ABSTRACT
Sickle cell disease (SCD) is a single gene genetic disease, which seriously threatens the life span and quality of patients. On the basis of the pathogenesis of SCD and the alternative therapy based on fetal hemoglobin F (HbF), the research progress of transcription factors involved in the regulation of HbF gene expression, such as BCL11A, ZBTB7A, KLF-1, c-MYB and SOX6, as well as the application of CRISPR / Cas9, TALEN, zinc finger nuclease and other gene editing technologies in this field has been made, providing a solid theoretical basis for the exploration of new treatment schemes for β- like hemoglobin diseases, such as sickle cell disease and β- thalassemia.
Subject(s)
Humans , Anemia, Sickle Cell/therapy , Cell Line, Tumor , DNA-Binding Proteins , Fetal Hemoglobin/genetics , Genetic Therapy , Repressor Proteins/genetics , Transcription FactorsABSTRACT
Objective@#To explore the effect of voluntary teaching for medical students on cardio-pulmonary resuscitation training for middle school students,and to provide a reference for education of first aid among primary and middle school students.@*Methods@#A total of 196 students from four classes in the first grade of a middle school were selected by convenient sampling method and divided into experimental group and control group according to the class. After the two groups of students were trained in unified theory, the students in the control group were trained by the medical staff in the hospital, and the students in the experimental group were trained by the volunteers of the medical students who had been strictly trained and assessed. After the training was finished, questionnaires were sent out to investigate the effect of training.@*Results@#Before the training, there was no significant difference in the theoretical scores between the two groups (t=1.18，P=0.24). After training, the theoretical and skill scores of the experimental group were(11.43±1.53)(5.68±1.80), that of the control group were(11.35±1.77)(5.30±1.76), and there was no significant difference between the experimental group and the control group(t=0.34，1.48，P>0.05).@*Conclusion@#The application of voluntary teaching in the training of middle school students’ cardiopulmonary resuscitation can improve the popularization rate of cardiopulmonary resuscitation, save medical resources effectively, and improve the practical ability of medical students.
ABSTRACT
<p><b>BACKGROUND</b>Acute exacerbation of chronic obstructive pulmonary disease (COPD) is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis (DVT) in patients with acute exacerbation of COPD.</p><p><b>METHODS</b>From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.</p><p><b>RESULTS</b>Among the 520 patients, DVT was found in 46 cases (9.7%). In patients with DVT, the duration of hospitalization was longer (P = 0.01), and the mechanical ventilation requirement increased (P < 0.001). Other indicators for patients with more possibility of DVT were immobility exceeding 3 days (P < 0.001); pneumonia as concomitance (P = 0.01); respiratory failure type II (P = 0.013); current smoking (P = 0.001). Lower extremity pain was more common in DVT cases in comparison to those without DVT (34.8% vs. 15.2%, P = 0.01).</p><p><b>CONCLUSIONS</b>The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type II, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies , Pulmonary Disease, Chronic Obstructive , Risk Factors , Venous Thrombosis , EpidemiologyABSTRACT
<p><b>BACKGROUND</b>Thoracoscopy is highly sensitive and accurate for detecting pleural effusions. However, most respiratory physicians are not familiar with the use of the more common rigid thoracoscope or the flexible bronchoscope, which is difficult to manipulate within the pleural cavity. The semi-rigid thoracoscope combines the best features of the flexible and rigid instruments. Since the practice with this instrument is limited in China, the diagnostic utility of semi-rigid thoracoscopy (namely medical thoracoscopy) under local anesthesia for undiagnosed exudative pleural effusions was evaluated.</p><p><b>METHODS</b>In 50 patients with undiagnosed pleural effusions who were studied retrospectively, 23 received routine examinations between July 2004 and June 2005 and the rest 27 patients underwent medical thoracoscopy during July 2005 and June 2006. Routine examinations of the pleural effusions involved biochemistry and cytology, sputum cytology, and thoracentesis. The difference in diagnostic sensitivity, costs related to pleural fluid examination and complications were compared directly between the two groups.</p><p><b>RESULTS</b>Medical thoracoscopy revealed tuberculous pleurisy in 6 patients, adenocarcinoma in 7, squamous-cell carcinoma in 2, metastatic carcinoma in 3, mesothelioma in 2, non-Hodgkin's lymphoma in 1, and others in 4. Only 2 patients could not get definite diagnoses. Diagnostic efficiency of medical thoracoscopy was 93% (25/27). Only 21% patients were diagnosed after routine examinations, including parapneumonic effusion in 2 patients, lung cancer in 2 and undetermined metastatic malignancy in 1. Twelve patients with tuberculous pleurisy were suspected by routine examination. Costs related to pleural effusion testing showed no difference between the two groups (P=0.114). Twenty-three patients in the routine examination group underwent 97 times of thoracentesis. Two pleural infection patients and 2 pneumothorax patients were identified and received antibiotic treatment and drainage. Medical thoracoscopy could be well tolerated by all the patients. The semi-rigid thoracoscope could be easily controlled by chest physicians. The most common complication was transient chest pain (20 of 27 patients) from the indwelling chest tube, which would be managed with conventional analgesics. One case of subcutaneous emphysema and 2 cases of postoperative fever were self-limiting. No severe complications occurred.</p><p><b>CONCLUSIONS</b>Medical thoracoscopy is a simple, safe, and cost-effective tool, with a high positive rate. Physicians should extend its access to proper patients if the facilities for medical thoracoscopy are available.</p>