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OBJECT IVE To investigate the influential factors of direct economic burden of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）patients in hospital ，and to provide related suggestions to reduce the direct economic burden of hospitalization. METHODS During Dec. 1st，2019-Oct. 31st，2020，the data of 1 923 AECOPD patients admitted into the First Affiliated Hospital of Guangzhou Medical University were collected. The information of demographic sociological characteristics，clinical characteristics and cost characteristics were collected ；descriptive analysis ，single factor regression analysis and multiple linear stepwise regression analysis were adopted to investigate the influential factors of direct economic burden of hospitalization. On the basis of literature review ，relevant suggestions were put forward to reduce the direct economic burden of AECOPD patients in hospital. RESULTS & CONCLUSIONS The median of hospitalization cost of AECOPD patients was 15 621.00 yuan. The multiple linear stepwise analysis regression analysis revealed that the influential factors of direct economic burden of AECOPD patients in descending order （by partial regression coefficient ）were the length of stay （logarithmic conversion value ）， admission to ICU ，surgical treatment ，discharge outcome ，whether to salvage ，the use of respirator ，common complications and smoking history （model F＝572.200，R2＝0.750，P＜0.001）. It is suggested to strengthen comprehensive hospital management and promote multidisciplinary cooperation to reduce hospitalization days ；strictly follow the diagnosis and treatment guidelines and clinical pathways to avoid deterioration of the condition and transfer to ICU treatment ；control indications for surgery to avoid“ask for great treatment with only miner illness ”；do a good job in the publicity and education of disease and smoking cessation ，and improve the self-management ability of patients.
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Objective To investigate the value of "one-stop" scanning of coronary and head and neck CTA in patients with normal body mass index (18 kg/m2 ≤ BMI ≤ 25 kg/m2) using low tube voltage (80 kVp).Methods In a retrospective analysis 80 patients with normal body mass index who had completed "one-stop" scanning of coronary and head and neck CTA were divided into A and B groups according to different scanning method,and 40 consecutive cases were selected in each group.Scanning parameters of group A and group B were tube voltage 80 kV,coronary CTA tube current 550 mA,head and neck CTA tube current 500 mA,and tube voltage 100 kV,coronary CTA tube current 450 mA,head and neck CTA tube current 400 mA separately.Subjective evaluation and objective evaluation were performed on the image quality of the two groups.CT values of coronary artery and head and neck CTA trunk branch vessel,contrast-to-noise ratio (CNR),image noise (SD) and effective dose between the two groups were compared.Results The image quality of both groups met the diagnostic requirements,and there was no statistically significant difference in subjective scores between two groups (P＞0.05).The CT values of coronary arteries,the main branches of the head and neck (the common carotid artery,the internal carotid artery) and SD of head and neck CTA were significantly different between two groups (t=4.737,6.552,3.359,2.165,2.685,4.617,P＜0.05).There was no statistically significant difference in SD of coronary CTA,CT values and CNR between head and neck vessels (middle cerebral artery) in group A and group B (P＞0.05).The effective dose of coronary CTA in group A (1.16±0.20) mSy was reduced by 51.1％ than that in group B (2.37±0.77) mSv.The effective dose of head and neck CTA in group A (0.37±0.03) mSv was reduced by 47.9％ than that in group B (0.71 ± 0.17) mSv.Conclusions The image quality with subjective evaluation met the diagnostic requirements when using a low-tube voltage for "one-stop"scanning of coronary and head and neck CTA.The CNR values were basically consistent with the conventional scanning method,and the patient effective dose was reduced by about 50％.
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<p><b>OBJECTIVE</b>To introduce the application and clinical effect of self-made liver fixing device in laparoscopic radical gastrectomy.</p><p><b>METHODS</b>Clinical data of 469 patients underwent laparoscopic radical gastrectomy in Nanfang Hospital, Southern Medical University from March 2014 to January 2017 were analyzed retrospectively. In laparoscopic radical gastrectomy, self-made liver fixing device was used to expose surgical field covered by hepatic lobe in gastric lesser curvature and hepatic flexure of colon. Manufacture of the self-made liver fixing device: appropriate length of the catheter was cut according to the size of liver; the lotus suture needle with a thread was put through two catheters to connect them. Then the prepared liver fixing device was sent into abdominal cavity through a 12-mm Trocar hole with needle holder and was fixed on the free hepatic lateral hepatogastric ligament with hemo-lock. Finally the application effect of the liver fixing device was evaluated by reviewing the surgical videos.</p><p><b>RESULTS</b>A mean time of 40.3 seconds was required to complete liver fixing by using the self-made liver fixing device in laparoscopic radical gastrectomy and liver did not slip down in all the cases. Liver secondary manual fixing by assistants was 2 times averagely. Three cases had mild liver injury.</p><p><b>CONCLUSION</b>The self-made liver fixing device in laparoscopic radical gastrectomy is easy to operate and can effectively expose sufficient surgical field, with high security and convenient materials.</p>
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Objective To investigate the changes of saliva biochemical parameters in the dynamic evolution of “normal constitution - kidney deficiency constitution - kidney deficiency syndrome”.Methods Totally 24 male and female SD rats of 3 months old (12 male rats and 12 female rats) were put in packet pair cage. Pregnant rats were randomly divided intoⅠ andⅡ groups, 6 rats in each group.Ⅰ group was without intimidation during pregnancy, with normal feeding, and then after the birth, 20 rats were randomly selected as normal control group and kidney deficiency syndrome model group, 10 rats in each group, half male and half female.Ⅱ group, from gestation day 2, was given intimidation until postnatal. 10 half male and half female rats were randomly selected as model group of kidney deficiency constitution. Rats in each group received normal feeding conditions for 6 weeks. The kidney deficiency syndrome model group was given intramuscular injection of hydrocortisone 25 mg/kg body weight every day, while normal control group and kidney deficiency constitution model group were injected with the same amount of normal saline for 10 consecutive days. The changes of salivary biochemical parameters were observed in each group of rats.Results Compared with the normal control group, salivary pH in the kidney deficiency constitution group and kidney deficiency syndrome group significantly increased (P<0.01). CK, ALT, AST, ALP levels in the kidney deficiency constitution group were reduced, but the contents of K, P, TP, AMY increased. The levels of CK, ALT, AST, ALP and LDH in the kidney deficiency syndrome decreased, while the contents of K, P, TP, and AMY increased (P<0.05,P<0.01). Compared with the kidney deficiency constitution group, the content of LDH in the kidney deficiency syndrome group decreased (P<0.05).Conclusion Rat saliva composition changes did occur in the kidney deficiency constitution group and kidney deficiency syndrome group.
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Objective To study the efficacy and complications of total hip arthroplasty (THA) with rivet system for reconstruction of joint capsule and external rotator muscles.Methods Data of 170 patients managed with THA of femoral neck fracture between January 2009 and January 2012 were reviewed retrospectively.Hip fracture was the result of a fall and all were subcapital fractures.The fracture patterns were classified as Garden Ⅳ in 139 patients and Garden Ⅱ in 31 patients according to the degree of displacement.In all,85 patients (37 males and 48 females;age between 61 and 84 years,mean 73 years) underwent joint capsule as well as external rotator muscle reconstruction by rivet system (study group).The remaining 85 patients (36 males and 49 females;age between 64-87 years,mean 74 years) were served as control group.The MOS 36-item short form health survey (SF-36),dislocation rate and complications were evaluated at postoperative follow-up.Results Duration of follow-up was 36 to 60 months (mean,46 months).SF-36 questionnaire scale was (45.95 ±4.27)points in study group and (45.38 ± 4.67) points in control group before operation (P ＞ 0.05),while (83.67 ± 3.93) points in study group and (82.16 ± 3.21) points in control group at postoperative follow-up (P ＜ 0.05).Six patients in control group suffered from early prosthetic dislocation,but none in study control.Perioperative incidence of complications was comparable between the two groups (P ＞0.05).Conclusions Application of rivet system for reconstruction of joint capsule and external rotator muscles in THA of patients with femoral neck fracture can reduce incidence of prosthetic dislocation after operation.The operation is simple and will not increase the rate of perioperative complications.
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Objective To explore the role of geniposide (Gen) in the proliferation of pancreatic βcells and the cell signaling transduction pathway .Methods After INS-1 pancreatic βcell line was treated with indicated concentrations of Gen for 24 hours, the number of viable cells was measured with MTT assay , and the cell proliferation was evaluated with BrdU labeled method .Additionally , Western blotting was used to probe the phosphorylation of Akt 308 and FoxO1 induced by Gen.Results The number of INS-1 cells and BrdU labeled positive cells was increased by Gen .Moreover, the phospho-rylation of Akt308 and FoxO1 was induced , and the phosphorylation of FoxO 1 induced by Gen could be prevented in the presence of LY294002, an inhibitor of PI3K kinase.Conclusion Gen induces the proliferation of INS-1 cells in a dose-dependent manner, and PI3K signal pathway plays an essential role in the phosphorylation of FoxO 1 induced by Gen.