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Objective:To establish and apply the electronic further modified early warning score system (e-fMEWS), and explore its role in the condition evaluation and early warning of inpatients in non-critical units, so as to provide clinical nurses with an early and dynamic method to identify the potential deterioration risk of patients' condition.Methods:A retrospective analysis of 262 805 inpatients in multiple non-critical units of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to December 2018 and January to December 2020 was performed. The patients who were hospitalized from January to December 2018 were used as the control group, and the responsible nurse used the traditional single evaluation index to start the emergency response system; the patients from January to December 2020 were used as the research group, and the emergency response system was started using e-fMEWS. The inclusion criteria were as follows: (1) hospitalization time ≥24 h; (2) patient ≥14 years old. Exclusion criteria were as follows: (1) patients had cardiopulmonary resuscitation before admission; (2) patients discontinued treatment or were transferred to another hospital during treatment; (3) patients received palliative care; (4) patients were admitted to non-critical wards in grade I of emergency pre-examination and triage. The activation of the rapid response team (RRT), the activation of the cardiorespiratory arrest team, the incidence of cardiac and respiratory arrest, the number of cases of invasive mechanical ventilation, the number of cases admitted to the intensive care unit, the length of hospital stay and the prognosis were compared. Statistical software SPSS 22.0 was used for data analysis.Results:Under the e-fMEWS assessment, compared with the control group, the rate of initiation of the research group decreased by 0.03%. For patients who initiated RRT, the average length of hospital stay was shortened, and the number of in-hospital respiratory cardiac arrest decreased (12.2% vs. 13.2%) and the number of cases transferred to the intensive care unit was less (42.8% vs. 50.6%), the rate of improvement and recovary increased (58.4% vs. 56.1%).Conclusions:The application of e-fMEWS can help clinical nurses to quickly and accurately identify the potential risk of deterioration of the patient's condition. Through early identification of potentially critically ill patients in non-critical units, early intervention and timely treatment can avoid adverse events and improve the patient prognosis.
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Objective:To investigate the therapeutic effect of artesunate on mice with acute Toxoplasma gondii ( T. gondii) infection. Methods:Based on body weight (16 - 18 g), sixty-four C57BL/6 female mice aged 6 - 8 weeks were divided into 4 groups by random number table method: uninfected control group without treatment; T. gondii-infected group (Tg group), each mouse was intraperitoneally (i.p.) infected with 100 tachyzoites of T. gondii RH strain; T. gondii-infected + artesunate treatment group (Tg + ART group), 3 hours after each mouse i.p. infected with 100 tachyzoites of T. gondii RH strain, artesunate solution was i.p. injected at a dose of 30 mg/kg, once a day for a total of 7 consecutive days; T. gondii-infected + sulfadiazine treatment group (Tg + SDZ group), 3 hours after each mouse i.p. infected with 100 tachyzoites of T. gondii RH strain, sulfadiazine solution was orally administrated at a dose of 100 mg/kg, once a day for a total of 7 consecutive days. There were 16 mice in each group, in which 10 mice were used to observe survival time and 6 mice were used to monitor body weight and collect tissue samples. Mice were weighed every day from day 1 post infection (p.i.); mice were sacrificed at day 7 p.i., the liver weights of mice were weighed and the liver indexes were calculated; liver tissues were paraffin-embedded, sectioned, and stained with hematoxylin-eosin (HE), and the pathological changes of liver tissues of mice in each group were observed under a light microscope. The expression levels of T. gondii major surface antigen 1 (SAG1) in the liver tissues of mice in each group were detected by real-time quantitative PCR for evaluating parasite load. Results:All mice in the uninfected control group were survived. The survival time was 7 - 9 days in Tg group, 8 - 11 days in Tg + ART group, and 9 - 13 days in Tg + SDZ group. Compared with Tg group, the survival times of mice in Tg + ART group and Tg + SDZ group were significantly longer ( P < 0.05). On day 7 p.i., compared with uninfected control group, Tg + ART group or Tg + SDZ group, the body weight of mice in Tg group was lower ( P < 0.05); however, there was no significant difference of body weight in Tg + ART group and Tg + SDZ group compared with uninfected control group ( P > 0.05). Compared with Tg group, Tg + ART group and Tg + SDZ group had lower liver indexes and SAG1 mRNA expression levels in the liver tissues ( P < 0.05 or < 0.001), and liver histopathological changes were milder. Compared with Tg + SDZ group, there was no significant difference in both liver index and SAG1 mRNA expression level in the liver tissue of Tg + ART group ( P > 0.05). Conclusion:Artesunate solution i.p. injection can prolong the survival time, reduce parasite load in the liver, and attenuate hepatic pathological damage, to a certain extent, of mice with acute T. gondii infection.
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ObjectiveTo observe the effects of Fuzitang （FZT） on the proliferation of MH7A cells， the human rheumatoid arthritis synovial fibroblasts， and the expression of miR-155 and explore its anti-rheumatoid arthritis mechanism. MethodMH7A cells were cultured in vitro and divided into a blank group， high- （25 g·L-1） and low-dose （12.5 g·L-1） FZT groups， and a positive drug group （hydroxychloroquine， 0.006 25 g·L-1）. The cell proliferation was detected by cell counting kit-8（CCK-8） method， and the change in the MH7A cell cycle was detected by flow cytometry. The mRNA expression of miR-155 and its downstream genes， including SH2 domain-containing inositol 5-phosphatase-1（SHIP-1）， protein kinase B 3（Akt3）， and mammalian target of rapamycin（mTOR）， was detected by Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the protein expression of phosphatidylinositol 3-kinase （PI3K）， Akt3， and mTOR was detected by Western blot. ResultFZT in vitro in a concentration of 6.25 g·L-1 above could inhibit the proliferation of MH7A cells in the significant dose- and time-effect manner. Compared with the blank group， the FZT groups showed increased proportions of cells in the G2/M phase （P<0.05）， and the high-dose FZT group showed a decreased proportion of cells in the G0/G1 phase （P<0.05）. The arresting effect of FZT on the cell cycle was in a significant dose-effect manner. Compared with the blank group， the FZT groups showed down-regulated miR-155 and mTOR mRNA expression （P<0.05）， and the high-dose FZT group showed up-regulated SHIP1 mRNA expression and down-regulated Akt3 mRNA expression （P<0.05）. Compared with the blank group， the FZT groups showed reduced protein expression of PI3K， Akt3， and mTOR （P<0.05）. ConclusionFZT can significantly inhibit the proliferation of MH7A cells， and the mechanism is related to the promotion of the expression of SHIP-1 and down-regulation of the gene expression of the PI3K/Akt3/mTOR signaling pathway by down-regulating the expression of miR-155.
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Under the background of efficiency medical reform, the authors introduced the nursing efficiency management system of a large public hospital, which was divided into two dimensions: nursing resource allocation efficiency and nursing service efficiency. The specific four measures included the establishment of multi-campus unified management organization structure based on nursing management committee, nursing performance reform based on structured big data information platform, the construction of nurse-led patient whole process management model and the accelerated rehabilitation nursing practice from surgery to the whole hospital, so as to provide reference for the nursing efficiency management of large general public hospitals under the medical reform.
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Objective:To compare the differences of short and long-term outcomes between laparoscopic surgery and open surgery treatment of intrahepatic cholangiocarcinoma patients.Methods:A retrospective cohort study was conducted to collect the clinical data of 118 patients with intrahepatic cholangiocarcinoma who underwent surgery in Qilu Hospital of Shandong University from January 2015 to June 2020. They were divided into laparoscopy group and open group according to the operation methods. The perioperative data, such as intraoperative surgical conditions, hospital costs, postoperative complications, postoperative blood biochemical tests, and the follow-up data of the two groups were compared.Results:In the laparoscopic group, there were 40 patients, 18 males and 22 females, aged (61.5±9.1) years. There were 78 patients in the open group, 48 males and 30 females, aged (61.2±8.3) years. The tumor size of the laparoscopic group was (4.4±1.8) cm, which was smaller than that of the open group (6.0±3.3) cm, and the differences were statistically significant ( P<0.05). In the laparoscopic group, 4 cases (10%) were converted to open surgery. The intraoperative blood loss, intraoperative blood transfusion proportion, 3 or more liver segments resection proportion and hospital costs of laparoscopic group were lower than those of open group [200.0(100.0, 261.8) ml vs. 300.0(100.0, 400.0) ml, 5.0%(2/40) vs. 26.9%(21/78), 37.5%(15/40) vs. 66.7%(52/78), (6.2±2.0) wan yuan vs. (7.2±2.3) wan yuan], the differences were statistically significant (all P<0.05). There were no significant differences in the incidence of postoperative complications between the two groups ( P>0.05). On the first post-operative day, ALT serum level and the third post-operative day TBil serum level in the laparoscopic group were lower than those in the open group [188.5(130.5, 274.0) U/L vs. 320.0(144.0, 427.0) U/L, 26.4(18.3, 26.4) μmol/L vs. 31.6(18.8, 37.5) μmol/l], the differences were statistically significant ( P<0.05). There were no significant differences in 1-year and 2-year overall survival rate and disease-free survival rate between the two groups ( P>0.05). Conclusion:Compared with open surgery, laparoscopic surgery in the treatment of intrahepatic cholangiocarcinoma has better short-term outcomes, and can achieve similar results in medium- or long-term outcomes.
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Objective:To develop and internally validate a fall related injury risk nomogram in of patients in Patients in hospital.Methods:Patients who fall during the hospital stay from a grade-three general hospital of Zhejiang province were recruited. Data were collected from January 2014 to December 2019. Data was collected after patients fall in hospital, including age, sex, and 18 other predictive factors. The LASSO regression model and multivariable logistic regression analysis were applied to build a predicting model. Discrimination and calibration of the predicting model were assessed using the C-index and calibration plot. Internal validation was assessed using the bootstrapping validation.Results:Of the 243 patients included in the study, 70 patients had fall related injury. The fall related injury probability was 28.81%. Predictors contained in the prediction nomogram included age≥60, dysfunction, combined utilization of special drugs, no-escort, hypocalcemia. The model displayed good discrimination with a C-index of 0.823 (95% confidence interval 0.756-0.875) and good calibration. High C-index value of 0.803 could still be reached in the interval validation.Conclusion:This fall related injury risk nomogram in of patients in Patients in hospital incorporating the age≥60, dysfunction, combined utilization of special drugs, no-escort, hypocalcemia could be conveniently used to predict fall related injury risk of patients in hospital.
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Objective:To investigate the regulation and mechanism of chronic Trichinella spiralis ( Ts) infection on liver immunopathology in mice co-infected with Plasmodium berghei ANKA( PbA). Methods:According to body weight, 64 specific pathogen free female Kunming mice (6 - 8 weeks old, weighting 22 - 25 g) were divided into 4 groups by using random number table method. Control group: uninfected; Ts group: mice were mono-infected with 30 Ts larvae by oral gavage on day 0; PbA group: mice were mono-infected with 1 × 10 6PbA-infected red blood cells in 0.1 ml of phosphate buffer (PBS) administered by intraperitoneal injection on day 121; co-infected ( Ts+PbA) group: mice were infected with 30 Ts larvae by oral gavage and intraperitoneal injected with 1 × 10 6PbA-infected red blood cells in 0.1 ml PBS on day 121 after Ts infection. There were 16 mice in each group, in which 10 mice in each group were monitored for the survival rate. The peripheral red blood cell parasitemia of PbA group and Ts + PbA group were monitored every other day by light microscope examination of Giemsa-stained thin tail-blood smears from day 3 after PbA infection. Mice were sacrificed at day 135 after Ts infection and/or at day 15 after PbA infection, the mouse body weight and liver weight were measured, and the liver index were calculated. Ts-infected mice were monitored by a light microscope examination of diaphragm compression slide. Under a light microscope, the liver pathology and liver fibrosis of mice were observed and compared with hematoxylin-eosin (HE) staining and Sirius red staining, respectively. The F4/80 + Kupffer cells in liver of mice were examined by immunohistochemical staining. Results:After infection with Ts or PbA, Ts larvae cysts were observed in diaphragm tissues and PbA were observed in red blood cells under the light microscope. After PbA infection, there was no significant difference in survival rate between PbA group and Ts+ PbA group ( P > 0.05). Compared with PbA group, the peripheral red blood cell parasitemia was significantly decreased in Ts+ PbA group on days 11 and 15 after PbA infection (%: 27.104 ± 7.623 vs 45.032 ± 9.849, 60.218 ± 2.776 vs 76.778 ± 6.351, P < 0.05), and the liver index and the liver pathology score were significantly decreased in Ts+ PbA group ( P < 0.05). Sirius red staining showed that the positive area of liver fibrosis in Ts+ PbA group was significantly higher than that in PbA group ( P < 0.05). Immunohistochemical staining showed that the average optical density value of F4/80 + Kupffer cells in Ts+ PbA group was significantly higher than that in PbA group ( P < 0.01). Conclusion:Chronic Ts infection may reduce the peripheral red blood cell parasitemia, increase F4/80 + Kupffer cells expression in liver, and attenuate liver pathology in mice co-infected with PbA.
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Parasitic diseases still remain the world's greatest health problems and cause huge economic burden in poor areas. The drugs currently used to treat protozoiases and helminthiases have certain defects, and it is urgent to develop more effective therapeutic drugs for these diseases. Berberine is one kind of important anti-inflammatory agents originally derived from Coptis rhizoma. The derivatives of berberine are obtained by modifying the structural site of berberine. In addition to its anti-inflammatory and anti-microbial activities, berberine and its derivatives also have significant anti-parasitic activity. In this paper, we summarized recent progress in the use of berberine and its derivatives against the infections of protozoa ( Leishmania spp ., Trypanosoma spp. , Toxoplasma gondii, Plasmodium falciparum, and Eimeria tenella) and helminths ( Schistosoma mansoni, Schistosoma. japonicum, Echinococcus granulosus, and Toxocara canis), which may providea useful reference for researchers in this field.
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Objective@#To evaluate the effect of hybrid operation suite in the treatment of cerebral and spinal vascular diseases and intracranial hypervascular tumors.@*Methods@#A retrospective study was conducted on 132 patients with various cerebral and spinal vascular diseases and intracranial hypervascular tumors who were treated by hybrid surgery at Department of Neurosurgery, Huashan Hospital from October 2016 to December 2017.There were 70 male and 62 female patients with a mean age of 48.33 years (range: 14-78 years), including 64 cases of intracranial aneurysm (41 complicated aneurysm cases), 28 cases of brain arteriovenous malformation (BAVM), 12 cases of hypervascular tumor, 12 cases of dural arteriovenous fistula (DAVF), 6 cases of carotid artery stenosis, 5 cases of Moyamoya disease, 3 cases of intracranial aneurysm or BAVM combined with tumor, 1 case of scalp arteriovenous fistula and 1 case of critical brain trauma in which a foreign metal stick approached the basal vascular circuit.Abnormalities were found in 16 cases in intraoperative angiography. The clinical data of all patients was collected as a perspective cohort. The success rate of hybrid surgery, intra-operative and post-operative complications, morbidity, mortality, rate of infection, the length of hospital stay were all analyzed to illustrate the effect of hybrid operation mode to traditional surgical pattern.@*Results@#For 64 cases with intracranial aneurysms, the immediate complete occlusion rate was 90.5%, with a mortality of 4.7% and a morbidity of 14.0%. For 28 cases of BAVM and 12 cases of DAVF, all patients achieved total obliteration and favorable social independent outcomes after hybrid surgery, with no complication.For 6 cases of carotid artery stenosis and 5 cases of Moyamoya, intra-operative confirmed good cerebral reperfusion without any new post-operative neurologic deficits. After tumor vessels embolization, 4 out of 12 cases of hypervascular tumor needed intra-operative blood transfusion, and all patients achieved total tumor resection in a single stage. Only one patient with medulla oblongata hemangioblastoma died 6 months after operation due to respiratory deficit related pneumonia. Compared to traditional surgeries, the hybrid operation pattern did not significantly increase the total infection rate, central nervous system infection rate, hospital stay days and post-operative hospital stay days (all P>0.05) while the in-patient cost increased mildly (119 332 yuan vs.98 215 yuan, t=2.38, P=0.02).@*Conclusions@#The operations of complex cerebral and spinal vascular diseases and intracranial hypervascular tumors can be performed in hybrid operation suite safely.This surgical mode can ensure the quality of operation and promote the development of innovative and complicated surgical procedures.
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With standard of living gradually increasing, people expect higher and higher from nurses, which brings great challenge to nursing service. However, excellent nursing team is the basic guarantee of promoting the development of nursing career better. Hence, this paper reviewed the researches on theory, influence factors and methods of construction of Chinese clinical nursing team, then sum up its tendency of development, so as to provide reference for building and managing our nursing team better.
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Objective To explore the effects of Six-Step standardized communication procedure in improving the communication ability of nurses.Methods C-I-CARE communication procedure was converted into Chinese.The Chinese version of Six-Step standardized communication procedure was Yi Kan,Er Yin,San Gaozhi,Si Wen,Wu Da,Liu Zaijian.The procedure was propagandized by making posters,setting up computer desktop,training nurses by lectures,video and role play.The effects were evaluated by pre and post self-control test among 100 nurses.Results The average score of communication behavior of 100 nurses after applying standardized communication procedure increased from 2.55±0.67 to 4.44±0.59 (t=-23.174,P＜0.001).In 2015,the nursing department received 622 silk banners and commendatory letters for appreciating nursing work,increased by 18.9％ compared to 2014.The discharged patient satisfaction increased from 94.2％ to 96.93％.The satisfaction of doctors to nurses' collaboration was 99.86％.There was no nursing complaint or dispute caused by bad communication.Conclusion The application of procedure and standardized communication method can improve the communication ability of nurses,optimize the relationship between nurses and patients and increase patient satisfaction.
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Objective To shorten the transfer time of critical inpatients from wards to intensive care unit (ICU). Methods From Novem-ber to December, 2015, 30 critical inpatients transferred from wards to ICU were investigated, and analyzed with Six Sigma DMAIC five-step method. There were 7 main processes and 22 sub-processes refined in transfer procedure, as well as the key quality points and the factors influencing the safety of transferring. Some improvement advice were recommended, including multifunctional transfer cart, Check-list before Transfer to Intensive Care Unit for Critical Patients, setting up transport group, training for young nurses and application of SBAR communication. Other 30 critical inpatients transferred from wards to ICU, from May to June, 2016, after the series of control pro-grams, were investigated. Results After improvement, the total transfer time from wards to ICU decreased (t=15.052, P<0.001), without the increase of human power and unsafety issues. The rescue success rate increased from 91.67%to 98.01%. Conclusion The process transfer-ring patient from wards to ICU has been reengineered based on Six Sigma DMAIC management, that reduces the time and improve the res-cue success rate.
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OBJECTIVE:To study the analgesic effect and mechanism of Gutongtie paste on model rats with formaldehyde-in-duced pain. METHODS:60 SD rats were randomly divided into blank group,model group,Gutongtie paste low-dose,medi-um-dose,high-dose groups(0.594,1.188. 2.376 g/paste,containing crude drug 0.48,0.96,1.92 g)and prednisone acetate group (ig,0.0054 g/kg,external bonding matrix). Model rats with pain was induced by formaldehyde method and immediately adminis-trated after modeling. Electronic tenderness instrument was adopted to determine the pain threshold of rats'ankle joint after adminis-tration of 1,2,3,4,6 h. After 6 h,blood sample 0.3 mL was taken from abdominal aorta then rats were sacrificed. Enzyme linked immunosorbent assay (ELISA) was conducted to determine the β-endorphin (β-EP),prostaglandin E2 (PGE2) contents;spectrophotometry was used to determine nitric oxide(NO)content in rats'serum and inflammatory tissue;and radioimmunoassay was adopted to detect the substance P content in rats'serum,inflammatory tissue and brain tissue. RESULTS:Compared with be-fore modeling,pain thresholds in model group at each period were significantly decreased (P<0.05 or P<0.01). Compared with blank group,PGE2,NO of rats,substance P content in inflammatory tissue and brain tissue in model group were significantly in-creased (P<0.05 or P<0.01). Compared with model group,pain thresholds in Gutongtie paste groups at corresponding time points were increased,PGE2 and substance P contents in inflammatory tissue and brain tissue were decreased (P<0.05 or P<0.01);β-EP and NO contents in serum in Gutongtie paste medium-dose,high-dose groups(P<0.05 or P<0.01),NO contents in serum in Gutongtie paste high-dose group were decreased(P<0.05). CONCLUSIONS:Gutongtie paste has a certain analgesic and anti-inflammatory effect,and the mechanism may be related to reducing PGE2, NO, substance P contents, increasing β-EP content.
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Objective To investigate the clinical features and pathogenic genes of a familial hypokalemic periodic paralysis ( HOKPP).Methods PCR amplification and DNA sequencing were used to screen candidate genes of the HOKPP family members (CACNA1S, SCN4A, KCNE3), and the clinical features were carefully analyzed at the same time.Results The sequencing analyses of the SCN4A gene in the proband identified three nucleotide sequence mutations, which influenced the amino acid sequence of the skeletal sodium channel.One of the mutations was identified as a C/T heterozygous pattern at the 2111th nucleotide position in exon 13, resulting in a change from Thr to Met at the 704th amino acid position of the sodium channel protein.All affected patients carried the Thr704Met mutation, whereas unaffected family members did not.Clinical symptoms in this family followed an autosomal dominant inheritance pattern.Muscles weakness, pain and hypokalemia in the period between attacks were seen in all patients.Paralytic symptoms occurred early, lasted longer and recurred frequently, while cold was the main predisposing factor.With the progress of the disease, patients represented persistent weakness and atrophy in proximal muscles.Conclusions Mutation (Thr704Met) in the SCN4A gene should be responsible for this family.This mutation causes severe HOKPP and progressive muscle atrophy.
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Objective:To investigate and evaluate the anti-tumor activity of hydroxychloroquine ( HCQ) in vitro. Methods:CCK-8 assay was applied to detect the inhibitory effect of HCQ at different concentrations(4. 78, 9. 55, 19. 10, 38. 20,76. 40 μg?ml-1 ) on A549 cells, HepG2 cells, HT-29 cells, K562 cells, Hela cells and B16 cells. Absorbance was detected by a microplate reader, and then the inhibitory rate of the tumor cells and the IC50 was calculated. Results:Compared with those of the negative control group, the inhibitory rates of HCQ at different concentrations against the six tumor cells were all increased significantly in a dose-dependent manner (P<0. 01). The inhibitory rates of the tumor cells were all above 60% when the concentration reached 38. 20μg?ml-1. The IC50 was 26. 70(A549), 27. 47(HepG2), 5. 72(HT-29), 14. 03(K562), 20. 21(Hela) and 13. 62(B16) μg?ml-1, respectively. Conclusion:HCQ shows anti-tumor activity on several cancer cells in vitro. There may be a good application prospect for HCQ in the treatment of colorectal cancer, liver cancer, cervical cancer, melanoma and leukemia.
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OBJECTIVE:To optimize the extraction technology of oligosaccharides of Morinda officinalis. METHODS:The liq-uid/solid ratio,extraction time and temperature were chosen as factors,and the yield of oligosaccharides was estimated as index. On the basis of single-factor experiments,using a 3-factor,3-level Box-behnken central composite experimental design,two-poly-nomial regression equation of extraction rate of oligosaccharide was established,and it was analyzed by response surface methodolo-gy to obtain the optimum extraction conditions,and the verification test was conducted. RESULTS:The optimum extraction condi-tions were as follows as material/liquid ratio of 23∶1(ml/g),extraction time of 1.7 h,and extraction temperature of 93℃,extract-ing for twice. Under these conditions, the estimated and observed average values of extraction rate of oligosaccharides were 10.37% and 10.29%(RSD=0.20%,n=3),respectively. The deviation value was 0.06%. CONCLUSIONS:The response surface methodology can be used to optimize the extraction process of oligosaccharides of M. officinalis.
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Objective To identify the specific genotype and analyze clinical features of spinocerebellar ataxias (SCAs) pedigree in the region of Yunnan Province.Methods Fourteen SCAs pedigrees and 183 blood samples of the family members were collected between January 2011 and July 2014 from Department of Neurology,First Affiliated Hospital of Kunming Medical College.Polymerase chain reaction (PCR) amplification,agarose gel electrophoresis and DNA sequencing technologies were utilized to identify the specific genotype of SCAs pedigree.Presymptomatic tests were carried out and the clinical features and genetic test results of patients were carefully analyzed.Results SCA3 was the most common subtype of SCAs in the Han nationality of Yunnan region.Nine of the 14 families were SCA3,only one family was SCA2.Additionally,there were four SCAs families that remained indeterminate.The patients with di-allele mutations (46/77) of SCA3 gene had early onset,rapid progression and serious clinical symptoms.Hereditary SCA3 and autonomic dominant polycystic kidney disease can happen simultaneously in a family.The proband SCA3 gene' s CAG repeat number is 28/76,and repetitions of the mutation allele are in all range.The PKD1 gene exon 23 is found to be in abnormal sequence.Conclusions SCA3 is the most common subtype of SCAs in the Han population of Yunnan region.There are 15/46 incomplete penetrance nutation and 46/77 di-allele mutations.It is possible that di-allele mutations make the disease worse and accelerate clinical course progression.SCA3 and polycystic kidney disease can uncommonly happen simultaneously in a family,which perhaps suggests there are interactions between the two disease-virulence genes.
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Malaria is the one of major diseases which threatens people’s life in Africa. Out of humanitarianism, Chinese scientists has contributed to research of Artemisinin and ACTS more than 30 years, China provides long-term antimalaria assistance to Africa and gain great achievements. In Moheli, the island of Comoros, the antimalaria group used a new strategy which universal medication and proactive intervention. They established not only an effective antimalaria system and reporting system but also a local antimalaria team. Furthermore, they enhanced publicity and put mass protection and treatment into effect. Finally, they achieved significant result. In order to apply those successful experience to other countries in Africa, this paper summed up those experience and inspirations.
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Malaria is the one of major diseases which threatens people’s life in Africa. Out of humanitarianism, Chinese scientists has contributed to research of Artemisinin and ACTS more than 30 years, China provides long-term antimalaria assistance to Africa and gain great achievements. In Moheli, the island of Comoros, the antimalaria group used a new strategy which universal medication and proactive intervention. They established not only an effective antimalaria system and reporting system but also a local antimalaria team. Furthermore, they enhanced publicity and put mass protection and treatment into effect. Finally, they achieved significant result. In order to apply those successful experience to other countries in Africa, this paper summed up those experience and inspirations.
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Objective To evaluate the effect of permanent right ventricular apical (RVA) pacing in different cumulative percent of right ventricular pacing( CUM% VP) on the heart function and cardiac ventricle structure in subjects with normal basic heart function. Methods Patients who had implanted pacemaker when heart function was still normal were recruited in the study while they revisited for replacement or examinations of implanted pacemaker at outpatient. According to different CUM% VP, patients were divided into group A ( CUM% VP≥85% ,n =78) and group B( CUM% VP≤40% ,n =63) . The primary composite endpoint was defined as new-onset heart failure, death, left ventricular ( LV ) dysfunction and remodeling. The occurrence of endpoints were compared between the two groups. The left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and interventricular septum(IVS) were measured through baseline and follow-up, their absolute alterations ( △ LVEF, △ LVEDD and △ IVS ) were observed. Results The mean duration of two assessment was 7.4 years in group A and 7.7 years in group B, respectively. Before pacemaker implantation,there were no differences in age, sex, basic diseases, cardiac function and constituent ratio of pacemakers between the two groups. By comparing the outcomes of group A with those of group B at the end of follow up, we found that: △ LVEDD in group A was significantly larger than that in group B ( [3. 8 ± 0. 5] mm vs [1.4 ± 0. 4] mm,t = 4. 540,P ＜ 0. 01 ), △ LVEF was ( - 6.5 ± 1.2) % and ( - 3.3 ± 1.0) % in group A and B, respectively,with significant difference between the two groups(t = 2. 578 ,P ＜0. 01 ). There were no significant difference in AIVS between the two groups. No death occurred in both group at the end of follow up. The incidence of LV dysfunction and remodeling was 25.6% (20/78) in group A,which was significantly higher than that of 6.3% (4/63) in group B( x2 =9. 183 ,P =0. 002). and the incidence of new-onset heart failure was 10. 3% (8/78)in group A,which was significantly higher than that of 1.6% (1/63) in group B (x2 =4.383,P =0.036).Conclusion Among patients with normal basic LV function who underwent permanent RVA pacing,there are potential risk in developing LV remodel, function damage and heart failure. The risk increases with the pacing time getting longer and CUM% VP getting higher.