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Objective:To investigate the effects of myeloid-derived growth factor(MYDGF) on inflammatory response and osteoclast differentiation of RAW264.7 cells.Methods:The RAW264.7 osteoclast precursor cells were cultured and treated with different concentrations of recombinant MYDGF protein(rMYDGF), and their cell viability was assessed using the MTT assay. RAW264.7 cells were induced with lipopolysaccharide(LPS) to induce inflammation, and the expression of inflammatory mediators and cell polarization were observed after intervention with rMYDGF. The RAW264.7 cells were induced for osteoclast differentiation using receptor activator of nuclear factor-κB ligand(RANKL), and rMYDGF was added for intervention. Osteoclast differentiation was evaluated by tartrate-resistant acid phosphatase(TRAP) staining. The osteoclast resorption pits and the number of actin rings(F-actin rings) were observed under a microscope. Reverse transcription PCR was performed to detect the expression of activated T cell nuclear factor 1(Nfatc1), cathepsin K(CTSK), and c-Fos genes during osteoclast differentiation. The protein phosphorylation levels of nuclear factor-κB(NF-κB) signaling pathway proteins were detected using Western blotting.Results:MTT assay showed that rMYDGF did not significantly inhibit the viability of RAW264.7 cell when the concentration was lower than 100 ng/mL. Moreover, rMYDGF inhibited the expression levels of inflammatory factors and M1 cell polarization after LPS stimulation. Compared with the control group, the number and area of TRAP positive cells, the number and area of bone resorption pit were decreased in rMYDGF intervention group respectively, as well as the area of the F-actin ring was reduced and its shape was incomplete after rMYDGF intervention. Furthermore, rMYDGF reduced the expression levels of osteoclast-specific marker genes and inhibited the phosphorylation of NF-κB signaling pathway protein IκBα during osteoclast differentiation.Conclusion:MYDGF inhibits the inflammatory response and osteoclast differentiation of RAW264.7 cells.
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BACKGROUND@#The previous study has indicated that lung cancer has a high incidence and mortality in China, and has caused a large economic burden. The purpose of this study was to analyze the incidence and economic burden of lung cancer by analyzing the information on the home page of discharge history of lung cancer patients in Hebei Tumor Hospital, and to provide scientific basis for the prevention and treatment of lung cancer.@*METHODS@#The information of all of the discharges, new cases, surgical patients, age, gender, length of stay and hospitalization cost of lung cancer patients in Hebei Tumor Hospital from January 2012 to December 2019 were retrieved based on the medical record management system, and the incidence trend, gender and age distribution as well as the economic burden of the disease were statistically described.@*RESULTS@#The number of new cases of lung cancer increased year by year, from 2,235 cases in 2012 to 5,012 cases in 2019. The number of males always outnumbered females, but the gender ratio decreased year by year, from 2.25 in 2012 to 1.56 in 2019. Among new cases of lung cancer, the proportion of surgical treatment increased year by year, from 28.14% in 2012 to 44.83% in 2019. Except for 2012, the proportion of surgical operations in female patients was higher than that in male patients from 2013 to 2019. The proportion of surgical operations in male and female patients was 23.52% and 28.07% in 2013, and 36.14% and 58.37% in 2019, respectively. The median age at the onset of lung cancer has increased year by year, from 61 years old in 2012 to 63 years old in 2019. The median age of onset in all lung cancer patients was higher in males than in females. The number of new lung cancer patients and surgical patients both showed an increasing trend with the increase of age, and both reached the maximum value in the age group of 60-69 years old. With the increase of age, the number of patients gradually decreased. The median length of hospital stay for all discharged lung cancer patients or surgical patients decreased year by year, from 10 d and 19 d in 2012 to 8 d and 17 d in 2019, respectively, while the median hospitalization cost increased year by year. It increased from 10,611.46 yuan and 38,750.13 yuan in 2012 to 17,187.15 yuan and 84,030.16 yuan in 2019, respectively.@*CONCLUSIONS@#Lung cancer is still one of the main cancers endangering the health of Chinese residents. The incidence of lung cancer is increasing year by year, and the distribution of gender and age has certain characteristics. In order to reduce the number of cases and the economic burden, effective prevention and control measures should be formulated and medical reform should be strengthened.
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Aged , Female , Humans , Male , Middle Aged , Age Distribution , China/epidemiology , Financial Stress , Incidence , Lung Neoplasms/surgeryABSTRACT
OBJECTIVE@#To analyze the clinical and genetic characteristics of a child with clinical manifestations of hypoplasia, epilepsy and abnormal face.@*METHODS@#The clinical data of the child were collected. The peripheral blood samples of the patient and his parents were extracted for high-throughput sequencing, and Sanger sequencing verification and bioinformatics analysis were performed to detect suspected pathogenic variants.@*RESULTS@#The clinical manifestations of the child were overall developmental backwardness, seizures, autism, and special facial appearance. High throughput sequencing showed that there was a heterozygous mutation of exon 11: c.1920_c.1927delCCTCTACC (p.Ser641Rfs*31) of the DYRK1A gene. The same variant was found in neither of her parents, suggesting that it has a denovo origin.@*CONCLUSION@#The exon11: c.1920_c.1927delCCTCTACC (p.Ser641Rfs*31) mutation in DYRK1A gene was the genetic etiology of the case, which enriches the pathogenic gene spectrum of DYRK1A and provides the basis for clinical diagnosis and genetic counseling.
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Child , Female , Humans , Arthrogryposis , Facies , Heterozygote , Intellectual Disability/genetics , MutationABSTRACT
Aiming at the problems of individual differences in the asynchrony process of human lower limbs and random changes in stride during walking, this paper proposes a method for gait recognition and prediction using motion posture signals. The research adopts an optimized gated recurrent unit (GRU) network algorithm based on immune particle swarm optimization (IPSO) to establish a network model that takes human body posture change data as the input, and the posture change data and accuracy of the next stage as the output, to realize the prediction of human body posture changes. This paper first clearly outlines the process of IPSO's optimization of the GRU algorithm. It collects human body posture change data of multiple subjects performing flat-land walking, squatting, and sitting leg flexion and extension movements. Then, through comparative analysis of IPSO optimized recurrent neural network (RNN), long short-term memory (LSTM) network, GRU network classification and prediction, the effectiveness of the built model is verified. The test results show that the optimized algorithm can better predict the changes in human posture. Among them, the root mean square error (RMSE) of flat-land walking and squatting can reach the accuracy of 10 -3, and the RMSE of sitting leg flexion and extension can reach the accuracy of 10 -2. The R 2 value of various actions can reach above 0.966. The above research results show that the optimized algorithm can be applied to realize human gait movement evaluation and gait trend prediction in rehabilitation treatment, as well as in the design of artificial limbs and lower limb rehabilitation equipment, which provide a reference for future research to improve patients' limb function, activity level, and life independence ability.
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Humans , Algorithms , Gait , Machine Learning , Neural Networks, Computer , WalkingABSTRACT
Objective:To investigate the application value of oral stimulation combined with maternal milk sucking in the pain caused by PICC in children with congenital digestive tract malformations.Methods:Using convenience sampling method, 80 children with congenital digestive tract malformations who were admitted to Hunan Children's Hospital from July 2018 to December 2019 were selected and divided into the experimental group and the control group of 40 cases in each group according to the random number table method. The control group was given routine nursing mode, while the experimental group was given oral stimulation combined with maternal milk sucking intervention on the basis of routine nursing. The intervention effects were evaluated by the Neonatal Infant Pain Scale (NIPS), the onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face, and indicators such as heart rate, respiratory rate and SpO 2. Results:The NIPS scores of children in the experimental group were (5.60 ± 1.24) and (4.10 ± 0.31) in the puncture period and the recovery period, which were significantly lower than those in the control group (6.10 ± 0.84), (4.93 ± 0.35), the differences were statistically significant (t = 2.12, 3.00, both P<0.05). The heart rate and respiratory rate of the children in the experimental group were (151.10 ± 12.37), (147.00 ± 12.16) times/min and (47.48 ± 7.59), (45.58 ± 6.51) times/min in the puncture period and the recovery period, which were significantly lower than those in the control group (159.75 ± 13.81), (156.05 ± 12.99) times/min and (52.38 ± 8.12), (49.75 ± 7.59) times/min, the differences were statistically significant (t values were 2.64-3.22, all P<0.05). The SpO 2 in the experimental group were 0.980 5 ± 0.009 0, 0.982 5 ± 0.010 8 in the puncture period and the recovery period, which were significantly higher than those in the control group 0.970 8 ± 0.014 2, 0.971 8 ± 0.018 1, the differences were statistically significant (t = 3.66, 3.23, both P<0.05). The onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face in the experimental group were (41.55 ± 6.38), (22.05 ± 4.47), (35.08 ± 5.94), (24.65 ± 5.46) s, significantly shorter than those in the control group (46.58 ± 5.26), (29.50 ± 6.48), (44.68 ± 13.31), (30.65 ± 9.42) s, the differences were statistically significant (t values were 2.63-5.98, all P<0.05). Conclusions:Oral stimulation combined with maternal milk sucking can effectively relieve the pain caused by PICC in children with congenital digestive tract malformation, and reduce the physiological stress response of children.
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@#Stimulator of interferon genes (STING) is an important factor in the auto-immune response of our bodies.Considering the mechanism of activating CD8+ T cells after the activation of STING protein, the combination of STING agonists and immune checkpoint inhibitors for the treatment of tumor immunotherapy has good clinical application prospect.In this paper, the research progress of molecular types, mechanism of action and structural modifications of STING agonists were reviewed.The developing tendency were outlined to provide some references for further investigation.
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The proteolysis targeting chimeras (PROTACs) technology has been rapidly developed since its birth in 2001, attracting rapidly growing attention of scientific institutes and pharmaceutical companies. At present, a variety of small molecule PROTACs have entered the clinical trial. However, as small molecule PROTACs flourish, non-small molecule PROTACs (NSM-PROTACs) such as peptide PROTACs, nucleic acid PROTACs and antibody PROTACs have also advanced considerably over recent years, exhibiting the unique characters beyond the small molecule PROTACs. Here, we briefly introduce the types of NSM-PROTACs, describe the advantages of NSM-PROTACs, and summarize the development of NSM-PROTACs so far in detail. We hope this article could not only provide useful insights into NSM-PROTACs, but also expand the research interest of NSM-PROTACs.
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Objective:To investigate the effect of alogliptin on bone loss in ovariectomized(OVX)mice.Methods:For animal experiments, thirty 8-week-old C57BL/6J female mice were divided into Sham group, OVX group, and OVX+ alogliptin group. OVX+ alogliptin group were administered with alogliptin in a dosage of 20 mg·kg -1·d -1 by gavage, Sham and OVX groups with equivalent saline. After 12 weeks intervention, serum bone anabolism indicators were detected, and Micro CT and HE staining were used to observe and analyze the bone trabecular structure of femur and tibia in mice. For in vitro experiments, bone marrow mesenchymal stem cells(BMSCs)were incubated with 100 μmol/L alogliptin for osteoblast differentiation. Alkaline phosphatase(ALP)and alizarin red S staining were used to determine the ALP activity and mineralization after osteogenic induction and culture. Real-time fluorescence quantitative PCR and Western blot were used to detect mRNA and protein expressions of osteoblast related genes. Results:Alogliptin intervention improved the biochemical indexes of bone anabolism and protected against bone microstructure deterioration to alleviate bone loss in OVX mice. Alogliptin stimulated osteoblast differentiation and elevated expression levels of Runt-related transcription factor 2(Runx2), ALP, osteocalcin, and osterix in in vitro experiments. Conclusion:Alogliptin can alleviate bone loss in OVX mice.
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The clinical data of a child with paroxysmal kinesigenic dyskinesia (PKD) and being diagnosed and treated in the Department of Pediatrics of the First Affiliated Hospital of Zhengzhou University in October 2018 were analyzed retrospectively.The male patient was 13 years old.The clinical manifestation was the change of body position, and the temporary movement cannot appear.The manifestations included the turning of head to one side, the falling back of neck, head shaking, swinging, the tightly hugging of hands in front of the chest, the touching of two tiptoes to the ground, numb sole, and ache.Gene detection: chromosome 16p11.2 (chr16: 29594293-30189789) had about 595.5 kb heterozygosity deletion.A total of 8 cases of 16p11.2 microdeletion in children with PKD were reported in details.16p11.2 microdeletion is another form of gene expression that causes PKD.16p11.2 microdeletion should be screened for genetic evaluation in patients with PKD.
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The clinical data of a child with anti-(α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid, AMPA2) receptor antibody encephalitis after herpes simplex encephalitis was retrospectively analyzed.The child was a 9-year-old female developing abnormal mental behavior after fever.The auxiliary examination of the first hospital displayed, cerebrospinal fluid: sugar qualitative (+ ), white blood cell count 32×10 6/L, albumin measurement (immune turbidity method) 317.00 mg/L, immunoglobulin IgG 45.80 mg/L.Herpes simplex virus (+ ). Skull magnetic resonance imaging showed: abnormal signal at the top of the frontal frontotemporal, considering intracranial infection.Video electroencephalogram: the background is diffuse slow wave, a small amount of multifocal spikes, sharp waves, spine slow wave release, left frontal, and temporal sacral protrusions.One partial seizure may be detected during the awake period.The diagnosis was " herpes simplex virus encephalitis" , and the body temperature of the child returned to normal after anti-infection and hormone therapy.However, there were still cognitive impairments, irritability, and no language communication.After 2 years, there was no abnormality in routine biochemical and viral cerebrospinal fluid examination.Serum and cerebrospinal fluid autoimmune encephalitis-related antibody spectrum: anti-NMDA, AMPA1/2, GABAB receptor antibody and anti-CASPR2, LGI1 antibodies were negative in serum.The anti-AMPA2 receptor antibody in the cerebrospinal fluid was weakly positive, and the final diagnosis was anti-AMPA2 receptor antibody encephalitis.After the application of hormones, the children′s cognition improved, mood was more stable than before, and language communication improved as well.Anti-AMPA2 receptor antibody encephalitis can be observed in children, and may be related to immune response after viral infection.For patients of viral encephalitis with poor treatment or disease relapse and progression, the possibility of autoimmune encephalitis should be considered.
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Objective:To explore the effect of oral motor intervention on oral feeding ability and growth of neonates with intestinal atresia.Methods:A total of 80 intestinal atresia neonates in the Hunan Children`s Hospital from January 2017 to January 2019 were admitted to the present study. Neonates were randomly assigned to oral motor group and control group according to the random number table. The control group received routine nursing, while the oral motor group carried out oral motor intervention for 14 consecutive days. Both groups were followed up for six months. The oral feeding ability and growth index such as body weight, body length and head circumference were compared between two groups.Results:The complete oral feeding rate transfer, complete oral feeding rate transfer, time to complete oral feeding were (10.48±2.96) ml/min, (90.02±8.36) %, (15.06±2.99) days in the oral motor group, those index were (8.18±2.44) ml/min, (72.58±9.46) %, (18.08±4.98) days in the control group, the differences were statistically significant ( t values were 3.633, 8.316, 3.106, P<0.01). After 7, 14 days of intervention, the non-nutritive sucking scores were (52.24±8.89) points, (69.81±12.94) points in the oral motor group, significantly higher than (48.08±6.72) points, (63.09±11.73) points in the control group, the differences were statistically significant ( t values were 2.265, 2.327, P<0.05). After 3, 6 months of intervention, the levels of body weight were (6 234.21±560.25) g, (7 630.19±782.25) g, significantly higher than (5 916.89±462.40) g, (7 293.65±979.98) g in the control group, the differences were statistically significant ( t values were 2.648, 2.148, P<0.05). After 6 months of intervention, the levels of head circumference were (43.81±5.59) cm in the oral motor group, significantly higher than (40.85±3.73) cm in the control group, the difference was statistically significant ( t value was 2.635, P<0.05). Conclusion:Oral motor intervention can promote oral feeding ability and improve growth performance of neonates with intestinal atresia.
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Objective:To explore the patterns and causes of occupational exposure to infectious diseases (OEID) among frontline medical staffs (FMS) in coronavirus disease 2019 (COVID-19) isolation wards (CIW), and the particularity of post-OEID management and the measures to prevent OEID.Methods:A total of 1 061 FMS of Wuhan Huoshenshan Hospital from February 4 to March 21, 2020 were enrolled. The OEID of FMS was investigated and analyzed from the perspectives of FMS physical and psychological conditions, protective equipment, infection-control related regulations and procedures, local air quality, exposure patterns, and the particularity of emergency treatment after exposure.Results:The incidence of OEID among FMS was 2.0%(21/1 061). The nurses and doctors accounted for 95.2%(20/21) and 4.8%(1/21), respectively. The incidences in 17 general wards and two intensive care units (ICU) were 71.4%(15/21) and 28.6%(6/21), respectively. Nearly 90.5%(19/21) and 9.5%(2/21) of the OEID events occurred in contaminated area and potential contaminated area, respectively. About 23.8%(5/21) of the OEID events were air exposure of oral-nasal skin, mucosa and respiratory tract, which was secondary to uncontrollable vomiting, and 76.2%(16/21) were pricking injuries. The inducement factors involved poor quality and inappropriate wearing of some goggles, atomization of the inside of goggles leading to blurring vision, chest distress and decreased sense of touch and operational flexibility related to level-3 protection equipment, poor air quality, FMS physical and psychological conditions, etc. Under the direction of "the Procedures for Handling OEID" , all incidents are properly handled and no FMS was infected by 2019 novel coronavirus and blood-borne pathogens. No new OEID event was found after the strict implement of set of preventive measures.Conclusions:The OEID among FMS in CIW is attributed to multiple causes. The optimized process that takes into account the specificity of OEID management for both COVID-19 and blood-borne infectious diseases can effectively prevent potential post-exposure infections. And reasonable precautions can fully reduce the risk of OEID of FMS in CIW.
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Objective To evaluate the clinical value of maternal serum 25(OH)D level and bilateral uterine artery S/D mean in early prediction of pre-eclampsia(PE). Methods Sixty normal pregnancy women(normal group),40 mild preeclampsia women(MPE group)and 60 severe preeclampsia women(SPE group)who were examined in Changzhou First People′s Hospital and Changzhou Maternal and Child Health Care Hospital between January 2016 and June 2018 were included. The mean value of S/D of bilateral uterine artery was measured from 15th to 20th weeks in all the 3 groups,and serum 25(OH)D level of the mother was measured at 24th week. Meanwhile, the ROC curves of S/D mean value,serum 25(OH)D level and combined detection were drawn to compare the area under each curve(AUC),and the diagnostic efficiency of S/D mean value,serum 25(OH)D level and combined detection PE were also calculated. Results The incidence of adverse pregnancy outcome in SPE group was significantly higher than that in MPE group,and that in MPE group was significantly higher than that in normal group(P < 0.05). The mean value of S/D of bilateral uterine artery in SPE group was(4.09 ± 0.62),which was higher than that in MPE group(3.26 + 0.55)and in normal group(2.62 ± 0.51),while the mean value of S/D in MPE group was significantly higher than that in normal group and the difference was statistically significant(P < 0.05). The level of serum 25(OH)D in SPE group was(32.44 ± 5.84),which was significantly lower than that in MPE group(37.15 ± 5.90)and in normal group(42.57 ± 7.44),while the serum 25(OH)D level in MPE group was significantly lower than that in normal group,and the difference was statistically significant(P < 0.05). The mean value of S/D of bilateral uterine artery in the pre-eclampsia group was negatively correlated with 25(OH)D level(r = -0.66,P < 0.01). The area under the ROC curve separately detected by S/D mean value and 25(OH)D level was 0.787 and 0.719 respectively,both of which were lower than that by jointly detection(0.908)and the difference was statistically significant(P < 0.001). Conclusion Both the mean S/D value of bilateral uterine arteries and serum 25(OH)D level can be used for the diagnosis and monitoring of pre-eclampsia,and the diagnostic efficacy of the combined detection is superior to that of single detection.
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Objective To investigate the effects of family-integrated care (FIC) on postoperative outcomes in children with enterostomy and their caregivers. Methods From August 2017 to August 2018, 50 children with enterostomy and 50 family members of the Children′s Hospital of Hunan Province were selected as subjects. According to the random number table, the children and their families were divided into control group and the observation group, each group was 25 cases. The control group was given a routine nursing mode to intervene, and the observation group was given an FIC mode for intervention. Postoperative outcomes were evaluated using the incidence of ostomy complications and readmission rates. The pre-intervention and outpatient follow-up were used to assess the psychological status of the family members using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), and to assess the postoperative care of the family's intestines using the postoperative evaluation of the postoperative intestines. The level of knowledge mastery. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used to assess the psychological state of the family members, and the postoperative care knowledge evaluation form for the postpartum was used to evaluate the postoperative care of the family. Results The incidence of ostomy complications in the observation group was 8.70% (2/23), which was lower than that in the control group (34.78% (8/23) (P<0.05). The readmission rate of the observation group was 0(0/23), which was lower than the control group 17.39% (4/23) (P<0.05). After intervention, the SAS scores and SDS scores of the families of the two groups were lower than those before the intervention, and the SAS scores and SDS scores of the observation group were lower than the control group(P<0.05). Before discharge and 3months of follow- up, the scores of postoperative care knowledge evaluation scores of the observation group were higher than those of the control group(P<0.05). Conclusions FIC mode can effectively reduce the incidence of complications and readmission rate in children with enterostomy. It has positive significance for improving the negative emotions of children′s family members and improving the mastery of postoperative care.
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@#Glucose-regulated protein 94(Grp94), an endoplasmic reticulum resident Hsp90 paralog, has a limited set of client proteins. Selective inhibition of Grp94 has emerged as a new direction for the development of drugs targeting the Hsp90 chaperone system. Now Grp94-Probe, an affinity-based probe of Grp94, was designed and synthesized based on DDO-5813, a most potent Grp94-selective inhibitor we found previously. Using fluorescence polarization(FP)assay and double staining assay with ER-Red in cells, we confirmed the binding of Grp94-Probe with ER Grp94. The FR results showed that the probe exhibited high affinity for Grp94N(EC50=117. 9 nmol/L)without exhibiting obvious Hsp90α inhibition, Moreover, as a fluorescence probe molecule, Grp94-Probe could better distinguish the inhibitory activity of compounds for Grp94N. The results of fluorescence analysis in cells showed that Grp94-Probe could co-stain with ER-Red in the endoplasmic reticulum, and the fluorescence did not decay rapidly with time after 4 h of staining, which further indicated the binding of Grp94-Probe with Grp94 in cells. This Grp94 selective probe can be further used for biology evaluation of Grp94 inhibitor and exploration of Grp94 biological functions.
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Objective@#To investigate the application of music intervention in combination with maternal voice during PICC placement procedures in malformation alimentary tract infants.@*Methods@#A total of 60 malformation alimentary tract infants were enrolled in the present study in Hunan Children Hospital from January to December 2018, infants were randomly assigned to the intervention group (n=30) and the control group (n=30). Patients in the control group received conventional nursing, the intervention group received music and maternal voice intervention method. The level changes of heart rate, respiratory rate, blood pressure, blood oxygen saturation and cortisol concentration were compared between two groups, meanwhile, the pain rating were assessed by Neonatal Infant Pain Scale (NIPS).@*Results@#Before procedure, no significant difference was found between the control and intervention group in heart rate, respiratory rate, systolic pressure, SpO2 and NIPS score (P>0.05). During and after the procedure, the mean heart rate [(144.43±15.93), (142.43±20.42) times/min], respiratory rate [(44.70±4.51) and (43.50± 4.12) times/min], systolic pressure [(87.40±8.53) and (86.10±4.60) mmHg] and NIPS score (5.34±0.71 and 5.19±0.87) of the intervention group was statistically lower compared to the control group [(160.97±39.35) and (159.17±31.87) times/min, (53.13±7.85) and (50.47±7.70) times/min, (97.60±9.82) and (94.27±7.23) mmHg, 6.17±0.54 and 6.15±0.66; during procedure, the mean SpO2 was statistically significantly higher, compared to the control group [(96.15±9.82)% versus (88.34±9.53)%]. The difference was statistically significantly (t=2.134-6.682, P<0.05). Before placement, the concentration of cortisol between the two groups showed no significant difference (P>0.05), and (208.91±21.07)ng/ml 5min after placement and (197.70±16.34) ng/ml immediately after placement, the cortisol concentration was statistically significantly lower, compared to the control group [(246.71±35.15), (230.95±21.81) ng/ml] (t=5.050-6.682, P<0.05). Compared with the control group, the time needed for PICC placement decreased remarkably in the intervention group [(15.62±3.30) min versus (24.63±4.26) min)](t=9.160, P<0.01).@*Conclusions@#Music in combination with maternal voice can significantly reduce stress levels, pain responses and time need for PICC placement, music and maternal voice is a potential intervention strategy in malformation alimentary tract infants undergoing PICC.
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Objective@#To investigate the effects of family-integrated care (FIC) on postoperative outcomes in children with enterostomy and their caregivers.@*Methods@#From August 2017 to August 2018, 50 children with enterostomy and 50 family members of the Children′s Hospital of Hunan Province were selected as subjects. According to the random number table, the children and their families were divided into control group and the observation group, each group was 25 cases. The control group was given a routine nursing mode to intervene, and the observation group was given an FIC mode for intervention. Postoperative outcomes were evaluated using the incidence of ostomy complications and readmission rates. The pre-intervention and outpatient follow-up were used to assess the psychological status of the family members using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), and to assess the postoperative care of the family's intestines using the postoperative evaluation of the postoperative intestines. The level of knowledge mastery. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used to assess the psychological state of the family members, and the postoperative care knowledge evaluation form for the postpartum was used to evaluate the postoperative care of the family.@*Results@#The incidence of ostomy complications in the observation group was 8.70% (2/23), which was lower than that in the control group (34.78% (8/23) (P<0.05). The readmission rate of the observation group was 0(0/23), which was lower than the control group 17.39% (4/23) (P<0.05). After intervention, the SAS scores and SDS scores of the families of the two groups were lower than those before the intervention, and the SAS scores and SDS scores of the observation group were lower than the control group(P<0.05). Before discharge and 3months of follow-up, the scores of postoperative care knowledge evaluation scores of the observation group were higher than those of the control group(P<0.05).@*Conclusions@#FIC mode can effectively reduce the incidence of complications and readmission rate in children with enterostomy. It has positive significance for improving the negative emotions of children′s family members and improving the mastery of postoperative care.
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OBJECTIVE： To establish the prediction model of steady-state dose of warfarin in patients with renal insufficiency on the basis of CYP2C9＊3（1075A＞C） and VKORC1-1639G＞A gene polymorphism. METHODS： The clinical data of 103 patients with renal dysfunction （involving primary glomerulonephritis， chronic pyelonephritis， hypertensive renal arteriosclerosis， diabetic nephropathy， secondary glomerulonephritis， tubulointerstitial lesions， hereditary kidney diseases） who took warfarin and whose INR was stable at 1.5-3.0 were collected from nephrology department of the First Affiliated Hospital of Xi’an Jiaotong University during Jun. 2016 to Jun. 2019. The CYP2C9＊3（1075A＞C） and VKORC1-1639G＞A genotypes were detected by fluorescence staining in-situ hybridization. The relationship of genotype， gender， age， body mass index （BMI） and glomerular filtration rate （eGFR） with steady-state dose of warfarin were analyzed. The multiple linear regression method was used to establish the prediction model for steady-state dose of warfarin in patients with renal insufficiency. Other 25 patients were involved in validation. RESULTS： The frequencies of CYP2C9＊3（1075A＞C） and VKORC1-1639G＞A genes in 103 patients were in accordance with Hardy-Weinberg equilibrium. The average steady-state dose （3.20±0.88） mg/d of warfarin in CYP2C9＊3 （1075A＞C） AA genotype was significantly higher than that （2.17±0.13） mg/d in CYP2C9＊3 （1075A＞C） AC genotype （P＜0.05）； average steady-state dose （2.89±0.08） mg/d of warfarin in VKORC1-1639G＞A AA genotype was significantly lower than that （4.01±0.17） mg/d in VKORC1-1639G＞A GA genotype （P＜0.05）； steady-state dose of warfarin in male patients （3.16±0.11） mg/d was higher than that in female patients （3.07±0.13） mg/d （P＞0.05）. Age was negatively correlated with steady-state dose of warfarin （P＜0.05）； eGFR was positively correlated with steady-state dose of warfarin （P＜0.05）. BMI had no significant correlation with steady-state dose of warfarin （P＞0.05）. The prediction model for steady-state dose of warfarin included steady-state dose of warfarin＝3.057－0.73* VKORC1-1639G＞A+0.08*eGFR－0.013* age+0.565* CYP2C9＊3（1075A＞C） [VKORC1-1639G＞A：AA＝1，GA＝0，GG＝0；CYP2C9＊3（1075A＞C）：AA＝1，AC＝0；the age was years old； the unit of eGFR was mL/（min·1.73 m2）] （R2＝0.502）. There was no statistical significance between the dose （3.12±0.56） mg/d of prediction model and actual steady-state dose （3.06±0.93） mg/d in 25 validation patients （P＞0.05）. CONCLUSIONS： There are significant differences in steady-state dose of warfarin among different genotype patients with CYP2C9＊3（1075A＞C） AA and VKORC1-1639G＞A. The prediction model of warfarin steady-state dose in patients with renal insufficiency is established successfully.
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Objective To investigate the clinical usefulness of quantitative dual-source dual-energy CT (DECT) iodine enhancement metrics combined with morphological CT features in distinguishing different lung cancer subtypes. Methods One hundred and sixty-two consecutive patients suspected with lung cancer were prospectively enrolled and underwent DECT in arterial phase prior to biopsy or surgery.Tumor histological subtypes were determined in 110 patients. Two radiologists interpreted CT morphologic features of 110 lesions in a consensual manner. In addition, two radiologists independently contoured lesions and placed regions of interest in descending aorta or subclavian artery on the same section for normalization , from which automated computer measurements were generated:iodine density and iodine ratio (the ratio of iodine density of lesion to that of artery on the same section). DECT metrics and morphological CT features were compared among different lung cancer subtypes. Chi-square was used to compare qualitative parameters. One way ANOVA was used to compare quantitative parameters satisfying normal distribution, while those parameters not satisfying normal distribution or ranked data were compared by Kruskal-Wallis rank sum test. Multinomial logistic regression models were used to differentiate the histological subtypes of lung cancer: adenocarcinoma, squamous cell carcinoma (SCC), small cell lung cancer (SCLC). Results There were 48 cases of adenocarcinomas, 36 cases of SCC and 26 cases of SCLC. In analysis of CT features, tumor diameter, distribution, spiculation, pleural retraction, vascular involvement, confluent mediastinal lymphadenopathy, encasement of mediastinal structures and enhancement heterogeneity showed statistical difference (all P<0.05). The diameter of SCC[(5.73 ± 3.67)cm] and SCLC [(6.08 ± 4.39)cm] were larger than adenocarcinoma [(3.75 ± 2.80 cm)] (H=13.806,P<0.05). Adenocarcinomas were mostly located in the periphery (31 cases), while SCC (26 cases) and SCLC (21 cases) were mainly centrally located. Spiculation was mostly found in adenocarcinoma (44 cases) rather than SCLC (13 cases). Pleural retraction was mostly observed in adenocarcinoma (36 cases) rather than SCC (10 cases) and SCLC (5 cases). Vascular involvement was mostly found in SCLC (19 cases) rather than adenocarcinoma (15 cases). Confluent mediastinal lymphadenopathy was more frequently found in SCLC (15 cases) compared with adenocarcinoma (3 cases) and SCC (4 cases). Encasement of mediastinal structures was mostly found in SCLC (13 cases) rather than adenocarcinoma (7 cases). Homogeneous enhancement was more frequently found in SCLC (10 cases) than SCC (6 cases). No significant differences were observed in other CT features between any other two groups. Iodine density and iodine ratio were statistically different among these three subtypes lung cancer (H=16.817,20.338,P<0.001). Iodine density of adenocarcinoma and SCC was (1.50±0.80) and (1.40± 0.40) mg/ml, respectively, higher than the (1.20±0.40) mg/ml for SCLC (P<0.01). Iodine ratio of adenocarcinoma and SCC was (16.10 ± 7.02)％and (15.05 ± 4.62)％, respectively, higher than the (11.55 ± 3.15)％ for SCLC (P<0.01). No significant difference was observed between adenocarcinoma and SCC. Accuracy of the model based on CT features was 69.1％, accuracy of the model based on CT features combined with DECT parameters was 80.9％. Conclusions Quantitative DECT metrics are different among adenocarcinoma, SCC and SCLC, when combined with morphological CT features, higher diagnostic accuracy can be achieved.
ABSTRACT
Objective To investigate the evaluating the value of CT quantitative analysis and visual scores on pulmonary alveolar proteinosis (PAP). Methods Thirty one patients with PAP who underwent chest HRCT scans and pulmonary function tests(PFTs)between July 2014 and April 2016 in our hospital were collected and analyzed.HRCT mean lung density(MLD)was measured by syngo InSpace Lung Parenchyma Analysis.Using CT visual scores(HRCT score and RE score),two radiologists with three-years experience at least evaluated pulmonary lesions retrospectively. SPSS 21.0 statistical software was used to analyze the data. Spearman correlation analysis was used to evaluate the correlation between MLD, HRCT score and RE score.The correlation between MLD, HRCT score, RE score, the parameters of PFTs, and blood gas parameters were also analyzed by Spearman correlation analysis. Results There were correlations between MLD,HRCT score and RE score.The correlation coefficient among MLD,HRCT score and RE score were r=0.835 vs r=0.768 vs r=0.838 in baseline. The correlation coefficient among MLD, HRCT score and RE score were r=0.827 vs r=0.780 vs r=0.896 in follow-up. And there were also strong correlation between ΔMLD, ΔHRCTscore and ΔREscore. The correlation coefficient among ΔMLD, ΔHRCTscore and ΔREscore were r=0.599 vs r=0.651 vs r=0.867. There were significantly (P＜0.05) negative correlations among MLD, HRCT score, RE score and VA, DLCO in baseline and follow-up retrospectively. There were significantly (P≤0.001) negative correlations among the ΔMLD, ΔHRCTscore, ΔREscore and ΔVA, ΔDLCO.The correlation among MLD, HRCT score, RE score and DLCO was more significant than that of VA. The correlation among ΔMLD, ΔHRCTscore,ΔREscore and ΔDLCO was more significant than that of ΔVA.There were markedly(P＜0.05) negative correlations between MLD and PO2,and the correlation coefficient were r=-0.738 in baseline vs r=- 0.810 in follow-up. Conclusion The HRCT quantitative analysis and HRCT visual scores are feasible to evaluate PAP.