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Reasonable intra-hospital hierarchical diagnosis and treatment system will effectively guide the patients to see a doctor on demand and improve the efficiency of medical services. Beijing Tongren Hospital, Capital Medical University, has explored the intra-hospital hierarchical diagnosis and treatment system depending on different situatioins such as for new patients, subsequent visit patient, and the same patients with different clinical stage. Through establishing a series of intra-hospital hierarchical diagnosis and treatment modes, such as the well-known expert team, the outpatient service for specialized diseases, the multidisciplinary outpatient service for complex diseases, the nursing service, and the pharmaceutical care service, the outpatients could be oriented by specialties and disciplines and graded by the complexity in diagnosis and treatment of diseases. Relying on the appointment methods such as referral and revisit to open up the information channel, it can optimize the time cost and economic cost of patients, reflect the functional positioning of the tertiary hospitals, and improve patients′ sense of medical access and happiness.
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Epidemiological evidence suggests that patients with hypertension infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at increased risk of acute lung injury. However, it is still not clear whether this increased risk is related to the usage of renin-angiotensin system (RAS) blockers. We collected medical records of coronavirus disease 2019 (COVID-19) patients from the First Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China), and evaluated the potential impact of an angiotensin II receptor blocker (ARB) on the clinical outcomes of COVID-19 patients with hypertension. A total of 30 hypertensive COVID-19 patients were enrolled, of which 17 were classified as non-ARB group and the remaining 13 as ARB group based on the antihypertensive therapies they received. Compared with the non-ARB group, patients in the ARB group had a lower proportion of severe cases and intensive care unit (ICU) admission as well as shortened length of hospital stay, and manifested favorable results in most of the laboratory testing. Viral loads in the ARB group were lower than those in the non-ARB group throughout the disease course. No significant difference in the time of seroconversion or antibody levels was observed between the two groups. The median levels of soluble angiotensin-converting enzyme 2 (sACE2) in serum and urine samples were similar in both groups, and there were no significant correlations between serum sACE2 and biomarkers of disease severity. Transcriptional analysis showed 125 differentially expressed genes which mainly were enriched in oxygen transport, bicarbonate transport, and blood coagulation. Our results suggest that ARB usage is not associated with aggravation of COVID-19. These findings support the maintenance of ARB treatment in hypertensive patients diagnosed with COVID-19.
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme 2/blood , Antibodies, Viral/blood , Antihypertensive Agents/therapeutic use , Biomarkers , COVID-19/complications , China , Hypertension/drug therapy , Intensive Care Units , Length of Stay , Retrospective Studies , Transcriptome , Viral LoadABSTRACT
Objective:To analyze the characteristics of stress symptoms before and after surgery in adolescent idiopathic scoliosis (AIS) patients and their correlation with postoperative pain.Methods:Fifty-four AIS patients aged 13-18 years from January 2015 to June 2018 in Foshan Traditional Chinese Medicine Hospital were selected. The anxiety, stress and stress symptoms of the patients before and 6 months after operation were assessed by the Trauma Symptom Checklist for Children-Alternative version (TSCC-A) and the Youth Self-Report (YSR). The pain was assessed by Visual Analogue Scale. The correlation between the stress symptoms of the patients and postoperative pain were analyzed by linear regression equation.Results:The score of anxiety/depression and internalization problems in YSR before operation was (5.40±2.48) and (12.19±4.67) respectively, and 6 months after operation, the score was (4.10±1.92) and (9.81±3.46) respectively, there were significant differences between preoperative and 6 months after operation ( t value was 7.266, 8.107, P < 0.05). Before operation, the scores of anger in TSCC-A, the scores of social problems and attention problems in YSR were positively correlated with postoperation pain ( P < 0.05), while postoperation pain was positively correlated with the scores of anxiety in TSCC-A, the scores of social problems and attention problems in YSR 6 months after operation ( P < 0.05). Conclusions:Preoperative stress symptoms of AIS patients are associated with postoperative pain, while postoperative pain is associated with postoperative recovery anxiety. Preoperative intervention should be actively taken to reduce perioperative stress symptoms and postoperative pain, so as to further improve the quality of nursing.
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Objective@#To analyze the characteristics of stress symptoms before and after surgery in adolescent idiopathic scoliosis (AIS) patients and their correlation with postoperative pain.@*Methods@#Fifty-four AIS patients aged 13-18 years from January 2015 to June 2018 in Foshan Traditional Chinese Medicine Hospital were selected. The anxiety, stress and stress symptoms of the patients before and 6 months after operation were assessed by the Trauma Symptom Checklist for Children-Alternative version (TSCC-A) and the Youth Self-Report (YSR). The pain was assessed by Visual Analogue Scale. The correlation between the stress symptoms of the patients and postoperative pain were analyzed by linear regression equation.@*Results@#The score of anxiety/depression and internalization problems in YSR before operation was (5.40±2.48) and (12.19±4.67) respectively, and 6 months after operation, the score was (4.10±1.92) and (9.81±3.46) respectively, there were significant differences between preoperative and 6 months after operation (t value was 7.266, 8.107, P < 0.05). Before operation, the scores of anger in TSCC-A, the scores of social problems and attention problems in YSR were positively correlated with postoperation pain (P < 0.05), while postoperation pain was positively correlated with the scores of anxiety in TSCC-A, the scores of social problems and attention problems in YSR 6 months after operation (P < 0.05).@*Conclusions@#Preoperative stress symptoms of AIS patients are associated with postoperative pain, while postoperative pain is associated with postoperative recovery anxiety. Preoperative intervention should be actively taken to reduce perioperative stress symptoms and postoperative pain, so as to further improve the quality of nursing.
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Specialist training following the standardized residency training in China lacks corresponding regulations as yet, while the fellow training system of the US can serve as a useful reference. Since 2014, the Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, has begun a trial of training system of fellows with clear training objectives, detailed training plans, one-to-one guidance from clinical tutors, strict admission and completion criteria, and detailed assessment methods. The 13 doctors completing the training program were surveyed by questionnaires.From the perspective of the number of operations performed and that of papers published, both the clinical and scientific research training of fellows have been fully guaranteed. The self-evaluation results showed that the clinical thinking, clinical ability and clinical self-confidence of them were well improved. The satisfaction with the training system of fellows was high. It was expected to provide a reference for the establishment of the training system of specialist in China.
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Objective To compare the effects of two kinds of lidocaine gel indwelling catheter on male patients with general anesthesia during recovery period. Methods A total of 90 cases of male patients with general anesthesia were selected and divided into experimental group and control group by random digits table method,45 cases in each group. The experimental group was given lidocaine gel injection indwelling catheter urethral surface anesthesia, the control group will lidocaine gel evenly to the catheter indwelling catheter. The incidence of catheter related bladder irritation and restlessness were observed during the recovery period of general anesthesia. Results The incidence of catheter related bladder irritation in grade 0, I, II, III during the recovery period of general anesthesia were 28, 14, 3, 0 cases in the experimental group and 7, 23, 12, 3 cases in the control group, there was significant difference between 2 groups (Z=1500, P<0.01). The incidence of restlessness in grade 0, I, II and III during the recovery period of general anesthesia were 27, 18, 0 and 0 cases, respectively in the experimental group and 7, 20, 9, and 9 cases in the control group, respectively. The difference between the 2 groups was statistically significant (Z=1435.5, P<0.01). Conclusions Lidocaine gel injection into the urethra surface anesthesia can effectively improve the comfort of male patients during the recovery period of general anesthesia.
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To observe the effects of sophoricoside and genistein on the biological characteristics of osteoblasts.
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OBJECTIVE To investigate the rate of the clinical isolation of ESBLs positive Escherichia coli and the resistance in intensive care units(ICU).METHODS We isolated E.coli from 2003 to 2004 in our hospital ICU,phenotypic confirmatory test was applied to detect ESBLs.Bacterial drug susceptibility test was performed by standard Kirby-Bauer method.RESULTS The isolation rate of ESBLs positive E.coli was 74.36% in 2003 and 81.58% in 2004.ESBLs positive bacteria had high resistance to antibacterial drugs,but the resistance rate did not rise.ESBLs negative bacteria were more susceptible to antibacterial drugs(P=0.001);but ESBLs negative bacteria in 2004 had higher resistance than in 2003(?2=84.511,P=0.001).CONCLUSIONS It is very important for ICU to use ESBLs detection test in time,and antibacterial drugs in reason.
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<p><b>OBJECTIVE</b>To observe the effects of dexamethasone on proliferation, differentiation and apoptosis of adult human osteoblasts in vitro.</p><p><b>METHODS</b>Iliac trabecular bone specimens were obtained from adult patients undergoing necessary surgery. After the bone pieces were digested with collagenase-trypsin, osteoblasts were released and incubated at 37 degrees C in a relative humidity of 95% and 5% CO2. Then, the cells were purified, and their passages were given DMEM-F12 and fetal bovine serum medium. Subsequently, 10(-8) mol/L dexamethasone was added into the culture medium to incubate the osteoblasts for three days, and the cells from control groups were incubated without any drugs. All cells were observed continually with phase contrast microscope and transmission electron microscope. Finally, apoptosis was detected by the use of terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) and biochemical indices, alkaline phosphatase (ALP) and osteocalcin (OCN) were used to determine the effects of dexamethasone on proliferation, differentiation and apoptosis of adult osteoblasts in vitro.</p><p><b>RESULTS</b>In the adult osteoblasts obtained by collagenase-trypsin digestion, it achieved high survival, stable biochemical indices and excellent purification. Under the condition of dexamethasone 10(-8) mol/L and osteoblasts 10,000/ml, there was significant promotion of ALP and OCN secretion without cell apoptosis.</p><p><b>CONCLUSIONS</b>Dexamethasone has a significant effect on the proliferation and differentiation of adult osteoblasts in vitro without apoptosis, and dexamethasone at the suggested concentration can be used as positive control in drug studies for osteoporosis treatment.</p>
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Adult , Humans , Apoptosis , Cell Differentiation , Cell Division , Cells, Cultured , Dexamethasone , Pharmacology , In Situ Nick-End Labeling , Osteoblasts , Cell BiologyABSTRACT
OBJECTIVE: To analyze the relationship of the height difference and bone density (BD) of premenopausal and postmenopausal women. METHODS: The height values of 191 premenopausal and postmenopausal women were recorded, and the BD values of lumbar vertebrae and hip were detected by double energy X-ray BD detector. RESULTS: The lower the height of the postmenopausal women, the less the BD value. The BD of lumbar vertebrae dropped 0.025 5 g/cm(2) with each 2 cm of the shortened height, and the BD of hip joint dropped 0.029 2 g/cm(2). The shortened value in postmenopausal women with osteoporosis was statistically greater than that in postmenopausal women without osteoporosis. CONCLUSION: The BD of the postmenopausal women can be estimated by the calculation of their shortened height value.
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To evaluate the potential preventive effect of Sophoricoside on bone loss in ovariectomized rats.
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AIM: To investigate the effect of 188Re labeled monoclonal antibody on prostatic specific membrane antigen 7E11C5.3,radioimmunotherapy for the treatment of human prostate cancer cell line LNCaP in vitro.METHODS: 188Re-7E11C5.3 was prepared by direct 2-mercaptoethanol reduction method.Labeling efficiency and radiochemical purity was measured by paper chromatography.Immunoreactive fraction was determined by linear extrapolation.Cytotoxicity to LNCaP cells was determined by MTT assay.RESULTS: The labeling yield of 188Re-7E11C5.3 was(93.16?2.18)%,the radiochemical purity was(95.62?0.48)%,and the immunoreactive fraction was(74.86?1.86)%.The inhibitory effect of 188Re-7E11C5.3 on cell proliferation of LNCaP cells was significantly higher than that of 188Re-mIgG or 188ReO-4.The 50% inhibitory doses(IC50) of 188Re-7E11C5.3,188Re-mIgG,and 188ReO-4 were(23.38?3.73)?107 Bq/L,(59.21?8.02)?107 Bq/L and(68.89?10.91)?107 Bq/L,respectively.CONCLUSION: 188Re-7E11C5.3 can effectively inhibit the growth of in vitro cultured prostate cancer cells and shows much potential for prostate cancer radioimmunotherapy.
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Objective To explore the change of the red blood cell(RBC) immunoadhensive function in children with asthma and the effect of glucocorticoid on RBC immunoadhensive function.Methods The rosette rate of RBC-C3b receptor(RBC-C3bRR) and rosette rate of RBC-Immunocomplex(RBC-ICR) were measured by using yeast rosette method in 42 children with asthma,20 healthy children(control group),and 28 asthmatic children in remission period were measured also by the same methods after one month and six months of glucocorticoid inhalation therapy.Results The levels of RBC-C3bRR were lower in asthma group than that in remission group and control group(P0 05).Conclusions RBC immunoadhensive function has shown significant decrease in asthmatic children;and it may be improved by using glucocorticoid inhalation therapy in asthmatic children at remission period.