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Objective:To investigate the change of D-Dimer (D-D), cardiac troponin I (cTnI) and vasoactive-inotropic score (VIS) after Stanford type A aortic dissection (TAAD) and thier predictive effect on death outcome.Methods:120 patients with TAAD who were treated in the Affiliated Hospital of Jining Medical College from January 2019 to January 2022 were retrospectively selected and divided into death group ( n=17) and survival group ( n=103) according to the 28-day survival after operation. The difference of clinical data between the two groups was compared, and the influencing factors of postoperative death in TAAD patients were analyzed by logistic regression method. Results:The age, deep hypothermic circulatory arrest time, D-D and cTnI of the patients in the death group were (60.50±5.42)years old, (30.40±9.92)min, (15.65±5.52)g/L and (3.32±0.82)mg/L, respectively, which were significantly higher than those in the survival group (all P<0.05). The VIS score and change of VIS score in the death group at 24 hours after operation were (9.66±1.10)points and (4.50±0.91)points respectively, which were significantly higher than those in the survival group (all P<0.05). Logistic regression analysis showed that age, D-D, cTnI and change of VIS score were the influencing factors of death after TAAD (all P<0.05). The area under the receiver operating characteristic (ROC) curve predicted by the D-D, cTnI and change of VIS score for death in TAAD patients was 0.718, 0.691 and 0.789 respectively (all P<0.05). Conclusions:Postoperative death of TAAD patients is affected by their age, D-D, cTnI and change of VIS score. The D-D, cTnI and change of VIS score have certain application value in predicting postoperative death of patients.
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Objective To evaluate the prevalence and risk factors of progressive liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).Methods A total of 2 054 subjects who underwent health check up and were diagnosed as NAFLD in 9 institutions were included in the study.Blood routine and biochemical findings were collected to calculate aspartate aminotransferase-to-platelet ratio index (APRI).Subjects were divided into three groups according to diagnostic threshold of liver fibrosis:APRI ＜0.43 group,APRI 0.43-0.53 group and APRI ≥ 0.54 group.The correlation between APRI and biochemical variables was analyzed,and the risk factors of progressive fibrosis were also analyzed.Results Among 2 054 subjects (male/female 1 598/456) there were 61 cases with APRI ≥ 0.98 (2.97％,progressive fibrosis),318 with APRI ≥0.54 (15.48％),1 475 with APRI ＜ 0.43 (71.81％),261 with APRI 0.43-0.53 (12.71％).Logistic stepwise regression analysis showed that TG (P =0.002,OR =1.095,95％CI:1.033-1.161),2 hPG(P =0.000,OR =1.103,95％ CI:1.058-1.151,BUN(P =0.034,OR =1.215,95 ％ CI:1.014-1.454) were risk factors,and H DL-C (P =0.034,OR =0.353,95 ％ CI:O.135-0.924) was a protective factor for the progression of fibrosis.Conclusion The progressive fibrosis in patients with NAFLD is closely associated to blood glucose and lipid metabolism disorder.
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Objective To explore the effect of dinoprostone suppositories and oxytocin on cervical maturation and delivery outcome in induction of labor in late pregnancy.Methods A total of 174 pregnant women in the department of obstetrics and gynecology in our hospital for treatment in late pregnancy were chosen.They were randomly divided into two groups: the control group 85 cases and the study group 89 cases.The control group was treated with routine induction of intravenous infusion of oxytocin, and the study group was taken with dinoprostone suppositories.The effective rates of induction of labor and the incidence of adverse reactions after induction of labor induced of the two groups were observed.The clinical effect of patients was with Bishop score to determine cervical maturity.The induction of labor time, natural childbirth rate, cesarean section rate, maternal postpartum hemorrhage and neonatal asphyxia score were as the evaluation criteria of childbirth outcome.Results The cervical maturation level was (7.26 ±1.82) after drug for 24 hours in the study group, significantly higher than that of the control group (6.34 ±1.37) (P<0.05).The induction time, spontaneous delivery rate and cesarean section rate of the study group were (6.34 ±1.37)h, 86.52%, 13.48%, significantly better than those in the control group (P<0.05).The average amount of bleeding in the study group was (225.96 ±12.81) mL and the neonatal asphyxia score was (9.73 ±0.15), the results were lower than the control group (P<0.05).The successful rate of induction of labor in the study group was 96.63%) higher than that in the control group 85.88%.The incidence of side effects in the study group was 10.11%, significantly lower than in the control group 21.18% (P<0.05), which were with statistical significance.Conclusion Dinoprostosterone suppositories have the advantage of promoting cervical ripening for late pregnancy in pregnant women compared with oxytocin.It can shorten induction time and improve natural childbirth rate.And the maternal prognosis is good, can be used as a safe and effective clinical induction.
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Objective To assess the screening capacity of Ezscan for abnormal glucose metabolism .Methods A total of 1 732 permanent residents of Chongqing city underwent physical examination from August 2013 to August 2014 were selected as subjects ,questionnair survey ,physical examination and Ezscan measurement were performed .Additionally ,the levels of fasting blood‐glucose(FPG) ,OGTT 2h blood glucose ,HbA1c and serum lipid were detected .Results The prevalence rate of abnormal glucose metabolism for residents with high Ezscan score was higher than that in those with low Ezscan score .The AUC of Ezscan screening for abnormal glucose metabolism was 0 .616 ,the optimum diagnosis tangent point was 24 .0% ,the sensitivity was 67 .0% .The optimum diagnosis tangent point of FPG was 5 .5 mmol/L for abnormal glucose metabolism ,the sensitivity and speci‐ficity was 70 .5% and 61 .7% respectively ,and the AUC was 0 .824 .The sensitivity of FPG for screening abnormal glucose metabo‐lism was 47 .2% ,when the cut‐off value of FPG was 6 .1 mmol/L .Conclusion The sensitivity of Ezscan for screening abnormal glucose metabolism is higher than that of FPG (when the cut‐off value was 6 .1 mmol/L) ,Ezscan can be used as an efficiency meth‐od for early detection of abnormal glucose metabolism in the asymptomatic population .
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Objective To observe the occurrence of nosocomial infection in maternal hospital cesarean deliv-ery situation,analyze risk factors of hospital infection,and to explore the corresponding prevention measures.Methods The clinical data of 943 lying -in women with cesarean section were retrospectively analyzed.The conditions of hospi-tal infection occurred were observed,the risk factors for nosocomial infection were analyzed.Results 73 cases occurred maternal hospital infection,the infection rate was 7.74%.The infection occurred at surgical site in 41 cases, 11 cases occurred in urogenital system,6 cases occurred in the respiratory system,10 cases occurred respectively in the digestive system,skin and nervous system.More than 2 times of cesarean delivery operation,too large age,with basic diseases,low medical staff operation proficiency,not using antibiotics,too long time of hospital stay,too long time of placing a urinary catheter were independent risk factors of hospital infection after cesarean section(OR =0.223, 0.670,1.850,6.062,0.302,2.190,3.583,all P <0.05).Conclusion The incidence rate of hospital cesarean sec-tion maternal hospital infection are rising year by year,so the medical personnel should aim at the risk of infection fac-tors,take corresponding prevention measures,so as to effectively reduce the incidence of infection.
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Objective To investigate the prevalence rate of hypertension ,overweight ,obesity and obesity/overweight ,thus to explore the relationship between hypertension and sleeping time .Methods Healthy individuals having physical examinations in Health Management Center of Southwest Hospital were randomly selected to take questionnaire and physical examination ,and then we analyzed the correction relationship of hypertension and sleeping time .Results The prevalence of overweigh ,obesity ,hyperten‐sion and perhypertension was 36 .68% ,11 .36% ,22 .14% and 33 .43% respectively .The prevalence rate of hypertension for men was 2 fold as that of women .There was a negative correlation between hypertension and sleeping time .The prevalence of stage 2 hypertension tended to U.People who sleep time less than 5 h have more risk for Isolated systolic hypertension than who sleeping 6 h .Conclusion There is a high risk of hypertension and stage 2 and stage 3 hypertention for people whose sleep time less than 5 h or more than 10 h .
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Objective To explore the association between waist-to-height ratio (WHtR) and dyslipidemia in Chinese adults and to find out an optimal threshold of WHtR for predicting dyslipidemia.Methods A total of 221 270 adults from 4 health checkup centers nationwide were selected by using cluster random sampling method.Height,body weight,waist circumference (WC),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol(LDL-C) were measured.Body mass index (BMI) and WHtR were then calculated.The area under the receiver operating characteristic curve(AUC) was analyzed and optimal cutoffs were estimated by maximizing the sums of sensitivity and specificity.Results WHtR showed the largest AUCs in the participants with higher TC,TG and LDL-C,followed by increased WC and BMI.In male and female,the optimal thresholds of WHtR,WC and BMI for predicting dyslipidemia were 0.49-0.50 and 0.47-0.49,83-85and 73-76 cm,and 24-25 and 22-23 kg/m2,respectively.Conclusion WHtR may be superior to WC and BMI for predicting dyslipidemia,and an unisex cutoff of 0.5 should be recommended.
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Objective To investigate current health status of civil servants from Chongqing.Methods A total of 62 169 adult civil servants who received health check-up during three consecutive years from January 1 st 2008 to December 31 st 2010 in Chongqing were assigned to five age groups to examine health conditions.Differences of parameters were compared among the groups.Results The top five commonly seen diseases or disorders were as follows:hypertension (24.25％,15074/62169 ),fatty liver ( 23.80％,14798/62169 ),hypertriglyceridemia ( 22.66％,14090/62169 ),hyperuricemia ( 18.19％,11307/62169 ),and osteoporosis ( 14.95％,9293/62169 ).The incidence of abnormal blood pressure,fatty liver,hypertriglyceridemia,hyperuricemia,osteoporosis/bone loss,abnormal glucose metabolism,and hyperlipidemia of male civil servants was much higher than that of female participants (P ＜0.01 ).In men,the incidence of abnormal blood pressure,osteoporosis,and abnormal glucose metabolism was increased with age.Fatty liver,hypertriglyceridemia,and hyperlipidemia were most identified in the 41 -50age group.The highest detection rate of hyperuricemia was found in young men.Conclusions The incidence rates of hypertension,fatty liver,hypertriglyceridemia,and hyperuricemia are higher in civil servants from Chongqing.Education and intervention should be strengthened to improve the health of this population.
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Objective To explore the correlation between ultrasonographic findings and relevant technical factors in traumatic lipohemarthrosis. Methods Fifty-two patients with traumatic lipohemarthrosis underwent ultrasonic examination in supine position (26 in unbent, 16 in external rotary position, 10 in unbent and 45° rotation) before operation, and 22 of them underwent dynamic examination. Findings of ultrasography were compared with manifestations of MRI and CT regarded as gold standard.Results Fifty-two patients with traumatic lipohemarthrosis were diagnosed correctly. The best effect of ultrasonic examination of lipohemarthrosis was observed on suprapatellar bursa. Superior border of patella were showed well in supine straight position, then turned to the level of patella, and the structure below patella were showed badly. The best posture was in supine genuflex position with 45° rotation when the joint effusion presented, by which thicker layer liquids could be displayed than in straight position. Three layer liquids could not be displayed synchronously in mild external rotary rest position of lower extremity, and the combination of findings at internal and external side were favorable to the diagnosis. Liquids bed changed from one layer to two layers and then to three layers, from fuzzy to clear gradually in dynamic examination.Conclusion Ultrasonic manifestations of traumatic lipohemarthrosis are closely correlated to the position, posture and arresting time during examination.
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Objective To observe the changes of apoptosis and caspase 3 activity in cardiomyocytes of rats at different time points after transient ischemia and the effects of caspase 3 inhibitor Ac DEVD CHO on reperfusion injury Methods A total of 122 rats were divided randomly into 3 groups: IR group, IR+Ac DEVD CHO group and sham group The ischemic samples were observed at 30 min after ischemia followed by reperfusion at 1, 3, 6, 12 and 24 h The apoptotic cardiomyocytes, the activity of caspase 3 and the myocardial infarction area were determined by TUNEL method, fluorescent assay and TTC dyeing method, respectively Results Apoptosis index(AI) of cardiomyocyte and caspase 3 activity changed in a time dependent manner Highest AI and caspase 3 were found after reperfusion at 12 h The myocardial infarction area in group IR kept increasing during the period of reperfusion AI and caspase 3 activity were positively correlated with the myocardial infarction area( P
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Objective To evaluate the usefuluness of the color Doppler flow imaging(CDFI) in subclinical atrial septal defects(ASD).Methods We reviewed 122 cases of subclinical ASD in adult which were first detected with CDFI.Results We found most of the patients were women and elder people,and no more special clinical symptoms and signs can be found.Color Doppler flow imaging had characteristic abnomallities making the dosis of ASD possible and easily with a high degree of accuracy in patients in whom the clinical presentation was atypical different magnitudes of left-to-right shunt were revealed in all these patients.Conclusion CDFI is a good noninvasive technique in the diagnosis of subclinical atrial septal defects.
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1. ③Higher examining rate of Ar wave was detected in acute phase in KD. ④V D was improved reversibly in convalescence phase. ⑤MVF showed that only E/A in acute phase in KD was lower than that of normal group. Conclusions It is available and valuable to combine PVF and MVF to assess left ventricular diastolic function in KD.
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Objective To study the RI value in HA to ocular blood flow in posthepatitis cirrhosis by CDFI.Methods The RI value of HA,OA,PCA,CRA in 32 normal person,102 posthepatitis cirhosis patients were studied by CDFI(U.S.A.Sequoia 512).Results The value of RI between HA to OA,PCA and CRA was 0.88,0.88,0.93 respectively.Conclusion A direct relationship is found between RI value of HA to ocular vascular,especially in HA to CRA.