ABSTRACT
The COVID -19 epidemic not only brings heavy burden to the society, but also makes the originally tense doctor-patient relationship closely connected from another aspect, which objectively becomes a new opportunity to improve the doctor-patient relationship. By comparing and analyzing the current situation of the doctor-patient relationship before and after the COVID -19 epidemic, this paper discussed the causes of tension between doctors and patients, and proposed corresponding solutions, so as to promote the continuation and development of highly harmonious doctor-patient relationship during the COVID -19 epidemic prevention and control period in the future.
ABSTRACT
ObjectiveTo investigate the influencing factors for the prognosis of patients with acute－on－chronic liver failure （ACLF）， and to establish a short－term prognostic model. MethodsA retrospective analysis was performed for the baseline clinical data of 247 patients with ACLF who were hospitalized in Department of Infectious Diseases， The First Affiliated Hospital of Xi’an Jiaotong University， from January 2011 to December 2016， and the patients were divided into survival group and death group. The two groups were compared to identify the influencing factors for prognosis； a prognostic model was established， and the receiver operating characteristic （ROC） curve was used to assess its predictive efficacy and determine the optimal cut－off value. The independent－samples t test was used for comparison of normally distributed continuous data between groups， and the Mann－Whitney U rank sum test was used for comparison of non－normally distributed continuous data between groups； the Fisher’s exact test or the Pearson’s chi－square test was used for comparison of categorical data between groups. The univariate and multivariate logistic regression analyses were used to investigate the independent risk factors for 28－ and 90－day prognosis， and the Kaplan－Meier method was used to plot the 28－day survival curves. ResultsA total of 220 patients with ACLF were included based on the inclusion and exclusion criteria； there were 148 patients in the 28－day survival group and 72 patients in the 28－day death group， with a 28－day transplantation－free survival rate of 67.27%； there were 115 patients in the 90－day survival group and 105 patients in the 90－day death group， with a 90－day transplantation－free survival rate of 52.27%. The logistic regression analysis showed that female sex （odds ratio ［OR］=2.149， P=0.030）， high Model for End－Stage Liver Disease （MELD） score （OR=1.120， P<0.001）， and low lymphocyte count （OR=0.411， P=0.002） were independent risk factors for 28－day prognosis， and an LS－MELD model for 28－day prognosis was established as Logit （28－day prognosis）=－3.432+0.765×sex－0.890×lymphocyte count×10－9+0.113×MELD（1 for male sex and 2 for female sex）. The ROC curve analysis showed that this model had an optimal cut－off value of 0.35， and then the patients were divided into low LS－MELD group （≤0.35） and high LS－MELD group （>0.35）； the low LS－MELD group had a significantly higher 28－day survival rate than the high LS－MELD group （P<0.001）. ConclusionPeripheral blood lymphocyte count combined with sex and MELD score has a certain value in predicting the short－term prognosis of ALCF patients.
ABSTRACT
Objective:To investigate the clinical and cardiac magnetic resonance (CMR) characteristics of heart involvement in patients with Fabry disease (AFD).Methods:From January 2018 to March 2021, eight AFD patients [3 males and 5 females, mean age (50±11) years old, range 26-60 years old] confirmed by genetic testing or pathology in Fuwai Hospital were retrospectively included in this study. At the same time, sixteen patients with hypertrophic cardiomyopathy (HCM) [6 males and 10 females, mean age (46±15) years old] and 16 healthy individuals [6 males and 10 females, mean age (51±11) years old] were included as controls. The clinical baseline data and CMR data of the patients were collected and analyzed. The CMR data were analyzed using the software CVI42, with the corresponding parameters automatically generated. One-way ANOVA or Kruskal-Wallis test was used to compare the differences in the parameters among the three groups. Independent-samples t test, Fisher precise test or Mann-Whitney U test were used for the comparison between each two groups. Results:Statistically significant difference was found in renal insufficiency between the HCM group and the AFD group; No other significant difference was found in other clinical factors and ECG results (all P>0.05). CMR results showed that in the AFD group, there were 5 cases with symmetric or roughly symmetric hypertrophy, and 3 with asymmetric hypertrophy. The late gadolinium enhancement (LGE) showed myocardial enhancement in 5 patients, mainly presenting as multiple intermural enhancement, and partially as local subendocardial enhancement. In the HCM group, fourteen cases suffered mainly asymmetric ventricular septal thickening, with or without thickening of other parts of left ventricular wall; and 2 cases had thickening of middle and distal part of the left ventricle. The LGE showed myocardial enhancement in 14 patients, which manifested as focal or patchy enhancement in hypertrophic myocardium, including focal enhancement in the right ventricular insertion of ventricular septum (more common) and subendocardial enhancement in the middle and far segments of left ventricle. Statistically significant difference was found in the differences between the left atrial anterior posterior diameter, the maximum wall thickness of left ventricular, the left ventricular myocardial mass index (LVMI) and the native T 1 value among the three groups (all P<0.001). However, there was no statistically significant difference in the left atrial anterior posterior diameter and the maximum wall thickness of left ventricular between AFD group and HCM group ( P>0.05). The LVMI in AFD group was higher than that in healthy group and HCM group (all P<0.05). Significant difference was found in the native T 1 value among the three groups, with the native T 1 value of the AFD group [(1 177.4±46.0) ms] was significantly lower than that of the healthy group [(1 244.5±34.3) ms] and the HCM group [(1 278.8±41.6) ms], with ( F=13.10, P<0.001). Conclusions:The clinical characteristics of AFD and HCM are quite similar. When AFD is suspected, CMR imaging should be the first choice for imaging examination. Especially, T 1 mapping imaging can provide important information for the diagnosis of AFD.
ABSTRACT
Objective:To investigate the changes of strains based on feature tracking in patients with hypertrophic obstructive cardiomyopathy (HOCM) after surgical myectomy and the potential factors that influenced post-myectomy global strains.Methods:A total of 27 patients with HOCM who underwent septal myectomy in Fuwai Hospital from June 2014 to July 2017 were retrospectively collected. They all received cardiac MR (CMR) cine acquisitions before and after surgery. Their preoperative and postoperative strain parameters, including radial strain (RS), circumferential strain (CS), and longitudinal strain (LS) of the global left ventricle, septum, and lateral wall, were assessed by feature tracking. Comparisons of pre-myectomy and post-myectomy imaging parameters were performed using paired-samples t-test or Wilcoxon matched-pairs signed-ranks test. Pearson or Spearman correlation analysis and linear regression analysis were utilized to find the correlated factors of postoperative global strains. Results:Compared with preoperative strains, postoperative global LS, septal LS, lateral RS, lateral CS, and lateral LS increased statistically (all P<0.05); postoperative global RS, global CS, and septal CS decreased (all P<0.05); no statistically significant difference was observed in septal RS ( P=0.165). Age at surgery ( r=0.428, P=0.026) and preoperative myocardial maximum ventricular wall thickness ( r=-0.587, P=0.001) were both linearly related to postoperative global RS; the further multivariate stepwise linear regressions showed that only preoperative myocardial maximum ventricular wall thickness might be correlated with postoperative global RS (adjusted R 2=0.287, P=0.002). Only myocardial maximum ventricular wall thickness was linearly related to global CS ( r=0.679, P<0.001) and global LS ( r=0.588, P=0.001), respectively; univariate linear regression revealed that preoperative myocardial maximum ventricular wall thickness might be correlated postoperative global CS (adjusted R 2=0.337, P=0.001) and postoperative global LS (adjusted R 2=0.281, P=0.003), respectively. Conclusions:Cardiac surgery definitely relieves left ventricular outflow tract obstruction and generally improves longitudinal and lateral strains, but a negative impact may occur in global and septal CS and RS. Preoperative maximum ventricular wall thickness may affect postoperative global strains.
ABSTRACT
Objective@#To understand the concern of freshmen with different characteristics on sexual knowledge in Sichuan province and to provide evidence for comprenensive sex education in colleges.@*Methods@#A survey was conducted among 2 532 freshmen from 13 universities in Sichuan Province in September 2018. Attention to specific sexual knowledge among students with different characteristics was analyzed.@*Results@#Sexual knowledge that the freshmen concerned included partner communication (39.25%~55.10%), STD and AIDS (37.78%~44.85%) and gender equality (33.33%~43.34%). Logistic regression results showed that male students payed more attention to partner communication(OR=0.77,95%CI=0.65-0.91), masturbation (OR=0.36，95%CI=0.27-0.47) and sexual minorities (OR=0.61,95%CI=0.41-0.90), while female students payed more attention to gender equality (OR=1.31,95%CI=1.10-1.57), sexual harassment and violence (OR=1.65,95%CI=1.37-1.98). Rural students pay. more attention to partner communication (OR=0.79,95%CI=0.65-0.94), while urban students pay. more attention to masturbation (OR=1.50,95%CI=1.08-2.08), sexual harassment and sexual violence (OR=1.30,95%CI=1.07-1.58). Students who had sex were more concerned about contraception and unwanted pregnancy than those who had not (OR=0.53,95%CI=0.39-0.72). Sexual minority students were more concerned about topic of sexual minorities than heterosexual students (OR=3.50,95%CI=2.30-5.33).@*Conclusion@#College freshmen with different characteristics varied in their concern on sexual knowledge, which is related to their needs. It is suggested that schools set up comprehensive education courses according to the needs of students, the content of sex education knowledge can be focused, and carry out comprehensive and targeted sex education.
ABSTRACT
Objective To investigate the epidemiologic and behavioral characteristics of HIV among community population in Liangshan prefecture.Methods We collected social demographic,behavioral and serological information by means of the monitoring questionnaire and serological tests.Data was analyzed by using the chi-square test and logistic regression.Results From April to June of 2010 to 2015,14 092 cases of community population were selected as the study objects,with 267 cases diagnosed as HIV positive patients.The HIV positive rates were 3.24％,3.07％,1.17％,1.38％,1.42％ and 1.25％,respectively.We observed that when community population having the following characteristics as:living in Butuo country (OR=3.83),being males (OR=1.77),being Yi nationality (OR=4.40) being widowed (OR=28.57),with history of drug abuse (OR=3.71) or injecting drug use (PWID) (OR=4.92),or history of needle sharing among PWID (OR=8.53),were under higher risks for HIV infection.With histories as:having had secondary or above levels of schooling (OR=0.59),having protected sex with regular parmers (OR =0.21) and with non-regular partners (OR =0.46),they seemed to be somehow protected for getting HIV infection.Conclusion The positive HIV rates of HIV among community population in Dechang,Ningnan and Butuo varied from 0.10％ to 8.77％while the HIV transmission among general population remained challenging.
ABSTRACT
Objective To analyze the HIV-infection related behaviors among unmarried youths in rural areas of Liangshan prefecture from 2011 to 2013 and factors that influencing the HIV transmission in the population under research.Methods According to the HIV sentinel surveillance methods for data collection,EpiData 3.1 and SPSS 19.0 were used to handle data and both Chi-square test and logistic regression were used to explore the related factors.Results A total number of 5 871 qualified youths were involved in this study from 2011 to 2013 with the prevalence rate on HIV infection among those unmarried youths from the rural areas as 3.45％ (201/5 833).27.56％ (1 607/ 5 833) of them had been working outside their hometown area.31.72％ (1 850/5 833) of the unmarried youths had sexual experiences,with 41.46％ (767/1 850) of them had casual sex but the rate of consistent condom use was only 3.46％ (64/1 850).5.04％ (294/5 833) of the unmarried youths admitted of ever having used drugs,with 34.35％ (101/294) of them having the experiences of injecting,with 84.16％ (85/101) of them sharing needles.Rates on factors as:working outside the resident areas,ever having had casual sexual behaviors,drug use and injecting drug use were seen higher among HIV infections,with differences statistically significant (X2=88.72,104.43,4.20,154.39,55.94,P＜0.05).Results from the logistic regression showed that factors as:being male,Yi ethnicity,illiteracy,experience of working outside the resident area,never or casual condom use and needle-sharing drug use etc.would significantly increase the risk of HIV infection.Conclusions HIV infection among unmarried youths from rural areas in Liangshan prefecture called for attention because of the high rates of risk behaviors.Factors as:having had sexual experiences with low condom use,popular injecting drug use with needle sharing,being male,under Yi ethnicity,with lower education level and ever working outside the resident area etc.were under risks that related to HIV infection for unmarried youths in this area.
ABSTRACT
Objective To investigate the epidemiologic and behavioral characteristics of HIV among community population in Liangshan prefecture.Methods We collected social demographic,behavioral and serological information by means of the monitoring questionnaire and serological tests.Data was analyzed by using the chi-square test and logistic regression.Results From April to June of 2010 to 2015,14 092 cases of community population were selected as the study objects,with 267 cases diagnosed as HIV positive patients.The HIV positive rates were 3.24％,3.07％,1.17％,1.38％,1.42％ and 1.25％,respectively.We observed that when community population having the following characteristics as:living in Butuo country (OR=3.83),being males (OR=1.77),being Yi nationality (OR=4.40) being widowed (OR=28.57),with history of drug abuse (OR=3.71) or injecting drug use (PWID) (OR=4.92),or history of needle sharing among PWID (OR=8.53),were under higher risks for HIV infection.With histories as:having had secondary or above levels of schooling (OR=0.59),having protected sex with regular parmers (OR =0.21) and with non-regular partners (OR =0.46),they seemed to be somehow protected for getting HIV infection.Conclusion The positive HIV rates of HIV among community population in Dechang,Ningnan and Butuo varied from 0.10％ to 8.77％while the HIV transmission among general population remained challenging.
ABSTRACT
Objective To analyze the HIV-infection related behaviors among unmarried youths in rural areas of Liangshan prefecture from 2011 to 2013 and factors that influencing the HIV transmission in the population under research.Methods According to the HIV sentinel surveillance methods for data collection,EpiData 3.1 and SPSS 19.0 were used to handle data and both Chi-square test and logistic regression were used to explore the related factors.Results A total number of 5 871 qualified youths were involved in this study from 2011 to 2013 with the prevalence rate on HIV infection among those unmarried youths from the rural areas as 3.45％ (201/5 833).27.56％ (1 607/ 5 833) of them had been working outside their hometown area.31.72％ (1 850/5 833) of the unmarried youths had sexual experiences,with 41.46％ (767/1 850) of them had casual sex but the rate of consistent condom use was only 3.46％ (64/1 850).5.04％ (294/5 833) of the unmarried youths admitted of ever having used drugs,with 34.35％ (101/294) of them having the experiences of injecting,with 84.16％ (85/101) of them sharing needles.Rates on factors as:working outside the resident areas,ever having had casual sexual behaviors,drug use and injecting drug use were seen higher among HIV infections,with differences statistically significant (X2=88.72,104.43,4.20,154.39,55.94,P＜0.05).Results from the logistic regression showed that factors as:being male,Yi ethnicity,illiteracy,experience of working outside the resident area,never or casual condom use and needle-sharing drug use etc.would significantly increase the risk of HIV infection.Conclusions HIV infection among unmarried youths from rural areas in Liangshan prefecture called for attention because of the high rates of risk behaviors.Factors as:having had sexual experiences with low condom use,popular injecting drug use with needle sharing,being male,under Yi ethnicity,with lower education level and ever working outside the resident area etc.were under risks that related to HIV infection for unmarried youths in this area.
ABSTRACT
AIM:To explore the effect of Pycnogenol on transforming growth factor-β1 ( TGF-β1)-induced he-patic stellate cell activation .METHODS:Cultured LX-2 cells were treated with 5μg/L TGF-β1 and different concentra-tions (0, 10, 25 and 50 mg/L) of Pycnogenol.The viability of the LX-2 cells under the conditions with or without autoph-agy inhibitor 3-MA and ERK inhibitor PD98059 was determined by MTT assay .The protein levels of α-SMA, ColⅠ, TIMP-1, LC3-Ⅱ/Ⅰ, beclin 1, p-ERK1/2 and ERK1/2 were detected by Western blot .RESULTS:Compared with con-trol group, 5μg/L TGF-β1 treatment elevated the cell viability , and increased the protein levels of α-SMA, ColⅠ, TIMP-1, LC3-Ⅱ/Ⅰ, beclin 1, p-ERK1/2, and ERK1/2 in the LX-2 cells (P<0.05).However, these effects were reversed by Pycnogenol pretreatment in a dose-dependent manner and the inhibitory effect of 50 mg/L Pycnogenol was the most sig-nificant in the LX-2 cells (P<0.05).Furthermore, compared with TGF-β1 group, pretreatment with 50 mg/L Pycnog-enol, 5 mmol/L 3-MA or 20 μmol/L PD98059 downregulated TGF-β1-induced cell viability and the protein levels of α-SMA and LC3-Ⅱ/Ⅰ in the LX-2 cells ( P<0.05 ) .CONCLUSION: Pycnogenol suppresses TGF-β1-induced hepatic stellate cell activation via p-ERK and autophagy inhibition .
ABSTRACT
BACKGROUND:In recent years, based on high-throughput molecular imaging, integration of genomics, proteomics and computer aided design and the application of correlative “technical chains” have achieved great achievements in the research of breast cancer, lung cancer, gastric cancer, colon cancer, ovarian cancer and melanin tumor. However, there are few researches on oral squamous cel carcinoma. OBJECTIVE:To detect the gene expression profile of the oral squamous cel carcinoma tissue and normal paracarcinoma tissue using DNA chip-based gene expression profile. METHODS:Two samples of oral squamous cel carcinoma tissue and normal paracarcinoma tissue of patients who received treatment at Stomatological Hospital of Guangdong Province of China in 2013 were included in this study. The gene expression profiles of oral squamous cel carcinoma and normal paracarcinoma tissue were determined by the Roche NimbleGen gene expression microarrays. RESULTS AND CONCLUSION: According to screening criteria of differential genes, 7 872 out of 32 448 detected genes were differentialy expressed genes of oral squamous cel carcinoma, which accounts for 24% of the total number of the screening genes. 3 800 genes were up-regulated, and 4 072 were down-regulated. The results confirm that through detection with the help of gene expression profile clip, 7 872 differentialy expressed genes were obtained through DNA chip-based gene expression profiles according to the screening criteria. Thus it can be concluded that the occurrence and development of the tumors are not a result of single or several genes. Previous experiments based on a single or several genes have great limitations. These findings also suggest that the occurrence of tumor is a result of mutual regulatory effects of many genes forming a network, moreover, the interactions of the network is quite complicated.
ABSTRACT
We conducted a meta-analysis to compare the EBV DNA and VCA-IgA in diagnosis of Nasopharyngeal Carcinoma, and provide important evidence for screening method of NPC. Three databases, Medline [from Jan. 1966 to Jan. 2012], EMBASE [from January 1988 to Jan. 2012] and Chinese Biomedical Database [from January 1980 to Jan. 2012] were used to detect the role of EBV DNA and VCA-IgA in diagnosis of NPC. Meta-DiSc statistical software was used for analysis. Twenty seven case-control and cohort studies were included in final analysis. A total of 1554 cases and 2932 controls were included in our meta-analysis. The Sensitivity specificity, positive likelihood [+LR] and likelihood negative [-LR] of EBV-DNA in diagnosis of NPC were 0.75[0.72-0.76], 0.87[0.85-0.88], 6.98[4.50-10.83] and 0.18[0.11-0.29], respectively, and they were 0.83[0.81-0.85], 0.85[0.83-0.86], 10.89[5.41-21.93] and 0.20[0.14-0.29] for VCA-IgA. The SROC for EBV DNA detection was 0.939, while this was 0.936 for VCA-IgA detection. The subgroup analysis showed EBV-DNA had larger areas under the summary receiver operator curve when compared with VCA-IgA in high quality and low quality studies. Our meta-analysis indicated the EBV DNA had higher sensitivity and specificity in diagnosis of NPC
Subject(s)
Herpesvirus 4, Human , Antigens, Viral , DNA, ViralABSTRACT
OBJECTIVE@#To study the alteration of the immune function in children with obstructive sleep apnea hypopnea syndrome.@*METHOD@#The changes of the IgG, IgA, IgM, CD3, CD4 and CD8 levels in serum were observed and analyzed pre and post adenoidectomy and tonsillectomy.@*RESULT@#Post-operatively, the level of IgG, IgA, IgM, and the CD3, CD4 and CD8 in serum showed no evident alteration.@*CONCLUSION@#Adenoidectomy and tonsillectomy have no injury on the immune function of children with OSAHS.
Subject(s)
Child, Preschool , Female , Humans , Male , Adenoidectomy , Antibodies , Blood , Antigens, CD , Blood , Postoperative Period , Sleep Apnea, Obstructive , Allergy and Immunology , General Surgery , TonsillectomyABSTRACT
OBJECTIVE@#To study the influence caused by the different intervention opportunity and frequencies in treatment chronic sinusitis after endoscopic sinus surgery.@*METHOD@#Eighty patients with chronic sinusitis and nasal polyps were divided into group A and group B randomly. First postoperative management of functional endoscopic sinus surgery was taken in one week after operation, a week one time at first and second month, two weeks one time at third and fourth month, one month one time after fifth month, in group A. First postoperative management of functional endoscopic sinus surgery was taken in two weeks after operation, two weeks one time at first and second month, one month one time from third month to fifth month, two month one time after sixth month, in group B. The nasal middle meatus mucociliary transport rate (MTR) was measured by saccharin method at third month, sixth month and twelfth month, the rate of epithelialization was measured at third months and the efficiency rate was measured at twelfth months after operation.@*RESULT@#All results were no significant difference.@*CONCLUSION@#Appropriate extended postoperative management time and decrease intervention frequencies were not influence the therapeutic effect of endoscopic surgery for chronic sinusitis and/or nasal polyps.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Chronic Disease , Endoscopy , Methods , Nasal Polyps , General Surgery , Nitric Oxide Synthase Type II , Metabolism , Otorhinolaryngologic Surgical Procedures , Postoperative Period , Sinusitis , General Surgery , Time FactorsABSTRACT
Freshwater crabs and snails were collected from Ninghai County in Zhejiang Province, and examined respectively for Paragonimus metacercariae and cercariae. Among 97 freshwater crabs found, the prevalence was 11.3% (11/97) with a mean intensity of 1 metacercariae per crab. It was 10.2% (5/49) and 20.2% (4/20) in the groups weighted 5-15 g and 15-25 g respectively, with an average intensity of 1, and no metacercariae were found in weight group of 25-35 g. Two positive crabs were found from 20 crabs with a low weight (