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Objective:To study the clinical characteristics, diagnosis, complications and prognosis of neonatal varicella.Methods:From September 2008 to December 2019, the clinical data of hospitalized neonates with varicella in our hospital were retrospectively analyzed.Results:A total of 33 cases of neonatal varicella were reviewed, including 18 males and 15 females, 32 full-term infants and 1 premature infant. The gestational age (GA) was (38.8±1.2)w and birth weight (BW) was (3 670±247)g. The onset of the disease occurred at 14.0 (8.0,19.0)d and was diagnosed at 18.0 (11.5,23.0)d. The hospital stay duration was (8.1±3.7)(2~20)d. All mothers denied varicella history or varicella vaccination. Among the 33 infants, 29 had a history of varicella/zoster exposure. All 33 infants had typical rash and 25 had fever, body temperature (38.3±0.6) ℃ and duration (2.4±1.4) d. 13 cases were congenital varicella, 20 cases were acquired varicella. 24 cases abnormality of cardiac enzymes, 11 cases skin infection, 8 cases liver damage, 4 cases pneumonia, 6 cases granulocytopenia/agranulocytosis, 9 cases anemia, 4 cases sepsis and 1 case viral encephalitis were diagnosed. 20 infants received intravenous antiviral therapy (acyclovir), 17 were treated with antibiotics, 15 were given intravenous immunoglobulin (IVIG), 8 received both antiviral therapy and IVIG and 6 were treated with recombinant human granulocyte stimulating factor. 31 infants were cured and discharged. 2 infants were discharged after improvement of rashes. All infants reported complete recovery on telephone follow-up.Conclusions:Most neonatal varicella cases have a definite exposure history. Besides rashes, complications including pneumonia, liver damage, myocardial injury, granulocytopenia/agranulocytosis, viral encephalitis are common. Intravenous antiviral therapy with acyclovir and combined treatment of IVIG and symptomatic support can often achieve a good prognosis.
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Objective:To investigate the causes of anemia in newborns delivered by human immunodeficiency virus (HIV) infected mothers.Methods:This was a retrospective study. Forty-two newborns delivered by HIV infected mothers during January 2010 and May 2019 in Beijing Ditan Hospital Affiliated to Capital Medical University were selected. According to the hemoglobin levels of newborns on the days of their birth, newborn cases were divided into two groups, anemia group and non-anemia group. The clinical data including gestational ages, birth weight, maternal anemia status during pregnancy, using of antiviral drugs during pregnancy, percentages of HIV RNA positivity in early pregnancy/pre-treatment and before delivery, maternal percentage of different CD4 + T lymphocyte counts in early pregnancy/pre-treatment and before delivery between two groups were compared. The efficacies of relative indicators for prediction of anemia in newborns were evaluated by the area under receiver operating characteristic curve (AUROC). Differences between groups were compared by chi-square test. Results:Among 42 cases of newborns, 14 cases were in anemia group and 28 cases in non-anemia group. There were no statistical differences in gestational ages, birth weight, maternal anemia status during pregnancy and positive percentage of HIV RNA before delivery between two groups ( χ2=2.211, 1.025, 1.362 and 3.783, respectively, P=0.283, 0.763, 0.181 and 0.092, respectively). In anemia group, 11 mothers took zidovudine during pregnancy, which was 12(42.86%) in non-anemia group. The difference was statistically significant ( χ2=4.359, P=0.037). Eight cases of mothers with HIV RNA positive in early pregnancy/pre-treatment in the anemia group, which was 11(39.29%) in the non-anemia group. The difference was statistically significant ( χ2=6.490, P=0.011). The number of CD4 + T lymphocyte count ≤500/μL was 13 in early pregnancy/pre-treatment in anemia group, which was 20(71.43%) in the non-anemia group. The difference was statistically significant ( χ2=16.396, P<0.01). The number of CD4 + T lymphocyte ≤0.28 was 13 in early pregnancy/pre-treatment in the anemia group, which was 19(67.86%) in the non-anemia group ( χ2=19.908, P<0.01). The number of CD4 + T lymphocyte count ≤500/μL was 14 before delivery, which was 15(53.37%) in the non-anemia group ( χ2=9.536, P=0.008). The number of CD4 + T lymphocyte ≤0.28 before delivery was 14 in anemia group, which was 15(53.37%) in the non-anemia group ( χ2=9.750, P=0.006). According to the receiver operating characteristic curve results, the AUROC, optimal cut-off value, sensitivity and specificity of CD4 + T lymphocyte count before delivery in predicting neonatal anemia were 0.708, 476.0/μL, 100.0% and 50.0%, respectively. The AUROC, optimal cut-off value, sensitivity and specificity of maternal CD4 + T lymphocyte percentage before delivery in predicting neonatal anemia were 0.719, 0.275, 100.0% and 53.6%, respectively. Conclusion:Low CD4 + T lymphocyte level in HIV-infected mothers before delivery, HIV positive in early pregnancy/pre-treatment and using of zidovudine during pregnancy may be associated with neonatal anemia.
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Objective@#To explain the true experience of death anxiety in elderly inpatients with chronic diseases, and provide a theoretical basis for hospice care.@*Methods@#The phenomenological study method was used to deeply interview the true feelings of death anxiety in 13 elderly inpatients with chronic diseases.@*Results@#Through analysis, collation and refinement, the five themes of death anxiety, life regret, death attitude, death reminder and final decision power.@*Conclusions@#As clinical medical workers, we must always pay attention to the death anxiety of elderly inpatients with chronic diseases and strengthen the assessment of death anxiety. In particular, patients with cancer and patients at the end of life are provided with personalized care to remind them of the meaning of life and reduce the anxiety level of death.
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Objective@#The purpose of the research was to draw up the questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly and to provide elderly people with a effective tool for evaluating the needs of medicine, pension, rehabilitation and care.@*Methods@#The theoretical framework of the questionnaire was based on the qualitative interview results of 12 community elderly and community health care workers. A preliminary draft was formed through two rounds of expert consultation and a preliminary survey of 102 elderly people in 3 communities in Taian. Construct validity was used to evaluate the validity of the questionnaire, and Cronbach's alpha coefficient and split half reliability were used to evaluate the reliability of the questionnaire.@*Results@#Sixteen experts were invited to conduct two rounds of consultation on 61 items of the questionnaire. The authoritative coefficient of experts was 0.881, and the positive coefficient of experts was 100%. In the first round, items I-CVI, S-CVI/UA and S-CVI/Ave were 0.68-1.00, 0.72 and 0.83, respectively. Seven items were modified, six items were deleted and three items were added. In the second round, one item was deleted and one item was added, and a questionnaire consisting of seven dimensions and 58 items was formed.7 common factors were extracted from exploratory factor analysis, and the cumulative contribution rate was 63.078%. Finally, 7 dimensions and 51 item questionnaires were formed. Each dimension is the community public health service and general services, health education, pension services, rehabilitation services, family beds, service charges The total Cronbach's alpha coefficient was 0.919, the Cronbach' s alpha coefficient of each dimension was 0.615-0.808, the retest reliability coefficient of the total questionnaire was 0.862.and the Guttman half coefficient is 0.865. The total questionnaire CVI was 0.85 and the item CVI was 0.80-1.00. Item analysis showed that the correlation coefficients of the 7 items were lower than 0.3, and the rest were all between 0.3~0.7, and were significantly correlated at P<0.05 level.@*Conclusion@#The questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly had good reliability and validity, and it could be used to evaluate the needs of medicine, pension, rehabilitation and care in the elderly.
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Objective To explain the true experience of death anxiety in elderly inpatients with chronic diseases, and provide a theoretical basis for hospice care. Methods The phenomenological study method was used to deeply interview the true feelings of death anxiety in 13 elderly inpatients with chronic diseases. Results Through analysis, collation and refinement, the five themes of death anxiety, life regret, death attitude, death reminder and final decision power. Conclusions As clinical medical workers, we must always pay attention to the death anxiety of elderly inpatients with chronic diseases and strengthen the assessment of death anxiety. In particular, patients with cancer and patients at the end of life are provided with personalized care to remind them of the meaning of life and reduce the anxiety level of death.
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Objective The purpose of the research was to draw up the questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly and to provide elderly people with a effective tool for evaluating the needs of medicine, pension, rehabilitation and care. Methods The theoretical framework of the questionnaire was based on the qualitative interview results of 12 community elderly and community health care workers. A preliminary draft was formed through two rounds of expert consultation and a preliminary survey of 102 elderly people in 3 communities in Taian. Construct validity was used to evaluate the validity of the questionnaire, and Cronbach 's alpha coefficient and split half reliability were used to evaluate the reliability of the questionnaire. Results Sixteen experts were invited to conduct two rounds of consultation on 61 items of the questionnaire. The authoritative coefficient of experts was 0.881, and the positive coefficient of experts was 100% . In the first round, items I-CVI, S-CVI/UA and S-CVI/Ave were 0.68-1.00, 0.72 and 0.83, respectively. Seven items were modified, six items were deleted and three items were added. In the second round, one item was deleted and one item was added, and a questionnaire consisting of seven dimensions and 58 items was formed.7 common factors were extracted from exploratory factor analysis, and the cumulative contribution rate was 63.078%. Finally, 7 dimensions and 51 item questionnaires were formed. Each dimension is the community public health service and general services, health education, pension services, rehabilitation services, family beds, service charges The total Cronbach's alpha coefficient was 0.919, the Cronbach' s alpha coefficient of each dimension was 0.615-0.808, the retest reliability coefficient of the total questionnaire was 0.862.and the Guttman half coefficient is 0.865. The total questionnaire CVI was 0.85 and the item CVI was 0.80-1.00. Item analysis showed that the correlation coefficients of the 7 items were lower than 0.3, and the rest were all between 0.3~0.7, and were significantly correlated at P<0.05 level. Conclusion The questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly had good reliability and validity, and it could be used to evaluate the needs of medicine, pension, rehabilitation and care in the elderly.
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Objective To explore the status and influencing factors of the integrated service needs of medicine, pension, rehabilitation and care of the community elderly in order to provide a theoretical basis for the construction of an old-age service model in line with the national conditions. Methods A total of 330 elderly people from three communities in Tai'an were selected and investigated by self-made questionnaire of the integrated services needs for medicine, pension, rehabilitation and care of community elderly. Results Nearly 83.54％(259/310) of the elderly had moderate and above pension needs, and the first three were rehabilitation services, family beds and community public health services. Age, educational level, self-rated health and number of chronic diseases were the influencing factors of the integrated service needs of medicine, pension, rehabilitation and care(t =2.374-4.844, all P<0.05). Conclusions The majority of elderly people have the moderate and above health care integration service demand, the elderly have the highest demand for rehabilitation services. Age, education, self-rated health status and the number of chronic diseases have different influence on the needs of the elderly;government, society, education and medical treatment institutions interdisciplinary multi linkage, and strengthen the professionals training of health, rehabilitation, health care, in order to explore the best old-age service model in line with national conditions.
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To observe and analyze the therapeutic effect of combinated application of lobaplatin and irinotecan in treating recurrant small cell lung cancer. The 140 patients who were treated in our hospital for recurrant small cell lung cancer
were selected as research objects. All selected patients were subjected to combined application of obaplatin and irinotecan, the total therapeutic effect was observed, and the adverse reactions occurring during treatment were recorded.
Through observing the total treatment effective ratio of 140 patients recurrant small cell lung cancer, the number of complete remission cases, number of partial remission cases, number of stable disease cases, and number of disease
progression cases were 40[28.57%], 28[20.00%], 30[21.43%], 42[30.00%], respectively, with total effective ratio of 48.57%. The average time to progression [TTP] was [4.5±0.8] months, average overall survival [OS] was [7.6+/-1.2]
months. The toxic and adverse effects mainly included hematological toxicity and gastrointestinal adverse reaction, such as leukocyte reduction, neutrophil reduction, thrombocytopenia, decreased hemoglobin, nausea and vomiting, diarrhea. No toxicity-related death occurred. In treatment of patients with recurrant small cell lung cancer, the combined application of lobaplatin and irinotecan can achieve great results, which is a safe and reliable way of treatment
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Objective This paper reviews the research context of the fear of cancer recurrence abroad, and presents the research hotspots and frontiers in this field, which will further provide references for the research of the fear of cancer recurrence in China. Methods Web of Science database was retrieved,the time of papers published, the number of publications and periodicals were analyzed.The Map drawing was accomplished with the help of Histcite software. Results Total 5322 effective literatures were investigated,most of the papers are published by the United States, Butow P was the high yield authors. and the core journal is "PSYCHO-ONCOLOGY". High frequency key words mainly concentrated on cancer, breast cancer, prostate cancer, quality of life, prognosis, chemotherapy (symptom distress and management). Conclusion In the aspect of fear of cancer recurrence, Europe and America are in a leading position, compared with the international level,there is still a gap in the field of FCR in China , the depth and breadth of research needs to be extended further, We should keep path with the international FCR research hotspot, to broaden our research scope and improve the quality of related research.
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Objective To analyzed the left ventricular (LV) regional and global strains in coronary artery stenosis by using three-dimensional speckle tracking imaging (3D-STI) and two-dimensional speckle tracking imaging (2D-STI) for the assessment of left ventricular systolic function,and to compare the clinical values between 3D-STI and 2D-STI in the detection of coronary stenosis.Methods 39 patients with coronary artery stenosis and 32 sex-age matched controls were enrolled in this study.Coronary artery stenosis group was divided into ischemic group and non-ischemic group.Real-time three dimensional full volume and two-dimensional dynamic image of the LV were obtained and then analyzed by off-line analysis software.The parameters of 3D-STI were three-dimensional longitudinal strain (3D-LS),circumferential strain (3D-CS),radial strain (3D-RS),area strain (3D-AS),global longitudinal strain (3D-GLS),global circumferential train (3D-GCS),global radial strain (3D-GRS) and global area strain (3D-GAS).The parameters of 2D-STI were two-dimensional longitudinal strain (2D-LS),circumferential strain (2D-CS),radial strain (2D-RS),global longitudinal strain (2D-GLS),global circumferential train (2D-GCS) and global radial strain (2D-GRS).The global/regional strains derived from 3D-STI and 2D-STI in patient group and controls were analyzed for comparing their efficacy in detecting coronary artery stenosis.Results Compared with non-ischemic group,2D-LS,2D-CS,3D-LS,3D-CS and 3D-AS were lower in ischemic group (P ＜0.05).ROC curves showed the sensitivity of 2D-LS,3D-LS and 3D-AS for the diagnosis of myocardial ischemia was 60.1％,64.2 ％ and 74.0 ％,while the specificity of them was 60.0％,61.0％ and 63.1％,respectively.There was no significant difference in 2D-GCS and 2D-GRS between coronary artery stenosis group and control group (P ＞ 0.05).Compared with control group,2D-GLS,3D-GLS,3D-GCS,3D-GRS and 3D-GAS were significantly lower in coronary artery stenosis group (P ＜0.05).ROC curves showed the sensitivity of 2D-GLS,3D-GLS and 3D-GAS in the diagnosis of coronary artery stenosis was 61.3％,73.3％ and 79.3 ％,while the specificity was 65.4％,66.0 ％ and 70.8 ％,respectively.The sensitivity and specificity of 3D-GAS were the highest in these parameters.It is revealed that 2D-GLS,2D-GCS and 2D-GRS were correlated with LVEF (r1 =-0.668,P1 ＜0.001 ;r2 =-0.551,P2 ＜0.001 ;r3 =0.310,P3 ＜0.05),and 3D-GLS,3D-GCS,3D-GRS,3D-GAS were correlated with LVEF (r1 =-0.634,P1 ＜0.001 ;r2 =-0.672,P2＜0.001 ;r3 =0.698,P3＜0.001 ;r4 =-0.707,P4＜0.001).The correlate of 3D-GAS and LVEF was higher than other parameters.Conclusions 3D-STI is superior to 2D-STI in assessing regional and global left ventricular systolic function in patients with coronary artery stenosis,and 3D-GAS derived from 3D-STI is a ideal parameter of detecting significant coronary artery stenosis based on its highest sensitivity and specificity.
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To study the mechanism of proliferous vascular disease as well as its prevention and treatment, an organic model was established with cultured aortas of rats, and the mechanism there-in invloved was probed. Immunostaining histology showed that smooth muscle cell (SMC) proliferation was observed in the aorta segments of rats, after their endothelia being injured and cultured in vitro with 20% fetal bovine serum. After being cultured for 5 days, various degrees of proliferation of SMC on cultured artery segments were observed by HE staining, and conspicuous plaques were developed after being cultured for 13 days. The proliferous SMC was also observed by Brdu labeling. RT-PCR examination showed that the mRNA expression of hypertension-related gene-1 (Hrg-1) and smooth muscle 22 alpha (SM22a) in the aortas decreased with the prolongation of culture time, and completely disappeared after being cultured for 13 days . But when cultured in vitro for ten days, the ET-1 content of supernatant and the proliferous SMC labeled by Brdu increased obviously and the expressions of Hrg-1 and SM22a decreased after the endothelium was destroyed. Compared with the injured endothelium groups, the proliferous SMC of injured endothelium plus BQ123 groups decreased visibly. The same significant differences between serum groups and serum-free groups were also observed. These results suggest that the culturing of rat aorta segments in vitro can induce the proliferation of SMC and the transform of phenotype from contractile type to synthetic type. The ET-1 and serum are the main factors in the proliferation of SMC and in the transform of phenotype. This organic model could serve as a good experimental platform for the researches into the mechanism of proliferous vascular disease as well as its prevention and treatment.
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Animals , Female , Male , Rats , Aorta, Abdominal , Cell Biology , Cell Proliferation , Disease Models, Animal , Endothelin-1 , Genetics , Metabolism , Microfilament Proteins , Genetics , Metabolism , Muscle Proteins , Genetics , Metabolism , Muscle, Smooth, Vascular , Cell Biology , Organ Culture Techniques , RNA, Messenger , Genetics , Metabolism , Rats, Sprague-DawleyABSTRACT
It is still controversial whether total splenectomy on adult animals would affect their immune function. In this study, total splenectomy and different kinds of splenic preservation operations including splenorrhaphy, partial splenectomy and spleen autotransplantation were performed on adult rats after the porta of the spleen of the rats was artificially ruptured and the splenic artery ligated.In the 4th month after the operations, the hemolysin antibody and the de-layed-type hypersensitivity reaction were determined in the rats. It was found that no significant difference occurred in the hemolysin antibody and the delayed type hypersensitivity reaction among the rats of the control group, the group with total splenectomy, and the groups with different kinds of splenic preservation operations.
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Objective To investigate whether calcitonin gene-related peptide(CGRP) can influence the proliferation and phenotypic modulation of vascular smooth muscle cells(VSMCs),and what is the relationship between them. Methods Vascular smooth muscle cells(VSMCs) were cultured respectively with rat aorta cultivated for 8 days in vitro and with normal aorta(not culture) through the explant-attached method,and CGRP was added into the culture medium of the experimental groups.The proliferation of cells was labeled by 5-bromodeoxyuridine(5-BrdU) with immunocytochemical method,and the mRNA expression of hypertension-related gene-1(HRG-1) and smooth muscle 22 alpha(SM22?) were determined by RT-PCR. Results The proliferating cells labeled by BrDU from the aorta cultured for 8 days in vitro were increased notablly and the mRNA expression of HRG-1 and SM22? were decreased.While the VSMCs were cultured in the culture medium containing CGRP,the proliferous cells labeled by BrdU were obviously decreased and the mRNA expression of HRG-1 and SM22? were significantly increased.Conclusion It is showed that CGRP could inhibit the proliferation of VSMCs and change the phenotype of VSMCs from synthesize to contractile type.It might be a good cellular model which provides a good experimental platform to research the proliferating vascular disease as well as its prevention and treatment.