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Objective To summary the hospitalization costs of lung cancer patients, and analyze the influence factors in these patients, and provide basis for controlling hospitalization costs of lung cancer patients. Methods The hospitalization costs data of hospitalized lung cancer cases in Wuhan from 2018 to 2020 were collected from medical records. Nonparametric test was used to analysis the data for single factor analysis. The patients were divided into two groups according on the upper quartile value of hospitalization cost, that is high-cost group (the cost ≥ the upper quartile value) and normal cost group (the cost “four major hospitals in Hubei” respectively. The hospital type is an independent influencing factors, compared with specialized hospital, the OR is 4.726 for general hospital. The hospitalization days is the independent influencing factors, more hospitalization days has high cost. The treatment mode is the independent influencing factors, compared with non-operative treatment, the OR is 556.129, 18.156 and 5.212 for surgical model, radio therapy model and interventional model respectively. Conclusion The age, hospital level, hospital type, hospitalization days and treatment mode are the independent influencing factors of hospitalization costs. To reduce the hospitalization cost of lung cancer patients, we should standardize the diagnosis of lung cancer patients, and focus on standardizing the treatment mode, also considering other influencing factors, such as hospital level, hospital type.
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Objective:To investigate the application effect of 3D digital modeling combined with 3D printed model in assisting the classroom theoretical teaching of orthopedics in five-year undergraduate students majoring in clinical medicine.Methods:In May 2022, 33 five-year undergraduate students majoring in clinical medicine in the class of 2018 in Southwest Medical University were selected and divided into experimental group with 17 students and control group with 16 students according to the odd or even student number. The students in the experimental group were taught by traditional PPT+3D digital modeling combined with 3D printed model, and those in the control group were taught by the traditional PPT teaching method. The teaching effect was evaluated by theoretical examination and a questionnaire survey on the degree of satisfaction with teaching. SPSS 25.0 was used to perform the t-test, the Mann-Whitney U test, the rank sum test, and the chi-square test. Results:The experimental group had a significantly higher score of theoretical examination than the control group (86.24±4.16 vs. 82.50±6.06). The questionnaire survey on the degree of satisfaction with teaching showed that compared with the control group, the experimental group had a significantly higher degree of satisfaction with the understanding and learning of orthopedic diseases [3 (2, 3) vs. 2 (2, 2), P < 0.05], the improvement in learning interest [2 (2, 3) vs. 2 (1, 2), P < 0.05], classroom innovation [3 (3, 3) vs. 2 (1.5, 2), P < 0.05], and overall classroom teaching [3 (2, 3) vs. 2 (2, 2), P < 0.05]. Conclusion:In assisting the classroom theoretical teaching of orthopedics in undergraduate students majoring in clinical medicine, 3D digital modeling combined with 3D printed model can provide concrete 3D models, reduce the difficulties in learning, improve the awareness of orthopedic diseases, strengthen learning interest, and increase the degree of satisfaction with teaching and academic scores.
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Objective:To retrospectively analyze the independent risk factors of complicated appendicitis(CA)in children under five years old and establish a clinical prediction model, and to evaluate the clinical application of this model.Methods:A retrospective analysis was performed on children under five years old who underwent appendectomy at Children′s Hospital of Shanghai Jiao Tong University School of Medicine from January 2018 to December 2021.The children were divided into CA group and uncomplicated appendicitis group according to whether there was sign of perforation or gangrene in appendiceal tissue after operation.The differences in clinical features and preoperative laboratory test results between two groups were compared.The independent risk factors of CA were identified and a clinical prediction model was established.The clinical prediction model was verified by receiver operating characteristic curve.Results:A total of 140 children were enrolled in this study, including 84 cases in the CA group and 56 cases in uncomplicated appendicitis group.Univariate and binary Logistic regression analysis showed that the duration of symptoms>23.5 h( OR=6.650, 95% CI 2.469-17.912, P<0.05), abdominal muscle tension( OR=3.082, 95% CI 1.190-7.979, P<0.05) and C-reactive protein>41 mg/L ( OR=3.287, 95% CI 1.274-8.480, P<0.05) were independent risk factors for CA( P<0.05). The clinical prediction model of CA was constructed by the above mentioned three independent risk factors.The area under the receiver operating characteristic curve of the clinical prediction model was 0.881(95% CI 0.825-0.936), the sensitivity was 77.4%, the specificity was 87.5%, the positive predictive value was 91.3% and the negative predictive value was 70.0%. Conclusion:Acute appendicitis in children under five years old is more likely to progress to CA if the duration of symptoms>23.5 h, the level of C-reactive protein is increased, and the abdominal muscle tension is accompanied.The clinical prediction model of CA constructed by common clinical information in pediatric clinics has good prediction efficiency, which provides a simple and feasible reference method for clinicians to distinguish CA from uncomplicated appendicitis.
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Objective:To investigate and analyze the clinical characteristics of chronic liver injury and glutathione treatment in patients with coal-burning-borne arsenism.Methods:A total of 71 patients with liver injury caused by coal-burning-borne arsenism admitted to Binzhou People's Hospital from March 2017 to December 2018 were randomly divided into observation group (37 cases) and control group (34 cases) by lottery. Both groups of patients were given routine treatment, including intravenous infusion of compound amino acids, oral administration of B vitamins, etc., and intravenous infusion of 5.0 g of vitamin C mixture dissolved in 250 ml of 5% glucose, once a day, treatment for 4 weeks. In addition, the observation group was given an intravenous infusiondrip of 1.8 g of glutathione dissolved in 250 ml of 5% glucose, once a day, for 4 weeks. The clinical characteristics of the patients were observed, and the changes of liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL)], serum antioxidant indexes [malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)], and clinical efficacy before and after the treatment were compared between the two groups.Results:In 71 coal-burning-borne arsenism patients with liver injury, the abnormal rate of electrocardiogram (ECG) examination was 64.79% (46/71), and the abnormal rate of chest X-ray examination was 26.76% (19/71). After treatment, the liver function indexes ALT, AST, TBIL and DBIL decreased in both groups [observation group before treatment: (131.82 ± 25.62), (109.84 ± 26.28) U/L, (81.47 ± 20.93), (57.38 ± 15.25) μmol/L; observation group after treatment: (58.93 ± 12.03), (51.20 ± 10.57) U/L, (25.66 ± 7.94), (16.49 ± 4.92) μmol/L; control group before treatment: (128.95 ± 31.20), (107.39 ± 29.81) U/L, (83.21 ± 17.95), (55.39 ± 16.30) μmol/L; control group after treatment: (76.42 ± 15.73), (74.33 ± 14.80) U/L, (36.72 ± 9.32), (23.74 ± 7.35) μmol/L, P < 0.05], and the liver function indexes in the observation group were significantly lower than those in the control group after treatment ( P < 0.05). The serum antioxidant indexes MDA, SOD and GSH-Px in the two groups were significantly increased after treatment [observation group before treatment: (25.47 ± 3.98) μmol/L, (85.72 ± 23.54), (1 729.84 ± 379.50) U/L; observation group after treatment: (46.31 ± 7.49) μmol/L, (122.31 ± 28.53), (2 410.29 ± 512.31) U/L; control group before treatment: (26.02 ± 4.11) μmol/L, (84.95 ± 21.03), (1 749.52 ± 405.28) U/L; control group after treatment: (38.92 ± 6.27) μmol/L, (103.12 ± 25.68), (2 097.42 ± 478.52) U/L, P < 0.05], and the serum antioxidant indexes in the observation group were significantly higher than those in the control group after treatment ( P < 0.05). The total effective rate of the observation group was significantly higher than that of the control group [91.89% (34/37) vs 76.47% (26/34), χ 2 = 4.254, P < 0.05]. Conclusions:Coal-burning-borne arsenism patients with chronic liver injury may have multiple system injury at the same time. Glutathione can effectively improve the clinical symptoms and liver function of patients. Its effect may be related to the improvement of antioxidant function, which is worthy of clinical promotion.
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OBJECTIVE@#To analyze variation of ISL1 gene and explore its functional characteristics in relation with congenital heart defect (CHD).@*METHODS@#Clinical data and peripheral blood samples of 194 CHD patients and 232 healthy controls were collected for the extraction of genomic DNA. The coding exons and flanking intronic regions of the ISL1 gene were sequenced. Expression plasmid for the wild-type ISL1 gene ISL1-pcDNA3.1 was constructed, and the corresponding variants were obtained by site-specific mutagenesis. The gene expression plasmid was transfected into CHO cells with liposome, and the functional characteristics of ISL1 variant were studied by double luciferase reporter gene analysis.@*RESULTS@#A novel variant of the ISL1 gene c.499C>T (p.Q167X) was detected in a patient with sporadic CHD. Functional study showed that the variant has lost its transcriptional activation function for the MEF2C promoter.@*CONCLUSION@#A novel variant of the ISL1 gene related to CHD has been identified. The defect of ISL1 gene may underlay the pathogenesis for a proportion of CHD.
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Objective To evaluate the effect of a new schistosomiasis control strategy based on the infection source control in four-lake regions of Hubei Province. Methods The new strategy based on the infection source control included the safe water sup-ply,feces harmless treatment,replacing cattle with machine,captive livestock,chemotherapy,Oncomelania hupensis snail con-trol in susceptible areas,hardening ditches,etc,and the new control strategy was implemented for 7 years in 9 counties(cities or districts)of the four-lake regions. The schistosomiasis situations were investigated before and after the intervention of the new strat-egy. Results The coverage rates of feces harmless toilets(three format toilets),biogas digesters,and safe water supply were 42.00%,23.16% and 93.76%,respectively. The number of ditch hardening was 1 960;the area of eliminating snails was 1 378.42 hm2;the number of persons who received the health education was 3 524 818 accounting for 92.17%of the total popula-tion;the number of person-time of taking active protection measures was 516 636 963. The average annual decline rates of schisto-some infection were 24.42%and 38.38%in residents and cattle,respectively. The endemic villages decreased by 4.77%,the vil-lages with snails decreased by 7.05%,and the villages with snails accounted between 63.19%and 66.21%of the total endemic vil-lages. The area with snails decreased by 90.35%,and the advance schistosomiasis patients decreased by 5.55%,and the fatality rate of advanced schistosomiasis patients decreased by 1.24%. No acute schistosomiasis patients occurred. Type One and Two en-demic(heavy endemic)villages decreased to zero;Type Three endemic(moderate endemic)villages decreased by 10.22%;but Type Four endemic(mild endemic)villages increased by 66.38%;and Type Five endemic(no endemic for 5 years)villages de-creased by 0.22%. The standards of schistosomiasis transmission controlled have achieved on schedule. Conclusion The imple-mentation of the new schistosomiasis control strategy based on the infection source control in four-lake regions of Hubei Province can effectively control schistosomiasis.
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Objective To evaluate the protective effect of Fangyouling extracted from herb on Schistosoma japonicum in-fection in the field. Methods The residents in 2 villages Zhaonao Village and Miaochang Village were divided into Group A 139 persons and Group B 162 persons and the residents in Group A embrocated Fangyouling before their contacting the in-fested water and the residents in Group B did not. All the residents were investigated with questionnaires and received the blood and stool examinations for schistosomiasis. Results The positive rates of blood tests were 3.13%and 9.34%in Group A and Group B respectively, the positive rates of stool examinations were 1.92%and 6.44%in Group A and Group B respectively both P values<0.05 . Conclusion Fangyouling has a good protective effect on S. japonicum infection.
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BACKGROUND:Some scholars believe that anesthesia can improve the quality of cord blood separation and colection, and subarachnoid block is commonly used in cesarean section, but there is no research on the influence of subarachnoid block on differentiation potential of mononuclear cels into neural stem cels and astrocytes. OBJECTIVE: To study the influence of subarachnoid block on differentiation potential of mononuclear cels in the cord blood of neonates into neural stem cels and astrocytes. METHODS:Mononuclear cels isolated from 20 neonates delivered spontaneously and 20 neonates born by cesarean delivery undergoing subarachnoid block were culturedin vitro, acting as control group and study group. After delivery, cord blood samples were taken to isolate and culture mononuclear celsin vitro. After 3 days of routine culture, the cels were subject to non-induced culture and induced differentiation into neural stem cels. The cultured cels were identified by the cellmakers Nestin and glial fibrilary acidic protein with immunohistochemistry identification. RESULTS AND CONCLUSION:The Nestin and glial fibrilary acidic protein showed no difference between the two groups after induced differentiation (P > 0.05), indicating subarachnoid block has no impact on the differentiation of mononuclear cels in the cord blood from neonates into neural stem cels and astrocytes.
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Objective To identify novel mutations in the GATA6 gene associated with congenital atrial septal defects (ASD).Methods This was a case-control study.A cohort of 220 unrelated Han-race patients with congenital ASD and 200 unrelated ethnically matched healthy individuals used as controls,who were admitted to Tongji University Affiliated Tongji Hospital from January,2007 to October,2011,were recruited.The peripheral venous blood samples from the participants were prepared.All the coding exons and their flanking sequences of the GATA6 gene were amplified by polymerase chain reaction and sequenced using the di-deoxynucleotide chain termination technique.The acquired sequences were aligned with the sequences derived from GenBank by BLAST to identify the sequence variations.The software ClustalW was used to analyze the conservation of the altered amino acids.Results Three novel heterozygous missense GATA6 mutations,c.250G ＞A (p.A84T),c.649G ＞C (p.G217R) and c.1270A ＞C (p.S424R),were identified in 3 of 220 ASD patients,respectively.None of the three mutations was detected in 200 healthy control individuals.A cross-species alignment of GATA6 encoded protein sequences showed that the mutated amino acids were relatively conserved evolutionarily.Conclusion The identification of novel GATA6 mutations associated with ASD contributes to the reveal of the mechanism involved in the pathogenesis of ASD.
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14 years) in female. ICA-C4: (4.3?0.6) mm in male, (3.9?0.6) mm in female. A1 segment of anterior cerebral artery (ACA-A1): (2.1?0.4) mm in male, (2.1?0.4) mm in female. Anterior communicating artery (ACoA): (1.4?0.4) mm in male, (1.3?0.4) mm in female. M1 segment of middle cerebral artery (MCA-M1): (2.7?0.4) mm in male, (2.6?0.4) mm in female. Basilar artery (BA): (2.9?0.5) mm in male, (2.8?0.4) mm in female. P1 segment of posterior cerebral artery (PCA-P1): (2.1?0.5) mm on the left and (2.0?0.5) mm on the right in male, (2.0?0.3) mm on the left and (1.9?0.3) mm on the right in female. PCA-P2: (1.8?0.4) mm in male, (1.7?0.3) mm in female. Posterior communicating artery (PCoA): (1.1?0.3) mm in male, (1.2?0.4) mm in female. Among various diameters, only PCA-P1 had significant difference between the left and the right (P=0.003); only MCA-M1 (P=0.048), PCA-P1 (P=0.012), ICA-C2 (P=0.000) and C4 segments (P=0.000) had significant differences in gender, respectively; and only ICA-C2 had significant difference in age (P=0.001). Of these significantly different diameters, the diameters in male were larger than those in female. There were significant correlation between PCA-P1 and PCA-P2 (r=0.652,P=0.000), and between ICA-C2 and ICA-C4 in female group (r=0.550,P=0.000), respectively. Conclusions The normal values of diameter of cerebral arteries on MR angiograms may play a reference role in diagnosing cerebral vascular diseases.