ABSTRACT
Objective:To construct the training program system for hospice care volunteers and provide reference for the training of hospice care volunteers in China.Methods:The training program system for hospice care volunteers was initially determined by using the method of literature analysis and investigation, and 16 experts were consulted by two rounds of letters using the method of expert inquiry from May to July 2022, and finally the training program system was established.Results:The effective recovery rate of the two rounds of expert consultation questionnaire was 100%, the expert authority coefficient was 0.88, and the Kendall coordination coefficient was 0.141, 0.131 (both P<0.05). The final training program system for hospice care volunteers contained 7 first-class indicators including training objectives, training objects, training contents, training methods, training hours, training resources and training evaluation, 27 second-class indicators and 92 third-class indicators. Conclusions:The training program system for hospice care volunteers constructed in this study has high reliability and scientificity, and has a good guiding role and reference value for the training of hospice care volunteers.
ABSTRACT
Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.
ABSTRACT
【Objective】 To investigate the effectiveness of current indicators in initial screening and retest before donation and access the optimal testing strategies. 【Methods】 Data of initial screening (rate method for ALT, colloidal gold method for HBsAg) and retest (rate method for ALT, ELISA for HBsAg) of 18 510 platelet donors in our center from January 2019 to December 2021 were collected, and the results were retrospectively analyzed and compared in terms of different years and number of donations. 【Results】 From 2019 to 2021, data of initial screening and retest of platelet donors were as follows: 1) the deferral rate of ALT and HBsAg was 12.98% (2 403/18 510) vs 0.26%(40/15 412); 2) the deferral rate of ALT was 13.19% (712/5 398) vs 0.20%(9/4 410)in 2019, 13.33% (873/6 549) vs 0.06%(3/5 387)in 2020 and 11.05% (725/6 563) vs 0.07%(4/5 615)in 2021; for initial screening, significant difference was noticed in ALT reactivity in 2021 as in comparison to other two years(P<0.05); 3) the reactive rate of HBsAg was 0.43% (23/5 398) vs 0.18%(8/4 410)in 2019, 0.66% (43/6 549) vs 0.20%(11/5 387)in 2020 and 0.41% (27/6 563) vs 0.09%(5/5, 615) in 2021. For initial screening, HBsAg deferral in 2021 was significantly different from 2019, while similar with 2020. 4) Among ALT deferral samples in the retest, 68.75% (11/16) were ALT≥45 U/L. Among HBsAg reactive samples, 91.67% (22/24) were reactive by single reagent. 【Conclusion】 Setting the threshold value of ALT for platelet donors in initial screening as less than 45 U/L can effectively reduce the reactive rate in the retest. HBsAg screening only for first-time platelet donors can reduce the detection cost. Adding pre-donation detection indicators according to local prevalence of transfusion transmitted diseases is conductive to reduce the discarding rate of platelets.
ABSTRACT
Idiopathic ventricular tachycardia(IVT), which is a clinical entity without any structural heart disease or definite inducing factors, has a low incidence and a good overall prognosis in children, but long-term episode can lead to hemodynamic collapse or even be life-threatening.According to the origin of IVT, the response to drugs and the morphological characteristics of electrocardiogram, it can be divided into different subtypes whose electrophysiological mechanisms are also different.Besides, these is no guideline for the indications and treatment of IVT.This paper summarizes the electrophysiological mechanisms and progress of treatment of idiopathic ventricular tachycardia in children by reviewing the relevant literatures.
ABSTRACT
Objective:To explore the application effect of flipped classroom teaching combined with micro-classes and PBL in the training of refresher nurses.Methods:Using the cluster sampling method, 35 refresher nurses from March 2017 to February 2018 were collected as the control group, and 38 refresher nurses from March 2018 to February 2019 were included as the observation group. The control group received the theoretical knowledge training of respiratory specialty by traditional teaching method, and the observation group received theoretical knowledge training of respiratory specialty by using flipped classroom teaching combining micro-classes and PBL. Before and after the training, the special theory assessment with the same difficulty was carried out, and the clinical teaching evaluation was carried out after the training.Results:After the training, the special theory assessment scores of the observation group were significantly higher than those of the control group ( t=7.560, P<0.05), with significant differences. Compared with the control group, the clinical teaching evaluation scores of the nurses in the observation group were significantly improved ( t=24.657, P<0.05), with significant differences, especially in the nurses' learning attitude, learning ability, teaching style and teaching satisfaction scores. Conclusion:The flipped classroom teaching combining micro-classes and PBL can significantly improve the special theory assessment scores of refresher nurses, promote the internalization of specialized knowledge, turn to active learning from the passive mode, change the learning attitude of refresher nurses, improve their recognition of clinical teachers and realize teaching benefits as well as learning benefits.
ABSTRACT
Objective@#To investigate the value of alpha-fetoprotein (AFP) level on survived hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) patients treated with artificial liver.@*Methods@#Clinical indicators of HBV-ACLF patients who were previously treated with plasma exchange-based artificial liver at our department were retrospectively collected. The difference of serum AFP level between the survival and the death group was compared at 30, 90 and 180 days after artificial liver treatment. The ROC curves of the subjects were plotted, and the sensitivity and specificity of AFP for the survival prediction of the patients at 30, 90 and 180 days after artificial liver surgery were calculated. AFP was divided into a high AFP group and a low AFP group using median value. AFP and postoperative survival predictive value at 30, 90, and 180 days were analyzed.@*Results@#A total of 93 cases were included in this study. The AFP of the survival group at 30, 90, and 180 days was (231.0 ± 286.2) ng / ml, (237.69 ± 297) ng / ml, (229.44 ± 286.46) ng/ml, and the death group was (76.4 ± 104.7) ng/ml, (103.13 ± 116.99) ng / ml, (136.34 ± 2.9.29) ng/ml, respectively. AFP of the death group was significantly lower than the corresponding survival group (P < 0.05). Receiver operating characteristic (ROC) curve analyses indicated that the area under the curve (AUC) and its 95% confidence interval at 30, 90, and 180 days after artificial liver surgery were 0.739 (0.611 ~ 0.867), 0.675 (0.550 ~ 0.80), 0.653 (0.524 ~ 0.781), respectively. The median serum AFP value was 110 ng/ml, and the survival analysis showed that the survival time of the high AFP group was significantly higher than the low AFP group at 30 d (P = 0.01), 90 d (P = 0.04) and 180 d (P = 0.03) after artificial liver surgery.@*Conclusion@#Serum AFP can be used as a predictor of survival for HBV-ACLF patients after artificial liver therapy and its clinical value needs to be further verified by the larger sample size.
ABSTRACT
Memory function is the core component of human brain cognition.Memory impairment significantly affects people's daily life and social ability,but existing cognitive training or drug therapy can not effectively improve memory function.In recent years,new techniques and methods have been emerging in brain science research,especially neural regulation techniques,such as transcranial electrical / magnetic stimulation,which can significantly regulate cognitive ability and effectively promote memory function.Transcranial direct current stimulation is a kind of noninvasive and safe technique.It can regulate cerebral cortex activity by changing the cerebral cortex excitability,and play a role in regulating brain function.At present,there have been reports at home and abroad that transcranial direct current stimulation can promote memory function and improve memory effectively.This technique is applied to the diagnosis and treatment of clinical diseases,but its mechanism is not clear.This article reviews the mechanism and application of transcranial direct current stimulation (TDCS) in promoting different types of memory function in order to provide evidence for early intervention and treatment of memory impairment.
ABSTRACT
Objective@#To explore the effects of hypoxic exosomes secreted from hepatocellular carcinoma Huh7 cells on the proliferation, migration and invasion under co-cultured normoxic condition.@*Methods@#Hypoxic exosomes secreted from Huh7 cells under hypoxic conditions were extracted by differential ultracentrifugation. Transmission electron microscopy, nanoparticles tracking analysis and western blot were used for the identification of hypoxic exosomes. Hypoxic exosomes were co-cultured with Huh7 cells under normoxic conditions. CCK8, cell scratch and transwell assay were used to detect the changes of cell proliferation, migration and invasion. Statistical analysis was performed by one-way ANOVA and t-test.@*Results@#Hypoxic exosomes secreted from Huh7 cells ranged in size from 30 to 150 nm in diameter, and expressed exosome surface markers CD9, CD63 and TSG101. Hypoxic exosomes significantly enhanced the proliferation of normoxic Huh7 cells (A value of hypoxic exosomes and control group at 48 and 72 h were 2.131 ± 0.092 and 1.760 ± 0.104,t= 3.740,P<0.01, 3.121 ± 0.157 and 2.298 ± 0.085,t= 8.289,P< 0.01). The migration distance between hypoxic exosome and control group at 48 and 72 h were (0.37 ± 0.06 cm)and(0.19 ± 0.05 cm),t= 4.813,P< 0.05, (1.15 ± 0.07 cm) and(0.62 ± 0.08 cm),t= 8.874,P< 0.05, and invasion ability [hypoxic exosomes and control group were (123 ± 18), (44 ± 12),t= 6.203,P< 0.01].@*Conclusion@#Hypoxic exosomes secreted from hepatocellular carcinoma Huh7 cells can promote cell proliferation, migration and invasion in hypoxic environment, suggesting that intercellular information transmission mediated by hypoxic exosomes may be one of the key mechanisms for the amplification of malignancy of hepatocellular carcinoma cells in hypoxic microenvironment.
ABSTRACT
Objective To investigate the effect of high-definition transcranial direct current stimula-tion on visual spatial working memory in patients with schizophrenia. Methods Sixty-six patients with schizophrenia were enrolled in a randomized,double-blind,placebo-controlled study. The subjects were ran-domized into a true stimulation group of 33 patients and a placebo control group of 33 patients,each patient only received one stimulation. After receiving a stimulus,the left dorsolateral prefrontal lobe was stimulated by high-precision transcranial direct current. The true stimulation group was stimulated with a current of 1. 5 mA for 20 min. The control group used pseudo-stimulation,and only the current was passed within 30 s of the beginning and the end of the stimulation. Both groups completed the neuropsychological background test and the n-back task before stimulation,and the stimulation was performed after five days. After the stimula-tion,the two groups completed the n-back task again,and compared the Changes in grades to reflect changes in working memory before and after the pseudo-stimulation. Results Before the stimulation,the response rate of the 3-back task was compared with that of the control group ((0. 32±0. 21),(0. 32±0. 22)),the true stimulation group ((0. 28 ± 0. 19), ( 0. 35 ± 0. 21)), and the difference was statistically significant ( F=5. 298,P=0. 025). Conclusion Using high-definition transcranial direct current stimulation to stimulate the left dorsolateral prefrontal cortex using can improve the visual memory function of patients. In the future,this technique can be applied to the cognitive promotion of memory impairment in patients with schizophrenia.
ABSTRACT
Objective To describe the study design,the characteristics of participants as well as the pedigrees included in the baseline survey of Fujian Tulou Family Cohort Study.Methods Fujian Tulou Family Cohort Study was a prospective open cohort study with a biological sample bank.A baseline survey was conducted in Tulou areas of Nanjing county in Fujian province from 2015 to 2018,including questionnaire survey,physical and biochemical indicators examinations,and blood sample collection in adults aged ≥ 18 years.In addition,family relationship of the participants was also recorded.The pedigree information of the juveniles under 18 years old were also collected.Results The baseline survey included 2 727 individuals in two clans,of whom 2 373 (87.0％) were adults,and 2 126 participants completed questionnaires,physical examinations and biochemical tests.The average age of the 2 126 participants was (57.9 ± 13.3) years,with 39.4％ being males.The current smoking rates in male and female participants were 41.2％ and 2.1％,respectively.The corresponding rates of current alcohol consumption were 19.0％ and 2.6％.For common chronic diseases,the prevalence rates were 51.3％ for hypertension,9.7％ for diabetes and 26.7％ for hyperlipemia according to the self-reported disease diagnoses,health examination results and biochemical examination results in class 1Ⅱor Ⅲ hospitals.Based on the family relationship information and genealogical data,710 pedigrees were finally identified,consisting of 5 087 family members.The numbers of five,four,three,and two generations pedigrees were 3,88,238 and 381,respectively.The pairs of the first to the fifth degree relatives were 12 039,2 662,1 511,202 and 31,respectively.Conclusion The establishment of Fujian Tulou Family Cohort provides valuable resources for exploring the genetic risk factors,environmental risk factors and gene-environment interactions contributing to the risk of common chronic diseases.
ABSTRACT
Objective To explore the effects of Tongyuan acupuncture combined with herbal medicine and moxibustion on the behavior and hypothalamic-pituitary-adrenal axis-related hormone levels in postpartum de-pression rats.To explore the therapeutic mechanism of this method in the treatment of postpartum depression.Meth-ods A total of 120 SD rats were randomly divided into 6 groups(n=20).The blank group was not treated.The sham operation group was performed without surgery to remove the ovaries. The model group,drug group,routine acupuncture group and experimental group were established in the model of postpartum depression.After modeling successfully,the model group did not interfere with any treatment. The rats in treatment group were treated with fluoxetine hydrochloride. The acupuncture group was treated with acupuncture of Baihui and Taichong. The rats in the experimental group were treated with the method of acupuncture and moxibustion.At the end of the second and fourth week after the initiation of intervention,10 rats were randomly selected from each group.They were sacrificed and the levels of serum corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),cortisol (Cor)were measured.Results The levels of CRH,ACTH and Cor in the model group were higher than those in the blank group(P<0.05).The levels of serum CRH,ACTH and Cor in the drug group,routine acupuncture group and experimental group were lower than those in the model group(P<0.05).The levels of serum ACTH and Cor in the experimental group were lower than those in the drug group and routine acupuncture group(P<0.05).There was no significant difference in serum CRH,ACTH and Cor level between the experimental group and blank group(P >0.05).Conclusions Tongyuan acupuncture combined with salt moxibustion and Shenque have significant effects on the depressive symptoms and serum levels of CRH,ACTH and Cor in postpartum depression rats,which may be re-lated to the regulation of hypothalamic-pituitary-adrenal axis-related hormone levels.
ABSTRACT
Objective To investigate and compare the effect of two kinds of transparent dressings in the use of fixed intravenous indwelling needle in restless patients in emergency first aid. Methods A total of 160 restless patients who were required to use intravenous indwelling needle were randomly divided into conventional dressing group and 3M dressing group by random digits table method, 80 patients in each group. The medical transparent dressings(Specification:6 cm × 7 cm) were used for the patients of conventional dressing group, and 3M dressings(Specification:6.5 cm×7.0 cm ) for 3M dressing group. The fixity time, number of cases intravenous indwelling needle detached, replaced time of transparent dressing, number of crimping cases were compared. Results For the conventional dressing group, fixity time was (19.67 ± 7.02) h, replaced time was (18.92 ± 6.58) h, 15 detached cases and 24 crimping cases happened. While for the 3M dressing group, fixity time was (41.64±17.79) h, replaced time was (41.11 ± 17.76) h, 4 detached cases and 7 crimping cases happened. The difference was statistically significant(t=-10.27,χ2=7.23, t=-10.48,χ2=11.56, all P<0.05). Conclusions 3M transparent dressing is suggested in fixing intravenous indwelling needle in restless patient in emergency first aid. It can ensure the use of intravenous indwelling needle during the period, effectively prevents the needle from detaching due to its good fixation effect.
ABSTRACT
Objective To systematically analyze the research trend of home non-invasive positive pressure ventilation in China. Methods The related literature in CBM database, CNKI database, Wanfang database and VIP database about home non-invasive positive pressure ventilation were reviewed and analyzed by Bibliometric. Results There were 214 articles retrieved, which had an increasing tendency.They were distributed in 135 kinds of journals and 28 provinces.The most research type was the experimental research(39.72%)and the research content focused on clinical effects of home non-invasive ventilation (47.67%). The average duration of researches was 12.33 months and the average interval for follow-up was 6.33 weeks. Conclusions Providing scientific and effective long-term medical support, optimizing the application process of home non-invasive ventilation and formulating scientific clinical standard should be the future research direction.
ABSTRACT
Objective To investigate the characteristics of implicit and explicit memory in patients with obsessive compulsive disorder (OCD) and its relationship with obsessive-compulsive symptoms.Methods Thirty-one patients with OCD and thirty healthy participants matched with sex,age,years of education were enrolled in present study.All participants were conducted vocabulary perception speed task and vocabulary recognition task to evaluate the ability of implicit memory and explicit memory toward neutral,positive and moral disgust words.The accuracy and response time during tasks were recorded to index memory performance.The obsessive-compulsive symptoms were assessed with Padovar scale-Washington State University revised edition (PI-WSUR).Results There was significant difference in the response time of implicit memory between two groups ((2 926.63± 1 718.31) ms for OCD group,(2 587.13±1 054.56) ms for controls group,t=0.926,P=0.358).There was significant difference two groups in the accuracy of implicit memory for moral disgust words ((0.607±0.267) for OCD group,(0.777±0.159) for controls group,t=-3.306,P =0.004),positive words ((0.528±0.265) for OCD group,(0.695±0.152) for controls group,t=-3.048,P=0.004) and all words ((0.597±0.248) for OCD group,(0.731±0.145) for controls group,t=-2.582,P=0.013).The response time of explicit memory in OCD group was significantly correlated with PI-WSUR (r=-0.410,P=0.022),OTAHSO (r=-0.470,P=0.008).Conclusion Compared with healthy controls,the implicit memory of OCD patients was impaired,especially the implicit memory of positive emotion words and moral disgust words.There is no correlation between implicit memory and obsessive-compulsive symptoms in OCD patients.Compared with healthy controls,the implicit memory of OCD patients is not impaired,but there is a correlation between explicit memory and obsessive-compulsive symptoms in OCD patients.
ABSTRACT
Objective To describe the study design,the characteristics of participants as well as the pedigrees included in the baseline survey of Fujian Tulou Family Cohort Study.Methods Fujian Tulou Family Cohort Study was a prospective open cohort study with a biological sample bank.A baseline survey was conducted in Tulou areas of Nanjing county in Fujian province from 2015 to 2018,including questionnaire survey,physical and biochemical indicators examinations,and blood sample collection in adults aged ≥ 18 years.In addition,family relationship of the participants was also recorded.The pedigree information of the juveniles under 18 years old were also collected.Results The baseline survey included 2 727 individuals in two clans,of whom 2 373 (87.0％) were adults,and 2 126 participants completed questionnaires,physical examinations and biochemical tests.The average age of the 2 126 participants was (57.9 ± 13.3) years,with 39.4％ being males.The current smoking rates in male and female participants were 41.2％ and 2.1％,respectively.The corresponding rates of current alcohol consumption were 19.0％ and 2.6％.For common chronic diseases,the prevalence rates were 51.3％ for hypertension,9.7％ for diabetes and 26.7％ for hyperlipemia according to the self-reported disease diagnoses,health examination results and biochemical examination results in class 1Ⅱor Ⅲ hospitals.Based on the family relationship information and genealogical data,710 pedigrees were finally identified,consisting of 5 087 family members.The numbers of five,four,three,and two generations pedigrees were 3,88,238 and 381,respectively.The pairs of the first to the fifth degree relatives were 12 039,2 662,1 511,202 and 31,respectively.Conclusion The establishment of Fujian Tulou Family Cohort provides valuable resources for exploring the genetic risk factors,environmental risk factors and gene-environment interactions contributing to the risk of common chronic diseases.
ABSTRACT
Objective To study the features and neural mechanism of pain empathy in autistic individuals.MethodsTotally 21 subjects with high level autistic traits and 22 subjects with low level autism traits completed the pain empathy task,recording RT and accuracy automatically.The event-related potentials(ERPs) were recorded by Neuroscan system simultaneously.Results(1)From the behavioral results,the IRI scores of the two groups had significant differences in the factors of perspective taking ((23.71±4.16) vs (26.95±3.24)),empathy concerning ((24.10±4.04) vs (26.36±2.82)) and personal distress ((24.19±3.59) vs (19.82±3.96)) (t=-2.86,P0.05).(2) According to the behavioral result of pain empathy test,the main effect of task type in reaction time and accuracy of the two groups had significant difference (F(1,41)=24.21,P0.05,F(1,41)=0.29,P>0.05;F(1,41)=3.20,P>0.05,F(1,41)=0.14,P>0.05).(3)From the results of ERP,the main effect of emotion type,task type and group didn't reach the significant level in the N2 amplitude of the two groups(F(1,41)=0.04,P>0.05;F(1,41)=0.08,P>0.05;F(1,41)=3.86,P>0.05).The main effect of emotion type had significant difference in the P3 amplitude of the two groups(F(1,41)=8.27,P0.05,F(1,41)=0.25,P>0.05).It had significant difference in LPP amplitude in the main effect of emotion type,task type and group(F(1,41)=32.07,P<0.01;F(1,41)=8.63,P<0.01;F(1,41)=4.73,P<0.05).ConclusionsThere are differences in the abilities of empathy between the high and low level autistic traits groups,especially in the late processing of pain empathy.
ABSTRACT
Objective To investigate the efficacy and safety of using stereotactic radiotherapy (SRT) technique for conducting re-therapy after thoracic tumor radiotherapy.Methods Thirty-eight patientswith SRT after receiving thoracic conventional radiotherapy (RT) in our hospital from July 2012 to November 2014 were selected.The treatment target area included the lung local primary lesion,recurrent lesions and lung metastasis tumor.Results Median dose of previous RT was 48 Gy (30-56 Gy).Median biologically equivalent effective dose (alpha/beta=10.0,BED10) of receiving SRT was 62 Gy (39-72 Gy).Median follow up time was 12.30 months;1-,2-year local progression-free survival (LPFS) was 76.32％ and 63.16 ％ respectively.Median recurrence-free (RFS) and overall survival (OS) were 13.20 months and 21.00 months respectively.Grade 2 and 3 pulmonary toxicity was 15.79 ％ and 7.89 ％ respectively.Other grade 2-4 toxicities adverse reactions included chest pain (15.79 ％),fatigue (18.42 ％) and skin lesion(2.63％).No grade 5 toxic injury occurred.Conclusion SRT can be safely and effectively used in the patients previously receiving thoracic RT.
ABSTRACT
Objective To evaluate the value of plasma soluble urokinase?type plasminogen activator receptor (suPAR)and D?dimer for assessing disease severity and prognosis in patients with traumatic brain injury(TBI). Methods A serial of 112 patients with traumatic brain injury admired to our hospital were divided into mild TBI (GCS score 13~15),moderate TBI(GCS score 9~12)and severe TBI(GCS score 3~8). The levels of plasma suPAR and D?dimer were monitored within 24 h after patient admission. Results The levels of suPAR and D?di?mer in TBI group were obviously higher than those in the control group(15.86±7.33 vs 2.79 ± 0.69,P<0.01;3.50 ± 2.78 vs 24 ± 0.15,P<0.01). The levels of suPAR and D?dimer in the severe TBI group were also obviously high?er than those in the moderate TBI group(P<0.05). Plasma suPAR levels and GCS score had significant negative correlation(r =- 0.854,P < 0.01). D?dimer levels and GCS score showed a negative correlation(r =- 0.738, P < 0.01). Plasma suPAR and D ? dimer was positively correlated(r = 0.753,P < 0.01). The area under the curve of D?dimer(AUC)was larger,0.854,95%CI 0.763~0.945;the AUC of suPAR was 0.801,95%CI 0.698~0.903. Conclusion Higher levels of suPAR and D?dimer in TBI patients is not only relevant to the injury sever?ity ,but also closely to the prognosis.
ABSTRACT
At present, the most effective therapeutic method for end-stage liver fibrosis is liver transplantation. However, the application of liver transplantation is limited by a shortage of liver donors, a high incidence rate of surgical complications, graft-versus-host disease, and high medical costs. Umbilical cord mesenchymal stem cell (UC-MSC) transplantation may become a promising method for the treatment of liver diseases. UC-MSCs are adult stem cells which exhibit multipotential differentiation and can differentiate into hepatic parenchymal cells. Due to their functions including immune regulation and secretion of trophic factors, UC-MSCs can inhibit immune response, promote hepatocyte regeneration, alleviate the progression of liver fibrosis, and improve liver function. In addition, compared with bone marrow mesenchymal stem cells, UC-MSCs have abundant sources, noninvasive collection, and high safety and thus they are attracting more and more attention. This article reviews the characteristics of UC-MSCs and their mechanism of action in the treatment of liver fibrosis, as well as risks of UC-MSCs therapy.
ABSTRACT
OBJECTIVE:To investigate the omeprazole off-label use and provide reference for rational drug use in clinic. METHODS:In retrospective survey,1838 omeprazole prescriptions were selected from outpatient department during Jun. 2014 to May 2017 by random number table. According to the latest drug instruction,whether the off-label use or not was determined. Off-label use was determined by reviewing domestic and foreign guidelines,literatures and Micromedex database. RESULTS:Among 1838 pre-scriptions,there were 1750 prescriptions of off-label drug use (95.21％),involving 13 items and 3 types of off-label drug use. Main type of off-label drug use was over-indication medication,involving 1747 prescriptions (96.47％). There was no statistical significance in the incidence of off-label drug use between digestive department and non-digestive department or among physicians at different levels(P>0.05). Among 13 items of off-label drug use,7 items were supported by evidence-based medicine evidence of domestic and foreign guideline,expert consensus/suggestion or literature reports,etc.;among which 1 item of off-label drug use were included in Micromedex grading system and other 6 items had no evidence-based medicine evidence. CONCLUSIONS:The phenomenon of omeprazole off-label use is widespread in outpatient department of the hospital,and some off-label drug use are sup-ported by evidences. There are differences in the quality of those evidences. It is suggested to standardize the off-label drug use to avoid legal risks and guarantee the safety of drug use for patients.