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Objective:To detective the cut-off values of amino acid levels in premature infants in Sichuan.Methods:Data of newborns screening for inherited metabolic diseases (IMD) by tandem mass spectrometry in Sichuan Province from January 2018 to December 2019 were retrospectively analyzed.They were divided into premature infant group ( n=2 264, 1 312 males and 952 females) and full-term infant group ( n=53 275, 28 269 males and 25 006 females). The cut-off values of amino acids in dry blood spots were expressed as percentage ( P0.5 - P99.5), and rank sum test was used for comparison between preterm and full-term infants. Results:(1) The distribution of 11 amino acids [alanine (ALA), arginine (ARG), citrulline (CIT), glycine(GLY), leucine (LEU), methionine (MET), ornithine (ORN), phenylalanine (PHE), proline (PRO), tyrosine (TYR) and valine (VAL)] in premature infants were abnormal.(2) The cut-off values of amino acids in premature infants were as follows: ALA: 135.20-552.33 μmol/L, ARG: 1.34-47.04 μmol/L, CIT: 5.66-32.02 μmol/L, GLY: 181.48-909.93 μmol/L, LEU : 71.10-283.29 μmol/L, MET: 4.21-34.51 μmol/L, ORN: 40.58-293.76 μmol/L, PHE: 23.60-106.30 μmol/L, PRO: 77.76-358.24 μmol/L, TYR: 27.52-352.91 μmol/L, VAL: 53.74-228.37 μmol/L.(3) The cut-off values of amino acid in full-term infants were as follows: ALA: 135.20-552.33 μmol/L, ARG: 1.30-42.73 μmol/L, CIT: 5.92-30.35 μmol/L, GLY: 208.17-980.09 μmol/L, LEU: 72.91-287.49 μmol/L, MET: 4.27-33.90 μmol/L, ORN: 48.40-305.59 μmol/L, PHE: 27.63-92.27 μmol/L, PRO: 97.38-372.75 μmol/L, TYR: 40.19-276.54 μmol/L, VAL: 65.75-237.92 μmol/L.(4) Except for PHE ( Z=-0.58, P>0.05), the other indicators were significantly different between 2 groups [ALA ( Z=-15.32, P<0.05), ARG ( Z=-5.62, P<0.05), CIT ( Z=-5.86, P<0.05), GLY ( Z=-14.52, P<0.05), LEU ( Z=-5.62, P<0.05), MET ( Z=-5.22, P<0.05), ORN ( Z=-13.01, P<0.05), PRO ( Z=-22.09, P<0.05), TRY ( Z=-2.09, P<0.05), VAL ( Z=-17.82, P<0.05)]. Conclusions:The establishment of the cut-off values of amino acids in premature infants in Sichuan provides a theoretical basis for laboratory diagnosis of IMD screening, which enhances the accuracy of diagnosis and avoids excessive medical treatment.
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Objective:To explore the change characteristics of amino acid levels in neonates, so as to provide theoretical basis for accurate clinical interpretation.Methods:By preliminary screening and diagnosis from 32 855 newborns, 32 843 samples were collected using tandem mass spectrometry to inherited metabolic disease (IMD) scree-ning in Sichuan Province from January to December 2018.Afterwards, according to gestational age (1 363 premature infants, 31 468 full-term infants and 12 overdue infants), blood collection time (3-7 days old, 3 095 cases, 8-28 days old, 1 637 cases, and more than 28 days old, 248 cases) and season (7 737 cases in the first quarter, 11 428 cases in the second quarter, 5 482 cases in the third quarter, and 8 196 cases in the fourth quarter), neonates were divided into different study groups.The difference of amino acid level in each group was compared, and the correlation between various influencing factors and metabolic index was analyzed.Results:(1) The distribution of 11 amino acids [alanine(ALA), arginine(ARG), citrulline(CIT), glycine(GLY), leucine+ isoleucine+ hydroxyproline (LEU+ ILE+ PRO-OH), methionine(MET), ornithine(ORN), phenylalanine(PHE), proline(PRO), tyrosine(TYR), and valine(VAL)] in neonates showed non-normally distribution.(2)The distribution of 11 amino acids in different gestational age were tested by nonparametric test, except for PHE( H=0.61, P>0.05)and TYR( H=2.02, P>0.05), and other indicators were significantly different [ALA( H=187.11, P<0.05), ARG( H=23.60, P<0.05), CIT( H=22.90, P<0.05), GLY( H=85.18, P<0.05), LEU( H=56.42, P<0.05), MET( H=18.74, P<0.05), ORN( H=129.27, P<0.05), PRO( H=344.40, P<0.05), and VAL( H=272.92, P<0.05)]. (3) The distribution of 11 amino acids in different blood collection time were significantly different [ALA( H=65.19, P<0.05), ARG( H=404.48, P<0.05), CIT( H=502.13, P<0.05), GLY( H=1 719.44, P<0.05), LEU( H=396.41, P<0.05), MET( H=199.39, P<0.05), ORN( H=31.26, P<0.05), PHE( H=325.49, P<0.05), PRO( H=70.09, P<0.05), TYR( H=159.29, P<0.05), and VAL( H=102.52, P<0.05)]. (4) The distribution of 11 amino acids in different birth seasons were significantly different [ALA( H=401.37, P<0.05), ARG( H=3 229.03, P<0.05), CIT( H=65.45, P<0.05), GLY( H=597.82, P<0.05), LEU( H=1 120.42, P<0.05), MET( H=10 515.18, P<0.05), ORN( H=1 275.23, P<0.05), PHE( H=2 260.17, P<0.05), PRO( H=319.57, P<0.05), TYR( H=884.37, P<0.05), and VAL( H=1 824.49, P<0.05)]. Conclusion:According to different gestational age, season and blood collection time, the metabolism of amino acids in neonates was different.When using tandem mass spectrometry for detection, appropriate interpretation criteria should be selected based on different conditions.
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Objective@#To investigate the adrenocortical function changes of patients with advanced solid tumors who received the anti- programmed cell death protein-1 (PD-1) antibody, SHR-1210 therapy.@*Methods@#The clinical data of 98 patients with advanced solid tumors who were enrolled in a prospective phase I trial of SHR-1210 therapy at our institution between April 27, 2016 and June 8, 2017 were collected. The levels of plasma adrenocorticotropic hormone (ACTH) and cortisol were evaluated in 96 patients. The clinical manifestations, laboratory tests and radiologic data were collected to define the immune-related adrenal insufficiency.@*Results@#Until December 14th, 2018, no SHR-1210 related primary adrenal insufficiency occurred, and the incidence of immune-related secondary adrenal insufficiency was 1.0% among the 96 patients, which was identified as grade 2. No patient developed grade 3-4 adrenal insufficiency. The main clinical manifestations of the patient who was diagnosed as secondary adrenal insufficiency were grade 2 fatigue, anorexia and headache.The patient developed fatigue and anorexia at the 267th day after receiving the first dose of SHR-1210, the hypocortisolism occurred on the 279th day, and the headache emerged on the 291th day. The anorexia of patient who treated by physiological replacement doses of glucocorticoid since the 457th day was attenuated.The patient whose cortisol level was still below the normal limit continued to accept the hormone replacement therapy up to 776 days after the initial administration of SHR-1210.@*Conclusions@#The incidence of SHR-1210 related adrenal insufficiency of patients with advanced solid tumors is low, and the symptoms can be effectively ameliorated by hormone replacement therapy. The potential adverse outcome of adrenal insufficiency following immunotherapy should be noticed by clinicians to avoid the occurrence of adrenal crisis.
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Objective@#To assess the incidence and characteristics of thyroid dysfunction during anti-Programmed cell death 1 receptor (PD-1) antibody SHR-1210 therapy in patients with advanced solid tumor.@*Methods@#The medical records of 98 patients who initiated SHR-1210 treatment between April 27, 2016 and June 8, 2017 in the phase 1 trial to evaluate the safety, efficacy, and pharmacokinetics of SHR-1210 in patients with advanced solid tumors were retrospectively reviewed. Serological tests of thyroid stimulating hormone (TSH) and free thyroxine (fT4) were measured at baseline and prior to each SHR-1210 administration.@*Results@#A total of 86 patients had normal thyroid function before the first dose of SHR-1210 treatment. Nine out of 86 (10.5%) patients developed new onset hypothyroidism from euthyroid state. 12 patients presented thyroid dysfunction at baseline, 10 of whom were subclinical hypothyroid and 2 were hypothyroidism. Four out of 10 patients developed hypothyroidism from subclinical hypothyroid. Most patients with hypothyroidism were asymptomatic. Thyroid dysfunction occurred early (median, 55days) after the initiation of SHR-1210. The severity of hypothyroidism were all grade 1-2. No grade 3-4 hypothyroidism occurred. No patients discontinue the treatment of SHR-1210 due to clinical impact of the thyroid dysfunctions.@*Conclusions@#Thyroid-related adverse events were common during anti-PD-1 antibody SHR-1210 treatment . The incidence of hypothyroidism is lower in patients with euthyroid state than in patients with thyroid dysfunction at baseline during SHR-1210 treatment . Thyroid function can be improved after thyroid hormone replacement. During SHR-1210 treatment, it is necessary to pay attention to monitor the thyroid function, especially in the patients with thyroid dysfunction at baseline.@*Trial registration@#Chinese Clinical Trial Registry, 2016L01455
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Objective To investigate the effect of sequential therapy of linezolid and teicoplanin for the treatment of the severe pneumonia induced by gram-positive coccus.Methods From September 2014 to August 2017,0 cases of severe pneumonia patients in the Traditional Chinese Medicine Hospital of Zhoushan were gram positive coccus,tumbled to rina amine for patients treated with intravenous drip,the course of treatment was 7 days,and then intravenous drip their stead better treatment,treatment for 7 days,the clinical situation of patients before and after treatment respectively,the characteristics of signs and adverse reactions were analyzed.Results Among the 51 cases (63.75％),19 cases (23.75％),8 cases (10.00％),and 2 cases (2.5％),the total effective rate was 87.5 ％.In the distribution and clearance rate of pathogenic bacteria,the bacterial clearance rate of liniazolamide and the replacement of gram-positive coccus pneumoniae was 87.50％.There was no other adverse reaction.Conclusion Sequential therapy of linezolid and teicoplanin for the treatment of the severe pneumonia induced by gram-positive coccus has several good effects,high clearance rate of pathogenic bacteria,good security.
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Objective Analyzed from row stone soup combined tan solo symplectic auxiliary row stone calculi in patients with ureteral Duan Jieshi under net rate and the influence of renal colic, so as to provide the basis for clinical treatment.Methods 90 patients with ureteral Duan Jieshi under in our hospital from January 2014 to February 2016 were selected, urology clinic of according to random, the principle of equal distribution is divided into group A (from row stone soup combined tan solo symplectic group) and group B (pure tan solo symplectic group), group C (pure traditional Chinese medicine medicinal broth group), 30 cases in each group.Observe and record the bladder irritation, frequent urination urgency), ureteral colic, discharge time, stones row net rate and incidence of adverse reactions after the comparison.Results In group A discharge time and stones row net both significantly better than B and C groups, the difference was statistically significant (P<0.05); the discharge time and stones row net between group B and C was no statistically significant difference.Group C on frequent urination urgency and ureteral colic happens to have more of A and B groups, the difference was statistically significant ( P <0.05 ); there was no statistically significant difference between group A and B.Adverse reaction of three groups of appeared in the process of treatment: group A in one case of mild diarrhea and one case of mild dizziness , group B in one case of mild headache and one case of mild dizziness, group C not present any adverse reaction, there were no significant differences in the incidence of adverse reactions among the three groups.Conclusion From row stone soup with tan solo symplectic auxiliary platoon stone therapy has good effect for patients with ureteral Duan Jieshi under, can give full play to the acetanilide spasmolysis effect of western medicine, also can better exert TCM row Shi Tong drench, analgesic anti-inflammatory, clear the role of the hot and humid, can improve the stone free rate, relieve patients with renal colic.
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Objective To investigate the current status of the willingness of organ donation among floating population in Guangdong Province and explore its influence factors.Methods The questionnaire survey was conducted to investigate general information of the floating population and their willingness of organ donation,knowledge of organ donation,attitude towards organ donation and death as well as the willingness of family discussion (organ donation),etc.The correlation analysis of variables and the willingness of organ donation in floating population was conducted by Spearman rank correlation,and the multivariate analysis was conducted by multiple linear regression model.Results Among the floating population,the people who were female,from city,owned an average monthly household income per capita of RMB 4 001 -5 000 yuan,got acquaintance with the organ donors or their families,got acquaintance with accepted the organ donors or their families had higher willingness of organ donation (all in P <0.05 ).Scores of the willingness of organ donation,knowledge of organ donation,attitude towards organ donation and the willingness of family discussion were 1.95 ± 0.91 ,5.02 ±2.40,92.00 ±1 6.78 and 3.98 ±1 .28 respectively.The willingness of family discussion,knowledge of organ donation and recognition of the value of organ donation showed positive correlation with the willingness of organ donation (P <0.05-0.01 ).The cause hindering organ donation and fear of death showed negative correlation with the willingness of organ donation (all in P <0.01 ).Five variables were integrated into the multiple linear regression analysis model,including willingness of family discussion,knowledge of organ donation,recognition of the value of organ donation, cause hindering organ donation and fear of death.Conclusions The willingness of organ donation among the floating population in Guangdong Province is on or below the medium level,and its influence factors include willingness of family discussion,knowledge of organ donation,recognition of the value of organ donation,cause hindering organ donation and fear of death.
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Objective To evaluate the efficacy and safety of Shenqi Fuzheng injection in the treatment of patients with laparoscopic gastric cancer. Methods A total of 94 cases with laparoscopic gastric cancer included in this study were divided into control group and experimental group with 47 cases in each group.The patients in both groups received laparoscopic gastric carcinoma.Patients in control group received fluorouracil, leucovorin and oxaliplatin infusion( FOLFOX4 ) chemotherapy and patients in the experimental group revieved Shenqi Fuzheng injection.Both groups received two courses treatment of 14 days for one course.The clinical efficacy, inflammatory levels, tumor indicators and adverse drug reactions were compared between the two groups.Results The clinical efficacy in experimental group was 95.74%, which was significantly higher than that in control group 82.98%(P<0.05 ) .The serum level of serum serum albumin (ALB), prealbumin (PA), glutathione-S-transferase (GST), carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) after treatment in experimental group were lower than the control group (P<0.05) .The adverse drug reactions was not statistically different between the two groups.Conclusion Shenqi Fuzheng injection has significant efficacy in the treatment of laparoscopic gastric cancer with high safety.
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Objective To analyze the effect of clinical pathway of nursing on health education in patients undergoing tonsil-lectomy.Methods Participants included 180 patients undergoing tonsillectomy in our hospital from September 2012 to September 2013 were randomly divided into the clinical pathway of nursing group ( experimental group) and the traditional nursing group ( control group) with 90 cases in each group.The sleep quality, heart rate, blood pressure, body weight, hemorrhage, health education com-pliance rate and nursing service satisfaction were recorded and compared between the two groups.Results The sleep quality, health education compliance rate and nursing service satisfaction in the experimental group was better than that in the control group;The inci-dence of heart rate speed up, blood pressure increase, loss weight, the standard rate of health education, hemorrhage and the satisfac-tion of nursing quality was lower than that in the control group.There was statistical significance in the difference between the two groups (p<0.05).Conclusion Health education with the clinical pathway of nursing can improve the quality of nursing, promote the rehabilitation and increase the nursing service satisfaction .
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Objective:To explore the clinical efficacy of Paishi granules on promoting stone expulsion after extracorporeal shock wave lithotripsy ( ESWL) . Methods:A retrospective study method was adopted. Totally 510 cases of lithangiuria patients were divided into the treatment group and the control group with 255 cases in each. The control group was treated by ESWL, and the treatment group was treated by Paishi granules after ESWL. The stone expulsion rate,clinical efficacy and adverse reactions in the two groups were stud-ied and compared. Results:The stone expulsion rate of the observation group was 78. 8%,which was significantly higher than that of the control group (51. 0%, P0. 05). Conclusion:Using Paishi granules after ESWL can promote stone expulsion with high efficacy and slight adverse reactions.
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BACKGROUND:Patients with Parkinson disease (PD) are always supplied exogenous dopamine so as to balance a disproportion of neurotransmitter.However,a long-term administration may easily cause drug resistance;therefore,it is not able to solve nerve injuries at all.A lot of researches suggest that ganglioside can promote neural axon growth,improve neurotrophy,and resist cellular toxicity mediated by glutamic acid (GA).OBJECTIVE:To probe into the duration and effect of oraL administration of ganglioside on improving clinical symptoms of PD patients.DESIGN:Retrospective case analysis.SETTING:Department of Internal Medicine.Shanghai Electric Power Hospital;Departments of Neurosurgery and Internal Medicine,the First Affiliated Hospital of Kunming Medical College.PARTICIPANTS:A total of 6 344 PD patients were selected from Heilongjiang,Hebei,Shandong,Henan, Beijing,Jiangsu,Gansu,Qinghai.Guizhou,Fujian,Hunan,Shanxi, Hubei,Sichuan,Chongqing,Jiangxi, Shanghai and Yunnan from January 2001 to January 2005.All patients met the diagnostic and typing criteria of PD in Practical Neurology.They orally took≥10 mg/d ganglioside for more than 1 month,and all of them were provided the consent.METHODS:Patients who were treated with oral ganglioside accepted neural functional rehabilitation. Every oral solution of ganglioside contained 0.25 g/L ganglioside [including monosialoteterahexosyl ganglioside 1 (21%),diplo-sialoteterahexosyl ganglioside 1a(40%),diplo-sialoteterahexosyl ganglioside 1 b(16%),and tri-sialoteterahexosyl ganglioside 1b(19%)],and patients fastingly took two ampoules in every morning and 2 in every evening before sleeping, or took 4 ampoules in every evening before sleeping. Every 3 months was regarded as a course, and patients were always treated for two or three courses;especially,patients having a long-term duration were treated for above 4 courses.Regular follow-up was performed during the administration to observe the improvements of PD patients on the aspects of chatter, myotone, bradypraxia,posture irregularity, etc. Effective evaluation: Iilness improvements of PD patients who orally took ganglioside were observed within 3,6,9 months and 1 year.Excellent effective: Chatter and myotone disappeared after gradually stopping administration of dopamine preparation;improvement: Symptoms mentioned above were relieved after gradually reducing administration of dopamine preparation (effect=apparent effect+improvement);inefficacy:Symptoms mentioned above were not changed.MAIN OUTCOME MEASURES:Effect at various time Points of administration.RESULTS:Among 5 937 patients who met the inclusion criteria,all of them were involved in the final analysis without any loss.① Improvement of clinical symptoms at various time points of administration:There were 669 PD patients with the effective improvements within 1-3 months.941 within 4-6 months and 1713 within 7-12 months.The total effective rate was 56%.② Therapeutic effective rate of PD patients at various administrating times:The therapeutic effective rates of patients who received administration from 1 to 3 months,from 4 to 6 months and from 7 to 12 months were 30%,57%and 84%respectively.The rate was higher of patients administrated from 4 to 6 months than.of those from 1 co 3 months(P<0.05),and also higher of those from 7 to 12 months than of those from 4 tp 6 months and from 1 to 3 months (P<0.05,P<0.01).CONCLUSION:Ganglioside can effectively improve clinical symptoms,such as chatter,myotone,bradypraxia,posture irregularity,etc.In addition,it has a better effect during a long-term administration.
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To develop the awareness of in student nurses during their clinical nursing practice for the prevention of legal disputes and protection of patients’ safety. Enough efforts should be made to strengthen legal education at the beginning, to enrich legal knowledge in the middle, and to stress nursing safety and related countermeasures towards the end of the clinical nursing practice. It is necessary to have student nurses under the supervision of the teachers make sure that they are aware of and abide by the law all the time.
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A spectrophotometric method for the determination of calcium in milk, hair and urine was developed using metal complezing dye orthocresolphth-alein complexone(OCPC).The organic matter in the tested sample was destroyed by digestion. An aliquot of the digested solution was mixed with color developing reagent, alkaline OCPC, cantaining 8-quinolinol to suppress interference such as magnesium, and the absorbance was measured at 570 nm.The coefficients of variation were 0.87, 3.6 and 1.2% for milk, hair and urine samples; and the analytical recoveries of calcium from milk, hair and urine averaged 100.4, 101.0 and 98.5% respectively. The calcium content of milk and hair determined by this method was closely correlated with that of the ICP-AES method (r =0.994, p