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OBJECTIVE To interpret Teacher Training Syllabus for Clinical Pharmacist Training Program （2023 edition） （hereinafter referred as to the “new syllabus”）， and to provide reference and guidance for promoting the implementation of the new syllabus and realizing the quality-improving goal of the reform of the clinical pharmacist teacher training program initiated by China Hospital Association. METHODS From the perspective of the management and based on the position of the designer， the new syllabus was interpreted from four aspects： the background of its compilation and release， the process of its compilation and its characteristics， the key improvements of the program and the points for attention about its subsequent implementation. RESULTS & CONCLUSIONS The development and release of the new syllabus provide a “construction blueprint” for the reform of the clinical pharmacist teacher training program of the China Hospital Association. The whole process of compiling the new syllabus is characterized by four basic features： theory-led， goal-oriented， research-based， and synergistic. Compared with the previous syllabus， in addition to the adjustment of the text structure，the new syllabus presents more complete and clearer competence requirements for clinical teaching competence in terms of training objectives； in terms of training content， it further structures the group of task items， pays attention to the 育。E-mail：zhenjiancun@163.com sequential planning and time arrangement of items， and puts forward both quantitative and qualitative refinement requirements for each specific training task；in terms of training methods， it emphasizes the interaction of lecturing， demonstrating and guiding， and the progression of observation， operation and reflection， with the intention of guiding teacher trainees to “learn how to teach by teaching”. In the subsequent implementation of the new syllabus， it is necessary for the teacher training bases to attach great importance to the guarantee of training conditions and process quality management， and to organize the teacher training team to do a good job in the two training programs of “clinical pharmacist training” and “clinical pharmacist teacher training”. Based on further improving the connection between the two training programs， the teacher training team should continue to explore the scientific model of clinical pharmacist teacher training oriented by clinical teaching competence.
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@#Abstract: Objective To investigate the dynamic changes and clinical significance of specific antibodies in patients with coronavirus disease 2019 (COVID-19). Methods A retrospective study was conducted to collect 141 adult COVID-19 survivors who were followed up in the Eighth Hospital affiliated to Guangzhou Medical University from February 6, 2020, to March 24, 2021. The patients were divided into severe group (severe and critical) and non-severe group (light and ordinary) according to the diagnosis at discharge. The antibody changes of the two groups were compared and analyzed at 1 week, 2 weeks, 1 month, 3 months, 6 months and 1 year after discharge. Results After discharge from hospital, the positive rate of IgG in the severe group was 95.00% after 1 week and 100.00% in the following year, in the positive rate of IgG in the non-severe group was 59.50% after 1 week, 90.08% in 6 months and 76.03% in one year. The level of serum IgG in the severe group was significantly higher than that in non-severe group (Z=-2.441, P=0.015). One-year follow-up: the serum IgG in the severe group was significantly higher than that in the non-severe group (Z=-3.410, P=0.001). The serum IgM level of the severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-2.259, P=0.024). The serum IgG and IgM level of the non-severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-7.37, P<0.01; Z=3.850, P<0.01). Conclusion The level of serum protective antibody in COVID-19 patients remained high within 6 months after discharge, and remained stable within 1 year after discharge. The antibody titers in the severe group were significantly higher than those in the non-severe group and lasted for at least one year. COVID-19 survivors receive 1 year of natural immune protection, and patients with critical conditions receive immunity for longer periods of time.
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OBJECTIVE：To interpret the new version of the Implementation Plan for Enrollment and Assessment of Clinical Pharmacist Teacher Training Project of Chinese Hospital Association （Trial）（hereinafter referred to as the “New Plan ”）officially announced by the Chinese Hospital Association in Sept. 2021，in order to provide guidance and reference for smoothly promoting the implementation of the New Plan and realizing the original intention of the reform. METHODS ：The New Plan was interpreted from four aspects ，including the background of the formulation of the New Plan ，the main features presented ，the innovations and the issues that need to be paid attention to in the next implementation. RESULTS & CONCLUSIONS ：The formulation and release of the New Plan marks the beginning of a new round of reform of the clinical pharmacist teacher training program of the Chinese Hospital Association. It is mainly based on the actual problems encountered in the operation of the current clinical pharmacist teacher training system ，the importance of clinical pharmacistteacher training itself ，and the opportunities and challenges that the development of the times has brought to our country ’s 163.com clinical pharmacy business. Research foundation ， problem orientation and professional demonstration present important characteristics. Compared with the old plan ，the New Plan adds a substantive selection mechanism for majors ，which intends to achieve the necessary “strictness”in the enrollment process ；it reconstructs the overall training goal of the benchmarking project and the three-in-one assessment system ，which intends to achieve a reasonable “lax”of assessment link ；it removes restrictions on off-site training ，advocates wide-ranging professional docking，and improves the flexibility of the training system and process management. The implementation of the New Plan is a complex work involving multiple parties and is affected by many factors. It requires multiple teams to perform their duties and promote together. The teacher training base and expert team must understand the spirit of reform and achieve the stable implementation of the New Plan ；at the same time ，the communication between the project working group and the teaching base and experts should be strengthened ，and finally realize the original intention of the reform of cultivating more high-quality clinical pharmacy teachers.
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Objective:To observe any effect of endoscopic evaluation of swallowing (FEES) on the functional outcomes of post-stroke patients in the subacute phase.Methods:A retrospective case-control study was conducted of 52 patients who had received an FEES assessment (the FEES group) and 51 who had not (the control group). Both groups received swallowing rehabilitation and intake training based on the results of the FEES assessment and those of a modified volume-viscosity swallowing test. The primary outcome indicator was the incidence of pneumonia. Secondary outcome indicators were the rate of removal of the nasal feeding tube, the length of indwelling of the nasal feeding tube, functional oral intake assessment scale (FOIS) scores, eating technique at discharge, and the length of hospital stay.Results:Compared with the control group, the incidence of pneumonia in the FEES group was significantly lower (7.7% vs. 39.2%). The removal rate of the nasal feeding tube was significantly greater (75.0% vs. 41.0%). The FEES group showed a significant improvement in its average FOIS score. And the proportion of patients who could try partial oral eating or complete oral eating at discharge was significantly higher in the FEES group. Regression analysis indicated that the risk of pneumonia in the FEES group was positively related to the time from onset to the first FEES examination.Conclusion:Early FEES examination after a stroke could reduce the incidence of pneumonia, increase chances of removing the nasal feeding tube and improve the swallowing function and outcome of stroke survivors.
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OBJECTIVE@#To investigate the relationship between sleep quality and bone mineral density (BMD) in urban residents.@*METHODS@#Data of 28 756 Han adults (14 355 males and 14 401 females), who completed both Pittsburgh sleep quality index (PSQI) assessment and radial BMD tests by dual energy X-ray absorptiometry in the Health Management Center of Southwest China University from June 2012 to June 2019 were retrospectively analyzed. The degree of sleep disorder was determined based on PSQI scores, while osteopenia and osteoporosis was diagnosed according to BMD T-value. The test and multiple regression model were used to investigate the relationship between sleep quality and BMD.@*RESULTS@#The numbers of normal BMD, osteoponia and osteoporosis were 17 039 (59.3%), 7916(27.5%) and 3801(13.2%), respectively. The mean PSQI score was 5.6±1.4 points. According to PSQI scores, there were 15 936 subjects without sleep disorder (55.4%), 5965 with mild (20.7%), 4897 with moderate (17.0%) and 1958 with severe sleep disorder (6.8%), respectively. There was no significant difference in osteoponia/osteoporosis rate between subjects with mild sleep disorder and normal ones (=0.948, >0.05), while the rate of osteoporosis in moderate sleep disorder group was higher than that in mild group (=525.583, <0.01), and the rate of osteoponia/osteoporosis in severe sleep disorder group was much higher than that in moderate group (=1124.877, <0.01). Multiple regression results showed that female, elders, mental labor, smoking and higher PSQI scores were independently associated with lower T-value (all <0.05), while moderate to intense daily physical activity was associated with higher T-value (<0.05).@*CONCLUSIONS@#Sleep disturbances may be a major risk factor for BMD loss in urban residents, indicating that it would be a potential target of osteoporosis prevention.
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Objective:To explore the risk factors related to hospitalization events in out patients on hemodialysis and to evaluate the effect of serum retinol-binding protein (RBP) level on hospitalization events in patients on hemodialysis.Methods:Case-control study. A total of 80 patients on dialysis were recruited, including 47 men (58.8%) and 33 women (41.2%), with an average age of (60.9±11.7) years (range: 32-89 years) and a median dialysis age of 43.6 months. Dialysis-related data were collected, the serum RBP level was detected using the ELISA method. Patients were followed-up until June 30, 2019, to record the events associated with all kinds of hospitalization events. The t-test, Mann-Whitney U test and chi-square test were used to compare the differences between the hospitalized event group and the non-event group. Multivariate logistic regression was used to analyze the related risk factors of hospitalization events. The Kaplan-Meier method, Log-rank test, and Cox proportional hazards regression model were used to analyze survival data. Results:During the 19-month follow-up period, 26/80 patients (32.5%) had 67 events of hospitalization. There was no difference ( P>0.05) in age, sex composition, dialysis age, ratio of diabetes/hypertension, interval dialysis weight gain (IDWG), systolic/diastolic blood pressure before dialysis, kt/v and URR between the groups with or without hospitalization events. The cut-off point of serum RBP was calculated using the patient′s highest Youden index. The patients were divided into the high-RBP group ( n=44) and low-RBP group ( n=36) according to the level of 165.34 mg/L. The incidence of hospitalization events in the high-RBP group was higher than that in the low-RBP group (45.45%>16.67%, P=0.006). Using the multivariate logistic regression model, after adjusting for sex, age, albumin and total cholesterol (CHO), only the serum RBP level was independently correlated with hospitalization events. The high-RBP group had an odds ratio ( OR) of 3.64 (95 %CI, 1.14-11.58; P=0.029) compared with the low-level group in hospitalization events. The Kaplan-Meier survival analysis showed that the incidence of hospitalization events in the high-RBP group was significantly higher than that in the low-RBP group ( P=0.0058). The test results of the multivariable Cox proportional hazards regression model showed that for patients on hemodialysis, an elevated serum RBP level is an independent risk factor for hospitalization events. Conclusion:Elevated serum RBP level is correlated with hospitalization events in patients on hemodialysis. RBP is an independent risk factor for hospitalization events in outpatients on hemodialysis.
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adrenocorticalcarcinoma；cortisolhypersecretion；hypokalemia；prognosis@#【Objective】To analyze the prognostic determinants of adreno cortical carcinoma（ACC）inadults.【Methods】Alladult patients who were admitted to SunYat-sen Memorial Hospital，SunYat-sen University from December 2011 to March 2017 and pathologically diagnosed ACC were included in this study.Thec linical data and preoperative laboratory examinations of those patients were analyzed retrospectively. Overall survival or disease-free survival was calculated and survivalcurves were plotted by Kaplan-Meier and compared by log-rank test. Harzardratios（HRs） with their 95% confidenceintervals（CIs） were calculated by univariate and multivariate Coxregression model.【Results】The study included 20 adult patients with ACC， with a median follow-up of 13months （6~73 months）. The mean survival time of those patients was 49.2 months（6~73months），with a 1-year survival rate of 70.0%. The results of multivariate Coxregression analysis revealed that the presense of cortisol hypersecretion（HR=23.60，95%CI：2.49-223.79，P=0.006） and hypokalemia（HR=23.60，95%CI：2.49-223.79，P=0.006）were predictors of poorprognosis of ACC. Moreover，in 18 patients with completely resected ACC，the presense of hypokalemia resulted in a worse disease-free survival.【Conclusion】The presense of cortisol hypersecretion and hypokalemiaare independent risk factors associated with poorprognosis of ACC in adults.
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OBJECTIVE: To investigate the expressions of hsa-miRNA-200 c and its relationship with metastasis of EOC.METHODS: The expression of hsa-miRNA-200 c was detected by Stem-loop Real-time Quantitative PCR(TaqMan probe method)in 73 cases of EOC,30 cases of benign ovarian epithelial tumors and 30 cases of normal ovarian tissues,which were collected in gynecological operations from Guangdong General Hospital from October 2010 to May 2011.Meantime,the clinical pathologic features data were analyzed.The assessment of the correlation between hsa-miRNA-200 c and clinicopathological features,and the hierarchical analysis of hsa-miRNA-200 c level in 73 cases of ovarian epithelial cancer was further undertaken(Among 73 cases,13 patients suffered liver metastasis and 60 patients had non-liver metastasis).Overexpression or knockdown of hsa-miRNA-200 c,ovarian cancer cell invasion and migration abilitywas detected.RESULTS: The expression of miRNA-200 c in the EOC tissues was 382.18±15.22,which was significantly higher than that in the benign ovarian epithelial tumors(35.61 ± 1.42)and normal ovarian tissues(4.43 ±2.23)(P0.05).The expressions of miRNA-200 c were low in EOC with late clin-ical FIGO stage(670.91±16.88 vs. 129.52±33.3,P0.05).The transwell cabinet invasion experiment showed the expression of miRNA-200 c was negatively correlated with the invasion capability of ovarian cancer cells.CONCLUSION: MiRNA-200 c is likely to play a double regulation role in the development of EOC,whose low-expression has been associated with late EOC,lymph node metastasis,liver metastasis,and poor prognosis.
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Objective To observe the effects of Qingyuan Shenghua Decoction on cardiovascular indexes and illness severity in sepsis patients after severe bone trauma. Methods Forty-eight sepsis patients after severe bone trauma were randomly divided into control group(22 cases)and treatment group(26 cases). The two groups were given routine treatment of western medicine according to International Guidelines for Management of Severe Sepsis and Septic Shock (2012). Additionally,the treatment group was treated with oral use or intranasal use of Qingyuan Shenghua Decoction, a herbal medicine recipe mainly composed of Radix Astragali, Radix Salviae Miltiorrhizae,Radix Angelicae Sinensis,Radix Paeoniae Rubra,Radix et Rhizoma Rhei,Rhizoma Curcumae, and Flos Carthami. Before and after treatment,we observed the mean arterial pressure(MAP),central venous pressure(CVP), heart rate(HR), arterial blood lactic acid(Lac), central venous blood oxygen saturation (ScvO2),central venous-arterial blood carbon dioxide partial pressure difference (Pcv-aCO2),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ) scores , sequential organ failure assessment (SOFA) scores, and oxygenation index (PaO2/ FiO2) of the two groups. Results With the prolongation of medication time,MAP,CVP,ScvO2,and Pcv-aCO2 of the two groups were increased gradually,and HR and Lac were decreased gradually (P < 0.05 or P < 0.01 compared with those before treatment) . Compared to the control group at the same time period, the treatment group had higher MAP, ScvO2, Pcv-aCO2 and PaO2/FiO2, and had lower HR, Lac, APACHEⅡ scores and SOFA scores 7 days after treatment, the difference being significant(P < 0.05). Conclusion Qingyuan Shenghua Decoction is effective on improving the abnormal hemodynamics and microcirculation, enhancing the efficient utilization of oxygen, protecting the function of multiple viscera,and alleviating the severity of disease in sepsis patients after severe bone trauma.
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The mosquito Aedes albopictus is the primary vector for dengue virus transmission in Fujian Province.Despite that active dengue surveillance has been launched in several sites since 2005,the genetic diversity of A.albopictus from these sites remains exclusive.In this study,mosquito pools collected from dengue surveillance sites during 2015-2016 were randomly selected,the full-length mitochondrial cytochrome C oxidase subunit Ⅰ (mtDNA-COⅠ) were amplified and sequenced.Preliminary sequence alignment of 12 amplicons with the reference sequence indicated 99 ％ homology at nucleotide level,due to varia tions at 9 nucleotide sites.Three haplotypes,namely H02,H03 and H08,were determined based on phylogenetic analysis with 72 reference sequences of known haplotypes.These observations facilitate surveillance and control of arboviral diseases in Fujian.
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Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base ofthe factor quality- quality of links-final quality3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.
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To evaluate several tests of physical performance for sarcopenia screening and assessment, by investigating physical performance and function in older women. 106 community-dwelling older women from a community in Shanghai were enrolled in this study. Physical function assessed by short physical performance battery (SPPB), timed get-up-and-go (TUG), handgrip strength, and usual gait speed were asked to perform. Total lean mass was determined by Dual energy X-ray absorptiometry, the relative appendicular skeletal muscle mass ( RASM) was defined as appendicular skeletal muscle mass/height2 . 13 individuals were diagnosed as sarcopenia according to a consensus diagnostic criteria for sarcopenia, as developed by the Asian Working Group for Sarcopenia ( AWGS) in 2014. Body mass index and handgrip strength in the sarcopenia group were significantly lower than those in the non-sarcopenia group (P=0. 026, P=0. 004 respectively), and there was no significant differences in the age, SPPB score, TUG, and usual gait speed. Linear regression analysis showed RASM was significantly positively correlated with body mass index (r=0. 842, P<0. 01), time to rise from a chair and return to the seated position five times (r=0. 203, P=0. 036),TUG(r=0. 258, P=0. 008)and grip strength (r=0. 217, P=0. 025), meanwhile, both body mass index and grip strength entered Logistic regression analysis. Low weight and low handgrip strength are independent predictive factors of sarcopenia in older women. Sarcopenia screening for older women with low body-weight and weak handgrip strength is more urgently required
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This review summarised and compared the contents and methods of America,s Health Rankings (AHR)and the County Health Rankings(CHR)in the United States by using literature review.AHR and CHR are the currently widely used population health assessment index ranking systems in the United States,respectively,which provided an analysis of population health on a state-by-state basis and a county-by-county basis by evaluating a histori-cal and comprehensive set of health outcomes and health determinants data to determine the health benchmarks and state/county rankings.The selection criteria of each indicator take into account of reliability, availability, stability, and intervention.The determination of weights of each indicator took into considerations the literature review,a histori-cal perspective,weights used by other rankings,internal analyses of the variation in outcomes explained by each factor, and pragmatic issues involving communications and stakeholder engagement.By comparison, it was found that AHR and CHR have a higher level of accuracy in the classification as they are well -defined by population demographics and geography respectively.The evaluation of health cities and health villages and towns in China is more complicated. There are few studies on village and town health rankings systems.This article reviewed the evaluation methods of AHR and CHR with a view to providing a reference for research on the evaluation system of City Health Rankings and the Village and Town Health Rankings in China.
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Objective To compare the difference of perception on nursing work environment between male and female nurses in secondary and tertiary hospitals in Guangdong Province.Methods Practice Environment Scale of the Nursing Work Index was used to measure nurses' perception on nursing work environment.Propensity score matching was used to control confounders when comparing the gender difference of nurses' perception on nursing work environment.Results Totally 3 456 nurses in secondary and tertiary hospitals in Guangdong Province were surveyed,and 190 of them were male nurses who were distributed with a significant higher proportion in tertiary hospitals,ICUs and emergency departments.Compared with female nurses,male nurses were significantly younger in age,had shorter working years and higher proportion of being single,contract employed,having associate degree or above for initial educational degree.Controlling confounders with propensity score matching,male nurses' perception on nursing work environment was significantly worse than females for three subscales:collegial nurse-physician relations,nursing foundations for quality of care,nurse manager ability,leadership,and support of nurses.Conclusion The proportion of male nurses in Guangdong Province should be raised.Distributed more in tertiary hospitals,ICUs and emergency departments,male nurses were characterized as being less experienced,more contract employed and having higher initial educational degree compared to female nurses.Worse perception on nursing work environment from male nurses indicated that nursing managers should attach more importance to male nurses to improve their orientation and in-service training,professional development support and collegial nurse-physician relations for their better perception on nursing work environment and retention.
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Objective To compare the difference of perception on nursing work environment between male and female nurses in secondary and tertiary hospitals in Guangdong Province.Methods Practice Environment Scale of the Nursing Work Index was used to measure nurses' perception on nursing work environment.Propensity score matching was used to control confounders when comparing the gender difference of nurses' perception on nursing work environment.Results Totally 3 456 nurses in secondary and tertiary hospitals in Guangdong Province were surveyed,and 190 of them were male nurses who were distributed with a significant higher proportion in tertiary hospitals,ICUs and emergency departments.Compared with female nurses,male nurses were significantly younger in age,had shorter working years and higher proportion of being single,contract employed,having associate degree or above for initial educational degree.Controlling confounders with propensity score matching,male nurses' perception on nursing work environment was significantly worse than females for three subscales:collegial nurse-physician relations,nursing foundations for quality of care,nurse manager ability,leadership,and support of nurses.Conclusion The proportion of male nurses in Guangdong Province should be raised.Distributed more in tertiary hospitals,ICUs and emergency departments,male nurses were characterized as being less experienced,more contract employed and having higher initial educational degree compared to female nurses.Worse perception on nursing work environment from male nurses indicated that nursing managers should attach more importance to male nurses to improve their orientation and in-service training,professional development support and collegial nurse-physician relations for their better perception on nursing work environment and retention.
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<p><b>BACKGROUND</b>The normal range of red cell distribution width (RDW) level is <15%. Several studies have indicated that a high RDW level was associated with mortality in critically ill patients, and the patients with a high RDW level need increased focus in clinical practice. In view of the difficulty in defining the specific value of high RDW level, the key is to focus on the patient with the level beyond the normal upper limit. This study aimed to determine whether dynamic change of RDW levels, rather than the level itself, is predictive of death in elderly patients with septic shock when RDW level is beyond 15%.</p><p><b>METHODS</b>Between September 2013 and September 2015, the elderly septic shock patients with RDW level beyond 15% were enrolled in this study. The RDW levels were measured at enrollment (day 1), and days 4 and 7 after enrollment. Sequential Organ Failure Assessment (SOFA) scores were recorded simultaneously.</p><p><b>RESULTS</b>A total of 45 patients, including 32 males and 13 females, were included in the final analysis. Based on their hospital outcomes, these patients were divided into the survivor group (n = 26) and the nonsurvivor group (n = 19). There were no significant differences in age, gender, body mass index, initial level of RDW, Acute Physiology and Chronic Health Evaluation II scores, and SOFA scores between survivors and nonsurvivors. At days 4 and 7 measurement, both RDW level (median [interquartile range]: day 4: 15.8 [2.0]% vs. 16.7 [2.0]%, P= 0.011; and day 7: 15.6 [1.8]% vs. 17.7 [2.5]%, P= 0.001) and SOFA scores (day 4: 7.0 [4.0] vs. 16.0 [5.0], P< 0.001, day 7: 5.5 [4.0] vs. 17.0 [5.0], P< 0.001) were significantly lower in survivors than those in nonsurvivors. Dynamic changes of RDW and SOFA scores in survivor group were significantly different from those in nonsurvivor group (all P< 0.05). Continuous increase in RDW level was observed in 10 of the 13 nonsurvivors, but only in 3 of the 26 survivors. The level of RDW7 and dynamic changes significantly correlated with their counterparts of SOFA scores (all P< 0.05), whereas the levels of RDW1 and RDW4 had no significant correlation with their counterparts of SOFA scores (all P> 0.05).</p><p><b>CONCLUSIONS</b>Continuous increase in RDW level, rather than the level of RDW itself, was more useful in predicting hospital death in elderly patients with septic shock when the level of RDW was >15%. The dynamic changes of RDW were highly correlated with the SOFA score in the patients.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , APACHE , Critical Illness , Erythrocyte Indices , Physiology , Hospital Mortality , Observational Studies as Topic , Organ Dysfunction Scores , Prognosis , Shock, Septic , Blood , MortalityABSTRACT
Objective To explore the clinical efficacy of Baihu decoction combined with insulin on type 2 diabetes with acute hyperglycemia patients.Methods A total of 86 cases of type 2 diabetes with acute hyperglycemia patients were randomly divided into experimental group (n=43) and control group (n=43).Two groups of patients underwent conventional exercise and diet adjustment intervention, control group was treated with insulin, continuous injection of 14d, experimental group was treated with Baihu decoction based on control group, 7d was taken for one courses, two course in all.The clinical symptoms of the two groups were compared, and the FPG, 2hPBG, HbAlc levels was detected in two groups pre-and post-reatment, the serum IL-6, hs-CRP, TNF-α, LP, APN, Cor were detected by enzyme linked immunosorbent assay method.Results The total effective rate was 91.7%in experimental group, higher than 76.7% in control group(P<0.05).After treatment, FPG, 2hPBG, HbAlc, IL-6, hs-CRP, TNF-αlevels in two groups were all significantly decreased (P<0.05), and those indexes in experimental group were significantly lower than those in control group (P<0.05).After treatment, APN and LP were significantly decreased, Cor was significantly increased in two groups(P<0.05), and the LP and APN in experimental group were significantly lower and Cor was significantly higher than that in control group (P<0.05).Conclusion Baihu decoction combine with insulin can significantly improve the clinical symptoms in type 2 diabetes with acute hyperglycemia patients, reduce the level of blood glucose and cytokines, and its mechanism may be relate to the increase APN level, reduce the LP and Cor levels.
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BACKGROUND:Periplaneta americana extract is recognized to have a positive effect on gastrointestinal mucosa. This study aimed to investigate the effects of periplaneta americana extract on immune function, nutrition status and gastrointestinal complications of early enteral nutrition patients with systemic inflammatory response syndrome (SIRS). METHODS:Patients with SIRS were randomly divided into two groups:treatment and control groups. All patients in the two groups received conventional therapy including enteral nutrition, but periplaneta americana extract, an additional Chinese medicine, was given to the patients in the treatment group. At the beginning of treatment (0 day) and 1, 3, and 7 days after treatment, the levels of immunoglobulin (IgA), total lymphocyte count (TLC), total protein (TP) and prealbumin (PA) were respectively tested in patients' venous blood. The incidences of bloating, diarrhea, aspiration pneumonia and high blood sugar at 7 days after treatment were recorded. The mortality of the patients in 28 days was recorded. RESULTS:At 3 and 7 days after treatment, the levels of IgA and TLC in the treatment group were higher than those in the control group (P<0.05). At 7 days after treatment, the levels of TP and PA in the treatment group were higher than those in the control group (P<0.05). The incidences of bloating and diarrhea in the treatment group were lower than those in the control group, the differences were significant (P<0.05). The mortality of treatment group was lower than that of the control group (P>0.05). CONCLUSION:Periplaneta americana extract could reduce gastrointestinal complications and improve immune function and nutritional status in patients with systemic inflammatory response syndrome.
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OBJECTIVE@#To investigate residents' psychological stress factors and research the correlation between post-traumatic stress disorder (PTSD) and platelet 5-HT concentrations so as to provide scientific bases for diagnosis and treatment of PTSD and psychological intervention for people in the disaster area.@*METHODS@#A questionnaire survey of 5500 residents who have accepted psychological help was conducted by the emphatic investigation method. While high performance liquid chromatography was used to detect the platelet serotonin concentration of 100 PTSD patients and 100 healthy people.@*RESULTS@#(1) Of the 5114 cases, 3167 (61.93%) showed positive results in screening for psychological stress symptoms, and 399 (7.8%) were tested having apparent PTSD symptoms. Male and female prevalence showed no significant difference (χ(2) = -0.380, P = 0.704). The differences of prevalence between different age groups were statistically significant (χ(2) = 381.89, P = 0.000). (2) The differences in the level of platelet 5-HT between PTSD patients and normal control group were statistically significant.@*CONCLUSIONS@#The typhoon of Hainan Province caused relatively large psychological problems to the disaster victims. Compared with normal control group, the platelet 5-HT levels of PTSD patients in the disaster areas are lower. It may be related to incidents exposure levels, cultural background, religious ideas, social concerns and psychological rescue of the residents who live in the disaster areas of Hainan.
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Objective To investigate residents' psychological stress factors and research the correlation between post-traumatic stress disorder (PTSD) and platelet 5-HT concentrations so as to provide scientific bases for diagnosis and treatment of PTSD and psychological intervention for people in the disaster area. Methods A questionnaire survey of 5 500 residents who have accepted psychological help was conducted by the emphatic investigation method. While high performance liquid chromatography was used to detect the platelet serotonin concentration of 100 PTSD patients and 100 healthy people. Results (1) Of the 5 114 cases, 3 167 (61.93%) showed positive results in screening for psychological stress symptoms, and 399 (7.8%) were tested having apparent PTSD symptoms. Male and female prevalence showed no significant difference (χ