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【Objective】 To observe the distribution of non-ABO-HDN and its clinical relevance, so as to provide reference for clinical diagnosis and treatment. 【Methods】 A total of 287 cases of non-ABO-HDN recorded during January 2012 to August 2022 were enrolled and tested in our laboratory. The correlation between maternal history of blood transfusion, pregnancy, unexpected antibody titers, gender, ABO-HDN and transfusion therapy was analyzed by chi-square test. 【Results】 All 287 cases of non-ABO-HDN involved 13 kinds of unexpected antibodies of 6 blood group systems. Rh-HDN accounted for 96.17% (276/287), and anti-D-HDN accounted for 47.04% (135/287). The proportion of non-ABO-HDN patients without ABO-HDN requiring exchange/transfusion was significantly higher than that of non-ABO-HDN patients with ABO-HDN(P8) was significantly higher than that in the low titer group (≤8) (P<0.05). There was no significant difference in gender, mother′s history of blood transfusion, pregnancy and whether or not to exchange/transfusion (severity of illness). 【Conclusion】 Understanding the characteristics of non-ABO-HDN and the specific distribution of unexpected antibodies, the correlation between various factors and diseases and their clinical significance are conductive to timely taking necessary intervention measures and reducing the risk of complications.
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【Objective】 To establish a rare blood group information supply platform in Shaanxi Province. 【Methods】 The rare blood group information supply platform consists of sample registration, result registration, donor files and inventory blood. The blood donation codes of voluntary blood donors were recorded for blood typing, and the antigen identification results of each blood group system were registered, all stored in the rare blood type information supply platform. When receiving an application for unusual or rare blood type missing multiple conventional antigens or a certain high-frequency antigen, the corresponding antigen negative blood donors and their blood status (in stock or not) were queried from the donor profile module of the platform, and the inventory of blood of rare blood type was monitored dynamically. 【Results】 The results showed that 5.060% (273/5 398) of rare Rh phenotype donors, 1.540‰ (51/33 010) of donors lacking multiple regular antigens, and 13 O-type donors lacking high-frequency antigens were recorded in the rare blood type information supply platform. Among them, 0.019‰ (3/158 484) of Jk(a-b-) phenotype, 0.436‰ (2/4 586) of Di(a+b-) phenotype, and 4.030‰ (8/1 983) of Fy (a-b+) phenotype were stored in the blood bank for rare blood type. 【Conclusion】 The establishment of rare blood group information supply platform can meet the urgent demand for blood of rare blood types in clinical practice and ensure the safety of blood transfusion.
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【Objective】 To evaluate the application of monoclonal typing reagents and human anti-A/B antibodies for absorption-elution test in ABO grouping. 【Methods】 The specificity of monoclonal typing reagents and human anti-A/B antibodies with standard A, B, O and AB phenotypes at 4 ℃, room temperature, and 37 ℃ were compared. Affinity was evaluated by the titer, agglutination time and agglutination intensity of the reaction with A1/B cells. 29 samples with ABO discrepancy were tested to evaluate the ability of monoclonal typing reagents and human anti-A/B antibodies to detect weak antigens in absorption-elution test. 【Results】 The specificity and affinity of human anti-A/B antibodies are low, and monoclonal typing reagents have cross reactivity. Human anti-A/B antibodies can detect most weak antigens in absorption-elution test with no cross reactivity. 【Conclusion】 In ABO grouping, the human anti A/B antibody binding absorption-elution test can serve as a supplement method for identifying ABO weak antigens. Accurate results can be obtained with reasonable reagents and corresponding methodology in serological tests,thus ensuring the safety of blood transfusion.
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Objective:To summarize the features of stenosis or premature closure of fetal ductus arteriosus and to investigate the perinatal management strategies.Methods:Three cases diagnosed with stenosis or premature closure of fetal ductus arteriosus in Peking University First Hospital between January 2022 and June 2022 were retrospectively enrolled. Clinical features and perinatal management strategies were summarized.Results:Fetal cardiac abnormalities (right heart enlargement and tricuspid regurgitation) were detected in the three cases by routine prenatal ultrasound at the gestational weeks of 24, 30 and 23, respectively. Fetal echocardiography confirmed the diagnosis of stenosis or premature closure of fetal ductus arteriosus and no other structural anomalies were detected. All three pregnant women denied taking non-steroidal anti-inflammatory drugs. Case 1 and case 2 underwent emergency cesarean section due to suspected fetal cardiac dysfunction with a cardiovascular profile score of 6 and 5. The two neonates were transferred to the neonatal intensive care unit and discharged with good prognosis (normal cardiac function) on the 56th and 42nd day after birth. During a close monitoring, the stenosis of fetal ductus arteriosus improved in case 3 and a full-term neonate was delivered at 38 weeks by elective cesarean section because of a history of cesarean section.Conclusions:In the second and third trimesters of pregnancy, attention should be drawn to the fetal ductus arteriosus during ultrasound imaging, especially when right heart enlargement and tricuspid regurgitation were detected. For fetuses with suspected ductus arteriosus stenosis, a close monitor of the ductus arteriosus and the ultrasound findings indicating cardiac dysfunction is needed and the cardiovascular profile score should also be involved. Fetuses with premature closure of the ductus arteriosus should be delivered promptly and the postnatal cardiac outcomes are good.
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Objective:To evaluate the effect of continuous positive airway pressure(CPAP) ventilation strategy during induction of general anesthesia on atelectasis after induction in obese patients.Methods:A total of 86 patients, aged 30-60 yr, with body mass index of 28-35 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱor Ⅲ, scheduled for elective cerebrovascular intervention under general anesthesia, were divided into 2 groups ( n=43 each) using a random number table method: CPAP group (group C) and routine group (group R). Group C received CPAP 5 cmH 2O-assisted ventilation after preoxygenation for spontaneous breathing and disappearance of spontaneous breathing. Chest CT scan and arterial blood gas analysis were performed after entering the operating room (T 1) and 5 min after endotracheal intubation (T 2) to calculate the percentage of atelectasis area and to record PaO 2. Dynamic lung compliance and plateau pressure were recorded at T 2. Mean minute ventilation under controlled breathing, P ETCO 2, and use of vasoactive drugs during induction were recorded. The occurrence of reflux and aspiration during mask ventilation was recorded. The development of pulmonary complications within 3 days after operation was recorded. Results:Compared with group R, the percentage of atelectasis area at T 2 was significantly decreased, PaO 2, dynamic lung compliance and plateau pressure were increased ( P<0.05), and no significant change was found in mean minute ventilation, P ETCO 2, requirement for vasoactive drugs and incidence of pulmonary complications in group C ( P>0.05). No reflux or aspiration was observed during mask ventilation. Conclusions:CPAP (5 cmH 2O) strategy during anesthesia induction can reduce the degree of atelectasis after induction in obese patients.
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Objective:To evaluate the effect of continuous positive airway pressure (CPAP) ventilation during induction of anesthesia on perioperative atelectasis and oxygenation in elderly patients.Methods:Forty-six elderly patients of either sex, aged 65-80 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, undergoing elective cerebrovascular intervention surgery under general anesthesia, were divided into 2 groups ( n=23 each) according to the random number table method: control group (group C) and CPAP ventilation group (group CPAP). During induction of anesthesia, CPAP was set at 5 cmH 2O during spontaneous breathing, and PEEP was set at 5 cmH 2O when spontaneous breathing disappeared, and the ventilation mode was changed to pressure-controlled ventilation (PCV) mode in group CPAP. CPAP was not set, and PEEP was set at 0 cmH 2O for PCV when spontaneous breathing disappeared in group C. During anesthesia maintenance, PCV-volume guaranteed mode was used in both groups, and PEEP was set at 5 cmH 2O. Whole lung CT scanning was performed immediately after radial artery catheterization (T 0), at 1 min after endotracheal intubation (T 1), and before tracheal extubation (T 2) at the end of operation to calculate the percentage of atelectasis area at 1 cm above the right diaphragm. At T 0, T 1, T 2 and 30 min after entering postanesthesia care unit (T 3), blood samples from the radial artery were taken to record PaO 2 and PaCO 2 and calculate the oxygenation index (OI). Results:Compared with the baseline at T 0, the percentage of atelectasis area was significantly increased at T 1 and T 2 in two groups ( P<0.05); PaO 2 was significantly increased at T 1 and T 2 and decreased to T 0 level at T 3, OI was decreased at T 1 and T 2 and increased to T 0 level at T 3 in two groups ( P<0.05). Compared with group C, the percentage of atelectasis area was significantly decreased and PaO 2 and OI were increased at T 1 and T 2 in group CPAP ( P<0.05). There was no significant difference in PaCO 2 at each time point between the two groups ( P>0.05). Conclusions:CPAP ventilation during induction of anesthesia can reduce the development of perioperative atelectasis and improve the oxygenation in elderly patients.
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Objective:To evaluate the effect of propofol on the sensitivity of glioma cells to temozolomide and the role of long noncoding RNAs (lncRNAs)-growth arrest-specific transcript 5 (GAS5) in it.Methods:Human glioma cell line U251 were cultured in vitro and seeded in 6-, 24- or 96-well plates at a density of 1×10 5 cells/ml, and were divided into 5 groups ( n=30 each) using a random number table method: control group (group C), temozolomide group (group T), propofol + temozolomide group (group PT), negative-siRNA + propofol + temozolomide group (group NPT) and GAS5-siRNA + propofol + temozolomide group (group GPT). The U251 cells in group C were cultured in the common culture medium.In group T, temozolomide 400 μmol/L was added to the culture medium.In group PT, the cells were cultured with propofol 8 μg/ml first and then with temozolomide 400 μmol/L.In group NPT and group GPT, U251 cells were transfected with negative-siRNA and GAS5-siRNA, respectively, and then cultured in the same way as previously described in group PT.The expression of lncRNA-GAS5 in U251 cells was detected by quantitative real-time polymerase chain reaction, the cell survival rate was measured by CCK-8 assay, the apoptosis rate was determined by flow cytometry, cell invasion was determined by Transwell invasion assay, and the expression of c-Myc, glutathione S-transferase mu 3 (GSTM3) and P21 was detected by Western blot. Results:Compared with group C, the cell survival rate was significantly decreased, the apoptosis rate was increased, the number of invasive cells was decreased, the expression of c-Myc and GSTM3 was down-regulated, and the expression of P21 and lncRNA-GAS5 was up-regulated in the other four groups ( P<0.05). Compared with group T, the cell survival rate was significantly decreased, the apoptosis rate was increased, the number of invasive cells was decreased, the expression of c-Myc and GSTM3 was down-regulated, and the expression of P21 and lncRNA-GAS5 was up-regulated in group PT and group NPT ( P<0.05). Compared with group PT, the cell survival rate was significantly increased, the apoptosis rate was decreased, the number of invasive cells was increased, the expression of c-Myc and GSTM3 was up-regulated, and the expression of P21 and lncRNA-GAS5 was down-regulated in group GPT ( P<0.05), and no significant change was found in the parameters mentioned above in group NPT ( P>0.05). Conclusions:Propofol can enhance the sensitivity of glioma cells to temozolomide, and the expression of lncRNA-GAS5 is involved in the process.
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Objective:To investigate the effect of diabetes mellitus in the elderly on memory function in patients with mild cognitive impairment(MCI).Methods:Totally 449 community residents were selected for a 2-year follow-up survey.Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)were selected for overall cognitive function assessment.Fuld Object Memory(FOM)and Digital Span Test(DST)were used to evaluate delayed recall and instantaneous memory.Demographic data such as gender, age, education level, marital history, annual income, blood pressure, medical history etc.were collected.The glycosylated hemoglobin, fasting insulin, and carotid artery intima-media thickness were checked regularly.All subjects were grouped into non-diabetes mellitus normal cognitive group(NDM-NC group), non-diabetes mellitus mild cognitive impairment group(NDM-MCI group), diabetes mellitus normal cognitive group(DM-NC group)and diabetes mellitus mild cognitive impairment group(DM-MCI group).Results:In cross-sectional observation, the first, second, and last recall scores in the FOM showed a decreasing trend in the DM-MCI group, showed a word "U" -shaped fluctuation trend in the DM-NC group and the NDM-MCI group, and showed no significant change in the NDM-NC group.There were no significant differences in DST anterior-backward test scores between the DM-MCI group and NDM-MCI group(all P>0.05).Through longitudinal follow-up and two-by-two comparison with the other three groups, the average value of glycosylated hemoglobin in the DM-MCI group(6.78±0.60)% was the highest, and the differences were statistically significant( P<0.05).During follow-up, the average carotid intima-media thickness(CIMT)was higher in the DM-MCI group(1.03±0.20)mm than in NDM-NC group(0.89±0.20)mm( P<0.05), and the difference was statistically significant.Comparing with the other three longitudinal follow-up groups, the CIMT thickening speed in DM-MCI group was fastest. Conclusions:Elderly DM patient population have a higher prevalence of MCI, and their memory function fluctuates or declines significantly.Therefore, regular detection of memory function is conducive to delaying the progression of DM and MCI.
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Objective@# To investigate the incidence and trends in incidence of stroke among residents in Lianyungang City, Jiangsu Province from 2014 to 2020, so as to provide insights into stroke control. @*Methods@#The stroke morbidity data in Lianyungang City from 2014 to 2020 were captured from Lianyungang Municipal System for Monitoring of Cardiovascular and Cerebrovascular Diseases, and standardized by the sixth national population census data in China in 2010. The trends in stroke incidence were evaluated using average annual percentage change (AAPC), and the gender-, age-, region- and disease type-specific incidence and trends in incidence of stroke were descriptively analyzed. @*Results@#Totally 162 423 new stroke cases were diagnosed in Lianyungang City from 2014 to 2020 new case, and the annual mean crude and standardized incidence rates were 435.32/105 and 357.28/105, which both appeared a tendency towards a rise (AAPC=12.61%, t=39.098, P<0.001; AAPC=9.91%, t=6.123, P<0.001) . The standardized incidence of stroke was significantly higher in men than in women (389.63/105 vs. 327.17/105; χ2=4.056, P=0.044). The crude incidence of stroke appeared a tendency towards a rise with age among residents (χ2trend=258.219, P<0.001), and appeared a tendency towards a rise among residents at ages of <35 (AAPC=22.52%, t=6.723, P<0.001), 35 to 64 (AAPC=9.78%, t=7.867, P<0.001) and 65 years and older (AAPC=10.24%, t=5.156, P<0.001). The crude incidence was higher in rural areas than in urban areas (437.72/105 vs. 425.31/105; χ2=20.709, P<0.001). Ischemic stroke was the predominant type (139 680 cases, 86.00% of all cases), and both the crude and standardized incidence appeared a tendency towards a rise (AAPC=13.79%, t=16.865, P<0.001; AAPC=10.88%, t=5.128, P<0.001). @*Conclusion@# The incidence of stroke appeared a tendency towards a rise among residents living in Lianyungang City from 2014 to 2020. Men, middle-age and elderly residents and rural residents are high-risk populations for stroke control.
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BACKGROUND@#Gene promoter methylation is a major epigenetic change in cancers, which plays critical roles in carcinogenesis. As a crucial regulator in the early stages of B-cell differentiation and embryonic neurodevelopment, the paired box 5 (PAX5) gene is downregulated by methylation in several kinds of tumors and the role of this downregulation in esophageal squamous cell carcinoma (ESCC) pathogenesis remains unclear.@*METHODS@#To elucidate the role of PAX5 in ESCC, eight ESCC cell lines, 51 primary ESCC tissue samples, and eight normal esophageal mucosa samples were studied and The Cancer Genome Atlas (TCGA) was queried. PAX5 expression was examined by reverse transcription-polymerase chain reaction and western blotting. Cell apoptosis, proliferation, and chemosensitivity were detected by flow cytometry, colony formation assays, and 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide assays in ESCC cell lines with PAX5 overexpression or silencing. Tumor xenograft models were established for in vivo verification.@*RESULTS@#PAX5 methylation was found in 37.3% (19/51) of primary ESCC samples, which was significantly associated with age (P = 0.007) and tumor-node-metastasis stage (P = 0.014). TCGA data analysis indicated that PAX5 expression was inversely correlated with promoter region methylation (r = -0.189, P = 0.011 for cg00464519 and r = -0.228, P = 0.002 for cg02538199). Restoration of PAX5 expression suppressed cell proliferation, promoted apoptosis, and inhibited tumor growth of ESCC cell lines, which was verified in xenografted mice. Ectopic PAX5 expression significantly increased p53 reporter luciferase activity and increased p53 messenger RNA and protein levels. A direct interaction of PAX5 with the p53 promoter region was confirmed by chromatin immunoprecipitation assays. Re-expression of PAX5 sensitized ESCC cell lines KYSE150 and KYSE30 to fluorouracil and docetaxel. Silencing of PAX5 induced resistance of KYSE450 cells to these drugs.@*CONCLUSIONS@#As a tumor suppressor gene regulated by promoter region methylation in human ESCC, PAX5 inhibits proliferation, promotes apoptosis, and induces activation of p53 signaling. PAX5 may serve as a chemosensitive marker of ESCC.
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Animals , Humans , Mice , Carcinoma, Squamous Cell/genetics , Cell Line, Tumor , Cell Proliferation/genetics , Epithelial Cells/metabolism , Esophageal Neoplasms/genetics , Esophageal Squamous Cell Carcinoma/genetics , Gene Expression Regulation, Neoplastic , PAX5 Transcription Factor/genetics , Tumor Suppressor Protein p53/genetics , Xenograft Model Antitumor AssaysABSTRACT
【Objective】 To observe the distribution of the unexpected antibodies in order to study the safety and strategies in 1 779 cases of clinical blood transfusion. 【Methods】 A total of 1 779 patients with unexpected antibodies were enrolled from transfusion candidates in various hospitals in Xi′an during a 10-year period(from 2012 to 2022.5). 【Results】 The unexpected antibodies were detected in 926(52.05%) of 1779 samples. The detected antibodies were mainly from 8 blood group systems and their distributions were as follows: Rh antibodies in 69.76%(646/926), Kidd in 2.59%(24/926), Lewis in 4.21%(39/926), MNS in 12.53%(116/926), P in 0.43%(4/926), Diego in 0.65%(6/926), Duffy in 0.54%(5/926), I in 0.97%(9/926), Rh+ MNS in 1.30%(12/926), Rh+ Lewis in 0.65%(6/926), Rh+ Kidd in 3.24%(30/926), Rh+ Diego in 1.51%(14/926), Rh+ Duffy in 0.86%(8/926), MNS+ Diego in 0.11%(1/926), Rh+ MNS+ Kidd in 0.22%(2/926), Rh+ Lewis+ Kidd in 0.22%(2/926), Rh+ Kidd+ P in 0.11%(1/926), Rh+ Kidd+ Diego in 0.11%(1/926). 【Conclusion】 According to the distribution of unexpected antibodies in Xi′an, antibodies from Rh system, were the most common ones.First, the production of unexpected antibodies can be effectively reduced by establishing Rh compatible blood transfusion. Secondly, antibody screen cells containing low-frequency antigens, such as Mur, Dia and Wra, should be reasonably selected to prevent missing detection of anti-low frequency antigen antibodies in Xi′an. Furthermore, the genotyping technology of rare blood group should be promoted and a rare blood group red blood cell bank be established to optimize the blood inventory and ensure the safety of blood transfusion.
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【Objective】 To screen individuals with rare blood type of Kidd, Diego, Duffy blood group system among the voluntary blood donor in Shaanxi province and to establish on-line and physical database of rare blood type. 【Methods】 Jk(a-b-)phenotype donors were screened by 2 mol/L urea hemolysis test. Blood donors with Di(a+ b-) phenotype were screened by genotyping; Fy(a-) and D-- phenotype donors were screened by modified antiglobulin assay. 【Results】 Three cases of Jk(a-b-) phenotype were detected out of 158 484 voluntary blood donors. The distribution frequency of Jk(a-b-) phenotype was 0.019‰. Di(a+ b-) phenotype was detected in 2(0.436‰) cases out of 4 586 voluntary blood donor. Fy(a-) phenotype was detected in 8(4.034‰) cases out of 1 983 voluntary blood donors. D-- phenotype was not detected in 29 430 voluntary blood donors. 【Conclusion】 The on-line database of Kidd, Diego, Duffy blood group system had been established by large-size screening of blood donor samples, which can conclude the region′s population distribution and genetic characteristics of RBC blood group. And physical database could further be established using the technology of red blood cells cryopreservation when the conditionspermit, so as to provide the most compatible blood for the clinical effectively improve blood transfusion safety, and provide data support for blood early warning.
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Objective:To understand the social networking using status of medical students, develop the social networking using status scale (SNUSS) and evaluate its reliability and validity.Methods:In March 2018, 665 valid questionnaires were collected via cluster sampling. The scale was retest in 46 subjects after an interval of 2 months. Factor analysis, correlation analysis and t-test were used to calculate the structure validity and content validity of the scale to evaluate the scale validity, and internal consistency reliability, broken half reliability and retest reliability were used to evaluate the scale reliability. Results:The result of exploratory factor analysis showed NSUSS had two subscales: the dimension of maintaining existing social relations and social network use and the dimension of expanding circle of friends and social network use. The result of confirmatory factor analysis showed that the factor load value of each item was greater than 0.500 ( P < 0.05), and the model fitted well ( χ2/ df = 2.873, GFI = 0.970, CFI = 0.971, RMSEA = 0.074). The r value of correlation between SNUSS and MSPSS was 0.295. I-CVIs were all equal to 0.90, and S-CVI was 0.90, the internal consistency reliability was 0.764, the split-half reliability was 0.555, and the retest reliability was 0.526. Conclusion:SNUSS has good reliability and validity for the use of social network among medical college students, and the use of social network is related to perceived social support.
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Objective:To assess the correlation between circulating chemerin and two indicators of renal function, estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR), in individuals with type 2 diabetes and to determine whether chemerin is an independent marker of early renal insufficiency.Methods:A total of 742 patients with type 2 diabetes were recruited into the cross-sectional community study. Basic information, anthropometric parameters, and biochemical parameters of these individuals were determined and collected, and serum chemerin level was measured using enzyme-linked immunosorbent assay.Results:Chemerin levels were significantly higher in the eGFR-impaired group compared with eGFR-normal group, and macroalbuminuria group compared to the normal or microalbuminuria groups. Spearman′ rank correlation analysis showed serum chemerin level was correlated with eGFR ( r=-0.25, P<0.001), UACR ( r=0.23, P<0.001) and some other biochemical indicators such as triglyceride. And univariate and multivariate logistic regression analyses revealed circulating chemerin was an independent risk factor for eGFR impairment or proteinuria after adjusting corresponding covariates. Receiver operating characteristic (ROC) curve analysis showed that the area under curve (AUC) of circulating chemerin for predicting early impaired eGFR in type 2 diabetes was 0.747, while the AUC of circulating chemerin for predicting macroalbuminuria in type 2 diabetes was 0.748. Conclusion:Circulating chemerin is associated with eGFR or UACR and may be a potential diagnostic marker for early renal insufficiency in type 2 diabetes.
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Objective:To evaluate the effect of edaravone on renal injury in rats with aldosterone-induced hypertension.Methods:Twenty-four clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-220 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (S group), hypertension group (H group) and edaravone group (E group). The hypertension model was developed by subcutaneously embedding aldosterone osmotic pump (administration rate 0.75 μg·kg -1·h -1) for 4 weeks.After embedding osmotic pump subcutaneously, edaravone 10 mg/kg was injected via the tail vein every day for 4 consecutive weeks in E group, while normal saline 10 ml/kg was injected instead for 4 consecutive weeks in H group.BP-2010A noninvasive manometry device was used to measure the systolic pressure of tail artery before embedding osmotic pump and at 1, 2, 3 and 4 weeks after administration.After 4 weeks of administration, the 24 h urinary albumin concentration, plasma creatinine (Cr) and blood urea nitrogen (BUN) concentrations were measured, the bilateral kidneys were weighed, the right kidney weight/body weight ratio (RKW/BW) was calculated, the glomerular extramesangial matrix area/glomerular area ratio (M/G) was measured by PAS method, and the collagen volume fraction (CVF) was measured by Masson staining method, and the expression of aldosterone receptor (MCR) and type Ⅰ collagen in renal tissues was detected by Western blot. Results:Compared with group S, the systolic pressure was significantly increased, the concentrations of 24-h urinary albumin, plasma Cr and BUN were increased, the RKW/BW ratio, M/G and CVF were increased, and the expression of type Ⅰ collagen and MCR was up-regulated after embedding osmotic pump in group H ( P<0.05). Compared with group H, the systolic pressure was significantly decreased, the concentrations of 24-h urinary albumin, plasma Cr and BUN were decreased, the RKW/BW ratio, M/G and CVF were decreased, and the expression of type Ⅰ collagen and MCR was down-regulated after embedding osmotic pump in group E ( P<0.05). Conclusions:Edaravone can reduce renal injury in rats with aldosterone-induced hypertension, and the mechanism is related to down-regulation of MCR expression.
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Objective To analyze 10 years survival status of urban female patients with corpus uteri cancer and its influencing factors in Liaoning Province. Methods Based on Liaoning cancer register database, 426 patients with corpus uteri cancer in Shenyang, Anshan and Benxi from 2000 to 2002 were randomly selected. They were followed up passively and actively. Life table method and Ederer Ⅱ method were used to calculate the observed survival rate (OSR), the expected survival rate (ESR) and the relative survival rate (RSR). Results We finally included 218 corpus uteri patients. The diagnosis proportions of stage Ⅰ-Ⅳ were 59.2%, 11.5%, 11.0% and 8.7%, respectively. Ten-year RSR and OSR were 59.6% and 67.9%. The diagnosis stage was negatively correlated with 10-year RSR. The 10-year RSR of patients treated with surgery was 71.3%, which was 6.6 times that of non-surgical treatment (10.8%). The 1-year RSR to 10-year RSR ranged from 88.4% to 67.5%. The RSR of each stage was Ⅰ-Ⅱ(95.7%-77.9%) > Ⅲ (71.4%-44.5%) > Ⅳ (58.4%-11.0%). Multivariate Cox model analysis showed that age > 55 years old, late diagnosis stage and non-surgical treatment were the main factors affecting the 10-year survival rate. Conclusion Early diagnosis and surgical treatment can significantly improve the long-term survival rate of patients. Therefore, we should strengthen the early detection and treatment of corpus uteri cancer, standardize and strengthen the screening program.
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Objective:Through the analysis of the evaluation index system of the major rankings of universities and hospitals, this paper aims to provide a reference for the discipline construction of affiliated hospitals in universities.Methods:This paper comprehensively analyzes and compares the evaluation objectives and indicators of the five major rankings of universities and the three major rankings of hospitals in China and abroad.Results:Each main rankings have its own characteristics that both positive and with possible limitations.Conclusions:Hospital management departments can refer certain indicators in order to identify possible gaps of the hospital discipline development. Also, tailored corresponding measurements for discipline development can be developed in combination with real-needs.
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Sixty general practitioners of in-service training undertaking rotation in gastroenterology department of Qingdao Municipal Hospital from July 2017 to July 2019 were randomized assigned in trial group ( n=30) and control group ( n=30). The problem-oriented mode was applied in trial group and conventional mode was applied in control group for teaching of two typical digestive diseases (upper gastrointestinal bleeding and acute pancreatitis). The formative evaluation and questionnaire survey were used to compare the teaching effects and the results of evaluation were compared with χ 2 test by SPSS 17.0 between two groups. The excellent and good rates of evaluation for the clinical psychological quality, clinical reasoning ability, doctor-patient communication ability and practice-based learning and improvement ability in trial group were significantly higher than those in the control group(χ2=7.38, P=0.03; χ2=12.96, P<0.01; χ2=23.33, P<0.01; χ2=16.14, P<0.01). Questionnaire survey showed more satisfaction towards teaching method in trial group was higher than that in control group(χ2=12.86, P<0.01); and the clinical reasoning ability, learning initiative and self-confidence in trial group were improved more markedly than those in control group(χ2=8.26, P=0.02; χ2=19.48, P<0.01; χ2=21.46, P<0.01). The problem-oriented clinical thinking teaching model demonstrates good effects on clinical comprehensive ability for general practitioners of in-service training during gastroenterology rotation, which is worth further promotion.
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Objective:To determine the median effective dose (ED 50) of 0.5% ropivacaine when combined with dexmedetomidine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block. Methods:American Society of Anesthesiologists physical statusⅠor Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 20-30 kg/m 2, scheduled for elective open reduction and internal fixation for patella fracture or removal of patella fracture by internal fixation, were randomly divided into dexmedetomidine and ropivacaine group (group DR) and ropivacaine group (group R). In group DR, 0.5% ropivacaine and 0.5 μg/kg dexmedetomidine were injected.In group R, 0.5% ropivacaine was injected.Ultrasonic localization of femoral nerve was performed for measurement of the femoral nerve cross-sectional area, and 0.5% ropivacaine was injected based on the area.ED 50 was determined by Dixon′ s up-and-down sequential method.The initial dose was 0.22 ml/mm 2, and the difference between the two successive doses was 0.02 ml/mm 2.The effective block was defined as complete loss of pain sensation in the areas of anterior skin of knee joint, skin on the inner side of the calf and dorsal medial skin of the foot and the degree of motor block was in stages 1-3 assessed using Brunnstrom motor function within 30 min after nerve block.Nerve block was considered ineffective if pain occurred in any nerve distribution area mentioned above.The study was terminated if 7 effective and ineffective alternating waves occurred.ED 50 and 95% confidence interval (CI) were calculated using Probit analysis. Results:In group R, 27 patients were enrolled in the study, and ED 50 (95%CI) of 0.5% ropivacaine for ultrasound-guided femoral nerve block was 0.106 (0.069-0.125) ml/mm 2.In group DR, 23 patients were enrolled in the study, and ED 50 (95% CI) of 0.5% ropivacaine for ultrasound-guided femoral nerve block was 0.038 (0.011-0.059) ml/mm 2.Compared with group R, ED 50 of 0.5% ropivacaine for femoral nerve block was significantly decreased in group R. Conclusion:When combined with dexmedetomidine 0.5 μg/kg, ED 50 of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block is 0.038 ml/mm 2.
ABSTRACT
Objective:To determine the median effective dose (ED 50) of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block. Methods:Patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status I or Ⅱ, with body mass index of 20-30 kg/m 2, scheduled for elective open reduction and internal fixation for patella fracture or removal of patella fracture by internal fixation, were enrolled in this study.Ultrasonic localization of femoral nerve was performed for measurement of the femoral nerve cross-sectional area, and 0.5% ropivacaine was injected based on the area.ED 50 was determined by Dixon′s up-and-down sequential method.The initial dose was 0.22 ml/mm 2, and the difference between the two successive doses was 0.02 ml/mm 2.The effective block was defined as complete loss of pain sensation in the areas of anterior skin of knee joint, skin on the inner side of the calf and dorsal medial skin of the foot and the degree of motor block was in stages 1-3 assessed using Brunnstrom motor function within 30 min after nerve block.Nerve block was considered ineffective if pain occurred in any nerve distribution area mentioned above.The study was terminated if 7 effective and ineffective alternating waves occurred.ED 50 and 95% confidence interval (CI) were calculated using Probit analysis. Results:Twenty-seven patients were enrolled in the study with the femoral nerve cross-sectional area (75±5) mm 2.ED 50 (95%CI) of 0.5% ropivacaine for ultrasound-guided femoral nerve block was 0.106 (0.069-0.125) ml/mm 2. Conclusion:ED 50 of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block is 0.106 ml/mm 2.