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Objective To investigate the characteristic manifestation of the peripheral seroimmunological indicators such as cellular immunity and cytokines in drug-induced liver injury (DILI). Methods The medical records of 219 patients with DILI collected in Shuguang Hospital and Baoshan Branch from January 2019 to August 2021 were retrospectively analyzed, grouped according to the type of drug injury and the degree of injury, and their clinical characteristics, biochemical and peripheral serum immunological characteristics were analyzed. analyze.Twenty-nine cases were selected from the healthy subjects as the normal liver function group, and 42 cases of DILI cases who had undergone cytokine and cellular immune evaluation within 1 week before the acute onset treatment were confirmed as the DILI control group. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Fisher test was used to compare the count data between groups. Results Among the 219 DILI patients, 122 (56%) were female and 97 (44 %) were male. 89 cases (40%) of injuries were caused by traditional Chinese medicines, proprietary Chinese medicines or health products, and 130 cases (60%) were caused by western medicines such as anti-tuberculosis and anti-tumor. Among them, 82 cases (37%) were classified as hepatocyte injury type, 17 cases (8%) of cholestatic type, and 120 cases (55%) of mixed injury type. The longest incubation period was 180 days, the shortest was 1 day, and the median was 15 days. Fatigue accounted for 49% of the main symptoms. There were statistically significant differences in cytotoxic T lymphocytes (%) and CD4/CD8 ratio between the traditional Chinese medicine, Chinese patent medicine or health product group and the western medicine group ( Z =2.55 and 3.08, P =0.011 and 0.002, ). From 219 DILI patients, it was confirmed that 42 patients who had detected peripheral immune indicators were compared with 29 patients with normal liver function physical examination. The statistical analysis showed that IL-6 and IL-10 were statistically significant in the peripheral immune serum distribution of DILI. Significance ( Z =3.828 and 2.695, P < 0.001 and 0.007). Conclusion Cytotoxic T lymphocytes may play different roles in the pathogenic mechanisms of Chinese herbal medicines, Chinese patent medicine preparations or health products and western medicines; drugs or drug-protein complexes may affect inflammatory and immune pathways and release related cytokines For example, IL-6 and IL-10 are involved in the pathogenesis of DILI.
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Objective@#To investigate the predictive value of thromboelastography (TEG) for early neurological deterioration (END) in patients with acute ischemic stroke.@*Methods@#Patients with acute ischemic stroke admitted to the Department of Neurology, Jiujiang Hospital Affiliated to Nanchang University from January 2018 to May 2019 were included as case group, and the healthy physical examinees in the same period were selected as control group. END was defined as an increase of ≥2 of the National Institutes of Health Stroke Scale score from baseline within 7 d after the onset of acute ischemic stroke. All subjects were routinely tested for traditional coagulation function, including prothrombin time, activated partial thromboplastin time, thrombin time, and plasma fibrinogen level. The reaction time (R value), coagulation time (K value), coagulation angle (α) and maximum amplitude (MA value) were monitored by TEG. Univariate analysis was used to compare the differences in clinical and laboratory results between the END group and the non-END group, and then multivariate logistic regression analysis was used to determine the independent risk factors for END.@*Results@#A total of 96 patients with acute ischemic stroke and 20 controls were included. Compared with the control group, the traditional coagulation parameters of the case group were not significantly different. For the TEG parameter, compared with the control group, the R value and K value of the case group were significantly shortened, and the α angle and MA value were significantly increased (all P<0.05). A total of 31 patients (32.3%) developed END, and the R and K values in the END group were significantly shorter than those in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that R value (odds ratio 1.192, 95% confidence interval 1.006-1.410; P=0.001) and K value (odds ratio 1.054, 95% confidence interval 1.012-1.150; P=0.001) shortening were the independent predictors of END.@*Conclusion@#The sensitivity of TEG in the monitoring of coagulation function in patients with acute ischemic stroke is higher than that of traditional coagulation indicators. The shortenings of R and K values are independent predictor of END in patients with acute ischemic stroke.
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The paper analyzes the application advantages of information technology in medical informatics education.Takes Shanghai Sipo Polytechnic College as an example, it elaborates the specific application of information technology in medical informatics education, including immersion education based on 3D virtual reality technology, two-way video teaching and other aspects.It also gives solutions on current existing problems.
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Objective To investigate the clinical value of color Doppler ultrasound (CDFI) in the diagnosis of carotid atherosclerosis lesion in patients with acute stroke.Methods Totally 60patients with acute cerebral infarction were examined with CDFI to observe vessel diameter and stenosis degree of common carotid artery,internal carotid artery and external carotid artery and the results were compared with digital subtraction angiography (DSA) test.Results Among 60patients,normal ultrasound diagnosis was in 28 cases,occlusion and stenosis in 32 cases,stenosis in 25 cases; mild,moderate and severe stenosis were in 18,20,12 vessels,occlusion in 7 cases,14vessels.DSA examination results showed normal in 29 cases,stenosis and occlusion in 31 cases,stenosis in 26 cases,mild,moderate and severe stenosis of the 18,16,18 vessels; occlusion in 5 cases,10 vessels.The consistency test results between carotid artery color Doppler ultrasound and DSA were Kappa=0.786,0.667(P＜0.05).All carotid DSA results were considered as gold standard,CDFI diagnosis of moderate to severe stenosis was in high accuracy compared with DSA.Conclusions CDFI in the diagnosis of different degrees of carotid stenosis is in good agreement with DSA diagnosis,and may replace invasive DSA diagnosis of moderate to severe stenosis.
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Under the high pressure of employment, traditional teaching method that is based on inculcating the knowledge to students does not adjust current condition any more. So, we start to looking for a new, more suitable way of teaching.--Project Based-on Learning, and have analyzed the advantages in health information technology teaching by construction doctrine in combination with the concept and principle in wedlock construction. At the same time we introduce project Based-on Learning in concrete application to find a way to put the theory into practice.
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Under low temperature conditions, the hapten carboxyl-norketamine was synthesized by reacting norketamine and succinaldehyde acid.Identification result using electrospray ionization mass showed the hap ten was successfully synthesized.The artificial antigen confirmed by infrared spectroscopy was developed by conjugating hapten to carrier proteins with carbodiimide(EDC) method.Matrix-assisted laser desorption ioni zation time of flight mass spectrometry(MALDI-TOF-MS) showed that the ratio of hapten to BSA was 11:1.The antibody with high titer(5.12 × 10~4) was produced after immuning to rabbits.