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Objective:To investigate the relationship between Helicobacter pylori(Hp)infections in Parkinson's disease(PD)patients at high altitude and peripheral inflammatory markers.Methods:In this prospective study, 120 PD patients in Qinghai Province(altitude: 2260 m)were enrolled and evaluated using PD motor symptom scales and a non-motor symptom scale.The 13C-Urea breath test was used to detect Hp, and patients were divided into an Hp infection group and a non-Hp infection group based on test results.The levels of high-sensitivity C-reactive protein(hs-CRP), white blood cell counts and ratios, serum interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α)were measured. Results:The incidence of Hp infections in PD patients was 56.67%(68/120).The scores of Unified Parkinson's Disease Rating Scale(UPDRS)-Ⅲ, UPDRS-Ⅳ, total UPDRS, Hoehn-Yahr(H-Y)score, constipation scoring system(CSS)and Leeds dyspepsia questionnaire(LDQ)in the Hp infection group were higher than those in the non-Hp infection group, while the mini-mental state examination(MMSE)score was lower in the non-Hp infection group(all P<0.05).The neutrophil count, neutrophil-to-lymphocyte ratio(NLR), monocyte-to-lymphocyte ratio(MLR), serum IL-6 and TNF-α in the Hp-infection group were elevated compared with the non-Hp infection group(all P<0.05).Multivariate Logistic regression analysis showed that IL-6, TNF-α, NLR and H-Y score were independent risk factors for Hp infections in PD patients( OR=1.103, 1.188, 3.320, 4.593, respectively, all P<0.05).Correlation analysis showed that IL-6, TNF-α and NLR had positive correlations with UPDRS-Ⅲ( r=0.676, 0.644, 0.488, respectively), UPDRS-Ⅳ( r=0.679, 0.660, 0.430, respectively), UPDRS-total score( r=0.391, 0.448, 0.319, respectively), H-Y( r=0.610, 0.750, 0.460, respectively), CSS( r=0.529, 0.366, 0.212, respectively)and LDQ( r=0.581, 0.440, 0.263, respectively), but were negatively correlated with MMSE score( r=-0.617, -0.596, -0.321, respectively)(all P<0.05). Conclusions:Peripheral inflammation caused by Hp infections may be involved in the occurrence and development of Parkinson's disease at high altitude and serum IL-6, TNF-α and NLR could serve as indicators to evaluate PD patients with Hp infections.
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Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.
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Objective:To evaluate the screening value of serum pepsinogen (PG) Ⅰ, pepsinogen ratio (PGR, PG Ⅰ/PG Ⅱ) and gastrin 17 (G17) levels combined with gastroscopy for early-stage gastric cancer in high incidence areas of gastric cancer in Qinghai Province.Methods:A total of 2 700 cases were identified as the appropriate age (40-69 years) target population through the questionnaire survey from 25 000 local residents in high incidence areas of gastric cancer in Qinghai Province. The serum PGⅠ, PGⅡ and G17 levels of the 2 700 target population were determined by ELISA, and PGR were calculated. And then 949 patients with abnormal levels of PG and G17 were screened out as a high-risk group of gastric cancer to receive gastroscopy and pathologic biopsy. According to the results of gastroscopy and biopsy, the patients were divided into non-atrophic gastritis group, atrophic gastritis group, peptic ulcer group, early-stage gastric cancer group, and advanced gastric cancer group. The optimal threshold and its sensitivity and specificity of serum PG Ⅰ, PGR and G17 levels for diagnosis of early-stage and advanced gastric cancer were determined based on the receiver operator characteristic curve (ROC).Results:Totally 949 cases received gastroscopy and 649 cases received pathological biopsy, including 239 cases of non-atrophic gastritis, 500 cases of atrophic gastritis, 197 cases of peptic ulcer, 5 cases of early-stage gastric cancer, and 8 cases of advanced gastric cancer. The level of serum PG Ⅰ in the early-stage gastric cancer group (70.00±12.35 μg/L) and advanced gastric cancer group (38.39±2.77 μg/L) was significant lower than that in the non-atrophic gastritis group (103.89±37.45 μg/L, both P<0.05), and the value of early-stage gastric cancer group was obviously higher than that of advanced gastric cancer group ( P<0.05). The PGR of the early-stage gastric cancer group (3.74±1.40) and the advanced gastric cancer group (2.05±0.59) was significantly lower than that in the non-atrophic gastritis group (9.18±4.10, both P<0.05), and the value of early-stage gastric cancer group was significantly higher than that of the advanced gastric cancer group ( P<0.05). The level of serum G17 in the early gastric cancer group (18.03±4.52 pmol/L) and the advanced gastric cancer group (25.15±3.76 pmol/L) was significantly higher than that in the non-atrophic gastritis group (14.99±7.12 pmol/L, both P<0.05), and the level of early-stage gastric cancer group was significantly lower than that of advanced gastric cancer group ( P<0.05). According to the analysis of ROC in the diagnosis of early-stage gastric cancer, the best threshold of PG Ⅰ, PGR and G17 was 71.85 μg/L, 5.04, and 15.65 pmol/L, respectively, and the corresponding sensitivity and specificity was 80.0% and 59.0%, 100.0% and 70.4%, and 80.0% and 69.3%, respectively, for PG Ⅰ, PGR and G17. The analysis of ROC in the diagnosis of advanced gastric cancer showd that the best critical value of PG Ⅰ, PGR and G17 was 42.55 μg/L, 2.79 and 20.55 pmol/L, respectively, and the corresponding sensitivity and specificity was 100.0% and 95.3%, 100.0% and 92.1%, and 100.0% and 89.7%, respectively. Conclusion:Using serological detection of PG and G17 to screen high-risk group of gastric cancer, and then making diagnosis by gastroscopy and biopsy is an effective, low-cost and non-invasive approach for the early-stage gastric cancer in high incidence areas of gastric cancer in Qinghai Province.
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Objective@#To explore the effect of rapid rehabilitation concept nursing on prognosis and quality of life of patients after laparoscopic choledocholithotomy.@*Methods@#A total of 140 patients undergoing laparoscopic choledocholithotomy in our hospital were selected as the subjects, and they were divided into control group (n=70) and experimental group (n=70) by random number table method. The patients in the control group received routine nursing intervention during the perioperative period, and the patients in the experimental group were based on the idea of rapid rehabilitation to carry out nursing intervention. The operation condition, postoperative recovery, incidence of postoperative complications, anti-oxidative stress ability, postoperative fatigue (fatigue visual analogue scale) and postoperative quality of life (QLO-C30 quality of life scale) were compared between the two groups.@*Results@#The operation time, hospitalization time, hospitalization cost, incidence of postoperative complications, postoperative fatigue score on the 4th and 5th day after operation in the experimental group were (120.49±16.74) min, (7.05±1.47) d, (17 482.82±849.37) yuan, 31.43% (22/70) , (1.56±0.12) points, (0.92±0.10) points, the control group were (156.13±14.59) min, (13.75±1.45) d, (28 544.58±1 549.05) yuan, 71.43% (50/70), (3.38±0.87) points and (1.89±0.29) points, respectively. The differences between the two groups were significant (t=8.446, 9.325, 7.763, χ2=9.545, t=10.235, 12.402, P< 0.05). The postoperative recovery, quality of life and anti-oxidative stress ability of the patients in the experimental group were significantly better than those of the control group (P<0.05) .@*Conclusion@#Rapid rehabilitation nursing can improve the recovery of gastrointestinal function, reduce the incidence of complications, eliminate fatigue and improve the quality of life of patients after laparoscopic choledocholithotomy.
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Objective To explore the effect of rapid rehabilitation concept nursing on prognosis and quality of life of patients after laparoscopic choledocholithotomy. Methods A total of 140 patients undergoing laparoscopic choledocholithotomy in our hospital were selected as the subjects, and they were divided into control group (n=70) and experimental group (n=70) by random number table method. The patients in the control group received routine nursing intervention during the perioperative period, and the patients in the experimental group were based on the idea of rapid rehabilitation to carry out nursing intervention. The operation condition, postoperative recovery, incidence of postoperative complications, anti-oxidative stress ability,postoperative fatigue (fatigue visual analogue scale) and postoperative quality of life (QLO-C30 quality of life scale) were compared between the two groups. Results The operation time, hospitalization time, hospitalization cost, incidence of postoperative complications, postoperative fatigue score on the 4th and 5th day after operation in the experimental group were(120.49±16.74)min, (7.05±1.47)d,(17 482.82±849.37)yuan, 31.43%(22/70),(1.56±0.12)points,(0.92±0.10)points, the control group were(156.13 ± 14.59)min,(13.75 ± 1.45)d,(28 544.58 ± 1 549.05)yuan, 71.43% (50/70), (3.38 ± 0.87)points and(1.89 ± 0.29)points, respectively. The differences between the two groups were significant (t=8.446, 9.325, 7.763, χ2=9.545, t=10.235, 12.402, P< 0.05). The postoperative recovery, quality of life and anti-oxidative stress ability of the patients in the experimental group were significantly better than those of the control group(P<0.05). Conclusion Rapid rehabilitation nursing can improve the recovery of gastrointestinal function, reduce the incidence of complications, eliminate fatigue and improve the quality of life of patients after laparoscopic choledocholithotomy.
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Objective · To investigate the status of depression and anxiety in patients with recurrent spontaneous abortion (RSA) and the possible influence factors and to provide theoretical support for further psychological intervention. Methods · RSA patients and women with no history of RSA were invited to complete a questionnaire, including basic information, Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS). All data were analyzed by SPSS. Results · Of all 1064 cases included in this study, 725 were RSA cases, 217 cases with one spontaneous abortion and 122 in control group with no history of spontaneous abortion. Our results showed that both RSA patients and patients with one spontaneous abortion have significantly higher SDS and SAS scores than control group. Furthermore, non-pregnant RSA patients with lower education level, lower household income and 3-5 years of marriage have significantly higher levels of depression and anxiety. Patients with multiple miscarriages (≥4), history of induced abortion and no live birth, score significantly higher in SDS. Conclusion · Whether pregnant or not, RSA patients are much easier to become depressive and anxious, which may be associated with education level, household income, length of marriage, numbers of pregnancy losses and previous live birth. Women with one spontaneous abortion also show a significant higher tendency of depression and anxiety. These patients should be given proper psychological intervention if necessary.
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Objective·To study the hemodynamic parameters of uterine at midluteal phase in patients with early recurrent spontaneous abortion (ERSA) and the effect of aspirin on them. Methods·Transvaginal color Doppler ultrasonography was used to measure the parameters of uterine blood flow and the endometrial thickness at midluteal phase of 271 women with ERSA (ERSA group) and 66 women without a history of recurrent spontaneous abortion (control group). Then ERSA group were administered with aspirin 50 mg/d orally for 2 months and other individualized treatment, and the effect of aspirin on parameters of uterine blood flow and the early pregnancy outcome of them were observed. Results·At midluteal phase, the endometrium was significantly thinner in ERSA group than that in control group. Pulsatility index (PI) of endometrial blood flow and mean PI (mPI), mean resistance index (mRI), and mean systolic/diastolic ratio value (mS/D) of uterine arteries were statistically significantly higher in ERSA group in comparison to control group (P<0.05). Following aspirin treatment, resistance to uterine blood flow reduced significantly in ERSA group (P=0.000), and the endometrial thickness increased in the patients with endometrial thickness less than 7 mm (P=0.000). Only 163 ERSA patients were re-examined by transvaginal color Doppler ultrasonography after aspirin treatment, among whom 136 women was pregnant after individualized treatment. Among these pregnant patients, 97 cases were pregnant for more than or equal to 12 weeks, while 10 cases aborted during the first 12 weeks, and the early pregnancy outcomes of the other 29 cases were still unclear. Conclusion·In comparison with normal fertile women, ERSA patients have significantly higher resistance to uterine blood flow and thinner endometrium. Aspirin can improve uterine blood perfusion, which improves early pregnancy outcome.
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Myelodysplastic syndromes are a group of heterogeneous myeloid tumors and the prognosis is affected by a variety of factors.The pathophysiology of myelodysplastic syndromes (MDS) is unclear.Recent studies have shown that MDS patients have extensive genetic abnormalities.With the development of new genome sequencing technology,abnormal genes can be found in about 80％ of MDS patients.These molecular biological abnormalities have the prospect of guiding targeted therapy and disease surveillance,and can give a hope for the individualized management of heterogeneous hematological malignancies.Here,the prognostic factors of MDS,especially for MDS molecular biology in recent years have been reviewed.
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Objective The aim of this study was to evaluate the glioma using the variety of functional magnetic resonance imaging( fMRI) ,and to perform a more accurate preoperative diagnosis of gliomas. Methods Thirty - five patients with gliomas confirmed by pathology were examined by magnetic resonance imaging (MRI)and functional MRI. Rapid diffusion coefficient(D?),Slow diffusion coefficient(D),perfusion fraction ( f) and distribution diffusion coefficient ( DDC ) in the intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) were analyzed statistically. Results The mean values of D?,D,f and DDC in the IVIM se-quence of the patients with high-grade of gliomas were statistically significant when compared to the IVIM values of the contralateral normal brain tissues(P<0. 05). Conclusion A variety of magnetic resonance functional im-aging sequences are used to analyze gliomas,which can avoid tumor heterogeneity and improve the recognition a-bility and accuracy of magnetic resonance imaging in high grade gliomas.
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Objective To study the effect of early mechanical ventilation in treatment of patients with severe acute pancreatitis(SAP).Methods Fifty-two patients with SAP admitted in the First People's Hospital of Zhaoqing from January 2010 to January 2015 were randomly allocated into two groups (n =26),early mechanical ventilation group(observation group) and conventional mechanical ventilation group(control group).Patients in the observation group treated with early lung protective ventilation when PaO2 ＜ 13.3kPa.Patients in the control group treated without mechanical ventilation untill PaO2 ＜ 8kPa.The symptoms,the extent of inflammatory reaction,the severity of lung lesions and the mortality of two groups were compared through monitoring vital signs,abdominal circumference,APACHE Ⅱ score,bladder pressure,oxygenation index (PaO2/FiO2),C reactive protein (CRP),procalcitonin (PCT),hospital stay and mortality.Results No statistically significant differences in the APACHE Ⅱ score,bladder pressure,oxygenation index,CRP and PCT in two groups before treatment were observed(P ＞ 0.05).The APACHE Ⅱ score (12.8 ± 7.6) points,bladder pressure (14.9± 7.9) cmH2O,CRP (48.8 ± 30.1) rmg/L,PCT (1.25 ± 0.55) μg/L,mortality (3.84％) of the observation group after treatment were significantly lower than those of the control group (t =2.057,2.091,3.252,2.697,x2 =4.305,all P ＜ 0.05),while the oxygenation index in the observation group [(300.0 ± 34.9) mmHg] was significantly higher than that in the control group [(278.1 ± 32.8) mmHg],the difference of the two groups was statistically significant (t =3.322,P ＜ 0.05).Conclusion Early lung protective ventilation is safe and effective for treatment of the patients with SAP.
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@#Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on paralytic hand and upper limb of stroke patients. Methods 32 patients were randomly divided into the treatment group (n=16) and the control group (n=16). All the patients accepted routine rehabilitation, and the patients in the treatment group accepted TEAS in addition for 6 weeks. They were assessed with Fug1-Meyer Assessment of upper extremities (FMA-UE), motor status scale (MSS) and Modified Barthel Index (MBI) before and 2, 4, 6 weeks after treatment. Results All the measures improved in both groups after 2, 4, and 6 weeks of treatment (P<0.05), while the scores of MBI improved more in the treatment group than in the control group 4 weeks after treatment (P<0.05), and all the measures improved more in treatment group than in the control group 6 weeks after treatment (P<0.05). Conclusion TEAS may promote the recovery of flaccid hand and upper extremity function post stroke.
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Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on paralytic hand and upper limb of stroke patients. Methods 32 patients were randomly divided into the treatment group (n=16) and the control group (n=16). All the pa-tients accepted routine rehabilitation, and the patients in the treatment group accepted TEAS in addition for 6 weeks. They were assessed with Fug1-Meyer Assessment of upper extremities (FMA-UE), motor status scale (MSS) and Modified Barthel Index (MBI) before and 2, 4, 6 weeks after treatment. Results All the measures improved in both groups after 2, 4, and 6 weeks of treatment (P<0.05), while the scores of MBI improved more in the treatment group than in the control group 4 weeks after treatment (P<0.05), and all the measures improved more in treatment group than in the control group 6 weeks after treatment (P<0.05). Conclusion TEAS may promote the recovery of flaccid hand and upper extremity function post stroke.
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Objective To evaluate the application value of 256 slice spiral CT angiography (CTA)in the bridge vessels lesions af-ter grafts operation in lower extremity arteriosclerosis obliterans patients.Methods Taken DSA as the gold standard,using 256 slices spiral CTA to analysis the post-processing image of 76 article Bridge vascular which can be assessed in 65 cases patients with lower extremity arteriosclerosis obliterans,and to evaluated the diagnosis accuracy,sensitivity,specificity,positive predictive rate and negative predictive rate of postoperative bridge intravascular lesions.Results Using 256 slices spiral CTA,the bridge vascular of grafts operation patients can be clearly displayed,stenosis or unobstructed,and the anastomosis of the bridge vascular.5 graft occlu-sion,22bridge intravascular plaque were diagnosed correctly,3 vascular lesions were undiscovered.The accuracy,sensitivity,speci-ficity,positive predictive rate and negative predictive rate were 98.15%,96.15%,97.90%,92.59% and 97.96% respectively. Conclusion Using 256 slices spiral CTA can clearly show the endovascular lesions of lower extremity arteriosclerosis obliterans after grafts operation,and has high accuracy and specificity.It can be safely used as one of noninvasive follow-up means after grafts oper-ation.
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Objective To compare the levels of four factors between gastric mucosa of Han and Tibetan patients with chronic gastritis residing in districts at the same altitude in Qinghai Province.Methods Levels of malonic aldehyde ( MDA) , superoxide dismutase (SOD) , nitric oxide ( NO) and xanthine oxidase (XOD) in gastric mucosa of Han and Tibetan patients with chronic gastritis resident in same altitude districts were examined, and a comparative study was performed.Results Levels of MDA and SOD were significantly higher in gastric mucosa of Han patients (2 2699 ± 1.58906 nmol/mgprot and 134.6313 ±48.35329 U/mgport, respectively) than those of the Tibetan (1.7095 ± 1.19474 nmol/mgprot and 109.5056 ± 28.26794 U/mgport, respectively) (P <0.05) , which indicated there were differences in metabolism of oxygen free radicals and antioxi-dant free radicals between 2 ethnics.However, there were no differences in NO and XOD levels between two ethnical groups, which suggested no ethnical difference in metabolism of the two factors.Conclusion There is ethnical difference in MDA and SOD metabolism in gastric mucosa of Han and Tibetan patients with chronic gastritis from same altitude district, which is presumably due to the different tolerance to the hypoxia at high altitude.
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Objective To explore the causes of the special cases showing the EKG changes of cardiac infarction. Methods To analyse the causes of 30 special cases showing the EKG changes of cardiac infarction between 2000 and 2004. Results Among 30 special cases there were 11 cases of viral myocarditis( 36. 7 % ), 7 cases of acute pancreatitis(23.3% ) ,6 cases of hypertrophic obstructive cardiomyopathy(20% ) ,4 cases of bile-cyst and heart syn-drome(13. 3% ) and 2 cases of pulmonary embolism(6. 7% ). Conclusions There are many causes showing the EKG changes of cardiac infarction. It isn't the typical symptom of the cardiac infarction. It should be combined with the clinic and be distinguished timely and exactly in order to avoid the misdiagnosis.
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Objective To investigate the relativity mechanism and clinical significance between the ST-T changes in electrocardiogram and cerebral apoplexy. Methods 2160 electrocardiogram materids of brain patients in our hospital for medical treatment were analyzed retrospectively. The clinical materials of 98 cases(contrast group) who had no obvious changes and 80 cases(observe group) who had obvious changes of ST-T in ECG were compared. Results 1327 cases of electrocardiographic presented abnormality of 2160, which accounted for 56. 97% of the unusual electrocardiogram. Compared with the contrast group, the incidence of hypertension, coronary heart disease, respiratory failure. electrolyte distur-rbances,beart expanding and mayn rinds of electrocardraphic abnormality was higher(P
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Objective To develop infant thermal container with forced protection circuit so as to ensure its security. Methods Temperature database was set in thermal container and Cygnal F005 was used as intelligent controller. The state of the sensor was judged by comparison precisely. Double temperature controller was adopted to ensure normal working temperature. When the container went wrong, it could automatically switch to protection circuit to keep the temperature for infant. Results With precise temperature control and steady working station, the new type thermal container for infant could provide a safe and comfortable condition with clean air and fitting temperature and humidity. Conclusion The container is steady, accurate, safe and convenient.