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Objective:To explore the factors influencing the clinical outcome of complex high-risk indicated patients percutaneous coronary intervention (CHIP-PCI) assisted by extracorporeal membrane oxygenation (ECMO).Methods:The clinical data of patients with CHIP-PCI assisted by ECMO in the First Affiliated Hospital of Zhengzhou University from April 2018 to April 2022 were retrospectively collected and analyzed. Patients were divided into the survival and death groups according to the in-hospital survival status. The baseline characteristic, the results of coronary angiography, and the use of ECMO, blood products and drug were compared between the two groups. The 24-h rate of change of biochemical test indicators after the use of ECMO were calculated and the univariate analysis was analyzed using rank sum test. According to the univariate analysis, the variables ( P<0.05) were included in multivariate logistic regression to analyze the factors affecting the clinical outcomes of patients. Results:A total of 67 CHIP patients who completed PCI with ECMO were included. In the survival group ( n=36), the duration of ECMO treatment was 59 (41, 87) h, 9 cases received continuous renal replacement therapy, and 11 cases received IABP. In the death group ( n=31), the duration of ECMO treatment was 31 (19, 80) h, 12 cases received continuous renal replacement therapy and10 cases received IABP. The proportion of patients with chronic total occlusion lesions (CTOs) in the survival group was lower than that in the death group, the duration of ECMO of the survival group was longer than that of the death group ( P<0.05). Multivariate logistic regression analysis showed that 24-h lactate change rate ( OR=2.864, 95% CI: 1.185-6.918, P=0.019), 24-h eGFR change rate ( OR=0.050, 95% CI: 0.003-0.871, P=0.040), 24-h D-dimer change rate ( OR=1.497, 95% CI: 1.044-2.146, P=0.028) and 24-h direct bilirubin change rate ( OR=2.617, 95% CI: 1.121-6.111, P=0.026) were associated with in-hospital mortality. Conclusions:Within 24 h after CHIP-PCI assisted by ECMO, the rapid decline in lactic acid, D-dimer and direct bilirubin, and the rapid recovery of eGFR, are associated with the decreased risk of hospital mortality from CHIP.
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OBJECTIVE：To study the ecological suitability zoning of Astragalus membranaceus var. mongholicus in Dingxi city. METHODS ：Taking 1 001 batches of A. membranaceus var. mongholicus in Dingxi city as the investigation samples （each natural village with A. membranaceus var. mongholicus cultivation as the collection unit ），the longitude and latitude information of them were obtained from Dingxi economic crop technology promotion station ，and 55 environmental ecological factors （including climate，terrain，soil，etc.）were obtained from the Grid Database of Spatial Information of TCM Resources . Combined with the information of longitude ，latitude and environmental ecological factors ，the maximum entropy model （MaxEnt model ） was established with 75％ samples as the training set ，and the main ecological factors were screened out ，and 25％ samples were set as the validation set for model validation. Then the suitable growing areas of A. membranaceus var. mongholicus were divided by using ArcGIS. RESULTS ：Established MaxEnt model had good prediction （the area under the working characteristic curve of subjects in training set and verification set was 0.970 and 0.968）. Eight main ecological factors ，such as altitude ，precipitation and temperature ， were selected （the total contribution rate was 98.90％）. The comprehensive analysis found that the altitude was 1 800 to 2 650 m， the average precipitation in April was 25 to 50 mm，the lowest temperature of the coldest month was －16 to －8 ℃，the wettest monthly precipitation was 95 to 110 mm，and the seasonal variation of temperature was 70 to 80，the average temperature in December was －6 to －3 ℃ ，the average precipitation in October was 30 to 50 mm，and the average precipitation in December was 0 to 10 mm，which was the suitable environmental parameter for the growth of A. membranaceus var. mongholicus in Dingxi city. Based the results of ArcGIS analysis ，in Dingxi city ，A. membranaceus var. mongholicus was generally suitable for growth ；in the northwest of Lintao county ，the north of Anding district ，the south of Tongwei county ，a small area in the south of Longxi county and the south of Minxian county ，the border between Weiyuan county ，Zhangxian county and Minxian county ，A membranaceus var. mongholicus was not suitable for growth. CONCLUSIONS： Ther results of established model is in E-mail：961308817@qq.com line with the actual investigation ， can provide reference for the planting regional planning of A. membranaceus var. mongholicus in Dingxi city.
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Objective@#To investigate the effects of single-chamber balloon combined with dinoprostone suppository on the progestation of the cervix in full-term maternal delivery.@*Methods@#From January 2017 to December 2018, 120 cases of full-term maternal women admitted to the Central Hospital of Yiwu were selected.According to the random number table method, all women were divided into control group (60 cases) and observation group (60 cases). The control group was given a single-cavity balloon to promote cervical ripening.The observation group received single-chamber balloon combined with dinoprostone to promote cervical ripening.The effects of maternal cervical ripening were observed.@*Results@#The total effective rate of maternal cervical ripening in the observation group (95.00%) was significantly higher than that in the control group (81.67%), and the difference was statistically significant (χ2=6.135, P<0.05). The differences of maternal postpartum hemorrhage and neonatal asphyxia rate were not statistically significant (t=1.684 , χ2=2.563, all P>0.05). The total maternal labor [(5.8±2.1)h] in the observation group was significantly shorter than that in the control group [(7.6±2.5)h], the difference was statistically significant (t=3.126, P<0.05). The vaginal delivery rate (95.00%) of the observation group was higher than that of the control group (73.33%), the difference was statistically significant (χ2=5.342, P<0.05). Before implanting the balloon and balloon combination, the Bishop score between the two groups had no statistically significant difference (t=3.623, P>0.05). After the balloon and balloon combination were taken out, the Bishop score of the maternal cervix[(8.6±1.5)points] in the observation group was higher than that in the control group [(7.2±1.3)points], and the difference was statistically significant (t=4.354, P<0.05). The incidence of adverse reaction of the observation group (6.67%) was lower than that of the control group (13.33%), the difference was statistically significant between the groups(χ2=3.821, P<0.05).@*Conclusion@#Compared with simple single-chamber balloon, single-chamber balloon combined with dinoprostone suppository has more significant effect on the maternal ripening of the cervix, it can improve the vaginal delivery rate and maternal cervical Bishop scores, effectively reduce the maternal total labor, and reduce the incidence of maternal adverse reactions.
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OBJECTIVE： To investigate the effects of Dendrobium officinale polysaccharides on gene expression profile of HUVEC. METHODS： HUVEC was selected as objects. MTS method was used to detect the effects of different doses of D. officinale polysaccharides （50， 100， 200， 400， 800 μg/mL） on the proliferation activity of HUVEC. The growth inhibitory concentration of 30％ cells （IC30） was calculated to screen the dose of follow-up tests. cDNA microarray assay was used to detect the changes of gene expression profile for HUVEC after treated with D. officinale polysaccharides for 24 h， so as to screen differentially expressed genes. GO enrichment analysis and KEGG pathway enrichment analysis were performed for top 5 differentially expressed genes by using DAVID bioinformatics resource database. Real-time fluorescence quantitative polymerase chain reaction （qRT-PCR） was used to validate the results of microarray detection with immunity-related differentially expressed genes as objects. RESULTS： After treated with 100， 200， 400， 800 μg/mL D. officinale polysaccharides， survival rate of HUVEC were decreased significantly （P＜0.05 or P＜0.01）. IC30 value was 408 μg/mL. After treated with 400 μg/mL （by IC30） D. officinale polysaccharides， there were 91 differentially expressed genes in HUVEC cells， of which 84 were up-regulated and 7 were down-regulated. Top 5 genes of up-regulated and down- regulated expression were SELE， CCL2， CXCL6， IL8， ICAM1 as well as VWCE， CPT1A， CLU， CCL14， CINS4， which may be mainly associated with immune conditions and inflammatory responses. The differentially expressed genes mainly distributed in extracellular domain， and were enriched in biological processes such as production and response of cytokines and stimulus response， and played molecular functions such as chemokine and its receptor activity. The up-regulated genes as SELE， ICAM1 and CXCL2 were mainly enriched in TNF signaling pathway， influenza A （H1N1）， herpes simplex virus infection and other pathways. The down-regulated gene CCL14 was mainly enriched in chemokine signaling pathway. Results of qRT-PCR validation tests showed that relative expression of ICAM1 was increased significantly， while that of CCL14 was decreased significantly （P＜0.05）， which was in agreement with microarray detection results. CONCLUSIONS： After treated with D. officinale polysaccharides， the expression of 91 genes in HUVEC cells are different significantly， mainly being up-regulated. The differentially expressed genes may participate in immune regulation through TNF signaling pathway， influenza A （H1N1） and herpes simplex virus infection.
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Poor experience of teacher-student interaction and low user loyalty exist in MOOC (massive open online courses).Therefore,the campus open online courses (COOC),a network teaching platform,was developed to integrate traditional classroom teaching and network teaching and to build an online-offline curriculum system according to professional training scheme of school.The online-offline teaching design and learning evaluation in COOC platform was also developed.The running data of COOC platform showed that the online-offline learning evaluation model has guiding impact on students' learning attitude because it can record the students' learning process and learning effect,which can enhance students' active participation in self-directed learning.The learning evaluation model in COOC is objective and scientific,which is helpful to improve the quality of teaching and learning.
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Objective To investigate the effects of single-chamber balloon combined with dinoprostone suppository on the progestation of the cervix in full-term maternal delivery.Methods From January 2017 to Decem-ber 2018,120 cases of full-term maternal women admitted to the Central Hospital of Yiwu were selected.According to the random number table method ,all women were divided into control group (60 cases ) and observation group (60 cases).The control group was given a single-cavity balloon to promote cervical ripening.The observation group received single-chamber balloon combined with dinoprostone to promote cervical ripening .The effects of maternal cervical ripening were observed.Results The total effective rate of maternal cervical ripening in the observation group (95.00%) was significantly higher than that in the control group (81.67%),and the difference was statisti-cally significant (χ2 ＝6.135,P＜0.05).The differences of maternal postpartum hemorrhage and neonatal asphyxia rate were not statistically significant ( t ＝1.684 ,χ2 ＝2.563,all P＞0.05).The total maternal labor [( 5.8 ± 2.1)h] in the observation group was significantly shorter than that in the control group [(7.6 ±2.5) h],the differ-ence was statistically significant (t＝3.126,P＜0.05).The vaginal delivery rate (95.00%) of the observation group was higher than that of the control group (73.33%),the difference was statistically significant ( χ2 ＝5.342,P＜0.05).Before implanting the balloon and balloon combination ,the Bishop score between the two groups had no statis-tically significant difference (t＝3.623,P＞0.05).After the balloon and balloon combination were taken out ,the Bishop score of the maternal cervix [(8.6 ±1.5)points] in the observation group was higher than that in the control group [(7.2 ±1.3)points],and the difference was statistically significant (t＝4.354,P＜0.05).The incidence of adverse reaction of the observation group (6.67%) was lower than that of the control group (13.33%),the differ-ence was statistically significant between the groups ( χ2 ＝3.821,P＜0.05).Conclusion Compared with simple single-chamber balloon,single-chamber balloon combined with dinoprostone suppository has more significant effect on the maternal ripening of the cervix ,it can improve the vaginal delivery rate and maternal cervical Bishop scores , effectively reduce the maternal total labor ,and reduce the incidence of maternal adverse reactions.
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Objective To analyze current situation and development tendency of medical teaching case library construction and to provide information for medical teaching reform. Methods Bibliometrics was used to retrieve and analyze literatures on the subject of medical teaching case library construction from China National Knowledge Infrastructure, CBMdisc, VIP and Wanfang Data from construction to June 20th,2017. Results Totally 116 articles published in 71 journals were included.A gradual growth was found in the number of publication and funded articles. The average citation count was 2.05. A majority of articles were produced in Beijing, Guangdong and Shanghai. Medical teaching case library covered 9 majors and 42 courses and applied in class teaching (50.00%, 58/116), clinical practice (37.07%, 43/116), refresher training (2.59%, 3/116), assessment and evaluation (0.86%, 1/116). Satisfaction investigate,examination score analysis and expert review were commonly used to evaluate the quality of case library. Conclusions Researches in China on medical teaching case library construction were increasing in recent years.Case library were applied in various aspects of medical teaching,however, there still remained some problems.Articles on the subject of case library were not highly-cited.There was no core author group yet. The subject on medical case library still needed deep and further exploration. There′s suggestion that we should attach importance to medical case library construction and related study to push medical education reform.
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Objective To explore the early laboratory indicators for risk of intravenous immunoglobin-resistant Kawasaki diseases. Methods The clinical data were retrospectively analyzed in 881 Kawasaki disease patients (group A: 26 cases of intravenous immunoglobin-resistant; group B: 855 cases of intravenous immunoglobin-sensitive) from July 1, 2015 to June 30, 2016. After 1:3 matching with age and sex, the regression model for each of variables including sex, age, fever days, temperature, red blood cell count (RBC), white blood cell count (WBC), neutrophil (N), lymphocyte (L), platelet count (PLT) and C reactive protein (CRP), was constructed by conditional logistic regression analysis. Results Compared with group B, group A had significantly lower RBC count and higher PLT (P<0.05). Logistic regression analysis showed that, with the age, the regression model was Y=-2.87+0.01×PLT (PLT OR=1.01, 95％ CI: 1.00～1.01, P<0.01); with the sex, Y=-32.98+0.44×WBC+0.28× N+0.01×PLT (WBC OR=1.55, 95％ CI: 1.17～2.05, P<0.01; N％ OR=1.32, 95％ CI: 1.04～1.68, P<0.05; PLT OR=1.01, 95％ CI 1.00～1.01, P<0.01). Conclusion In case that abnormally high levels of PLT exist in confirmed Kawasaki disease, it should be aware of possibility of the intravenous immunoglobin-resistant Kawasaki disease.
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Objective To research the promoter methylation level of RAS association domain family 1A (RASSF1A) and RASSF1A gene mRNA expression level in cervical cancer tissue, and to analyze their relationships with clinicopathological parameters of cervical cancer and the clinical significance.Methods The RASSF1A gene promoter methylation and RASSF1A gene mRNA were detected respectively by methylation specific PCR and quantitative real-time PCR method in 40 cases of cervical cancer tissues and corresponding adjacent tissues.Results RASSF1A mRNA expression level in cervical cancer (0.26±0.05) was significantly lower than that in adjacent tissues (0.28±0.03), and the difference was statistically significant (t=2.27, P=0.026).The methylation rate of RASSF1A gene promoter region (0.71%±0.04%) was significantly higher than that in adjacent tissues (0.66%± 0.03%), and the difference was statistically significant (t=6.78, P=0.000).The expression of RASSF1A mRNA was significantly correlated with pathological differentiation (t=3.31, P=0.002), International Federation of Gynecology and Obstetrics (FIGO) stage (t=2.13, P=0.040), lymphatic metastasis (t=2.56, P=0.015).The promoter methylation level of RASSF1A gene was significantly correlated with pathological differentiation (t=2.08, P=0.045), FIGO stage (t=2.66, P=0.011), lymphatic metastasis (t=2.22, P=0.033), depth of invasion (t=2.12, P=0.041).Conclusion The RASSF1A gene promoter region methylation level and the RASSF1A gene mRNA expression level are associated with the malignant degree of cervical carcinoma.The RASSF1A gene promoter region methylation level may be used as a reference indicator for predicting the risk of metastasis of cervical cancer.
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Objective To know of the concerning conditions of health information ,the ways to get health information ,and its influence factors among young people .Methods The health information seeking behaviors of people aged from 18 to 44 were inves-tigated by online electronic questionnaire and paper questionnaire from March to April in 2014 .Results 502 valid questionnaires were collected ,including 46 .81% men and 53 .19% women ,mean age was (29 .77 ± 6 .27)years old .40 .96% people were often concerned about the health information ,and 82 .39% people got health information through two or more ways ,the select frequency of the various ways were as follows :computer (77 .20% ) ,television (60 .3% ) ,relatives and friends (58 .70% ) ,mobile phones (54 .87% ) ,newspapers ,magazines ,books (53 .20% ) ,radio (9 .26% )and others 4 .80 % .Gender ,education ,occupation ,medical ed-ucation background ,all of them have effect on the ways of obtained health information ,and the effect of knowledge on the selection of internet pathways was greatest .Conclusion The internet has become the most major ways for people to obtain health informa-tion .The ways to obtain health information are affected by multiple factors ,so relative department should provide some convenient channels according to the characters of each group to get health information .
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Objective To analysis residents'death causes in the Three Gorges Reservoir Area,and analysis the distribution of causes of death and age,gender characteristics,therefore provide basis for governments at all levels to develop disease prevention. Methods Data for classification of death cause was analyzed by Excel 2003,according to the ICD-10 classification,the years of po-tential life lost(YPLL)was calculated by SPSS1 7.0.Results Totally 62 702 death date of resident population in Three Gorges Reservoir Area from July,2003 to December,2013 were collected.The crude death rate for males and standardized mortality rate was significantly higher than that in female;Cause of death of the top five were:circulatory system disease,respiratory system dis-ease,malignant tumor,injury and poisoning and digestive system diseases;Chronic disease was the main cause of death which ac-counting for 87.76%;years of potential life lost rate of top five were:injury and poisoning,tumor,circulatory system disease,respir-atory system diseases and perinatal diseases.Conclusion The main cause of death in Three Gorges Reservoir area is a county in the circulatory system diseases,malignant tumor,respiratory system disease,and show a younger trend.Therefore,prevent premature death has become one of the focal points of disease prevention and control.
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The construction of open course for information literacy education in the era of ubiquitous network was described according to the COOC self learning platform that we developed with information retrieval course construc-tion as its standards.
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The xMOOC model of campus open course was analyzed according to the problems in domestic and foreign MOOC construction and the specific characteristics of online learning in campus open course. The roles of students, teachers, performance assessment system and observers were analyzed, which showed that their roles were not accu-rately positioned. Suggestions were put forward for improving the campus open course xMOOC.
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〔Abstract〕 The paper introduces the definition of mobile health care app , sorts out the research status of mobile health care App from aspects such as classification , contents and quality , supervision , standards and requirements and problems such as low quality , lack of supervision, unsafe data and indefinite definitions , and proposes suggestions from the angle of developers , users, markets, etc.
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A competency dictionary of advanced health informatization application persons was compiled by inter-viewing 20 health information persons with behavior events interview , their competency characteristics were coded By Nvivo, the coding frequency and characteristics score in good performance group and ordinary group were ana-lyzed by variance analysis, which showed 8 characteristics of key competency and 12 characteristics of basic compe-tency in advanced health information application persons.
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Objective To understand the status quo of the health statistics human resources in Chongqing municipality. Methods The status quo of the health statistic human resources in Chongqing municipality was investigated by the national health statistics reporting system.The age,seniority,qualifications,specialty,job title,distribution,etc.in the health personnel were ana-lyzed by the SPSS17.0 statistical software.Results 74.89% of health statistic personnel were part-time workers.In the vast ma-jority of medical institutions,the number of health statistician was 1 or 2.As to the education background,73.50% of the total stat-istician number only got the junior college degree even below.Only 216 statistic personnesls′major fitted to the staff positions.Ba-nan district in the major city,Tongnan county and Dazu district in the west area,Wushan county in the east area,Dianjiang county and other counties in central area,and the new urban development area were relatively lack of human resources of the health statistic personnel.Conclusion The health statistic team in Chongqing municipality has low stability,inadequate staff and poor professional quality.The distribution of statistic personnel human resources is uneven among the five functional areas and various districts and counties.
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With the deepening and subdivision development of health informatization industry, the advanced applied talents training mode reform of medical informatics put forward a new requestto college medical information,information management and information system (medical) and relevant majors. Based on advanced applied talents' competency iceberg model,the personnel training mode of medical informatics subject was reconstructed from several dimensions such as the training objectives, capacity-building programs,faculty and training system.Andan empirical research on competency based talent training mode reform was conducted in a school's information management and informa-tion system(medical and health) field of Chongqing.
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The course evaluation scheme oriented ability cultivation was established. The for-mative evaluation indexes which were practiced in information retrieval course were divided into two indicators:classroom learning and performance including five secondary indexes(classroom discipline, classroom learning, homework, questions and answer questions online, personal essay and group dis-cussion reports) with the and seven observation points(pre-class preparation, teacher-student interac-tions, classroom discussions and classroom reports, experimental class performance, homework com-pletion, the utilization of network teaching platform, personal essay and group discussion), and these were practiced in the teaching of “information retrieval” curriculum, the usual results was composed with the usual academic performance and utilization of the network teaching platform. Finally, the practice results were discussed and summarized in order to cultivate the ability of the students who major in information management and to improve the teaching quality.
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Objective To establish the determination method synthetic borneol and menthol in Keyou nanoemulsion. Methods HP-5 quartz capillary column (30 m×320 μm×0.25 μm) was used with nitrogen as the carrier gas, and FID as the detector. The temperature of the entrance of the capillary vessel column was at 230 ℃. Results Synthetic borneol and menthol in Keyou nanoemulsion were separated well. The calibration curves of synthetic borneol was obtained with good linear relationship within the range of 0.337-1.685 μg (r 2=0.998 2), the average recovery was 97.5%. The calibration curves of menthol was also obtained with a good linear relationship within the range of 0.234-1.17 μg (r 2=0.997 4), the average recovery was 97.0%. Conclusion The methord is simple and accurate. It can be used to control the quality of Keyou nanoemulsion.
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Objective:To improve our hospital staff on medical safety awareness. To strengthen the medical device safety management practices. Methods:On the status of hospital, improve the scientific management level of medical equipment. On clinical equipment compulsory verification process, strong check of equipment maintenance is discussed. Results:the clinical departments to further understand the importance of safety in medical equipment using. Conclusion:Enhancement of medical engineering professional cooperation, improve the inspection equipment safety, reliability and validity.