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Objective:To explore whether life satisfaction has a mediating effect between child neglect and middle school student’ problematic mobile phone use.Methods:Totally 1 692 middle school students from four middle schools of Xiamen in June 2020 were selected by cluster stratified sampling.The self-rating questionnaire for adolescent problematic mobile phone use (SQAPMPU), child neglect scale (CNS) and quality of life scale for children and adolescents (QLSCA) were used for the survey. SPSS 23.0 software was used for descriptive statistics, correlation analysis, regression analysis and the mediating effect analysis.Results:The scores of CNS, QLSCA and SQAPMPU were (24.45±14.28), (134.44±19.34), (23.20±8.94)respectively.And the detection rate of problematic mobile phone use was 23.6%. There were significant differences in the scores of SQAPMPU scale in different grades, father's education degrees, mother's education degrees and monthly pocket money(all P<0.05). In SQAPMPU, high school students scored significantly higher than junior school students( t=-2.403, P=0.016), adolescents with undergrate education of their father and mother scored the lowest( F=3.411, P=0.017; F=2.729, P=0.043), adolescents with monthly pocket money of "500-1 000" and "1 000-2 000" scored significantly higher than those with monthly pocket money of "under 500". The total scores and sub scores of child neglect were significantly positively correlated with the total scores and sub scores of problematic mobile phone use ( r=0.177-0.360, all P<0.05). The total scores and sub scores of life satisfaction were significantly negative correlated with the total scores and sub scores of problematic mobile phone use ( r==-0.508--0.250, all P<0.05). Child neglect had a positive predictive effect on problematic mobile phone use ( t=15.598, R2=0.130, P<0.05), but had a negative predictive effect on life satisfaction ( t=-27.798, R2=0.321, P<0.05). There were the part intermediary role of life satisfaction between child neglect and problematic mobile phone use( t=-13.937, R2=0.222, P<0.05), and the mediating effect accounted for 58.29% of the total effect. Conclusion:The neglected experience in childhood of adolescents not only can directly affect problematic mobile phone use, but also can affect the problematic mobile phone use by affecting life satisfaction.
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Objective:To investigate the relationships between severe, diffuse decrease in global brain 18F-fluorodeoxxglucose(FDG)uptake, whole-body total lesion glycolysis(TLG)and short-term death in elderly patients with newly diagnosed stage Ⅳ cancer. Methods:Clinical and 18FFDG PET/CT data of 24 elderly patients newly diagnosed stage Ⅳ cancer showing marked diffuse decrease in global brain FDG uptake(the decreased brain uptake group)were retrospectively enrolled.Sixteen elderly patients with newly diagnosed stage Ⅳ cancer but without decreased global brain FDG uptake(the no decreased brain uptake group)and 25 healthy subjects were enrolled as the control groups.Correlations between brain FDG uptake and whole-body TLG were analyzed.We followed up the final outcomes of all patients and analyzed the short-term prognostic value of these manifestations. Results:The decreased brain uptake group included 17 patients with stage Ⅳ lymphoma and 7 patients with stage Ⅳ malignant tumor of other types[15 males, age: (73±9)years], while the no decreased brain uptake group included 8 patients with stage Ⅳ lymphoma and 8 patients with stage Ⅳ malignant tumor of other types[12 males, age: (65±5)years]and the healthy control group included 25 subjects[13 males, age: (65±6)years]. Patients were older in the decreased brain uptake group than in the no decreased brain uptake group( t=3.8, P=0.001). The global brain SUV means of the decreased brain uptake group and the no decreased brain uptake group were 4.9±1.8 and 10.9±2.0, respectively( t=-9.8, P=0.000). The global brain total glycolysis(TG)values of the two groups were 1786.5±1162.5 and 2868.4±1424.5, respectively( t=-2.6, P=0.012). The whole-body TLG values of the two groups were 6825.5±4776.9 and 2919.5±2031.7, respectively( t=3.6, P=0.001). Pearson correlation analysis showed that brain FDG uptake was adversely correlated with whole-body TLG.We followed up the survival outcomes of the two groups.The median follow-up lengths of the two groups were 6 months and 10 months, respectively( χ2=3.7, P=0.054). Fourteen(14/24)patients died in the decreased brain uptake group while 9(9/16)died in the no decreased brain uptake group( χ2=0.017, P=0.896). However, 8 cases died within 1 month post PET/CT scan in the decreased brain uptake group while none died in the no decreased brain uptake group( χ2=4.7, P=0.029). Conclusions:Severe, diffuse decrease in 18F-FDG PET/CT uptake in the whole cerebral cortex is more common in elderly patients with newly diagnosed stage Ⅳ cancer, whose total tumor load is significantly higher than that of cancer patients without decrease in whole cerebral cortex FDG uptake.This uptake reduction may indicate poor short-term outcome and the probability of short-term death may be high.
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Objective:To investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in detecting N 1 or N 2 metastasis of lymph node (LN) with different densities in patients with non-small cell lung cancer (NSCLC). Methods:A total of 118 patients (68 males, 50 females, age range: 27-87 (65.4±10.8) years) with N 0-N 2 M 0 NSCLC in Beijing Hospital between October 2007 and December 2017 were included in this study. All patients underwent 18F-FDG PET/CT, followed by surgery within 1 month. The pathological findings of the resected hilar mediastinal LN were taken as the gold standard, and ratios of LN metastasis were calculated for different density groups (calcification, partial calcification, hyper density, hypodensity/isodensity). The cut-off values of LN size (short diameter) and the maximum standardized uptake value (SUV max) in the detection of N 1 and N 2 metastases was determined by the receiver operating characteristic (ROC) curve, and the diagnostic efficiencies were calculated. Independent-sample t test, Mann-Whitney U test and χ2 test (partition of χ2) were used for data analysis. Results:A total of 433 LN has the histopathologic results: 365 LN was in stage N 0, 68 LN was in stage N 1-N 2. There were no metastases in calcification group (0/8). The metastatic LN proportions in partial calcification group (28.6%, 8/28), hypodensity/isodensity group (20.3%, 44/217) were significantly higher than that in the hyper density group (8.9%, 16/180; χ2 values: 7.369, 9.945, both P<0.017 (threshold for partition of χ2)). There was no significant difference between the partial group and hypodensity/isodensity group ( χ2=1.021, P>0.017). The SUV max of N 1+ N 2 group was significantly higher than that in N 0 group (6.94 (4.51, 11.36) vs 2.45 (1.93, 3.42); z=-10.388, P<0.01). According to the ROC curve, the cut-off value of SUV max in detecting hilar and mediastinal LN was 3.66. The diagnostic sensitivity, specificity and accuracy for N 1+ N 2 metastasis was 85.3%, 78.9%, 80.0% respectively. The cut-off values of SUV max for hypodensity/isodensity group and hyper density group were 3.66 and 2.79 respectively, and the corresponding sensitivities, specificities, accuracies and positive predictive values (PPV) were 93.2%, 86.7%, 88.0%, 64.1% vs 93.8%, 57.9% ( χ2=10.724), 61.1% ( χ2=7.326, P<0.01), 17.9%( χ2=32.971, P<0.01). The specificity of LN size (1.0 cm)+ SUV max was significantly higher that of LN size or SUV max alone (94.2% vs 80.9%, 86.7%; χ2 values: 14.048, 5.661, both P<0.05) in hypodensity/isodensity group. The specificity and accuracy of LN size (1.0 cm)+ SUV max were significantly higher those of SUV max alone ( χ2 values: 58.043, 37.037, both P<0.01) in hyper density group. Conclusions:18F-FDG PET/CT is useful in diagnosing the N 1+ N 2 metastases in hypodensity/isodensity LN, but has limitation in diagnosing the partial calcification LN. Combination of lymph node short diameter and SUV max cut-off value can improve the diagnostic specificity or accuracy of 18F-FDG PET/CT for hypodensity/isodensity and high density LN.
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Objective@#To explore the impact of multidisciplinary quality improvement handover system on handover errors and medical staff satisfaction.@*Methods@#The study group consisted of a team of nurses, surgeons, anesthesiologists, ICU doctors and nurses in the operating room of Yangzhou Friendship Hospital. From May 2015 to May 2016, the team transferred from the operating room to the ICU. After the patient handover, the traditional oral handover was followed as the normal handover group. From June 2016 to June 2017, the standardized quality improvement handover system was adopted as the quality improvement. Handover group. 50 patients with elective surgery were randomly selected from the two groups. The errors that occur during the handover process are recorded during each handover. After the handover of all patients in each group, an anonymous questionnaire was provided to the operating room medical staff, anesthesiologists, and ICU medical staff.@*Results@#Compared with the quality improvement handover group (50 cases), the number of errors in the handover process, the number of errors in the process of handover, the number of interruptions in the handover, the delivery of the ICU to the medical staff. The organization of medical staff reported that there was a statistically significant difference in the treatment plan of the patients (t=5.34, 4.53, 3.34, χ2=23.45, 14.94, 16.28, P<0.05). The two groups of medical staff were satisfied with the handover, satisfied with the report of the operating room doctor, and reported to the anesthesiologist, I was able to get all the reports of the patients, satisfied the evaluation of the anesthesia of the preoperative patients, and provided effective patient information before the operation. Regarding the information on potential problems, the satisfactory score for the interruption of the handover, the idea of the handover process is clear from beginning to end, the time of the medical personnel is tight, and the responsible doctors and nurses feel the statistically significant difference in the handover time(t=2.32-6.34, P < 0.05).@*Conclusions@#Multidisciplinary quality improvement handover system can reduce handover errors and improve the satisfaction of medical staff.
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Objective To explore the impact of multidisciplinary quality improvement handover system on handover errors and medical staff satisfaction. Methods The study group consisted of a team of nurses, surgeons, anesthesiologists, ICU doctors and nurses in the operating room of Yangzhou Friendship Hospital. From May 2015 to May 2016, the team transferred from the operating room to the ICU. After the patient handover, the traditional oral handover was followed as the normal handover group. From June 2016 to June 2017, the standardized quality improvement handover system was adopted as the quality improvement. Handover group. 50 patients with elective surgery were randomly selected from the two groups. The errors that occur during the handover process are recorded during each handover. After the handover of all patients in each group, an anonymous questionnaire was provided to the operating room medical staff, anesthesiologists, and ICU medical staff. Results Compared with the quality improvement handover group (50 cases), the number of errors in the handover process, the number of errors in the process of handover, the number of interruptions in the handover, the delivery of the ICU to the medical staff. The organization of medical staff reported that there was a statistically significant difference in the treatment plan of the patients (t=5.34, 4.53, 3.34, χ2=23.45, 14.94, 16.28, P<0.05). The two groups of medical staff were satisfied with the handover, satisfied with the report of the operating room doctor, and reported to the anesthesiologist, I was able to get all the reports of the patients, satisfied the evaluation of the anesthesia of the preoperative patients, and provided effective patient information before the operation. Regarding the information on potential problems, the satisfactory score for the interruption of the handover, the idea of the handover process is clear from beginning to end, the time of the medical personnel is tight, and the responsible doctors and nurses feel the statistically significant difference in the handover time( t=2.32-6.34, P < 0.05). Conclusions Multidisciplinary quality improvement handover system can reduce handover errors and improve the satisfaction of medical staff.
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Objective After implementation of new standard iodized salt,to comprehensively assess the iodine nutrition levels of different populations in Dali City of Yunnan Province.Methods From 2012 to 2015,in Dali City,there were 5 districts divided into east,west,south,north and middle,each district selected 1 township (town),and each township (town) selected 4 administrative villages,15 households for edible salt in each administrative village were sampled,and the salt iodine content was measured by "General Test Method in Salt Industry Determination of Iodine" (GB/T 13025.7-2012).In 2014,in the five districts of east,west,south,north and middle of Dali City,one township (town) was selected,and 20 pregnant women in the early,middle and late stages,respectively,20 lactating women,20 ordinary healthy adults and 20 children aged 0 to 4 were selected from each township (town);one primary school in each township (town) was selected in each district,and 40 students aged 8-10 years old were selected from each primary school as the survey objects.The urine samples of the survey objects were collected,and the urinary iodine content was measured by "Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry" (WS/T 107-2006).In 2015,in each administrative village of Dali,a water source with the largest number of drinking people was investigated,and water iodine was detected by the "Method of Water Iodine Detection Suitable for Iodine Deficiency and High Iodine Areas".Through questionnaires,the sources of iodine supplementation for pregnant and lactating women were investigated.Results The qualified iodized salt consumption rate of residents was higher than 90％ per year from 2012 to 2015,and median of salt iodine decreased from 29.38 mg/kg (2012) to 24.96 mg/kg (2015).The medians of urinary iodine in different populations were 136.85 μg/L for pregnant women (n =356),102.63 μg/L for lactating women (n =111),164.03 μg/L for adults (n =163),209.61 μg/L for 8-10 years old children (n =200),157.27 μg/L for children aged 0-＜ 2 years old (n =57),and 134.08 μg/L for 2-4 years old children (n =50).The median of iodine content of drinking water (n =142) in Dali was 0.62 μg/L,the range of iodine content was 0.00-9.92 μg/L.The average intake frequencies of iodine-rich seaweed for pregment women and lacting women were 0.99,1.07 time/month,respectively,only 1.99％ (9/453) of the population supplemented iodine through multivitamin and minerals tablets.Conclusions After reduction of salt iodine content,the iodine nutrition of populations in Dali City (a low water iodine region) is generally at an appropriate level.Maintaining a higher level of qualified iodized salt consumption rate,strengthening the monitoring of different populations and promotion of healthy behaviors are key steps in prevention and control of the disease in the future.
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Objective To explore the effects of first-degree relatives' anxious traits on the anxious emotion in children with Tic disorders ( TD) . Methods A total of 31 children with TD and 32 normal chil-dren were assessed by The Screen for Child Anxiety Related Emotional Disorders ( SCARED) ,and their first-degree relatives were assessed by State-Trait Anxiety Inventory ( STAI) . The differences of first-degree rela-tives' personality traits between two groups were compared,and the effects of these personality traits on chil-dren's anxious emotion were further analyzed. Results Compared with the control group(36. 66±8. 24),the first-degree relatives of children with TD had higher scores in trait anxiety (40. 10±8. 24,P<0. 05),but there was no significant difference in state anxiety between TD group and control group((35. 00±9. 09) vs (40. 90 ±10. 21),P>0. 05). The school phobia in children with TD was positively correlated with the education lev-els of their mothers(r=0. 407,P<0. 05). Conclusion The first-degree relatives of children with TD are more anxious emotion than normal children. Children with TD are more likely to have school phobia if their mothers have better education.
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Objective To investigate the traits of anxiety characteristics and its influencing factors in children with tic disorders ( TD) . Methods 31 children with tic disorders and 32 normal children were assessed by the screen for child anxiety related emotional disorders(SCARED), eysenck personality ques-tionnaire(EPQ) for child,attachment security scale and egma minnen av bardndosnauppforstran(EMBU).In-dependent sample t-test was used to compare the differences in anxiety disorders between the children of the two groups,and Pearson correlation and multivariate linear step-by-step regression analysis were used to ana-lyze the effects of personality traits,parent-child attachment and parental education on anxiety. Results So-matization/panic and separation anxiety in TD((6.20±5.33),(4.87±3.18)) were higher than those in con-trol group((3.75±3.34),(3.06±2.61);both P<0.05).There was positive correlation between somatization/panic and children's personality of introversion-extroversion(E),psychoticism(P),excessive interference mother,the mother refusal and denial,mother severely punishment(r=0.580,0.427,0.399,0.674,0.575,P<0.05 or P<0.01),and negative correlation between somatization/panic and mother closeness(r=-0.365,P<0.05).Generalized anxiety was positively correlated with E,P,lie,excessive interference mother,the mother refusal and denial,mother severely punishment(r=0.604,0.543,0.526,0.365,0.613,0.395,P<0.05 or P<0.01) . Separation anxiety was positively correlated with E, lie, the mother refusal and denial ( r=0. 440, 0.401,0.365,P<0.05).Social phobia was positively correlated with excessive interference mother,the mother refusal and denial (r=0.367,0.482,P<0.05 or P<0.01).School phobia was not only positively associated with E, N, P, excessive interference mother, the mother refusal and denial, mother severely punished ( r=0.635,0.449,0.526,0.463,0.541,0.589,P<0.05 or P<0.01),but also negatively correlated with mother closeness(r=-0.394,P<0.05).The mother refusal and denial affected on somatization/panic and social pho-bia(accounted for 45.4％,23.2％) ,the mother refusal and denial and lie affected on generalized anxiety( ac-counted for 51.0％) ,E affected on separation anxiety( accounted for 19.3％) ,E and mother severely punish-ment affected on school phobia( accounted for 50.0％) ,the mother refusal and denial and E affected on total anxiety( accounted for 49.4％) . Conclusions Somatization/panic and separation anxiety in children with tic disorder is higher than that in normal children.Anxiety disorder is mainly affected by fewer mother's encour-agement and tolerance,and children's extroversion.
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Objective To evaluate the diagnostic efficacy of the pulmonary perfusion tomography combined with low dose CT scan (Q SPECT/ CT) in detecting acute pulmonary embolism (PE) by compa-ring with pulmonary ventilation/ perfusion (V/ Q) SPECT imaging. Methods A total of 203 patients sus-pected with acute PE (88 males, 115 females, age range 19-94 years) from January 2013 to December 2015 were enrolled in this retrospective study. All patients underwent V/ Q SPECT and low dose CT scan. Final clinical diagnosis was regarded as the gold standard. The diagnostic consistency and diagnostic efficacy of Q SPECT/ CT were compared with those of V/ Q SPECT. χ2 test was used to compare the differences be-tween the two methods. Kappa analysis was used to analyze the agreement of them. Results The coinci-dence rate of Q SPECT/ CT and V/ Q SPECT was 94.09％(191/ 203), Kappa= 0.882, P<0.001. Among the 12 cases with inconsistent diagnosis, 9 were finally diagnosed as chronic obstructive pulmonary disease (COPD). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Q SPECT / CT in the diagnosis of PE were 95. 12％(78/ 82), 80.99％(98/ 121), 77.23％(78/ 101), 96.08％(98/ 102), 86. 70％ ( 176/ 203). The counterpart parameters of V/ Q SPECT were 95. 12％ ( 78/ 82), 90. 91％(110/ 121), 87.64％ (78/ 89), 96.49％ (110/ 114), 92.61％ (188/ 203). Compared with V/ Q SPECT, Q SPECT/ CT had the same sensitivity but lower specificity (χ2 = 4.928, P = 0.026). The positive predictive value, negative predictive value and accuracy of Q SPECT/ CT were lower than those of V/ Q SPECT, but there was no significant difference (χ2 values: 3.491, 0.000, 3.824, all P>0.05). Conclusion In the majority of patients with suspected acute PE, V/ Q SPECT scan can be replaced by Q SPECT/ CT, but it must be careful to select Q SPECT/ CT for patients with COPD history.
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Objective To study the FDG SUVmax cutoff values in detection of metastases in mediastinal lymph nodes (MLN) and hilar/intralobar lymph nodes (HILN) in pre-operative patients with N0-2 stage NSCLC.Methods A total of 69 patients with stage N0-2 NSCLC (40 males,29 females,age 36-87 years) were included in this retrospective study.18F-FDG PET/CT was performed and followed by lung cancer resection with lymph node dissection in 1 month.The excised lymph nodes were compared one by one between their SUVmax and histopathology.The SUVmax cutoff value in detection of lymph node metastases was determined by the ROC curve.Mann-Whitney u test,x2 test,and Fisher exact test were used for data analysis.Results Metastatic MLN and (or) HILN were found in 21 of 69 NSCLC patients.The histopathologic results demonstrated metastases in 61 of 339 lymph nodes.The SUVmax of metastatic lymph nodes (4.95(3.46,7.19)) was significantly higher than that of benign lymph nodes (2.10(1.59,3.22);z=-7.576,P＜0.05).The SUVmax of metastatic HILN (6.32 (4.28,8.27)) was significantly higher than that of metastatic MLN (3.90(2.12,6.41);z=-2.921,P＜0.05).With cutoff of SUVmax ≥2.5,the sensitivity,specificity and accuracy in detection of all metastatic lymph nodes were 83.6％ (51/61),61.9％ (172/278)and 65.8％ (223/339) respectively,and the parameters were 74.2％ (23/31),79.6％ (160/201) and 78.9％ (183/232) for metastatic MLN,and 93.3％ (28/30),15.6％ (12/77) and 37.4％ (40/107) for metastatic HILN.The diagnostic sensitivities for metastatic MLN and for metastatic HILN were not significantly different (Fisher exact test,P＞0.05),while the specificities and accuracies between the two groups were significantly different (x2 values:96.7 and 56.1,both P＜0.05).According to ROC curves,cutoff values of SUVmax in detecting metastatic MLN and metastatic HILN were 2.78 and 4.93.With the specific cutoff value,the sensitivity,specificity and accuracy in detection of metastatic MLN were 71.0％ (22/31),87.1％ (175/201)and 84.9％(197/232),respectively.The corresponding data in detection of metastatic HILN were 73.3％ (22/30),77.9％(60/77) and 76.6％(82/107).Conclusion Different cutoff values of SUVmax in detecting metastatic MLN and metastatic HILN should be considered for more accurate lymph nodes staging in patients with NSCLC.
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Objective To compare the difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children diagnosed with mental retardation(MR) or borderline intellectual funcition(BIF).Methods 80 children aged 6-16 years were enrolled in this study.All of them were diagnosed with MR or BIF based on the criteria of DSM-Ⅳ-R.Then,C-WISC and WISC-Ⅳ were used to measure the IQ.Results There was no significant difference in the scores of full IQ between C-WISC and WISC-Ⅳ in these children ((65.49±12.83) vs (64.86±10.10),t=-0.591,P＞0.05).The score of verbal intelligence quotient in the C-WISC was significantly lower than the corresponding score in the WISC-Ⅳ ((64.96± 13.14) vs (68.26 ± 10.99),t=3.029,P＜0.05).The score of performance intelligence quotient in the C-WISC was significantly higher than the corresponding score in the WISC-Ⅳ ((72.48±14.04) vs (69.35±11.75),t=-2.488,P＜0.05).The scores of similarities,coding,and block design in the C-WISC were significantly higher than the corresponding score in the WISC-Ⅳ (P＜0.05)).There was no significant difference in the scores of comprehension and digit span between the two methods (P＞0.05).There was also no significant difference in MR hierarchical diagnosis between the two methods (x2=0.427,P9＞0.05).Conclusion There is no significant difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children aged 6-16 years who were diagnosed with MR or BIF.Both C-WISC and WISC-Ⅳ can be used to diagnose the MR and marginal intelligence for the children aged 6-16 years.
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Objective To investigate the left ventricular synchrony under different ischemic statuses using phase analysis of 99Tem-MIBI gated SPECT MPI (GSMPI).Methods The data of 129 patients (65 males,64 females,age:48-88 (68.6±10.2) years) who underwent 2-d stress-rest GSMPI were retrospectively analyzed.Perfusion images were scored by a 5-grade criteria (0-4) based on 17 coronary artery segments.Patients were divided into normal perfusion group (G1) and abnormal perfusion group (G2) according to the summed stress scores.G2 was divided into reversible perfusion defect subgroup (G2a) and irreversible perfusion defect subgroup (G2b) by the summed difference scores.The difference of PSD and PHB between groups and the difference between stress and rest GSMPI within each subgroup were compared using two-sample t test and paired t test,respectively.Results The numbers of patients in G1,G2,G2a and G2b were 66,63,39 and 24,respectively.The PSD (18.3±7.8) and PHB (68.6±30.9) of G2 were significantly higher than those (14.3±6.6 and 50.2±20.0) of G1 (t =-3.110,-3.989,both P＜0.05).The PSD and PHB of G2b were higher than those of G2a,but the difference was not statistically significant (t:-1.554 to-0.408,all P＞0.05),and the differences of PSD and PHB between rest and stress MPI within each subgroup were not significantly different (t:-0.961 to-0.114,all P＞0.05).The PSD (20.4±8.1 and 20.8±6.4) and PHB (77.8±53.5 and 78.4±26.7) of rest and stress GSMPI in patients with LVEF ≤60％were significantly higher than those in patients with LVEF＞60％(15.0±6.8 and 15.3±7.0,53.5±23.0 and 55.9±24.5;t:3.642 to 4.567,all P＜0.05).Conclusions 99Tcm-MIBI GSMPI phase analysis can show damage effect of abnormal myocardial perfusion on left ventricular synchrony,which influencing global left ventricular function,and it can show different left ventricular synchrony due to different degrees of myocardial ischemia.There is nearly same value of stress GSMPI and rest GSMPI in assessment of left ventricular synchrony.
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Objective To observe the expression of Toll-like receptor(TLR) on peripheral blood dendritic cells(DC) in children with Henoch-Schtinlein purpura(HSP),and to investigate the pathogenesis of the abnormal expression of TLR in children with HSP.Methods Twenty hospitalized children with HSP in the Affiliated Hospital of Qingdao University Medical College from Dec.2011 to Jul.2012 were enrolled in the study(HSP group).Twenty agemetched healthy children were selected as a healthy control group.Peripheral venous blood was sampled under aseptic condition,peripheral blood mononuclear cells (PBMC) were isolated from density gradient centrifugation,and DC were generated by recombinat human granulocyte-macrophage colony-stimulating factor(GM-CSF),interleukin-4(IL-4) and tumor necrosis factor-α(TNF-α) in vitro.Expressions of CD83,CD86 and TLR2,TLR3,TLR4 in peripheral blood DC were examined by fluorescent activated cell sorter (FACS).Results 1.No significant distinction was found in the expression of the C Ds3 on peripheral blood DC between HSP group and healthy control group(t =0.80,P ＞ 0.05) ;in HSP group had remarkably increased expression of the CD86 on peripheral blood DC than that of the healthy control group (t =9.56,P ＜ 0.01).2.Expression rates of TLR2,TLR3,TLR4 on peripheral blood DC in the HSP group were higher than those in the healthy control group(t =1 1.79,13.29,9.45,all P ＜ 0.01).3.Expression rates of TLR2,TLR3 and TLR4 in HSP group had positive correlation with expression rates of CD86 (r =0.84,P ＜ 0.01 ; r =0.53,P ＜ 0.05 ; r =0.66,P ＜ 0.05).Conclusions Expressions of TLR2,TLR3 and TLR4 on peripheral blood DC significantly increased and were positively correlated with expression of CD86.This implies that TLR and co-stimulatory molecules might participate in the pathogenesis of HSP by mediating signal transduction,leading to abnormity of cytokines,then inducing Th1/Th2 immune imbalance by showing the advantage of Th2 function.
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Objective To explore the expressions and clinical significance of Toll-like receptor (TLR) 3 and TLR4 in peripheral blood mononuclear cells in Henoch-Schsnlein purpura nephritis (HSPN) children.Methods According to their 24-hour urinary albumin and whether children with HSP had renal damage or not,105 cases were divided into group A,B and C.Group A were children only with HSP but without renal damage,while group B were children only with HSPN not proteinuria and group C were children with both HSPN and proteinuria.Thirty healthy children were in healthy control group(group N).Flow cytometry (FCM) and real-time PCR detected the mRNA and protein expressions of TLR3 and TLR4 in peripheral blood mononuclear cells.Results 1.The mRNA and protein expressions of TLR4 in peripheral blood mononuclear cells were significantly higher in group A,B,C than those in group N (F =37.33,24.01,all P ＜ 0.05).The mRNA and protein expressions of TLR4 in group C were much higher than those in group A and B (all P ＜ 0.05).Meanwhile,there was no significant difference between group A and B(all P ＞0.05).2.Moreover,there was a positive relationship between protein expression of TLR4 and 24-hour urinary albumin in group C(r =0.69,P ＜ 0.01).3.Expression of TLR3 was of no significant difference in all groups(F =0.86,1.78,all P ＞ 0.05).4.The expression of TLR4 mRNA had a positive correlation with protein expression of TLR4(r =0.61,P ＜ 0.0 1).Conclusions Expressions of TLR4 in peripheral blood mononuclear cells significantly increased and had a positive correlation with urinary protein excretion from HSPN in children.This implied that aberrant activation of TLR4might be relevant to the development of HSPN.
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Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.
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Objective To investigate the incidence rate, onset time and electrophysiological characteristics of rapid eye movement sleep behavior disorder (RBD) and the relationship between RBD and synucleinopathies as well as the electrophysiological diagnostic criteria of RBD in Parkinson' s disease (PD) and multiple system atrophy (MSA). Methods Sleep survey and night video-polysomnography (NPSG)were used to study sleep disturbance of PD and MSA. (1) Subjective sleep assessments: All subjects,including 66 PD patients, 65 age and sex matched healthy controls and 30 MSA patients, completed the sleep questionnaires, and the RBD incidence rate and onset time were got. (2) Objective sleep assessments: 8 PD patients, 13 MSA patients, and 15 age and sex matched healthy controls underwent video-NPSG recording on two consecutive nights. Sleep architect were analyzed. The NPSG characteristics of RBD accompany with PD and MSA were analyzed, and the electrophysiological diagnostic varameters of it were determined. Results Patients with PD or MSA had a higher prevalence of RBD. RBD was found in 59. 1% (39/66) PD patients and 86. 6% (26/30) MSA patients, among those, 46. 2% ( 18/39 ) and 84.6% (22/26) had the waking symptoms of MSA and PD. The main NPSG characteristics of RBD of PD or MSA were chin REM without atonia (RWA) and increased movement. Conclusions The relatively higher RBD prevalence in MSA and PD patients indicates that RBD has close relationship with PD and MSA.Part of patients with RBD preceding neurology disease indicates that RBD may be the early marker of PD and MSA. The main NPSG characteristics of RBD accompany with PD and MSA are chin RWA and the motor manifestations. RWA and phasic EMG activity density are supposed to be the NPSG diagnostic parameters.
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Objective To investigate the expression of XIAP and survivin and its significance in diffuse large B-cell lymphoma. Methods The expression of XIAP and survivin were detected by immunohistochemistry in 49 patients with diffuse large B-cell lymphomas. Results The positive rate of XIAP and survivin in cases of DLBCL were 40.8%(20/49) and 44.9%(22/49) respectively, which was higher than that of benign lymph node pathological changes (P ＜0.05). The expression of XIAP in DLBCL positively correlated with the expression of surviving (r =0.382, P =0.01). Moreover, the mean survival period in DLBCL expressing XIAP was shorter than the XIAP-negative group. Conclusion The up-regulation of expression of XIAP may play an important role in the development of DLBCL, and may cooperate with the expression of survivin in apoptosis pathway. Furthermore, the expression of XIAP might be a new unfavorable prognosis factor of DLBCL.
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Objective To explore the clinical features of nervous system involvement of acquired immunodeficiency syndrome (AIDS).Methods A retrospective clinical analysis of 15 admitted AIDS patients with neurological involvement in our hospital from February 2002 to February 2008.Eight of them visited department of neurology for the first time.Results There were 4 cases of human immunodeficiency virus (HIV) encephalopathy, 1 of them appearanced as general chorea, 1 HIV-associated encephalopathy accompanied with myopathy; 1 progressive multifocal leukoeneephalopathy (PML); 1 PML accompanied with toxoplasmosis; 1 HlV-associated myopathy; 1 multicranial nerve injury companied with myelopathy; 1 peripheral neuropathy; 1 drug-associated neuromuscular disease; 4 meningoencephalitis and 1 brain abscess cases.Conclusion The manifestations and AIDS neurological involvement are varied.A close attention should be paid to screening.
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Objective To compare the classification rate of three classifications of epilepsy syndromes proposed by International League Against Epilepsy(ILAE),and analyze their stuctural changes.Methods All patients with epilepsy who consecutively visited the epilepsy center of Peking Union Medical College Hospital between Aug.1st,2007 and Mat.31st.2008 were included.Thtee classifications of epilepsy syndromes were used in order.Results In this study,we could categorize 75.5 % of 1356 patients by applying the 1989 international classification of epilepsy syndromes.89.0 % of them by the 2001 proposed diagnostic scheme and 88.1 % of them by the 2006 report.In this aspect,the 2001 and 2006 classifications were better than the 1989 classification(x2=116.3,P<0.01).However,only 11.6 % (157),12.O % (162)and 11.9 % (160)of patients with specific epilepsy syndromes were identified from the 1356 epileptic patients by three classifications.respectively.This data based on the 2001 and 2006 classifications did not change markedly in comparison with the 1989 classification(x2=0.09,P>0.05).Conclusions The 2006 report involve mole scientific mode of classification and systematic evaluation,and can classify more patients with epilepsy.It can be ased in clinical and scientific research.which can not only accumulate data for developing more scientific classification but also stimulate research especially in the fields of genetics and functional morphology.
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Objective To investigate the expression of NF-κB/p65 in nasal NK/T cell lymphomas. Methods Immunohistochemis-try and TUNEL were used to study the expression of NF-KB/p65 and cell apoptosis in 23 nasal NK/T cell lymphoma samples and 14 benign lymph node lesions. Results The NF-KB/p65 positive rates were 43.5% (10/23). The expression of NF-κB/p65 was negative correlated with apoptotic index among 23 nasal NK/T cell lymphomas(P <0. 05). The mean survival period in patients expressed NF-KB/p65 was sig-nificantly shorter than that in negative group(P <0. 05). Conclusions Apoptosis inhibited by overexpression of NF-κB/p65 might be in-volved in the development of nasal NK/T cell lymphoma. NF-κB/p65 expression may be an unfavorable prognostic factor of nasal NK/T cell lymphoma.