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OBJECTIVE To investigate the current situation of pharmaceutical clinic service in medical institutions in China and provide experience and suggestions for promoting the development of pharmaceutical clinics. METHODS Questionnaire survey was used to investigate the development of pharmaceutical clinics in medical institutions of 31 provinces （autonomous regions and municipalities directly under the central government） in March to April 2023， and the descriptive analysis was conducted. The regression analysis was carried out for the influential factors of pharmaceutical clinic service. RESULTS A total of 1 368 questionnaires were distributed in this survey and 1 304 valid questionnaires were collected with the effective response rate of 95.32%. A total of 463 medical institutions carried out pharmaceutical clinic service， the rate of which was 35.51% （463/1 304）； the rates of pharmaceutical clinics in tertiary， secondary， primary and other medical institutions were 52.80%， 17.18% and 5.88%， respectively. The frequency of opening pharmaceutical clinics was 3.17 days per week on average， with an average of 5.99 visiting pharmacists in each medical institution. Among the visiting pharmacists， clinical pharmacists accounted for the vast majority （88.68%， 2 459/2 773）. There were various categories of pharmaceutical clinics， including joint clinics and pharmacist-independent clinics； among pharmacist-independent clinics， pharmaceutical specialty/specialty disease clinics were the main ones， accounting for 89.72% of the total number of pharmaceutical clinics. The value of pharmacists in pharmaceutical clinics was manifested in various forms， among which the proportion of medical institutions charging pharmaceutical clinics was 10.80%. The main experiences in developing pharmaceutical clinics were to attach importance to discipline construction and personnel training. The main difficulties in developing pharmaceutical clinics were low compensation levels and a shortage of talent.The number of clinical pharmacists， the number of visiting pharmacists in pharmaceutical clinics and additional compensation were positively correlated with the amount of pharmaceutical clinic services（P＜0.05）. CONCLUSIONS In recent years， pharmaceutical clinics have made significant progress； in the future， it is still necessary to further strengthen discipline construction and talent cultivation， pay attention to the value embodiment of pharmacists， to promote the healthy development of pharmaceutical clinics.
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Objective:To construct the training program system for hospice care volunteers and provide reference for the training of hospice care volunteers in China.Methods:The training program system for hospice care volunteers was initially determined by using the method of literature analysis and investigation, and 16 experts were consulted by two rounds of letters using the method of expert inquiry from May to July 2022, and finally the training program system was established.Results:The effective recovery rate of the two rounds of expert consultation questionnaire was 100%, the expert authority coefficient was 0.88, and the Kendall coordination coefficient was 0.141, 0.131 (both P<0.05). The final training program system for hospice care volunteers contained 7 first-class indicators including training objectives, training objects, training contents, training methods, training hours, training resources and training evaluation, 27 second-class indicators and 92 third-class indicators. Conclusions:The training program system for hospice care volunteers constructed in this study has high reliability and scientificity, and has a good guiding role and reference value for the training of hospice care volunteers.
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As the focus of public health work in the world, diabetic foot disease has aroused high public concern. This paper introduces the application of the diabetic foot wearable monitoring equipment types, including plantar pressure monitoring, temperature monitoring, monitoring of the biomechanics and multimode monitoring, and wearable devices application status in patients with diabetes, puts forward the existing problems and prospect, in order to carry out domestic related to diabetic foot wearable monitoring equipment research to provide the reference.
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【Objective】 To retrospectively analyze the safety and product quality of NGL XCF 3000 blood cell separator for collecting platelet-rich plasma (PRP) in 256 cases, so as to provide reference for safe collection and product quality control of PRP. 【Methods】 The data of 256 patients receiving PRP treatment in our hospital from June 2021 to June 2022 were statistically analyzed, and the differences in the collection time, circulating blood volume and the occurrence of adverse reactions to blood donation were analyzed when NGL XCF 3000 was used to collect autologous PRP among patients of different genders, ages and platelet counts. The differences in platelet content, red blood cell(RBC) contamination and white blood cell(WBC) residues in PRP products were analized. 【Results】 1) There were no significant differences in collection time, circulating blood volume and collection volume among patients of different genders, ages and platelet counts (P<0.05). 2) The contents of WBC, RBC and platelet were not significantly different between male and female patients after collection (P<0.05); 3) The WBC contents increased with the increase of age, and the WBC residue in the elder group[ 56 to78 years old, (0.64±0.41) ×109/L] was significantly higher than that in the younger group[group 1,18 to 40 years old, (0.50±0.35)×109/L], with significant difference was Statistically significant (P<0.05). 4) The residues of WBCs and RBCs in in low platelet group [group 1, (100-150)×109/L] were higher than those in other platelet count groups, and the difference was Statistically significant (P<0.05), and the platelet count in this product was significantly lower than that in other platelet count groups (P<0.05). Conclusion The NGL XCF 3000 blood cell separator is safe and stable for PRP collection in patients with different genders, ages and platelet counts of (100-450)×109/L, and the PRP products collected can meet clinical therapeutic needs.
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Objective To investigate the relationship between sleep duration and obesity, and the risk of common chronic diseases in the occupational population in Shanghai City. Methods A total of 18 775 occupational individuals were selected as the study subjects using convenience sampling method in Shanghai City. Data on personal lifestyle behaviors and medical examination results were collected. The relationship between sleep duration and different types of obesity with dyslipidemia, hyperuricemia, hypertension, and hyperglycemia was analyzed. Results The incidence of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia among the study subjects was 24.9%, 16.2%, 11.5%, and 7.3%, respectively. The incidence of these four chronic diseases were higher in individuals with central obesity and suboptimal sleep compared to the control group (all P<0.01). Multivariate logistic regression analysis showed that suboptimal sleep combined with general obesity/overweight increased the risk of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia in the study subjects ［odds ratio (OR) were 2.40, 3.47, 3.30, and 2.79, respectively; all P<0.01］, after adjusting for age, gender, education level, marital status, occupation type, labor intensity, smoking, and drinking. Suboptimal sleep combined with central obesity also potentially increased the risk of these four chronic diseases (OR were 2.25, 3.09, 3.09, and 2.98, respectively; all P<0.01). Conclusion The incidence of common chronic diseases is relatively high in the occupational population in Shanghai City. Suboptimal sleep combined with different types of obesity increases the risk of common chronic diseases.
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Objective:A retrospective study was conducted to analysis the clinical characteristics of 7insulin autoimmune syndrome (IAS) patients.Methods:Clinical data were collected by searching the computerized database.Results:The male-female ratio of these seven patients was 4:3; age of the four patients was between 60-70 years old;two patients with the history of Hashimoto's disease. Of the seven cases, six wereexogenous IAS. The level of insulin was excessively high, the level of C-peptide was not low, and insulin auto-antibodies (IAA) were positive of all the seven patients. The lowest blood glucose of one patient was 4.2 mmol/L. The insulin to C-peptide molar ratios were >1 in five patients. Symptoms were relieved after discontinuing use of the suspicious drugs, small frequent meals, taking acarbose and metformin.Conclusions:IAS should not be easily excluded in patients without hypoglycemia record. For diabetes patients receiving insulin therapy, exogenous IAS might be mistaken as hypoglycemia induced by insulin overdose. The identification of the genotype might be meaningful in the diagnosing and prevention of IAS.
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The research progress of the frailty risk prediction model for the elderly were reviewed in order to analyze its evaluation content, prediction effect and clinical application, so as to provide reference for the risk prediction model construction and application, reduce the risk of the elderly frailty.
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ObjectiveTo explore the beliefs and attitudes about sleep in patients with comorbid depressive disorder and insomnia， and to explore its influence on sleep quality. MethodsPatients with comorbid depressive disorder and insomnia （n=61） and patients with primary insomnia （n=62） who met criteria specified in the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） in Beijing Anding Hospital Affiliated to Capital Medical University were enrolled， meantime， another 64 healthy controls were recruited. All subjects were assessed using Dysfunctional Beliefs and Attitudes about Sleep （DBAS） and Pittsburgh Sleep Quality Index （PSQI）. Additionally， patients with comorbid depressive disorder and insomnia were evaluated using Hamilton Depression Scale-17 item （HAMD-17）. The PSQI and DBAS scores were compared among three groups using analysis of covariance， and multiple linear regression analysis was used to screen the factors affecting PSQI score in patients with comorbid depressive disorder and insomnia. ResultsCompared with healthy controls， higher scores of PSQI （t=18.932， 18.610， P<0.01） along with lower scores of DBAS （t=-5.561， -5.791， P<0.01） were observed in patients with comorbid depressive disorder and insomnia and patients with primary insomnia. Taking the PSQI score of patients with comorbid depressive disorder and insomnia as the dependent variable， statistically significant equations were generated using multiple linear regression analysis （F=14.095， R2=0.327， P<0.05）， and the predictive and control factors of sleep in DBAS and age were found to be the influencing factors of PSQI score in patients （B=-0.100， -0.279， P<0.05 or 0.01）. ConclusionCompared with the normal，depression patients with insomnia have more dysfunctional beliefs and attitudes towards sleep，and dysfunctional cognition may be the influencing factor of their sleep quality.
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Objective:To investigate clinical efficacy of tunneled subcutaneous pedicle flaps in the repair of ipsilateral nasal alar defects.Methods:A total of 20 patients with nasal alar defects after excision of basal cell carcinoma, which were repaired with ipsilateral tunneled subcutaneous pedicle flaps, were retrospectively collected from January 2018 to January 2020. There were 11 male patients and 9 female patients, with an average age of 60.6 years (range, 48 - 76 years) . According to clinical manifestations, the basal cell carcinoma lesions could be classified into 3 types: nodular-ulcerative type (13 cases) , superficial type (4 cases) and pigmented type (3 cases) , and the skin lesions varied from 0.4 cm × 0.5 cm to 0.9 cm × 1.1 cm in size. All the patients received extended surgical resection of basal cell carcinoma, and nasal alar defects were repaired with tunneled subcutaneous pedicle flaps, with the size of flaps ranging from 0.7 cm × 0.8 cm to 1.2 cm × 1.4 cm.Results:All flaps survived successfully, the nasal alar defects were completely repaired, and all wounds healed primarily. During the postoperative follow-up of 6 - 24 months, neither recurrence of tumors nor obvious scar hyperplasia occurred on the nasal ala, and nasal morphology and appearance were favorable.Conclusion:The tunneled subcutaneous pedicle flap can be used for the repair of ipsilateral nasal alar defects following excision of tumors or other lesions, resulting in favorable therapeutic outcomes and aesthetic appearance.
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Objective:To detective the cut-off values of amino acid levels in premature infants in Sichuan.Methods:Data of newborns screening for inherited metabolic diseases (IMD) by tandem mass spectrometry in Sichuan Province from January 2018 to December 2019 were retrospectively analyzed.They were divided into premature infant group ( n=2 264, 1 312 males and 952 females) and full-term infant group ( n=53 275, 28 269 males and 25 006 females). The cut-off values of amino acids in dry blood spots were expressed as percentage ( P0.5 - P99.5), and rank sum test was used for comparison between preterm and full-term infants. Results:(1) The distribution of 11 amino acids [alanine (ALA), arginine (ARG), citrulline (CIT), glycine(GLY), leucine (LEU), methionine (MET), ornithine (ORN), phenylalanine (PHE), proline (PRO), tyrosine (TYR) and valine (VAL)] in premature infants were abnormal.(2) The cut-off values of amino acids in premature infants were as follows: ALA: 135.20-552.33 μmol/L, ARG: 1.34-47.04 μmol/L, CIT: 5.66-32.02 μmol/L, GLY: 181.48-909.93 μmol/L, LEU : 71.10-283.29 μmol/L, MET: 4.21-34.51 μmol/L, ORN: 40.58-293.76 μmol/L, PHE: 23.60-106.30 μmol/L, PRO: 77.76-358.24 μmol/L, TYR: 27.52-352.91 μmol/L, VAL: 53.74-228.37 μmol/L.(3) The cut-off values of amino acid in full-term infants were as follows: ALA: 135.20-552.33 μmol/L, ARG: 1.30-42.73 μmol/L, CIT: 5.92-30.35 μmol/L, GLY: 208.17-980.09 μmol/L, LEU: 72.91-287.49 μmol/L, MET: 4.27-33.90 μmol/L, ORN: 48.40-305.59 μmol/L, PHE: 27.63-92.27 μmol/L, PRO: 97.38-372.75 μmol/L, TYR: 40.19-276.54 μmol/L, VAL: 65.75-237.92 μmol/L.(4) Except for PHE ( Z=-0.58, P>0.05), the other indicators were significantly different between 2 groups [ALA ( Z=-15.32, P<0.05), ARG ( Z=-5.62, P<0.05), CIT ( Z=-5.86, P<0.05), GLY ( Z=-14.52, P<0.05), LEU ( Z=-5.62, P<0.05), MET ( Z=-5.22, P<0.05), ORN ( Z=-13.01, P<0.05), PRO ( Z=-22.09, P<0.05), TRY ( Z=-2.09, P<0.05), VAL ( Z=-17.82, P<0.05)]. Conclusions:The establishment of the cut-off values of amino acids in premature infants in Sichuan provides a theoretical basis for laboratory diagnosis of IMD screening, which enhances the accuracy of diagnosis and avoids excessive medical treatment.
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【Objective】 To analyze the safety of apheresis granulocyte(AG) collection from blood donors mobilized by G-CSF and apheresis granulocyte transfusion efficacy in patients. 【Methods】 The blood routine results, collection process and follow-up of blood donors mobilized by G-CSF before and after AG collection were collected to analyze the safety of AG collection, and the blood routine results, clinical symptom improvement and treatment outcome of patients before and after AG transfusion were collected to analyze the transfusion efficacy. 【Results】 A total of 27 blood donors donated 29 U AG, with collection time at (229±20)min, circulating blood volume at (9 890±1 107)mL, and the dosage of anticoagulant at (1 002±97)mL.Two blood donors had adverse reactions to blood donation, and the AG collection was carried out after treatment.After G-CSF mobilization, WBC increased significantly from (5.61±1.06) ×109/L to (22.85±5.23) ×109/L, while RBC, Hb, Hct and Plt showed no significant change.The blood routine returned to the level before G-CSF mobilization 1-2 days after blood donation.No physical discomfort occurred during the one week after blood donation.Four patients with granulocyte deficiency complicated with multidrug-resistant bacterial infection, who failed to respond to antibiotic treatment, were transfused with 29 U AG, with no adverse reactions and no obvious change in blood routine, but the infection symptoms were improved significantly judged from clinical manifestation, bacterial culture results, temperature monitoring and CT examination, suggesting that the AG infusion was effective.Among the 4 patients, 1 was cured and discharged, 1 gave up treatment, 1 died of sepsis, and 1 died of multiple organ failure. 【Conclusion】 It is safe to collect AG from blood donors mobilized by G-CSF through blood cell separator, and the AG products basically meet the national quality requirements and the treatment needs.Sustained high-dose AG transfusion has a significant effect on infection control in patients with agranulocytosis combined with refractory multidrug-resistant bacterial or fungal infection.
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Objective@#Cisplatin resistance is a huge problem encountered in ovarian cancer treatment. Our study probed the roles and the underlying mechanisms of lncRNA MCF2L-AS1 in ovarian cancer cisplatin-resistance. @*Methods@#SKOV3 and IGROV-1 cells were subjected to gradually increasing concentrations of cisplatin to construct ovarian cancer cisplatin-resistance cells. Cell proliferation was evaluated by cell counting kit-8 and colony formation assays. Cell apoptosis was assessed using Annexin V and PI staining. The relationships between SP1, MCF2L-AS1 and insulin-like growth factor-2 mRNA binding protein 1 (IGF2BP1) were verified by RNA pull-down, RIP, ChIP and dual-luciferase reporter gene assay, respectively. Tumor xenograft experiment was employed to evaluate the effects of MCF2L-AS1 silencing on ovarian cancer cisplatin-resistance in vivo. TUNEL staining and immunohistochemistry were performed in tumor tissue. @*Results@#MCF2L-AS1 and IGF2BP1 were upregulated in cisplatin-resistant cells. MCF2L-AS1 silencing suppressed cell proliferation of cisplatin-resistant cells, while promoted the apoptosis, suggesting that MCF2L-AS1 knockdown suppressed ovarian cancer cells cisplatin-resistance. Meanwhile, MCF2L-AS1 silencing enhanced cisplatin sensitivity in ovarian cancer parental cells and IGF2BP1 overexpression impaired cisplatin sensitivity of parental cells. MCF2L-AS1 activated IGF2/MEK/ERK pathway through interacting with IGF2BP1. Transcription factor SP1 activated MCF2L-AS1 expression. MCF2L-AS1 knockdown inhibited ovarian cancer cisplatin-resistance in vivo. @*Conclusion@#SP1-induced MCF2L-AS1 promoted ovarian cancer cisplatin-resistance through activation of IGF2/MEK/ERK pathway via interacting with IGF2BP1.
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Objective@#To classify the characteristics of circadian type among clinical nurses and examine their relationships with presenteeism and work-related flow. @*Methods@#Using a cross-sectional design, 568 nurses were recruited through convenience sampling in January 2021 from three hospitals in Shandong Province, China. The data were collected using self-report measures, including the 11-item Circadian Type Inventory, Stanford Presenteeism Scale-6, and Work-Related Flow Inventory. Latent class analysis was performed to identify any clustering of circadian types. One-way analysis was performed to compare the differences between presenteeism and work-related flow in different circadian types. @*Results@#Four latent classes were identified, including high response class (14.4%), high flexible class (20.1%), high languid class (51.1%), and low response class (14.4%). Regarding presenteeism, the high languid class had higher scores than others. Regarding work-related flow, the scores of high flexible class were higher than those of high languid class, while the differences in all three dimensions were statistically significant. @*Conclusion@#Although the shift work mode is not expected to change, nursing managers could use circadian type as a predictive index to select and employ individuals for shift work to enhance work performance and provide sufficient support to staff who are intolerant to shift work.
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Objective:To investigate the effects of dexmedetomidine on monocyte pyroptosis in peripheral blood of patients with cardiac valve replacement.Methods:Forty-four American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 45-64 yr, with body mass index of 18-25 kg/m 2, of New York Heart Association Ⅱ or Ⅲ, scheduled for elective cardiac valve replacement, were divided into 2 groups ( n=22 each) using a random number table method: dexmedetomidine group (group Dex) and normal saline group (group NS). In group Dex, dexmedetomidine was intravenously infused in a dose of 0.5 μg/kg over 10 min starting from the end of anesthesia induction, followed by a continuous infusion at 0.5 μg·kg -1·h -1 until the end of operation, while the equal volume of normal saline was given instead of dexmedetomidine in group NS.Before skin incision (T 1), at 30 min after the beginning of cardiopulmonary bypass (CPB) (T 2), immediately after the end of CPB (T 3) and at 24 h after CPB (T 4), the blood samples of internal jugular vein were collected for determination of the concentrations of plasma interleukin-18 (IL-18) and IL-1β (by enzyme-linked immunosorbent assay), and the expression of NOD-like receptor family, pyrin domain containing 3 (NLRP3), caspase-1 and gasdermin-D (GSDMD) in monocytes (by Western blot). The intraoperative consumption of propofol, sufentanil and norepinephrine, time of postoperative mechanical ventilation and time of intensive care unit stay were recorded. Results:The levels of plasma IL-18 and IL-1β and expression of NLRP3, caspase-1 and GSDMD in monocytes were significantly higher at T 2-4 than at T 1 in two groups ( P<0.05). Compared with group NS, the levels of plasma IL-18 and IL-1β were significantly decreased and the expression of NLRP3, caspase-1 and GSDMD was down-regulated at T 2-4, postoperative mechanical ventilation time was shortened ( P<0.05), and no significant change was found in the consumption of propofol, sufentanil and norepinephrine and time of intensive care unit stay in group Dex ( P>0.05). Conclusion:The mechanism by which dexmedetomidine reduces inflammatory responses may be related to inhibiting the NLRP3/caspase-1 pathway and reducing monocyte pyroptosis in the patients undergoing cardiac valve replacement.
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Objective:To analyze the autistic severity and developmental level of children with autism spectrum disorder (ASD) of different gender and age.Methods:From March 2018 to February 2019, a total of 286 ASD children aged 18-96 months were enrolled.Severity of ASD was evaluated by the autism behavior checklist (ABC) and the childhood autism rating scale (CARS), while the Griffiths mental development scales-Chinese (GDS-C) was used to evaluate the children's mental development.According to gender and age, ASD severity and developmental levels of different subgroups were analyzed.SPSS 23.0 statistical software was used to analyze the data.According to the non-normal distrbution of variables, Mann-Whitney U test was used for comparison between the two groups, and Kruskal-Wallis H test was used for comparison between multiple groups and Spearman correlation analysis was used to analyze the correlation between two variables. Results:No gender difference was found in the total scores of ABC (52(40, 62), 57(36, 67), Z=0.661, P=0.509) and CARS (31(28, 35), 33(27, 36), Z=0.672, P=0.502) between the ASD boys and ASD girls.No gender difference was found in the total scores of ABC (43(33, 53), 52(34, 58), Z=0.717, P=0.473) and CARS (29(26, 32), 27(26, 30), Z=0.212, P=0.832) between the ASD boys and ASD girls when the general quotient of the GDS-C were all greater than or equal to 70 points.Also, no gender difference was found in the total ABC (55(44, 67), 59(40, 67), Z=0.067, P=0.947) and CARS (32(30, 35), 34(30, 36), Z=0.657, P=0.511) between the ASD boys and ASD girls when the general quotient of the GDS-C were all less than 70 points.The eye-hand coordination (64(52, 77), 60(43, 72), Z=2.138, P=0.033), performance (68(51, 86), 59(43, 68), Z=3.270, P=0.001), and practical reasoning (68(55, 91), 51(33, 58), Z=2.686, P=0.007) quotients of the ASD boys were significantly higher than those of the ASD girls.Compared with boys, a markedly higher proportion of developmental delay (35(80%), 124(51%), χ 2=12.083, P=0.001) was recorded for girls in relation to the performance subscale.There were significant differences in the total scores of ABC and CARS, the locomotor and eye-hand coordination quotients in GDS-C among ASD children of different ages(all P<0.05). The older the first diagnosis age, the lower the scores.The age of initial diagnosis was negatively correlated with the total scores of ABC ( r=-0.259), CARS ( r=-0.268), general quotient of GDS-C ( r=-0.127), locomotor ( r=-0.275), eye-hand coordination ( r=-0.213), performance ( r=-0.160) and practical reasoning ( r=-0.307) (all P<0.05), while positively correlated with hearing and language development quotient ( r=0.143) ( P<0.05). Conclusion:No significant gender difference was found on the severity of ASD in children aged 18 to 96 months, but the developmental level of some areas in boys was better than that of girls with ASD.ASD severity and developmental level vary depending on the age at which their ASD was diagnosed.The age of initial diagnosis is related to the severity and developmental level of ASD.
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Objective:To construct the core competence evaluation indicators for clinical teaching nurses,provide quantifiable indicators for the core competency of clinical teaching nurses.Methods:Using literature review, survey of nursing students, interview of clinical teaching nurses, and two-round Delphi expert consultation for 18 clinical teaching nurses, the core competence evaluation indicators was constructed.Results:The response rates for two rounds of expert consultation were 18/18 and 16/18, authority coefficients were 0.83 and 0.85, and coordination coefficients at all levels ranged from 0.096-0.503( P<0.05). The core competence evaluation indicators for clinical teaching nurses consisted of 7 first-class indicators, 25 second-class indicators and 43 third-class indicators. Conclusions:The enthusiasm, authority, concentration degree and coordination degree of experts are comparatively high. It can provide references for standardized evaluation, training and management of clinical teaching nurses.
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【Objective】 To explore the factors affecting the collection and product quality of platelet-rich plasma (PRP), and to provide reference for ensuring the safety of PRP collection and the quality of PRP products. 【Methods】 A total of 108 patients receiving PRP treatment in our hospital from February 20 to April 20, 2016 were investigated by analyzing the time of PRP collection, the amount of circulating blood, the amount of anticoagulant and the use of calcium from four factors including gender, age, Plt before collection and collection equipment. The effects of PRP product volume, platelet content, RBC and WBC contamination, and the occurrence of adverse reactions were statistically analyzed. 【Results】 The type of equipment had little influence on the collection parameters and product quality(P>0.05). RBC residues in female patients were (0.07±0.03) ×1012/L, higher than that in male patients (0.04±0.02)×1012/L (P<0.05). Significant differences in collection time, circulating blood volume, anticoagulant dosage and collection volume were noticed by age(18~40 vs 56~77 years old, P<0.05) and platelet count(×109/L) (201~450 vs 100~150, P<0.05). In patients with low Plt count (100~150)×109/L before collection, the Plt content in PRP product was relatively low(771±218)×109/L, and WBC(0.45±0.25)×109/L and RBC(0.07±0.03)×1012/L residual amount was rather high(P<0.05), but also satisfied the quality criteria. 【Conclusion】 The MCS+ and NGL XCF 3000 blood cell separators are safe and stable in PRP collection, even in patients with low platelet count(100~150)×109/L or old age (>55 years old).
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Objective:To investigate the influence of metformin on serum thyrotropin (TSH) levels in type 2 diabetes patients with euthyroidism.Methods:A retrospective case-control study was conducted to analyze the clinical data of 180 patients with type 2 diabetes who were newly diagnosed with normal thyroid function or first treated with metformin from June 2014 to June 2018 in the endocrine metabolism Department of Beijing Anzhen Hospital Affiliated to Capital Medical University.The patients were divided into metformin group and non metformin group according to the different treatment plan, 90 cases in each group.According to the baseline TSH level, the metformin group was divided into 36 cases of high TSH (baseline TSH>2.50 mU/L-≤4.91 mU/L) and 54 cases of low TSH (baseline TSH ≥ 0.49 mU/L-≤ 2.50 mU/L). The high TSH group was further grouped and analyzed according to the level of thyroid peroxidase antibody (TPOAb). Treatment for 12 months.The changes of TSH, FT3 and FT4 were observed at baseline and 12 months after treatment.Results:There was no significant difference in serum TSH and thyroid hormone between metformin group and non metformin group at baseline and 12 months after treatment (all P>0.05). However, in metformin group subjects only with high-normal basal TSH level, significant decrease in TSH levels after 12-month therapy was observed ((2.31±1.48) mU/L vs.(3.19±0.62) mU/L, t=3.291, P=0.002). Further grouping analysis showed that, regardless of TPOAb positive / negative, the TSH level in the high TSH subgroup decreased significantly after treatment compared with that before treatment ( TPOAb(+ ): (1.92±1.27) mU/L vs.(3.34±0.56) mU/L, t=3.235, P=0.005) ( TPOAb(-): ( 2.36±1.50) mU/L vs.(3.16±0.63) mU/L, t=2.507, P=0.016). Conclusion:Metformin treatment reduced TSH levels in type 2 diabetic patients with normal and high baseline TSH, and TPOAb levels had no effect on this effect.
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Objective:To explore the application of lecture-based learning (LBL) combined with problem-based learning (PBL) in the teaching of pathophysiology case analysis.Methods:The subjects were 62 preventive medicine majors of Grade 2015 and 68 stomatology majors of Grade 2015, and the course content was case analysis. PBL teaching was implemented in the preventive medicine major group and LBL+PBL teaching was implemented in the stomatology major group. Both groups received 6 class hours, among which the LBL+PBL teaching hours were allocated 2 class hours for LBL and 4 class hours for PBL. In addition, the questionnaire was used to evaluate the teaching effects between the two groups, and the descriptive analysis was used to evaluate relevant data lines.Results:Eleven students (17.742%) from the preventive medicine major group chose PBL teaching, while 38 students (92.647%) in the stomatology major group held a very positive attitude towards LBL+PBL teaching. It can be seen that the recognition degree of LBL+PBL teaching in the stomatology major group was higher than that of PBL teaching in the preventive medicine major group.Conclusion:Since students have received LBL teaching mode for a long time, it is difficult to accept and adapt to PBL teaching in terms of thinking and teamwork. Therefore, in the course of pathophysiology case analysis, LBL+PBL teaching shows a good effect, which is worthy of further exploration.
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Objective:To investigate the current situation of kinesiophobia in patients with knee osteoarthritis and its influencing factors, in order to provide basis for clinical intervention.Methods:Totally 230 patients with knee osteoarthritis were selected from 2 tertiary hospital in Ji′nan by convenience sampling method, the self-designed general data questionnaire, Tampa Scale for Kinesiophobia, Numerical Rating Scale, Self-efficacy for Managing Chronic Disease, Hospital Anxiety and Depression Scale were used as research tools. Logistic regression analysis was used to analyze the influencing factors.Results:A total of 219 valid questionnaires were collected. Kinesiophobia occurred in 166 patients, with an incidence of 75.80% (166/219). Logistic regression analysis showed that gender, education level, chronic complications, pain and self-efficacy were the main influencing factors of kinesiophobia in patients with knee osteoarthritis ( P<0.05). Conclusion:The incidence of kinesiophobia in patients with knee osteoarthritis is relatively high, and medical staff should pay attention to the evaluation of kinesiophobia symptoms in this population, early identify the high-risk factors, provide timely health education, implement the appropriate intervention measures to reduce the occurrence of kinesiophobia.