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Objective:To observe the risk factors of acute renal injury(AKI) after coronary artery bypass grafting(CABG) and the influence of blood pressure on AKI.Methods:980 patients in CABG of Cardiology Department of TEDA International Cardiovascular Hospital were diagnosed with AKI according to the AKIN standard, with 706 males and 274 females, averaged(61.9±8.0)years old. Patients were divided into two groups according to whether AKI occurred: AKI group(86 cases) and non AKI group(894 cases). The baseline clinical data, operation related data were compared between the two groups. At the same time, according to the preoperative mean systolic blood pressure(SBP) level, LSP[mean systolic blood pressure<120 mmHg(1 mmHg=0.133 kPa), 374 cases], MSP(mean systolic blood pressure 120-140 mmHg, 481 cases) and HSP(mean systolic blood pressure≥140 mmHg, 125 cases) were classified as covariates, and the influencing factors of dependent variable AKI were analyzed by multivariate logistic regression.Results:The prevalence of AKI was 8.7%(86/980). Compared with non-AKI group, preoperative SBP[(129.8±13.8)mmHg vs.(124.4±13.3)mmHg, P=0.000], mean arterial pressure[(91.9±8.8)mmHg vs.(88.8±9.1)mmHg, P=0.004], and mean pulse pressure[(56.9±10.7)mmHg vs.(53.2±9.8)mmHg, P=0.001]were increased significantly. After adjusted for other risk factors, preoperative SBP elevation, hypertension history, cardiopulmonary bypass(CPB), use of intra-aortic-balloon-pump(IABP), secondary thoracotomy, preoperative diuresis, intraoperative blood transfusion and baseline low glomerular filtration rate(eGFR) were independent risk factors for AKI after CABG. Compared with LSP group, the relative risk of AKI after CABG in HSP group was 2.743(95% CI: 1.595-4.715). In patients with hypertension history, AKI in HSP group was significantly higher than that in LSP group(18.4% vs. 8.1%, P=0.001). However, the preoperative blood pressure level of patients who denied the history of hypertension had no effect on AKI. Conclusion:Preoperative SBP is a risk factor for AKI after CABG. The incidence of AKI after CABG can be significantly reduced by controlling SBP below 140 mmHg in patients with hypertension.
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Ossifying fibroma (OF) and fibrous dysplasia (FD) are two fibro-osseous lesions with overlapping clinicopathological features, making diagnosis challenging. In this study, we applied a whole-genome shallow sequencing approach to facilitate differential diagnosis via precise profiling of copy number alterations (CNAs) using minute amounts of DNA extracted from morphologically correlated microdissected tissue samples. Freshly frozen tissue specimens from OF (n = 29) and FD (n = 28) patients were obtained for analysis. Lesion fibrous tissues and surrounding normal tissues were obtained by laser capture microdissection (LCM), with ~30-50 cells (5 000-10 000 µm
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Humans , DNA Copy Number Variations , Diagnosis, Differential , Fibroma, Ossifying/genetics , Fibrous Dysplasia of Bone/genetics , Galactosyltransferases , Jaw , Neoplasm Recurrence, Local , Nuclear ProteinsABSTRACT
Objective To study the effect of comprehensive pain intervention on newborns' acute pain stimulus on heel's blood collection.Methods One hundred neonates were equally randomized into control group and treatment group.In the former,blood collection was done from heel without any intervention and in the latter the comprehensive intervention was done five minutes before blood collection from heel and 5 minutes after that.The two groups were compared in terms of heart rate,blood oxygen saturation,acute pain stimulus,crying time during collection and time for facial expressions 30 seconds before collection and 30 seconds after that.Results The score on pains and crying time during collection and time of pain face in the intervention group were significantly lower or shorter than those in the control group and the time for crying and painful facial expressions was both significantly shorter than those in the control group (P＜0.001).There was insignificant different in blood oxygen saturation (P＞0.05) and significant in the heart rate (P＜.0.01) 30 seconds before and after collection.Conclusion The comprehensive intervention by radiation warming,nipple or 10％ glucose sucking,caressing and curled-up position can relieve effectively the pains from neonatal invasive operation.
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Objective To investigate the effect of dietary and exercise on the incidence of GDM in women with pre-pregnancy obesity. Methods One hundred and sixty early pregnant women with BMI≥25 kg/m2 in our hospital from April 2013 to January 2015 enrolled in the study were divided into two groups: The eighty women hospitalized during June 2013 to January 2014 were assigned as the control group, while the other 80 women from February 2014 to January 2015 as the study group. In the former group, the routine pregnancy inspection and pregnancy health education seminars were conduced during pregnancy of 12 weeks , and in the study group weekly nutritional assessment , diet planning by a dietitian and exercise guidance by a professional nurse were performed apart from the same care as in the control group. The two groups were compared in terms of weight growth and GDM incidence. Result The weight increased and the GDM incidence in the study was both significantly lower than those in the control group ( P < 0 . 05 ) . Conclusion The dietary and exercise during pregnancy can effectively control the weight and decrease the incidence of GDM , which can ensure the health of pregnant women.
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To improve the curative effect in chronic hepatitis B is a major problem to be solved. With the development of technology, an increasing number of novel markers have been used to guide treatment selection, to predict the curative effect and prognosis of hepatitis B.This paper focuses on the characteristics, applications and developmental trend of serological, virological and immunological markers associated with curative effect of chronic hepatitis B.
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<p><b>OBJECTIVE</b>To explore the relationship between socioeconomic status (SES) and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>The medical records of Tianjin Third Central Hospital were retrospectively reviewed to identify patients who had been hospitalized for treatment of T2DM but without diagnosis of NAFLD between 2007 and 2012 and who had required a second hospitalization during this same period. Each patient was contacted by telephone for self-reporting of SES. Analysis was carried out with patients grouped according to SES (high vs. low) to determine association of SES with incidence of NAFLD at the second hospitalization; the relative risk (RR), attributable risk (AR) and attributable risk percent (ARP) were calculated. Furthermore, the correlation of SES with other clinical and socio-psychological variables was assessed.</p><p><b>RESULTS</b>The patients in the high and low SES groups showed no significant differences at baseline. For development of NAFLD by the time of the second hospitalization, the low SES group had an RR of 2.19, an AR of 20.74%, and an ARP of 54.39%. Correlation analysis showed that SES was positively correlated with body mass index (r=-0.582) and levels of glycated hemoglobin (r=-0.421), fasting serum insulin (r=-0.570), insulin resistance (as assessed by the HOMA method) (r=-0.487), low-density lipopmtein (r=-0.396) and C-reactive protein (r=-0.353) (all P<0.05), and negatively correlated with high-density lipopmtein (r =0.539) and with the scores for physical functioning (r =0.241), general health (r=0.234), social functioning (r =0.286), emotional health (r=0.251), and mental health (r=0.215) (all P<0.05).</p><p><b>CONCLUSION</b>SES is an influencing factor of NAFLD in patients with T2DM and is closely related to obesity, insulin resistance, lipid metabolic disorder, chronic inflammation and life quality in patients with NAFLD and T2DM.</p>
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Humans , Body Mass Index , C-Reactive Protein , Diabetes Mellitus, Type 2 , Insulin Resistance , Non-alcoholic Fatty Liver Disease , Obesity , Risk Factors , Social ClassABSTRACT
Objective To investigate the effect of Kangaroo care(KC)on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups:intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC(neonates were put in direct and continuous skin-to-skin contact with his/her mom)from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN(Douleur Aigue Nouveaune)scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect(PHeel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.
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Objective To assay the plasma omentin level in patients of type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD) and investigate the relationship between plasma omentin level,glucose and lipid metabolism,insulin resistance and NAFLD.Methods The plasma omentin level was assayed by enzyme-linked immunosorbent assay(ELISA) in all subjects,including patients of T2DM controls with NAFLD (group A,50 cases),T2DM without NAFLD (group B,50 cases),simple with NAFLD(group C,51 cases) and normal controls (group D,49 cases).Meanwhile,blood glucose,glycosylated hemoglobin(HbA1c),lipids and insulin levels were also measured.Body mass index (BMI) and waist-to-hip ratio were evaluated.Insulin sensitivity was assessed by HOMA-IR.Results The plasma omentin level was (17.85 ±3.68),(13.89 ±10.68),(26.05 ±7.26) and (22.92 ±2.71)μg/L in group A,B,C and D respectively.The plasma omentin level of group A and group B was significantly lower than that of group C and group D(P ＜ 0.05).The plasma omentin level of group A was higher than that of group B (P ＜ 0.05).The plasma omentin level of group C was higher than that of group D (P＜ 0.05).Correlation analysis showed that the plasma omentin level was negatively correlated to weight,BMI,waist,triglyceride,fasting blood glucose,fasting insulin (FINS) and HOMA-IR (P ＜0.05 or ＜0.01),and positively correlated to high-density lipoprotein cholesterol (HDL-C)(P ＜0.01).Multiple stepwise regression analysis showed that BMI,HOMA-IR and FINS was independent variable of omentin.The concentration of omentin was 24.82 μ g/L which could predict the risk of NAFLD in people with normal glucose regulation.Conclusions The plasma omentin level is closely correlated with glucose,lipid metabolism and insulin resistance.Plasma omentin may play an important role in the pathogenesis of T2DM and NAFLD.
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Objective To analyze the detection rate of HBV serological makers in non-hepatic inpatients in the past six years. Methods Serum samples of 70 582 non-hepatic inpatients from three large hospitals were collected during 2003 to 2008. Serological markers of HBV ( HBsAg, anti-HBs, HBeAg, antiHBe and anti-HBc) were detected by the AxSYM MEIA system (Abbott Laboratories,Abbott Park,IL).Combining the test results of serological makers with other clinical data, several analysis models for this retrospective study were set up to evaluate the year-to-year changes in serological makers and the detection rates of each model. Results The order from high to low of detection rate of the 5 HBV serological markers was anti-HBc (55. 17% ), anti-HBs (49. 57% ), anti-HBe (28.42%), HBsAg ( 8. 92% ) and HBeAg (2. 12% ), and all of them had a downward trend in the past six years. The positive rate of HBsAg went down from 9. 30% (2003) to 8.70% (2008). The positive rate of HBsAg among people who were born after 1992 (2. 28% ) were significantly lower than that of the overall population (8. 92% ) and fell from 3.57%(2003) to 1.85% (2008). Each detection rate of all serological makers had male sexual side effect [HBsAg ( 12. 38%/7. 25% ), HBeAg ( 2. 72%/1.58% ), anti-HBc ( 56. 57%/53.43% ), anti-HBe (41.50%/28. 35% ) and anti-HBs (65.48%/50. 00% ), male/female]. The differences were statistically significant (Chi-square values of HBsAg, HBeAg, anti-HBc, anti-HBe and anti-HBs were 509.74,105.78, 69.66, 1 321.61 and 1 726.91, respectively; all P ＜ 0. 01).Twenty-six models of HBV serological makers from 70 582 inpatients were summed up, and 8 models had positive rates geater than or equal to 1%. The "All Negative" model ranked No. 1 and had no significant change from year to year. During the past six years, models representing "A11 Negative" and "anti-HBs Positive alone" were mainly in individuals younger than or equal to 20-year-old, while the models representing "anti-HBc and/or anti-HBe,anti-HBs Positive" were mostly in people older than 20-year-old. The distribution curve of models representing "HBsAg, HbeAg and anti-HBc Positive" and "HBsAg, anti-HBc, anti-HBe Positive"etc. showed a bell-shape, covering the population from 20-year-old to 70-year-old. Conclusions The slowlydescending tendency of the detection rates of HBV serological makers was observed during the past six years.The detection rates of HBV in the younger generation decreased significantly. However, the HBV infection rates of overall population is still high, so it is a high time that we made continuous improvement for the serum HBV screening technique in order to reduce the HBV infection ratess.
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Objective To evaluate the predictive effect of Braden scale for the risk of development of pressure ulcers (PU) in the department of neurology bedridden patients and to explore subgroup preventive measures. Methods 400 cases newly hospitalized bedridden patients in the department of neurology were collected with no pressure ulcers at the first evaluation and pressure ulcer risk was continuously predicted by a Braden scale skin assessment. The high-risk, middle-risk and low-risk groups were randomized into the experimental group and the control group respectively. Routine preventive measures were taken for the control group while the air fluidized bed for the high-risk group, the sponge mattress for the middle-riskgroup, and turning the body over every 4 hours for low-risk group. Other preventive procedures were undertaken simultaneously in beth the experimental and the control groups. Results The area under the ROC curve (AUC)was 0.771 and 0.828 at the first and last time Braden scale scores respectively. Such vMues as sensitiveness, specificity, positive predictive value, negative predictive value were found in higher level,when the diagnosis value was 17. There was no significant difference of incidence rate of the subgroup pressure ulcers between the high-risk, middle-risk, low-risk groups compared to the control group. Conclusions The effect of predicting pressure ulcer risk for bedridden patients in the department of neurology with Braden scale was fairly good, while the score 17 as the diagnosis value was ideal. The air fluidized bed for the high-risk group and the sponge mattress for the middle-risk group resulted in no significant decrease of incidence rate of the pressure ulcer, while taming over the patients' body every 4 hours for low-risk groups showed acceptable and therefore saving medical resources.