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Objective To explore the effects and influencing factors of traditional occupational health training on occupational health literacy (OHL) of employees in micro-, small- and medium-sized enterprises. Methods A total of 540 employees from 154 micro-, small- and medium-sized enterprises, who participated (347 employees) and not-participated (193 employees) in traditional occupational health training, and 171 community residents/students (not-participated in occupational health training) were selected as the research subjects using the convenient sampling method. The OHL level was investigated using Occupational Health Literacy Questionnaire of National Key Populations. Results The overall OHL level of employees was 43.3% (234/540). Among them, the overall OHL level of untrained and trained employees was 38.9% and 45.8%, respectively, and the overall OHL level of community residents/students was 43.3%. The results of multivariate logistic regression analysis showed that the higher the educational level, the higher the OHL level (all P<0.01). The OHL level of untrained and trained employees was higher than that of untrained community residents/students (all P<0.05). The interaction of education level and training status had no statistical difference on the OHL level of the research subjects (P>0.05). The results of factorial design analysis of variance showed that the overall OHL score rate of untrained employees and trained employees was higher than that of untrained community residents/students (all P<0.05). However, there was no significant difference in overall OHL score rate between untrained and trained employees (P>0.05). Conclusion The role of traditional occupational health training in improving the OHL level of employees in micro-, small- and medium-sized enterprises needs to be improved. The responsibility of enterprise occupational health training should be implemented, and multiple measures should be taken to enrich the ways and approaches of occupational health education for enterprise employees, to effectively improve the OHL of workers.
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Tinosporae Radix， as a traditional Chinese medicinal herb， is the dried root tuber of Tinospora sagittata or T. capillipes. It was first recorded in the Compendium of Materia Medica Supplement in the Qing Dynasty and included in the previous edition of the Chinese Pharmacopoeia. Tinosporae Radix is excavated in autumn and winter and used after removing fibrous roots， washing， and drying. It is indicated for sore throat， carbuncle boils poison， waist and abdominal pain， and various heat syndromes and is commonly used to treat chronic inflammation. Its efficacy is significantly known as “broad-spectrum antibiotics in Zhuang medicine”. Tinosporae Radix is a traditional Chinese medicinal herb often taken by Zhuang and Yao nationalities in Guangxi province and has a wide range of application and development values and research significance. Modern studies have shown that Tinosporae Radix contains diterpenoids， alkaloids， sterols， anthraquinones， glycosides， fatty acids， volatile oils， and other compounds， which have many pharmacological activities such as anti-inflammatory and analgesic， antibacterial and antibacterial， antioxidant， anti-diabetic， and anti-tumor and anti-cancer effects， and it has achieved good efficacy in inhibiting inflammation and treating sore throat and other diseases. In recent years， there have been many research reports on the status， chemical constituents， pharmacological action， clinical application， and quality evaluation of Tinosporae Radix resources， but there is no systematic review and introduction at present. By consulting the literature and combining it with modern research， this paper systematically summarizes and collates Tinosporae Radix resources to provide guidance for the comprehensive development and utilization of Tinosporae Radix resources and subsequent in-depth study.
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Objective:To investigate the application value of oral stimulation combined with maternal milk sucking in the pain caused by PICC in children with congenital digestive tract malformations.Methods:Using convenience sampling method, 80 children with congenital digestive tract malformations who were admitted to Hunan Children's Hospital from July 2018 to December 2019 were selected and divided into the experimental group and the control group of 40 cases in each group according to the random number table method. The control group was given routine nursing mode, while the experimental group was given oral stimulation combined with maternal milk sucking intervention on the basis of routine nursing. The intervention effects were evaluated by the Neonatal Infant Pain Scale (NIPS), the onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face, and indicators such as heart rate, respiratory rate and SpO 2. Results:The NIPS scores of children in the experimental group were (5.60 ± 1.24) and (4.10 ± 0.31) in the puncture period and the recovery period, which were significantly lower than those in the control group (6.10 ± 0.84), (4.93 ± 0.35), the differences were statistically significant (t = 2.12, 3.00, both P<0.05). The heart rate and respiratory rate of the children in the experimental group were (151.10 ± 12.37), (147.00 ± 12.16) times/min and (47.48 ± 7.59), (45.58 ± 6.51) times/min in the puncture period and the recovery period, which were significantly lower than those in the control group (159.75 ± 13.81), (156.05 ± 12.99) times/min and (52.38 ± 8.12), (49.75 ± 7.59) times/min, the differences were statistically significant (t values were 2.64-3.22, all P<0.05). The SpO 2 in the experimental group were 0.980 5 ± 0.009 0, 0.982 5 ± 0.010 8 in the puncture period and the recovery period, which were significantly higher than those in the control group 0.970 8 ± 0.014 2, 0.971 8 ± 0.018 1, the differences were statistically significant (t = 3.66, 3.23, both P<0.05). The onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face in the experimental group were (41.55 ± 6.38), (22.05 ± 4.47), (35.08 ± 5.94), (24.65 ± 5.46) s, significantly shorter than those in the control group (46.58 ± 5.26), (29.50 ± 6.48), (44.68 ± 13.31), (30.65 ± 9.42) s, the differences were statistically significant (t values were 2.63-5.98, all P<0.05). Conclusions:Oral stimulation combined with maternal milk sucking can effectively relieve the pain caused by PICC in children with congenital digestive tract malformation, and reduce the physiological stress response of children.
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【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.
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Esophagogastric variceal bleeding is one of the main causes of death in patients with liver cirrhosis, and therefore, early monitoring of esophageal and gastric varices may help to improve the prognosis of patients; however at present, hepatic venous pressure gradient and upper gastrointestinal endoscopy used as the gold standard for diagnosis are invasive examinations, which may not help with long-term follow-up. This article introduces the noninvasive evaluation of esophageal and gastric varices in cirrhotic patients by shear-wave ultrasound elastography.
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OBJECTIVE：To study the improvement effects of ginsenoside Rb 3 combined with β-asarone on vascular dementia （VD）model mice and its mechanism. METHODS ：ICR mice were randomly divided into model group ，ginsenoside Rb 3 group（10 mg/kg），β-asarone group （10 mg/kg），drug combination group （ginsenoside Rb 3 10 mg/kg+β-asarone 10 mg/kg），positive control group（donepezil hydrochloride 1 mg/kg）and Akt inhibitor group （LY294002，1 mg/kg），and sham operation group was set up ， with 10 mice in each group. Except for sham operation group ，VD model was induced by four vessel occlusion method in other groups. After modeling ，sham operation group and model group were given constant volume of normal saline ，Akt inhibitor group was given relevant medicine intraperitoneally ，and other groups were given relevant medicine intragastrically ，twice a day ，for consecutive 30 d. After last administration ，the learning and memory ability of mice was detected by avoiding darkness test. The contents of 4-hydroxydecenoic acid （4-HNE），8-hydroxydeoxyguanosine （8-OHdG） and reactive oxygen species （ROS） in hippocampus was detected by ELISA. RT-PCR assay was used ， to detect the mRNA expression of Bcl- 2 and Bax inhippocampus. The protein expression of Bcl- 2 in cortex wadetected by immunofluorescence method. Western blotting deng- assay was used to detect the protein expression of Bcl- 2 and mz1@126.com Bax in hippocampus. RESULTS ： Compared with sham operation group ，the incubation period of avoiding darkness xiaoyinlanlp@126.com test in model group was shortened significantly ； and the number of errors was increased significa ntly；4-HNE，8-OHdG and ROS contents ，mRNA and protein expression of Bax were increased significantly ，and mRNA and protein expression of Bcl- 2 was decreased significantly （P＜0.01）. Compared with model group，the incubation period of avoiding darkness test was prolonged significantly in ginsenoside Rb 3 group，β-asarone group ，drug combination group and positive control group ，the number of errors was decreased significantly ；4-HNE，8-OHdG，ROS contents ， mRNA and protein expression of Bax were decreased significantly ，and mRNA and protein expression of Bcl- 2 were increased significantly，especially in drug combination group （P＜0.05 or P＜0.01）. But the incubation period of avoiding darkness test was shortened significantly in Akt inhibitor group ，and the number of errors was increased significantly ；4-HNE，8-OHdG，ROS contents，mRNA and protein expression of Bax were increased significantly ，and mRNA and protein expression of Bcl- 2 were decreased significantly （P＜0.05）. CONCLUSIONS ：Ginsenoside Rb 3 combined with β-asarone has a protective effect on VD model mice ，and the effect was better than that of each compound alone. The mechanism of which may be associated with anti-oxidative stress and anti-apoptosis of hippocampus.
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Objective To investigate the clinical efficacy and safety of high-dose caspofungin (70 mg/d)as initial or salvage treatment for invasive pulmonary aspergillosis.Methods Twenty-one patients with proven or probable invasive pulmonary aspergillosis from June 2014 to October 2017 in Huashan Hospital,Fudan University were retrospectively reviewed.According to the anti-fungal treatment before high-dose caspofungin application,patients were divided into initial treatment group and salvage treatment group.Patients' clinical data and laboratory data were collected.The characteristics,clinical efficacy,adverse reactions,one-year survival rate and the overall effective rate were evaluated.The prognosis of the two groups was compared by Kaplan-Meier analysis.Results Twenty of the 21 patients opportunistic acquired invasive pulmonary aspergillosis during the treatment of underlying diseases.Five patients were initially treated with high-dose caspofungin for 68 (62) days.At week 12,one patient achieved complete response,3 patients achieved partial response,and the overall effective rate was 80％ (4/5).Sixteen patients received caspofungin as salvage therapy for 66.50 (58) days,of which one patient got complete response at week 12,10 had partial response,and the overall effective rate was 68.75％ (11/16).One-year follow-up showed that no patient died in the initial treatment group,and the one-year survival rate was 100％ (5/5).In salvage treatment group,3 patients died of pulmonary bacterial infections and the one-year survival rate was 81.25％ (13/16).During treatment,one patient had elevated total bilirubin,which was possibly associated with high-dose caspofungin.Conclusions High-dose caspofungin regimen has good efficacy and safety,both for initial treatment and salvage therapy in patients with invasive pulmonary aspergillosis.
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Objective@#To develop a method for rapid detection of influenza virus and its subtypes based on flow fluorescence technology, and then detect the clinical specimens by our established method .@*Methods@#We designed degenerate primers and specific probes, synthesized plasmids, used Luminex platform to establish detection method and later detected 430 clinical specimens, and compared the result with those of Fujian Center for Disease Control and prevention.@*Results@#A method for the simultaneous determination of influenza viruses A, B, C and its subtypes (H116, N19) was established. The time consumption was 3.5 hours, with good specificity, high sensitivity and feasible stability. The detection result of 430 clinical specimens showed high consistency with the result of Fujian Center for Disease Control and Prevention.@*Conclusions@#We established a method for simultaneous determination of influenza viruses and its subtypes, high sensitivity, specificity and stability.
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Objective@#To investigate the association between the time of neutrophils to the lowest and prognosis of patients with esophageal squamous cell carcinoma (ESCC) treated with non-operative therapy.@*Methods@#The clinical data of 325 non-operative treated ESCC patients were collected in this study. The X-title software was applied to establish optimal threshold of neutrophil reduction to the lowest value. According to the optimal threshold, the patients were divided into early group (115 cases) and late group (210 cases). The clinical features and survival time of the two groups were compared, and the factors of prognosis were analyzed by Cox regression model with univariate and multivariate analysis.@*Results@#The X-title software demonstrated the optimal cutoff values for the time of neutrophils to the lowest was 39 days. The median overall survival time was 21.0 months in the early group which was significantly higher than that in the late group (16.0 months). Multivariate Cox regression analysis showed that the treatment methods and the time of neutrophils to the lowest were independent factors for overall survival of patients with ESCC treated by non-surgical therapy. Compared with radiotherapy alone, concurrent chemoradiation could benefit the survival (HR=0.64, P=0.026). The prognosis of patients in the late group of neutrophils to the lowest (HR=1.38, P=0.038) was poor compared with the early group. Furthermore, stratified by treatment methods, the overall survival of two groups showed statistically significant difference only in patients received concurrent chemoradiation. The mortality risk in the late group was higher than that in the early group (HR=3.53, P=0.010).@*Conclusion@#The time of neutrophils to the lowest is an independent prognosis factor for non-operative treated ESCC patients. The prognosis of patients in the early group is better than that in the late group.
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Objective@#To investigate the application of music intervention in combination with maternal voice during PICC placement procedures in malformation alimentary tract infants.@*Methods@#A total of 60 malformation alimentary tract infants were enrolled in the present study in Hunan Children Hospital from January to December 2018, infants were randomly assigned to the intervention group (n=30) and the control group (n=30). Patients in the control group received conventional nursing, the intervention group received music and maternal voice intervention method. The level changes of heart rate, respiratory rate, blood pressure, blood oxygen saturation and cortisol concentration were compared between two groups, meanwhile, the pain rating were assessed by Neonatal Infant Pain Scale (NIPS).@*Results@#Before procedure, no significant difference was found between the control and intervention group in heart rate, respiratory rate, systolic pressure, SpO2 and NIPS score (P>0.05). During and after the procedure, the mean heart rate [(144.43±15.93), (142.43±20.42) times/min], respiratory rate [(44.70±4.51) and (43.50± 4.12) times/min], systolic pressure [(87.40±8.53) and (86.10±4.60) mmHg] and NIPS score (5.34±0.71 and 5.19±0.87) of the intervention group was statistically lower compared to the control group [(160.97±39.35) and (159.17±31.87) times/min, (53.13±7.85) and (50.47±7.70) times/min, (97.60±9.82) and (94.27±7.23) mmHg, 6.17±0.54 and 6.15±0.66; during procedure, the mean SpO2 was statistically significantly higher, compared to the control group [(96.15±9.82)% versus (88.34±9.53)%]. The difference was statistically significantly (t=2.134-6.682, P<0.05). Before placement, the concentration of cortisol between the two groups showed no significant difference (P>0.05), and (208.91±21.07)ng/ml 5min after placement and (197.70±16.34) ng/ml immediately after placement, the cortisol concentration was statistically significantly lower, compared to the control group [(246.71±35.15), (230.95±21.81) ng/ml] (t=5.050-6.682, P<0.05). Compared with the control group, the time needed for PICC placement decreased remarkably in the intervention group [(15.62±3.30) min versus (24.63±4.26) min)](t=9.160, P<0.01).@*Conclusions@#Music in combination with maternal voice can significantly reduce stress levels, pain responses and time need for PICC placement, music and maternal voice is a potential intervention strategy in malformation alimentary tract infants undergoing PICC.
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Objective@#To evaluate the efficacy and safety of high-dose fluconazole alone or combined with flucytosine as initial therapy for cryptococcal meningitis (CM) in non-human immunodeficiency virus (HIV)-related patients.@*Methods@#Twenty-five non-HIV-infected patients with CM from June 2015 to September 2018 in Huashan Hospital, Fudan University, who were initially treated with high-dose fluconazole with or without flucytosine for at least seven days were retrospectively reviewed.Clinical features and antifungal (600-800 mg/d) regimens were recorded, clinical responses and drug-related adverse events were evaluated. Mann-Whitney test and Fisher′s exact probabilities test were applied to compare variables between groups.@*Results@#Of the 25 patients enrolled in this study, 15 had predisposing factors. Headache (25 cases), fever (21 cases), vomiting (13 cases) and neck stiffness (13 cases) were common manifestations. Abnormalities of cranial computed tomography (CT) scan and/or magnetic resonance imaging (MRI) were found in 22 cases.Nineteen patients were treated with high-dose fluconazole plus flucytosine for initial therapy, and six patients were treated with high-dose fluconazole alone. The course of initial regimens with high-dose fluconazole was 42 (29, 120) days. At the end of initial therapy, partial response in 20 patients, stable response in three patients and death in two patients were observed, and the overall effective rate was 80%(20/25). In treatment failure group of initial treatment, the proportion of patients with baseline cerebrospinal fluid opening pressure over 300 mmH2O (1 mmH2O=0.009 8 kPa) and with altered mental status were both significantly higher compared with those in treatment success group. Fluconazole related adverse drug events were observed including elevated transaminases (one case), gastrointestinal symptoms combined with hypokalemia (two cases), and systemic rash (three cases). Except for three patients with rash reduced the dosage of fluconazole, no other patients were given dosage adjustment.@*Conclusion@#High-dose fluconazole alone or combined with flucytosine is effective and safe for the initial therapy of non-HIV-related CM patients.
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Objective To evaluate the efficacy and safety of high-dose fluconazole alone or combined with flucytosine as initial therapy for cryptococcal meningitis(CM)in non-human immunodeficiency virus(HIV)-related patients.Methods Twenty-five non-HIV-infected patients with CM from June 2015 to September 20 18 in Huashan Hospital,Fudan University,who were initially treated with high-dose fluconazole with or without flucytosine for at least seven days were retrospectively reviewed.Clinical features and antifungal(600-800 mg/d)regimens were recorded,clinical responses and drug-related adverse events were evaluated.Mann-Whitney test and Fisher's exact probabilities test were applied to compare variables between groups.Results of the 25 patients enrolled in this study,15 had predisposing factors.Headache(25 cases),fever(21 cases),vomiting(13 cases)and neck stiffness(13 cases)were common manifestations.Abnormalities of cranial computed tomography(CT)scan and/or magnetic resonance imaging(MRI)were found in 22 cases.Nineteen patients were treated with high-dose fluconazole plus flucytosine for initial therapy,and six patients were treated with high-dose fluconazole alone.The course of initial regimens with high-dose fuconazole was 42(29,120)days.At the end of initial therapy,partial response in 20 patients,stable response in three patients and death in two patients were observed,and the overall effective rate was 80％(20/25).In treatment failure group of initial treatment,the proportion of patients with baseline cerebrospinal fuid opening pressure over 300 mmH2 O(1 mmH2O=0.009 8 kPa)and with altered mental status were both significantly higher compared with those in treatment Success group.Fluconazole related adverse drug events were observed including elevated transaminases(one case),gastrointestinal symptoms combined with hypokalemia(two cases),and systemic rash(three cases).Except for three patients with rash reduced the dosage of fluconazole.no other patients were given dosage adjustment.Conclusion High-dose fluconazole alone or combined with flucytosine is effective and safe for the initial therapy of non-HIV-related CM patients.
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Objective To evaluate the role of mitochondrial ATP-sensitive potassium (mito-KATP) channels in urocortin postconditioning-induced protection of rat cardiomyocytes.Methods Clean-grade healthy male Sprague-Dawley rats,aged 16-20 weeks,weighing 200-250 g,were used in this study.Cardiomyocytes of rats were isolated,cuhured and divided into 4 groups (n =28 each) using a random number table method:control group (group C),H/R group (group HR),urocortin postconditioning group (group U) and 5-hydroxydecanoate (5-HD,mito-KAw channel blocker) plus urocortin postconditioning group (group HU).In group C,the cells were continuously cultured for 150 min in an incubator filled with 95％ O2-5％ CO2 at 37 ℃.In group HR,the cells were exposed to 40-min hypoxia in an incubator filled with 95％ N2-5％ CO2 at 37 ℃,followed by 110-min reoxygenation.In group U,the cells were exposed to 40-min of hypoxia,followed by 10-min reoxygenation,and then cultured in a cuhure medium containing 10-8mmol/L urocortin for 30 min,followed by 70-min reoxygenation.In group HU,the cells were cultured for 10 min in a culture medium containing 10-4mmol/L 5-HD,and the other treatments were similar to those previously described in group U.At the end of reoxygenation,the opening of mitochondrial permeability transition pore (mPTP) and mitochondrial membrane potential (MMP) were measured by fluorescence spectrophotometry.The expression of Bax and Bcl-2 was determined by Western blot,and the cell viability was measured by CCK-8 assay.Results Compared with group C,the viability of cardiomyocytes and MMP were significantly decreased,the opening of mPTP was increased,the expression of Bcl-2 was down-regulated,and the expression of Bax was up-regulated in the other 3 groups (P＜0.05).Compared with group HR,the viability of cardiomyocytes and MMP were significantly increased,the opening of mPTP was decreased,the expression of Bcl-2 was up-regulated,and the expression of Bax was down-regulated in group U,and the opening of mPTP was decreased (P ＜ 0.05),and no significant change was found in the other parameters in group HU (P＞0.05).Compared with group U,the viability of cardiomyocytes and MMP were significantly decreased,the opening of mPTP was increased,the expression of Bcl-2 was down-regulated,and the expression of Bax was up-regulated in group HU (P＜0.05).Conclusion The mechanism by which urocortin postconditioning attenuates H/R-induced damage to rat cardiomyocytes is associated with promoting mito-KATP channel opening and inhibiting mPTP opening.
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The presence of gastroesophageal varices (GOV) is one of the independent risk factors for the death of patients with chronic liver diseases, and at present, non-selective β-blockers or endoscopic treatment is recommended for the prevention of variceal bleeding in patients with chronic liver diseases at a high risk of GOV. This article describes the latest advances in the noninvasive diagnosis of GOV in patients with liver cirrhosis with the help of ultrasound elastography and points out that although new techniques such as shear wave elastography have improved screening performance, a single examination is not sufficient for clinical practice. A combination of various examinations may be more efficient and is worthy of further exploration.
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Objective To evaluate the clinical outcome of fetus diagnosed as mild and moderate isolated ventriculomegaly(IVM)and its correlation with imaging follow-up. Methods Totally,161 cases of single pregnancy whose fetus was diagnosed as mild or moderate IVM by ultrasound were administrated. Data of prenatal ultrasound examination, pregnancy outcomes, and the postnatal MRI results were collected. New borns' growth and development, language expression, movement coordination, auditory and visual function were followed up to evaluate the neurodevelopment. Results (1)Before birth:80.1%(129/161) of IVM disappeared before the delivery, 16.1%(26/161)remained stable, and 3.7%(6/161)continued to deteriorate.(2)Postnatal MRI: 8 cases(9.6%, 8/83)were diagnosed IVM, of which 3 cases were found additional abnormalities(1 case was the corpus callosum dysplasia and 2 cases were leukodystrophy). The additional abnormal detection rate was 3/8.(3)Postnatal assessments: There were 7 cases(8.9%, 7/79) neunatal behavioral neurological assessment (NBNA), 6 cases (7.6%, 6/79) Bayley scales of infant development (BSID)-psychomotor developmental index(PDI) and 3 cases (3.8%, 3/79) BSID-mental development index(MDI) whose scores were low. There was no significant difference of the NBNA and BSID scores between mild and moderate IVM (NBNA: x2=2.042,P=0.210; BSID-PDI: x2=-1.359,P=0.174; BSID-MDI: x2=-1.205,P=0.228). Follow-up of 9 cases(11.4%, 9/79)with low BSID score, 6 of them were found to be stable in the medial ventricle of the uterus, and the size of the lateral ventricle was normal after birth by ultrasound and MRI. Conclusions The majority of IVM fetuses have good prognosis, but there is also a risk of neurodevelopmental dysplasia. The postnatal follow-up should be paid attention to, and MRI should be performed as the postnatal imaging evaluation.
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Objective To investigate pregnancy outcomes and neurodevelopment in fetuses with ventriculomegaly. Methods This was a cohort study of 173 gravidas with singleton pregnancy who were diagnosed with fetal ventriculomegaly by ultrasound in Prenatal Diagnostic Center of Nanfang Hospital Affiliated to Southern Medical University from March 2010 to July 2016. Thirty normal gravidas who received antenatal care in the same hospital and at the same period were selected as control. Clinical data were collected. Gravidas who had chosen to continue their pregnancy were followed up to monitor the variations of fetal ventricular. Fetal mild and moderate ventriculomegaly were respectively defined as a ventricular atrial width of 10-12 mm and >12 mm but <15 mm. Isolated ventriculomegaly (IVM) indicated those without any other ultrasound abnormalities, otherwise the case would be defined as non-isolated ventriculomegaly (NIVM). Among the 173 gravidas, 54 cases were mild IVM, 53 mild NIVM, 26 moderate IVM and 40 moderate NIVM. Fetuses with chromosome abnormalities were excluded from the study. Neonatal behavioral neurological assessment (NBNA) was used to analyze the neonatal neurodevelopment at the age of 7 days, and Bayley scales of infant development was used to evaluate the development of nervous system at the age of 6 months through analyzing their mental development index (MDI) and psychomotor development index (PDI). Statistical methods included t test, χ2 test (or Fisher's exact test), nonparametric test, Mann-Whitney test and multiple Kruskal-Wallis H test. Results (1) Among the 107 fetuses with mild ventriculomegaly, 72.9％ (78), 23.4％ (25) and 3.7％ (4) of them regressed, stabilized and progressed,respectively; however, among the 66 moderate cases, the figures were 45.4％ (30), 37.9％ (25) and 16.7％ (11) respectively (χ2=15.769, P<0.001). For those in the IVM and NIVM subgroups within the moderate ventriculomegaly group, significant difference was shown [17(65.4％), 8(30.8％) and 1(3.8％) vs 13(32.5％), 17(42.5％) and 10(25.0％), χ2=8.552, P=0.014], but not within the mild groups (χ2=2.412, P=0.299). (2) There were 164 gravidas who continued their pregnancy and delivered. Significant differences in NBNA score were observed between the ventriculomegaly group and the control (37.70±1.80 vs 38.53±1.38, t= - 2.424, P<0.05). Numbers of neonates with NBNA score < 36 and ≥ 36 points were 5(4.7％) and 101(95.3％) in the mild group, and 8(13.8％) and 50(86.2％) in the moderate group (χ2=4.231, P=0.004). There was significant difference in NBNA score between the IVM and NIVM subgroup within neither mild nor moderate group (χ2 were 0.210 and 0.201, P were 1.000 and 0.720). (3) Totally, 137 cases completed the assessment of nervous system development at the age of 6 months. There was significant difference in PDI score between the ventriculomegaly group and the control (90.50±10.85 vs 95.80±9.65, t= - 2.471, P=0.014), but not in MDI score (95.42+11.20 vs 99.50+12.00, t= - 1.786, P=0.076). (4) The comparison of the proportion of excellent, average and poor PDI scores: Significant differences were found between the IVM and NIVM subgroup within the moderate ventriculamegaly group and in the different intrauterine outcome groups [IVM vs NIVM groups: 3(15.0％), 16(80.0％) and 1(5.0％) vs 1(3.1％), 24(75.0％) and 7(21.9％),Z= - 2.097, P=0.036;intrauterine regression, stable and progress group: 9(10.6％), 75(88.2％) and 1(1.2％);3(6.5％), 37(80.4％) and 6(13.1％) vs 0, 2(2/6) and 4(4/6), χ2=19.808, P<0.001], but not between the mild and moderate vetriculamegaly group, or between the subgroups within the mild ones (Z were - 1.869 and - 1.946, P were 0.062 and 0.052). (5) The comparison of the proportion of excellent, average and poor scores of MDI: Significant difference was only found among the different intrauterine outcome groups[13(15.3％), 71(83.5％), 1(1.2％); 2(4.4％), 41(89.1％), 3(6.5％) vs 0, 5(5/6), 1(1/6); χ2=7.980, P=0.018], but not in any other comparisons (all P>0.05). Conclusions Prognosis of fetal ventriculomegaly is affected by co-existed abnormalities and intrauterine progression. Fetus with mild ventriculomegaly can also have risk of abnormal neural development, suggesting that we should pay much attention to such cases and a regular follow-up is required.
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Objective To analyze the clinical manifestations of pulmonary fungal disease in patients with different pathogen infection and different immune states. Methods A retrospective analysis was carried out with the clinical data of 78 patients with pulmonary fungal disease who were treated in Fujian Provincial Hospital from June 2012 to June 2016. Results The identified pathogens included Cryptococcus (78.2％, 61/78), Aspergillus(17.9％, 14/78), Talaromyces marneffei, Mucor, and Trichosporon asahii (one each). Cryptococcus was mostly found in healthy individuals without underlying disease and Aspergillus largely infected those with underlying disease. Diabetes mellitus was the most common underlying disease. Pulmonary fungal infection was confirmed by pneumonectomy (41.0％, 32/78), CT-guided percutaneous transthoracic biopsy (43.6％, 34/78), transbronchial lung biopsy (14.1％, 11/78), or blood culture (1.3％, 1/78). Pulmonary cryptococcosis was often asymptomatic (47.5％, 29/61). Hemoptysis was only found in the patients with underlying disease. The patients with pulmonary aspergillosis showed higher prevalence of hemoptysis (57.1％, 8/14) than the patients with other pulmonary fungal diseases. Bronchoscopy usually gave negative finding in case of pulmonary cryptococcosis (77.8％, 14/18). Inflammatory exudation was the primary finding of pulmonary aspergillosis (6/10). Intraluminal necrosis and neoplasia were only found in the aspergillosis patients with underlying disease. The primary imaging findings in pulmonary cryptococcosis was nodule or mass (78.7％, 48/61). Halo sign and crescent sign were rarely found in pulmonary aspergillosis. Of the 78 patients, 45 (57.7％) patients received pharmacological therapy alone, 15 (19.2％) surgical treatment alone, and 18 (23.1％) received drugs in combination with surgery. Six patients died, 25 lost to follow-up, and 47 with stable disease. Conclusions The clinical characteristics of pulmonary fungal disease vary with the pathogen and the immune states of patients. Clinical symptoms and immune status of patients should be taken into account when making diagnosis of pulmonary fungal disease for the purpose to speculate the probable fungal pathogen and choose the most appropriate diagnostic tool.
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[Objective] To summarize Prof. YANG Jinkun gastric cancer clinical experience of diagnosis and treatment, in order to promote clinical application. [Method] Through clinical diagnosis, collecting cases, Prof. YANG Jinkun stomach cancer treatment methods are analyzed and summarized, and enumerated case evidence. [Results] Prof. YANG Jinkun offered to poison pixu(spleen deficiency) for the basic pathogenesis of gastric cancer, on the basis of the spleen and the centralizer, and combined disease according to the nature of different pathogenic toxin, chase respectively eliminating phlegm and stasis fights, qingrejiedu, etc of evil spirits, all applications in the west, comprehensive treatment, the clinical good results have been achieved. For medical record satisfactory curative effect. [Conclusion] Gastric cancer experience of diagnosis and treatment of YANG Jinkun is unique, curative effect is distinct, worthy of clinical application and promotion.
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Objective The efficacy and safety of rectal instillation with formula for clearing heat, eliminating phlegm and relaxing bowel on treating encephalopathy complicated with pulmonary infection were evaluated by randomized controlled clinical trials. Methods Eighty eligible cases of encephalopathy complicated with pulmonary infection were randomly divided into treatment group and control group. Control group was given conventional treatment and treatment group was given rectal instillation treatment with formula for clearing heat , eliminating phlegm and relaxing bowel. The changes of index were observed before and after treatment in two groups including temperature,antifebrile time,white blood cell count,neutrophils ratio,C-reactive protein,procalcitonin, pneumonia severity index,and the efficacy score of TCM syndrome. Results Rectal instillation with formula for clearing heat and eliminating phlegm to relax bowel can be better improved encephalopathy complicated with pulmonary infection with syndrome of phlegm-heat obstructing in which the patients have yellow sputum, constipation,yellow urinary and other symptoms. It can reduce TCM syndrome score and level of serum calcitonin, relieve inflammation,enhanc antibacterial effect,and improve the clinical curative effect. Conclusions The curative effects of rectal instillation with formula for clearing heat and eliminating phlegm to relax bowel on treating encephalopathy complicated with pulmonary is definite which has no adverse reaction and safety use. It is worthy of further popularizing in clinic.
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Objective To investigate the diagnostic value of real-time shear wave elastography (SWE) technique in evaluating classification of liver fibrosis.Methods PubMed,CNKI,CBM,VIP,and Wanfang Data were searched for Chinese and English articles on SWE for evaluating classification of liver fibrosis published from January 2010 to December 2016,and these articles were screened and evaluated.Meta-disc 1.4 software was used for the meta-analysis of the data in the articles included.Results A total of 11 English articles were included,with 1560 cases in total.In the ≥F2 group,SWE had a pooled sensitivity of 0.85 (95％ confidence interval [CI]:0.82-0.87),a specificity of 0.79 (95 ％ C1:0.76-0.82),and a diagnostic odds ratio (DOR) of 30.81 (95 ％ CI:16.55-57.34).In the ≥ F3 group,SWE had a pooled sensitivity of 0.87 (95 ％ CI:0.84-0.91),a specificity of 0.84 (95 ％ CI:0.82-0.87),and a DOR of 41.45 (95 ％ CI:18.25-94.45).In the F4 group,SWE had a pooled sensitivity of 0.88 (95％ CI:0.83-0.91),a specificity of 0.91 (95％ CI:0.89-0.92),and a DOR of 67.18 (95％ CI:30.03-150.31).The areas under the receiver operating characteristic curve for these three groups were 0.914 7,0.922 3,and 0.952 0,respectively.Conclusion SWE has a high diagnostic value in evaluating the classification of liver fibrosis and can be used to determine liver fibrosis stage in clinical practice.