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OBJECTIVE To quantitatively and qualitatively analyze the progress of potentially inappropriate medication （PIM） research by means of bibliometrics， and to predict the hotspots and trends of PIM， so as to provide reference for PIM research in China. METHODS The research literature related to PIM were searched from Web of Science core database， and the publication trend of the literature was analyzed on the bibliometric online analysis platform and CiteSpace 5.8.R3 software. The research results were visualized and analyzed， and the research hotspots of PIM were summarized through gCLUTO. RESULTS About PIM research， the annual number of the literature issued from 2012 to 2021 showed a continuous growth trend totally； the United States had the largest number of literature （241 pieces）； the University of Sydney in Australia was the research institution with the largest number of literature （59 pieces）； O’Mahony D from University College Cork， Ireland， published the most literature （23 pieces）； the research of PIM involved 57 disciplines， among which there was the largest number of literature about gerontology （384 pieces）； International Journal of Clinical Pharmacy was the journal with the largest number of literature （61 pieces）； Journal of the American Geriatrics Society was cited most frequently （1 197 times）. The hotspots of PIM research mainly focused on seven aspects： the standard of PIM， the safety and economy research of PIM， the risk factors research of PIM， the PIM research of chronic patients， the PIM research of antipsychotics， the research of pharmacists’ participation in PIM management， and the PIM research about palliative care of tumor patients. CONCLUSIONS The heat of research on PIM has been on the rise， and there is little cooperation between countries and institutions， and more cooperation is needed. In the future， the focus of Chinese pharmacists’ research on PIM may be on the deep localization of PIM standards， PIM intervention and precise medication guidance， and PIM management of specific diseases and drugs.
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ObjectiveA rapid enrichment and detection method for Escherichia coli O157∶H7 was developed by using multienzyme isothermal rapid amplification （MIRA） fluorescence method combined with metal organic frameworks immunomagnetic beads. MethodsUsing rfbE gene as the target， the primers， probes and reaction system were screened， and the specificity， sensitivity and practical application of this method were investigated. ResultsThe detection limit of Escherichia coli O157∶H7 was 1.18×105 CFU‧mL-1， and the detection limit of DNA concentration was 9 pg‧μL-1. The detection process was completed in 20 minutes. The test results of 47 strains （24 target strains and 23 non-target strains） were consistent with real-time PCR （RT-PCR）. ConclusionA method based on metal-organic framework immunomagnetic beads enrichment combined with MIRA assay is developed in this study. The method is simple， rapid and suitable for rapid enrichment and detection of Escherichia coli O157∶H7 in food.
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Objective:To explore the diagnostic accuracy of bedside ultrasound measurement of limb skeletal muscle thickness for intensive care unit-acquired weakness (ICU-AW) in patients receiving mechanical ventilation.Methods:A prospective observational study was conducted. Patients receiving mechanical ventilation admitted to the emergency ICU of Cangzhou Central Hospital from June 2018 to March 2020 were enrolled. The demographic data were collected. Medical Research Council (MRC) score was used to assess muscle strength and to determine the presence of ICU-AW once the patients were awake. The thicknesses of biceps brachii (BB), flexor carpi radialis (FCR), rectus femoris (RF) and tibialis anterior (TA) were measured by bedside ultrasound. The difference of each index was compared between the patients in ICU-AW group and in non-ICU-AW group. Receiver operator characteristic (ROC) curves were plotted to examine the values of the thicknesses of these four muscles in diagnosing ICU-AW.Results:Forty-one patients receiving mechanical ventilation (15 patients with ICU-AW, 26 patients without ICU-AW) were recruited. Compared with the non-ICU-AW group, the MRC score, the thicknesses of FCR, RF and TA were lower in the ICU-AW group [MRC score: 36 (30, 40) vs. 60 (56, 60), FCR (cm): 1.09±0.19 vs. 1.30±0.28, RF (cm): 1.57±0.58 vs. 2.23±0.58, TA (cm): 1.76±0.33 vs. 2.21±0.43, all P < 0.05], and the length of ICU stay was longer [days: 15 (9, 26) vs. 10 (4, 12), P < 0.05]. Although the thickness of BB was also lower in the ICU-AW group, there was no statistical difference between the two groups (cm: 2.45±0.57 vs. 2.70±0.61, P = 0.205). ROC curve showed that the thicknesses of FCR, RF and TA had diagnostic values for ICU-AW [area under ROC curve (AUC) and 95% confidence interval (95% CI) was 0.742 (0.582-0.866), 0.787 (0.631-0.899), 0.817 (0.665-0.920), respectively, all P < 0.01]. The thicknesses of BB couldn't diagnose ICU-AW (AUC = 0.597, 95% CI was 0.433-0.747, P = 0.296). Conclusion:The thicknesses of FCR, RF and TA measured by bedside ultrasound in patients with mechanical ventilation had diagnostic values for ICU-AW, while the thickness of BB could not diagnose ICU-AW.
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Objective:To observe the effect of traditional Chinese medicine anal fumigation combined sitz bath for mixed hemorrhoids.Methods:A total of 90 patients with mixed hemorrhoids who met the inclusion criteria in our hospital from March 2017 to March 2019 were divided into two groups according to the random number table method, 45 cases in each group. The control group was treated with conventional western medicine. The treatment group was treated with traditional Chinese medicine anal fumigation combined sitz bath. Both of the two groups were treated for 14 d. The pain, swelling, and symptoms of the two groups were compared. The clinical efficacy was evaluated.Results:After the treatment, the total efficacy of the treatment group was 95.6% (43/45), and the control group was 80.0% (36/45). The difference between the two groups was statistically significant ( χ2=5.075, P=0.024). The pain level after 7 d (2.36 ± 1.02 vs. 3.55 ±1.34, t=4.740), 14 d (1.52 ± 0.38 vs. 2.28 ± 0.78, t=5.876) in the treatment group were significantly lower than those of the control group ( P<0.01). After 14 d, it showed the distribution of edema of anal edge with Degree Ⅰ in the treatment groupwas higher than that of the control group, and distribution of Degree Ⅲ-Ⅳ was lower than that of control group ( Z=6.543, P<0.01).. After 14 d, the pain (6.32 ± 0.90 d vs. 7.01 ± 1.82 d; t=-2.280, P=0.025) and edema of anal edge time (5.28 ± 0.51 d vs. 6.55 ± 1.05 d; t=-7.298, P<0.01) in the treatment group were significantly earlier than those of control group. Then followed up for 2 weeks, the wound healing time (17.78 ± 2.30 d vs. 15.25 ± 1.63 d, t=6.02) in the treatment group was significantly earlier than that of the control group ( P<0.01). Conclusions:Traditional Chinese Medicine anal fumigation combined sitz bath could relieve postoperative pain and edema of anal edge after external strip for mixed hemorrhoids patients.
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Objective To study the effect of estrogen on proliferation of astrocytes in hippocampus of mice following middle cerebral artery occlusion(MCAO).Methods One hundred and eight Kunming mice were randomly divided into estrogen group(n=54)and saline group(n=54).The animals in two groups underwent right MCAO with tissue samples taken at 3,6,12,24,48and 72h after MCAO.The ischemic site was detected and the ischemic size was measured with TTC staining,the damage of neurons in hippocampus was assayed with HE staining,the expression of GFAP in hippocampal astrocytes was detected with immunohistochemical staining.Results The cerebral infarction size was significantly smaller in estrogen group than in saline group at different time points after MCAO(P＜0.05,P＜0.01)especially at 12hafter MCAO(31.50％±3.36％vs 54.50％±5.68％,P=0.019).The damage of hippocampal neurons aggregated with the prolonged ischemia time in two groups and was milder in estrogen group than in saline group at the same time points.The expression level of GFAP positive cells in bilateral hippocampal areas was higher when the ischemia time was prolonged and was significantly higher in ischemic hippocampus of estrogen group than in that of control group except at 6hin CA3ischemic area(P＜0.05).Conclusion Estrogen can protect mice against focal cerebral ischemia,stimulate the genesis of astrocyte synapses,alleviate neuronal damage after ischemia,and can thus reduce the size of cerebral infarction.
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Objective To investigate pathogenic genes related to the phenotype of fetus with severely short limbs in the first and second trimester by whole exome sequencing (WES). Methods Thirteen fetuses with severely short limbs detected by ultrasonography in the first and second trimester admitted in Chinese PLA General Hospital from September 2016 to June 2018 were collected. All cases were performed induced abortion, 6 of which were carried out karyotype analysis of amniotic fluid at the same time. WES and copy number variations (CNV) were performed on specimens from fetal tissues after labor induction. The suspected pathogenic mutations were validated by Sanger sequencing reactions. Results No abnormal karyotypes or pathological CNV were found. In 10 fetuses, pathogenic or possibly pathogenic mutations were detected in the following genes: COL2A1, FGFR3, COL1A1, COL1A2, DYNC2LI1 and TRIP11, all of which were essential to skeletal development. The diagnostic yield of WES in the fetuses with severe short limbs was 10/13. Conclusions In the first and second trimester, most of the fetuses with extremely short limbs suffer from monogenic diseases. WES is likely to be a valuable diagnostic testing option for the fetuses with severe short limbs.
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Objective To compare the efficacy and toxicity of nedaplatin and cispaltin chemotherapy combined with intensity modulated radiotherpy ( IMRT) in the treatment of locally advanced nasopharygeal carcinoma (NPC) patients in unendemic area. Methods From January 2014 to July 2016, sixty-two pairs of patients with stageⅢ-ⅣB NPC patients who underwent radical radiotherapy were selected for pair analysis (nedaplatin group and cisplatin group, 62 cases for each group). The nedaplatin group was treated with IMRT concurrent with nedaplatin at a dose of 100 mg/m2 every three-weeks for 2 -3 cycles, and sequential adjuvant chemotherapy of nedaplatin + fluorouracil regimen for 2 to 3 courses. The cisplatin group was treated with IMRT concurrent with cisplatin at a dose of 80 mg/m2 every three-weeks for 2-3 cycles, and sequential adjuvant chemotherapy of cisplatin + fluorouracil regimen for 2 to 3 courses. Results The 2-year overall survival ( OS ) of nedaplatin group and cisplatin group was 89. 9％ and 91. 1％, local recurrence free survival ( LRFS ) 90. 5％ and 93. 5％, regional recurrence free survival ( RRFS ) 96. 4％ and 96. 0％, and distant metastasis free survival ( DMFS ) 85. 9％ and 90. 3％, respectively. There were no significant differences between nedaplatin group and cisplatin group ( P >0. 05 ) . In the occurrence of acute toxicity, during concurrent chemoradiotherapy and adjuvant chemotherapy, the incidence of grade 3-4 vomiting in nedaplatin group was significantly lower than that in cisplatin group. During adjuvant chemotherapy, the incidence of grade 3 - 4 thrombocytopenia in nedaplatin group was significantly higher than that in cisplatin group. Conclusions For NPC patients with stage Ⅲ-ⅣB in unendemic area, the 2-year survival rates of nedaplatin group was silimiar to cisplatin group, while the incidence of grade 3 -4 vomiting was significantly lower than that in cisplatin group. Nedaplatin maybe an alternative chemotherapy for patients who cannot tolerate cisplatin chemotherapy.
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OBJECTIVE:To reduce drug repercussion of outpatient pharmacy,and to promote safe drug use.METHODS:By quality control circle (QCC),the data of drug repercussion were selected from outpatient pharmacy of our hospital in Sept.2016.The drug repercussion reason check list was designed to master the situation of drug repercussion in outpatient department,formulate improvement measures and confirm effect through field inspection.The case number of drug repercussion and the improvement of circle members' ability were compared one month before and after QCC (Mar.2017).Finally,the effects of QCC were evaluated.RESULTS:Referring to the reasons for the repercussion of adjunct drugs for inspection and the repercussion of unsuitable drug use in our hospital,those problems were improved by formulating manual for drug use examination project,optimizing and examining drug delivery process in the department,etc.The case number of drug repercussion in outpatient pharmacy decreased from 31 cases per month to 12 cases per month;the rate of goal achievement was 119％;the rate of improvement was 61％.The ability of QCC members to solve problems and the ability to use QCC skills were increased positively.CONCLUSIONS:The development of QCC activity in our hospital reduces case number of drug repercussion and optimizes drug delivery process in outpatient pharmacy,and promotes safe drug use.
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Objective To explore the mechanism of parents' psychological flexibility and marriage quality on children's behavioral problems and to provide theoretical basis for the use of the acceptance and commitment therapy(ACT) to intervene children's behavioral problems.Methods Acceptance and action questionnaire-second edition(AAQ-Ⅱ),the cognitive fusion questionnaire (CFQ),the child behavior rating scale (CBRS),evaluating & nurturing relationship issues,communication,happiness (ENRICH) were used to investigate the parents of 310 pupils.Results (1) There were significant differences between father and mother in the total score of marriage(father(120.59±18.25) vs mother(129.65±21.61),P＜0.01),the score of children and marriage (father (29.80± 5.80) vs mother (33.26 ± 6.14)),the score of communication between husband and wife (father(28.75±6.48) vs mother(31.56±7.23)),and the score of experiential avoidance(father(21.48±9.85) vs mother(18.48±9.40)) and cognitive fusion scale (father (32.20± 12.46) vs mother(27.23± 13.70)) (P＜0.05).(2)The experiential avoidance of parents,the cognitive fusion of parents,the total score of marriage and subscales were significantly related to children's behavior problems (r=-0.35-0.81,P＜0.05 or 0.01).(3) The quality of marriage played a part intermediary role in the relationship between the two aspects of parents'psychological flexibility (experiential avoidance and cognitive fusion) and children behavior problems.The mediating effect was 32％ and 22.58％ respectively.Conclusion The psychological flexibility of parents can not only directly affect the behavior problems of children,but also affect the behavior problems of children through the quality of marriage as an intermediary variable.It can provide a new theoretical basis and effective methods to intervene and correct children behaviors problems.
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Objective To measure the reliability and validity of the Chinese version of the compre-hensive assessment of ACT processes(CompACT)in financial staffs. Methods A total of 3 735 valid ques-tionnaires were obtained from financial staffs.The valid questionnaires were randomly allocated into two groups,of which one subset(n=1 873)was used for exploratory factor analysis(EPA),and the other(n=1 845)for confirmatory factor analysis(CFA).Criterion and convergent validity were tested by Pearson corre-lation respectively.Incremental validity was tested by hierarchical regression analysis. Results The EFA suggested theoretically-coherent three-factor structure for a 15-itemed version of the CompACT.The three fac-tors named as acceptance and cognitive defusion,mindfulness and self as context,value and committed ac-tion,and explained 73.75% of the total variance and factor loadings ranged from 0.67 to 0.90.The CFA con-firmed the hypothesized three-factor mode(χ2/df=5.91,CFI=0.98,TLI=0.98,RMSEA=0.05). Conclu-sion The research suggests that the Chinese version of the CompACT has acceptable psychometric in prop-erties,so it can be applied in the assessment of the psychological flexibility and mental health in China.
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Objective To develop a washing tube for minimally invasive treatment of sinus cavity pressure ulcer, and to observe its clinical effect. Methods Using transparent non-toxic PU plastic to make sinus cavity flushing and drainage tube, and with rounded hemispherical blunt head for the entry of the sinus, the perforated tube in the sinus cavity was designed with perforated holes (3 rows, 5 for each row); the end of the tube is blocked with heparin cap. The invented sinus cavity flushing tube was used for clinical observation and its use effect was observed. When used, the sinus cavity flushing drainage tube must be placed in the deepest antrum. The wounds were covered with PU sponge. By the active aspiration drainage of the negative pressure with sterile isotonic flushing fluid, bacteria, liquefied necrotic tissue, purulent secretion, internal and external toxins produced by bacteria, and the harmful material such as exudate of inflammatory medium in the sinus cavity was thoroughly removed. Results When treating sinus cavity and mixed pressure ulcer, minimally invasive treatment using the developed sinus cavity flushing drainage tube for irrigation and negative pressure drainage can significantly reduce patients' iatrogenic trauma, observably reduce the pain of the patients, shorten the treatment cycle, improve the cure rate of sinus pressure ulcers, and achieve good clinical effect. The sinus cavity flushing drainage tube has no damage to soft tissue, with simple operation and easy tolerance of patients. It is low price and using disposable materials, which can avoid cross-infection; It can be used to treat oxygen negative pressure in sinus cavity, and it has therapeutic effect on the sinus cavity pressure sore infected by anaerobic bacteria. It can be made into different specifications, different models, and widely used in different professional fields. Conclusion The sinus cavity flushing drainage tube combined with negative pressure treatment is a new technique of mild and undamaged cleansing wound, which makes up for the deficiency of flap surgery, and it is a very ideal method for minimally invasive treatment for sinus and cavity pressure ulcers.
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Objective To analyze the mutations of causal genes in sixteen Chinese patients with suspicious Bartter syndrome,and follow up their treatment results.Methods Mutations were identified by the next generation sequencing and the multiplex ligation-dependent probe amplification (MLPA).Clinical and biochemical features at the first presentation as well as follow-up results were reviewed.Results 15 different CLCNKB gene mutations were identified in sixteen patients with BS,including 11 novel ones.A novel missense mutation and a novel small deletion were found from SLC12A1 gene.A novel gross deletion was found in CLCNKA gene.A recurrent missense mutation was identified from BSND gene.The whole gene deletion mutation of CLCNKB gene was the most frequent mutation (32％),and the rate of gross deletion was up to 50 percent in this group of Chinese patients.The most common clinical manifestations were development retardation (15/16),polydipsia and polyuria (15/16).All of the patients were detected with hypokalemia,hypochloremia and metabolic alkalosis.Indomethacin treatment had significant improvement to the stature and weight restoration.Conclusion The present study has found 19 mutations,including 14 novel ones,which enriches the human gene mutation database (HGMD) and provides valuable references to the genetic counseling and diagnosis of Chinese population.
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Objective To investigate the clinical values of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET-CT) and magnetic resonance imaging (MRI) in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma.Methods A total of 53 patients with oropharyngeal squamous cell carcinoma were enrolled and underwent PET-CT and MRI imaging within two weeks after surgery.The detection rates of residual lesions and lymph node metastases after surgery by PET-CT and MRI were compared on the basis of the pathological results of biopsy.The gross tumor volume (GTV) and clinical target volume (CTV) determined by PET-CT and MRI were compared;the normally distributed data were analyzed using the t test, and the skewed distribution data by the Wilcoxon rank sum test.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in predicting precise radiotherapy after surgery, as determined by PET-CT and MRI, were compared with the chi-square test.Results Fourteen patients had residual lesions after surgery.The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET-CT in detecting residual lesions after surgery were significantly higher than those of MRI (92.86%, 94.87%, 86.67%, 97.37%, and 94.34% vs.57.14%, 76.92%, 47.06%, 83.34%, and 71.70%, all P0.05).For the 14 patients with residual lesions, GTVPET/CT was significantly smaller than GTVMRI(45.62±22.13 cm3 vs.60.61±23.12 cm3, P=0.034), so did CTV (125.54±17.53 cm3 vs.142.18±21.22 cm3, P=0.011).There was no significant difference between CTVPET-CT and CTVMRI in 39 patients without residual lesions after surgery (117.87±17.66 cm3 vs.128.05±20.65, P=0.099).Conclusions PET-CT is superior to MRI in detecting the residual lesions and lymph node metastases after surgery in patients with oropharyngeal squamous cell carcinoma, which provides valuable information for radiotherapy planning.
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OBJECTIVE:To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate, relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS:110 patients with rectal cancer atⅡ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy(3DCRT)af-ter operation;observation group was additionally given capecitabine 1 500 mg/m2,d1-14,qd,on the basis of control group. A treatment course lasted for 21 d,and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS:The follow-up total survival rate and disease-free survival rate of observation group were 89.09%and 76.36%,which were significantly higher than 74.55%and 54.55%of control group;the distant metastasis rate and lo-cal recurrence rate were 12.73% and 5.45%,which were significantly lower than 30.91% and 21.82%,with statistical significance (P0.05). There was no statistical significance in the incidence of nausea and vom-iting,diarrhea and urinary tract reaction between 2 groups (P>0.05);but the incidence of bone marrow arrest in observation group was significantly higher than control group(P<0.05). CONCLUSIONS:Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage,and reduce the metastasis and recurrence risk;do not lower life quality and induce serious adverse reactions.
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Objective To investigate the effect and mechanism of necrostatin-1 (Hec-1) on the level of HMGB-1 protein in liver of rats with hemorrhagic-traumatic shock.Methods A number of 96 male SD rats were divided into sham-operated group,dimethyl sulfoxide (DMSO) group and Nec-1 group (n=32in each) by randomized number method.Rat model of hemorrhagic-traumatic shock was made by fracture of femoral bone and tibia bone and exsanguination from femoral vein until 30 mmHg and maintained at 30-40 mmHg for 90 min,then the shed blood was transfused back with Ringer's solution.The rats in shamoperated group were only under anesthesia for separating and ligating blood vessels,without exsanguination to induce hemorrhagic shock and without replenishment with blood.Rats in Nec-1 group were given 1 mg/kg Nec-1 through femoral vein 5 min before replenishment with blood and Ringer' s solution,while the rats in DMSO group were given equal volume of DMSO solution instead.Eight rats in each group were sacrificed separately at 2 h,8 h,16 h and 24 h after replenishment.The serum and liver tissues of rats in each group were collected to detect serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST),and to observe the pathological changes in liver with hematoxylin-eosin (HE) staining.The level of HMGB-1 in serum was detected by using ELISA.The cytoplasm protein and total protein expressions of HMGB-1 were assessed by using western blot analysis.Results Compared with DMSO group,levels of serum ALT at 8 h (P ＜0.05),16 h (P ＜ 0.01) and 24 h (P ＜ 0.01) in Nec-1 group were significantly lower.Level of serum AST in Nec-1 group were lower compared with DMSO group at 8 h (P ＜ 0.01),16 h (P ＜ 0.01) and 24 h (P ＜0.01).Compared with DMSO group,levels of serum HMGB-1 at 8 h (P ＜ 0.05),16 h (P ＜0.01) and 24 h (P ＜ 0.01) in Nec-1 group were significantly lower.Under light microscopy and transmission electron microscope,hepatic lobule destroyed,the blood extravasated,the immunocyte infiltrated and cellular organelle destroyed were found.Compared with DMSO group,the level of HMGB-1 protein in cytoplasm protein in Nec-1 group were significantly decreased at 8 h (P ＜ 0.01),16 h (P ＜0.01) and 24 h (P ＜0.01).The level of HMGB-1 protein in total protein in Nec-1 group were significantly decreased 8 h (P ＜ 0.05) and 24 h (P ＜ 0.05).Conclusions Nec-1 can remarkably protect the liver of rats with hemorrhagic-traumatic shock,decrease the level of HMGB-1,and protect the hepatocyte effectively.
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Objective To understand the medical staff's real experience after implementing patients participate and interactive health education method.Methods A qualitative method was conducted with 2 doctors and 7 nurses.Data were analyzed based on Colaizzi phenomenotogical research method.Results 3 themes were extracted:conflict,including the role and the education methods;the benefits of patients participate and interactive health education method,such as palliative the relationship between medical workers and patients,and help patients to manage diseases,etc;and obstacles as work burden and time limit of medical staff,patients with low health literacy,negative psychology,lack of supervision and timely feedback on both sides.Conclusions Patients participate and interactive health education method is beneficial and feasible,but some obstacles we should faced in the implementation process.Its smooth implementation needs medical staff change idea,and also needs the support of some objective factors.
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Objective The patients with non-syndromic deafness in Shanxi Province were retrospectively an_alyzed for the common deafness gene mutations and frequency of mutations carrying rate ,to understand the molecu_lar pathogenesis of deafness in Shanxi area .Methods Genomic DNAs of 800 patients of non -syndromic deafness within Shanxi were obtained from peripheral blood .Genes GJB2 ,GJB3 ,SLC26A4 and mitochondrial 12SrRNA 1494 and 1555 loci were sequenced after polymerase chain reaction (PCR) amplification and compared with the NCBI website for the analysis of the formation of mutations .ResuIts Among 800 patients ,353 cases (44 .13% ) showed detected deafness related mutations and the genetic etiology was found for 294 patients (36 .75% ) .Among them , 153 cases (19 .13% ) carried double allele mutations in the GJB2 gene .The most frequent mutation of GJB2 gene was 235delC ,and the carrying rate was 13 .5% (216/1 600) .The double mutant allele of SLC26A4 gene was detec_ted in 123 cases (15 .38% ) ,and the most common mutation was IVS7-2A>G ,identified in 7 .44% (119/1 600) of patients .Homogenic mitochondrial 12S rRNA 1494C> T mutation in one patient and 1555A> G mutation in 15 patients were detected .GJB3 gene c .538C > T heterozygous mutation was found in two patients .Altogether , 36 .75% (294/800) of patients with deafness were caused by gene mutations .ConcIusionThe data containing GJB2 gene and SLC26A4 gene carrying rate are consistent with the published data of non-syndromic deafness in the Northwest region of China ,but the carrying rate of mitochondrial gene mutations is lower than the average level of China .Our data show that the gene mutations contribute to 36 .75% of etiology in patients with deafness .This study reflects the importance of deafness related genes screening in Shanxi area for early diagnosis and genetic con_sultation .
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Objective To explore the risk factors of cognitive impairment of elderly patients with cerebral infarction in order to provide the theoretical basis for the clinical intervention. Methods A total of 237 cases with senile cerebral infarction were selected as ours subjects who were hospitalized from Mar. 2010 to Jun. 2013 in Kailuan General Hospital Affiliated to Hebei United University. The general condition and medical history were recorded. The auxiliary examination was performed. Cerebral infarction was diagnosed based on the onset to diagnosis standard and MoCA scores of within 2 weeks. The patients with less than 26 MoCA score were diagnosed as cognitive dysfunction and otherwise were thought as normal. Single factor analysis methods and non conditional Logistic regression were applied to analyze the analysis. Results There was no significant difference in terms of incidence between patients with different gender. Patients with age more than 75 years old and lower education levels had the high incidence rate than those with younger age and high education levels( χ2=16. 661,5. 453;P﹤0. 05). The cognitive dysfunction incidence of patients with white collar was lower than those with blue collar(χ2 = 5. 458,P ﹤ 0. 05 ). And the cognitive dysfunction incidence of patients with hypertention,diabetes,heart disease and leukoaraiosis were higher than those without the above diseases(χ2 =28. 423,5. 621,7. 768,6. 070;P﹤0. 05). The incidence of patients smoking more was significantly higher than that of smoking less or no(χ2 =5. 045,P ﹤0. 05 ). Multiple factors and non conditional Logistic regression analysis showed that,67 Senile cerebral infarction patients occurred cognitive impairment within 2 weeks. The independent risk factors for its occurrence included age greater than 75 years( P=0. 000 ),diabetes mellitus( P=0. 043),hypertension(P=0. 000)and leukoaraiosis(P=0. 041). Conclusion There are many risk factors related to cognitive impairment after cerebral infarction occurred in the elderly. The intervention should take in many aspects and the risk factors should early found.
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<p><b>OBJECTIVE</b>To investigate the value of maternal plasma cell-free fetal DNA (cff-DNA) examination in detection of fetal chromosomal aneuploidy in pregnant women at advanced maternal ages during the first trimester of pregnancy.</p><p><b>METHODS</b>A total of 136 pregnant women (11 to 13+6 gestational weeks) with advanced maternal ages were screened for fetal chromosomal aneuploidy with ultrasound and maternal plasma cff-DNA examination during March 1, 2011 to August 31, 2013, and the results were then confirmed by karyotype analysis and fluorescence in situ hybridization (FISH).</p><p><b>RESULTS</b>Of the 136 women examined, cff-DNA screening detected chromosomal aneuploidy in 5 cases, including trisome-21 in 3 cases, trisome-18 in 1 case, and 45,X in 1 case as confirmed subsequently by karyotype analysis. Ultrasound screening reported a normal finding in one case of trisomy-21, thickening of the NT in the case of trisomy-18, and fetal anasarca in the case of 45,X. Karyotype analysis and follow-up of the women did not find chromosomal abnormality in the 131 negative cases screened by cff-DNA detection.</p><p><b>CONCLUSION</b>Screening of material plasma cff-DNA allows accurate and early detection of fetal chromosomal aneuploidy in women of advanced maternal ages to avoid unnecessary invasive antenatal examinations.</p>
Subject(s)
Female , Humans , Pregnancy , Aneuploidy , Chromosomes, Human, Pair 18 , DNA , Blood , In Situ Hybridization, Fluorescence , Karyotyping , Maternal Age , Pregnancy Trimester, First , Prenatal Diagnosis , TrisomyABSTRACT
Objective To discuss the demands of replacement care service for family caregivers of the aged in Zhengzhou City,so as to provide the reference for replacement care service of the aged.Methods A total of 145 family caregivers of the aged were collected in Zhengzhou city and were investigated with a self-designed questionnaire.Results In the 145 questionnaires,106 were valid.81 (76.4％) of them expressed needing to be replaced in the process of care,and 68 (64.1％) were willing to accept replacement care service.Order of demands of replacement service content was daily life nursing (77,72.6％),disease (66,62.3％) and psychological care (60,56.6％),etc.Influencing factors of selecting replacement care service for family caregivers included quality of service (63,59.4％),service price (38,35.8％) and professional skill (37,34.9％).The degree of demand of different ages,different careers,as well as different duration of daily care of family caregivers was statistically significant for replacement care service.Conclusions The degree of demand of family caregivers of the aged for replacement care service was higher.The government needs to establish replacement care service mechanism which is suitable for China's national conditions through policy guidance and support.