A study of the home care model based on the Omaha system for elderly maintenance hemodialysis patients / 中华老年医学杂志

Objective:To analyze the application effect of the home care model based on the Omaha system for elderly maintenance hemodialysis patients.Methods:A total of 73 elderly patients undergoing maintenance hemodialysis in the First People's Hospital of Longquanyi District, Chengdu city from December 2018 to December 2019 were enrolled.According to the randomization and double-blind principle, they were divided into the control group receiving the clinical routine care mode(n=32)and the intervention group undergoing the home care mode based on Omaha system(n=41). The Quality of Life Score, care satisfaction and awareness rate of health knowledge of patients were compared between the two groups before and after the care intervention.Results:Compared with before intervention, the quality of life scores was increased after caring in both two groups.And the scores in all dimensions were better in the intervention group than in the control group( t=3.173, 3.833, 3.514 and 4.593, P=0.001, 0.000, 0.000 and 0.000). The awareness rates of nutrition knowledge, water-intaking knowledge, iron supplementation knowledge, potassium and phosphorus limitation and dialysis mode were better in the intervention group than in the control group( χ2=7.592, 5.423, 8.494, 6.161 and 6.962, P=0.011, 0.011, 0.000, 0.010 and 0.011). The total satisfaction rate was 97.6%(40/41)in the intervention group, which was superior to that in the control group(75.0% or 24/32)( χ2 =8.460, P=0.000). Conclusions:The extended home care model based on the Omaha system can effectively improve patients' awareness of health knowledge, improve patients' quality of life and improve the satisfaction with care in elderly maintenance hemodialysis patients with a low education level, and it is worthy of clinical promotion.

Detection and analysis of respiratory pathogens in patients with acute exacerbation of chronic obstructive pulmonary disease / 中国基层医药

Objective:To detect and analyze the infections of respiratory pathogens in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:Through retrospective analysis, 335 AECOPD patients hospitalized from October 2016 to September 2018 in the First People′s Hospital of Pinghu were selected.The indirect immunofluorescence method was used to detect IgM antibody of eight kinds of respiratory pathogens, and the results were analyzed.Results:The positive rate of respiratory pathogens-IgM antibody in patients with AECOPD was 29.9%.There were 57 cases with one single pathogen infection, 36 cases with two pathogens mixed infection, 7 cases with three kinds of pathogens mixed infection.The influenza virus B [52.0%(78/150)] was the most common, followed by influenza virus A [27.3%(41/150)], the positive rates of pathogens were influenza virus B>influenza virus A>respiratory syncytial virus>parainfluenza virus>Legionella pneumophila>Mycoplasma pneumoniae>Chlamydia pneumoniae>adenovirus.There was no statistically significant difference in different age groups(χ 2=0.047, P=0.829). The positive rates of pathogens-IgM in spring[55.3%(63/114)] and winter[58.1%(54/93)] were higher than those in summer[26.2%(16/61)] and autumn[25.4%(17/67)], the differences were statistically significant(χ 2=30.398, P<0.01). Conclusion:AECOPD is closely related with respiratory pathogens, especially influenza virus.We should do preventive work well in epidemic season.

Hospital service optimization practice based on third-party satisfaction measurement / 中华医院管理杂志

The paper introduced the third-party satisfaction measurement and refined appraisal for quality continuous improvement programs launched by the hospital,and the PDCA management tools which optimized quality of care and patient satisfaction.The hospital is thus recommended to leverage databases for big data comparison,and carry out refined management on such basis,for the purposes of better performance management,higher doctor-patient friendship and patient trust.

Application of three biomarkers in diagnosis of heart failure / 中华老年心脑血管病杂志

Objective To study the application of BNP,NT-proBNP and ST2 in diagnosis of heart failure (HF).Methods Ninety-seven HF patients admitted to our hospital served as a HF group and 61 HF-free patients served as a control group.The patients in HF group were further divided in to class Ⅱ group (n=32),class Ⅲ group (n=36) and class Ⅳ group (n=29) according to their cardiac function in NYHA classification.The serum ST2,BNP and NT-proBNP levels were measured and their value in diagnosis of HF was analyzed.Results The serum BNP,NT-proBNP and ST2 levels were significantly higher in HF group than in control group (396.0 ng/L vs 39.4 ng/L,P＜0.01;1825.0 ng/L vs 215.0 ng/L,P＜0.01;56.8 μg/L vs 25.4 μg/L,P＜0.01),which increased with the increasing cardiac function in NYHA classification (P＜0.01).The area under the ROC curve for BNP,NT-proBNP,ST2,combined NT-proBNP and ST2 was 0.874,0.891,0.842,0.905 respectively for the diagnosis of HF.Conclusion BNP,NT-proBNP and ST2,3 new biomarkers,can improve the diagnosis of HF.

Computed tomography and magnetic resonance imaging features of the myomatous hepatic angiomyolipoma / 中华消化外科杂志

Objective To investigate the computed tomography (CT) and magnetic resonance imaging (MRI) features of the myomatous hepatic angiomyolipoma (MHAML).Methods The retrospective cross-setional study was conducted.The clinicopathological data of 22 patients with MHAML who were admitted to the Southwest Hospital of the Third Military Medical University between January 2010 and June 2016 were collected.Patients underwent plain and enhanced scans of CT and MRI,and then received pathological examination after surgical resection or liver puncture and immunohistochemical staining.Observation indicators:(1) findings of CT and MRI,2 radiologists independently read films;(2) diagnostic consistency of 2 radiologists;(3) results of pathological examination.The Kappa test was used for evaluating the consistency,κ ≥0.75 as a good consistency,0.40＜κ＜0.75 as a normal consistency and κ ≤0.40 as a poor consistency.Results (1) Findings of CT and MRI:of 22 patients,16 received CT scans and 6 received CT and MRI scans.Tumors of 22 patients were single lesion,showing similar-circular type.Tumors located in the right liver lobe,left liver lobe and caudate lobe were respectively detected in 14,7 and 1 patients.① Plain and enhanced scans of CT:tumors of 22 patients showed low density.Twenty patients had clear boundary of tumor and 2 had an unclear boundary.Tumors of 22 patients demonstrated obvious enhancement in arterial phase by enhanced scans of CT,including fast-in and slow-out enhancement in 10 patients and fast-in and fast-out enhancement in 12 patients.The draining veins inside tumors were detected in 12 patients in early arterial phase by enhanced scans of CT.The dilated blood vessels inside tumors were found in 12 patients.The ring enhancement of tumor margin was detected in 16 patients,with formation of small blood vessels involving tumor blood supply.② MRI scan:tumors of 6 patients presented as low signal on T1WI and high signal on T2WI.Of 6 patients,5 had clear boundary of tumor and 1 had an unclear boundary.Tumors of 6 patients demonstrated obvious enhancement in arterial phase by enhanced scans of MRI,with a fast-in and fast-out enhancement.The draining veins inside tumors were detected in 3 patients in early arterial phase by enhanced scans of MRI.The dilated blood vessels inside tumors were found in 1 patient.The persistent ring enhancement of tumor margin was detected in 5 patients,with formation of small blood vessels.All the lesions of 6 patients using GD-EOB-DTPA MR contrast-enhanced scan demonstrated restricted diffusion with a high b value (b=800 s/mm2),an average apparent diffusion coefficient of 1.549× 10-3 mm2/s (1.209× 10-3-1.796× 10-3 mm2/s) and low a signal in liver phase.(2) Diagnostic consistency of 2 radiologists:there were good diagnostic consistencies of 2 radiologists in tumor location,density,T1WI,T2WI,bleeding,enhancement method and dilated blood vessels (κ=1.00,1.00,1.00,1.00,0.82,0.82,P＜0.05).There were normal diagnostic consistencies of 2 radiologists in tumor fat,calcification,component of cystolization,boundary,draining veins and enhancement of tumor margin (κ =0.46,0.45,0.64,0.54,P＜0.05).(3) Results of pathological examination:results of pathological examination of tumors from surgical resection of 17 patients and liver puncture of 5 patients showed that smooth muscle cells were the major components,and thick-walled vessels were found in the tumor of 12 patients.Results of immunohistochemical staining showed that anti melanoma specific monoclonal antibody (HMB-45) was positive.Conclusion The persistent enhancement of tumor margin,draining veins in early arterial phase by enhanced scans and dilated blood vessels might play roles in diagnosis of MHAML.

Association of ADAMTS-1 gene polymorphisms with ischemic stroke caused by large artery atherosclerosis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of a disintegrin and metallo-proteinase with thrombospondin type 1 motifs (ADAMTS-1) gene polymorphism and ischemic stroke caused by large artery atherosclerosis (LAA).</p><p><b>METHODS</b>In total 767 patients and 506 controls were recruited. Single nucleotide polymorphisms (SNPs) rs416905 (T/C) and rs402007 (G/C) of the ADAMTS-1 gene were genotyped by polymerase chain reaction and DNA sequencing.</p><p><b>RESULTS</b>Frequencies of the rs402007 GC+CC genotype and the C allele were significantly different between the two groups (68.84% vs. 60.67%, χ2=9.012, P=0.003, OR=1.432; 45.24% vs. 38.54%, χ2=11.208, P=0.001, OR=1.318). Binary logistic regression has confirmed that the above difference was significant (P=0.001, OR=1.521, 95%CI: 1.183-1.955). The frequencies of TC+CC and GC+CC genotypes were similar between the two groups, and so was it with the C allele. The two SNPs had been in complete linkage disequilibrium (D'=1.0, r2=1.0).</p><p><b>CONCLUSION</b>The rs416905 and rs402007 polymorphisms of the ADAMTS-1 gene may be associated with ischemic stroke caused by LAA. The C allele of the rs402007 locus may be a susceptibility factor for this subtype of stroke.</p>

Aflatoxin M1 preparation and identification of artificial antigens / 中国免疫学杂志

Objective:AFM1-BSA and AFM1-OVA were synthesized and then identified in this experiment.Methods: Using oximation method ,AFM1 was transformed to oxime compounds while the reaction process was monitored via TLC method aiming to identify the compounds.Coupled with carrier protein BSA and OVA respectively , we obtained AFM1-BSA and AFM1-OVA, then identified synthetic antigen via UV spectrophotometry and SDS-PAGE.Antigens were injected into experimental animals , finally obtaining the murine multi-antiserum.Eventually , the multi-antiserums were detected via indirect inhibition ELISA method to judge whether the antigens were effectively or not.Results:After oximation reaction ,the migration distance of oxime compounds in the thin layer plate was shorter.The maximum absorption peak of AFM1-BSA occurred in 274 nm,and was inconsistent with both UV absorption peaks of BSA and AFM 1.The electrophoretic velocity of AFM 1-BSA was less than that of BSA.All the titers of three immunized mice were 1×10-4 approximately;the multi-antiserum from No.3 sample had the best sensitivity ,its IC50 was 359.9 ng/ml.Conclusion:In this study,we obtained AFM1 artificial antigen and murine multi-antiserum of high sensitivity.

Association of MMP-14 gene polymorphism with cerebral infarction - a case-control study / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association between cerebral infarction (CI) and single nucleotide polymorphism (SNP) in the exon of membrane-type 1 matrix metalloproteinase (MMP-14) gene in Chinese Han population.</p><p><b>METHODS</b>Five hundred seventy four patients with CI and 463 healthy individuals were recruited. Serum MMP-14 level was measured with enzyme-linked immunosorbent assay (ELISA). rs1042704 and rs2236307 polymorphisms of the MMP-14 gene were genotyped with a TaqMan assay. Multivariate logistic regression was carried out to analyze the risk factors of CI.</p><p><b>RESULTS</b>A significant lower risk of CI was found in individuals with MMP-14 rs2236307 TC and CC genotypes (vs. TT genotype: P<0.05). The frequencies of MMP-14 rs2236307 C allele were significantly different between the CI group (37.46%) and the control group (43.95%) (P=0.003). Serum level of MMP-14 was higher in the CI group (P=0.003) and was also higher in the group with MMP-14 rs2236307 TT genotype compared with those with CT and CC genotypes (P=0.000; P=0.009). Logistic regression analysis indicated that the MMP-14 rs2236307 CT+CC genotypes was a protective factor, and that history of hypertension, smoking status, triglycerides, diastolic blood pressure and systolic blood pressure were the independent risk factors of CI (AOR:2.027, 1.302, 1.296, 1.434, 2.087; P<0.05).</p><p><b>CONCLUSION</b>The rs2236307 polymorphism of MMP-14 gene is associated with CI, for which the C allele maybe a protective factor. No association of MMP-14 gene rs1042704 polymorphism with CI has been found.</p>

Association between -1296T/C and -915A/G polymorphisms of matrix metalloproteinase inhibitor-3 gene and atherosclerotic cerebral infarction in an ethnic Han Chinese population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association between -1296T/C and -915A/G polymorphisms in the promoter region of matrix metalloproteinase inhibitor-3 gene (TIMP-3) and atherosclerotic cerebral infarction in an ethnic Han Chinese population.</p><p><b>METHODS</b>Peripheral blood samples were collected from 485 patients with atherosclerotic cerebral infarction and 525 healthy controls. Serum levels of TIMP-3 were measured with an enzyme-linked immunosorbent assay (ELISA). The polymorphisms of the TIMP-3 gene were analyzed with DNA sequencing.</p><p><b>RESULTS</b>There were significant differences in genotype and allele frequencies in -1296T/C and -915A/G between the patients and healthy controls (chi-square: 5.227 and 5.869; P: 0.022 and 0.015, respectively). Besides, there was a strong linkage disequilibrium between -1296T/C and -915A/G (D'=1.0, r(2)=0.991). The serum levels of TIMP-3 in patients were significantly higher than the control group [(248.90 ± 97.10) pg/mL vs. (200.17 ± 79.70) pg/mL, t=2.098, P=0.039].</p><p><b>CONCLUSION</b>The -1296T/C and -915A/G polymorphisms of the TIMP-3 gene are associated with increased risk for atherosclerotic cerebral infarction in ethnic Han Chinese and may be used as molecular markers for the disease. There is also strong linkage disequilibrium between the two loci.</p>

Therapeutic Effect of Shenling Baizhu Powder Combined with Erchentang in Treatment of Senile Pneumonia and Influence on Procalcitonin / 中国中医药信息杂志

Objective To observe the efficacy of Shenling Baizhu powder combined with Erchentang in treatment of senile pneumonia, and its influence on serum procalcitonin. Methods With randomized controlled trial, 100 patients were randomly divided into two groups. The control group (49 cases) was treated by routine western medicine, and the treatment group (51 cases) was treated by Shenling Baizhu powder combined with Erchentang additionally. The treatment course was 1 week, and the therapeutic effect was observed after two courses. The improvement time of clinical symptoms and signs, and the change of serum procalcitonin were detected. Results Clinical efficacy of the two groups had no significant difference (P>0.05). The improvement time of signs and symptoms in treatment group was better than that in control group (P<0.05). The serum procalcitonin improved in treatment group was better than that in control group (P<0.05). Conclusion Shenling Baizhu powder combined with Erchentang has obvious anti-infection effect, and can improve symptoms and signs of senile pneumonia rapidly.

Association of serum levels of matrix metalloproteinase-12 and a functional polymorphism in the promoter-82A/G of the matrix metaiioproteinase-12 gene with acute atherosclerotic cerebral infarction / 中华神经科杂志

Objective To investigate the association of serum levels of matrix metalloproteinase-12 (MMP-12) and a functional polymorphism in the promoter - 82A/G of the MMP-12 gene with acute atherosclerotic cerebral infarction (ACI).Methods All 608 cascs of acute ACI and 374 healthy controls were included in the study.Serum levels of MMP-12 were measured using the enzyme-linked immunosorbent assay (ELISA). At the same time,polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed on the - 82A/G polymorphism in the MMP-12 gene.Results The serum levels of MMP-12 in ACI group (( 17.36 ± 9.12) ng/ml) were not significantly higher than those in the healthy control group ( ( 17.42 ± 7.70) ng/ml,t ＝ 0.047,P =0.962).The frequency of the AG + GG genotypes was not significantly different between the two groups (7.6％ vs 5.9％,x2 =0.281,P =0.584),and the frequencies of the G allele were 3.8％ and 2.9％ in the ACI group and the control group respectively which were also not significantly different between the two groups ( x2 =0.746,P =0.374).Conclusion There is no correlation between serum level with genetic polymorphism in MMP-12 promoter (-82A/G) and cerebral infarction.

Influence of plasma matrix metalloproteinase-7 levels and genetic polymorphism of -181A/G on the stability of carotid plaque / 中华神经科杂志

Objective To explore the influence of plasma matrix metalloproteinase-7 ( MMP-7 ) levels and genetic polymorphism of MMP-7 - 181 A/G on the stability of carotid plaque.Method According to carotid ultrasound examination, 503 patients with carotid atherosclerotic lesions were consecutively recruited and divided into vulnerable plaque group (n = 118) and stable plaque group (n = 385).Plasma MMP-7 levels were measured by enzyme-linked immunosorbent assay (ELISA), and MMP-7 -181 A/G genotypes were determined by polymerase chain reaction-restiction fragment length polymorphism (PCR-RFLP).Results Plasma MMP-7 levels in carotid vulnerable plaque group were significantly enhanced as compared to stable plaque group (t =5.49, P =0.00).The frequency of MMP-7 -181G allele in vulnerable plaque group was significantly higher than that in stable plaque group (11.4% vs 7.0% ,χ2 = 4.78, P= 0.029).Compared to AA genotype, the genotypes with - 181G allele (AG + GG) significantly increased susceptibility to carotid vulnerable plaque ( χ2 = 5.01, OR = 1.81, P = 0.025 ) .When further analyzing the relationship between genotype and plasma MMP-7 levels, no significant differences of plasma MMP-7 levels were observed between AA genotype and AG + GG genotype in stable plaque group.However, in vulnerable plaque group, plasma MMP-7 levels of AG + GG genotype were significantly higher than that of AA genotype( t = 2.62, P = 0.01).Conclusion The present findings suggest that plasma MMP-7 level may be a biomarker for carotid vulnerable plaque.Genetic polymorphism of - 181 A/G in MMP-7 promoter may affect the expression of MMP-7, and seems to be implicated in susceptibility to carotid vulnerable plaque.

Association of iodine nutrition and thyroid health conditions among residents in Zhoushan archipelago / 中华内分泌代谢杂志

Objective To investigate iodine nutrition and thyroid health status among residents in Zhoushan archipelago, and to analyse their relationship.Methods A total of 3 284 residents in Zhoushan archipelago were surveyed by questionnaire and their thyroids were examined by B-mode ultrasound.The levels of urinary iodine and thyroid function were detected.Results The median level of urinary iodine in 3 284 residents was 226.0 μg/L, being 320.7 μg/L in citizens, 188.9 μg/L in farmers, 122.2 μg/L in salt-makers, 193.6 μg/L in fishers, and 271.7 μg/L in buddhist.The prevalence of diffuse goiter, nodular goiter, colloid goiter, thyroid adenoma, thyroid carcinoma, hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism, and positve rate of TPOAb were 1.7% ,25.3% ,8.7% ,0.2% ,0.4% ,0.5% ,0.8% ,0.03%,1.0% ,and 9.5% repectively.The prevalence of thyroid diseases was increasing with aging, and higher in women than in men (P＜0.05).There was no significant relationship of the thyroid diseases with seafood, smoking,drinking, and tea (P＞0.05).Conclusions The citizens of Zhoushan archipelago have adequate iodine intake.It is pertinent to discuss Universal Salt Iodization.Excessive iodine intake may contribute to the high prevalence rate of thyroid diseases in Zhoushan.