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The global incidence rate of nonalcoholic steatohepatitis (NASH) continues to rise. The pathogenesis of NASH is complex, and there is no effective clinical treatment. Previous study has shown that DEAD box protein 5 (DDX5) can significantly alleviate the NASH process in mice. This study screened the natural product library of the research group and found that the active compound hypercalin B (HB) in Hypericum beanii N. Robson, a traditional Chinese medicine, can upregulate the expression of DDX5 protein in a dose-dependent manner. In this study, an in vitro model of NASH stimulated by palmitic acid (PA) and an animal model of NASH induced by the methionine- and choline-deficient diet (MCD) were constructed. Different concentrations of HB were used to investigate the effect and mechanism of HB in alleviating NASH progression. All animal experiments in this paper were approved by the Ethics Committee of China Pharmaceutical University (NO: 2021-02-003). In vitro model results showed that HB significantly reduced the intracellular lipid deposition induced by free fatty acid (FFA). Animal experiments showed that HB improved liver injury by significantly reducing lipid accumulation in the liver of NASH mice, and reducing serum aspartate transaminase (AST) and alanine transaminase (ALT) levels. Moreover, HB could inhibit liver inflammation by reducing the mRNA levels of liver pro-inflammatory cytokines including interleukin 6 (IL-6), interleukin 1β (IL-1β), and tumor necrosis factor α (TNFα). Further research showed that HB could reduce the phosphorylation level of the mechanical target of rapamycin (mTOR) and reduce the expression of sterol regulatory element binding protein 1 (SREBP1) and fatty acid synthase (FASN), thereby improving lipid metabolism and alleviating NASH progression, and the effects of HB against NASH were dependent on DDX5. In conclusion, HB can improve lipid metabolism and inhibit inflammatory activation by suppressing mTORC1 pathway via upregulating DDX5 protein, and showed promising anti-NASH activity in vitro and in vivo.
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Objective:To develop a scientific and comprehensive job competency evaluation scale for pre hospital emergency nurses, and to test its reliability and validity.Methods:Based on the theory of nurse medical quality responsibility model, the first draft of the scale was formed through literature review, Delphi method, and other research methods. A questionnaire survey was conducted among 563 pre hospital nurses from 6 tertiary A hospitals in Shandong Province. SPSS 27.0 statistical software was used for factor analysis to test the reliability and validity of the scale.Results:The final competency evaluation scale for pre hospital emergency nurses included 6 dimensions and 40 items. Cronbach′s α coefficient of the total scale was 0.921, and the Spearman Brown split half reliability coefficient was 0.756. Conclusion:The job competency evaluation scale for pre hospital emergency nurses constructed in this study has good reliability and validity, and can be used to evaluate the job competency of pre hospital emergency nurses.
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Objective To investigate the causes of false-positive results in the 68Ga-labeled fibroblast activation protein inhibitor (68Ga-FAPI-04) PET/CT imaging. Methods The imaging data of 547 patients undergoing 68Ga-FAPI-04 PET/CT examination in the Department of Nuclear Medicine of the Affiliated Hospital of Southwest Medical University from September 2020 to May 2021 were retrospectively collected.Two experienced nuclear medicine diagnostic physicians analyzed the clinical data,relevant imaging examinations,laboratory examinations,pathological results and follow-up results of the patients with false-positive results. Results The 68Ga-FAPI-04 PET/CT imaging of 547 patients showed false-positive results in 99 (18.1%) patients,including 56 males and 43 females.The postoperative pathological examination confirmed false-positive results in 13 patients,including 1 patient of thyroiditis,2 patients of pulmonary tuberculosis,1 patient of bone tuberculosis,2 patients of pulmonary inflammatory pseudotumor,1 patient of pulmonary sarcoidosis,1 patient of pulmonary benign fibroma,1 patient of organic pneumonia,2 patients of renal angiomyolipoma,1 patient of mass pancreatitis,and 1 patient of pancreatic mucinous cystadenoma.The medical history,relevant imaging examination,and long-term follow-up confirmed false-positive results in 86 patients.Specifically,the false-positive uptake in the neck,chest,abdomen,bone joint,and skin occurred in 8 (9.3%),13 (15.1%),5 (5.8%),57 (66.3%),and 3 (3.5%) patients,respectively.Inflammation-related uptake appeared in 83 (83.8%) patients with false-positive imaging results,of which arthritis (23 patients) and osteophyte (29 patients) were the most common.Sixteen (16.2%) patients showed the false-positive uptake related to fibroblasts. Conclusion 68Ga-FAPI-04 PET/CT imaging will show non-malignant tumor false-positive results,which are mainly associated with inflammation and fibroblasts.
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Female , Male , Humans , Gallium Radioisotopes , Positron Emission Tomography Computed Tomography , Angiomyolipoma , Retrospective Studies , Kidney Neoplasms , Fibroblasts , Inflammation , Fluorodeoxyglucose F18 , QuinolinesABSTRACT
Objective:To investigate the urineinterleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-33 (IL-33) and matrix metalloproteinase-9 (MMP-9) in patients with IgA nephropathy (IgAN) and their predictive value for disease progression.Methods:110 IgAN patients admitted to Zhuozhou Hospital from January 2018 to October 2021 were selected and divided into IgAN progression group (39 cases) and IgAN non progression group (71 cases) according to the progress of IgAN patients. According to the Oxford Classification Standard System (MEST-C) of IgAN, they were divided into MEST-C≥3 group (42 cases) and MEST-C<3 group (68 cases). According to the estimated glomerular filtration rate (eGFR), they were divided into eGFR≥50 ml/(min·1.73 m 2) group (group A, 63 cases) and eGFR<50 ml/(min·1.73 m 2) group (group B, 47 cases). According to the amount of urinary protein, they were divided into urinary protein≥1.5 g/24 h group (66 cases) and urinary protein<1.5 g/24 h group (44 cases). Multivariate logistic regression was used to analyze the risk factors affecting the progression of IgAN. Receiver operating characteristic (ROC) curve was drawn to analyze the value of urinary IL-6, IL-8, IL-33 and MMP-9 levels in predicting the progression of IgAN. Results:The urinary IL-6, IL-8, IL-33 and MMP-9 levels in IgAN progression group were significantly higher than those in IgAN non progression group, while the serum albumin, eGFR and complement C3 in the IgAN progression group were lower than those in the IgAN non progression group (all P<0.05). The urinary IL-6, IL-8, IL-33 and MMP-9 levels in the MEST-C≥3 group were significantly higher than those in the MEST-C<3 group (all P<0.001). The urinary IL-6, IL-8, IL-33 and MMP-9 levels in the eGFR<50 ml/(min·1.73 m 2) group were significantly higher than those in the eGFR≥50 ml/(min·1.73 m 2) group (all P<0.001). The urinary IL-6, IL-8, IL-33 and MMP-9 in the urinary protein≥1.5 g/24 h group were significantly higher than those in the urinary protein<1.5 g/24 h group (all P<0.001). Multivariate logistic regression analysis showed that the course of disease, serum albumin, eGFR, urinary protein, IL-6, IL-8, IL-33 and MMP-9 were risk factors affecting the progression of IgAN (all P<0.005). The ROC curve showed that the area under the curve (AUC) of IL-6, IL-8, IL-33 and MMP-9 in predicting the progression of IgAN was 0.956 (95% CI: 0.891-0.998), and the sensitivity and specificity were 98.4% and 86.2%, respectively. Conclusions:The elevated levels of urinary IL-6, IL-8, IL-33 and MMP-9 are closely related to the progress of IgAN, and the combination of these four indicators has a good value in predicting the progress of IgAN.
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Objective:To understand the correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions of Fujian Province, and to explore the influencing factors of thyroid diseases.Methods:A cross-sectional study was conducted in Dongshan County and Pingtan County of Fujian Province from September to November 2019. According to the inclusion criteria, 140 pregnant women and 270 children aged 8 - 10 years were selected in Dongshan County, and 189 pregnant women and 368 children aged 8 - 10 years were selected in Pingtan County. Random urine and edible salt samples were collected to determine iodine content, and iodine nutrition was evaluated in each population. Thyroid was examined by B ultrasound and questionnaire survey of thyroid diseases was carried out. The correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions was analyzed.Results:There were statistically significant differences in the median urinary iodine among children in different genders (male: 151.30 μg/L, female: 130.30 μg/L) and regions (Dongshan County: 160.30 μg/L, Pingtan County: 129.70 μg/L, P < 0.05); there was no significant difference in the median urinary iodine among children of different ages (8, 9, 10 years old: 141.60, 128.05, 150.30 μg/L, P > 0.05). The median urinary iodine among pregnant women was 119.30 μg/L, and there was no significant difference in median urinary iodine among pregnant women in different stages and regions ( P > 0.05). The medians of salt iodine from children and pregnant women were 20.30 and 23.65 mg/kg, respectively. Urinary iodine in children was positively correlated with salt iodine ( r = 0.13, P < 0.05). However, there was no correlation between urinary iodine and salt iodine in pregnant women ( P > 0.05). The detection rate of thyroid nodules in children was 21.79% (139/638). There was significant difference in the detection rate of thyroid nodules in children of different ages ( P < 0.05). The detection rate of thyroid nodules in pregnant women was 4.26% (14/329). There was no correlation between detection rate of thyroid nodules and urinary iodine or salt iodine in children and pregnant women ( P > 0.05). Thyroid volume of children in the two counties was within the normal range, and there was no correlation between thyroid volume and urinary iodine or salt iodine ( P > 0.05). Conclusions:The iodine nutrition of children in Dongshan County and Pingtan County is suitable (100 - 199 μg/L), while iodine deficiency (< 150 μg/L) exists in pregnant women. Urinary iodine in children is related to salt iodine, and urinary iodine increased with increase of salt iodine. The prevalence of thyroid nodules in children of different ages is different, which requires further study. The detection rate of thyroid nodules in children and pregnant women is not correlated with urinary iodine and salt iodine.
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Objective:To investigate the clinical value of computer tomography (CT)-based three-section formula in identification of Siewert types of adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 62 AEG patients who were admitted to two medical centers, including 33 patients from Peking University Cancer Hospital and 29 patients from the First Affiliated Hospital of Amy Medical University, between January 2019 and January 2021 were collected. There were 53 males and 9 females, aged (66±9)years. All patients underwent CT examination to obtain the coronal and axial images and determine the upper and lower edges of the tumor and the esophagogastric junction, which were imported into the formula for Siewert classification. Observation indicators: (1) results of CT examination and pathological examination; (2) consistence of judgements for CT examination between doctors; (3) consistence of judgements between CT examination and patholo-gical examination. Results of pathological examination came from intraoperative surgical observa-tion and postoperative histopathological examination. Measurement data with normal distribution were represented as Mean± SD, and count data were described as absolute numbers or percentages. The consistency coefficient Kappa ( κ) was used to evaluate the consistency of diagnosis between resear-chers. The κ≥0.75 was regarded as excellent consistency, 0.40< κ<0.75 as good consistency, κ ≤0.40 as poor consistency. Wilcoxon rank sum test was used to evaluate the statistical difference between results of the CT-based three-section formula method and the pathological examination. Taking the results of histopathological examination as standard, the sensitivity, specifi-city, accuracy and 95% confidence interval of the CT-based three-section formula method were calculated. Results:(1) Results of CT examination and pathological examination: all the 62 patients underwent CT examination successfully to obtain the coronal and axial images and determine the upper and lower edges of the tumor and the esophagogastric junction, which were used for Siewert classifica-tion. There were 3 cases with AEG of Siewert type Ⅰ, 47 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ according to doctor's judgement from the Peking University Cancer Hospital, and there were 3 cases with AEG of Siewert type Ⅰ, 49 cases with AEG of Siewert type Ⅱ and 10 cases with AEG of Siewert type Ⅲ according to doctor's judgement from the First Affiliated Hospital of Amy Medical University, respectively. After arbitration, there were 2 cases with AEG of Siewert type Ⅰ, 48 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ determined by the CT based three-section formula. There were 7 cases of stage T1, 10 cases of stage T2, 24 cases of stage T3, 14 of stage T4a and 7 cases of stage T4b of pathological T staging. There were 2 cases with AEG of Siewert type Ⅰ, 48 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ determined by pathological examination. (2) Consistence of judgements for CT examination between doctors: the consistency of Siewert classification determined by CT-based three-section formula between 2 doctors was good ( κ=0.74, P<0.001). (3) Consistence of judgements between pathological examination and CT examination: with Siewert classification determined by pathological examination as reference, the accuracy of Siewert classification determined by CT based three-section formula was 90.3%( κ=0.73, P<0.001). The sensitivity and specificity of CT-based three-section formula were 66.7%(95% confidence interval as 20.8%-93.9%) and 100.0%(95% confidence interval as 93.9%-100.0%) for AEG of Siewert type Ⅰ, 97.7%(95% confidence interval as 88.2%-99.6%) and 72.2%(95% confidence interval as 49.1%-87.5%) for AEG of Siewert type Ⅱ, 73.3%(95% confidence interval as 48.0%-89.1%) and 97.9%(95% confidence interval as 88.9%-99.9%) for AEG of Siewert type Ⅲ, respectively. Conclusion:The CT-based three-section formula can be used for identification of Siewert types of AEG, with a high accuracy.
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Objective:To investigate the correlation between hematological parameters and testicular viability, and to identify potential indicators of intraoperative testicular viability or postoperative testicular atrophy.Methods:Clinical data of 173 children with testicular torsion treated by emergency operation in the Department of Urology, Beijing Children′s Hospital, Capital Medical University from January 2006 to January 2020 were retrospectively analyzed.According to the surgical methods, 90 and 83 cases were included in the orchiectomy group and orchiopexy group, respectively.The duration of onset, spermatic cord torsion degree and hematological parameters of the 2 groups were compared by the independent-samples t test, χ2 test and Mann- Whitney U test.Risk factors for testicular resection were analyzed by multivariate Logistic regression.In addition, 30 children in the orchiopexy group were followed up for bilateral scrotal ultrasound at 6 months postoperatively.They were sub-grouped into testicular atrophy group (13 cases, 43.3%) and non-atrophy group (17 cases). Differences between 2 subgroups were compared by the independent-samples t test and Mann- Whitney U test.Receiver operating characteristic (ROC) curves were plotted to analyze the prognostic potentials of indexes with significant differences in children with the duration of onset of >6-<51 h. Results:Duration of onset (9.3 h vs.51.0 h)( Z=-8.293, P<0.001), spermatic cord torsion degree (360.0° vs. 540.0°)( Z=-5.267, P<0.001), mean platelet volume (MPV) (9.8 fL vs.10.1 fL)( Z=-2.018, P=0.044) and age (147.5 months vs. 143.0 months)( Z=-2.165, P=0.030) were significantly different between the orchiopexy group and the orchiectomy group.The multivariate Logistic regression analysis suggested that the duration of onset ( OR=1.033, P<0.001), spermatic cord torsion degree ( OR=1.004, P<0.001) and MPV ( OR=1.662, P=0.044) were positively correlated with testicular resection.For patients with the duration of onset of >6-<51 h, the area under the curve (AUC) of duration of onset, spermatic cord torsion degree and MPV was 0.753, 0.755 and 0.629, respectively.MPV was significantly different in the postoperative testicular atrophy group and the non-atrophy group [(10.2±0.5) fL vs.(9.8±0.5) fL]( t=2.426, P=0.022). The ROC curve analysis showed that the cut-off value of MPV for predicting testicular atrophy was 9.9 fL, and its sensitivity and specificity were 83.3% and 70.6%, respectively, the AUC was 0.752. Conclusions:The duration of onset, spermatic cord torsion degree and MPV can be used as predictors of intraoperative testicular viability, which are helpful for clinicians to predict and judge the testicular necrosis caused by testicular torsion before operation.In addition, 43.3% of children with testicular torsion eventually developed testicular atrophy after orchiopexy, and only MPV may be used as a predictor of postoperative testicular atrophy.
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Objective:To investigate the efficacy of CT imaging features in evaluating occult peritoneal metastasis (OPM) of diffuse infiltrating gastric cancer (Borrmann Type Ⅳ).Methods:Totally 101 patients with locally advanced Borrmann type Ⅳ gastric cancer were retrospectively collected who were admitted to Peking University Cancer Hospital from March 2014 to March 2021. The patients were divided into OPM group (53 cases) and the non-OPM group (48 cases) according to the results of preoperative CT and laparoscopic exploration/peritoneal cytology examination. The pathological examination results were recorded, including the degree of histological differentiation and Lauren classification. The evaluation indicators included the tumor center position, the number of tumor-occupied portions, involved orientation, mucosal broadband sign, stratified enhancement, serosa invasion, increased density of peripheral fat tissue, and enlarged lymph nodes. The maximum thickness of the primary tumor, average CT value of the primary tumor (arterial phase, venous phase, and delayed phase), difference between venous phase and arterial phase, difference between delayed phase and venous phase, and pattern of the enhanced curve were recorded. The Mann-Whitney U or Chi-square test was used to compare the differences of pathological and CT features between two groups. The multivariate logistic regression was used to screen independent predictors and establish a nomogram. The receiver operating characteristic curve was used to evaluate the performance of the nomogram in predicting OPM, and the Hosmer-Lemeshow test was used to test the model′s goodness of fit. Results:There was statistical significance in the seven indicators between the OPM and non-OPM groups, including tumor-occupied portions of stomach, mucosal broadband sign, stratified enhancement, serosa invasion, increased density of peripheral fat tissue, the enhanced curve pattern and the degree of histological differentiation ( P<0.05). Among them, the degree of histological differentiation (OR=0.19, P=0.033), stratified enhancement (OR=7.02, P=0.005) and serosa invasion (OR=14.27, P<0.001) were independent predictors of OPM. The nomogram was established based on the three significant features. The area under the curve for predicting OPM was 0.826 (95%CI 0.745-0.908), the sensitivity was 0.566 and the specificity was 0.938. The Hosmer-Lemeshow test showed a good agreement between the OPM risk predicted by the nomogram and the actual risk ( P=0.525). Conclusions:The CT features of Borrmann type Ⅳgastric cancer complicated with OPM have specific characteristics. The diagnosis model based on the degree of histological differentiation, stratified enhancement, and serosa invasion had high efficacy in evaluating OPM.
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Objective:The iodine excretion of adult individuals was calculated by two creatinine correction methods of urinary iodine, and the significance and value of the methods to measure individual iodine nutrition levels were assessed to provide a reference basis for further epidemiological investigation and study of iodine deficiency disorders.Methods:Healthy adults aged 18 - 59 years from Fujian Province were recruited and their 24 h urine, fasting urine, and morning spot urine (8:00 - 12:30) were collected and the corresponding urinary iodine and creatinine concentrations were measured. The estimated 24 h urinary iodine excretion was calculated using two different creatinine correction and creatinine estimation formulas were compared with the measured 24 h urinary iodine excretion.Results:There were no significant differences in measured 24 h urinary iodine excretion value, estimated 24 h urinary iodine excretion value 1 of fasting urine and morning spot urine, and estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine between genders (μg/d: 195.5 vs 190.9, 190.0 vs 181.7, 160.2 vs 144.2, 174.8 vs 179.2, 148.3 vs 131.5); there were no significant differences in measured 24 h urinary iodine excretion and fasting urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P > 0.05), and there were significant differences in measured 24 h urinary iodine excretion and morning spot urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P < 0.01). And there were significant linear correlations between measured 24 h urinary iodine excretion and estimated 24 h urinary iodine excretion 1 of fasting urine and morning spot urine, estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine ( r = 0.772, 0.266, 0.828, 0.391, P < 0.01). Conclusions:It is feasible to estimate 24 h urinary iodine excretion in adults with creatinine-corrected fasting urinary iodine concentration. Creatinine-corrected fasting urinary iodine concentration can be used as an individual iodine nutrition level evaluation index, but whether it is applicable to children and pregnant women remains to be further studied.
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Objective@#To analyze knowledge, attitudes and practice regarding protection against COVID-19 among primary and middle school students in Hangzhou and to provide a scientific basis for schools to carry out targeted prevention and control measures.@*Methods@#Anonymous network sampling survey was carried out through the questionnaire star, and a total of 14 216 subjects from primary and middle school in Hangzhou were recruited to fill in the questionnaire regarding knowledge, attitudes and practice of COVID-19 from March 3 to March 7, 2020.@*Results@#Primary and middle school students showed high awareness rate of transmission (85.83%) and incubation period (77.44%), but lower awareness on symptoms (44.70%) of COVID-19. The practice of wearing masks, cough etiquette and correct hand washing were 97.27%, 88.01% and 91.82%, respectively. The protective practice among primary and middle school students were generally good, 91.21% of them were at moderate level or above. 83.91% of primary and secondary school students reported worries about infection of COVID-19, and 55.42% of primary and secondary school students were anxious about returning to school. Primary school students and rural students were more anxious about returning to school(χ 2=46.66, 26.70, P<0.05).@*Conclusion@#The primary and middle school students in Hangzhou have a relatively good level of knowledge and practice concerning COVID-19. Yet, it is necessary to carry out targeted health education and strengthen mental health education for primary and middle school students.
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Objective:To understand the assessment results of external quality control of iodine deficiency disorders laboratories of centers for disease control and prevention at the three levels of province, city and county, so as to promote the improvement of testing ability of laboratories at all the three levels in Fujian Province.Methods:In 2019, iodine deficiency disorders laboratories of one provincial and nine municipal centers for disease control and prevention in Fujian Province participated in the external quality control blind sample examination of urinary iodine, salt iodine and water iodine; iodine deficiency disorders laboratories of 84 county-level centers for disease control and prevention participated in the blind sample examination of external quality control of urinary iodine and salt iodine. The external quality control assessment results were collected and analyzed by descriptive statistics.Results:The qualified rates of urinary iodine, salt iodine and water iodine in provincial and municipal iodine deficiency disorders laboratories all reached 100.0% (10/10); the qualified rate of urinary iodine in county-level iodine deficiency disorders laboratories was 96.4% (81/84), and the qualified rate of salt iodine was 100.0% (84/84).Conclusion:The overall detection capacity of provincial, municipal and county-level iodine deficiency disorders laboratories in Fujian Province remains at a high level, and the urinary iodine detection capacity of some county-level iodine deficiency disorders laboratories still needs to be improved.
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Objective Based on the lanthanum bromide scintillator detector, the calculation method of G(E) function was developed to measure the air absorbed dose rate. Methods Firstly, the gamma energy spectrumof the lanthanum bromide detector were simulated and the response functions with different energies were determined with Monte Carlo simulation method. Then, the G(E) function was calculated by the least square method. Finally, the air absorbed dose rate measured by the lanthanum bromide detector using G(E) function conversion method was compared with the theoretical calculation value based on the point source experiments. Results The experimental verification results showed that the relative deviation between thecalculated value with G(E) function and the theoretical calculation value wasmostly controlled within ± 6%, which verified the accuracy of G(E) function. Conclusion The results showed that the method of G(E) function could be applied to calculate the gamma radiation dose rate based on the in-situ the gamma spectrum with LaBr3 detector.
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Objective:To discuss the treatment and prognosis of children with torsion of inguinal cryptorchidism.Methods:Clinical data of 15 cases of inguinal cryptorchidism with testicular torsion admitted to Beijing Children's Hospital from October 2015 to February 2019 were retrospectively analyzed. The average age of onset was 5.1 years (4 months-17 years). The clinical manifestations included inguinal swelling and pain in 13 cases, abdominal pain in 1 case and abdominal pain with vomiting in 1 case. The average duration of symptoms (up to the time of surgery) was 45.9 (5-170) h. Physical examination showed scrotal voided on affected side, groin swelling with tenderness. Lesions were found in 12 cases on the left and 3 cases on the right. Groin color Doppler ultrasound examination showed testis enlargement, uneven echo, decrease or disappearance of blood flow signal, suspected testicular torsion. Clinical diagnosis was inguinal cryptorchidism testicular torsion. Inguinal canal testicular exploration under general anesthesia. During the operation, the testicle was dark and twisted with an average torsion of 600°(180°-1 080°). Testicular activity was observed after exposure and reduction and torsion. After reduction, testicular color was immediately restored in 5 cases. After cutting open the white membrane of the testicular, there was blood outflow. In 2 cases, the testis was found to be inactive during the operation, but the parents requested to retain the testis and performed orchiopexy. 8 cases underwent orchiectomy due to necrosis of testis. The mean symptom duration (up to the time of operation) of the orchiectomy group and the orchiectomy group was 24.3 (5-73) h and 64.8 (7-170) h, respectively. The average torsion degree was 514° and 675°, respectively.Results:The average operative time of 15 patients was 56.7 min (40-85 min). Intraoperative blood loss averaged 1.5 (1-2) ml. There were no complications during and after operation. Postoperative follow-up averaged 27 (8-47) months. Among the 7 patients in the orchiopexy group, 3 patients had atrophy of testis 7.3 months after operation, and the remaining 4 patients had normal testis. In the orchiectomy group, 8 cases had normal contralateral testis without torsion.Conclusions:Inguinal cryptorchidism testicular torsion is a relatively rare disease in children. Color Doppler ultrasonography and inguinal canal exploration can help diagnosis and treatment. According to the condition of testis, orchiopexy or orchiectomy can be performed. Early diagnosis of this disease is difficult, easy to lead to testicular loss or postoperative atrophy.
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Objective:To analyze the disease burden of iodine deficiency disorders (IDD) and its changes in China in 1990 and 2016.Methods:Based on the data of Global Burden of Disease Study 2016 (GBD 2016), a descriptive statistical method was used to compare and analyze the changes of deaths number, mortality, disability adjusted life year [DALY, including years of life lost (YLL) and years lived with disability (YLD)], DALY rate and other disease burden indicators caused by IDD in China in 1990 and 2016.Results:The GBD 2016 data showed that the deaths number from IDD in China decreased from 259.31 in 1990 to 116.41 in 2016, the mortality decreased from 0.022 827/100 000 in 1990 to 0.008 515/100 000 in 2016; and the mortality in different age groups had decreased, the children mortality in the < 5 years old group had decreased from 0.088 639/100 000 to 0.009 875/100 000. The DALY and YLD due to IDD in China increased from 406.13 thousand person-years and 391.68 thousand person-years in 1990 to 455.05 thousand person-years and 451.95 thousand person-years in 2016, while YLL decreased from 14.45 thousand person-years to 3.10 thousand person-years; the DALY rate, YLL rate, and YLD rate decreased from 35.75 person-years per 100 000, 1.27 person-years per 100 000 and 34.48 person-years per 100 000 in 1990 to 33.29 person-years per 100 000, 0.23 person-years per 100 000 and 33.06 person-years per 100 000 in 2016. The main component of DALY for IDD was YLD, and the proportion increased from 96.44% in 1990 to 99.32% in 2016.Conclusions:The mortality of IDD in China has decreased, and IDD in the younger age group has been effectively controlled; however, the disease burden, especially the burden caused by disability has increased, and the disability of the population due to IDD should be given special attention.
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Objective:To observe the near-and long-term effects of acceptance and commitment therapy (ACT) on psychological flexibility, self-efficacy, and glycemic control in patients with type 2 diabetes.Methods:A total of 96 patients with type 2 diabetes admitted to Zhuzhou Central Hospital during the period from January to December 2017 were selected as subjects. According to the random number table method, they were divided into the control group and the ACT group, 48 cases in each group. The control group was given regular health education, and the ACT group was given ACT-oriented health education. The psychological flexibility, self-efficacy and glycemic control of the two groups were compared before intervention, 7 weeks after intervention and 1 year after intervention.Results:After 7 weeks of intervention, the psychological flexibility and self-efficacy scores of the ACT group was (21.47±4.89) and (8.96±1.70) respectively, the control group was (25.28±6.33) and (7.80±1.42) respectively. After 1 year of intervention, the psychological flexibility and self-efficacy scores of the ACT group was (23.87±5.03) and (8.09±1.38) respectively, and the control group was (27.19±5.48) and (6.97±1.24) respectively. The ACT group was significantly better than the control group, and the difference was statistically significant ( t=-3.300-4.044, P<0.01). After 7 weeks of intervention, the effective rate of blood glucose control in the ACT group was 93.75% (45/48), and the control group was 75.00% (36/48). After 1 year of intervention, the effective rate of blood glucose control in the ACT group was 86.96% (40/46), and the control group was 65.91% (29/44). The ACT group was significantly higher than the control group, and the difference was statistically significant ( χ2=6.400, 5.569, P<0.05). Conclusions:The application of health education activities based on ACT is significant in patients with type 2 diabetes, can significantly improve the patient's near-term psychological flexibility and self-efficacy, conducive to better long-term blood sugar management.
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Objective@#To observe the near-and long-term effects of acceptance and commitment therapy (ACT) on psychological flexibility, self-efficacy, and glycemic control in patients with type 2 diabetes.@*Methods@#A total of 96 patients with type 2 diabetes admitted to Zhuzhou Central Hospital during the period from January to December 2017 were selected as subjects. According to the random number table method, they were divided into the control group and the ACT group, 48 cases in each group. The control group was given regular health education, and the ACT group was given ACT-oriented health education. The psychological flexibility, self-efficacy and glycemic control of the two groups were compared before intervention, 7 weeks after intervention and 1 year after intervention.@*Results@#After 7 weeks of intervention, the psychological flexibility and self-efficacy scores of the ACT group was (21.47±4.89) and (8.96±1.70) respectively, the control group was (25.28±6.33) and (7.80±1.42) respectively. After 1 year of intervention, the psychological flexibility and self-efficacy scores of the ACT group was (23.87±5.03) and (8.09±1.38) respectively, and the control group was (27.19±5.48) and (6.97±1.24) respectively. The ACT group was significantly better than the control group, and the difference was statistically significant (t=-3.300-4.044, P<0.01). After 7 weeks of intervention, the effective rate of blood glucose control in the ACT group was 93.75% (45/48), and the control group was 75.00% (36/48). After 1 year of intervention, the effective rate of blood glucose control in the ACT group was 86.96% (40/46), and the control group was 65.91% (29/44). The ACT group was significantly higher than the control group, and the difference was statistically significant (χ2=6.400, 5.569, P<0.05).@*Conclusions@#The application of health education activities based on ACT is significant in patients with type 2 diabetes, can significantly improve the patient's near-term psychological flexibility and self-efficacy, conducive to better long-term blood sugar management.
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Objective To validate a developing method for determination of iodine in serum by inductively coupled plasma mass spectrometry (ICP-MS).Methods Ammonium chloride,ethanolamine,ascorbic acid and water were mixed at a certain ratio,adding ethanol as sensitization,to dilute samples in the ratio of 1 ∶ 20,and then the diluted samples were analyzed by ICP-MS.Re was used as the internal standard.Serum samples were from 8 different individuals.After combining,they were divided into 4 groups,control group and low,medium and high iodine groups.Iodine groups were added with potassium iodide (100 mg/L),iodine standard solution 1.5,9.0,15.0 μl.The methodological evaluation of this method was done through standard curve linearity,sample detection limit,precision,recovery and accuracy in determining biological sample.And the results were compared with the current serum iodine arsenic cerium catalytic spectrophotometry standard method (WS/T 572-2017).Results The linear range of the calibration curve was 0-300 μg/L and the linear correlative coefficients of the standard curve were 0.999 8-1.000 0.The detection limit was 0.38 μg/L (the sample amount was 0.2 ml).The coefficients of variation (CV) were all below 2％ for 4 serum samples in precision.The recovery rate was in a range of 95.8％-108.5％.No significant difference was found between the results of the 15 serum samples determined by the standard method andthis new method (t =1.139,P ＞ 0.05).Conclusions The newly developed method in determination of iodine in serum by ICP-MS,has wide linear range,high sensitivity,good precision,and wide applicability.It is suitable for application in determining serum iodine.
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Objective:To explore the guiding role of blood concentration monitoring (TDM) for valproate (VPA) in the treatment of epilepsy,and provide reference for the clinical rational use. Methods:Totally 384 epilepsy patients treated with VPA alone were collected between August 2016 and November 2017 in our hospital. The serum concentrations of VPA were determined by HPLC. The relationship was analyzed between TDM and the efficacy and safety. The correlation between TDM and factors(age, dose,sex and dosage form)was assessed using binary logistic regression. Results:Among the 384 patients,272 (70.83%) ones were with an effective range of blood (50-100 μg·ml-1). The clinical efficacy within the range of effective blood concentration (50-100 μg·ml-1) and that with the plasma concentration above 100 μg·ml-1were both significantly higher than that with the plasma concentration below 50 μg·ml-1(P < 0.01). The incidence of adverse reactions with the range above 100 μg·ml-1was significantly higher than that with the range below 50 μg·ml-1and within the range of 50-100 μg·ml-1. Logistic regression analysis showed that dose and age had significant effect on the blood concentration(P < 0.05). Conclusion:The individual difference of VPA is obvious,therefore,VPA should be used in clinic based on TDM to improve the clinical effect and reduce the adverse reactions.
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OBJECTIVES@#To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma.@*METHODS@#According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）.@*RESULTS@#The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P<0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P<0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （ P>0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma.@*CONCLUSIONS@#The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.
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Humans , Craniocerebral Trauma/pathology , Personality , Personality Disorders/psychology , Personality Inventory , Psychotic Disorders/psychologyABSTRACT
Objective To study the relationship between myofibril fragmentation index (MFI) of human skeletal muscle and postmortem interval (PMI). Methods The protein concentrations of human right bi-ceps brachii muscle and right quadriceps femoris muscle were obtained at different PMI, and detected at room temperature by biuret method. The MFI of skeletal muscle at 540 nm was measured by ultraviolet spectrophotometer. Regression analysis was performed with time of death as independent variable (x) and MFI as dependent variable (y). Results In early PMI, the MFI of human skeletal muscle increased obviously according to the prolongation of PMI, and peaking by 12 h and then tended to steady. Within 12 h after death, the regression equations of right biceps brachii muscle and right quadriceps femoris muscle were y=32.660+3.227 x(r=0.9879) and y=32.380+3.495 x(r=0.9839), respectively. Conclusion There's high correlation between MFI and PMI. Combining with forensic practice, MFI can be used for the estimation of early PMI (especially in 12 h).