Value of peripheral blood lymphocyte count in evaluating the short－term prognosis of patients with acute－on－chronic liver failure / 临床肝胆病杂志

ObjectiveTo investigate the influencing factors for the prognosis of patients with acute－on－chronic liver failure （ACLF）， and to establish a short－term prognostic model. MethodsA retrospective analysis was performed for the baseline clinical data of 247 patients with ACLF who were hospitalized in Department of Infectious Diseases， The First Affiliated Hospital of Xi’an Jiaotong University， from January 2011 to December 2016， and the patients were divided into survival group and death group. The two groups were compared to identify the influencing factors for prognosis； a prognostic model was established， and the receiver operating characteristic （ROC） curve was used to assess its predictive efficacy and determine the optimal cut－off value. The independent－samples t test was used for comparison of normally distributed continuous data between groups， and the Mann－Whitney U rank sum test was used for comparison of non－normally distributed continuous data between groups； the Fisher’s exact test or the Pearson’s chi－square test was used for comparison of categorical data between groups. The univariate and multivariate logistic regression analyses were used to investigate the independent risk factors for 28－ and 90－day prognosis， and the Kaplan－Meier method was used to plot the 28－day survival curves. ResultsA total of 220 patients with ACLF were included based on the inclusion and exclusion criteria； there were 148 patients in the 28－day survival group and 72 patients in the 28－day death group， with a 28－day transplantation－free survival rate of 67.27%； there were 115 patients in the 90－day survival group and 105 patients in the 90－day death group， with a 90－day transplantation－free survival rate of 52.27%. The logistic regression analysis showed that female sex （odds ratio ［OR］=2.149， P=0.030）， high Model for End－Stage Liver Disease （MELD） score （OR=1.120， P<0.001）， and low lymphocyte count （OR=0.411， P=0.002） were independent risk factors for 28－day prognosis， and an LS－MELD model for 28－day prognosis was established as Logit （28－day prognosis）=－3.432+0.765×sex－0.890×lymphocyte count×10－9+0.113×MELD（1 for male sex and 2 for female sex）. The ROC curve analysis showed that this model had an optimal cut－off value of 0.35， and then the patients were divided into low LS－MELD group （≤0.35） and high LS－MELD group （>0.35）； the low LS－MELD group had a significantly higher 28－day survival rate than the high LS－MELD group （P<0.001）. ConclusionPeripheral blood lymphocyte count combined with sex and MELD score has a certain value in predicting the short－term prognosis of ALCF patients.

Reliability and validity of the 10-item resilience sale in Chinese community-dwelling adults / 中华行为医学与脑科学杂志

Objective:To explore the reliability and validity of the 10-item Connor-Davidson resilience scale (CD-RISC-10) in Chinese community-dwelling adults.Methods:Using multistage stratified sampling, totally 2 051 community-dwelling adults were selected and they were investigated by the 10-item Connor-Davidson resilience scale, the center for epidemiological studies depression scale (CES-D) and 10-item Kessler psychological distress scale (K10). The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the CD-RISC-10 by SPSS 22.0 and AMOS 22.0.A parallel analysis and Velicer's minimum average partial (MAP) test were also supplemented to confirm the EFA-derived structure of the scale.Results:The Cronbach α coefficient of the CD-RISC-10 was 0.94, and the Spearman-Brown reliability was 0.89.The total correlation of the questions ranged from 0.74 to 0.81 (all P<0.01). The exploratory factor analysis retained its single dimension, which can explain 63.24% of the total variance.Confirmatory factor analysis revealed the single factor model fit data adequately ( χ2/ df=4.596, CFI=0.967, TLI=0.973, RMSEA=0.065). The resilience(27.02±13.50) was negatively correlated with depression(9.75±5.24) and psychological distress (19.23±6.37)( r=-0.32, -0.35, both P<0.01). Conclusion:The CD-RISC-10 scale has acceptable reliability and validity, with using easily and conveniently.Therefore, it is an effective tool for measuring the resilience of the community-dwelling adults.

Perioperative rehabilitation clinical pathway of acetabular fracture in light of the integration of orthopedics and rehabilitation: a prospective randomized control trial / 中国康复理论与实践

ObjectiveTo evaluate the efficacy and safety of a perioperative rehabilitation clinical pathway of acetabular fracture in light of orthopedics rehabilitation team approach. MethodsA prospective randomized control trial was conducted in 82 patients with acetabular fractures who had been admitted from the Emergency Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from June, 2019 to January, 2021. The patients were randomly divided into control group (n = 41) and intervention group (n = 41). The control group was managed routinely, while the intervention group received the rehabilitation clinical pathway, for 24 weeks. The Visual Analogue Score (VAS) of pain, the Barthel Index (BI) and Majeed Pelvic Score were compared. ResultsFinally, 76 patients completed the trial. There was no statistical difference in VAS score between two groups in all periods (|Z| < 1.926, P > 0.05). The BI score was higher in the intervention group than in the control group at discharge, two weeks, six weeks and twelve weeks after operation (|Z| > 2.121, P < 0.05); and no significant difference was found before operation and 24 weeks after operation (|Z| < 1.862, P > 0.05). Majeed Pelvic Score was higher in the intervention group than in the control group two weeks, six weeks, twelve weeks and 24 weeks after operation (|Z| > 2.428, P < 0.05). Six, twelve and 24 weeks after operation, the excellent rate of Majeed Pelvic Score was higher in the intervention group than in the control group (χ2 > 6.136, P < 0.05). ConclusionIn comparison with traditional protocol in acetabular fracture, the perioperative rehabilitation clinical pathway was proved effective and of great safety in the light of the integration of orthopedics and rehabilitation mode for improving the function and activities of daily living of patients.

Association between primiparas’ willingness of a second child and cesarean section / 上海预防医学

ObjectiveTo explore the impact of primiparas’ intention to have a second child on their delivery mode. MethodsDuring March 1st， 2019 and November 30th， 2020， the enrolled pregnant women were investigated by questionnaires at two points， first trimester pregnancy registration and post-natal visit at maternal and child healthcare community centers of Xuhui District. Logistic regression analysis was used to examine the association of willingness of a second birth and their mode of delivery. Results2 000 questionnaires were distributed and 1 664 valid questionnaires were analyzed. The overall cesarean delivery rate in nulliparous women was 40.08% （667/1 664）， with 8.95% （149/1 664） of non-medical indication cesarean delivery. Multiple Logistic regression analysis of overall delivery rate showed that age， willingness to have more children in the future， plan of vaginal delivery at first questionnaire， and complications during pregnancy were associated with overall cesarean delivery rate， and women without the willingness to have more children in the future were more likely to undergo cesarean delivery （OR=1.350， 95%CI： 1.052-1.732）. Age， whether to have a second child in the future， plan of vaginal delivery at first questionnaire， and complications during pregnancy were all factors associated with increased risks of non-medical indicated cesarean delivery， while women with no plan of a second child in the future had nearly 2 times of risk of non-medical indicated cesarean delivery （OR=1.909， 95%CI： 1.117-3.262）. ConclusionThe mode of delivery is affected by many factors， among which willingness to have more children in the future is an important factor associated with increased risks of overall cesarean delivery and non-medical indicated cesarean delivery.

Development of hedgehog pathway inhibitors by epigenetically targeting GLI through BET bromodomain for the treatment of medulloblastoma

Medulloblastoma (MB) is a common yet highly heterogeneous childhood malignant brain tumor, however, clinically effective molecular targeted therapy is lacking. Modulation of hedgehog (HH) signaling by epigenetically targeting the transcriptional factors GLI through bromodomain-containing protein 4 (BRD4) has recently spurred new interest as potential treatment of HH-driven MB. Through screening of current clinical BRD4 inhibitors for their inhibitory potency against glioma-associated oncogene homolog (GLI) protein, the BRD4 inhibitor

Differential expression and bioinformatic analysis of microRNA in the plasma of patients with type 2 diabetes mellitus / 中华医学遗传学杂志

OBJECTIVE@#To construct the differential expression profile of microRNA (miRNA) in plasma of patients with type 2 diabetes mellitus (T2DM) and explore the possibility of using miRNA as the target for diagnosis and treatment of T2DM.@*METHODS@#Agilent miRNA microarray was used to determine the expression profiles of miRNA in the plasma of patients with T2DM (FC> 2, P< 0.05). The result was verified by real-time quantitative PCR (RT-qPCR). Candidate miRNA was analyzed by bioinformatic tools.@*RESULTS@#In total 122 differentially expressed miRNAs were identified. Among these, 14 were selected by multi-source intersection screening, which included 5 up-regulated genes and 9 down regulated genes. RT-qPCR showed that the expression of hsa-miR-185-5p and hsa-miR-328-5p have significantly increased in T2DM patients (P< 0.05). Bioinformatic analysis suggested that these miRNAs may be involved in the pathogenesis of T2DM through insulin secretion and PI3K-AKT signaling pathway.@*CONCLUSION@#Differential expression of hsa-miR-185-5p and hsa-miR-328-5p in the plasma may be closely associated with the pathogenesis of T2DM.

Perioperative rehabilitation approaches based on the concept of Enhanced Recovery After Surgery for pelvic fractures: a prospective randomized control trial / 中华创伤骨科杂志

Objective:To evaluate the efficacy and safety of perioperative rehabilitation approaches based on the concept of Enhanced Recovery After Surgery (ERAS) for pelvic fractures.Methods:A prospective randomized control trial was conducted to include 114 emergency patients who had been admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital for surgical treatment of pelvic fractures from June 2019 to December 2020. Of them, 57 were assigned into an intervention group according to a random digits table. They were 42 males and 15 females, aged from 18 to 77 years and subjected to management of pelvic fractures with tentative perioperative ERAS approaches which were adjusted at different stages. The other random 57 patients were assigned into a control group. They were 40 males and 17 females, aged from 17 to 70 years and subjected to management of pelvic fractures with conventional rehabilitation approaches which included postoperative in-hospital consultation and guidance by rehabilitation physicians. The 2 groups were compared in terms of Majeed pelvis scores and Barthel indexes at postoperative 2, 6, 12 and 24 weeks, and visual analogue scale (VAS) pain scores and SF36 scores at postoperative 12 and 24 weeks.Results:A total of 105 patients (55 in the intervention group and 50 in the control group) were completely followed up for 151 to 254 d (mean, 177 d). The 2 groups were comparable due to no significant difference between them in the preoperative general data ( P>0.05). The Majeed scores (44±13, 67±16, 86±14 and 98±7) and Barthel indexes (57±13, 79±16, 95±8 and 100±2) at postoperative 2, 6, 12 and 24 weeks in the intervention group were significantly higher than those in the control group [(35±16, 51±16, 73±14 and 91±12) and (45±19, 67±18, 86±12 and 98±4)] (all P<0.05). At postoperative 12 and 24 weeks, the SF-36 scores (129±15 and 141±6) in the intervention group were significantly higher than those in the control group (114±15 and 131±12) ( P<0.05). There was no significant difference in the pain degree between the 2 groups ( P>0.05). Conclusion:In management of pelvic fractures, compared with conventional perioperative rehabilitation approaches, the perioperative ERAS rehabilitation approaches may improve early functional outcomes and thus help the patients restore their activities of daily living earlier.

Exploration of building a smart management platform for large-scale medical equipment in hospitals / 中华医院管理杂志

Strengthening the supervision over the use of large-scale medical equipment is an effective means to improve the efficiency of equipment use and the quality of medical services, and it is an important part of promoting the construction of the Healthy China and the development of health undertakings. Through four stages of preliminary demand investigation, intelligent collection of data, intelligent analysis and evaluation, and continuous improvement, a large-scale medical equipment intelligent management platform was built in our hospital. Real-time data collection, interconnection, analysis and evaluation were achieved, which could help the use and supervision, improve efficiency and effectiveness, and optimize the evaluation system.

Thinking on the construction of medical equipment management system based on the response to COVID-19 epidemic / 中华医院管理杂志

As an important part of public emergency response mechanism, medical supplies and equipment support is an important material support for medical rescue and disposal.For the medical equipment management industry, the epidemic prevention and control practice is a major test, but also a leap forward development opportunity. Based on the working experience, the authors put forward that medical equipment support should be upgraded to the strategic material support for the prevention and control of major infectious diseases. It is suggested to improve the whole process support management system of medical equipment purchase, collection, allocation and donation. The authors discuss how to implement the construction of medical equipment support elements from four aspects of system, technology, supply chain and information system, and also discuss how to promote the development of medical engineering interdisciplinary.

Data platform based fine management practice of medical devices in hospitals / 中华医院管理杂志

Medical device management has become a key to medical quality management, medical risk prevention and medical cost control. Continuous innovation is needed to realize the refinement of device management, ensure the safety of patients and improve medical quality. The authors take MRI as an example to monitor the medical devices based on the data platform support in combination with hospital specifics, so as to provide references for the rational use of medical devices.

The role of isokinetic muscle strength training in rehabilitation after rotator cuff repair / 中华物理医学与康复杂志

Objective:To explore the effect of isokinetic strength training on post-operative rehabilitation of rotator cuff injury after arthroscopy.Methods:Forty patients who had received arthroscopic repair of a rotator cuff tear no less than 3 months previously and who had normal joint movement were selected and randomly divided into a routine training group (the control group) and an isokinetic strength training group (the experimental group), each of 20. Both groups did internal and external rotation strength training with Thera-Band elastic bands, 10-20 times/session, 3 sessions/day. The experimental group additionally underwent isokinetic strength training of the shoulder for 15-20 minutes twice a week. Isokinetic strength tests were performed after 3 and 6 months at test speeds of 60°/s and 180°/s. The evaluation indexes included the internal and external rotation peak torque, peak TQ/BW, the deficit of the affected shoulder joint, the peak torque difference and peak TQ/BW difference before and after training.Results:Both groups had improved significantly after the treatment, but the improvement in the experimental group was significantly greater than in the control group, on average.Conclusion:Isokinetic muscle strength training is helpful to recover strength after arthroscopic repair of a rotator cuff injury, especially the rapid external rotation muscle strength. It is worthy of clinical application.

Practice on fine management and control of medical consumables of hospitals / 中华医院管理杂志

Furthering healthcare reform calls for public hospitals to curb unreasonable growth of medical expenses,reduce drug proportion,and lower the costs of medical materials consumed per 100 RMB medical income.In view of the hospital,the authors established a data-based monitoring system for key indicators of medical consumables,formulated an evaluation scheme of rational use,and implemented the corresponding control measures,which provide a reference for scientific control of clinical rational use of the medical consumables.

Inhibitory effect of activation of cardiac TRPV1 receptors on cardiovascular activity in rats / 吉林大学学报(医学版)

Objective: To investigate the cardiovascular reflex induced by the activation of cardiac transient receptor potential vanillic acid receptor 1(TRPV1), the central location of reflex and its peripheral neurotransmitters of the rats, and to elucidate the central and peripheral neural mechanisms of cardiovascular reflex mediated by TRPV1 receptor. Methods: A total of 60 healthy male SD rats were randomly divided into control group, ido-RTX group, atropine group, immunofluorescence group and nerve tract tracking group; there were 12 rats in each group. Pericardial intubation was performed in the rats in various groups after anesthesia. The changes of heart rates and blood pressures of the rats in control group, ido-RTX group and atropine group were observed by arterial intubation. The tissue samples were collected 1 h after intropericardial injection of capsaicin in imunofluorescence group, and the co-expression of c-Fos positive neurons induced by capsaicin and cholinesterase positive neurons in the medulla oblongata was observed by immunofluorescence technigue. Intraopericardial injected carbonyl cyanine fluorescent dye (Dil) was used as retrograde tracer in nerve tract group, and the distribution of Dil positive cells in the medulla oblongata was observed by fluorescence microscope 1 week later. Results: The blood pressure and heart rate of the rats in control group were decreased significantly after intrapericardial injection of capsaicin of the rats in control group (P0. 05); after intrapericardial injection of capsaicin, the number of c-Fos positive neurons in nucleus tractus solitarii, dorsal motor nucleus of vagus and nucleus ambiguous of medulla oblongata was increased significantly (P<0. 05); most of these neurons were cholinesterase positive neurons; after intrapericardial injection of Dil, a large number of red fluorescent labeled neurons and nerve endings appeared in the nucleus tractus solitarii, dorsal motor nucleus of vagus and nucleus ambiguous. Conclusion: Intrapericardial injection of capsaicin can selectively activate the TRPV1 receptors in the heart, increase the excitability of cholinergic neurons in the cardiovascular center of the medulla oblongata, increase the peripheral release of acetylcholine, and produce an inhibitory effect on the cardiovascular activity by activating the M receptor.

Anti-disturbance Fetal Heart Rate System Based on Combined Maternal-fetal Monitoring / 中国医疗器械杂志

The existing fetal monitor is prone to false detection in the case of high maternal interference in the second stage of labor. With this background, the article designs and implements a combined maternal-fetal fetal heart monitoring system. The system obtains the Doppler signal of the abdominal fetal heart and the blood oxygen signal of the mother's finger, and estimates the maternal interference degree in the fetal heart rate Doppler signal according to the maximum correlation value between the maternal finger blood oxygen signal and the abdominal fetal heart Doppler signal, and switches the fetal heart rate extraction algorithm between the autocorrelation method suitable for lower interference and improved template method suitable for higher interference according to the maternal interference degree. The accuracy of our method is 9.2% which is higher than that of the improved template matching method and 6.1% higher than that of the autocorrelation method.

Optimal template selecting combined with non-liner template matching for Doppler fetal heart rate extraction / 生物医学工程学杂志

The ultrasound Doppler fetal heart rate measurement is the gold standard of fetal heart rate counting. However, the existing fetal heart rate extraction algorithms are not designed specifically to suppress the high maternal interference during the second stage of labor, and false detection occurrences are common during labor. With this background, a method combining time-frequency frame template library optimal selecting and non-linear template matching is proposed. The method contributes a template library, and the optimal template can be selected to match the signal frame. After the short-time Fourier transform of the signal, the difference between the signal and the template is optimized by leaky rectified linear unit (LReLU) function frame by frame. The heart rate was calculated from the peak of the matching curve and the heart rate was calculated. By comparing the proposed method with the autocorrelation method, the results show that the detection accuracy of the proposed method is improved by 20% on average, and the non-linear template matching of 23% samples is at least 50% higher than the autocorrelation method. This paper designs the algorithm by analyzing the characteristics of the interference and signal mixing. We hope that this paper will provide a new idea for fetal heart rate extraction which not only focuses on the original signal.

Effects of garcinia acid on proliferation and invasion of human bladder cancer cell line / 国际中医中药杂志

Objective To investigate the impacts of garcinia acid on the proliferation and invasion abilities of human bladder cancer cell line(BIU-87), and to study the possible molecular mechanisms. Methods The BIU-87 cells were cultured in vitro, and then the cells were divided into control group, low-dose, middle-dose, and high-dose garcinia acid groups. The cells in the drug groups were treated with 20, 40, 80μmol/L of garcinia acid for 24, 48, and 72 h, and control group were incubated by normal medium. The inhibition of proliferation of BIU-87 cells was performed using CCK8 assay. The abilities of BIU-87 cell invasion were assessed using Transwell chambers, and the expression levels of vascular endothelial growth factor(VEGF) were analyzed using Western Blot technology.Results Compared with control group, the proliferation inhibitory rates of cells after treatment with low-, middle-, and high-dose garcinia acid for 24, 48, and 72 h were significantly decreased(P<0.05). Moreover, the proliferation inhibitory rates in different drug groups were greatly increased with the time extension. Compared with control group, the number of cells passing through the membrane(26 ± 4, 41 ± 4, 53 ± 5vs.119 ± 7) in low-, middle-, and high-dose garcinia acid group significantly decreased(P<0.05), the expression levels of VEGF (41.2 ± 6.2, 23.8 ± 5.2, 17.9 ± 4.7 vs. 14.8 ± 4.2) in low-, middle-, and high-dose garcinia acid group significantly decreased(P<0.05).Conclusions The Garcinia acid can inhibit the proliferation and invasion of BIU-87 cells via the down-regulation of VEGF expression.

Vascular endothelial growth factor-loaded microspheres promote dental pulp regeneration and vascularization / 中华口腔医学杂志

Objective@#To evaluate the effect of vascular endothelial growth factor (VEGF)-loaded microspheres on dental pulp tissue regeneration and vascularization in vivo.@*Methods@#In vitro release experiment and human umbilical vein endothelial cell migration experiment were conducted with VEGF loaded microspheres. The dental pulp stem cells (DPSC) were co-cultured with VEGF microspheres to observe the compatibility between the cells and the microspheres. DPSC and VEGF loaded microspheres were injected into the root lumen through the apical foramen, which were then transplanted subcutaneously into nude mice. Histological and immunohistochemical features were observed after nine weeks.@*Results@#DPSCs attached and spread on the surface of the microspheres. HE staining showed that the regenerated pulp-like tissue fulfilled the whole apex and middle third of the root. Differentiated odontoblast-like cells aligned with the existing tubular root dentin.@*Conclusions@#VEGF-loaded microspheres promoted the regeneration of pulp-like tissues and formation of blood vessels.

Study of niacin skin flushing response for the diagnosis of major depressive disorder / 中国神经精神疾病杂志

Objective To investigate the difference of niacin skin flush response between patients with major depressive disorder (MDD) and healthy controls (HCs), and its sensitivity and specificity for the diagnosis of MDD. Methods Twenty-one untreated patients with MDD and 28 age- and gender-matched HCs were enrolled in this study. The severity of depressive symptoms was assessed mainly by using the 17-item Hamilton Depression Rating Scale (HDRS-17). Methyl Nicotinate (MN) solution at 8 different concentrations (10-5 mol/L, 10-4 mol/L, 10-3.5 mol/L, 10-3 mol/L, 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L, 10-1 mol/L) were applied on subjects' forearms. Signals of blood flow were collected using the Doppler Laser Flowmetry to detect the skin flushing of the test. Results Under the concentrations of 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L and 10-1 mol/L MN solution, the blood flow was significantly higher in depressive patients than in HCs (P<0.01). The MN sensitivity (logEC50) was inversely correlated to the severity of depressive symptoms (r=-0.57, P<0.05). ROC curve analysis implied that the maximum blood flow (MBF) caused by the niacin skin flush response, could efficiently discriminate MDD from HCs (AUC=0.90, P<0.01). Conclusion The presence of enhanced niacin skin flush response may be helpful in the diagnosis of MDD.

Application of unique device identification in hospital's medical consumables supply chain:practice and experience / 中华医院管理杂志

This paper introduced the current demands for medical consumables supply chain and the management characteristics of unique device identification ( UDI). In line with management needs of the hospital and management of high-risk medical consumables, the paper proposed to establish the UDI-based database, and the solution of standardized coding management and information system equipped with barcode resolution and automatic identification. These efforts provide useful references to overcome difficulties in product identification, process management, and follow-up tracking of such consumables.

Performance appraisal practice: an exploration based on basic data architecture of medical equipments / 中华医院管理杂志

The hospital effectively improved the accuracy of data acquisition in performance appraisal of medical equipment, by means of better basic data management architecture, full-course supervision, clarified responsibility system, and intelligent new technologies. It holds that the information system and application of new technologies can help ensure the collection of basic data in a timely and effective manner, while orchestrated work of sections can ensure the authenticity and accuracy of performance appraisal and improve the using efficiency of medical equipments.