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Objective:To explore the relationship between ABCB1 or ABCG2 gene polymorphisms and therapeutic effects of gefitinib in non-small cell lung cancer (NSCLC) patients, and establish a prediction model of efficacy.Methods:A total of 176 NSCLC patients with epidermal growth factor receptor (EGFR) -sensitive mutation treated with gefitinib admitted to Department of Pulmonary Disease of Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province from December 2018 to December 2020 were employed as subjects, and all patients were detected ABCB1 and ABCG2 gene polymorphisms. Patients were divided into remission group and non-remission group according to curative effect after 3 months of gefitinib treatment. The clinical data, ABCB1 and ABCG2 gene polymorphisms, levels of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) were compared between the two groups. The related factors of failure to remission after treatment were analyzed by multivariate logistic regression analysis. Combined with ABCB1 and ABCG2 gene polymorphisms, the prediction model for gefitinib efficacy was constructed and the nomogram was drawn.Results:During the follow-up period, 5 patients were lost to follow-up and 7 patients withdrew from the trial due to intolerable adverse effects, finally 108 patients were employed as remission group, and 56 patients were employed as non-remission group. The numbers of GG, GT and TT at ABCB1 rs2032582 in the remission group were 49, 50 and 9, and those in the non-remission group were 12, 35 and 9, with a statistically significant difference ( χ2=9.56, P=0.008). The numbers of GG, GA and AA at ABCG2 rs2231137 in the remission group were 13, 72 and 23, and those in the non-remission group were 11, 42 and 3, with a statistically significant difference ( χ2=7.74, P=0.021). Before treatment, the levels of serum CEA in the remission group and the non-remission group were (34.28±5.11) ng/ml and (37.88±7.05) ng/ml, with a statistically significant difference ( t=3.74, P<0.001). The levels of CA125 of the two groups were (27.24±6.50) U/ml and (33.31±6.09) U/ml, with a statistically significant difference ( t=-5.79, P<0.001). Multivariate logistic regression analysis showed that TT at rs2032582 of ABCB1 gene ( OR=12.99, 95% CI: 3.17-53.23, P<0.001), GG at rs2231137 of ABCG2 gene ( OR=7.75, 95% CI: 1.36-44.07, P=0.021) and GA ( OR=6.94, 95% CI: 1.47-32.84, P=0.015), CA125 ( OR=1.18, 95% CI: 1.10-1.28, P<0.001) were independent risk factors of failure to remission in NSCLC patients with EGFR sensitive mutation after treatment. The consistency index (C-index) of nomogram for predicting failure to remission was 0.92 (95% CI: 0.86-0.94) . Conclusion:ABCB1 rs2032582 and ABCG2 rs2231137 polymorphisms are related to therapeutic effects of gefitinib in the NSCLC patients, the nomogram based on the two genes combined with serum CA125 can predict efficacy of gefitinib.
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Objective:To investigate the Graf classification results and risk factors of infants for developmental dysplasia of the hip (DDH) by B-ultrasound screening in Tianjin.Methods:A retrospective analysis was conducted from January 2013 to December 2020 using the three-tier maternal and child health care management and the Tianjin maternal and child health information system for the early B-ultrasound screening data of 6-8 weeks old infants. The "2+1" screening model of "primary screening-re-screening-diagnostic treatment" was applied. The positive screening rate and age of infants at the time of referral for treatment in different years and different Graf classifications were analyzed, and the differences in positive infants with different sex, parity, fetal position, mode of production, gestational age, birth weight, and family history were compared. Binary logistic regression was used to analyze risk factors for DDH.Results:A total of 807 889 babies were screened, and 2 039 children (2 841 hips) were detected with B-ultrasound Graf classification count IIa and above, with the positive rate was 2.52‰ (2 039/807 889). Among the abnormal hips, 685 were type IIa(+) hips, 959 were type IIa(-) hips, 367 were type IIb hips, 262 were type IIc hips, 227 were type D hips, 265 were type III hips, and 76 were type IV hips. Type IIa(-) was the most common, accounting for 33.76% (959/2 841), type IIa(+) accounted for 24.11% (685/2 841), type D and above was 19.99%(568/2 841). The abnormality rate of the left hip was 2.02‰ (1 632/807 889), which was greater than 1.50‰ (1 209/807 889) of the right side, and the difference is statistically significant (χ 2=63.09, P<0.001). The rate of hip abnormalities in female infants was 3.27‰ (2 541/777 272), greater than 0.36‰ (300/838 506) in male infants, which the difference between the sexes had statistically significant (χ 2=1 947.871, P<0.001). The positive rate of DDH in male infants was 0.50‰ (209/419 253), and that in female infants was 4.71‰ (1 830/388 636). The detection ratio of male to female infants was 1∶8.76, and the difference in the positive rate of DDH between the sexes was statistically significant (χ 2=1 420.102, P<0.001). Different fetal position (cephalic position/breech presentation), delivery method (normal delivery/cesarean section), birth weight (normal/low weight), family history (with DDH/without DDH) showed statistically significant differences in the positive rate of DDH ( P<0.05), whereas there was no significant difference in the positive rate of DDH at different parity (first/second and above) and gestational age (term/premature) ( P>0.05). Logistic regression analysis showed that gender ( OR=10.50, P<0.001) and fetal position ( OR=3.40, P<0.001) were independent risk factors for DDH, and gestational age ( OR=0.91, P<0.001) was a protective factor for DDH. Differences in referral age of infants with different B-ultrasound Graf classification from year to year were statistically significant ( P<0.05). Conclusion:Through the "2+1" screening model of "primary screening-re-screening-diagnostic treatment", the DDH positive rate in 6-8 weeks old infants in Tianjin was 2.52‰, and the positive rate of DDH in female infants and left hip was higher. The more severe the Graf classification of B-ultrasound was, the younger the age of referral was. Women and infants with breech presentation had a higher risk of developing DDH, and the risk of DDH in preterm infants was lower.
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Objective:To explore the early application effect of the bedside sitting respiratory training in patients with respiratory failure and noninvasive positive pressure ventilation of the acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 102 patients with respiratory failure and noninvasive positive pressure ventilation of the AECOPD treated in Shanghai Public Health Clinical Center from June 2018 to December 2019 were selected and divided into the control group and the research group by random digits table method with 51 cases in each group. The control group was given the conventional treatment and nursing measures; and the research group was given the bedside sitting respiratory training. Pulmonary functional and blood -gas analysis parameters, clinical outcome of patients, etc. before and after the intervention between the two groups were compared. Results:After the intervention, the forced expiratory volume in one second (FEV 1), forced vital capacity(FVC), FEV 1/FVC were (1.79±0.22) L, (3.09±0.28) L, (62.16±5.94)% in the research group, and (1.43±0.18) L, (2.66±0.23) L, (53.48±5.31)% in the control group, the differences were statistically significant(t values were 8.36, 8.00, 7.19, P<0.01). Arterial partial pressure of carbon dioxide (PaCO 2) and arterial partial pressure of oxygen (PaO 2) in blood gas analysis were (51.14±3.79) mmHg(1 mmHg=0.133 kPa), (71.07±5.49) mmHg in the research group, and (57.52±3.86) mmHg, (65.62±5.27) mmHg in the control group, the differences were statistically significant ( t values were -7.78, 4.72, P<0.01). The non-invasive positive pressure ventilation time, hospital stays were (7.41±1.76) d, (11.27±2.41) d in the research group, and (9.79±2.11) d, (15.46±3.12) d in the control group, the differences were statistically significant ( t values were -5.71, -6.70, P<0.01). The incidence of adverse events was 3 cases in the research group, 1 case in the control group, the difference was no statistically significant ( P>0.05). Conclusions:The application of the bedside sitting respiratory training in patients with respiratory failure and noninvasive positive pressure ventilation of the AECOPD can effectively improve the pulmonary physiological function, shorten the noninvasive positive pressure ventilation time and hospitalization time, which has clinical application value.
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OBJECTIVE@#To investigate the role of petroleum ether extract of Rhizoma Amorphophalli (SLG) in inhibiting proliferation and promoting apoptosis and differentiation of leukemia K562 cells.@*METHODS@#K562 cells were processed by SLG and PD98059 which was the ERK signaling pathway blocker. Then cell vitality was tested by MTT. Cell apoptosis rate and positive percentage of antigen expression related with differentiation were detected by flow cytometry. The protein expression levels of ERK1/2 and pERK1/2 were detected by Western blot.@*RESULTS@#The proliferation activity of K562 was reduced by 50, 100, 200 mg/L SLG in a concentration dependent manner (r=0.9997). The apoptosis rate and positive expression rate of CD11b, CD14 and CD42b which were related with differentiation were raised by SLG, as well as the expression of pERK1/2, while PD98059 could reverse the promoting effect of SLG on apoptosis and differentiation partially.@*CONCLUSION@#SLG can inhibit the proliferation and promote apoptosis and differentiation of K562 cells through ERK signaling pathway.
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Humans , Alkanes , Apoptosis , Cell Proliferation , K562 Cells , Petroleum , Plant Extracts/pharmacologyABSTRACT
OBJECTIVE@#To observe the effect of electroacupuncture on postpartum uterine contraction pain and uterine involution.@*METHODS@#A total of 80 patients with postpartum uterine contraction pain were randomly divided into an observation group and a control group, 40 cases in each group. The observation group was treated with electroacupuncture at Dahe (KI 12), Zhongzhu (KI 15), Hegu (LI 4), Xuehai (SP 10), etc. for 30 min, once a day, 3 days were as one course, and 2 courses with 1-day interval were required. The control group was treated with oral @*RESULTS@#Compared before treatment, the VAS scores of 24, 48, 72 h into treatment and after treatment were decreased in both groups (@*CONCLUSION@#Electroacupuncture can effectively relieve postpartum uterine contraction pain, accelerate the discharge of residual uterine hemorrhage in the uterine cavity, and promote uterine involution.
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Female , Humans , Pregnancy , Acupuncture Points , Electroacupuncture , Pain , Postpartum Period , Uterine ContractionABSTRACT
Objective To determine the prevalence rate of elevated fasting plasma glucose(FPG)in residents of Liaoning Province and to identify the risk factors, which will help to effectively prevent/alleviate the occurrence and development of diabetes for reduction of socioeconomic burden. Methods A multi-stage stratified random cluster sampling method was used to investigate the residents of 3 towns and 3 rural areas in Liaoning Province. A total of 53 497 adults(aged 35-75 years)were surveyed by questionnaires and the risk or protective factors were analyzed by logistic regression method. Results The prevalence rate of elevated FPG was 24.7% with 23.2% in males and 26.0% in females, respectively. The results of multivariate logistic regression showed that age increase, female, high education, occupation(except farmers), alcohol drinking, obesity, hypertension, and dyslipidemia were risk factors of FPG(P < 0.05 or P < 0.001). Conclusion The prevalence of elevated FPG is high in the study population aged 35-75 years in Liaoning. It is necessary to strengthen the intervention in this part of the population in order to reduce the incidence of diabetes mellitus.
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The peak period of cardiovascular disease (CVD) is around the time of awakening in the morning, which may be related to the surge of sympathetic activity at the end of nocturnal sleep. This paper chose 140 participants as study object, 70 of which had occurred CVD events while the rest hadn't during a two-year follow-up period. A two-layer model was proposed to investigate whether hypnopompic heart rate variability (HRV) was informative to distinguish these two types of participants. In the proposed model, the extreme gradient boosting algorithm (XGBoost) was used to construct a classifier in the first layer. By evaluating the feature importance of the classifier, those features with larger importance were fed into the second layer to construct the final classifier. Three machine learning algorithms, i.e., XGBoost, random forest and support vector machine were employed and compared in the second layer to find out which one can achieve the highest performance. The results showed that, with the analysis of hypnopompic HRV, the XGBoost+XGBoost model achieved the best performance with an accuracy of 84.3%. Compared with conventional time-domain and frequency-domain features, those features derived from nonlinear dynamic analysis were more important to the model. Especially, modified permutation entropy at scale 1 and sample entropy at scale 3 were relatively important. This study might have significance for the prevention and diagnosis of CVD, as well as for the design of CVD-risk assessment system.
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Humans , Algorithms , Cardiovascular Diseases , Heart Rate , Machine Learning , SleepABSTRACT
Inflammation plays important roles in the progress of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease. Microglia is responsible for the homeostasis of the central nervous system (CNS), and involved in the neuroinflammation. Therefore, it could be potential in treatment of neurodegenerative diseases to suppress the microglia-mediated neuroinflammation. Mangiferin, a major glucoside of xanthone in Anemarrhena Rhizome, has anti-inflammatory, anti-diabetes, and anti-oxidative properties. However, the effect of mangiferin on the inflammatary responses of microglia cells are still poorly understand. In this study, we investigated the mechanism by which mangiferin inhibited inflammation in LPS-induced BV
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Objective:To demonstrate the state of the art and trends on the global status of chronic disease management of patients with systemic lupus erythematosus (SLE) in recent 30 years.Methods:Literature relating to chronic disease management of patients with lupus from 1989 to 2018 was retrieved from Web of Science TM, using Mesh terms "lupus" and "management". CiteSpace was used to analyze countries/institutions, authors/cited authors, cited references and keywords. The information visualization analysis of centrality and counts was used to reveal countries/institutions, active authors, cited references, hot topics and frontiers. Results:A total of 3 328 papers were included, and a year-by-year increase of the number of publications were noticed. Most productive authors were from Europe, who were also open to communication and collaboration. Dr. M Petri is a representative figure in the area of lupus and antiphospholipid syndrome. She was involved in the composition of lupus classification and treatment guidelines, and played important roles in the arena of lupus treatment. Most productive countries/organizations were/from the United States, the United Kingdom, Spain, Italy, since European countries and organizations paid much attention to colaboration. The basis was focused on the treatment and management of lupus nephritis, the classification of lupus, the classification criteria of APS, and the usage as wells efficacy evaluation of belimumab in lupus. According to the time trend, the most popular key words were treatment, classification, antiphospholipid syndrome, disease activity, pregnancy, which could be categorized to 14 clusters. We could predicted that comprehensive evaluation including the clinical efficacy and safety of biological agents, as well as studies on quality of life and psychological state of lupus patients would become the main stream in this area. The research focus shifted from the diagnosis and treatment of lupus to the quality of life of patients.Conclusion:CiteSpace is used to collect the information of the literatures about chronic disease management of lupus. The results have shown that chronic disease management is still a hot topic. CiteSpace could help us to identify authors and institutions that are collaborative, as well as the research subjects that may lead the directions and future development.
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Based on archival materials, the Xiangya's anti-epidemic history in a century from its establishment to 2020 is divided into 4 stages. The first stage (1906-1926), Edward Hicks Hume and YAN Fuqing, the founders of Xiangya, prevented and controlled smallpox and plague. The second stage (1929-1953), during the resumption of Xiangya, students prevented and controlled cholera, plague, dysentery, typhus, and other infectious diseases. In the third stage (1953-1999), in a peacetime, Xiangya actively fought against schistosomiasis, hydatidosis, malaria, leprosy, tuberculosis and other epidemics. The fourth stage (2000-2020), the era of Central South University. Medical staff in Xiangya fight SARS, influenza A (HN) flu, Ebola hemorrhagic fever, coronavirus disease 2019, etc. Over the past hundred years, Xiangya people joined together to spread benevolence and love, apply medical knowledge and skills, combat the epidemic and rescue people in difficulties, which made a great contribution to the motherland and the people.
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Humans , Betacoronavirus , China , Communicable Disease Control , History , Communicable Diseases , History , Coronavirus Infections , Epidemics , History , History, 20th Century , History, 21st Century , Incidence , Pandemics , Pneumonia, ViralABSTRACT
Objective:To explore the effectiveness of an information system on the prevention and control of venous thromboembolism(VTE)in elderly inpatients.Methods:Through retrospectively reviewing medical records of Beijing Shijitan Hospital and files of all patients admitted to the geriatric department of our hospital before and after an information management system was instituted, data of those diagnosed with deep venous thrombosis of the lower extremities, intermuscular venous thrombosis and/or pulmonary thromboembolism(PE)at discharge were collected.General information, prognosis of disease, risk factors for VTE, the detection rate and assessment rate of VTE and other factors were analyzed.Methods:A total of 146 patients were enrolled, and they were mainly elderly patients from the respiratory, cardiology and integrative medicine wards.Diabetes mellitus, cancer and chronic heart failure were the top-three high-risk diseases, and most patients were at high risk or very high risk.The rate of elderly patients assessed as at high risk for VTE on admission was higher after the institution of the information system than that before the institution(93.22% vs.24.66%, P<0.05). The rate of VTE patients receiving standard diagnosis and anticoagulant treatment procedures had an upward trend since the information system became available, compared with before(8.47% vs.5.48%, P>0.05). There was a downward trend in the incidence of PE and all-cause mortality with the use of the information system(3.39% vs.9.59%, 5.08% vs.9.59%, P>0.05). Conclusions:The use of information systems can effectively increase the risk assessment rate for VTE and reduce the incidence of related adverse events in hospitalized elderly patients.
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Objective The recommended concentration of botulinum toxin type A is 40 100 U/ml.This study observed diffusion areas of two different concentration (40 U/ml and 100 U/ml) of botulinum toxin type A with intradermal injection to provide data for clinical application.Methods Intradermal injections with two different concentrations of botulinum toxin type A were conducted in subjects' forearm,with each level 4 points,and 4U per point (40 U/ml as 0.1 ml,100 U/ml as 0.04 ml).Minor's tests were conducted in 2nd day,5th day,2nd week and every month between 1st to 9th month respectively.The anhidrosis areas were measured and then effects of both concentrations were compared.Results The round anhidrosis areas were found in 2nd day,reaching the maximum range nearly at 2nd week,and then gradually dimming from 6th month,and completely vanishing at 9th month.In different measured points,the definite anhidrosis areas of high concentration (100 u/ml) were 113,345,530,380,330,255,285,295 and 295 mm2 respectively,while the low concentration (40 u/ml) were 113,345,450,345,285,255,255,255 and 255 mm2 respectively.The results did not show significant difference.Conclusions Concentration and volume do not show significant influence on areas of sweat gland when botulinum toxin type A is injected intradermally in a certain dose.
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Objective To investigate the safety and effect of bloodletting after hyaluronic acid embolization.Methods Rabbit ear auricle artery was chosen as a vascular model.After injection of hyaluronic acid,artery embolization was made.Rabbit ears were randomly divided into three groups,including bloodletting,hyaluronidase injection and untreated groups.We evaluated the effect through appearance observation and histological examination of the rabbit ears.Results During bloodletting,some points in acupuncture needles after extrusion appeared hyaluronic acid,some points even appeared massive hemorrhage and hematoma,but most points did not present any change.The histological examination showed the auricle artery was still full of hyaluronic acid,and the surrounding tissues showed necrosis after bloodletting.Long-term observation showed,after 12 days,all rabbits were alive,all of three groups presented scabby necrosis on the edge of ear.Scabby necrosis area ranked from large to small in untreated group (33.6 ％),bloodletting group (22.0％) and hyaluronidase injection group (12.6％) (t=0.013,P＜0.05);there was a statistical difference between the later two groups.At the same time,80％ of rabbit ears after bloodletting showed obvious color sink,infection or congestion.Conclusions After embolization of the hyaluronic acid artery,bloodletting is not as effective as hyaluronidase,and it would cause the adverse changes of local tissues.
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Objective The mechanism of traditional double-eyelid blepharoplasty is adhering skin to tarsus,by which the skin below the incision could be elevated along with the tarsus and produce the crease.But the anatomic basis of native double-eyelids is not the same,which depends on the connection of levator aponeuroses with muscle and skin.That is,the elevations of tarsus and skin is based on the different branches of levator aponeuroses to skin.According to this,the authors have developed a modified blepharoplasty suturing levator aponeuroses to the obicularis occuli muscle to mimic the native double eyelid.Methods The surgical procedures were modified from traditional surgery.The major improvements were:keeping obicularis occuli muscles intact,dissecting the levator aponeuroses and suturing them together.Since the suturing was performed between mobilized tissues of muscle and aponeurosis,the method was named as "flexible suspension technique".Five-hundred patients were performed with this method.Forty cases randomly selected from them were compared with 40 cases performed with traditional method,and the results were investigated using questionnaire survey.Results The results of the modified surgery were more natural than traditional technique.Majority of patients were satisfactory,whereas 15 cases (3％) had asymmetry,narrowing and even fold loss.All these 15 cases were puffy eyelids.Statistical results indicated that the satisfaction rate was significantly high (P =0.003),and the adverse effects (edema,bruise and scar) were significantly lighter than traditional technique;whereas the asymmetry and fold loss were higher than traditional technique.Conclusions The flexible suspension technique of blepharoplasty can obtain more natural double eyelid appearance,and is suitable for primary blepharoplasty but not applicable for severe puffy eyelids.
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Objective To explore the application of 3D printing templates for titanium plate contouring (TrPC) in pelvic ring surgery.Methods From May 2016 to June 2018,12 patients with pelvic ring injury were treated by internal fixation with 24 titanium plates at Department of Orthopedics and Trauma,Sanshui People's Hospital.After solid digital models of the damaged pelves of the patients were reconstructed from their CT images via software,the hollowed ones were created with the wall thickness of 1.2 mm.After the models of damaged pelves were restored to be intact,the templates for titanium plate contouring were designed based on the area of fixation and manufactured via a stereo lithography apparatus.The total manufacturing time and material consumption of 3D printing TTPC were recorded and compared with those of 3D printing solid and hollow models.Before operation,the titanium plates were contoured according to the templates.The time for preoperative shaping the plate and the time for intraoperative preparing the plate before installation were recorded.After operation,all patients underwent CT scan again for reconstruction of 3D models of the postoperative pelves which were compared with their corresponding preoperative ones in the software.Matta criteria were used to evaluate the pelvic reduction and Majeed criteria to evaluate the functional recovery 6 months after operation.Results All patients were followed up for 6 to 28 months (average,16.3 months).The total manufacturing time and material consumption of 3D printing a TTPC were significantly less than those of 3D printing a solid or hollow model (P ＜ 0.05).The time for preoperative shaping the plate was 12.8 ± 4.1 minutes and the time for intraoperative preparing the plate was 1.4 ± 1.1 minutes.The average deviation between the preoperative 3D models and the postoperative ones was 1.4 ± 1.1 mm.According to the Matta criteria for pelvic reduction,6 cases were excellent,4 good and 2 satisfactory.According to the Majeed criteria,the pelvic functions were excellent in 7 cases,good in 4,and fair in one.Conclusion Application of 3D printing TTPC in the surgery for pelvic ring injury is advantageous in lowering the costs of 3D printing and reducing the intraoperative time for contouring the titanium plate,leading to satisfactory outcomes.
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OBJECTIVE@#To observe the clinical effect of warm acupuncture on endometrial cavity fluid (ECF) from in vitro fertilization-embryo transfer (IVF-ET), and to explore the mechanism of warm acupuncture on ECF.@*METHODS@#Twenty-nine patients who were prepared for IVF-ET from 2016 to 2019 and whose transplantation was cancelled due to ECF found by vaginal B-ultrasound examination were divided into an observation group (14 cases) and a control group (15 cases) according to random number table method. The warm acupuncture was applied at Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3), Guilai (ST 29), Zigong (EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6) after the end of menstruation in the observation group, the treatment lasted for 60 min, once a day, 5 times as a course, with 2 days interval between the courses and 3 consecutive courses of treatment were given, until the embryo transfer was performed in the IVF assisted pregnancy cycle. After the end of menstruation, fresh leonurus japonicus capsule was given in the control group, 3 times a day, 0.8 g each time, 7 days as a course, and 3 courses of continuous treatment were received, until the embryo transfer was performed in the IVF assisted pregnancy cycle. The changes of ECF before and after treatment, the time required to prepare for embryo transfer during IVF assisted pregnancy cycle, and the clinical outcome of embryo transfer were observed in the two groups.@*RESULTS@#The decrease of ECF in the observation group was more significant than that in the control group (<0.05). The time required for the embryo transfer in the IVF assisted pregnancy cycle in the observation group was shorter than that in the control group (<0.05). The clinical pregnancy rate in the observation group was 42.9% (6/14), which was significantly higher than 26.7% (4/15) in the control group (<0.05).@*CONCLUSION@#Warm acupuncture may improve the clinical pregnancy rate by raising the local temperature of the lower abdomen, accelerating the blood circulation around the uterus and appendages, promoting the absorption of ECF, improving the uterine environment and endometrial receptivity.
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Female , Humans , Pregnancy , Acupuncture Therapy , Embryo Transfer , Endometrium , Fertilization in Vitro , Pregnancy RateABSTRACT
Objective To investigate the prevalence of main chronic diseases and explore its influencing factors among urban residents in Liaoning Province. Methods Using multistage stratified and cluster random sampling method, 30 953 urban residents of 14 districts were investigated with a standard questionnaire and physical examination. The logistic regression was applied to explore the influencing factors of main chronic diseases. Results The prevalence rate of chronic diseases was 39.25% and the standardized prevalence rate was 32.29%. The top three chronic diseases were hypertension, diabetes mellitus, and dyslipidemia, and the standardized prevalence rates were 21.13%, 9.48% and 5.25%. The results of the logistic regression analysis showed that the three chronic diseases shared older age(OR: 1.266-7.325)and overweight or obesity(OR:1.107-2.982)as the risk factors .In addition, there existed certain interactions among hypertension, diabetes mellitus and dyslipidemia(OR: 2.424-3.121). Conclusion Hypertension, diabetes mellitus and dyslipidemia which shared older age, overweight and obesity as the risk factors are the main chronic diseases to damage the health of urban residents in Liaoning. The corresponding prevention and treatment strategies should be taken based on the key groups and related influencing factors.
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Objective To search for a treatment approach for scalp avulsion injury based on the clinical experiences and review of literature.Methods Twenty-six consecutive scalp avulsion cases were involved in the study:15 cases were complete scalp avulsion (5 including forehead skin) and 11 cases were partial scalp avulsion.Cranial bones exposure occurred in 16 cases,11 of which had a size over 4 × 4 cm2.The treatment methods were various:11 cases with microsurgical replantation,9 cases with skin grafting,4 cases with secondary skin grafting followed by multiple drilling of the calvarium,1 case with local flap,and 1 case with free flap.According to the clinical cases and literature reviews,authors tried to search for an optimal protocol.Results Patients with microsurgical replantation achieved the best recovery including hair growth.In case of not qualified or fail to microsurgical replantation,skin graft could be considered as an alterative step,whereas the result of it was no hair growth and usually scar healing.In summary,14 different clinical conditions followed with 10 surgical techniques were concluded in a route chart.Conclusions To achieve the optimal outcomes of scalp avulsion injury,proper techniques should be chosen according to the treatment protocols.
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To analyze the clinical features of deep venous thrombosis(DVT) in hospitalized patients and evaluate the effectiveness of Padua risk assessment model. The clinical data of DVT patients were retrospectively analyzed in Beijing Shijitan Hospital from April 1 2017 to June 30, 2017. Padua risk assessment scale was used to evaluate the risk score of DVT in the departments of internal medicine and surgery. Effectiveness of predicting DVT was analyzed by receiver operating characteristic curve (ROC). Logistic regression analysis was used to evaluate the related factors of DVT. In DVT group, age ( OR=0.96), acute infection( OR=8.23),prothrombin time( OR=0.76),D dimer(OR=1.00),erythrocyte sedimentation rate( OR=1.02) and platelet count( OR=1.01) were significantly associated with thrombosis(all P<0.05). The specificity of Padua model to predict DVT in internal medical patients was better than the sensitivity(80.7% vs. 50%,P<0.05).Surgical patients reported similar findings with specificity to sensitivity of 87.5% vs. 67.5%(P<0.05). The area under curve of ROC in internal medical patients was more than that in surgical patients[0.62 (95% CI 0.59-0.67)vs. 0.61(95% CI 0.56-0.66),P<0.05]. Padua model is more specific than sensitive to predict DVT in hospitalized patients.It has better predictive value of DVT in internal medical patients than surgical patients.
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Objective To evaluate the effects of enteral immunonutrition on cell immunity level and clinical efficacy in patients with severe tuberculosis. Methods Sixty patients with severe tuberculosis were admitted to the department of tuberculosis intensive care unit of Hangzhou Red Cross Hospital from June 2015 to June 2017, and they were randomly divided into a conventional enteral nutrition group (EN group) and a enteral immunonutrition group (EIN group), each group 30 cases. Based on the patients' gastrointestinal tolerance condition, the EN group was treated with therapies of normal nutrition support, anti-tuberculosis, anti-infection, etc.; the EIN group was treated with enteral immunonutrition (TPF-T), and simultaneously with anti-tuberculosis, anti-infection, etc. therapies according to the disease situation. The target energy maintained at 104.6 kJ·d-1·kg-1and the therapeutic course was 14 days in the two groups. The levels of interleukins (IL-6, IL-10) and interferon-γ (IFN-γ), white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), cell immune indexes (T cell subgroup CD4+, CD8+) were observed before treatment and on day 14 after treatment in the patients of two groups; the changes of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score before treatment and after treatment and 28-day mortality rate were recorded in the two groups. Results After treatment, the levels of WBC, CRP, PCT were obviously lower than those before treatment, while the levels of IL-6, IFN-γ, CD4+in the two groups were significantly higher than those before treatment, and the changes of the EIN group were more significant than those in the EN group [WBC (×109/L): 8.0±3.1 vs. 10.0±2.4, CRP (mg/L): 30.3±9.1 vs. 45.8±6.6, PCT (μg/L): 2.2±1.8 vs. 4.3±2.2, IL-6 (mg/L): 182.53±8.52 vs. 168.42±7.62, IFN-γ (mg/L): 32.52±3.5 vs. 25.41±2.6, CD4+: 0.56±0.06 vs. 0.45±0.08, all P < 0.05]. The level of CD8+after treatment in the two groups was higher than that before treatment (the EN group: 0.28±0.06 vs. 0.27±0.07, the EIN group: 0.27±0.08 vs. 0.26±0.09), the APACHE Ⅱ scores in the two groups were lower than those before treatment (the EN group: 11±6 vs. 18±4, the EIN group: 10±3 vs. 17±6), the 28-day mortality in the EIN group was lower than that in the EN group [13.3% (4/30) vs. 16.7% (5/30)], no statistical significant difference in CD8+, APACHE Ⅱscore, 28-day mortality between the two groups being found (all P > 0.05). Conclusion Enteral immunonutrition can improve the level of cell immunity and decrease the degree of inflammatory response, and increase the clinical curative effect in patients with severe tuberculosis.