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Objective:To compare the fully covered self-expanding metal stents (FCSEMS) and multiple plastic stents (MPS) in the effectiveness, safety and cost-effectiveness for benign bile duct strictures.Methods:A single-center retrospective study was conducted to analyze the clinical data of 107 patients with benign biliary strictures who underwent FCSEMS or MPS implantation through endoscopic retrograde cholangiopancreatography (ERCP) in Hangzhou First People's Hospital from January 2013 to June 2019.There were 54 cases in group FCSEMS and 53 cases in group MPS. Benign biliary stricture was confirmed by computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography. The primary index was the rate of stricture remission, and the secondary indices were the incidence of stricture recurrence, ERCP-related complications, the rate of stent migration, hospital stay and charges.Results:The median follow-up times were 10.0 (6.5, 18.0) months and 12.0 (9.0, 20.0) months in group FCSEMS and in group MPS respectively ( P>0.05). The rates of stricture remission in the two groups were 87.0% (47/54) and 83.0% (44/53), the incidences of stricture recurrence were 14.6% (6/41) and 23.5% (8/34), and the incidences of ERCP-related complications were 14.8% (8/54) and 11.9% (13/109), respectively. And the differences were not statistically significant (all P>0.05). But the stent migration rates of the two groups were 22.9% (11/54) and 2.8% (3/109) with significant difference ( P<0.001). Cost-effectiveness analysis showed that the median numbers of ERCP intervention in the two groups were 2 (2,2) times and 3 (2,4) times ( P<0.001), and the median hospital stays were 6.0 (4.0,11.0) days and 9.0 (6.5,16.0) days respectively ( P=0.009). The median hospitalization expenses of the two groups were 44 646 yuan and 51 355 yuan without significant difference ( P>0.05). Conclusion:The effectiveness, safety and cost of FCSEMS for benign bile duct stenosis are similar to those of MPS, but it reduces ERCP intervention and treatment cycles. Even with a certain migration rate, it can still be a first-line treatment approach.
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Objective:To examine the plasma expression levels and clinical significances of microRNA(miR)-101-3p and miR-141-3p in children with sepsis.Methods:One hundred and fifty-three children with sepsis admitted in Sanya People′s Hospital from January 2016 to October 2019 were divided into sepsis without shock group (94 cases) and septic shock group (59 cases). In addition, they were further divided into survival group (107 cases) and death group (46 cases) according to the 28-day survival.Another 60 healthy children were selected as the healthy control group.Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was performed to detect plasma levels of miR-101-3p and miR-141-3p in all subjects.Receiver operating characteristic curve(ROC) were depicted to identify the diagnostic and prognostic potentials of plasma miR-101-3p, miR-141-3p and procalcitonin(PCT) in sepsis. Pearson′ s correlation analysis was performed to analyze the correlation between the expression levels of miR-101-3p, miR-141-3p and PCT with Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score, Sequential Organ Failure Assessment(SOFA)score, leukocyte count and C-reactive protein level in children with sepsis. Results:Plasma levels of miR-101-3p, miR-141-3p and PCT in septic shock group and sepsis without shock group were significantly higher than those in the healthy control group (all P<0.001). Moreover, plasma levels of miR-101-3p (4.25±1.46 vs.1.86±0.75), miR-141-3p (3.17±1.08 vs.1.20±0.52) and PCT [(20.75±9.36) μg/L vs.(5.80±2.40) μg/L] in septic shock group were significantly higher than those in sepsis without shock group (all P<0.001). In addition, plasma levels of miR-101-3p, miR-141-3p and PCT in survival group and death group were significantly higher than those in the healthy control group (all P<0.001). Notably, plasma levels of miR-101-3p (4.83±1.62 vs.1.40±0.58), miR-141-3p (3.50±1.13 vs.0.96±0.47), and PCT [(26.30±11.72) μg/L vs.(3.25±2.16) μg/L] in death group were significantly higher than those in the survival group (all P<0.001). ROC curve analysis showed that the area under the curve (AUC) and 95% confidence interval (95% CI) of the combined diagnosis of sepsis with miR-101-3p, miR-141-3p and PCT were significantly higher than that of miR-101-3p, miR-141-3p or PCT alone [0.908 (0.850-0.970) vs.0.810 (0.748-0.873), 0.784 (0.723-0.844) and 0.825 (0.764-0.883), respectively; Z1=4.682, Z2=5.380 and Z3=4.417, all P<0.05]. The sensitivity and specificity of the combined diagnosis was 92.5% and 84.0%, respectively.The AUC and 95% CI of the combined prediction of miR-101-3p, miR-141-3p and PCT in the mortality of children with sepsis children with were significantly higher than those with miR-101-3p, miR-141-3p or PCT alone [0.930 (0.872-0.986) vs.0.848 (0.786-0.907), 0.792 (0.730-0.853) and 0.820 (0.762-0.878), respectively; Z1=4.537, Z2=5.728 and Z3=5.106, all P<0.05]. The sensitivity and specificity of the combined prediction in the mortality was 94.6%, and 87.0%, respectively.Correlation analysis showed that miR-101-3p and miR-141-3p levels were positively correlated with PCT ( r=0.804, 0.773, all P<0.001), APACHE Ⅱ score ( r=0.738, 0.695, P<0.001) and SOFA score ( r=0.752, 0.764, all P<0.001). Conclusions:Plasma levels of miR-101-3p and miR-141-3p in children with sepsis significantly increased, which are correlated with the severity of sepsis.A combination detection of miR-101-3p, miR-141-3p and PCT has high diagnostic and prognostic potentials in children with sepsis.
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Objective:To observe the relationship between bone metabolism biochemical markers and clinic features in patients with spinal cord injury. Methods:From July, 2018 to December, 2019, totally 135 patients with spinal cord injury were enrolled. They were assessed with American Spinal Injury Association Impairment Scale (AIS). β-collagen type I C-terminal telopeptide (β-CTX), total N-terminal propeptide of type I precollagen (TP1NP), 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH), serum calcium and serum phosphorus were measured. The level of TP1NP, β-CTX, 25(OH)D and PTH among clinical characteristics (gender, age, disease course, AIS grade and so on) were analyzed. Results:The levels of β-CTX and 25(OH)D were lower in women than in men (|t| > 2.044, P < 0.01). There was difference in the level of 25(OH)D among different ages (F = 3.156, P < 0.05). The levels of β-CTX and TP1NP increased in the first four months after spinal cord injury, and decreased then; while the level of PTH decreased in the first four months, and increased then (P < 0.001). The level of β-CTX was lower in patients of AIS D than in patients of AIS A and C (t >2.679, P < 0.05). The level of TP1NP was higher in paraplegics than in quadriplegics (Z = -2.035, P < 0.05). The level of β-CTX was higher in patients with fractures or surgeries involving bone than in patients without fractures or surgeries involving bone (t = 2.169, P < 0.05). There was no difference in all the bone metabolism markers between patients with and without lower extremity motor function (t < 0.839, Z < 1.822, P > 0.05). The ratio of 25(OH)D deficience was 85.19%. Conclusion:Bone conversion was active in the first four months after spinal cord injury, and decreased gradually then, which may be related to fractures of spine or surgeries involving spine after injury. The effect of spinal cord injury on bone metabolism markers is not clear. Most of patients with spinal cord injury were lack of vitamin D.
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Objective:To investigate the occurrence and related factors of autonomic dysreflexia (AD) during intermittent catheterization in patients with spinal cord injury (SCI). Methods:Case control study was used in this study. Intermittent catheterization was performed on 44 SCI patients hospitalized from April, 2019 to April, 2020, The data of age, gender, time after injury, segment of injury, degree of injury, resting blood pressure, immediate blood pressure after catheterization, catheterization numbers, catheterization volume and duration of catheterization were collected. Descriptive analysis and binary Logistic regression analysis were used to analyze the occurrence and related factors of AD. Results:Totally, AD happened in 26 (59.1%) patients. Urethral catheterization was done 1738 times, out of which AD accounted for 187 times (10.8%). The risk of AD increased with the time after injury and age (P < 0.05). The probability of AD was lower in T7 SCI and below than in T6 SCI and above (P = 0.002). Catheterization numbers, gender, degree of injury, catheterization volume and duration of catheterization were not influencing factors of AD (P > 0.05). Conclusion:It is necessary to have a full understanding for the occurrence of AD in patients with SCI during intermittent catheterization. For patients with SCI in T6 and above, long time after injury and elderly patients, routine monitoring of blood pressure during intermittent catheterization is recommended to detect and deal with AD in time.
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Objective:To explore the clinical manifestations and MRI features of pediatric spinal cord injury (SCI) after back bend. Methods:A retrospective study was performed. All the medical records and MRI images of children with SCI after back bend were identified in Beijing Bo'ai Hospital from January 1st, 2002 to August 31st, 2020. Results:A total of 120 SCI children after back bend were reviewed, out of whom 119 cases were girls, one case was boy. The age ranged from 38 to 162 months, with the median age of 76 months. More cases were discovered in July and September every year (32 cases, 26.7%), as well as in weekends (67 cases, 55.8%). The main clinical manifestations were sensory and motor dysfunction of both lower limbs (120 cases, 100%), bladder and bowl incontinence (120 cases, 100%). The common first symptoms included sudden attack of lumbar pain (39 cases, 32.5%), lower limbs paralysis (30cases, 25.0%) and leg pain (10 cases, 8.3%). The peak time of symptoms ranged from five minutes to two days, with the median time of 50 minutes. The MRI features of 104 children with SCI within one week after back bend were as follows: the abnormal signals of MRI in spinal cord involved lower cervical and all the following segments of spinal cord. The number of the segments of spinal cord with abnormal signals ranged from two to 15, with the median of seven segments. The most common segments with abnormal signals were T9 (96 cases, 92.3%), T10 (96 cases, 92.3%) and T11 (90 cases, 86.5%). Among the cases followed up, 48 cases with complete injury demonstrated a vast and serous spinal cord atrophy (SCA) below the injury segments as early as 37 days after the injury, the SCA would become worse at the chronic stage and maybe involve the spinal cord above the injury segments. In 31 cases with incomplete injury, the abnormal signals of MRI in spinal cord were limited in the lumbar enlargement, with a various degree of SCA at the late stage. All the cases were diagnosed as SCI without radiologic abnormality, out of whom 89 (74.2%) cases suffered from thoracic complete SCI, 31 (25.8%) cases suffered thoracic or lumbar incomplete SCI. The common complications included scoliosis, hip joint dysplasia, urinary tract infection, hydronephrosis, osteoporosis, pathological fracture of lower limbs and valgus knee. Conclusion:The main clinical symptoms of pediatric SCI after back bend were sudden lumbar pain, sensory and motor dysfunction of both lower limbs, and bladder and bowl incontinence. Most of the cases were thoracic complete SCI, the MRI features at the early stage were multiple segments of abnormal signals of spinal cord around T9 and T10, and later an extensive severe SCA below the injury segments to the conus medullaris, accompanied by the SCA above the injury segments.
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Objective:To investigate the outcome of neurological function and the clinical characteristics of complications in children with spinal cord injury. Methods:From 2011 to 2019, children under 15 years old with spinal cord injury were selected in our hospital. Their level of injury and American Spinal Injury Association Impairment Scale (AIS) at one month, three months and one year were recorded. And the complications such as pressure ulcers/scald, urinary tract infection, hydronephrosis/vesicoureteral reflux, constipation, osteoporosis/fracture, deep vein thrombosis, neurodynia, heterotopic ossification, scoliosis and hip dysplasia were analyzed. Results:Of 159 individuals, 41 were boys and 118 were girls, the average age at injury was (6.08±2.57) years. The main cause of spinal cord injury was sports accidents (47.8%), and the main injury sites were thoracic spinal cord injury (89.3%). The cause of spinal cord injury was correlated with age at injury (r = -0.160, P = 0.044), gender (r = -0.458, P < 0.001) and injury sites (r = -0.249, P = 0.002). Complete spinal cord injury counted for 71.7%, and the AIS grade at one month was correlated with that at twelve months (r = 0.984, P < 0.001). The main complications were urinary tract infection (69.2%), constipation (67.9%), hydronephrosis/vesicoureteral reflux (37.7%), scoliosis (25.8%) and hip dysplasia (25.2%). The incidence of ulcers/scald was correlated with injury site (r = 0.179, P = 0.024). The AIS grade three months after injury was significantly correlated with urinary tract infection, constipation, scoliosis and hip dysplasia (|r| > 0.227, P < 0.01). The incidence of ulcers/scald was correlated with osteoporosis/fracture (r = 0.208, P < 0.01). The incidence of urinary tract infection was significantly correlated with hydronephrosis/vesicoureteral reflux, constipation, scoliosis and hip dysplasia (r > 0.261, P < 0.001), as well as osteoporosis/fracture (r = 0.195, P < 0.05). The incidence of hydronephrosis/vesicoureteral reflux was significantly correlated with constipation, osteoporosis/fracture, scoliosis and hip dysplasia (r > 0.146, P < 0.01). The incidence of constipation was significantly correlated with scoliosis and hip dysplasia (r > 0.313, P < 0.01), as well as osteoporosis/fracture (r = 0.160, P < 0.05). The incidence of osteoporosis/fracture was significantly correlated with scoliosis and hip dysplasia (r > 0.342, P < 0.01). The incidence of scoliosis was significantly correlated with hip dysplasia (r = 0.818, P < 0.001). Conclusion:The recovery of neurological function after spinal cord injury in children is closely correlated to AIS. The outcome of complete spinal cord injury is poor. The common complications after spinal cord injury in children demonstrate specific age characteristics, and the incidence of urinary tract infection, constipation, hydronephrosis/vesicoureteral reflux, scoliosis and hip dysplasia are common complications, which need more attention.
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Objective:To investigate the clinical characteristics of old patients with spinal cord injury. Methods:From January 1, 2013 to December 31, 2019, totally 386 old (≥ 60 years) patients with spinal cord injury were enrolled. Their gender, age, etiology, American Spinal Injury Association Impairment Scale (AIS) and complications were analyzed. Results:In the old patients with spinal cord injury, traumatic spinal cord injury was more common in males (71.17%) and non-traumatic spinal cord injury was more common in females (56.19%). Fall on level surface was the most important cause of spinal cord injury both in old men (28.83%) and women (24.76%). Tumor (19.05%) was the most common non-traumatic cause of spinal cord injury in old female patients. Cervical segment (78.46%) was the most common site of injury in old traumatic spinal cord injury, while thoracic segment (52.14%) was the most common site of injury in non-traumatic spinal cord injury. Grade D (38.08%) was the most common AIS grade, followed by grades C (28.76%), A (21.50%), and B (11.66%). Spinal canal stenosis (23.31%) played an important role in the etiology of old spinal cord injury. Neuralgia, venous thrombosis of lower extremities and urinary tract infection were the most common complications in old patients with spinal cord injury. Conclusion:Fall on level surface is the leading cause of spinal cord injury in old patients, and the proportion of fall in the etiology of old spinal cord injury tends to increase with age. It is important to take effective measures to avoid falling in the old adults to prevent spinal cord injury.
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Objective:To observe the clinical efficacy of levosimendan in the treatment of patients with acute myocardial infarction (AMI) combined with cardiogenic shock (CS) and its effects on monitoring hemodynamic parameters of pulse index continuous cardiac output (PICCO).Methods:One hundred and six patients with AMI combined with CS admitted and treated in Jiaxing Second Hospital from June 2017 to December 2019 were divided into the control group and observation group according to the random number table method , with 53 cases in each group. The control group received routine comprehensive intervention, while the observation group received levosimendan treatment based on the control group. In observation group, 12 μg/kg of levosimendan was administered intravenously within 10 min, then, 0.1 μg/(kg·min) was administered intravenously and continued for 24 h. In control group, 5% glucose injection was administered intravenously, and the intravenous infusion rate and time was same as that in observation group. Both groups were treated for 24 h. PICCO was used to monitor the hemodynamic parameters , including heart rate (HR), central venous pressure (CVP), cardiac index (CI), global end-diastolic volume index (GEDVI) and extravascular lung water index (EVLWI) before and after the treatment; the neurohumoral indexes including norepinephrine (NE), angiotensinⅡ(AngⅡ); cardiac function indexes including stroke volume (SV), left ventricular ejection fraction (LVEF), and the efficacy and complications were observed and compared between two groups.Results:After 24 h of treatment, the levels of HR, CVP, GEDVI, EVLWI in two groups were decreased, and the levels of above index in the observation group were lower than those in the control group: (90.26 ± 12.61) beats/min vs. (97.82 ± 12.58) beats/min, (9.85 ± 1.14) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (11.63 ± 1.37) cmH 2O, (759.53 ± 62.47) ml/m 2 vs. (867.21 ± 63.24) ml/m 2, (7.95 ± 1.56) ml/kg vs. (9.01 ± 1.78) ml/kg; after treatment the level of CI in the observation group was higher than that in the control group: (3.58 ± 0.74) L/(min·m 2) vs. (2.37 ± 0.86) L/(min·m 2), and the differences were statistically significant ( P<0.05). After 24 h of treatment, the levels of NE and AngⅡ in two groups was decreased, and the levels of NE and AngⅡ in the observation were lower than those in the control group: (60.42 ± 5.93) ml vs. (54.42 ± 6.14) ml, (41.62 ± 4.19)% vs. (36.87 ± 4.36)%, and the differences were statistically significant ( P<0.05). After 24 h of treatment, the time of intra-aortic balloon counterpulsation (IABP) in the observation was shorter than that in the control group: (61.52 ± 15.41) h vs. (89.56 ± 17.63) h; the injury rate of renal functions in the observation was lower than that in the control group: 3.77%(2/53) vs. 18.87%(10/53), and the differences were statistically significant ( P<0.05). There was no significant difference in mortality and other complications after 30 d of follow-up between two groups ( P>0.05). Conclusions:Levosimengdan can significantly improve the PICCO hemodynamics, neurohumoral indexes and cardiac function indexes of patients with AMI and CS. It has a protective effect on the kidneys of patients, but it cannot significantly improve the 30-day mortality rate of patients.
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Objective:To explore the etiological features and prevention strategies for pediatric spinal cord injury (SCI). Methods:A retrospective study of etiology and demographics features was performed and all the children with SCI (less than 14 years old) were identified in our hospital from January 1st, 2015 to December 31st, 2019. Results:A total of 221 children with SCI were reviewed, with 62 boys and 159 girls. The age ranged from one to 13 years with the median age of six years old. Children aged four to seven years accounted most (55.7%), and were mainly girls (83.7%). Sports and leisure activities (78 cases, 35.3%), non-traumatic causes (56 cases, 25.3%), other traumatic causes (48 cases, 21.7%), transport activities (24 cases, 10.9%) and falling from height (12 cases, 5.4%) were the top five leading causes of pediatric SCI. Among the cases caused by sports and leisure activities, 96.2% (75/78) were related to back bend in dancing exercise, in which most were five to seven years old (80.0%), and all of them were thoracic cord injury without radiologic abnormality, in which 70.7% (53/75) suffered from complete SCI. Conclusion:Pediatric SCI after back bend in dancing exercise is increasing rapidly in recent years. More attention should be paid on education about professional evaluation and the risk of back bend before dancing exercise, and more protective measures should be implemented.
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Objective:To evaluate the efficacy and safety of clip-with-endoloop method during endoscopic submucosal dissection (ESD) in treatment of early gastric angle cancer and precancerous lesions.Methods:A total of 59 patients with early gastric angle cancer or precancerous lesions underwent ESD from January 2018 to December 2018 were randomly divided into the routine ESD group ( n=28) and the clip-with-endoloop group ( n=31). The frequency of supplementary submucosal injection, ESD procedure time, area of the resected specimen, dissection time, submucosal dissection speed, complete resection rate and complications were compared between the two groups. Results:The frequency of supplementary submucosal injection in the clip-with-endoloop group was less than that in the routine ESD group (2.3±1.1 VS 3.7±1.4, t=4.557, P<0.001). There was no significant difference in the area of the resected specimen between the two groups (12.7±2.6 cm 2 VS 11.7±2.7 cm 2,t=1.485, P=0.143). The ESD procedure time (72.4±24.7 min VS 93.6±28.9 min, t=3.043, P=0.004) and dissection time (67.7±23.3 min VS 88.2±28.3 min, t=3.054, P=0.003) in the clip-with-endoloop group were significantly shorter compared with those in the routine ESD group. The submucosal dissection speed in the clip-with-endoloop group was higher than that in the routine ESD group (20.2±3.2 mm 2/min VS 14.3±3.4 mm 2/min, t=6.879, P<0.001). The complete resection rate was 100.0% in the both groups. No perforation or postoperative bleeding occurred in the two groups. The incidence of intraoperative bleeding in the clip-with-endoloop group was lower than that in the routine ESD group [19.4% (6/31) VS 35.7% (10/28), χ2=1.992, P=0.158]. Conclusion:Clip-with-endoloop method makes ESD procedures easier and faster, with a lower possibility of intraoperative bleeding in treatment of early gastric angle cancer.
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Objective To establish a method for the determination of propylthiouracil in human plasma by UPLC-MS/MS and provide methodological basis for therapeutic drug monitoring (TDM) and bioequivalence test (BE) in clinical. Methods The chromatographic separation was performed on an Agilent SB-C18 column (4.6 mm×150 mm, 5 μm), the mobile phase was methanol and water containing 0.1% formic acid (80∶20, V/V), isocratic elution. MS condition was optimized in the positive ion detection mode by multiple reaction monitoring (MRM), along with the Agilent JetStream electrospray source interface (AJS-ESI). The precursors to the product ion transitions were m/z 171.1→112.1 for propylthiouracil and m/z 176.1→117.0 for the internal standard (IS). Results The calibration curve was linear in the range of 10−5 000 ng/ml for propylthiouracil in human plasma, r=0.999 3. The intra-day and inter-day precision and accuracy were good (RSD<10%，RE<±10%). The matrix effect of different concentrations was less than 110% and the coefficient of variation was less than 5%. The average recovery of different concentrations was 101.60%−113.56%, which conformed with the requirement of methodological validation. Conclusion The method is rapid, sensitive and accurate, which can be used for the determination of propylthiouracil in human plasma.
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Objective To analyze the colonic transit time in patients with different severities of constipation.Methods From June, 2015 to September, 2017, 73 male patients with supraconal spinal cord injury were grouped as mild constipation group (n = 25) and severe constipation group (n = 48). They were measured the transit time of entire colorectum, ascending colon (including the right colic flexure), transverse colon, descending colon (including the left colic flexure) and rectosigmoid with Abrahamsson method.Results The transit time of entire colorectum, transverse colon, descending colon increased in the severe constipation group compared with that of the mild constipation group (P ＜ 0.05). For each group, the transit time of rectosigmoid was the longest among colon segments (P ＜ 0.05).Conclusion The colonic transit time of SCI male patients with various constipation is different in colon segments. Accurate interventions are needed to target colon segments.
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Objective@#To investigate the effect of cluster sedation and analgesia for patients with mechanical ventilation.@*Methods@#From June 2016 to June 2017, 234 patients with mechanical ventilation admitted to the ICU of the Second Hospital of Jiaxing were selected and divided into study group (120 cases) and control group (114 cases) according to the random number method.The control group received conventional nursing, while the study group was given cluster sedation and analgesia.The drug use dose, mechanical ventilation time, ICU admission time, sputum incidence and 1-month survival rate were compared between the two groups.@*Results@#The total dose and unit dose in the study group were lower than those in the control group [(252.17±38.42)mg vs.(326.50±50.88)mg, (60.50±9.33)μg·kg-1·h-1 vs.(79.41±10.52)μg·kg-1·h-1, t=12.562, 14.564, P=0.000, 0.000]. The duration of mechanical ventilation and ICU stay in the study group were also shorter than those in the control group [(5.13±0.73)d vs.(7.57±0.95)d, (7.02±0.91)d vs.(10.55±1.26)d, t=21.949, 24.460, P=0.000, 0.000]. The incidence rate of delirium in the study group was lower than that in the control group (28.33% vs.50.88%, χ2=12.453, P=0.000). The 1-month survival rate of the study group was higher than that of the control group (91.67% vs.80.70%, χ2=5.954, P=0.015).@*Conclusion@#Cluster sedation and analgesia is an effective method for ICU mechanical ventilation patients, which can improve the quality of medical and nursing, and is an important embodiment in critical medical management, it is worthy of attention in intensive care workers.
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Objective:To investigate the test-retest reliability and inter-rater reliability of Numerical Rating Scale (NRS) for abnormal sensation points of patients with spinal cord injury (SCI). Methods:From October, 2016 to December, 2018, 69 patients with SCI were enrolled. Their impaired sensory points were measured with NRS. The score of sensory points was tested by examiner A firstly, and examiner B did the same work next day. Then, the examiner A retested the same patients after three weeks. Results:The Pearson correlation coefficients and intraclass correlation coefficient (ICC) of the test-retest reliability and inter-rater reliability for sensory score of both sides were all above 0.88 and 0.93 respectively (P < 0.001). The Pearson correlation coefficients and ICC of the sensory score of the different injury levels were all above 0.88 and 0.93 respectively (P < 0.001). Conclusion:NRS has high test-retest reliability and inter-rater reliability for the assessment at abnormal sensation points of patients with SCI.
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Objective:To explore the modification of the 2019 International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) worksheet and the significance for clinical practice. Methods:The 2019 ISNCSCI worksheet (English version) was compared literally with the 2015 ISNCSCI worksheet (English version) to find the advantages of current version and analyze its significance. Results:Five modifications were found in the 2019 ISNCSCI worksheet, in which the muscle function grading, the sensory grading and how to determine the zone of partial preservation were modified. Conclusion:The ASIA International Standards Committee made prudent modification according to the experience of the 2015 ISNCSCI worksheet to make the worksheet more scientific and clearer for recording.
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Objective@#To investigate current status and associated factors of preschool children’s physical fitness, in order to provide scientific basis for improving preschool children’s physical fitness.@*Methods@#A total of 3 240 preschool children aged 3-6 years old in Kunshan city were selected through cluster sampling method. They were surveyed about physical fitness and influencing factors.@*Results@#The number of excellence of preschool children’s physical fitness was 269, and the rate was 8.30 percent. The excellence rates of preschool children’s physical fitness in girls, high grade, non-residency in Jiangsu Province were higher(10.87%, 10.96%, 14.88%), and the excellence rate of preschool children’s physical fitness in premature group was lower(4.31%)(P<0.05). Further unconditioned logistic regression analysis found that girls, middle and high grade and non-residency in Jiangsu Province were the protective factors for the excellence of preschool children’s physical fitness, OR values were 1.96, 1.94, 2.45 and 1.87, respectively; premature was a risk factor for the excellence of preschool children’s physical fitness, OR value was 0.47.@*Conclusion@#Preschool children in Kunshan have poor physical fitness, especially in boys, low grade and premature groups. Education department and health department should work together to improve the preschool children’s physical fitness.
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Objective To investigate the effect of cluster sedation and analgesia for patients with mechanical ventilation.Methods From June 2016 to June 2017,234 patients with mechanical ventilation admitted to the ICU of the Second Hospital of Jiaxing were selected and divided into study group (120 cases) and control group (114 cases) according to the random number method.The control group received conventional nursing ,while the study group was given cluster sedation and analgesia.The drug use dose,mechanical ventilation time ,ICU admission time, sputum incidence and 1－month survival rate were compared between the two groups.Results The total dose and unit dose in the study group were lower than those in the control group [(252.17 ±38.42) mg vs.(326.50 ±50.88) mg, (60.50 ±9.33)μg· kg －1· h－1 vs.(79.41 ±10.52)μg· kg－1· h－1 ,t＝12.562,14.564,P＝0.000,0.000].The duration of mechanical ventilation and ICU stay in the study group were also shorter than those in the control group [(5.13 ±0.73)d vs.(7.57 ±0.95) d,(7.02 ±0.91) d vs.(10.55 ±1.26) d,t＝21.949,24.460,P＝0.000, 0.000].The incidence rate of delirium in the study group was lower than that in the control group (28.33% vs. 50.88%,χ2 ＝12.453,P＝0.000).The 1－month survival rate of the study group was higher than that of the control group (91.67%vs.80.70%,χ2 ＝5.954,P＝0.015).Conclusion Cluster sedation and analgesia is an effective method for ICU mechanical ventilation patients , which can improve the quality of medical and nursing , and is an important embodiment in critical medical management ,it is worthy of attention in intensive care workers.
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<p><b>OBJECTIVE</b>Osteosarcoma is the most common type of malignant bone tumor in children and adolescents. The role of E3 ligases in tumorigenesis is currently a focus in tumor research. In the present study, we investigated the role of the E3 ligase tripartite motif 21 (TRIM21) in osteosarcoma cell proliferation.</p><p><b>METHODS</b>3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assays were used to assess osteosarcoma cell viability. U2-OS cells stably carrying a recombinant lentivirus expressing tetracycline-regulated TRIM21 were screened. Co-immunoprecipitation was coupled with LCMS/MS analysis to identify novel interacting partners of TRIM21. Co-immunoprecipitation and bimolecular fluorescence complementation (BIFC) were performed to validate the interactions between TRIM21 and its novel partner YWHAZ. A TRIM21-ΔRING construct was generated to test the effects of TRIM21 ligase activity on YWHAZ.</p><p><b>RESULTS</b>TRIM21 positively regulated osteosarcoma cell proliferation. Overexpression of TRIM21 enhanced osteosarcoma cell tolerance toward various stresses. YWHAZ protein was identified as a novel interacting partner of TRIM21 and its expression levels were negatively regulated by TRIM21. The RING domain of TRIM21 was required for TRIM21 negative regulation of YWHAZ expression. However, overexpression of YWHAZ did not affect positive regulation of osteosarcoma cell proliferation by TRIM21.</p><p><b>CONCLUSION</b>Our results further clarify the molecular mechanisms underlying the pathogenesis of osteosarcoma.</p>
Subject(s)
Humans , 14-3-3 Proteins , Genetics , Metabolism , Cell Proliferation , Genetics , Osteosarcoma , Genetics , Ribonucleoproteins , Genetics , Metabolism , Tumor Cells, CulturedABSTRACT
Objective To develop a new method to determine the contents of rutaecarpine in Fuzhengpingxiao capsule by HPLC method.Methods Samples were handled by ethanol and extraction with ethyl acetate.The separation was achieved on an Agilent TC-C18column using a mobile phase system of acetonitrile-water(2% Tetrahydrofuran and 0.2 % formic acid)at a flow rate of 1.0 ml/min.The temperature of column was 40 ℃ and the detection wavelength was 240 nm.Results The cali-bration curves of rutaecarpine showed good linearity in the ranges of 1.18-118 μg/ml,r=0.999 9.The results of intra-day and inter-day precisions were both within 2%,the average additional recovery rate was 94.20%.Conclusion The HPLC method was accurate,specific,sensitive and reproducible,which could be used for quality control of rutaecarpine in the preparation of Fuzhengpingxiao capsule.
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Objective To investigate the clinical efficacy of basiliximab-induced glucose-free corticosteroid immunosuppressive regimen after liver transplantation.Methods The retrospective cohort study was conducted.The clinicopathological data of 227 patients with liver transplantation who were admitted to Bayi Hospital affiliated to Nanjing University of Traditional Chinese Medicine from January 2010 to October 2016 were collected.Of the 227 patients,125 who postoperatively received a glucose-free corticosteroid immunosuppressive regimen using a monoclonal antibody + tacrolimus + mycophenolate mofetil tablets were allocated into the hormone-free group,and 102 who were postoperatively treated with the immunosuppressive regimen using glucocorticoid steroid + tacrolimus + mycophenolate mofetil tablets were allocated into the hormone group.Observation indicators:(1) comparison of follow-up and survival;(2) comparison of postoperative infection,rejection and biliary stenosis between groups.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival,infection,rejection and biliary stenosis up to June 2017.The measurement data with normal distribution were represented as (x) ± s,and comparison between groups was done by the t test.Measurement data with skewed distribution were described as M (P25,P75) and M (range),and comparison between groups was analyzed using the rank sum test.The count data were compared by the chi-square test.Kaplan-meier method was used to draw survival curve and calculated survival rate.Log-rank test was used for survival analysis.Results (1) Comparison of follow-up and survival:patients between groups were followed up for 9-89 months,with a median time of 45 months.The 1-and 3-year overall survival rates were respectively 93.25％,85.24％ in the hormone-free group and 89.89 ％,74.22％ in the hormone group,with a statistically significant difference (x2 =8.450,P＜0.05).(2) Comparison of postoperative infection,rejection and biliary stenosis between groups:① The total cases with postoperative infections,cases with infection of Klebsiella pneumoniae,Staphylococcus aureus,Candida,Acinetobacter baumannii and Stenotrophomonas maltophilia were 25,18,3,2,2,0 in the hormone-free group and 40,26,6,3,3,2 in the hormone group,respectively,showing a statistically significant difference between groups (x2 =10.149,P＜0.05).The patients between groups with postoperative infection were treated with active anti-infective symptomatic treatment.Three patients in the hormone group died of severe pulmonary infection,and the remaining patients in both groups were improved.② The cases with postoperative rejection in the hormone-free group and hormone group were 6 and 5,respectively,with no statistically significant difference (x2 =0.950,P＞ 0.05).The rejection of both groups occurred within 1 week postoperatively.Two patients in the hormone group were treated with glucocorticoid hormonal shock.The other patients in the 2 groups were improved by adjusting the amount of tacrolimus and mycophenolate mofetil tablets.③ The cases with postoperative biliary stenosis in the hormone-free group and the hormone group were 32 and 8 respectively,with a statistically significant difference (x2 =12.200,P＜0.05).In the hormone group,biliary stenosis occurred after stopping glucocorticoids.The patients with biliary stenosis were improved after biliary stent implantation by endoscopic retrograde cholangio pancreatography (ERCP).Conclusion The basiliximab-induced glucose-free corticosteroid immunosuppressive regimen after liver transplantation is safe and feasible,and it can significantly reduce the incidence of postoperative infection and improve long-term overall survival compared with the conventional glucocorticoid immunosuppressive regimen,but increased postoperative biliary stenesis.