ABSTRACT
Objective:To investigate the degree of psychological pain in patients with gastrointestinal cancer after multiple chemotherapy, and analyze the influencing factors of psychological pain.Methods:Totally 130 patients with gastrointestinal tumors admitted from December 2017 to December 2019 admitted to the People′s Hospital of Jiangsu Province were included, and all patients received multiple chemotherapy. Using the psychological pain screening tools to evaluate the degree of psychological pain of patients. The data of patients were collected and statistically analyzed by single factor and binary logistics regression model.Results:Among the 130 patients, 32 cases(24.62%) had no psychological pain and 98 cases (75.38%) had psychological pain. There were differences in the age, pathological stage, distant metastasis, monthly family income, accompanying staff, hospitalization time, and personality type of the mentally distressed and psychologically distressed ( χ2 values were 4.598-12.404, P<0.05). Binary logistics regression model analysis suggested that age, pathological stage, distant metastasis, family monthly income, accompany status, length of hospital stay, and personality type were the influencing factors of patients' psychological pain ( P<0.05). Conclusions:Psychological pain of patients with gastrointestinal tumors after multiple chemotherapy is more common, and its occurrence is mainly related to the patient′s age, pathological stage, distant metastasis, family monthly income, accompanying staff, hospitalization time and personality type.
ABSTRACT
Objective To investigate the application value of susceptibility weighted imaging (SWI) combined with platelet distribution width (PDW) in intravenous thrombolysis for treatment of patients with acute cerebral infarction (ACI). Methods One hundred and ten patients with ACI treated by intravenous thrombolysis admitted to the Department of Radiology of the Second Affiliated Hospital of Medical College of Zhejiang University from February 2017 to June 2018 were enrolled as the subjects. Before treatment, all patients were detected by routine magnetic resonance imaging (MRI), SWI scanning and PDW detection. The patients were divided into hemorrhage group (77 cases) and non-hemorrhage group (33 cases) according to the presence or absence of hemorrhage shown in SWI, and according to the amount of bleeding, the hemorrhage group patients were subdivided into light (24 cases), medium (32 cases) and severe (21 cases) three groups. After intravenous thrombolysis, the patients were scanned by SWI to show whether bleeding being present or not, the cerebral microbleeding (CMBs) after 24 hours treatment in two groups, and after treatment of 14 days, modified Rankin score (MRS), PDW and hemorrhagic transformation (HT) situation in the two groups were evaluated and compared, the differences in hemorrhagic infarction 1 (HI1), hemorrhagic infarction 2 (HI2), parenchymal hemorrhage 1 (PH1) and parenchymal hemorrhage 2 (PH2) in different bleeding volume groups were compared. Results Before treatment, 129 lesions detected by SWI were significantly greater than 14 lesions detected by T1 weighted imaging, 22 lesions detected by T2 weighted imaging and 86 lesions detected by diffusion weighted imaging. After treatment for 24 hours, the number of CMBs (number: 10 vs. 0), after treatment for 14 days, the incidence of HT [36.36% (28/77) vs. 12.12% (4/33)], MRS (1.78±0.39 vs. 1.51±0.42) and PDW [(12.34±5.29)% vs. (6.79±3.27)%] in the hemorrhagic group were higher than those in non-hemorrhagic group (all P < 0.05). After treatment of 14 days, the incidences of HT [71.43% (15/21) vs. 20.83% (5/24), 25.00% (8/32)], PDW [(14.52±4.11)% vs. (10.78±3.67)%, (11.34±3.89)%] in severe group were higher than those in light group and moderate groups (all P < 0.05), and the rate of good prognosis was significantly lower than those in mild and moderate groups [42.86% (9/21) vs. 70.83% (17/24), 71.88% (23/32), P < 0.05]. The incidence of HT in severe group was also significantly higher than those in the non-hemorrhage group [71.43% (15/21) vs. 11.76% (4/34), P < 0.05]. Conclusion SWI combined with PDW can guide the intravenous thrombolysis very well for patients with ACI, and has relatively high clinical value.
ABSTRACT
Objective To investigate the effect of calcium on the stability of VWF-A2 domain. Methods The crystal structures of A2 (not containing calcium) and A2/Ca2+ (with calcium bound) were downloaded from protein data bank. For A2 domain, the conformational changes, unfolding pathway differences and the exposure degree variance of cleavage sites caused by calcium binding were observed and analyzed by steered Molecular Dynamics simulations under constant force. Results The unfolding pathway of A2 domain and exposure process of cleavage sites were force-dependent. Calcium binding did not affect the unfolding process of A2 in the early stage. As the conformational rearrangement of α3β4-loop reduced its localized dynamic properties, the movement among β1-β4-β5 strands was restrained, which suppressed its further unfolding to stay in the intermediate steady state and delayed the cleavage-site exposure. Conclusions Stretch force could induce β5 strand of A2 unfolding and the cleavage-site exposure, while calcium binding inhibited ADAMTS13 proteolysis efficiency through stabilizing A2 hydrophobic core and covering its cleavage sites. These results way help to understand how ADAMTS13 cleavages the VWF-A2 domain and regulates the hemostatic potential of VWF, and further provide useful guidance on the design of related anti-thrombus drugs.
ABSTRACT
OBJECTIVE:To provide reference for rational use of narcotic drugs and category Ⅰ psychotropic drugs. METH-ODS:The utilization of narcotic drugs and category Ⅰ psychotropic drugs in clinical wards of Zhengzhou People's Hospital during Jan.-Dec. in 2014 was analyzed statistically in respects of drug types,department distribution medication purpose,DDDs,DDC, DUI,etc. RESULTS:A total of 16 kinds of narcotic drugs and one kind of categoryⅠpsychotropic drugs were used in 28 981 pre-scriptions of narcotic drugs and category Ⅰ psychotropic drugs in our hospital in 2014;A total of 16 kinds of narcotic drugs and one categery Ⅰ psychotropic drugs were used,narcotic drugs mainly included Sufentanil citrate injection(7 816 prescriptions)and Fentanyl citrate injection (5 104 prescriptions),and category Ⅰ psychotropic drugs mainly was Ketamine hydrochloride injection (190 prescriptions). Narcotic drugs and category Ⅰ psychotropic drugs were mainly used in anesthesia department,pain depart-ment and medical oncology department. Main purpose of narcotic drugs and category Ⅰ psychotropic drugs were intraoperative an-esthesia,cancer pain and postoperative analgesia. Top 3 drugs in the list of DDDs were Sufentanil citrate injection,Fentanyl citrate injection(0.1 mg)and Remifentanil for injection. CONCLUSIONS:The utilization of narcotics and category Ⅰ psychotropic drugs are generally rational in the hospital;the doctors can grasp the indication and medication principle,and use drugs rationally accord-ing to disease condition.
ABSTRACT
Objective To analyze the common reasons for misdiagnosis of atypical pulmonary embolism (APE) ,and to im‐prove the identification of APE .Methods The risk factors ,clinical manifestations ,laboratory examinations and radiographic data of 120 cases of APE diagnosed from January 2006 to December 2013 in the department of cardiovascular medicine and respiratory medicine of Xinqiao Hospital and the Affiliated Hospital of Luzhou Medical College were studied retrospectively .Results Among those 120 cases of APE ,39 cases were misdiagnosed on admission (32 .5% ) .8 cases were misdiagnosed as acute coronary syn‐drome ,7 cases as stable angina pectoris ,7 cases as chronic cor pulmonale ,5 cases as pneumonia ,3 cases as pleural effusion ,3 cases as tuberculosis ,3 cases as asthma ,1 case as atrial septal defect ,1 case as acute heart failure ,and 1 case as cardiogenic syncope .Con‐clusion APE is easy to be misdiagnosed for its non‐specific clinical manifestation .Pulmonary enhanced CT or CTPA should be car‐ried out in time for those highly suspected patients ,in order to reduce the misdiagnosis of APE .
ABSTRACT
Objective To investigate the effect of the evaluation on teaching hospitals affiliat-ed to medical colleges in Guangdong province. Methods Questionnaire and on on-the-spot investi-gation was conducted among 18 teaching hospitals which owned the accreditation for 2-3 years based on Guangdong provincial teaching hospital accreditation indicator system 2008 modified version. Contents of investigation included general situation,teaching condition,management and implementa-tion of teaching activities as well as medical staffs' comments and suggestions for the teaching work. SPSS 13.0 software was used for frequency analysis. Results The general situation,teaching condi-tion,management and implementation of teaching activities were improved to varying degrees after the evaluation according to results of the questionnaire. 90.0%(54/90)people thought that the overall scale of the hospital was expanded and 5.0%(3/60)people thought that the overall scale of the hos-pital was obviously reduced or marinated the original level. 11.6%(7/60)and 88.3%(53/60)people thought that medical quality of the hospital was improved or obviously improved. 60.0%(36/60)people thought that educational occupancy of the hospital was improved while 5.0%(3/60)people thought that it was unsatisfactory. 83.3%(50/60)people thought that teaching mold and infrastructures were improved while 10.0%(6/60)people thought that it was unsatisfactory. 95.0%(57/60)people thought that teaching management was improved. Due to the lack of incentives and support in teaching work, management of teaching was loose. Conclusions The teaching work of t hospitals affiliated to medical colleges in Guangdong province do persevere basically and achieve desired purposes.
ABSTRACT
Objective: To explore the major factors which influence the hospitalization expense of fibroid operation,provide references for the effective control of the increasing medical expense and ease the burden of patients. Methods: From January 2011 to December 2012, 1 837 cases of fibroids in our hospital were investigated, and pathway analysis method was used to analyze the factors which influence the hospitalization expense. Results: Operation method, whether use hysterectomy, the year of medical treatment, complication, medical group and nosocomial infection are the critical influencing factors which can directly effect on the hospitalization expense, and these factors not only have direct effects but also have indirect effects on hospitalization expense. Conclusion:Government and medical institutions should take comprehensive measures to decraease hospitalization expense, including the reasonable treatment options, rational drug use, active treatment and prevention of infection.
ABSTRACT
Protocarcinogenic gene Her-2/neu was closely related to the development of gastric cancer. Herceptin is an antibody according to Her-2/neu and is used for treating breast cancer. Topo Ⅱ α is the important Nuclear enzymes needed by DNA duplicate, and is closely related to the proliferation of malignant tumors, so it is the important target enzymes of cancer chemotherapy. Her-2/neu and Topo Ⅱ α are located in the same chromosomes, there are correlation between the two genes' proliferation or loss. We reviewed the expression of Her-2/neu and Topo Ⅱ α in the stomach and the new progress of the correlation between the two genes home and abroad in this paper, which provides new methods for the prevention and treatment of gastric cancer.
ABSTRACT
Objective To evaluate the clinical outcomes of PCI in elder patient four years after the operation.Methods One hundred and one elder patients with ACS were divided into two groups according to the treatment during hospitalization:48 patients in the experimental group underwent primary PCI ;53 patients in control group underwent conservative treatment without PCI.For all the patients,the clinical data on admission and during the four-year follow-up were retrospectively analyzed and the incidence of cardiovascular events at different period,all-cause mortality and prognostic risk factors were compared.Results There was no statistical difference in baseline data between the two groups.The success rate of PCI in experimental group was 93.75％.Imaging examination suggested that the numbers of single vessel lesion,double- vessel lesion and three-vessel lesion were observed in 6,20 and 22 of the patients,respectively.One hundred and fifty-eight cases had lesions involved more than 70％ of the vascular diameter.The numbers of type A,B1,B2 and C vessel lesions were 12,36,48,and 62,respectively.There was no significant difference(8.33％ vs 9.43％,x2 =0.04,P =0.85 ) in the lost follow-up rates in the two groups in the four years' follow-up.The adverse cardiovascular events incidence inthe experimental group were significantly lower than that in the control group during the first 12 months after operation ( RR =2.89,x2 =3.83,P =0.05,RR95 ％ CI:1.00,8.35 ).The adverse cardiac events incidence in the experimental gr?up was significantly lower than in control group during the second 12 months after speration ( RR =3.18,x2 =6.55,P =0.01,RR95 ％ CI:1.09 - 9.29).There was no significant difference in the incidence of adverse cardiac events between the two groups during the 36 - 48 months after the operation.There was no significant difference in the survival rate between the two groups during the follow-up period ( x2 =2.22,P =0.14).The logistic regression analysis for the cardiac events and risk factors such as age,smoking,high blood pressure,Cr,CHO,TG,BS,UA,LDL-C and so on demonstrated that age ≥ 80 years,high blood Cr,BS,LDL-C and high blood pressure were risk factors for adverse cardiac events ( P ＜ 0.05 ).Conclusion The adverse cardiac events incidence was significantly lower in elder patients with ACS who underwent PCI in the following 24 months after operation,but there was no significant difference in terms of the long-term survival rate and adverse cardiac events incidence between the two groups.Age ≥80 years and high blood Cr,BS,LDL-C,high blood pressure were risk factors for adverse cardiac events.
ABSTRACT
OBJECTIVE:To improve the level of rational use of drugs in hospitals.METHODS:Information on the application of the monitoring system for rational administration of drugs in our hospital was analyzed.RESULTS:Manifestations of irrational drug use in our hospital were mainly manifested as incompatibility of parenteral injection,drug interactions,the repetitive use of drugs,drug dosage exceeding the limit dose,medication warnings for specific group of people.CONCLUSION:Incidences for drug-induced diseases in our hospital have been reduced while the general rational drug-use level in our hospital has been improved through the monitoring system of rational use of drugs.