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Objective@#To explore the association of body fat mass and distribution indices including fat mass percentage (FMP), visceral fat area (VFA) and percentage of trunk fat mass (%TFM) with blood pressure in children to inform early management of blood pressure in children.@*Methods@#Based on the Beijing Child Growth and Health Cohort in Shunyi District, lifestyle questionnaire survey, baseline and follow up physical examination were conducted among children from October to November 2018 and September 2020. Bioelectrical impedance analysis (BIA) was used to measure the body composition, and 1 098 participants with completed data were finally included.@*Results@#Both body fat indices and blood pressure increased with age in boys and girls. For FMP, VFA, and %TFM, no significant differences presented between sex at baseline, while FMP, VFA, and %TFM were significantly higher in boys than girls at follow up ( t=2.73, 3.76, 3.41, P <0.01). Before and after adjusting for age, height and lifestyles or not, linear mixed effect models showed longitudinal associations existing between body fat indices and blood pressure in both boys and girls ( β=0.64-3.48, P <0.05). The association coefficients of body fat indices with systolic blood pressure were ranked as %TFM>FMP>VFA in both boys and girls. The association coefficients of body fat indices with diastolic blood pressure were ranked sequentially as FMP>%TFM>VFA in boys, and VFA>FMP>%TFM in girls.@*Conclusion@#Longitudinal associations are observed between body fat indices and blood pressure in children. Primordial prevention of high pressure should pay attention on body fat distribution.
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In order to solve the difficulties and challenges in the implementation of the original blood distribution and collection regulations caused by the expansion of hospital area, the extension of blood transfer time, the changeability of blood transfer environment, and the strain of personnel due to the increase of workload, as well as to ensure the accuracy of the information throughout blood remote verification and distribution and the safety of clinical blood transfusion, , Shanghai experts related to clinical transfusion and blood management had made a systematic study on the applicable scope and management rules of remote verification of blood distribution and collection, and formulated this Expert Consensus combined with the development status of digital, intelligent and remote communication technologies, so as to provide corresponding guidance for clinical medical institutions in line with the changes in reality.
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Objective:To explore the application effect of Cornell's note-taking method in pediatric nursing teaching.Methods:A total of 100 nursing students of 2019 who practiced in department of pediatrics were selected as the research objects, and they were randomly divided into a control group and a study group, with 50 students in each group. The control group used traditional teaching, and the research group used Cornell's note-taking method of teaching. After the internship, the teaching effect of the two groups of intern nursing students was evaluated through subject assessment, teaching satisfaction and teaching evaluation. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical knowledge, nursing operation skills and comprehensive ability of the nursing students in the study group were better than those of the control group, and the difference was statistically significant ( P<0.05). The satisfaction degree of nursing students in the control group was 90.00% (45/50), and the satisfaction degree of nursing students in the study group was 100.00% (50/50), with statistically significant differences ( χ2=5.26, P=0.022). More than 88% of interns in the research group believed that Cornell's note-taking method could mobilize learning initiative and enthusiasm, improve learning efficiency and knowledge mastery, improve analysis and problem-solving skills, cultivate assessment and comprehensive judgment skills, and enhance nurse-patient communication skills, thereby improving the overall quality. Conclusion:Cornell's note-taking method can improve the theoretical knowledge, clinical practice skills and comprehensive ability of pediatric nursing students, which is recognized by the interns, and obtains high teaching satisfaction and evaluation.
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With continuous discovery of tumor immune targets and continuous changes in antibody research and development technology, antibody drugs are becoming more and more widely used in clinical practice. However, some targets are not only expressed on tumor cells, but also on red blood cells. Therefore, the clinical application of antibodies against the corresponding targets may interfere with the detection of blood transfusion compatibility, resulting in difficulty in blood matching or delay of blood transfusion. This consensus summarizes the current solutions for the interference of CD38 monoclonal antibody (CD38 mAb) in transfusion compatibility testing. After analyzing the advantages and disadvantages of different methods, polybrene and sulfhydryl reducing agents [dithiothreitol (DTT) or 2-mercaptoethanol (2-Me)], as a solution for CD38 mAb interference in blood compatibility testing, are recommended for Chinese patients, so as to eliminate blood transfusion interference produce by CD38 mAb and further provide a pre-transfusion workflow for clinicians and technicians in Department of Blood Transfusion.
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【Objective】 To explore the clinical applications of low ionic strength salt solution polyethylene glycol (LISS-PEG) and low ionic strength salt solution bovine serum albumin (LISS-BSA) in the indirect antiglobulin test (IAT). 【Methods】 The common standard red blood cell(RBC) IgG irregular antibodies (anti-D, anti-M, anti-N, anti-S, anti-s, anti-Jka, anti-Jkb, anti-Fya, anti-Fyb, anti-Dia, anti-K) were reacted with RBCs with corresponding antigens in IAT with LISS-PEG and LISS-BSA modification for 5-minute and 10-minute incubations, and then compared the results with conventional IAT. One hundred of blood samples from patients presenting irregular antibodies of erythrocyte IgG were selected to observe the effect of these two self-made modification. The agglutination intensity was recorded by AABB scoring method. 【Results】 No difference was noticed in IAT intensity reaction between LISS-PEG 5-minute and 15-minute incubation (P>0.05), nor between 5-minute/15-minute LISS-BSA incubation and conventional IAT (P>0.05). However, LISS-PEG modification demonstrated a significant superiority over the conventional technique just after incubation with 5 minutes(P<0.05). 【Conclusion】 Using the self-made LISS-PEG as the enhancement medium allows not only reduced incubation time (5 minutes) but also increased intensity of the reaction, which shortens the cross-matching time for emergency blood transfusion and is worthy of popularization.
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Objective To study whether SGK1 is involved in the phenotypic transformation in adventitial fibroblasts (AF).Methods Vascular AF were separated from the thoracic aortas of SD rats.The AF not stimulated with TGF-β1 were divided into blank group,control group 1 and control group 2.The AF induced with 2.5,5.0,10.0 and 15.0 ng/ml TGF-β1 were divided into groups A-D.The AF pretreated with 50 μmol/1 EMD638683 and SB203580 were divided into inhibitor group 1 and inhibitor group 2.The AF stimulated with 5 ng/ml TGF-β1 were divided into stimulation group 1 and stimulation group 2.The expression of SGK1,α-SMA and collagen Ⅰ was detected by Western blot.Results The expression of SGK1 was significantly higher in groups AC than in blank group.The expression of α-SMA was significantly higher in groups B-D than in controlgroup (P＜0.05).The α-SMA and collage Ⅰ expression levels were significantly higher in stimulation group 1 than in control group 1,and were significantly lower in inhibitor group 1 than in stimulation group 1 (P＜0.05).The SGK1 expression level was significantly higher in stimulation group 2 than in control group 2 and was significantly lower in inhibitor group 2 than in stimulation group 2 (P＜0.05).Conclusion SGK1 participates in TGF-β1-induced phenotypic transformation via p38 MAPK and is thus involved in vascular remodeling.
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Objective To explore the MRI features about the annular ligament injuries in pediatric patients. Methods The appearance of MRI about annular ligament injuries in 15 pediatric patients diagnosed clinically were retrospectively analyzed. All patients (aged 4 years 8 months to 12 years 11 months) were scanned by MRI in 2-4 days after injury. Patients were divided into three groups according to the annular ligament injuries severity, which were simple annular ligament injuries, annular ligament injuries combined dislocation, annular ligament ruptures combined dislocation. Results Simple annular ligament injuries were showed in 2 cases, which appeared high signal but continuous configuration. Annular ligament injuries combined dislocation were showed 9 cases. Bald head sign, thickening and continuous ligment were found on axial image, together with compression of the radial joint space on sagittal and coronal view. Annular ligament ruptures combined dislocation were showed in 4 cases. The ligment showed"bald head sign", tortuosity and uneven thickening on axial view and compression of the radial joint space on sagittal and coronal view. Combining with the other tissue injuries were detected in 15 cases. Conclusion The annular ligament injuries show some MRI characteristics. Bald head sign is specific in the annular ligament injuries of pediatric patients.
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Objective:To explore therapeutic effect of ticagrelor on patients with acute ST elevation myocardial in‐farction (STEMI) and its influence on short‐term prognosis .Methods :A total of 180 STEMI patients undergoing e‐mergency percutaneous coronary intervention (PCI) were selected ,randomly divided into clopidogrel group (n=90) and ticagrelor group (n=90) .Clinical therapeutic effect was compared between two groups ;platelet function ,inci‐dence of major adverse cardiovascular events (MACE) ,adverse reactions and bleeding events were observed in two groups .Results:Total effective rate of ticagrelor group was significantly higher than that of clopidogrel group (93.4% vs .87.8% ,P=0.036);compared with clopidogrel group on 24h and 7d after operation ,there were signif‐icant reductions in platelet aggregation rate [24h :(62.1 ± 5.2)% vs . (56.5 ± 5.4)% ,7d:(47.3 ± 6.1)% vs . (38.7 ± 5.2)% ] and P2Y12 reaction unit [24h:(218.1 ± 12.3) U vs . (201.3 ± 11.1) U ,7d:(173.4 ± 11.8) U vs . (152.6 ± 12.6) U] in ticagrelor , P0. 05 all .Conclusion:Compared with clopi‐dogrel ,ticagrelor can better reduce platelet aggregation rate and improve clinical therapeutic effect without increas‐ing incidence of adverse reactions and bleeding events .
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Objective To evaluate the perioperative blood loss and blood transfusion in liver transplantation patients.Methods Retrospectively selected and classified 119 patients with liver transplantation medical recordsaccording to the clinical diagnosis of age,gender.Analyzed (disease)patients' blood coagulation index 24 h before surgery,intraoperative and postoperative perioperative bleeding,and blood red blood cell suspension,frozen plasma,cold precipitation,coagulation factor injection lossplateletpheresis.Results There were no significant differences in the amount of blood loss and the amount of blood preparations duringthe perioperative period of liver transplantation according to the age and sex of patients (P＞0.05);According to the clinical diagnosis of different groups,the diagnostic group (primary liver cancer group,hepatitis B cirrhosis group and severe hepatitis group) patients with a single platelet transfusion dosewas similar (P＞0.05)withsuspended red blood cells (U) at 8.4+11.9,16.2+15.7,18.1+13.5,frozen plasma (U) at 8.2+7.1,18.1+15.6 and 18.2+ 17.9 respectively andcold precipitation (U) at 9.5+ 8.2,17.1 + 16.318.5 + 16.4 (P＜ 0.05);The diagnosis group surgery before and after immediate PT (s) were 15.6+3.8,24.6+4.1,APTT (s) were 44.3+5.8,84.9+9.2,TT (s) were 20.4 +4.5,40.1+6.2,and Fib(s) were 2.6+0.8 and 1.3+0.9 (P＜0.05);however,there was no significant difference in the 24 h PT,APTT,TT and Fib between the two groups after diagnosis (P＞0.05).Conclusion Ascientific,safe and reasonable selection of perioperative blood preparation for clinical diagnosis for different liver transplantation patients is critical to the success rate and prognosis of liver transplantation;the evaluation of coagulation indexes at each interval can help guiding the blood transfusion during liver transplantation.
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Objective To investigate the effect of microcolumn gel reagent card,micro-column glass bead reagent card and classical test tube on the antibody titer of O-type pregnant women with ABO blood group.Determination of antibody potency of pregnant women with rabbit by reagent card.Methods Using microcolumn gel reagent card,micro-column glass beads reagent card,and classical test tube parallel detection to detect the IgG blood group antibody titer of O blood type pregnant women.Results There was no significant difference in the positive detection rate between the microcolumn gel reagent card and the microcolumn glass beads reagent card at 1:128 and the test tube method at 1:64 (P＞0.05).Conclusion The clinical reference value of microcolumn gel reagent card and microcolumn glass beads reagent kit for detecting antibody titer of IgG blood group in O-type pregnant women should be set to ≥ 1:128.
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Objective To explore the MRI features about the annular ligament injuries in pediatric patients. Methods The appearance of MRI about annular ligament injuries in 15 pediatric patients diagnosed clinically were retrospectively analyzed. All patients (aged 4 years 8 months to 12 years 11 months) were scanned by MRI in 2-4 days after injury. Patients were divided into three groups according to the annular ligament injuries severity, which were simple annular ligament injuries, annular ligament injuries combined dislocation, annular ligament ruptures combined dislocation. Results Simple annular ligament injuries were showed in 2 cases, which appeared high signal but continuous configuration. Annular ligament injuries combined dislocation were showed 9 cases. Bald head sign, thickening and continuous ligment were found on axial image, together with compression of the radial joint space on sagittal and coronal view. Annular ligament ruptures combined dislocation were showed in 4 cases. The ligment showed"bald head sign", tortuosity and uneven thickening on axial view and compression of the radial joint space on sagittal and coronal view. Combining with the other tissue injuries were detected in 15 cases. Conclusion The annular ligament injuries show some MRI characteristics. Bald head sign is specific in the annular ligament injuries of pediatric patients.
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Objective To provide reference for exploring the senile chronic disease health management new model by apply‐ing the chronic disease health management model into the practice of home‐based care service center in community .Methods The chronic disease health management team was established and the management platform of home‐based care service centers in com‐munity was applied to implement the chronic disease health management service .The senile chronic disease management and service situation were compared between before and after implementing chronic disease health management ,and the difference of service be‐tween the home‐based care service center and community health service center after implementing the chronic disease health man‐agement was compared as well .Results The service content implementation in the home‐based care service center was significantly improved after senile chronic disease health management (P<0 .01) ,and the chronic disease management satisfaction was increased by 39 .66% .Meanwhile ,the management rate and control rate of chronic diseases in the community home‐based care service center were superior to those in the community health service center (P<0 .01) .Conclusion Applying the chronic disease health manage‐ment model into the platform of the home‐based care service center can provide more comprehensive ,specific and efficient chronic disease health management service ,w hich provides a new model of senile chronic disease management application .
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Objective:To investigate the association of pretherapeutic neutrophil, lymphocyte, monocyte, and serum albumin levels with nasopharyngeal carcinoma (NPC) prognosis in 401 patients. Methods:This study involved 401 NPC patients recently diagnosed and admitted in Sun Yat-sen University Cancer Center, China. Laboratory variables, such as immunology-related parameters and albumin level prior to treatment, were analyzed. The overall survival and disease-free survival rates were determined using the Kaplan-Meier method and were then compared using the log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards model to identify prognostic factors. Results:Patients with neutrophil counts>5.20×109/L (n=172) had significantly lower overall survival and disease-free survival rates compared with those with neutrophil counts≤5.20×109/L (n=229) (P=0.014, P=0.009). In the 401 NPC cases, patients with high albumin levels (>43.00 g/L;n=253) had significantly higher overall survival (P=0.000) and disease-free survival (P=0.006) rates compared with those with low albumin levels (≤43.00 g/L;n=148). Multivariate analysis showed that the neutrophil level is an in-dependent risk factor for disease-free survival, whereas the albumin level is a strong independent prognostic factor for overall survival. Conclusion:The pretherapeutic neutrophil and albumin levels are independent prognostic factors for survival in NPC patients.
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Objective To investigate the preventive effect of low molecular weight heparin or tranexamic acid in the rabbits with hypercoagulation induced by impact injury and intravenous infusion of the endotoxin. Methods Combination of impact injury and endotoxin was created by strike on rabbit chest with type BIM-Ⅱ biological impact machine and injection of endotoxin via vein.Thirty-two male New Zealand rabbits were divided into four groups in a completely random design as follows:impact injury combined with endotoxin without treatment group(control group),treatment with low molecular weight heparin(L group),treatment with tranexamic acid(TA group),and treatment with low molecular weight heparin and tranexamie acid(L+TA group).The changes of interleukin-1β(IL-1β)and interleukin-6(IL-6)were observed by using the enzyme-linked immunosorbent assay;changes of antithrombin-Ⅲ(AT-Ⅲ)activity,tissue factor(TF)and tissue factor pathway inhibitors(TFPI)were detected by the chromogenic substrate method chromozym P:the content of fibrinogen was observed by coagulation analyzer.The lung and kidney were removed from the experimental animals at 24 hours post impact injury forhistopathologic observation. Results In the control group,the activity of AT-Ⅲ was decreased obviously.while the content of fibrinogen and the activity of TF and TFPl were increased,with formation of the thrombosis in the kidney after injection of PLS.Compared with control group,the activity of TF and the content of IL-1β and IL-6 were reduced but the TFPI was increased in the L group,which resulted in a decrease of TF/TFPI ratio.with decrease of formation of the micro-thrombosis in the organs.The content of IL-1β and IL-6 in the TA group were reduced,which was still higher than that in tIle L group.In the TA group.the activity of IF and TFPI Was lower than that in the L group and control group,with higher TF/TFPI ratio than the L group.The frequency of thrombosis increased in pulmonary artery and other important organs.The content of IL-1β and IL-6 in the L+TA group wag lower than that in the L group.In the L+TA group.the activity ofTF was lower than that inthe L group and control group,but the activity of TFPI was higher than that in the L group and control group.with lower TF/TFPI ratio than the L group.There found no increase of thrombus in the pulmonary arterial and other important organs. Conclusions Besides anticoagulation function,the low molecular weight heparin can inhibit the inflanunation reaction,reduce the release of TF and attenuate the coagulation reaction.On the basis of treatment with low molecular weight heparin,application of the tranexamic acid will not lead to the formation of thrombus,but the only use of the tranexamic acid would have the contrary results.The rtsults of the study provide a theoretical and experimental basis for clinical diagnosis and prevention of hypercoagulation induced by injury and infection.
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Objective To probe into the nursing experience of reasonable cooperation between op-eration room nurses and anesthesiologists. Methods Strengthening preoperative propaganda and psy-chological education,paying attention to the temperature and humidity in operation room,assisting the anesthesiologists to arrange patients'body position,giving cooperation of infusion and transfusion,actively involving in rescue work.Results Surgery patients got good care,anesthesia and surgery went along smoothly. Conclusions Smooth coordination between operation room nurses and anesthesiologists has great significance on the smooth going and satisfactory results of operation.
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Sixty patients who underwent brain and neck CT angiograpby (CTA) were randomly divided into two groups: conventional protocol group and optimizing protocol group with 30 in each. The images were evaluated by two radiologists independently. The images of optimizing group avoided the artifact disturbance of the brachiocephalic vein effectively and greatly improved the imaging quality of arteria carotis communis and arteria vertebralis initial segment. Compared with the conventional group the differences were statistically significuat(P <0.05). The optimization of 64-MDCT brain and neck CTA is feasible and effective.
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A poly(amino black 10B)/Nafion modified glassy carbon(GC) electrode for the detection of dopamine(DA) has been developed. The modified electrode showed an excellent electrocatalytic effect on the oxidation of DA. In cyclic votammetric measurements, the redox peak current increased linearly with the concentration of DA in the range of 2.0×10~(-7) 3.0×10~(-5) mol/L in PBS of pH 6.0, with a correlation coefficient of 0.9993 and 0.9991, respectively. The detection limit(S/N=3) was 1.0×10~(-7) mol/L. Moreover, the modified electrode exhibited good repeatability and long-time stability, and avoided the interference of ascorbic acid. The modified electrode has been used for the determination of DA in the injections and calf serum with good recovery and reproducibility.
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Objective To explore the imaging findings and diagnostic values of X-ray, CT, MR,and ultrasonography in traumatic knee joints hemarthrosis and lipohemarthrosis. Methods Traumatic knee joints hemarthrosis (12 knees) and lipohemarthrosis (18 knees) proved by operation (27 knees) or puncturation (3 knees) were included in the study. Horizontal-beam plain radiographs (16 knees), CT (30 knees), MRI (30 knees) and ultrasonography (24 knees) in supine position were investigated. Results (1)supine position horizontal-beam plain radiographs: Fat-liquid layer was found in 8 cases of lipohemarthrosis. Dense supragenual bursa was found in 1 case of lipohemarthrosis and 7 cases of hemarthrosis. Fracture (13 knees) was diagnosed correctly. (2) CT findings: double fluid-fluid layer was found in 11 of all 18 cases, and single fluid-fluid layer was found in 7 of 11 cases of lipohemarthrosis. Single fluid-fluid layer was found in 3 of 12 cases of hemarthrosis. Isodensity was detected in 9 cases, and high-density blood clot was found in 4 cases. Fracture (30 knees) was diagnosed correctly. (3) MRI findings: in 12 of 18 cases of lipohemarthrosis, double fluid-fluid layer was shown including supernatant layer as short T1, long T2signal and low signal after fat-suppression, middle layer as long T1, long T2 signal and high signal after fat-suppression, and dependent layer as iso-T1, iso-T2 and slight high signal after fat-suppression. Single fluid-fluid layer was seen in 6 cases, only had aforementioned upper and under layer.Only aforementioned supernatant layer and dependent layer were seen in 12 cases of hemarthrosis. 4 cases showed entire blood clot in fluid, T1WI showed middle signal or center iso-signal accompanied with peripheral high signal ring, and fat-suppression imaging showed high signal. T2WI and fat-suppressionimaging showed middling or high signal accompanied with peripheral low signal ring. Fracture (30 knees) was diagnosed correctly. (4) Ultrasound findings: In 10 of 14 cases of lipohemarthrosis, double fluid-fluid level was shown, supernatant layer as equal echo, middle layer as echoless, and dependent layer as cloudy echo. Four cases with single fluid-fluid level only showed aforementioned upper and under layer. Three of 10 cases of hemarthrosis showed single fluid-fluid level, only showing aforementioned upper and under layer,and 7 cases showed cloudy echo and float. In 3 cases the fluid blood clot showed irregular shape low-equal echo bolus. No fracture hne was found. Conclusions CT can clearly detect fracture line, hemarthrosis and lipohemarthresis, and can substitute plain radiography. MRI is the best way to diagnose hemarthresis and lipohemarthrosis. Ultrasonography can be used in diagnosing hemarthresis and lipohemarthrosis but not helpful in the diagnosis of fracture.
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Objective To explore MRI findings of intervertebral suppurative spondylitis. Methods MRI findings of intervertebral suppurative spondylitis in 12 cases proved by surgery and 6 cases defined by clinical features were retrospectively analyzed. The MRI protocol included un-enhanced conventional scan in 18 cases and contrast-enhanced scan in 11 cases. Results Of the 18 cases, single focus was found in 16 cases, and multiple loci were seen in 2 cases. MRI findings included (1) Disappearance sign of nuclear crevice in 17 cases, accumulated fluid sign of intervertebral disc in 15 cases, intervertebral disc perforation in 4 cases, and intervertebral space narrowing in 7 cases. (2) Bone destruction under end plate and marrow oedema were shown in 18 cases, 17 cases had end plate destruction, 16 cases had covered sign of end plate.(3) Paraspinal soft tissue swelling was shown in 18 cases, in which thick wall microabscess was formed in 4 cases. (4) Vertebral canal was involved in 12 cases, vertebral canal abscess was formed in 5 cases.(5) Lump enhancement was demonstrated in 4 cases, nodular enhancement in 2, and ring-like enhancement in 2, respectively. No enhancement was seen in 3 cases. Dural sac linear enhancement was shown in 6 cases, and patchy enhancement in the anterior dural sac was shown in 10 cases. Conclusion Intervertebral suppurative spondytitis had characteristic MRI findings, and the key to correct diagnosis was to combine MRI finding with clinical characteristics.
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Objective To describe MRI findings of acute spinal cord decompression sickness.Methods MRI findings of 5 cases with clinical definite acute spinal cord decompression sickness were retrospectively analyzed.The main clinical informations included underwater performance history against regulations,short-term complete or incomplete spinal cord injury symptoms after fast going out of water,sensory disability and urinary and fecal incontinence,etc.Results Spinal cord vacuole sign was found in all 5 cases.Iso-signal intensity(n=3),high signal intensity(n=1),and low signal intensity (n=1)was demonstrated on T1 WI,and high signal intensity(n=5)was found on T2 WI.Owl eye sign was detected in 3 cases,and lacune foci were seen in 2 cases.Conclusion MRI findings of acute spinal cord decompression sickness had some characteristics,and it was easy to diagnose by combining diving history with clinical manifestations.