational people during 2007 to 2011 as investigating objects were selected and epidemiological study was carried out with standard clinical diagnostic criteria for dental caries TMD.ResultsThe people with dysfunctional first molars showed that TMD positive rate was 51.48％,and normal molars was 23.47％.The results had significant difference( x2 =54.34,P ＜ 0.01 ).ConclusionThe people with dvsfunction of first molars mav be liable to TMD.
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<p><b>OBJECTIVE</b>The aim of this investigation was to study the effects of fat-soluble extracts from vegetable powder (FEFVP) and beta-carotene on the proliferation and apoptosis of cultured YTMLC-90 lung cancer cells.</p><p><b>METHODS</b>The lung cancer cells were continuously exposed to a broad range of concentration of FEFVP and beta-carotene. The proliferation was evaluated in MTT test. The induction of apoptosis was evaluated by morphological change, DNA fragmentation analysis, and DNA content analysis combined with flow cytometric analysis.</p><p><b>RESULTS</b>Both FEFVP and beta-carotene were found to inhibit cell proliferation and to induce morphologic changes consistent with apoptosis in YTMLC-90 cancer cells, including cellular shrinkage, chromatin condensation and nuclear fragmentation. DNA agarose gel electrophoresis showed DNA fragmentation 'ladder'. Flow cytometric analysis revealed decreased DNA content and the presence of a sub-G1 apoptotic peak.</p><p><b>CONCLUSION</b>These findings are consistent with the induction of apoptosis. Moreover, the effects of FEFVP are stronger than those of beta-carotene. FEFVP inhibits the growth of YTMLC-90 probably via the induction of apoptosis cancer cells.</p>