Application of self-made anti-pressure sore cotton cover in preventing facial pressure injury in patients with non-invasive ventilation / 中华危重病急救医学

Objective:To observe the application effect of self-made anti-pressure sore cotton cover on the prevention of facial pressure injury in patients with non-invasive ventilation, and to explore the effective method of preventing facial pressure injury.Methods:A prospective study was conducted. Patients with mild to moderate respiratory failure and non-invasive ventilation admitted to the department of intensive care medicine of Harisen International Peace Hospital Affiliated to Hebei Medical University from March 2020 to August 2021 were enrolled, and they were divided into gauze pad group, foam dressing group and self-made anti-pressure ulcer cotton cover group by random number table method. Before wearing the ventilator mask, the gauze pad group and the foam auxiliary dressing group should fold or cut out the auxiliary dressing with the corresponding size and suitable for the patient's facial contour. In the self-made anti-pressure sore cotton cover group, the ventilator cotton cover could be worn only by selecting the cotton cover suitable for the patient's face shape, aligning the vent to the mouth and nose, and tying the fixed belt behind the ear. The incidence of facial pressure sore, the time required to connect man-machine interface (from the preparation of auxiliary dressing for pressure sores to the connection of ventilator) and the cost of dressing were compared among the three groups.Results:A total of 150 patients with non-invasive ventilation were enrolled, with 50 patients in each group. Compared with the gauze pad group and the foam dressing group, the incidence of facial pressure sore in the self-made anti-pressure sore cotton cover group was significantly reduced [6.0% (3/50) vs. 44.0% (22/50), 12.0% (6/50), both P < 0.05], and the time required to connect the man-machine interface was significantly shortened (minutes: 5.0±1.5 vs. 10.0±1.5, 8.0±2.0, both P < 0.05), dressing cost was significantly reduced (yuan: 30±10 vs. 150±20, 118±29, both P < 0.05). Conclusion:Compared with the gauze pad and the foam dressing, the incidence of facial pressure sore in non-invasive ventilation patients with self-made anti-pressure sore cotton cover is lower, the time required to connect man-machine interface is shorter, and the cost of pressure sore prevention dressing is less, which is suitable for the prevention of facial pressure injury in non-invasive ventilation patients.

Evidence-based practice of self-made tracheal catheter fixation band in prevention of unplanned extubation / 中华危重病急救医学

With the development of medical technology, the fixation method of the oral duct is constantly updated, and the selection of a relatively safe, effective, simple and fast fixation method of the oral duct has been widely concerned. However, the use of traditional 3M I-shaped tape fixation needs to be cut, which wastes time and easily leads to the outward displacement of the tracheal tube, and is easy to be soaked by oral secretions, resulting in facial skin damage. Therefore, the medical staffs of the department of critical care medicine of Hengshui People's Hospital designed a self-made tracheal catheter fixing band (composed of the main structure, the fixed band, the internal adjusting structure and the internal structure of the fixed block), and obtained the national utility model patent (ZL 2018 2 0508681.6). The inner side of the fixing band is fixed with a spongy body, which can absorb the secretions around the mouth to avoid the moist condition around the mouth and cheek skin. Meanwhile, the endotracheal catheter is fixed with the help of the card slot, hinge and other structures, which can fully ensure the fixation effect. A total of 80 patients undergoing airway intubation were admitted to the department of critical care medicine of our hospital from October 2020 to September 2021. They were divided into observation group and control group according to intubation time (single number and double number), with 40 patients in each group. The observation group was fixed with self-made tracheal catheter fixation band. Through evidence-based practice path, relevant literatures at home and abroad were searched for clinical practice basis, and the practice plan was formulated and implemented. The control group was fixed with 3M tape + inch tape according to the traditional method. The fixation of tracheal tube and the degree of facial skin injury were compared between the two groups. All patients were included in the final analysis without shedding cases. Severe catheter displacement occurred in 3 patients (7.5%) in the control group, and no severe catheter displacement occurred in the observation group. The incidence of facial skin injury in the observation group was significantly lower than that in the control group [25.0% (10/40) vs. 55.0% (22/40), P < 0.05]. Moreover, the fixation time of the observation group was significantly shorter than that of the control group (minute: 12.11±1.69 vs 17.59±1.27, P < 0.05). The application of self-made tracheal catheter fixation band can shorten the fixation time of tracheal catheter and reduce the incidence of unplanned endotracheal extubation (UEE) and facial skin injury, which is worthy of clinical promotion and application.

Echocardiographic diagnosis of special type of atrioventricular septal defect / 中华超声影像学杂志

Objective:To improve the understanding of special type of atrioventricular septal defect (AVSD) and reduce clinical missed diagnosis and misdiagnosis by investigating its echocardiographic features.Methods:Echocardiographic images of patients with special type of AVSD diagnosed by echocardiography and confirmed by surgery in Pediatric Cardiovascular Center, Beijing Anzhen Hospital, Capital Medical University from November 2011 to November 2021 were retrospectively analyzed. Depending on the presence of ventricular septal defect(VSD), special type of AVSD were divided into two types, namely AVSD with intact ostium primum and AVSD with intact ostium primum and ventricular septum. The echocardiographic features of special type of AVSD were summarized.Results:Twenty-five cases of special type of AVSD were diagnosed by echocardiography and 13 cases were confirmed by surgery, including 12 cases with intact ostium primum and 1 case with intact ostium primum and ventricular septum. There were 5 cases without surgical indications, and 1 case was kept under observation due to small VSD. One patient with complex malformation only underwent pulmonary artery banding operation without treating intracardiac malformation. The other 4 cases of perimembrane VSD and 1 case of partial AVSD were misdiagnosed as special type of AVSD by echocardiography. All patients had mild to severe left atrioventricular regurgitation before surgery, and most patients remained left atrioventricular regurgitation of varying degrees after left atrioventricular valve formation. Characteristic sonographical findings included: ①The ostium primum was continuous and there was no ostium primum defect. ②The attachment points of the left and right atrioventricular valves were at the same level. ③The left atvioventricular valve was a trileaflet left atrioventricular valve and attached to the crest of the ventricular septum, forming the so-called "anterior mitral valve leaflet cleft". ④The two groups of papillary muscles of the left ventricle changed the normal anterolateral and posterolateral alignment, but showed a anteriorly and posteriorly relationship (counterclockwise transposition). ⑤In the presence of VSD, an inlet ventricular septal defect would be present. ⑥Color Doppler showed varying degrees of regurgitation signals from the left atrioventricular valve during systolic period. ⑦Other complex deformities may be combined with special type of AVSD.Conclusions:Echocardiography can make a definite diagnosis for special types of AVSD. The prognosis of this malformation is closely related to the left atrioventricular valve, and the shaping effect depends on the development of left atrioventricular valve and regurgitation.

Prenatal diagnosis of isolated tricuspid valve dysplasia by echocardiography / 中华超声影像学杂志

Objective:To improve the prenatal recognition and diagnostic accuracy of isolated tricuspid valve dysplasia (TVD) by analyzing fetal echocardiographic features.Methods:The fetal echocardiographic features of 7 cases with prenatal diagnosis of TVD were analyzed retrospectively in Pediatric Cardiovascular Center, Beijing Anzhen Hospital, Capital Medical University and Children′s Hospital of Shanxi from June 2012 to December 2020. The fetal echocardiographic characteristics of TVD were summarized.Results:Among the 7 fetuses with TVD, 6 cases showed functional pulmonary atresia with intact ventricular septum and different degrees of pulmonary valve regurgitation, and 1 case showed slightly narrowed pulmonary artery. Characteristic sonographical findings included: ①The axis of heart was exaggerated left-axis deviation and the ratio of cardiothoracic was obviously increased. The right heart was enlarged, in which the right atrium was significantly dilated (an important feature of TVD). ②The position of tricuspid valve ring was normal, the attachment point of each leaf was normal, some tricuspid valves were thickened and insufficiency. ③It was common to be complicated with functional pulmonary valve atresia with intact ventricular septum or severe pulmonary valve stenosis. ④Color Doppler imaging showed severe tricuspid regurgitation and the regurgitation velocity was less than 350 cm/s (an important feature of TVD). ⑤In fetus with functional pulmonary valve atresia with intact ventricular septum, color Doppler imaging showed retrograded ductal flow across the pulmonary artery and the different degrees regurgitation of pulmonary valve.Conclusions:Fetal TVD has typical echocardiographic features, mainly including large tricuspid regurgitation and significant enlargement of the right atrium. The prognosis of fetus with functional pulmonary atresia is poor. Early diagnosis plays a crucial role in prenatal consultation and prognosis evaluation.

Chinmedomics facilitated quality-marker discovery of Sijunzi decoction to treat spleen qi deficiency syndrome / 医学前沿

Sijunzi decoction (SJZD) is a Chinese classical formula to treat spleen qi deficiency syndrome (SQDS) and has been widely used for thousands of years. However, the quality control (QC) standards of SJZD are insufficient. Chinmedomics has been designed to discover and verify bioactive compounds of a variety of formula rapidly. In this study, we used Chinmedomics to evaluate the SJZD's efficacy against SQDS to discover the potential quality-markers (q-markers) for QC. A total of 56 compounds in SJZD were characterized in vitro, and 23 compounds were discovered in vivo. A total of 58 biomarkers were related to SQDS, and SJZD can adjust a large proportion of marker metabolites to normal level and then regulate the metabolic profile to the health status. A total of 10 constituents were absorbed as effective ingredients that were associated with overall efficacy. We preliminarily determined malonyl-ginsenoside Rb2 and ginsenoside Ro as the q-markers of ginseng; dehydrotumulosic acid and dihydroxy lanostene-triene-21-acid as the q-markers of poria; glycyrrhizic acid, isoglabrolide, and glycyrrhetnic acid as the q-markers of licorice; and 2-atractylenolide as the q-marker of macrocephala. According to the discovery of the SJZD q-markers, we can establish the quality standard that is related to efficacy.

Prenatal diagnosis of anomalous origin of one pulmonary artery branch from the aorta and unilateral absence of pulmonary artery by echocardiography / 中华超声影像学杂志

Objective To improve the prenatal diagnosis and differential diagnosis ability for anomalous origin of one pulmonary artery branch from the aorta ( AOPA ) and unilateral absence of pulmonary artery ( U APA ) by comparing and analyzing different types of fetal echocardiography features . Methods Fetal echocardiographic features were analyzed retrospectively in fetus with prenatal diagnosis of U APA or AO PA between June 2012 and December 2018 ,and the different types of fetal echocardiography characteristics and main points of identification were summarized . Results A total of 6 fetuses with AOPA and 6 fetuses with U APA were diagnosed .Among the 6 fetuses with AOPA ,5 cases were anomalous origin of right pulmonary artery from the aorta ( AORPA ) ,including 3 cases with isolated AORPA and 2 cases combined with Berry syndrome ,and 1 case was anomalous origin of left pulmonary artery from the aorta ( AOLPA ) with an absent pulmonary valve . All 6 cases of AOPA had proximal form . Among the 6 fetuses with U APA ,4 cases were isolated unilateral absence of right pulmonary artery ,1 case was isolated unilateral absence of left pulmonary artery and 1 case was unilateral absence of left pulmonary artery combined with tetralogy of Fallot ( T OF) . T he main common characteristic sonographical findings included :there was no confluence at the bifurcation of the main pulmonary artery on multiple view s ,and the affected pulmonary branch was not attached to the main pulmonary artery . T he different characteristic sonographical findings in fetus included :the affected pulmonary artery of AO PA arosed from the right posterior or left posterior portion of the ascending aorta on three vessels and trachea view ( 3V T ) and long axial view of left ventricle , and 3V T and the coronary view of brachiocephalic trunk artery showed that the abnormal origin of pulmonary artery branch of U APA connected with the root of brachiocephalic trunk artery by the ipsilateral vertical arterial duct ( DA ) ,and color Doppler flow imaging showed that the blood flow of the affected pulmonary artery branch was isolated in the pulmonary field . Conclusions AOPA and UAPA have many similarities in the characteristics of fetal echocardiography . 3V T and long axial view of left ventricle are the best view s for displaying proximal AOPA ,3VT and the coronary view s of the root of brachiocephalic trunk artery are the best view s for displaying UAPA .

Prenatal diagnosis of anomalous origin of one pulmonary artery branch from the aorta and unilateral absence of pulmonary artery by echocardiography / 中华超声影像学杂志

Objective@#To improve the prenatal diagnosis and differential diagnosis ability for anomalous origin of one pulmonary artery branch from the aorta (AOPA) and unilateral absence of pulmonary artery (UAPA) by comparing and analyzing different types of fetal echocardiography features.@*Methods@#Fetal echocardiographic features were analyzed retrospectively in fetus with prenatal diagnosis of UAPA or AOPA between June 2012 and December 2018, and the different types of fetal echocardiography characteristics and main points of identification were summarized.@*Results@#A total of 6 fetuses with AOPA and 6 fetuses with UAPA were diagnosed.Among the 6 fetuses with AOPA, 5 cases were anomalous origin of right pulmonary artery from the aorta (AORPA), including 3 cases with isolated AORPA and 2 cases combined with Berry syndrome, and 1 case was anomalous origin of left pulmonary artery from the aorta (AOLPA) with an absent pulmonary valve. All 6 cases of AOPA had proximal form. Among the 6 fetuses with UAPA, 4 cases were isolated unilateral absence of right pulmonary artery, 1 case was isolated unilateral absence of left pulmonary artery and 1 case was unilateral absence of left pulmonary artery combined with tetralogy of Fallot (TOF). The main common characteristic sonographical findings included: there was no confluence at the bifurcation of the main pulmonary artery on multiple views, and the affected pulmonary branch was not attached to the main pulmonary artery. The different characteristic sonographical findings in fetus included: the affected pulmonary artery of AOPA arosed from the right posterior or left posterior portion of the ascending aorta on three vessels and trachea view (3VT) and long axial view of left ventricle, and 3VT and the coronary view of brachiocephalic trunk artery showed that the abnormal origin of pulmonary artery branch of UAPA connected with the root of brachiocephalic trunk artery by the ipsilateral vertical arterial duct (DA), and color Doppler flow imaging showed that the blood flow of the affected pulmonary artery branch was isolated in the pulmonary field.@*Conclusions@#AOPA and UAPA have many similarities in the characteristics of fetal echocardiography. 3VT and long axial view of left ventricle are the best views for displaying proximal AOPA, 3VT and the coronary views of the root of brachiocephalic trunk artery are the best views for displaying UAPA.

Prenatal diagnosis of unilateral absence of pulmonary artery by echocardiography / 中华超声影像学杂志

Objective To analyze the echocardiography features of unilateral absence of pulmonary artery ( U APA ) features and improve the prenatal diagnosis accuracy of U APA by analyzing fetal echocardiography features . Methods Fetal echocardiographic features were analyzed retrospectively in 6 cases with prenatal diagnosis of U APA between June 2012 and October 2018 . A t the same time ,ultrasonic manifestations of 3 patients whose antenatal examinations were performed in other hospitals and diagnosed as UAPA in our hospital were retrospectively analyzed . T he fetal echocardiography characteristics of UAPA were summarized . Results Among the 6 fetuses with UAPA ,4 cases were diagnosed as isolated unilateral absence of proximal right pulmonary artery ,1 was unilateral absence of proximal left pulmonary artery with tetralogy of Fallot ( T O F ) and 1 was isolated unilateral absence of proximal left pulmonary artery . Characteristic sonographical findings included : ① When other intracardiac abnormalities were absent ,the inner diameter and proportion of the heart cavity was normal . ② M ulti‐view showed that the normal confluence structure disappeared at the branch of the main pulmonary artery ,and the diameter of normal pulmonary artery branch was widened . ③On the basis of three vessels and trachea view ( 3V T ) ,moved the probe up and dow n to make a transverse scan ,two‐dimensional and color Doppler flow imaging ( CDFI ) showed a large vessel ( the brachiocephalic trunk artery ) originating from the aortic arch w hich had dual vascular features ,it means that it was difficult to distinguish the pulmonary artery branch from the aortic branch . ④ On coronal view of the large vessel ,two‐dimensional and CDFI clearly showed that the large vessel originating from the aortic arch was the brachiocephalic trunk artery ,and the pulmonary artery branch connected with the brachiocephalic trunk artery by the ipsilateral vertical arterial duct ( DA ) which originated from the root of brachiocephalic trunk artery ,but the left pulmonary artery branch connected with the ventral side of the aortic arch by the left DA in UAPA fetus with T O F . ⑤Spectrum Doppler of the anomalous vessels of the lungs confirmed that it was the pulmonary artery ,and the blood flow of the anomalous PA branch was isolated and no exact connection with the main pulmonary artery . Conclusions U APA can be accurately diagnosed prenatally by echocardiography . T he brachiocephalic trunk artery coronary view is very important for the diagnosis of this disease .Early diagnosis plays an important role in prenatal counseling and prognosis assessment .

The effect of DNA hydroxymethylase Tet2 on γ globin activation in the treatment of β-thalassemia / 中华内科杂志

Objective To study the function of ten-eleven translocation 2 (Tet2) in γglobin gene expression in patients with β-thalassemia.Methods Gamma globin expression was induced by 5-azacytidine and Tet2 gene expression was knocked down by short hairpin RNA (shRNA) in a human immortalized myelogenous leukemia K562 cell line.The global 5-hydroxymethylcytosine (5hmC) level was measured by an ELISA kit.5hmC level of γglobin gene was quantified by sulfite sequencing.The mRNA level of Tet2,γglobin,and related transcription factors Nfe4 and Klfl were quantified by real-time PCR.Results Tet2 knockdown resulted in a decreased global 5hmC level from 0.14％ to 0.03％ as of the control group in K562 cells.The expression of γ globin was enhanced after 5-azacytidine treatment in vitro.However,γglobin mRNA level in Tet2 knockdown cells was only 55％ as that in control group.The CG sites on γ globin gene were unmethylated.As Tet2 was down-regulated,the expression levels of Nfe4 and Klf1 decreased by about 80％ and increased to 3.5 folds,respectively.Conclusions Tet2 appears to maintain 5hmC level and facilitates γ globin gene activation.Moreover,Tet2 more likely regulates γglobin expression via affecting transcription factors rather than the gene itself.Thus,Tet2 could be a potential therapeutic target for β thalassemias.

Research Progress of Measurement and Evaluation System of Physician Professionalism / 中国医学伦理学

This paper analyzed the foreign measurement and evaluation system of physician professionalism,from the perspectives of the evaluation of occupation behavior,the multi sources of evaluation,the evaluation of empathy,and the cross-cultural background.It also discussed the basic condition of the development of domestic evaluation and evaluation system,and analyzed it from the diversity and comprehensiveness of evaluation perspectives,the specific and objectivity of evaluation items,the clarity and quantitative feature of evaluation indexes,as well as the openness and feedback of evaluation system.In addition,this paper reviewed the domestic and foreign measurement and evaluation methods of physician professionalism in recent years and pointed out that the construction of good measurement and evaluation system is the only way to deepen the research of physician professionalism.

Expression of Ki-67 and PTEN in oral adenoid cystic carcinoma and its clinical significance / 实用肿瘤学杂志

Objective The aims of this study were to determine the expression of Ki-67 and PTEN in oral adenoid cystic carcinoma( OACC) and its relationship with clinicopathological features,and to explore the re-lationship between the expression of Ki-67 and PTEN. Methods Forty cases of oral adenoid cystic carcinoma were collected from the pathological laboratory in our hospital. Another 15 cases of normal gland in patients with oral adenoid cystic carcinoma were selected as the control group. The expression of Ki-67 protein and PTEN in adenoid cystic carcinoma was detected by immunohistochemistry. Results The positive rate of Ki-67 protein in oral adenoid cystic carcinoma was 70%(28/40),which was significantly higher than that in the control group(2/15)(P<0. 05). The positive rate of PTEN in oral adenoid cystic carcinoma was 63%(25/40),which was signif-icantly higher than that in the control group 20%(3/15)(P <0. 05). They were associated with histological types,metastasis,lymph node metastasis and neural invasion,and not correlated with age,gender and tumor loca-tion. The expression of Ki-67 and PTEN in oral adenoid cystic carcinoma may have a significant correlation. Conclusion The expression of Ki-67 and PTEN in adenoid cystic carcinoma is high,and their occurrence and development in adenoid cystic carcinoma play an important role in the process of evolution and metastasis. Ki-67 and PTEN proteins may be markers of oral adenoid cystic carcinoma.

Application of self made guidance for difficult gastric tube placement in patients with artificial airway / 中华危重病急救医学

Objective To use evidence-based nursing on patients with artificial airway to the practice of stomach tube, and to evaluate the self made guidance for difficult gastric tube placement in patients with artificial airway.Methods Forty patients with artificial airway and were difficult to put the tube, and admitted to Department of Critical Care Medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University from April to December in 2016 were enrolled as observation group. Through the evidence-based nursing strategy, the related literatures at home and abroad were collected to search clinical evidence and formulate and implement the nursing program, the gastric tube was inserted into the stomach tube under the direct vision of the laryngoscope. Thirty-six patients of difficult gastric tube placement with artificial airway straightly under the direct vision of the laryngoscope from August 2015 to March 2016 were retrospectively analyzed as the control group. The success rate of first catheterization, indwelling time, throat edema and bleeding of pharyngeal mucosa were compared between the two groups.Results All patients were enrolled in the final analysis. In the control group, 28 patients were successfully placed once, while 8 failed. Only 1 patient in observation group failed to catheterize, and successful placed after symptomatic treatment, the one-time success rate of catheter was significantly higher than that of control group (97.5% vs. 77.8%), and catheter time was significantly shortened (minutes: 4.8±1.2 vs. 5.1±1.0), the difference was statistically significant (bothP < 0.05). There were 2 patients with laryngeal edema in the control group and 4 patients of pharyngeal mucosal hemorrhage. In the observation group, there was no laryngealedema and laryngeal edema occurred in the patients with laryngoscopy, and only 1 patient had a hemorrhage of pharyngeal mucosa.Conclusion Using self made guiding device can effectively insert the difficult gastric tube in patients with artificial airway, and increase the one-time success rate of intubation, shorten the catheter time, and have a trend in reduce complication as compared with traditional gastric tube placement.

Effects of Rosuvastatin on Blood Lipid and Thyroid Nodules in Elderly Patients with Dyslipidemia / 中国药房

OBJECTIVE:To investigate the effects and safety of rosuvastatin on blood lipid and thyroid nodules in elderly pa-tients with dyslipidemia. METHODS:70 elderly patients with dyslipidemia were selected and randomly divided into control group (33 cases) and treatment group (37 cases). Control group was treated with routine treatment as abstain from tobacco and drink, low fat diet,Aspirin enteric-coated tablets 100 mg at bed time;treatment group was additionally treated with Rosuvastatin calcium tablet 10 mg at bed time,on the basis of control group. Both groups received the treatment for consecutive 12 weeks. BMI,blood lipid and the size of thyroid nodules were compared between 2 groups before and after treatment,and the occurrence of ADR was also observed. RESULTS:There was no significant difference in BMI between 2 groups before and after treatment (P>0.05). There was no significant difference in blood lipid level and the size of thyroid nodules between 2 groups before and after treatment (P>0.05). The blood lipid level and the size of thyroid nodule of 2 groups were improved significantly after treatment,and the treatment group was significantly better than the control group,with statistical significance(P<0.05). 2 pationts of creatment suf-fered from the increase of ALT but recovered withont angtreatment. CONCLUSIONS:Rosuvastatin can significantly improve blood lipid and decrease thyroid nodules in elderly patients with dyslipidemia with good safety.

Prenatal diagnosis of isolated mirror-image right aortic arch with vascular ring by fetal echocardiography / 中华超声影像学杂志

Objective To improve the prenatal echocardiographic diagnostic accuracy for fetus with isolated mirror-image right aortic arch which combined with vascular ring by analyzing and accumulating its echocardiographic features.Methods Echocardiographic signs were analyzed retrospectively and fetal echocardiographic features were accumulated in 16 cases with prenatal diagnosis of isolated mirror-image right aortic arch with left-side ductus arteriosus which formed vascular ring between January 2014 and February 2016.All cases were confirmed by neonatal echocardiography.Results The fetal echocardiography characters:① In 3-vessel and trachea view,fetal right aortic arch was demonstrated a Ushaped appearance of the great vessels,the right arm of the ‘ U’ represented the aortic arch and its left branch with ductal continuation.② In 3-vessel and trachea view or upper axial mediastinal transverse view,left innominate artery passed straightly to the left of the trachea.Left innominate artery and right-side ductus arteriosus were overlapped and the distance of two vessels was very close.③ In double arch view and longitudinal view for ductus,Left innominate artery did not connect to descending aorta or ductus arteriosus and did not involve in the formation of vascular ring.④ Color Doppler played an important role in diagnosis of this disease.Power Doppler or high-definition imaging easily showed color overflow and wrongly displayed the crossed relationship of left innominate artery with descending aorta as the anatomical connection,and caused the misdiagnosis of this disease as double aortic arch.Conclusions Isolated mirrorimage right aortic arch with vascular ring is not rare in the fetal period.Because ductus arteriosus is large and patent during the prenatal period,it is easily mistaken for the crossed relationship of left innominate artery with descending aorta as the anatomical connection and finally misdiagnoses this anomaly as double aortic arch.The keys to accurate diagnosis of the disease are clearly visualization of the innominate artery and its relationship with descending aorta and ductus arteriosus by scanning different views.

Diagnosis value on four biochemical indicator detection for the early renal impairment in multiple myeloma patients / 国际检验医学杂志

Objective To explore the changes and comparisons of the four biochemical indicator detection for the early renal im‐pairment in multiple myeloma patients .Methods The 54 patients with multiple myeloma of early onset(MM group) and 54 healthy peoples(control group) were retrospectively analyzed .The levels of serum Cystatin C(Cys C) ,creatinine(Cr) ,β2‐microglobulin(β2‐MG) ,and lactate dehydrogenase(LDH) were detected .And the results for statistical analysis .Results The levels of serum Cys C , Cr ,β2‐MG and LDH were higher significantly in the MM group than in the control group ,the difference was statistically significant (P<0 .05) .In the MM group ,the positive rate of Cys C ,Cr ,β2‐MG ,LDH ,combined detection of Cys C and Cr ,combined detection of β2‐MG and LDH ,combined detection of Cys C ,Cr ,β2‐MG and LDH was 63 .0% ,42 .6% ,74 .1% ,61 .1% ,66 .7% ,85 .2% and 96 .3% respectively .The positive rate of Cys C was higher than Cr ,the difference was statistically significant(P<0 .05) .Between the positive rate of combined detection of β2‐MG ,LDH and Cys C ,Cr ,the difference was statistically significant(P<0 .05) .The positive rate of combined detection of the four biochemical tests was the most highest .Conclusion In the early stage of the renal in‐jury in the patients with MM ,the combined detection of the four biochemical tests is most sensitive to discovery the early stage of the renal glomerular function injury .

Survey on oral health status of inpatients with schizophrenia / 中国医师进修杂志

Objective To investigate and analyze oral health status of inpatients with schizophrenia.Method We selected 105 patients from Beijing Anding hospital included hospitalization length 1-5 years group (39 cases) and hospitalization length over 5 years (55 cases) were investigated with Self-made questionnaire and assessment guide for psychiatric care (OAG-PC).Results Tooth loss and oral health status of schizophrenia inpatients were both poor.There was significant difference in the number of people with tooth loss (x2 =7.68,P ＜ 0.05) and mean number of tooth loss (F =9.20,P ＜ 0.05) between two groups.The OAG-PC total score (F=11.1,P＜ 0.05),odour from the mouth (F=4.34,P＜ 0.05),saliva (F=3.93,P＜ 0.05),mucous membranes (F=5.64,P＜ 0.05),teeth or dentures (F=5.34,P＜ 0.05),calculus on teeth (F=15.34,P ＜ 0.05),looseness of teeth (F =14.14,P ＜ 0.05),and No.of teeth in the lower jaw (F =7.70,P ＜ 0.05) in the schizophrenia inpatients with hospitalization length 1-5 years group was better than those with hospitalization length over 5 years,there were significant difference between two groups.There were no significant difference in lips (F =0.69,P ＞ 0.05),tongue (F =0.65,P ＞ 0.05),gums (F =1.87,P ＞ 0.05),appearance of teeth (F=1.52,P＞ 0.05),and No.of teeth in the upper jaw (F=3.58,P ＞ 0.05) between two groups.Conclusions Patients with schizophrenia are special vulnerable people.The more course of the disease was longer,the more the oral health status was worse.Tooth loss,calculus,and looseness of teeth are much more serious and will influence chew function seriously.Society,medical institutions,and families should pay more attention to the oral health status of patients with schizophrenia.And taking the preventative measures against poor oral health can improve quality of life of patients with schizophrenia.

Diagnosis of transposition of the great arteries with posterior aorta by echocardiography / 中华超声影像学杂志

Objective To improve the understanding to transposition of the great arteries with posterior aorta and decrease the clinic misdiagnosis by summarizing their echocardiography features . Methods Echocardiography images were retrospectively reviewed for 7 cases with transposition of the great arteries with posterior aorta who diagnosed in Anzhen Hospital ,and their echocardiography features were summarized .Results In 7 patients ,5 patients had operation ,including 3 for arterial switch operation ,1 for right GLEEN ,1 for right GLEEN and Fortan surgery ,and 2 patients were lost to follow‐up .The echocardiography characters:① Artery short view showed aorta and pulmonary artery existed the half‐surrounding relationship .The aorta was situated posteriorly and the pulmonary artery anteriorly .②Multiple views showed aorta was completely and mostly arised from the right ventricle ,while the pulmonary artery was came off the left ventricle .③ Ventricular septal defects were presented in all cases and aorta could ride the defect of ventricular septal .④ In most cases ,fibrous continuity between the aortic and mitral valve through a ventricular septal defect was found and there was no conus under the aorta .⑤ Some cases could combine the different degree stenosis of the outflow tract of subpulmonary valve and pulmonary valve . Conclusions The connection relationship between two arteries and ventricles can displayed clearly on the long axis view of double outflow tracts of two ventricles under xiphoid process .The acoustic window under the xiphoid process is the key for diagnosis and differential diagnosis of the disease .

Adverse effects of type B ventricular pre-excitation on ventricular wall motion and left ventricular function: clinical analysis of 9 cases / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the adverse effects of type B ventricular pre-excitation on ventricular wall motion and left ventricular function and its clinical characteristic.</p><p><b>METHOD</b>The clinical, electrophysiological and echocardiographic characteristics of the 9 cases with type B ventricular pre-excitation before and after ablation seen between March 2011 and March 2013 were analyzed. The patients aged from 3 to 16 years. Five of them were female.</p><p><b>RESULT</b>Dyschronous left ventricular contraction was demonstrated by M-Mode echocardiography in all of the cases. The basal segments of the interventricular septum turned thin and moved in a manner similar to that of an aneurysm, with typical bulging during end-systole, which was observed in six cases. All patients received successful RFCAs. The locations of the accessory pathways (APs) were the right-sided anteroseptum (n = 2) and the free wall (n = 7). Their physical activities and growth improved greatly in the four cases with coexisting dilated cardiomyopathy (DCM). The echocardiographic data demonstrated that their LV contraction recovered to synchrony shortly after the ablation, LVEF recovered to normal and LVED decreased to almost normal gradually during the follow-up.</p><p><b>CONCLUSION</b>Overt right-sided APs may have adverse effects on ventricular wall motion and left ventricular function. They can even result in DCM. Dyssynchronous ventricular contraction induced by right-sided overt accessory pathway may be the vital mechanism. Such kinds of cases are indication for ablation with good prognosis.</p>

Clinical characteristics of ventricular preexcitation dilated cardiomyopathy induced by accessory pathway / 中华实用儿科临床杂志

Objective To discuss the characteristics,diagnosis,mechanism and the prognosis of dilated cardiomyopathy (DCM) induced by accessory pathway (AP).Methods The clinical,electrophysiological and echocardiographic characteristics in four cases,who were diagnosed as AP-induced DCM in the Department of Pediatric Cardiology of Beijing Anzhen Hospital,Capital Medical University from Mar.2011 to Aug.2012,were analyzed before and after ablation.Results The electrocardiograms of the 4 patients all indicated type B ventricular preexcitation.The locations of the APs were the right-sided anteroseptum and the free wall.Dyschronous contractions between posterior wall of left ventricle and interventricular septum were demonstrated by M-Mode echo.The basal segments of the interventricular septum turned thin and moved similar to an aneurysm,with typical bulging during end-systole,which was observed in all cases by two-dimension echo.Dyschronous left ventricular contraction was shown by speckle tracing technique.All patients received successful radio frequency current ablations.Their physical activities and growth improved greatly in the 4 cases.The echocardiographic data demonstrated that their left ventricular contraction recovered to synchrony shortly after the ablation,left ventricular ejection fraction recovered to normal and left ventricular end diastolic diameter decreased to almost normal gradually during the follow-up.Conclusions Overt right-sided APs localized in anteroseptum or free wall may have adverse effects on ventricular wall motion and left ventricular function.They can even result in DCM.Dyssynchronous ventricular contraction induced by right-sided overt accessory pathway may be the vital mechanism.AP-induced DCM is an indication for ablation with good prognosis.

Organization and management in hospital's humanistic services / 中华医院管理杂志

The service behavior of medical staff is influenced by the organizational environment and management mode of the hospital. That is to say, the organization and management determine the standardization and sustainability of a hospital's humanistic services, and organizational driving force is also an important factor for the staff to innovate their services. Organization and management of a hospital' s humanistic services is composed of three factors: service operation management, service elements management and service performance management. These factors ensure a hospital's humanistic services to achieve whole-staff-participation, sustainability and standardization.