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Objective:To investigate the assessment and occurrence of first-occured venous thromboembolism(VTE) among hospitalized patients.Methods:The clinical data of 6 532 surgical patients in Shenzhen Hospital, Peking University who were admitted from May 1, 2021 to June 30, 2021 were collected and analyzed retrospectively. The demographic data, Caprini score at admission and the incidence of VTE during hospitalization were analyzed by two independent sample t test and chi square test. Results:The Caprini score at admission of 6 532 patients was 1.81 ± 1.71. The number of cases in high, medium and low risks was 363 (5.6%), 1 189 (18.2%), 4 980 (76.2%), respectively. There was significant difference in VTE risk assessment scores and grades in different gender ( t=5.31, χ 2=48.31), length of stay ( F=195.21, χ 2=548.52) and hypertension ( t=17.07, χ 2=280.89), diabetes ( t=12.14, χ 2=51.18), smoking ( F=31.71, χ 2=53.23) and drinking ( F=18.78, χ 2=30.07) ( P<0.05). Forty-four(0.7%) patients got hospital-acquired VTE totally, among which, 24 cases (6.6%) were in high-risk, 14 cases (1.2%) were in medium-risk and 6 cases (0.1%) were in low-risk. What′s more, the top five VTE risky departments based on the assessment were not completely consistent with the top five departments with the highest incidence of VTE. Conclusions:The hospitalized patients are at high risk of VTE. The risk factors of diabetes, hypertension, smoking, drinking and other related factors should be included in the evaluation model. Meanwhile, the VTE risk assessment of in-patients should be emphasized and prophylactic treatments should be taken to reduce the incidence of VTE.
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Objective:To develop a negative emotion screening scale for inpatients(NESSI) and test its validity and reliability.Methods:Based on our previous studies and the theory model of psychological stress, the original item pool was established through literature review, expert interviews and patient consultation.The first version of NESSI was constructed by Delphi method, then initially tested in 421 inpatients followed by the project analysis and reliability test. After those above, the formal scale was developed and tested in 318 inpatients followed by confirmatory factor analysis and reliability test.Finally, 7-item generalized anxiety disorder scale (GAD-7), 9-item patient health questionnaire (PHQ-9), anger state expression scale (SAS) and simplified Chinese version of fear of disease progression scale(FoP-Q-SF) were used to test the criterion validity.Results:After exploratory factor analysis, 17 items were retained in the final scale, which can be categorized into four dimensions: fear of illness, depression, somatization and anger, which could explain 63.49% of the total variation.Confirmatory factor analysis showed that the fitting degree of each factor model was good and met the requirements of reference value (χ 2/ df=2.949, RMR=0.044, CFI=0.929, NFI=0.897, IFI=0.930, TLI=0.915, PGFI=0.655, RMSEA=0.078). The Cronbach's α coefficient of the total scale was 0.925, and the Cronbach's α coefficient of the four factors ranged from 0.762 to 0.898.The criterion validity showed that there was a significant positive correlation between the scale and the four criterion scales ( r= 0.574-0.805, all P<0.01). Conclusion:The NESSI scale has good reliability and validity, and can be used as a psychological problem screening tool among non-psychiatric inpatients.
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Objective To research the efficacy of alprostadil injection combined the octreotide for acute severe pancreatitis and influence on the serum levels of tumor necrosis factor-α(TNF-α),interleukin-6,interleukin-18,occludin.Method 68 cases of patients with acute severe pancreatitis from September 2013 to February 2017 in our hospital,according to the treatment method group,34 cases in each group,control group treatmented by octreotide,the research group based on the control group treatmented by alprostadil injection,both groups was treated for five days.Clinical curative effect,alleviate clinical symptoms time,TNF-α,IL-6,IL-18,occludin,and adverse reactions occur was compared between two groups.Results The total effective rate of research group was higher than the control group(97.07％vs.79.41％,P<0.05).Bowel sounds,stomach ache,body temperature and serum amylase remission time of research group was shorter than control group(P<0.05).TNF-α,IL-6,IL-18 of research group was lower than the control group(P<0.05),the occludin of research group was higher than the control group(P<0.05).The adverse reactions was no differences between the two groups.Conclusion The exact effect of alprostadil injection combined the octreotide for acute severe pancreatitis,improve serum levels of TNF-α,IL-6,IL-18,occludin.
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Objective To investigate the effects and partial mechanism of prednisone and TACI-Ig combination on MRL/Mpslac-lpr ( MRL/lpr) mice. Methods MRL/lpr mice were randomly divided into 6 groups, which includ-ed model group, prednisone (2. 5, 5. 0 mg/kg) group, TACI-Ig (15. 0 mg/kg) group, prednisone and TACI-Ig combination [(2. 5+7. 5) mg/kg, (2. 5+15. 0) mg/kg] group. BALB/c mice were set as normal group. Pred-nisone was given intragastrically everyday and TACI-Ig was given subcutaneously every two days for 13 weeks. In the meantime, the normal and model group were treated with an equal volume of normal saline. The general sign and proteinuria level were observed in the treatment period. The sections of spleen and kidney tissues for pathologi-cal analysis were stained with HE. Serum levels of auto-antibodies and BAFF were detected by ELISA kit. The per-centage of plasma cells and CD138 expression in the spleen were detected by flow cytometry analysis and immuno-histochemistry, respectively. Results The skin damage and the proteinuria level were improved and decreased by prednisone and TACI-Ig combination treatment. The spleen and kidney pathology were also improved including re-ducing germinal center formation and alleviating the glomerular fibrosis, mesangial cell hyperplasia and inflammato-ry cell infiltration, respectively. What was more, the percentage of splenic plasma cells ( CD19 -CD138 +) was re-duced significantly, which maybe resulted in the decrease in ANA. However the high level of anti-dsDNA antibody was not influenced by the combination treatment. The serum level of BAFF was also reduced by the combination treatment. Conclusion Prednisone and TACI-Ig combination treatment has a beneficial effect on murine SLE, which may be associated with the inhibition of plasma cell differentiation and the secretion of auto-antibody.
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Objective To investigate the satisfaction degree with nursing for discharged patients by telephone interview,and understand the nursing quality improvement during hospitalization of patients.Methods In January and December 2011,24 clinical departments were selected as the research object,10 patients were selected from each department.The questionnaires of satisfaction degree with nursing were adopted to investigate the satisfaction degree of patients by telephone interview.The difference of satisfaction degree with nursing were compared between January and December 2011.Results Compared with the results of January,there were statistical differences in overall mean score of satisfaction degree and the dimensions of service attitude,knowledge information,ward management and working ability.While the means of dimensions of basic nursing care and care-taking patient were in high levels.Conclusions The method of telephone interview to investigate the satisfaction degree of discharged patients is direct,real and objective.It is convenient for the hospital to understand the nursing quality and existing problems during hospitalization of patients,and offers scientific way for continuous improvement of nursing service.
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Objective To detect biomarker proteins in relation to metastasis by comparing serum protein profiles of primary colorectal cancer patients with or without metastasis. Methods A total of 219 serum samples were analyzed using surface enhanced laser desorption ionization time of flight mass spectrometry(SELDI-TOF-MS).The samples were divided into two groups:the training group consisting of 57 primary colorectal cancer patients、63 metastatic colorectal cancer patients and 42 healthy controls,and the test group consisting of 26 primary colorectal cancer patients and 31 metastatic colorectal cancer patients.Samples in training group were analyzed to identify serum biomarker proteins which could differentiate colorectal cancer patients with or without metastasis.The sensitivity and specificity of biomarker proteins were examined by results from blind test group. Results In the m/z region of 2000～30000,31 proteins had statistically significant difference between primary colorectal cancer patients and healthy controls.The m/z of difierentiated proteins were respectively 3240.7、9289.3、5334.4、4596.1 and 4792.4 according to P value.38 proteins had statistically significant diffefence between metastatic colorectal cancer patients and healthy controls.The m/z of differentiated proteins were respectively 3240.7、9289.3、9184.4、3191.5 and 9340.9 according to P value.Only two protein peaks(9184.4 and 9340.9)were found of statistical difference between primary eolorectal cancer patients and metastatic colorectal cancer patients.The sensitivity and specificity of the combination use of the two biomarkers were respectively 90.3% and 88.5% in the test group. Conclusion SELDI-TOF-MS was helpful to find protein biomarkers with relation to metastasis in colorectal carcinoma patients.
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Objective To investigate clinicopathological and neuroimaging features of meninheal malignant melanosis.Methods The cytologic study of cerebrospinal fluid(CSF)and neuroimaging examination and meningeal histochemistry were performed in 3 cases of meningeal malignant melanosis. Results Three patients were found to have initial onsets of headache.followed by meningeal irritation.One case had huge malignant melanoma on skin.The second patient had diabrotic malignant melanoma on her face,which did not healed for a long time.The third patient had no malignant melanoma on skin and viscera.The MRI enhanced scanning of all 3 cases showed abnormal enhancement of meninge.There were a large number of abnormal shape cells in CSF.The meninxes were blackbrown or brown.The tumor cells were in various shapes with big and round irregular nucleus and rich cytoplasm.There were a great quantitv of melanosomes.The tumor cells were disarranged. Immunohistochemistry analyses found S-100 protein and Vim and HMB-45 were positive reaction. Conclusions The patients with meningeal malignant melanosis have an initial onset of headache,followed by meningeal irritation,and MRI enhanced scanning plays a valueble role in the diagnosis.A lage number of tumor cells in abnormal shape have been found in CSF.Thetumour cells of meninx presents different shapes with big and round or irregular nucleus.There are a great quantity of mellanosomes,and the tumour cells are arranged in a state of chaos.
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Objective To study the clinical and pathological manifestations of microsporidian encephalitis.Methods The clinical findings and the brain pathological features of a patient with microsporidian encephalitis hospitalized in 2004 were studied.Results The onset was subacute or chronic. The body temperature was usually normal or below 37.5℃,but it rose when patient's condition deteriorated and coma appeaxed.The patient had hypoimmunity but without human immunodeficiency virus infection. Multifocal lesions in the whole brain,signs of meningeal irritation and infective myelogram were observed. Rheumatoid factor increased in the early stage and indirect bilirubin,proteins in cerebrospinal fluid(CSF), and immunoglobulin IgG,IgA increased in the middle stage.Cytological examination of CSF showed lymphocyte reaction.Blood routine test showed normal eosinophil granulocyte count.The patient was found to have pleurisy,peritonitis and cystitis.Brain magnetic resonance image(MRI)manifested plaque-like isometric T1 weight image and long T2 weight image signal in white matter of bilateral cerebral hemisphere and cerebella where FLAIR sequence showed hyperintensity.No apparent mass was identified.Contrast- enhanced MRI scan showed patchy and ring-like intensification.The neural system impairments were permanent and not improved after treatment.The pathology of brain tissue showed neuronal degeneration, karyopycnosis and Derivasculitis.The infectious agents were observed in the cytoplasm of neurons.Wister rats had muhiple organ inflammatory reaction 2 weeks after intraperitoneal inoculation of the patient's CSF and a large quantity of pathogens were found in the peritoneal lavage fluid.Conclusions The patient was PAS staining method is useful for detecting the pathogen in neurons and the rate can be raised by animal intraperitoneal cultivation
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Objective To investigate the function and clinical significance of platelet-derived microparticles (PMP), glycoprotein(GP)Ⅱb-Ⅲa, PagT and blood-lipid in whole blood of patients with cerebro-thrombotic diseases before and after treatment. Methods The quantity of PMPs, activation ratio of GPⅡb-Ⅲa and PAgT were measured before and after treatment of cerebro-thrombotic patients by using flow cytometry and platelet adhesion instrument. Blood-lipid concentration was measured by automatic-biochemical analyzer. Results PMP, GPⅡb-Ⅲa , PAgT, TC, TG, and LDL were (223?54)/10 4 Plt, (77.98?14.22)%, (69.78?16.93) %, (5.12?0.85) mmol/L, (1.78?0.28) mmol/L, and (3.49?0.66) mmol/L respectively before treatment; and were (136?18)10 4Plt, (40.71?11.64) %, (58.12?12.51)%, (4.84?0.73) mmol/L, (1.43?0.33) mmol/L, and (3.03?0.62) mmol/L,respectively in the treatment group. These parameters were significantly decreased than that before treatment (P
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0.05). Conclusion The extract technology is basically reasonable,and need further improvement.