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Objective@#To develop a method that can continuously monitor duration of students outdoor activities for a long time, so as to provide data support for the relationship between outdoor activity duration and students health.@*Methods@#From April 28 to July 6, 2022, 1 168 students from a primary school in Shenzhen were selected. Fixed cameras were placed on the top of school classrooms, corridors and critical paths were used to identify student data and duration in the picture. And AI, cloud computing and other methods were used to measure students-non-classroom time instead of outdoor activity time in school.@*Results@#The average length of time spend on outdoor activities in school of the 24 pilot classes were 67.6-113.0 min, and showed a downward trend by grade ( F =42.74, P <0.05). The duration of outdoor activities among students was negatively correlated with the detection rate of myopia and overweight( r =-0.74, -0.45, P <0.05).@*Conclusion@#The data on outdoor activity time calculated by AI image recognition is basically in line with the reality. Monitoring students outdoor activity time at school through AI image recognition is feasible and popularized.
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Objective:To explore the value of the Wilcoxon-Mann-Whitney generalized dominance ratio (T max-weighted ratio) based on residual tissue time to peak (T max) delayed severity weighting in predicting the moderate to severe edema after acute anterior circulation ischemic stroke. Methods:The clinical and imaging features of patients with acute anterior circulation ischemic stroke from January 2019 to April 2022 in Yidu Central Hospital of Weifang were retrospectively analyzed. A total of 85 patients were enrolled, including 60 males and 25 females, with the age from 34 to 93 (67±11) years old. Patients underwent non-contrast CT, CT angiography of the head and neck, and CT perfusion imaging of the head, and ischemic core volume and the ratio of T max 4-6 s volume, T max 6-8 s volume, T max 8-10 s volume, and T max >10 s volume relative to the entire hypo-perfused area (T max>4 s volume) was measured, and the T max-weighted ratio was calculated, the collateral circulation were assessed. Patients were divided into mild edema group and moderate to severe edema group according to whether local swelling exceeded 1/3 of the unilateral cerebral hemisphere on non-contrast CT at 24-48 h. The indicators were compared between the two groups by independant t test, Mann-Whitney U and χ 2 test. The performance to predict moderate to severe edema was assessed using the receiver operating characteristic (ROC) curve. The univariate and multivariate logistic regression was used to analyze the risk factors for the moderate to severe edema. Differences in baseline National Institutes of Health Stroke Scale (NIHSS) score and infarct core volume were equalized by 1∶1 propensity score matching (PSM) and the differences of T max-weighted ratio between the two groups were further compared. Results:There were 52 cases in the mild edema group and 33 cases in the moderate to severe edema group. Baseline NIHSS score, T max>10 s volume, ischemic core volume, T max-weighted ratio and proportion of poor collateral circulation were higher in the moderate-severe edema group than those in the mild edema group ( P<0.001), T max 4-6 s volume was lower than in the mild edema group ( P<0.001). ROC analysis showed that the area under the curve (AUC) of T max-weighted ratio for predicting the incidence of moderate to severe edema was 0.885 (95%CI 0.798-0.944), with an optimal cut-off value of 1.17, sensitivity of 84.85% and specificity of 82.69% before PSM. The predictive ability based on T max-weighted ratio was similar to ischemic core volume( Z=0.64, P=0.520), T max 4-6 s volume ( Z=1.48, P=0.140) and superior to T max 6-8 s volume( Z=5.65, P<0.001), T max 8-10 s volume( Z=4.46, P<0.001), T max >10 s volume ( Z=2.91, P=0.004). Multivariate logistic regression analysis showed that T max-weighted ratio>1.17 was an independent predictor of the development of moderate to severe edema (OR=10.40,95%CI 2.65-40.83, P=0.001) through adjusted for baseline NIHSS score and ischemic core volume. After PSM, 14 patients in each group were included; the T max-weighted ratio was higher in the moderate-to-severe edema group than that in the mild edema group ( P<0.001), and the differences in other factors were not statistically significant (all P>0.05); ROC analysis showed that the AUC of T max-weighted ratio to predict the occurrence of moderate-to-severe edema was 0.852 (95%CI 0.667-0.957). Conclusion:The T max-weighted ratio can predict the occurrence of moderate-to-severe edema in brain tissue after acute anterior circulation ischemic stroke.
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Background@#The emergence of the severe acute respiratory syndrome coronavirus 2 omicron variant has been triggering the new wave of coronavirus disease 2019 (COVID-19) globally. However, the risk factors and outcomes for radiological abnormalities in the early convalescent stage (1 month after diagnosis) of omicron infected patients are still unknown. @*Methods@#Patients were retrospectively enrolled if they were admitted to the hospital due to COVID-19. The chest computed tomography (CT) images and clinical data obtained at baseline (at the time of the first CT image that showed abnormalities after diagnosis) and 1 month after diagnosis were longitudinally analyzed. Uni-/multi-variable logistic regression tests were performed to explore independent risk factors for radiological abnormalities at baseline and residual pulmonary abnormalities after 1 month. @*Results@#We assessed 316 COVID-19 patients, including 47% with radiological abnormalities at baseline and 23% with residual pulmonary abnormalities at 1-month follow-up. In a multivariate regression analysis, age ≥ 50 years, body mass index ≥ 23.87, days after vaccination ≥ 81 days, lymphocyte count ≤ 1.21 × 10 -9 /L, interleukin-6 (IL-6) ≥ 10.05 pg/mL and IgG ≤ 14.140 S/CO were independent risk factors for CT abnormalities at baseline. The age ≥ 47 years, presence of interlobular septal thickening and IL-6 ≥ 5.85 pg/mL were the independent risk factors for residual pulmonary abnormalities at 1-month follow-up. For residual abnormalities group, the patients with less consolidations and more parenchymal bands at baseline could progress on CT score after 1 month. There were no significant changes in the number of involved lung lobes and total CT score during the early convalescent stage. @*Conclusion@#The higher IL-6 level was a common independent risk factor for CT abnormalities at baseline and residual pulmonary abnormalities at 1-month follow-up. There were no obvious radiographic changes during the early convalescent stage in patients with residual pulmonary abnormalities.
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Objective:To investigate the status quo and influencing factors of unsatisfied needs of patients after radical gastrectomy for gastric cancer through quantitative and qualitative mixed research methods, and to provide reference for the development of effective health management programs in the future.Methods:A total of 297 patients who were hospitalized in Tianjin Medical University Cancer Hospital from January to December 2021 after radical gastretomy were selected as subjects by convenient sampling method. The general data questionnaire and Short-Form Survivor Unmet Needs Survey (SF-SUNS) were used to investigate. Selected 12 patients with gastric cancer by objective sampling method for semi-structured in-depth interview and collate data by Colaizzi 7-step analysis method.Results:The total average score of 297 subjects who did not meet the requirements was (60.91 ± 16.00), which was in the middle level. The average score of each dimension from high to low was: continuous care unmet needs (2.37 ± 0.75) points, work economy unmet needs (2.22 ± 0.65) points, information unmet needs (2.20 ± 0.92) points, emotion unmet needs (1.72 ± 0.60) points. Educational background, main economic source of family and working state were the influencing factors of unmet demand ( t=5.32, -3.59, -3.28, all P<0.05). Qualitative research had extracted four themes: unmet needs for symptom network recognition and accurate symptom management, unmet needs for shared decision participation and disease perception trajectory, unmet needs for dignity maintenance and reconstruction of psychological stress mechanism, and unmet needs for "Internet plus" mobile medical continuous care. Conclusions:The problem of unmet needs of patients after radical gastritis is still prevalent and affected by a variety of factors. It is suggested that medical workers build an effective supportive care system based on the status quo of unmet needs of patients, promote the whole process of multidimensional health management services for patients with gastric cancer, and improve the quality of life.
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Background The association between serum nickel (Ni) and oral cancer incidence is unclear and most of the previous studies were observational studies that did not control for confounding factors between groups. Objective To assess the correlation of serum Ni with oral cancer incidence based on propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Methods A cohort of 456 newly diagnosed oral cancer patients was recruited from the First Hospital of Fujian Medical University during November 2011 to May 2019, and residents ordered their health check-up in hospitals or local community health centers over the same period were selected as a control group, which included a total of 1410 participants. Serum Ni was evaluated by inductively coupled plasma mass spectrometry. Case-control pairs were selected using a 1:1 PSM (caliper value of 0.02), and the study subjects in the case group and control group were weighted for subsequent analysis by IPTW. The general characteristics of the study subjects were tested for equilibrium before and after matching by chi-square test and standardized mean difference (SMD). This was followed by exploring the potential nonlinear dose-response relationship between serum Ni and oral cancer using restricted cubic splines as well as analyzing the association between serum Ni and oral cancer incidence by conditional logistic regression and weighted logistic regression. Results After controlling for between-group covariates by PSM and IPTW, the dose-response curves demonstrated that the risk of developing oral cancer tended to decline and then increase with the increasing serum Ni level. The outcome of the analysis using PSM demonstrated that as compared to the control group, the risk of developing oral cancer in the 0.09-16.80 μg·L−1 serum Ni group was negatively correlated with serum Ni level (OR=0.36, 95%CI: 0.24-0.54), whereas the risk of developing oral cancer in the >16.80 μg·L−1 serum Ni group was positively correlated with serum Ni level (OR=5.43, 95%CI: 2.76-10.68). After applying IPTW, a negative association was found between the risk of oral cancer and serum Ni concentration within a serum Ni window ranging from 0.09 to 20.55 μg·L−1 (OR=0.39, 95%CI: 0.29-0.52), while a positive association with an OR and 95%CI of 5.54 (3.62-8.49) for the Ni concentration > 20.55 μg·L−1. Conclusion In this study, a J-shaped relationship between serum Ni concentration and the risk of developing oral cancer is found, which shows that high serum Ni concentration (>20.55 μg·L−1) may be a risk factor for oral cancer.
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Objective:To study the influences of different levels of hyperbilirubinemia on the myocardium of newborn rats.Methods:Ninety-six 7-day-old newborn SD rats were selected and randomly assigned into control group (n=32, intraperitoneal injection of normal saline 0.5 ml), test group 1 (n=32, intraperitoneal injection of bilirubin solution 100 mg/kg) and test group 2 (n=32, intraperitoneal injection of bilirubin solution 200 mg/kg). Four time points were set at 0 h, 8 h, 24 h and 48 h. The general conditions of 8 rats from every group at each time point were recorded. The total serum bilirubin (TSB), cardiac troponin I (cTnI),heart fatty acid-binding protein (H-FABP) and B-type natriuretic peptide (BNP) were examined. The heart was removed and the pathological changes of the myocardium were observed under microscope. The caspase-3, B-cell lymphoma-2 protein (bcl-2) and bcl-2-associated X protein (bax) were tested. Using SPSS 20.0 statistical software, two-way ANOVA analysis of variance was conducted.Results:The TSB in test group 1 and 2 at 8~48 h were 2.5~4.4 times and 3.5~7.4 times higher than at 0 h [(20.8±3.0~36.5±10.4) μmol/L and (31.9±12.3~67.4±19.0) μmol/L vs. (8.4±2.1) μmol/L and (9.1±2.9) μmol/L]. No significant changes existed in cardiac histopathology at each time point among the three groups. At 48 h, as TSB level increased, the expression of apoptosis-related proteins caspase-3 and bax increased and the expression of bcl-2 decreased. Significant differences existed in the protein levels between any two groups (all P<0.05), except that bcl-2 in test group 1 was similar to control group ( P=0.255). With the prolonged duration of hyperbilirubinemia in test group 2, the expression of caspase-3 and bax increased, while the expression of bcl-2 decreased. Statistically significant differences existed in the protein levels between any two time points (all P<0.05), except that bax in 8 h subgroup was similar to 12 h subgroup ( P=0.820), and bcl-2 in 8 h subgroup was similar to 0 h subgroup ( P=0.064). The cTnI at 8 h, 24 h and 48 h in test group 1 and 2 were all significantly higher than the control group (all P<0.05),however, no significant differences existed between test group 1 and 2 (all P>0.05). H-FABP and BNP showed no significant differences among the three groups at any time point (all P>0.05). Conclusions:Hyperbilirubinemia can induce apoptosis of myocardial cells in newborn rats in a concentration- and time-dependent manner. Hyperbilirubinemia shows no significant effects on cardiac tissue pathology. Hyperbilirubinemia may cause mild injury to myocardium of newborn rats. The injury shows no correlation with TSB level and BNP level was not influenced.
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OBJECTIVE@#To conduct clinical and genetic analysis of two male patients with atypical Rett syndrome.@*METHODS@#Collection of clinical data in the two patients and these parents; whole exome sequencing (WES) was used to detect the potential variants, which were verified by Sanger sequencing. X chromosome inactivation (XCI) detection is performed in the Patient 1's mother to detect the allelic expression difference of the MECP2 gene.@*RESULTS@#Patient 1, a 5-year and 10-month-old boy, had mental disorders and mild intellectual disability (ID) (IQ: 54), whose mother had ID. Patient 2 was a 9-month and 18-day-old male presented with recurrent infections, respiratory insufficiency, hypotonia and global developmental delay. WES indentified a hemizygous mutation, c.499C>T (p.R167W), in the MECP2 gene in patient 1, which was inherited from his mother. The inactivation of X chromosome is skewed, and the expression ratio of wild-type and mutant MECP2 is 100%:0. Patient 2 was found a de novo splicing mutation, c.62+2_62+3del in the MECP2 gene. They were both reported pathogenic variant related to Rett syndrome. c.499C>T (p.R167W) was defined as likely pathogenic (PS1+PM2+PP3) and c.62+2_62+3del was pathogenic (PVS1+PM2+PM6) based on American College of Medical Genetics and Genomics standards and guidelines.@*CONCLUSION@#Both the two patients were diagnosed with rare male Rett syndrome, which had atypical clinical manifestations and large difference. Above foundings have revealed novel phenotypes in Chinese male patients with Rett syndrome.
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Female , Humans , Male , Craniosynostoses , Genetic Testing , Intellectual Disability/genetics , Methyl-CpG-Binding Protein 2/genetics , Mutation , Phenotype , Rett Syndrome/geneticsABSTRACT
Depressive disorder is a common mental disorder.At present, the diagnosis of depressive disorder mainly relies on patients' self-reported symptoms and clinical interviews which are relatively subjective.As one of the new technologies assisting diagnosis and therapeutic effect evaluation of depressive disorder, near-infrared spectroscopy (NIRS) has received a lot of attention in recent years.This article reviewed studies of using NIRS in the diagnosis and therapeutic effect evaluation of depressive disorder in the past five years.The review showed that NIRS could reflect abnormal hemodynamic activities of the prefrontal cortex and temporal cortex of patients with depressive disorder, especially the dorsolateral prefrontal cortex and inferior frontal gyrus.Changes of concentration of oxygenated hemoglobin in these areas showed higher accuracy in assisting the diagnosis of depression disorder.Until now, only a few longitudinal studies utilized NIRS to compare changes of cerebral hemodynamic activities at different time points of treatment which preliminarily confirmed the potential of NIRS in the evaluation of therapeutic effects of depressive disorder.In future, more large-scale studies will be needed to further determine the specific application standards for NIRS in the diagnosis and therapeutic effect evaluation of depressive disorder.
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Objective:To investigate the role of polyomavirus enhancer activator 3 (PEA3) in hyperoxia-induced injury of type Ⅱ alveolar epithelial cells (AEC Ⅱ) and the underlying mechanism.Methods:AEC Ⅱ cells were cultured in vitro and divided into hyperoxia group and normoxia group.After 24 h, 48 h and 72 h of hyperoxia or air treatment, cells were collected and the best treatment time was selected at 48 h. AEC Ⅱ cells were divided into 3 groups: control group, negative control group (transfected with negative control) and PEA3 over expression group (transfected with PEA3 overexpression plasmid). Each group was further divided into hyperoxia subgroup and normoxia subgroup.Cells were harvested at 48 h after hyperoxia or normoxia treatment.Reactive oxygen species (ROS), Nod-like receptor domain 3 (NLRP3), monocyte chemoattractant protein-1 (MCP-1), interleukin(IL)-1β, IL-6, IL-8, IL-18, surfactant protein C (SP-C), aquaporins 5 (AQP5), PEA3 and manganese superoxide dismutase (MnSOD) levels were detected.Differences were compared by the t-test and repeated measures analysis of variance using SPSS 20.0 statistical software. Results:The interaction of grouping and treatment duration had significant effects on ROS, IL-1β, IL-6, IL-8, IL-18, SP-C and AQP5 levels in AEC Ⅱ cells ( F=19.857, 20.132, 23.133, 18.673, 28.341, 27.333 and 34.217, respectively, all P<0.05). At 24 h, 48 h and 72 h, ROS level in hyperoxia group was 1.78, 1.94 and 2.26 times higher than that in normoxia group ( t=18.649, 17.486 and 19.385, respectively all P<0.05). NLRP3 and MCP-1 levels were significantly upregulated in hyperoxia group.IL-1β level was 1.33, 1.69, and 1.65 times higher in hypoxia group at 24 h, 48 h and 72 h than that of normoxia group; IL-6 level was 1.26, 1.56 and 2.12 timers higher; IL-8 level was 1.13, 1.47 and 2.34 times higher; and IL-18 level was 1.46, 1.72 and 1.95 times higher, respectively (all P<0.05). The protein expression of SP-C was downregulated, while that of AQP5 was significantly upregulated in hypoxia group.The RNA expression of SP-C was 22%, 63% and 72% lower in hypoxia group than that in normoxia group at 24 h, 48 h and 72 h ( t=3.982, 16.328 and 20.259, P<0.05, respectively), and that of AQP5 was 1.92, 5.23 and 7.36 times higher ( t=14.631, 18.945 and 19.521, respectively, all P<0.05). There were significant differences in ROS, IL-1β, IL-6, IL-8, IL-18, SP-C and AQP5 levels at 24 h, 48 h and 72 h in hyperoxia group ( F=22.343, 20.566, 23.701, 19.222, 32.146, 40.278 and 37.107, respectively, all P<0.05). After 48 h of PEA3 overexpression, compared with the hyperoxic negative control group, ROS level in hyperoxic AEC Ⅱ cells overexpressing PEA3 decreased by 34% ( t=14.635, P<0.05). NLRP3 and MCP-1 were downregulated in hyperoxic AEC Ⅱ cells after overexpression of PEA3.IL-1β, IL-6, IL-8 and IL-18 levels decreased by 29%, 22%, 27% and 18%, respectively ( t=15.895, 17.872, 18.749 and 15.274, all P=0.000). SP-C was upre-gulated and AQP5 was downregulated by overexpression of PEA3 in hyperoxic AEC Ⅱ cells.In addition, PEA3 and MnSOD levels were significantly enhanced. Conclusions:Overexpression of PEA3 can alleviate the increase of ROS level in AEC Ⅱ cells, block the activation of various inflammatory pathways and reduce the transformation from AEC Ⅱ to AEC Ⅰ cells via enhancing MnSOD level.
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Objective:To evaluate the correlation, consistency and safety of an smartphone application (APP) in screening neonatal jaundice using the smartphone based on the image-based bilirubin (IBB) and transcutaneous bilirubin (TcB).Methods:From July to October 2018, neonates with the age ≤28 d and gestational age ≥35 weeks who were admitted to Department of Neonatal and Obstetrics, Xuzhou Central Hospital without blue light phototherapy were recruited.They were randomly divided into two groups to measure the jaundice value of skin in front of sternum by a cross-control analysis.Jaundice level in group Ⅰ was first measured using the Nezhabaobei? APP in iPhone 6, and then measured using the JM-103 transcutaneous jaundice instrument as the control device.In group Ⅱ, jaundice level was sequencially measured by the control device and the Nezhabaobei? APP.Sex, age, gestational age, birth weight and the mean value of three consecutive tests were recorded.The Pearson′s correlation analysis, Bland-Altman plots consistency analysis, t test and receiver operating characteristic (ROC) curve were used for statistical analysis. Results:A total of 185 eligible neonates were enrolled, including 99 males and 86 females, with the median age of 5 d (3-8 d), gestational age of (37.6 ± 1.7) weeks, and birth weight of (2 950 ± 645) g. There were good correlation ( r=0.860, P<0.05) and consistency (95.1% of the samples fall within the 95% consistency interval) between IBB and TcB.Good correlation and consistency were also yielded in subgroup analyses based on the sex, age, gestational age and birth weight.The consistency was better in subgroups of ≤7 d, >37 weeks and>2 500 g. The ability of IBB to predict TcB>256.5 μmol/L was better than that of TcB>171.0 μmol/L.The area under the ROC curve was 0.93, the cut-off value was 232.6 μmol/L, the sensitivity was 96.7%, and the specificity was 82.6%.The difference of the mean values of IBB and TcB detected for 3 times was significantly lower than that obtained in the first measurement of IBB and TcB [(12.0 ± 34.4) μmol/L vs.(14.4 ± 38.6) μmol/L, P=0.038]. There were no adverse events and no defects in the device itself. Conclusions:There are good correlation and consistency between IBB and TcB.The ability of IBB to predict TcB>256.5 μmol/L is better than that of TcB>171.0 μmol/L, which is safe in clinical use.
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Hyperbilirubinemia is the most common clinical symptom in neonates that requires evaluation and treatment.It has been confirmed that free indirect bilirubin of high concentration have direct toxic effect on nerve tissue and impair its function, but its effect on extraneural organs or systems (such as kidney, heart, liver, intestine, lung, blood coagulation and immune function) is still controversial.This present study reviewed the previous relevant research in recent years to understand the effect of bilirubin of different concentrations on neonatal kidney.
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Vertical one-and-a-half syndrome (VOHS) is a rare ophthalmoplegia syndrome caused by unilateral thalamo-mesencephalic infarct. It is manifested as a conjugate upgaze palsy and a monocular paresis of downward gaze. Recognition of VOHS helps clinical localization. No cases of VOHS with photos or videos of ocular motility have been reported in China. Herein a case of VOHS caused by unilateral thalamo-mesencephalic infarct is reported, in order to improve awareness about the ocular sign.
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Objective At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.
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Objective:To investigate the effect of laparoscopic surgery in the treatment of ectopic pregnancy and its influence on pregnancy and complications.Methods:From January 2014 to January 2018, 130 cases of ectopic pregnancy patients admitted to the Fourth People's Hospital of Tongxiang were selected.Among them, 93 cases with fertility requirements were selected as the study subjects.According to different surgical method, they were divided into observation group (46 cases) and control group (47 cases). The observation group was treated by laparoscopic surgery, while the control group was treated by open surgery.The operative indicators and complications were compared between the two groups.The pregnancy was followed up at 12 months after operation.Results:The bleeding volume in the observation group was (43.24±8.98)mL, which was less than that in the control group[(87.94±15.46)mL], the anal exhaust time[(14.96±3.24)h] and the time of getting out of bed activity[(10.13±2.41)h]in the observation group were shorter than that in the control group[(26.53±2.89)h and (18.65±2.76)h], the hospitalization time[(5.41±1.23)d] and the operation time[(65.89±13.21)min] in the observation group were shorter than that in the control group[(7.87±1.54)d and (81.32±14.25)min], the differences between the two groups were statistically significant( t=17.002, 18.183, 15.844, 8.501, 5.405, all P<0.05). The incidence of postoperative complications in the observation group (6.52%) was lower than that in the control group (25.53%) (χ 2=6.211, P<0.05). The intrauterine pregnancy rate in the observation group (78.26%) was higher than that in the control group (51.06%) (χ 2=7.482, P<0.05). Conclusion:Laparoscopic surgery is effective in the treatment of ectopic pregnancy.It can improve the rate of intrauterine pregnancy, reduce postoperative complications and shorten hospitalization time.
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Objective:To evaluate the rationality of the "Sandwich Principle teaching mode" adopted in our teaching of internal medicine and verify the necessity of its "Intergroup intersecting discussion".Methods:33 students majoring in traditional Chinese medicine were divided into control group (taught by standard process of sandwich principle) and experiment group (taught by simplified process of sandwich principle). The Dundee Ready Education Environment Measure (DREEM) was used to evaluate students' feelings toward the two teaching modes.Results:The total score of DREEM in the control group was higher than that in the experiment group, with statistically significant difference; the total score in the academic perception subscale in the control group was higher than that in the experiment group, among which the scores of "I have faith in passing the exam this year" and other 2 items were better than that in the experiment group, with statistically significant difference ( P<0.05); there were no statistical difference in the total scores of other perception subscales between the two groups( P>0.05), but the scores of the 9 items including "the atmosphere is very harmonious in the clinical teaching process" in the control group were significantly better than those in the experiment group, with statistically significant difference( P<0.05). Conclusion:The teaching mode of Sandwich Principle can create a positive and effective learning environment for supporting students. "Intergroup intersecting discussion" can encourage students to actively participate in the teaching process, and help increase their academic confidence and sense of achievement in learning. It is also helpful to build a harmonious teacher-student relationship and create a relaxing and pleasant learning environment so that students can gain a better learning experience. Therefore, "Intergroup intersecting discussion" is indispensable in medical teaching.
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Objective To observe the clinical efficacy and safety of caffeine citrate combined with heated humidified high-flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) in preterm infants.Methods From June 2017 to December 2018,a total of 82 preterm infants with RDS (28 weeks ≤ gestational age＜32 weeks) who were hospitalized in Neonatal Intensive Care Unit of the Affiliated Xuzhou Hospital of Southeast University were chosen as research subjects.They were randomly (random number table method) divided into two groups:the combined treatment group (n=42) and the control group (n=40).Infants in the combined treatment group were given caffeine citrate combined with HHHFNC,while infants in the control group were given nasal continuous positive airway pressure (NCPAP) without caffeine citrate.The general clinical data,results of blood gas analysis at 6 h and 24 h after breath support therapy,clinical efficacy,related complications and adverse drug reactions between the two groups were compared statistically by LSD-t test,Chi-square test and Kruskal-Wallis H rank sum test.Results ① No significant differences were found between the two groups in the general clinical data (all P＞0.05).② The results of intra-groups comparison within the combined treatment group or control group showed that the pH value,partial pressure of arterial carbon dioxide (PaCO2),partial pressure of arterial oxygen (PaO2) of blood gas analysis and PaO2/fraction of inspired oxygen (P/F) at 6 h and 24 h after breath support therapy were all significantly improved compared to those of before treatment (all P＜0.05);The PaO2 and P/F of premature infants in the combined treatment group at 6 h and 24 h after breath support therapy were significantly higher than those in the control group,while PaCO2 were significantly lower than that in the control group (all P＜0.05).③ The duration of noninvasive ventilation,total oxygen inhaling,failure rate of machine withdrawal,use of pulmonary surfactants,the rate of tracheal intubation within 72 h and the times of apnea in combined treatment group were 3.0 d (1.0,18.0)d,5.5 d (3.0,21.0)d,4 case(9.5％),10 case(23.8％),3 case(7.1％) and 6.0 times(3.0,21.0)times,which were significant shorter,or lower,or less than those in control group,which were 7.0 d (2.0,22.0),10.0 d (4.0,28.0),11 case(27.5％),19 case(47.5％),12 case(30.0％)and 15.0 times(4.0,28.0)times,and the differences were all statistically significant (all P＜0.05).④ The occurrence of nasal trauma,abdominal distention and head shaping in the combined treatment group were significantly lower than those in the control group (all P＜0.05).⑤ There were no significant differences between the two groups of premature infants in related complication and caffeine associated adverse reactions (all P＞0.05).Conclusions Caffeine citrate combined with HHHFNC treatment strategy for premature infants with RDS can effectively improve oxygenation,shorten the duration of noninvasive mechanical ventilation,increase the success rate of machine withdrawal,and reduce the incidence of nasal trauma and abdominal distention.
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Objective The vertical transmission of HIV, from mother to child remains one of the most important challenges all over the world. This study evaluated the implementation and effectiveness of prevention of mother to child HIV transmission program (PMTCT) from 2012 to 2019 in Suzhou. Methods The data used in this study were obtained from the PMTCT program carried out in hospitals and maternal and child health care centers of Suzhou from 2012 to 2019. The basic information of the HIV positive mothers including marital status, gravidity and parity history, educational background, date of HIV diagnosis, transmission route of HIV, information about the sexual partner, last menstrual period, current pregnancy outcome, and neonatal information were collected. The characteristics of the HIV positive mothers from 2012 to 2019 were analyzed. The statistical difference between the groups was evaluated by the χ2-test or Fisher's exact test as appropriate. P<0.05 was considered statistically significant. Results A total of 116 HIV positive women were diagnosed through prenatal examination. Among the 116 pregnant women, 75 gave birth to 76 live neonates. Only one infant was diagnosed HIV infected because of the HIV positive mother didn't take the anti-virus drugs until delivery. Conclusion The HIV prevalence of Suzhou city showed a low-level tendency. It's important to perform early diagnosis and early prevention for HIV positive pregnant women. There are improvements to make in the program implementation in Suzhou city.
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Objective:To explore the influence of organizational management mode and regional medical resource allocation on thrombolysis rate of stroke.Methods:A cross-sectional study was carried out in 61 thrombolytic units distributed at 16 administrative districts of Shanghai to collect information including the number of imaging equipment, neurologists and nurses, hospital organization and management mode, thrombolytic rate, etc. Using SPSS 19.0 statistical software, simple linear regression analysis and chi square test were used to analyze the correlation between related indexes and thrombolysis rate.Results:There was no linear correlation between imaging equipment, human resources and regional thrombolysis rate. The key factor to improve thrombolysis rate was the organizational management of stroke( OR=1.488, 95% CI=1.357-1.631, P<0.001). Conclusions:An effective hospital organization and management model, including the establishment of multi department cooperation, stroke emergency team, stroke green channel, can significantly improve the thrombolysis rate of stroke.
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Objective@#To analyze the correlation between the continuous opening of patent ductus arteriosus(PDA) in preterm infants and platelet parameters in the first 24 hours of life.@*Methods@#The preterm infants (gestational age <34 weeks) admitted to Neonatal Intensive Care Unit(NICU)of the Affiliated Xuzhou Hospital of Southeast University from November 2012 to July 2018 were enrolled.The following data were collected retrospectively: the platelet parameters in the first 24 hours of life, clinical factors possibly related to continuous opening of PDA, and echocardiography examination fin-dings on the 4th-7th day after birth.According to the diagnostic criteria of PDA, all preterm infants were divided into symptomatic PDA(sPDA) group, non-sPDA (nsPDA) group, and non-PDA (nPDA) group.SPSS 20.0 software was used for data analysis.Data were analyzed by Chi-square test, LSD or Tambane′s T2 of One-Way analysis of variance, and binary Logistic regression analysis of the receiver operating characteristic (ROC) curve.@*Results@#Totally 760 preterm infants were chosen, and among them there were 67 cases (8.8%) in sPDA group, 106 cases (14.0%) in nsPDA group, and 587 cases (77.2%) in nPDA group.There were significant diffe-rences in the terms of gestation age, birth weight, platelet counts (PLT), and plateletcrit (PCT) in the first 24 hours of life among 3 groups (all P<0.05). The smaller gestation age, the lower birth weight, the lower PLT and PCT in the first 24 hours of life, and the higher incidence of PDA in preterm infants.There were no significant differences in the platelet distribution width, mean platelet volume, and platelet large cell ratio in the first 24 hours of life among 3 groups (all P>0.05). The low lower birth weight and PCT in the first 24 hours of life were independent risk factors for the occurrence of sPDA in preterm infants (P=0.013, 0.000). The risk of occurrence of sPDA in preterm infants will be increased by 3.279-fold (95%CI: 2.369-4.479) if PCT in the first 24 hours of life is decreased by 0.10%.The area under the ROC curves of PCT and PLT in the first 24 hours of life for prediction of sPDA in preterm infants was 0.757 (95%CI: 0.712-0.814) and 0.718 (95%CI: 0.671-0.768), respectively.The best cutoff values of PCT and PLT were 0.178% (sensitivity was 75.7%, specificity was 71.9%) and 207.5×109/L (sensitivity was 71.4%, specificity was 63.2%).@*Conclusions@#The continuous opening of PDA in preterm infants may have correlation with the platelet.The low PCT, rather than PLT, in the first 24 hours of life was an independent risk factor and has medium predictive value for the occurrence of sPDA in preterm infants on the 4th-7th day after birth.
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Objective To evaluate the clinical value of 3D printed modeling used to assist internal fixation for pelvic fractures.Methods The databases,Pubmed,EMBase,Cochrane library,CNKI,Wanfang and VIP,from initiation till August 2018,were searched for the controlled studies comparing surgery assisted by 3D printed modeling and conventional surgery in the treatment of pelvic fractures.The 2 groups were compared in terms of surgical time,blood loss,Matta score for reduction,Majeed score for functional recovery and complications.This meta-analysis was performed using software RevMan 5.3.Results A total of 6 relative controlled studies were included for this analysis involving 513 patients.There were 221 cases in the 3D printed modeling group and 292 ones in the conventional group.Our Meta-analysis showed that there were significant differences between the 2 groups in surgical time (MD =-48.11,95％ CI:-74.16 ～-22.06,P ＜0.05),blood loss (MD=-250.63,95％ CI:-337.42～-163.84,P ＜0.05) and Matta score for reduction (OR =1.85,95％ CI:1.07 ～ 3.20,P =0.03),favoring the 3D printed modeling group.No statistically significant difference was found between the 2 group in the rate of complications (OR =0.61,95％ CI:0.32 ～ 1.17,P =0.14).Conclusion Assistance with 3D printed modeling may help the surgery for pelvic fractures to shorten surgery time,decrease blood loss and improve reduction quality.