ABSTRACT
Objective:To explore the expression of caveolin-1 (Cav-1) and Chitinase-40 (YKL-40) in acute cerebral infarction and the value of combined detection in prognosis evaluation.Methods:118 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Hebei Northern University from January 2016 to June 2019 were selected as the research objects. According to the cerebral infarction volume, the patients were divided into small infarction group (<5 cm 3), middle infarction group (5-10 cm 3) and large infarction group (>10 cm 3). 108 healthy people were selected as the healthy control group. The serum levels of Cav-1 and YKL-40 were compared in the 3 groups, and the correlation between the degree of cerebral infarction and serum levels of Cav-1 and YKL-40 was analyzed. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of the expression levels of Cav-1 and YKL-40 in patients with acute cerebral infarction; the patients were followed up for one year and the prognosis was evaluated by modified Rankin Scale (mRS); the correlation between serum Cav-1 and YKL-40 and prognosis was analyzed. Results:The expression levels of serum Cav-1 and YKL-40 in patients with acute cerebral infarction were significantly higher than those in healthy group ( P<0.001). The serum levels of Cav-1 and YKL-40 were positively correlated with the infarct volume of acute cerebral infarction ( r=0.854, P=0.004; r=0.867, P=0.002). ROC curve analysis showed that the sensitivity, Youden index and area under ROC curve of Cav-1 (21.78 μg/L) combined with YKL-40 (158.69 ng/ml) in the diagnosis of acute cerebral infarction were 85.59%, 0.532 and 0.896 (95% CI: 0.741-0.932), respectively, which were significantly higher than those of single index ( P<0.05). At 8 and 12 months of follow-up, the proportion of death and mRS score in the positive group were significantly higher than those in the negative group ( P<0.05). Conclusions:The serum Cav-1 and YKL-40 levels are significantly higher in patients with acute cerebral infarction. The combined examination of Cav-1 and YKL-40 can improve the diagnostic efficiency and has potential application value for early diagnosis and prognosis prediction of patients.
ABSTRACT
Collaborative development among medical practice, education and research is a strategic decision of the country in disciplinary development guided by the innovation-driven strategy. In October 2017, Beijing Hospitals Authority organized 18 tertiary hospitals with pediatrics discipline and founded a collaborative development center for pediatrics. This center operated in a model featuring both leadership of due authorities and autonomous administration. Two of the specialized pediatrics hospitals work as leading units, and existing high quality pediatrics resources of the member hospitals were pooled to establish an academics committee and an executive committee. A development system was established with disciplinary construction as the focus, collaborative development as the goal and horizontal collaboration as the means. It was designed to explore a new model featuring overall planning and standardized management of the discipline, building of a shared platform for clinical capacity development, joint development of continued medical education and talent cultivation, as well as diversified and multi-centered research and platform resources sharing. This model can effectively promote the overall development level of pediatrics in Beijing municipal hospitals.
ABSTRACT
Objective:To investigate the current status of doctor-patient communication of pediatric residents, and to explore the specific demand of communication skills training in clinical practice.Methods:A self-made questionnaire was conducted to investigate 77 residents taking standardized residency training of pediatrics in Beijing Children's Hospital training base, including basic information, self-satisfaction of communication ability and the needs of doctor-patient communication courses, etc. SPSS 22.0 statistical software was used for data processing and analysis.Results:In terms of the doctor-patient communication ability, the results showed that the satisfaction degree of pediatric resident surgeons was higher than that of pediatric resident physicians (78.9% vs. 58.5%, P=0.108) and the satisfaction degree of high-seniority residents was higher than that of low-seniority residents (78.6% vs. 62.5%, P=0.330; 78.6% vs. 58.9%, P=0.278). Besides, the importance of communication objectives and the degree of difficulty were sorted in order, and the top three were family members, superior and children for importance, and family members, children and nurses for difficulty, respectively. The main reasons of difficult communication included heavy work (41.6%) and lack of communication skills (46.7%), with no statistical difference between different majors and seniorities ( P >0.05). More than 80% residents agreed that effective doctor-patient communication could promote the clinical work. The lower of seniority, the higher demands for the class time allocation and teaching frequency of doctor-patient communication training courses. Conclusion:Pediatric residents have a good cognition of medical doctor-patient communication. There are some obvious communication problems in pediatric physicians and low-seniority pediatric residents. Therefore, it's necessary to adjust courses according to different majors and seniorities, so as to improve the training quality, thereby promoting the clinical work and reform of medical education.
ABSTRACT
OBJECTIVE@#To analyze a patient with infertility and a fragile site found at 16q22 by using cytogenetic methods.@*METHODS@#Peripheral blood sample was taken from the patient and subjected to chromosomal karyotyping and single nucleotide polymorphism microarray (SNP-array) analysis.@*RESULTS@#The patient was found to be a mosaicism for a fragile site at 16q22, which has a variable morphology and cannot be induced by folic acid treatment. No abnormality was found by SNP-array analysis.@*CONCLUSION@#A rare fragile site, which can be induced without folic acid treatment, has been identified at 16q22. The strategy of assisted reproduction for such individuals is yet to be explored.
Subject(s)
Humans , Chromosome Fragile Sites , Chromosome Fragility , Chromosomes, Human, Pair 16 , Genetic Testing , Karyotyping , MosaicismABSTRACT
Objective:To analyze the research status and development trend of pediatrician competence in China and abroad, for reference in promoting the pediatrician competence research in the country.Methods:Literature review on pediatric resident′s competency was made using CNKI, WanFang and PubMed databases, ranging from their establishment up to December 25, 2019. A descriptive statistical analysis was made on the literatures′ publication year, publication area, research object and application area among others, using Excel 2019 and EndnoteX8.Results:A total of 199 Chinese documents and 262 English documents were finally retrieved. From 2009, the number of publications increased year by year, of which the Pediatrics has topped the rest, followed by Academic Medicine and Chinese Journal of Medical Education Research. The publishing institutions were mostly universities and affiliated hospitals, among which the Children′s Hospital of Chongqing Medical University topped the rest. The keyword of the highest frequency was education and the researches focus on the competency application and modelling. Conclusions:The pediatric healthcare system is paying greater attention on competence researches, but China has not yet established an appropriate pediatric resident competency model fitting local conditions. Meanwhile, the researches are plagued by such setbacks as excessive concentration of resources, simple methods and lack of empirical studies. It is recommended to broaden the explorations in this regard so as to identify pediatric resident competency development models fitting China′s conditions.
ABSTRACT
Objectives To investigate the prevalence of left ventricular hypertrophy (LVH) and risk factors in children with chronic kidney disease (CKD). Methods The biochemical indices, blood pressure and left ventricular mass index (LVMI) in pa-tients with CKD were retrospectively analyzed. The risk factors of LVH were analyzed using Logistic regression. Results In 125 CKD patients, 32.00%were at 4th stage and 68.00%were at 5th stage. The estimate glomerular ifltration rate (eGFR) and hemo-globin (Hb) level were signiifcantly higher in CKD patients at 4th stage than in those at 5th stage. The intact parathyroid hormone (iPTH), serum phosphorus and LVMI were signiifcantly lower in CKD patients at 4th stage than in those at 5th stage (P<0.01). LVH was detected in 33.60%CKD patients. The eGFR and Hb level were signiifcantly lower in CKD patients with LVH than in those without LVH. The iPTH, serum phosphorus, systolic blood pressure and diastolic blood pressure were signiifcantly higher in CKD patients with LVH than in those without LVH (P<0.05). Logistic regression analysis indicated that only hypertension, hyperphosphatemia, moderate and severe anemia were the risk factors of LVH. Conclusion Control of hypertension, hyperphos-phatemia and anemia is the key to prevent LVH in CKD patients.
ABSTRACT
OBJECTIVE:To investigate the status quo and the feature of licensed pharmacists in Hubei province to provide experimental reference and policy bases for the concerned governmental department in making decision about management regulations. METHODS: 486 licensed pharmacists who came to attend the continuing education were investigated by questionnaire survey and personal interview regarding their essential information, social approval, and attitude towards their profession etc. RESULTS: The obtained essential information of the licensed pharmacists in Hubei province revealed that the majority of them regarded that they failed to bring their role in into full play in their daily work and their social approval degree was low; as for attitude towards their profession, most of the interviewees responded that the evolvement of policy is the important factor to bring into the role of licensed pharmacists into full play, meanwhile they thought highly of the active role of continuing education. Different type of licensed pharmacists have different needs, to satisfy the diversified needs, a pertinent study is needed. CONCLUSION: The government should establish licensed pharmacists law as soon as possible to identify the legal position of licensed pharmacists and solve their orientation problem so as to bring their role into full play.
ABSTRACT
OBJECTIVE: To investigate the status quo and feature of the distribution rationality of licensed pharmacists in different regions in China in recent 2 years.METHODS: Using "per capita licensed pharmacists every ten thousand people" as index to contrast and analyze the distribution of licensed pharmacists.SPSS13.0 statistical analysis software was used to calculate the distribution Tail index(TI) of licensed pharmacists in the east,middle,and west regions of China taking population and GDP as weight.RESULTS: The distribution of licensed pharmacists in the east region in China was more intensive;TI was far greater when using population as weight than using GDP as weight,and all TI decreased in the past 2 years.CONCLUSIONS: The licensed pharmacists should be distributed rationally according to the practical demand on pharmaceutical care,and the government should intensify the education and training of licensed pharmacists in the middle and west regions of China.