ABSTRACT
Objective:To study the relationship between the level of serum homocysteine (Hcy) and the antisense non coding gene (ANRIL) of long chain non coding RNA (lncRNA) cell cycle dependent kinase inhibitor 2B gene, and the effect on Atherosclerosis inflammation, that is, the expression of interleukin-10 (IL-10) and Monocyte chemoattractant protein-1 (MCP-1) in Human umbilical vein endothelial cell (HUVEC).Methods:HUVEC was cultured in vitro and cells were treated with different concentration gradients (blank control group, 0.5, 1.0, 2.0, 5.0 mmol/L) of Hcy. The expression level of lncRNA ANRIL was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of MCP-1 and IL-10. LipoFilter transfection reagents were used to transfect shANRIL and shNC into different cells, respectively. In the above experiment, the optimal Hcy concentration (5.0 mmol/L) was selected for intervention for 24 hours. Western blot was used to detect the protein expression levels of MCP-1 and IL-10.Results:After 24 hours of intervention with different concentrations of Hcy in HUVEC, Hcy significantly damaged endothelial cells, and the higher the Hcy concentration, the more severe the cell damage. Compared with the blank control group, the Hcy intervention group showed an increase in lncRNA ANRIL and MCP-1, while IL-10 decreased (all P<0.05); As the concentration of Hcy intervention increases, IL-10 decreases, while lncRNA ANRIL and MCP-1 increased (all P<0.05). Compared with the blank control group, the Hcy group, the shNC+ Hcy group, and the shANRIL+ Hcy group had lower levels of IL-10 protein expression and higher levels of MCP-1 protein expression (all P<0.05). Compared with the shANRIL+ Hcy group, the Hcy group and the shNC+ Hcy group had lower levels of IL-10 protein expression and higher levels of MCP-1 protein expression (all P<0.05). There was no statistically significant difference in the expression levels of IL-10 protein and MCP-1 protein between the shNC+ Hcy group and the Hcy group (all P>0.05). Conclusions:Hcy upregulates MCP-1 expression and downregulates IL-10 expression by promoting lncRNA ANRIL expression. Thus, it can promote cellular inflammatory reaction and participate in Atherosclerosis.
ABSTRACT
Objective:To explore application of blended learning mode in the teaching of the general theory of surgery.Methods:Clinical undergraduates from Batch 2015 and Batch 2016 of Medical College of Hunan University of Medicine were taken as participants. One teaching class of Batch 2015 was selected as control group ( n=117), and the traditional teaching method was adopted; one teaching class from Batch 2016 was selected as experimental group ( n=115), and the blended learning model was adopted. The results of two groups' process assessment and final assessment were compared. A questionnaire was conducted among the clinical undergraduates of Batch 2016 who practiced blended learning to evaluate their satisfaction with this learning mode. SPSS 22.0 was used for t test. Results:The experimental group was significantly better than the control group in process assessment and final assessment results [(93.65±3.71) vs. (91.46±5.63); (68.36±8.14) vs. (64.94±8.98)]. The analysis of the questionnaire survey showed that students had a high satisfaction with the blended learning mode, and their approval rate reached over 90%.Conclusion:In the teaching process of clinical course of general theory of surgery, blended learning mode is highly recognized by students, which can significantly improve students' independent learning ability and interest, simultaneously increase students' classroom participation and teacher-student interaction, and finally improve students' professional overall qualities and critical thinking.
ABSTRACT
Objective:To evaluate the efficacy and side effects of PD-1 monoclonal antibody in the treatment of advanced metastatic renal cell carcinoma in China.Methods:The clinical data of 117 patients with advanced metastatic renal cell carcinoma (mRCC) treated with PD-1 monoclonal antibody from October 2016 to February 2022 were retrospectively analyzed. There were 87 males (74.4%) and 30 females (25.6%), with an average age of (57.9±10.9) years old, BMI of (23.6±3.4) kg/m 2and smoking history of 79 (67.5%). There were 44 cases (37.6%) with hypertension, 19 (16.2%) cases of diabetes. The ECOG score of 59.8% (70/117) patients was 0, 33.3% (39/117) was 1, 4.3% (5/117) was 2, and 2.5% (3/117) was 3. The pathological type of 104 cases were renal clear cell carcinoma (ccRCC), 8 cases of papillary renal cell carcinoma, 2 cases of chromophobe cell carcinoma, 2 cases of collecting duct carcinoma and 1 case of eosinophilic cell carcinoma. The general condition of the overall population and the overall survival (OS) of relevant subgroups were analyzed. Secondary goals included progression free survival (PFS), objective response rate (ORR), adverse reactions, overall survival (OS), and progression free survival (PFS). Results:65.8% (77 / 117) of the patients chose targeted combined with PD-1 monoclonal antibody in the first-line treatment. The main targeted drugs were acitinib (81.8%, 63 / 77), tirelizumab (37.6%, 29 / 77) and cindilimab (25.9%, 20 / 77). After first-line treatment, 19.6.1% (23 / 117) patients needed to be converted to second-line treatment, and 15 patients changed the type of PD-1 antibody during treatment. In addition, the targeted drug of combined therapy was replaced by acitinib in 8 patients. The main causes of drug withdrawal were disease progression (70.7%, 29 / 41) and death (29.2%, 12 / 41). The median OS of the overall population was 35.6 (19-60) months and PFS was 12.1 (1-60) months. The ORR of the overall population was 47.8% (56 / 117). 4.2% (5/117) patients had complete remission, another 17.0% (20/117) patients were in stable condition, and 43.5% (51 / 117) patients were in partial remission. In the first-line treatment, the median PFS time of targeted combined with PD-1 monoclonal antibody was 12.6 (1-30) months, the median PFS time of PD-1 single drug immunotherapy was 10.5 (1-60) months. In the second-line treatment, the PFS of patients treated with PD-1 monoclonal antibody was 10.1 (4-19) months, and that of patients treated with PD-1 monoclonal antibody combined with targeted therapy was 11.7 (1-25) months. The most common adverse reactions were elevated blood pressure (18.5%, 23 / 124), followed by hypothyroidism (15.3%%, 19/124), rash (14.5%, 18 / 124), elevated transaminase (10.5%, 13 / 124) and bone marrow suppression (9.7%, 12/124). 9.4% (11 / 117) patients needed to reduce the related adverse reactions by interrupting the treatment control of PD-1 monoclonal antibody.Conclusions:The safety and efficacy of PD-1 monoclonal antibody in domestic patients are better, and the side effects are less. The efficacy and safety of PD-1 monoclonal antibody combined with targeted therapy in the real world population are consistent with many key clinical trials abroad. PD-1 monoclonal antibody combined with targeted drugs can be popularized in the domestic MRCC population.
ABSTRACT
Objective:To investigate the application value of magnetic resonance T2mapping in the diagnosis of knee osteoarthritis (KOA).Methods:The MRI data of the knees of 148 patients with KOA who underwent diagnosis and treatment between January 2017 and December 2020 in Benxi Central Hospital (KOA group) and 30 healthy volunteers (control group) were retrospectively analyzed. T2 values of cartilage in each sub-region of the knee were measured, grouped, and statistically analyzed.Results:There was no significant difference in the T2 value of cartilage in each sub-region of the knee between male and female patients in mild and severe KOA groups (all P > 0.05). T2 values in the medial anterior, middle, and posterior areas of the tibia, lateral anterior, middle and posterior areas of the tibia, medial middle, posterior and lateral areas of the femur, and lateral posterior area of the femur were (44.47 ± 2.35) ms, (46.52 ± 3.12) ms, (45.47 ± 2.40) ms, (43.68 ± 2.12) ms, (46.33 ± 3.36) ms, (43.92 ± 3.42) ms, (43.58 ± 2.40) ms, (45.53 ± 3.91) ms, (44.36 ± 3.15) ms, (46.41 ± 3.04) ms, respectively in the control group. They were (49.56 ± 2.05) ms, (51.67 ± 2.38) ms, (50.47 ± 2.53) ms, (48.68 ± 3.05) ms, (51.33 ± 4.62) ms, (48.92 ± 2.53) ms, (48.58 ± 3.15) ms, (50.53 ± 3.72) ms, (48.36 ± 2.41) ms, and (51.41 ± 3.64) ms, respectively in the mild KOA group, and (53.47 ± 2.46) ms, (56.52 ± 3.57) ms, (54.85 ± 2.89) ms, (52.68 ± 3.57) ms, (56.33 ± 3.91) ms, (52.92 ± 3.04) ms, (53.58 ± 3.36) ms, (55.53 ± 3.42) ms, (52.36 ± 4.13) ms, and (56.41 ± 3.56) ms, respectively in the severe KOA group. There were significant differences in abovementioned indices among the three groups ( F = 38.768, 39.412, 38.981, 40.432, 38.416, 38.635, 38.347, 40.712, 38.158, 39.418, all P < 0.05). Conclusion:The T2 value of knee cartilage in patients with KOA is unrelated to gender and related to the severity of the disease. Magnetic resonance T2 mapping can help diagnose KOA, and provide information about the changes in cartilage components of patients with early KOA.
ABSTRACT
Objective:To screen aberrant DNA methylation sites associated with melanoma using gene chip technology, and to preliminarily construct a melanoma-specific methylation profile.Methods:The Illumina Human Methylation 450K whole-genome methylation chip was used to detect the whole-genome DNA in 6 melanoma tissues and their paralesional skin tissues, and DNA differentially methylated sites were obtained. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) -based pathway analysis were carried out to investigate gene functions.Results:Gene chip testing showed that there were 27 779 differentially methylated sites between melanoma tissues and paralesional tissues, of which 16 673 were hypermethylated sites and 11 106 were hypomethylated sites in melanoma tissues. According to more stringent screening criteria " P < 0.01 and |Δβ| > 0.2", a total of 4 883 differentially methylated sites were screened out after filtering out all single nucleotide polymorphism-related probes, probes located on the XY chromosomes and cross-reactive probes, 1 459 (30%) of which were located in the promoter region including TSS1500, TSS200, 5′UTR and 1st Exon. GO enrichment analysis showed that differentially methylated genes were involved in many biological processes, including cell growth, differentiation, adhesion, movement and migration, signal transduction, transcriptional regulation, etc. KEGG-based pathway analysis showed that differentially methylated genes were mainly involved in signaling pathways, such as focal adhesion pathway, cancer pathways, transforming growth factor-β signaling pathway, phosphatidylinositol signaling pathway, melanogenesis pathway, chemokine signaling pathway, adhesion junction pathway, calcium signaling pathway, cell adhesion molecule pathway, mitogen-activated protein kinase signaling pathway, Wnt signaling pathway, Janus kinase-signal transducer and activator of transcription signaling pathway. Based on the criteira "the top 16 most differentially methylated genes related to hypermethylated sites in the promoter region, the genes with the highest methylation frequency (CpG sites ≥ 7) , the genes with certain functions or involved in a certain signaling pathway", 8 genes (KAAG1, DGKE, SOCS2, TFAP2A, GNMT, GALNT3, ANK2 and HOXA9) were selected as candidate biomarkers for melanoma. Conclusion:There are many hypermethylated genes in melanoma tissues, and 8 differentially methylated genes may serve as biomarkers for melanoma.
ABSTRACT
Objective:To assess the efficacy and safety of 100 units of botulinum toxin A (BTX-A) intradetrusor injection in patients with overactive bladder.Methods:From April 2016 to December 2018, 17 tertiary hospitals were selected to participate in this prospective, multicenter, randomized, double-blind, placebo-controlled study. Two phases of study were conducted: the primary phase and the extended phase. This study enrolled patients aged 18 to 75 years who had been inadequately managed by anticholinergic therapy (insufficient efficacy or intolerable side effects) and had spontaneous voiding with overactive bladder. Exclusion criteria included patients with severe cardiac, renal and hepatic disorders, patients with previous botulinum toxin treatment for 6 months or allergic to BTX-A, patients with urinary tract infections, patients with urinary stones, urinary tract tumors, diabetes mellitus, and bleeding tendency. Eligible patients were randomly assigned to BTX-A group and placebo control group in a ratio of 2∶1. Two groups of patients received 20 intradetrusor injections of BTX-A 100U or placebo at the depth of the submucosal muscle layer respectively under cystoscope, including 5 injections at the base of the bladder, 3 injections to the bladder triangle, 5 injections each to the left and right walls and 2 injections to the top, sparing the bladder neck. As a placebo control group, patients received same volume of placebo containing no BTX-A and only adjuvant freeze-dried preparations for injection with the same method. A combination of gelatin, sucrose, and dextran served as adjuvants. Average micturition times per 24 hours, urinary incontinence (UI) episodes per day, average micturition volume per day, OAB symptom score(OABSS), and quality of life (QOL) score were recorded at baseline and the 2nd, 6th and 12th week after treatment. The primary efficacy endpoint was the change from baseline in the average micturition times per 24 hours at the 6th week after treatment. The secondary efficacy endpoints included the change from baseline in the average micturition times per 24 hours at 2nd and 12th week, as well as the change from baseline in the OABSS, QOL score, average frequency of urgency and UI episodes per day, urgency score, average micturition volume per day at 2nd, 6th and 12th week after treatment. Patients were followed for 12 weeks to assess adverse events (AEs). After assessed at week 12, if the micturition times has decreased less than 50% compared to baseline and the patient is willing to receive retreatment, then patients could enter the extended trial phase. In that phase, patients in both groups were injected with 100 units BTX-A from 12th week onwards and then followed up the same indicators for 12 weeks.Results:216 patients were enrolled in this trial (144 cases in the BTX-A group and 72 cases in the placebo control group). Baseline characteristics such as age (47.75±14.20 in the BTX-A group and 46.39±15.55 in the control group), sex (25 male/117 female in the BTX-A group and 10/61 in the control group), and disease duration (0.51 years in the BTX-A group and 0.60 years in the control group) were balanced between the two groups( P>0.05). A marked reduction from baseline in average micturition times per 24 hours was observed in all treatment groups at the 6th week and the reduction of the two groups was statistically different ( P<0.001 and P=0.008 respectively). Compared with the baseline, the average micturition times per 24 hours at the 6th week decreased from baseline by 2.40(0.70, 4.60)times for the BTX-A group and 0.70(-1.00, 3.30) times for the placebo control group respectively, and the difference between the two groups was considered to be statistically significant ( P=0.003). The change rates of average micturition times per 24 hours from baseline at the 6th week of the two groups were (16±22)% and (8±25)% respectively, and the difference between the two groups was statistically significant ( P=0.014). Compared with the baseline, the average micturition times per 24 hours at 2nd and 12th week decreased by 2.00(0.00, 4.00)and 3.30(0.60, 5.03)for the BTX-A group, 1.00(-1.00, 3.00)and 1.70(-1.45, 3.85)for the placebo control group respectively. The difference between two groups was considered to be statistically significant ( P=0.038 and P=0.012); the changes of average urgency times per day for the BTX-A group and the control group at the 2nd, 6th and 12th week were 2.00(0.00, 4.30)and 2.40(0.30, 5.00), 3.00(0.30, 5.70)and 0.70(-1.30, 2.70), 0.70(-1.30, 3.00) and 1.35(-1.15, 3.50), respectively. There were significant differences between two groups at the 2nd, 6th and 12th week, ( P=0.010, P=0.003 and P=0.025, respectively). The OABSS of the BTX-A group and the control group at the 6th week decreased by 1.00(0.00, 4.00)and 0.50(-1.00, 2.00) compared with the baseline, and the difference between the two groups was statistically significant ( P=0.003). 47 cases of BTX-A group and 34 cases of placebo control group entered the extended trial phase, and 40 and 28 cases completed the extended trial phase, respectively. The average micturition volume per 24 hours changed by -16.60(-41.60, -0.60)ml and -6.40(-22.40, 13.30)ml, (-35.67±54.41)ml and(-1.76±48.69)ml, (-36.14±41.51)ml and (-9.28±44.59)ml, (-35.85±43.35)ml and(-10.41±40.29)ml for two groups at the 12th, 14th, 18th and 24th week, and the difference between two groups was statistically significant at each follow-up time ( P=0.01, 0.006, 0.012 and 0.016, respectively). There was no significant difference in other parameters( P>0.05). However, adverse reactions after intradetrusor injection included increased residual urine volume (27 in the BTX-A group and 3 in the control group), dysuria (21 in the BTX-A group and 6 in the control group), urinary infection (19 in the BTX-A group and 6 in the control group), bladder neck obstruction (3 in the BTX-A group and 0 in the control group), hematuria (3 in the BTX-A group and 1 in the control group), elevated alanine aminotransferase (3 in the BTX-A group and 0 in the control group), etc. During the follow-up period, there was no significant difference in the other adverse events between two groups except the increase of residual urine volume( P<0.05). In the primary trial phase, among the 27 cases with increased residual urine volume in BTA group, only 1 case (3.70%) with PVR more than 300 ml; the PVR of 3 patients in the placebo group was less than 100 ml. The increase of residual urine volume caused by the injection could be improved or disappeared with the passage of time. Conclusions:Intradetrusor injection of Chinese BTX-A improved the average micturition times per 24 hours, the average daily urgent micturition times, OABSS, and average micturition volume per time, and reduced the adverse effects in patients with overactive bladder.Chinese BTX-A at dose of 100U demonstrated durable efficacy and safety in the management of overactive bladder.
ABSTRACT
Objective@#To investigate the sleep quality and influencing factors of the first batch of college students returning to school during COVID-19 epidemic, so as to provide scientific basis for taking corresponding measures.@*Methods@#An anonymous self-administered questionnaire survey was conducted among the first batch of college students returning from a certain university by cluster sampling, which included general demographic characteristics, Trait Coping Style Questionnaire (TCSQ) and Pittsburgh Sleep Quality Index(PSQI).@*Results@#The detection rate of sleep disorders was 19.33%(522/2 701). The mother s education level was high school or technical secondary school or below(OR=2.24, 95%CI=1.47-3.41), never eat breakfast(OR=3.25, 95%CI=1.86-5.68), families were damaged during the outbreak (OR=1.48, 95%CI=1.17-1.87) and negative coping (OR=1.15, 95%CI=1.12-1.17) were risk factors for sleep disorders(P<0.05). Compared to having a very poor relationship with parents, the relationship between parents was average(OR=0.23, 95%CI=0.06-0.89), better(OR=0.23, 95%CI=0.06-0.87), very good (OR=0.19, 95%CI=0.05-0.74) were protective factors for sleep disorders(P<0.05). Exercise once or twice a week during the epidemic(OR=0.76, 95%CI=0.58-1.00), positive coping (OR=0.93, 95%CI=0.91-0.96) were protective factors for sleep disorders(P<0.05).@*Conclusion@#In this COVID-19 epidemic, the sleep quality of returning college students was affected to different extent, and the relationship between parents, sports, mother s education, breakfast habits, and family damage during the COVID-19 were factors affecting their sleep quality. Targeted psychological intervention measures should be given to returning college students in the early stage.
ABSTRACT
Objective@#To understand the current situation and influencing factors of Internet addiction among college students after returning to school during the COVID-19 epidemic, and to provide scientific basis for timely intervention measures to adjust the risk factors of Internet addiction.@*Methods@#A cluster sampling method was adopted to conduct a questionnaire survey among 2 700 college students who firstly returned to college using general condition questionnaire and Internet Addiction scale.@*Results@#The detection rate of Internet addiction disorder was 32.4% among returning college students, moreover, the detection rate of Internet addiction in male students(36.0%) was higher than that in female students (31.2%) (χ 2=5.42,P<0.05). The degree of Internet addiction was negatively correlated with the physical health score (r-s=-0.20) and mental health score (r-s=-0.24) of college students (P<0.01). Multivariate Logistic regression analysis showed that compared with introversion, neutral (OR=0.67, 95%CI=0.55-0.82) and extroverted college students (OR=0.59, 95%CI=0.48-0.74) were protective factors for Internet addiction; compared with no exercise, physical exercise ≥3 times or more per week (exercise 3-4 times：OR=0.67, 95%CI=0.51-0.87; ≥5 times：OR=0.67, 95%CI=0.50-0.90) were the protective factors for Internet addiction among college students; family loss during the epidemic was a risk factor for Internet addiction among college students (OR=1.34, 95%CI=1.12-1.60); the risk of Internet addiction was 2.13 times higher for college students who actively sought psychological help than for those who did not seek psychological help (95%CI=1.14-3.96); college students who did not want to go back to school had 1.50 times the risk of Internet addiction as those who did (95%CI=1.26-1.77).@*Conclusion@#The current situation of college students online behaviors during COVID-19 is not optimistic, and should arouse sufficient attention from society and universities. In addition, college students returning to school should take more physical exercises and psychological counseling to detect and intervene in psychological problems in time, reduce their psychological burden, and enhance their psychological quality.
ABSTRACT
Objective@#To explore the effectiveness of short-term high-intensity exercise combined with nutritional intervention in female college students with Internet addiction and obesity.@*Methods@#Eighty female internet addicted and obese college students from Shijiazhang Information Engineering Vocational College were recruited into the intervention. They were divided into intervention group and control group (n=40) by random number table method. The control group maintained the original exercise and dietary habits, while the intervention group received nutritional intervention and 8-week high intensity intermittent exercise. Body composition, lipid metabolism index and Internet Addiction Scale scores before and after intervention were compared between the two groups.@*Results@#After intervention, weight, body fat percentage and abdominal fat in the intervention group decreased significantly, while lean mass and bone mass increased significantly(t=7.32，4.95，6.99，3.21，2.78，3.06，P<0.05). Water content did not change significantly. Body weight, body fat percentage and abdominal fat of the intervention group were significantly lower than those of the control group, and lean mass and bone mass of the intervention group were significantly higher than those of the control group(t=-7.87，-9.90，-5.24，2.19，6.17，P<0.05). The level of TG in the intervention group was significantly decreased after intervention, and there was significant difference between the two groups(t=8.76，6.66，P<0.05). After intervention, total and dimensional scores of Internet addiction in the intervention group were significantly lower than those in the control group(t=6.27，4.97，8.21，10.06，5.39，9.25，P<0.05), and the scores of compulsive Internet use behavior, Internet addiction tolerance, withdrawal reaction, time management problems, interpersonal and health problems and total scores in the intervention group were significantly lower than those in the control group(t=-8.61，-5.32，-8.65，-6.69，-5.56，-17.59，P<0.05).@*Conclusion@#Short-term high-intensity exercise and nutritional intervention among obese female college students with Internet addiction shows positive effects in reducing body fat and improving lipid metabolism, as well as Internet addiction.
ABSTRACT
OBJECTIVE@#To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis.@*METHODS@#Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients.@*RESULTS@#Female patients are more likely to have anxiety (=3.206, 95%: 1.073-9.583, <0.05) and depression (=9.111, 95%: 2.143-38.729, <0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (=3.267, 95%: 1.082-9.597, <0.05).@*CONCLUSIONS@#During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.
Subject(s)
Female , Humans , Male , Anxiety , Diagnosis , Therapeutics , Betacoronavirus , Coronavirus Infections , Diagnosis , Psychology , Depression , Diagnosis , Logistic Models , Pandemics , Pneumonia, Viral , Diagnosis , Psychology , Risk FactorsABSTRACT
Objective@#To evaluate the effect of continuous care on patients with high risk of diabetic foot in China.@*Methods@#A random control of continuing care for patients with diabetes foot at high risk before June 2018 was published in the full text of the Chinese VP full text database (VIP), the full text database (CNKI), the Chinese biomedical literature database (CBM), Wan Fang, PubMed, Science Library. The test (randomized clinical trial), by 2 researchers, according to the inclusion and exclusion criteria, the literature quality was evaluated and extracted by the document quality standard of Cochrane cooperation network, and the different subgroups were divided according to the difference of the determination time of each outcome index, and the RevMan5.3 software was used to match the data. The required literature is analyzed by Meta.@*Results@#A total of 13 randomized clinical trials were included in the Mate analysis, including 1 450 subjects, 721 in the intervention group and 729 in the control group. The results showed that continuous nursing could effectively reduce the value of fasting blood glucose (combined effect MD=-1.34, 95%CI -1.44--1.24, P < 0.01), and effectively reduce the value of glycosylated hemoglobin (combined effect MD=-0.75, 95%CI -1.24- -0.27, P=0.002), and reduce the diabetic foot in patients with diabetic foot risk(combined effect RR=0.31, 95%CI 0.24-0.40, P<0.01). Continuous care could improve patients′ self-management ability and self-foot nursing ability.@*Conclusions@#Continuous care can reduce the fasting blood glucose, glycosylated hemoglobin and the incidence of diabetic foot in high-risk patients with diabetic foot, improve their self-management ability and self-foot nursing ability, which is of great significance to prevent and reduce the occurrence and development of diabetic foot.
ABSTRACT
Objective To evaluate the effect of continuous care on patients with high risk of diabetic foot in China. Methods A random control of continuing care for patients with diabetes foot at high risk before June 2018 was published in the full text of the Chinese VP full text database (VIP), the full text database (CNKI), the Chinese biomedical literature database (CBM), Wan Fang, PubMed, Science Library. The test (randomized clinical trial), by 2 researchers, according to the inclusion and exclusion criteria, the literature quality was evaluated and extracted by the document quality standard of Cochrane cooperation network, and the different subgroups were divided according to the difference of the determination time of each outcome index, and the RevMan5.3 software was used to match the data. The required literature is analyzed by Meta. ResuLts A total of 13 randomized clinical trials were included in the Mate analysis, including 1 450 subjects, 721 in the intervention group and 729 in the control group. The results showed that continuous nursing could effectively reduce the value of fasting blood glucose (combined effect MD=-1.34,95% CI -1.44--1.24, P < 0.01), and effectively reduce the value of glycosylated hemoglobin (combined effect MD=-0.75, 95% CI-1.24--0.27, P=0.002), and reduce the diabetic foot in patients with diabetic foot risk(combined effect RR=0.31, 95% CI 0.24-0.40, P<0.01). Continuous care could improve patients′ self-management ability and self-foot nursing ability. ConcLusions Continuous care can reduce the fasting blood glucose, glycosylated hemoglobin and the incidence of diabetic foot in high-risk patients with diabetic foot, improve their self-management ability and self-foot nursing ability, which is of great significance to prevent and reduce the occurrence and development of diabetic foot.
ABSTRACT
Objective@#To review the imaging characteristics and evaluate the diagnostic value of echocardiography for levoatriocardinal vein(LACV) in children.@*Methods@#Doppler echocardiography was performed and these images were compared retrospectively in 9 children with LACV, which were diagnosed through the operation of cardial surgery and computed tomography angiography findings.@*Results@#LACV was characterized by an anomalous vein connected the left atrium to the left innominate vein. There was a normal connection of the pulmonary vein with the left atrium. The associated malformations included mitral valve stenosis and mitral atresia (8 cases), single ventricle(3 cases), double outlet right ventricle (2 cases), hypoplastic left heart syndrome (2 cases), atrial septal defect with restrictive shunt (1 case), and patent foramen ovale (1 case). Six of 9 cases(66.7%) were diagnosed correctly using Doppler echocardiography, in the remaining 3 cases (33.3%), 1 case was miss diagnosed, 1 case misdiagnosed as persistent left superior vena cava, and 1 case misdiagnosed as partial anomalous pulmonary venous connection.@*Conclusions@#LACV can be diagnosed by Doppler echocardiography. This malformation should be differentiated from persistent left superior vena cava, and anomalous pulmonary venous connection.
ABSTRACT
Objective To investigate the clinical application of fast locator in proximal femoral nail antirotation (PFNA) for treating femoral intertrochanter fractures.Methods A retrospective case series study was conducted on the clinical data of 188 patients with femoral intertrochanteric fractures who were treated with closed reduction and PFNA from October 2010 to October 2014.There were 86 males and 102 females,with an average age of 69.5 years (range,55-96 years).Before operation,the patients were divided into two groups according to their will.Group A (98 cases) used the self-made locator to identify the entry point,and Group B (90 cases) used the routine incision operation.The operative preparation time,operation time,fluoroscopy frequency,incision length of major nail,intraoperative blood loss,Harris scores of hip joint function at 4 months after operation,and complications were recorded and compared between the two groups.Results Group A had a longer operative preparation time than Group B[(10.6 ±2.4) minutes vs.(2.5 ±0.9) minutes].However,the operation time [(26.0 ±5.5) minutes vs.(56.6 ± 9.4) minutes],total operation time [(36.6 ± 6.6) minutes vs.(59.6 ± 9.9) minutes],fluoroscopy frequency [(18.9 ± 5.1) times vs.(31.2 ± 9.1) times],blood loss [(50.5 ± 3.7) ml vs.(220.5 ± 2.7) ml] and incision length of major nail [(2.5 ± O.7) cm vs.(5.5 ± 1.7) cm] in Group A were all less than those in Group B (P ＜ 0.05).There was no significant difference in the excellent and good rate of Harris score at 4 months after operation between the two groups (97％ vs.97％) (P ＞0.05).Postoperative incision infection,hypostatic pneumonia,and deep vein thrombosis occurred in some patients.No significant difference in the incidence rates of complications in two groups (14％ vs.10％) was found (P ＞ 0.05).Conclusion Femoral nail needle point locator can quickly identify the entry point,improve the nail placement accuracy and reduce surgical trauma as well as shorten operation time,and hence is worthy of clinical application in the treatment of femoral intertrochanteric fractures.
ABSTRACT
Objective:To analyze the sleep quality before treatment and related risk factors of sleep disorder in patients with nasopharyngeal carcinoma (NPC). Methods: Totally 143 patients first diagnosed as nasopharyngeal carcinoma were selected [ average age (43 ± 10) years, 100 males and 43 females] in a NPC ward of one hospital, the Chinese version of Pittsburgh Sleep Quality Index (PSQI, total score ＞ 5 diagnosed as sleep disorder) was used to investigate the sleep quality before treatment, and the logistic regression analysis was used to analyze related factors of the sleep disorder before treatment Results: The rate of sleep disorder was 50.3％. The logistic regression analysis showed that age was a risk factor of sleep disorder before treatment in patients with NPC (OR = 1.04, 95％ CI: 1.01-1.08), while gender, culture degree, clinical stage, body mass index were not correlated with sleep disorder (Ps＞0.05). Conclusion: It suggests that patients with NPC may have a higher incidence of sleep disorder before treatment, and older patients may be more prone to pre-treatment sleep disorder.
ABSTRACT
Objective To evaluate the effect of "health education mobile classroom " in the outpatient department of children's hospital, and to analyze the needs of the outpatient and family members on health education. Methods Through the retrospective analysis of the information of the outpatient and emergency patients in the children's specialist hospital to determine the content, the venue and the time period of the "health education mobile classroom". Selection and training the health educator to implement the health education. At the same time, push the training content through the mobile APP to the patient's family, to expand the education audience. To compare and analyze the patient satisfaction of the hospital and the satisfaction with the dimensions of the project. In the evaluation of the effect of health education and the influencing factors, the relationship between income, occupation and children is positively related, and age is negatively related to it. Results After the implement of this project, the satisfaction of the patient had increased for 3.65%(P=0.001). Overall assessment of the audience was very satisfied with (3.94 ± 0.25) points. In each dimension analysis, the satisfaction of the "training method"was the highest, at (3.94 ± 0.26) points. Satisfied with the attitude of the trainers and comprehensive ability were more than 3.80 points. Conclusions The "health education mobile classroom" can improve patient satisfaction in the outpatient department and emergency of children's specialist hospital. Audience has a certain degree of acceptance and satisfaction with this health education mode.
ABSTRACT
Objective To investigate serum IgG subclass concentrations in the adult population of Hunan region,and the effects of age,gender and lifestyle on them.Methods Serum IgG1,IgG2,IgG3,IgG4 and IgG concentrations from 170 adults making a health examination were detected by the immunonephelometric assay.Results The concentrations (mean or median [P25,P75]) of serum IgG1,IgG2,IgG3,IgG4 and IgG were (7.53 ± 0.14) g/L,3.99 (3.13,5.02) g/L,0.49 (0.30,0.70) g/L,0.53 (0.26,0.93) g/L and 12.2 (10.5,14.1) g/L,respectively.The serum IgG1/IgG,IgG2/IgG,IgG3/IgG and IgG4/IgG were (61.3 ±0.69)％,33.38％ (27.8％,38.8％),3.97％ (2.5％,5.3％) and 4.44％ (2.1％,7.3％),respectively.The serum IgG3 concentrations and IgG3/IgG ratios in female adults were significantly higher than that in male adults (P =0.005 and 0.014).However,there were no significant difference in serum IgG1,IgG2 and IgG4 concentrations and IgG1/IgG,IgG2/IgG and IgG4/IgG ratios between male and female adults.The serum IgG3 concentrations in the 31-40 years old adults were significantly higher than that in the 41-50 years old (P =0.03),while there were no significant difference in serum IgG1,IgG2 and IgG4 concentrations between different age groups.The serum IgG1 concentrations in the adults with heavy smoking were significantly lower than that without smoking (P =0.023),while the serum IgG4/IgG ratios were the opposite (P =0.018).The serum IgG1 and IgG3 concentrations and IgG3/IgG ratios in the adults with midrange or heavy drinking were significantly lower than that without ethanol consumption (P =0.05,0.004 and 0.015,respectively).The serum IgG3 concentrations and IgG3/IgG ratios in the adults with low-risk metabolism syndrome were significantly higher than that with the high-risk (P =0.034 and 0.038).Conclusion Gender and age have the significant effect on serum IgG3 concentration.Heavy smoking may reduce serum IgG1 concentration and increase IgG4/IgG ratio.The decrease of serum IgG1,IgG3 and IgG3/IgG may be related to ethanol consumption.
ABSTRACT
Objective To investigate the effects of triamcinolone acetonide combined with tanshinone ⅡA (Monomer of tanshinone)injection on oral submucous fibrosis(OSF)and the effect of serum TGF-β1 and IL-6 on patients.Methods 92 patients with OSF,w ho came to the hospital for treatment from April 2013 to April 2016,were selected and randomly divided into control group(46 cases)and experimental group(46 ca-ses).They were respectively treated with triamcinolone acetonide and triamcinolone acetonide combined with tanshinone injection.The two groups were treated for 3 courses and were followed up for 12 months.The VAS scores and mouth opening were compared between the two groups before the treatment and 2,4,6,and 12 months after the treatment,The serum TGF-β1,IL-6,lesion area and the changes of quality of life oral health impact scale(OHIP-14)scores of two groups were compared before and after treatment.Results 6 months after follow-up,the maximum mouth opening of the two groups was significantly increased than that before treatment,and improvement speed and improvement degree of the experimental group were better than those of the control group(P<0.05).After 2,4,6 and 12 months follow-up,the VAS scores of the two groups were significantly lower than those before treatment,and the experimental group were significantly lower than those of the control group(P<0.05),but the VAS score of two groups after 12 months increased than that after 6 months,and the control group was more obvious(P<0.05).After treatment,the levels of TGF-β1 and IL-6 of the experimental group were significantly lower than those of the control group and before the treat-ment(P<0.05);After treatment,the lesion area of the experimental group was significantly lower than that of the control group,and the OHIP-14 score was significantly higher than that of the control group,and the difference was significant compared with this group before treatment(P<0.05).Conclusion The local injec-tion treatment of triamcinolone and tanshinone injection has godd efficacy of OSF patients,and significantly re-duces the levels of TGF-β1 and IL-6 in serum.
ABSTRACT
Objective To analyze the clinical data of brucellosis, provide the references for brucellosis therapy. Methods The patients definitely diagnosed brucellosis at the First Affiliated Hospital of Xinjiang Medical University from 2005 to 2015 were assessed, data of clinical features, laboratory examination, complications, treatment and prognosis were analyzed. Results Of all 590 cases,the mean age was(44.24 ± 15.83)years old,the range was 3-75 years old,357(60.51%) cases had a history of raising and closely contacted with cattle and sheep, acute phase in 316(53.56%)cases,and chronic phase in 127(21.53%).The most common symptoms were fatigue in 537 (91.02%) cases, sweating in 520 (88.14%), fever in 513 (86.95%) and arthralgia in 478 (81.02%). Serum test tube agglutination test was positive in 583 (98.81%), blood culture was positive in 159 (33.97%,159/468).After patients receive antimicrobial treatment, body temperature decreased in 2 - 14 d. The overall recurrence rate was 5.98%(28/468),those patients with osteoarticular involvement even reached 23.22%(137/590).Doxycycline combined with rifampicin was the most common used antibiotics regimen, triple antibacterial drug program was recommended for patients with comorbidities. Conclusions The clinical manifestations of brucellosis is diversity, fatigue, sweaty, fever and arthralgia are the most common symptoms, and osteoarticular is the most frequently involved. Serum agglutination test is an important method in diagnosis of the disease, and combination of antibacterial drugs therapy is recommended.
ABSTRACT
Objective To review the imaging characteristics and evaluate the diagnostic value of echocardiography for congenital malformations of the right atrium(CMRA).Methods Doppler echocardiography was performed and these images were compared with operative findings in 1 1 children with CMRA.Results CMRA was characterized by idiopathic dilation of the right atrium and right heart appendage,congenital diverticulum of the right atrium and coronary sinus.CMRA consisted of idiopathic dilation of the right atrium(4 cases),congenital diverticulum of the right atrium(3 cases),idiopathic dilation of the right heart appendage(2 cases),and congenital diverticulum of the coronary sinus(2 cases).The associated malformations included patent foramen ovale(6 cases),atrial septal defect(3 cases),pulmonary hypertension(3 cases),and hypoplastic tricuspid valve(2 cases).Eight of 1 1 cases were diagnosed correctly,and other 3 cases were misdiagnosed,in which 1 case with idiopathic dilation of the right atrium misdiagnosed as Ebstein's anomaly,1 case with congenital diverticulum of the right atrium misdiagnosed as congenital enlargement of the right atrial appendage,and 1 case with congenital diverticulum of the coronary sinus misdiagnosed as coronary sinus stenosis.Conclusions CMRA could be diagnosed accurately by Doppler echocardiography,but it is prone to be misdiagnosed and must be distinguished from Ebstein's anomaly.