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Objective:To explore the value of a nomogram model based on the CT enterography (CTE) signs for prediction of intestinal penetrating lesions in patients with Crohn disease (CD).Methods:The clinical and CTE data of CD patients who underwent at least two CTE examinations from January 2010 to June 2020 in the First Affiliated Hospital of Sun Yat-sen University were retrospectively collected. A total of 112 patients were enrolled, and according to whether there was intestinal wall penetration in the last CTE observation were divided into non-penetration group (84 cases) and penetration group (28 cases). First, the clinical and CTE data for the first examination was analyzed by using univariate and multivariate Cox proportional hazards regression to screen out high-risk factors that could effectively predict intestinal wall penetrating lesions in CD patients and established a nomogram model. Then the change trend of CTE data (ΔCTE) between the first and last clinical and CTE signs was analyzed by using univariate and multivariate Cox proportional hazards regression, and built a nomogram model to sort out ΔCTE that may accompany the development of penetrating lesions in CD patients. The Harrell concordance index was used to evaluate the discriminative ability of the nomogram model.Results:In the first time clinical and CTE signs, multivariate Cox proportional hazards regression results showed that numbers of diseased bowel segments (HR=0.686, 95%CI 0.475-0.991, P=0.045) and the shortest diameter of the largest lymph node (HR=0.751, 95%CI 0.593-0.949, P=0.017) were independent protection factors for penetrating lesions, and rough bowel wall surface (HR=5.626, 95%CI 2.466-12.839, P<0.001) was an independent risk factor for penetrating lesions. The specificity and sensitivity of the nomogram model to predict non-penetration lesions were 82.1% and 59.5% respectively, and the Harrell concordance index was 0.810 (95%CI 0.732-0.888). In the ΔCTE signs, multivariate Cox proportional hazards regression showed that Δrough bowel wall surface (always rough bowel wall surface HR=12.344, 95%CI 2.042-74.625, P=0.006; slide bowel wall surface becomes rough bowel wall surface HR=28.720, 95%CI 4.580-180.112, P<0.001) and Δthe shortest diameter of the largest lymph node (HR=1.534, 95%CI 1.091-2.157, P=0.014) were independent risk factors for penetrating lesions. The specificity and sensitivity of the nomogram model were 89.3% and 79.2% respectively, and the Harrell concordance index was 0.876 (95%CI 0.818-0.934). Conclusion:The nomogram based on CTE signs of numbers of diseased bowel segments, the shortest diameter of the largest lymph node and rough bowel wall surface and ΔCTE can effectively predict the intestinal wall penetrating lesions of CD patients.
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Objective:To study the effects of arsenic exposure on necroptosis pathway and inflammatory response of mouse myocardial cells.Methods:Sixty male C57BL/6J mice were randomly divided into control group (group C) and low, medium, and high dose arsenic exposure groups (groups L, M, H) based on body weight using a random number table method. Each group had 15 mice, and they drank 0.00, 0.15, 1.50, and 15.00 mg/L arsenic trioxide (As 2O 3) solution prepared with deionized water. The exposure period was 12 weeks. Hematoxylin-eosin (HE) staining and Masson trichrome staining of paraffin-embedded heart tissues were used to observe the histopathology changes of the heart. Transmission electron microscopy (TEM) was used to evaluate the ultrastructural changes of myocardial cells. The quantitative real-time PCR (qRT-PCR) was used to detect the mRNA expression of inflammatory genes [tumor necrosis factor (TNF)-α and interleukin(IL)-6] and the genes involved in necroptosis pathway [receptor-interacting protein (RIP) 1, RIP3 and mixed-lineage kinase domain-like protein (MLKL)]. Protein expressions of RIP1 and RIP3 in the heart were assessed by western blotting. Results:Histopathological examination results showed there were myocardial necrosis, inflammatory cells infiltration and fibroblasts hyperplasia and other changes in groups M and H. TEM analysis revealed marked ultrastructural changes in groups M and H, including fractured myofibril, fractured Z lines of sarcomere, and swollen mitochondria with fractured cristae. Compared with group C (1.00 ± 0.00), the mRNA expression of RIP1 in group H was significantly up-regulated (1.41 ± 0.06, P < 0.05); the mRNA expressions of RIP3 (1.29 ± 0.14, 1.56 ± 0.08), MLKL (1.23 ± 0.05, 1.36 ± 0.07), TNF-α (2.20 ± 0.10, 2.23 ± 0.18) and IL-6 (1.87 ± 0.16, 1.63 ± 0.15) were significantly up-regulated in groups M and H ( P < 0.05). The protein expressions of RIP1 (0.43 ± 0.04, 0.50 ± 0.04) and RIP3 (0.68 ± 0.02, 0.84 ± 0.05) in groups M and H were higher than those in group C (0.25 ± 0.01, 0.45 ± 0.04, P < 0.05). Conclusion:Subchronic arsenic exposure induces histopathological changes such as myocardial necrosis and fibrosis in mice, inducing necroptosis and inflammatory reactions in myocardial cells.
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The aim of this paper is to explore the practical measures of integrating “ideological and political course” into “Psychiatry”. “Ideological and political course” is a key measure to foster character and civic virtue in colleges and universities， and a crucial link of “three -full education”. Based on the characteristics of the course “Psychiatry” and the practical experience of the course “ideological and political work” in the faculty of mental health， North Sichuan Medical College， this paper puts forward the strategies of implementing “ideological and political course” from four aspects： improving teachers’ understanding and practical ability of “ideological and political course”， constructing the integration point of ideological and political course in “Psychiatry”， choosing the teaching methods of “ideological and political course” and evaluating the teaching effect， thus providing references for the implementation of “ideological and political course” in the follow-up professional courses.
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Objective:To construct the index system of the core competence of nursing emergency personnel in the case of infectious disease outbreak, and to provide reference basis for the assessment and training of the core competence of nursing emergency personnel.Methods:Based on the core competence indicators of nurses defined by the International Nurses' Association and the action framework of WHO's outbreak of infectious diseases as the theoretical framework, the item pool was summarized through semi-structured interviews and research group meetings, the Delphi expert letter consultation method was used to construct the indicator system, and the analytic hierarchy process and the average distribution method were used to determine the weight of indicators at all levels.Results:Two rounds of Delphi expert letter consultation, 36 questionnaires were issued in each round, and the effective recovery rate was 86% (31) and 92% (33), respectively.Finally, it was determined that the core competence index system of nursing emergency personnel for infectious disease emergencies included 5 first-level indicators, 13 second-level indicators and 53 third-level indicators. The coefficient of variation ranged from 0 to 0.173, the weight ranged from 0.074 to 0.525, and the balanced combination weight ranged from 0.165 to 0.266.Conclusion:The index system of the core competence of nursing emergency personnel in infectious disease emergencies is comprehensive and scientific, which can provide theoretical basis for evaluating and training the core competence of nursing emergency personnel in infectious disease emergencies.
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Objective:To develop a mesenteric creeping fat index (MCFI) based on CT enterography (CTE) to characterize the degree of creeping fat wrapping around the inflamed gut in Crohn disease (CD), and to assess the relationship between MCFI and the inflammatory intestinal stricture.Methods:From December 2018 to July 2019, the patients with CD who underwent surgery in the First Affiliated Hospital of Sun Yat-Sen University were prospectively collected. The extent of perienteric mesenteric vessels wrapping around the gut was reconstructed to develop MCFI based on CTE images. The intestinal stricture index was obtained by calculating the ratio of the maximal upstream luminal diameter divided by the minimum luminal diameter apparent within the stricturing region. Using region-by-region correlation between CTE and surgical specimen, creeping fat score in intestinal specimen was obtained by assessing the extent of creeping fat wrapping around the resected bowel segment, and HE staining was performed on the bowel specimen corresponding to creeping fat to obtain the pathological inflammatory score. The Spearman correlation analysis was used to evaluate the correlation between MCFI, creeping fat score in intestinal specimen, and inflammatory score, intestinal stricture index. The ROC curve analysis was used to assess the accuracy of MCFI in distinguishing moderate-severe and mild inflammatory bowel walls.Results:Totally 30 CD patients were enrolled. The creeping fat score in intestinal specimen positively correlated with pathological inflammatory score ( r s=0.403, P=0.027) and with intestinal stricture index ( r s=0.642, P<0.001). MCFI positively correlated with creeping fat score in intestinal specimen ( r s=0.840, P<0.001), with pathological inflammatory score ( r s=0.497, P=0.005), and with intestinal stricture index ( r s=0.599, P<0.001). ROC analysis showed that the area under the curve of MCFI for differentiating moderate-severely from mildly inflammatory bowel walls was 0.718 (95%CI 0.522-0.913). Using MCFI≥4 as a cutoff value, the sensitivity and specificity were 81.8% and 47.4%, respectively. Conclusions:There was a correlation between creeping fat and inflammatory intestinal strictures in CD. MCFI can non-invasively depict the degree of creeping fat wrapping around the gut and assess the inflammatory intestinal stricture.
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OBJECTIVE: To establish a novel standardized magnetization transfer ratio (MTR) parameter which considers the element of the normal bowel wall and to compare the efficacy of the MTR, normalized MTR, and standardized MTR in evaluating intestinal fibrosis in Crohn's disease (CD).MATERIALS AND METHODS: Abdominal magnetization transfer imaging from 20 consecutive CD patients were analyzed before performing elective operations. MTR parameters were calculated by delineating regions of interest in specified segments on MTR maps. Specimens with pathologically confirmed bowel fibrosis were classified into one of four severity grades. The correlation between MTR parameters and fibrosis score was tested by Spearman's rank correlation. Differences in MTR, normalized MTR, and standardized MTR across diverse histologic fibrosis scores were analyzed using the independent sample t test or the Mann-Whitney U test. The area under the receiver operating characteristic curve (AUC) was computed to test the efficacies of the MTR parameters in differentiating severe intestinal fibrosis from mild-to-moderate fibrosis.RESULTS: Normalized (r = 0.700; p < 0.001) and standardized MTR (r = 0.695; p < 0.001) showed a strong correlation with bowel fibrosis scores, followed by MTR (r = 0.590; p < 0.001). Significant differences in MTR (t = −4.470; p < 0.001), normalized MTR (Z = −5.003; p < 0.001), and standardized MTR (Z = −5.133; p < 0.001) were found between mild-to-moderate and severe bowel fibrosis. Standardized MTR (AUC = 0.895; p < 0.001) had the highest accuracy in differentiating severe bowel fibrosis from mild-to-moderate bowel wall fibrosis, followed by normalized MTR (AUC = 0.885; p < 0.001) and MTR (AUC = 0.798; p < 0.001).CONCLUSION: Standardized MTR is slightly superior to MTR and normalized MTR and therefore may be an optimal parameter for evaluating the severity of intestinal fibrosis in CD.
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Humans , Crohn Disease , Fibrosis , Magnetic Resonance Imaging , ROC CurveABSTRACT
Objective:To explore the diagnostic efficacy of nomogram based on multi-parameter MRI for assessment of bowel fibrosis in patients with Crohn disease（CD).Methods:The clinical and imaging data of CD patients diagnosed by surgical histopathology in the First Affiliated Hospital of Sun Yat-sen University from June 2015 to March 2018 were prospectively collected. All the patients underwent conventional MRI and diffusion kurtosis imaging（DKI) within 2 weeks before surgery. Patients who underwent surgery between June 2015 and September 2017 were included in the model building group, and those who underwent surgery between October 2017 and March 2018 were included in the model validation group. We measured the apparent diffusion coefficient（ADC) from monoexponential model of diffusion-weighted imaging（DWI), apparent diffusional kurtosis（K app), and apparent diffusion for non-Gaussian distribution（D app) from non-Gaussian DKI model, and observed T 2WI signal intensity and enhancement pattern of the same segment. One to three intestinal specimens per patient were stained with Masson′s trichrome for the histological grading of fibrosis. Correlations between qualitative/quantitative MRI indexes and histological grades were evaluated using the Spearman rank test. Multivariate logistic regression analysis was performed to identify independent factors to be included into the nomogram for predicting the degree of bowel fibrosis and its diagnostic performance was assessed by internal and external validation. Results:A total of 40 CD patients were included, including 31 in the model construction group and 9 in the model verification group. A total of 81 intestinal specimens from 31 patients were graded as none-to-mild bowel fibrosis（ n=32) and moderate-to-severe bowel fibrosis（ n=49) according to a scoring system of fibrosis. In the training cohort, the K app value of moderate-to-severely fibrotic bowel walls was significantly higher than that of none-to-mildly fibrotic bowel walls, and the D appand ADC values of moderate-to-severely fibrotic bowel walls were significantly lower than those of none-to-mildly fibrotic bowel walls（ Z=-5.999, -4.521 and -3.893; P<0.001). There was no significant difference in T 2WI signal intensity or enhancement pattern between these two groups（χ2=1.571 and 0.103; P>0.05). Moderate and mild correlations of histological fibrosis grades with K appand D app( r=0.721 and -0.483; P<0.001), and a mild correlation with ADC（ r=-0.445, P<0.001) were found. Independent factors derived from multivariate logistic regression analysis to predict the degree of bowel fibrosis were K app and D app. Internal and external validation revealed good performance of the nomogram with concordance index of 0.901（95% confidence interval, 0.824-0.978) and 1.000, respectively, for differentiating none-to-mild from moderate-to-severe fibrosis. Conclusion:The DKI-based nomogram can be used to evaluate the bowel fibrosis in CD patients and provides a visual and simple prediction method for clinic.
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Objective:To construct a standardized training course system for new nurses in radiology department based on their post competency.Methods:The first draft of standardized training course for new nurses in radiology department was drawn up by referring to domestic and foreign literature, expert interview and group discussion. 20 experts in radiology department from 12 third grade hospitals were consulted for two rounds by Delphi method, and the index weight at all levels was determined by AHP.Results:The standardized training course system of new nurses in radiology department based on post competency includes four first level indicators (knowledge, skills, situational decision-making, humanistic quality), 10 second level indicators and 55 third level indicators. In the second round of expert consultation, the positive coefficient of experts was 85%, 100% and the authoritative coefficient was 0.75 and 0.80 respectively; In the second round expert consultation, the harmony coefficient of the first, second and third level indexes was 0.401 and 0.493 respectively, P < 0.01. Conclusion:the standardized training course system of new nurses in radiology department based on post competency is scientific and reasonable, which can provide reference for standardized training of new nurses in radiology department.
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Objective To determine the correlation between intravoxel incoherent motion (IVIM) parameters and both histologic inflammatory and fibrotic grades of Crohn disease (CD) in adults. Methods Prospectively, 17 patients (77 lesions) with a clinical and pathological diagnosis of CD in the first affiliated hospital of sun yat-sen university from July 2015 to June 2016 underwent MRE 15 days before surgery. All patients underwent T2WI, IVIM and enhanced MRI and calculated IVIM parameters include diffusion-related coefficient (D), perfusion-related coefficient (D*) and perfusion-related fraction (f). Histological intestinal inflammation and fibrosis was scored using the surgical histopathology as reference standard and further divided into mild-moderate (score 1 to 2) and severe (score 3 to 4) groups. Intestinal microvessel density (MVD) were also analyzed. Differences in IVIM parameters among different histological inflammation and fibrosis grades were assessed with the Kruskal-Wallis test. The Wilcoxon test was used for assessing differences in f between mild-moderate and severe fibrosis. The bivariate correlations between IVIM parameters and histological inflammation and fibrosis grades were analyzed using partial correlation . The bivariate correlations between IVIM parameters and MVD were analyzed using Spearman rank correlation. The areas under the receiver operating characteristics curves (AUROC) were analyzed to evaluate the efficacy for distinguishing severe from mild-moderate fibrosis. Results Of 77 surgical specimens, there were 41 mild-moderate and 36 severe inflammatory bowel segments, along with 22 mild-moderate and 55 severe fibrotic bowel segments. Positive correlation was shown between histologic inflammatory and fibrotic scores (r=0.592, P<0.01). MVD (42.7 ± 39.9)/HP presented weak positive correlation with histologic inflammatory scores (r=0.332, P=0.003) while no correlation with histologic fibrotic scores (r=0.129, P=0.262) was presented. Neither the D nor the D* values significantly correlated with histologic inflammation or fibrosis (P>0.05) while the f value significantly correlated with both histologic inflammation and fibrosis (P<0.05). Significant correlation was present between the f value and histologic inflammatory and fibrotic scores, respectively (r=-0.280, -0.520;P<0.05). There was significant difference in the f value between mild-moderate and severe fibrosis(Z=-5.255,P<0.01). The AUROC for the f value to distinguish between patients with mild-moderate fibrosis and severe fibrosis were 0.885. Using a threshold fractional perfusion of 0.33, the sensitivity and specificity values were 95.5％ and 81.8％, respectively. No correlation between f, D and D*value with histologic fibrotic scores (r=0.129, P=0.262) was presented. Conclusion The f value derived from IVIM could help to evaluate the severity of intestinal inflammation and fibrosis CD in adults.
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Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.
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Objective To assess the diagnostic value of magnetization transfer MRI (MTI) for bowel inflammation and fibrosis in humans with Crohn disease (CD). Methods From July 2014 through April 2017, 31 patients with a confirmed diagnosis of CD were prospectively recruited from the First Affiliated Hospital of Sun Yat Sen University. They were scheduled for elective surgery due to bowel obstruction and other complications, and underwent preoperative MR enterography (MRE) and MTI within 15 days of surgery. All cases had available intestinal specimens identified on MRE and resected bowel segments for region by region matching. All patients underwent breath hold conventional MRE and MTI examinations, and then the magnetization transfer ratios (MTRs) of pathological bowel segments were measured. Using region by region correlation between MTI and surgical specimen, the bowel segments were resected to stain with HE for evaluating bowel inflammation, Masson for bowel fibrosis, and typeⅠcollagen staining for the deposition of typeⅠcollagen within the bowel walls. The histologic sections from the most severe areas were scored as 0 (normal), 1 (mild), 2 (moderate) and 3 (severe). The correlations between MTR and histologic scores were analyzed by using Spearman rank correlation or partial correlation. The differences in MTR among different grades of bowel fibrosis were analyzed by one way ANOVA. The efficacy of MTR for predicting bowel fibrosis was evaluated by receiver operating characteristic curves analysis. The difference in MTRs between purely inflammatory bowel walls and mixed fibrotic and inflammatory bowel walls was analyzed by Student s t test. Results Sixty two resected bowel specimens from 31 patients including 9 purely inflammatory bowel walls and 53 mixed fibrotic and inflammatory bowel walls were obtained in this study. There were significant differences in MTR among non fibrotic [(21.45 ± 2.65)%], mildly [(30.88 ± 6.14)%], moderately [(35.14 ± 4.31)%] and severely [(35.14 ± 4.31)%] fibrotic walls (F=38.397,P<0.01). MTRs strongly correlated with fibrosis scores (r=0.681, P<0.01). High accuracy of MTRs was shown (curve under area=0.905, P<0.01) for differentiating moderately severely fibrotic from non fibrotic and mildly fibrotic bowel walls. Using MTR of 31.50% as a cutoff value, the sensitivity and specificity were 93.6% and 80.0%, respectively. The MTRs of purely inflammatory bowel walls [(21.45 ± 2.65)%] were significantly higher than that of mixed fibrotic and inflammatory [(36.28±5.21)%] bowel walls (t=-13.052,P<0.01). MTRs correlated with the scores of type Ⅰ collagen (r=0.325, P=0.044) but did not correlate with inflammation scores (r=-0.024, P=0.857). Conclusions MTI enables quantitative evaluation of bowel fibrosis in patients with CD and can be used to differentiate purely inflammatory CD from mixed fibrotic and inflammatory CD.
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Objective@#To analyze the resting energy expenditure and optimal energy supply in different age groups of critically ill children on mechanical ventilation in pediatric intensive care unit (PICU).@*Methods@#Patients on mechanical ventilation hospitalized in PICU of Beijing Children's Hospital from March 2015 to March 2016 were enrolled prospectively. Resting energy expenditure of patients was calculated by US Med Graphic company critical care management (CCM) energy metabolism test system after mechanical ventilation. Patients were divided into three groups:<3 years, 3-10 years, and >10 years. The relationship between the measured and predictive resting energy expenditure was analyzed with correlation analysis; while the metabolism status and the optimal energy supply in different age groups were analyzed with chi square test and variance analysis.@*Results@#A total of 102 patients were enrolled, the measured resting energy expenditure all correlated with predictive resting energy expenditure in different age groups (<3 years (r=0.3, P=0.0) ; 3~10 years (r=0.6, P=0.0) ;>10 years (r=0.5, P=0.0) ) . A total of 40 cases in < 3 years group, including: 14 cases of low metabolism (35%), 14 cases of normal metabolism (35%), and 12 cases of high metabolism (30%); 45 cases in 3-10 years group, including: 22 cases of low metabolism (49%), 19 cases of normal metabolism (42%), 4 cases of high metabolism (9%); 17 cases in>10 years group, including: 12 cases of low metabolism (71%), 4 cases of normal metabolism (23%), 1 case of high metabolism (6%). Metabolism status showed significant differences between different age groups (χ2=11.30, P<0.01, r=-0.01). Infants had higher metabolic status, which lessened with aging. The total average actual energy requirement was (210±84) kJ/ (kg⋅d) . There were significant differences in actual energy requirement between age groups (F=46.57, P<0.001), with (277±77) kJ/ (kg⋅d) in<3 years group, (184±53) kJ/ (kg⋅d) in 3-10 years group, and (120±30) kJ/ (kg⋅d) in>10 years group.@*Conclusion@#The resting energy metabolism of the critically ill children on mechanical ventilation is negatively related to the age. The actual energy requirement should be calculated according to different ages.
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Objective To explore the impact of family single room practices in NICU on maternal anxiety and breastfeeding status and neuropsychological development in preterm infants. Methods One-hundred NICU-born preterm infants were divided into the experimental group (n= 48) and the control group (n=52) according to random number table. Neonates in the experimental group were guaranteed parental care in the family ward for at least 4 hours a day during hospitalization in NICU, while the control group used a traditional video-based approach for daily scheduled visits. Finally, the results of exclusive breastfeeding, nosocomial infection, maternal anxiety, parental satisfaction, and full-term NBNA score after correction of gestational age were collected and recorded. Results The rates of exclusive breastfeeding were 82.50%(33/40),42.50%(17/40)during hospitalization and six months old in the experimental group, and 17.07%(7/41),12.20%(5/41)in the control group. The difference between the two groups was statistically significant during hospitalization and at 6 months of age (χ2=32.25, 9.40,P <0.01). The score of maternal anxiety was 33.00(31.00, 41.75)in the experimental group, and 43.00(34.50, 46.00)in the control group. The difference between the two groups was statistically significant (Z=-2.97, P =0.003).The NBNA score in the experimental group was 38.50(38.00, 40.00), and 37.00(36.00, 39.00)in the control group. The difference between the two groups was statistically significant(Z=-2.86, P<0.01). Conclusions The development of family ward is conducive to raising the rate of exclusive breastfeeding, reducing the incidence of nosocomial infection, relieving the anxiety of mother-infant separation and enhancing the satisfaction of parents, which can promote the behavioral and neuropsychological development of preterm infants.
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Objective To understand the related risk behaviors,knowledge and status of HIV/ AIDS infection among rural adults of Derung minority,to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group.Methods We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township,Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province,with a sample size estimated as 383.Adult residents with Derung minority in six villages of Gongshan County were involved,with relevant information collected through door-to-door visit.HIV antibody was tested and SPSS 17.0 was used for statistical analysis.Results Information on 394 valid respondents was collected,with age as between 18 and 65 (34.39 ± 9.74),80.7％ (318/394) as married,54.0％ (213/394) having had primary school education,13.2％ (52/394) as migrant workers.In this population,the overall HIV infection rote appeared as 0.5％ (2/400),mainly through sexually transmission.The rate of awareness on HIV/AIDS was 69.8％ (275/394),mainly through free publicized materials 50.0％ (197/394).Rates on premarital sexual behavior on multiple sexual partners in the past year,on temporary sexual partners in the past year,having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex,were 6.4％ (60/366),18.0％(66/366),5.7％(21/366),1.9％(7/366) and 8.0％(25/311),respectively.Conclusions Few numbers of HIV infections were identified among the migrating workers with Derung minority,with sexual transmission as the major route,along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use,accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority.Relative strategies on HIV/AIDS intervention and control should be developed.
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Objective To understand the characteristics of newly detected HIV infection cases and related high risk behaviors in the areas with high HIIV infection prevalence in Yunnan province.Methods A questionnaire survey was conducted with census method during January to March 2016 among newly detected HIV infected persons in Dehong,Honghe,Lincang and Dali prefectures in Yunnan during 2012-2015.Results Among 451 HIV seropositive cases,the major transmission route of HIV was heterosexual contact,accounting for 92.5％ (417/451).The total awareness rate of AIDS related knowledge was 73.0％ (329/451).The rates of condom use at sex with regular sexual partners,occasional sexual partners,commercial sexual partners and men who have sex with men within 1 year before knowing their infection status were 48.7％ (167/343),4.2％ (7/165),9.9％ (15/151) and 0.0％ (0/3),respectively.The risk factors for using no condom at sex with regular sexual parmers included living at Dali,being farmer,unmarried,cohabitation,divorced and widowed,monthly income under 1 000 yuan (RMB),living in urban area before infection,knowing no AIDS related knowledge etc.The risk factors for using no condom at sex with occasional sexual partners included living in Dehong,Honghe and Lincang,aged ≤30 years and being farmer.The injecting drug users accounted for 8.2％ (37/450) and 75.5％ of these cases had received AIDS related intervention (340/450).Conclusion High prevalence of heterosexual transmission of HIV,poor AIDS related knowledge on awareness,high risk behavior and poor condom use and poor intervention service utilization were found among newly detected HIV infected persons in areas with high HIV infection prevalence in Yunnan.
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Objective To design a questionnaire to explore nursing care behavior demand from patients'vision, and verify its reliability and validity. Methods The nursing care behavior index entry pool were summed up through literature analysis and discussion, and then a questionnaire containing 40 items was designed through per-investigation. A total of 150 patients from 30 departments in general hospital of Shenyang military region were selected for questionnaire survey using the convenience sampling method. The SPSS 19.0 was used to test the reliability and validity. Results Totally 149 effective questionnaires were recycled. Finally the questionnaires contained 6 dimensions and 35 items. Six factors were extracted with exploratory factor analysis, which explained 57.976% variance respectively. Total questionnaire Cronbach alpha coefficient was 0.892, the dimension Cronbach alpha coefficient was 0.747-0.914; Total remeasuring reliability was 0.824, the remeasuring reliability was 0.733-0.867. Binary validity was 0.806, binary coefficient was 0.748-0.872. Conclusions This study scientifically and reliably built a nursing care behavior demand questionnaire from patients′vision, which can be used to survey patients′satisfaction on nursing humanities.
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Objective To explore the diagnostic value of magnetization transfer imaging (MTI) and DWI for detecting intestinal wall property of crohn's disease (CD). Methods Forty four patients with CD were prospectively enrolled in the study, and MR enterography (MRE), MTI and DWI were performed. According to MRE findings, patients were divided into three subgroups:acute inflammatory group, chronic fibrotic group and combined inflammatory with fibrotic group. Intestinal wall T2WI signal, magnetization transmisson rate (MTR) and ADC value were measured on MRE, MRI and DWI imagings, respectively. The differences of MTR and ADC among the three groups were analyzed by one-way ANOVA;the differences of T2WI scores were analysed by Kruskal Wallis;the differences of MTR and ADC values between normal and pathological intestinal wall were analyzed by paired t test;ROC curve were used to evaluate the CD fibrosis and inflammation diagnostic efficiency of MTI ana DWI based on MRE signs. Results Among the 44 cases, 11 cases were in the acute inflammatory group, 18 cases were in the chronic fibrotic group and other 15 cases were in the combination group. The T2WI score, MTR and ADC among the three groups showed significant differences (all P<0.01).The mean MTR and ADC of pathological intestinal wall of the 44 cases were (40.77±6.05)%and (1.04±0.18)× 10-3mm2/s, and the adjacent normal bowel were (21.75±4.17)%and (1.97 ± 0.23) × 10- 3mm2/s, respectively. Moreover, the difference of the above values showed significant differences (t=19.12,-21.80 respectively, all P<0.01). There was a negative correlation between MTR and T2WI score (r=-0.71,P<0.01). While ADC value was positively correlated with T2WI score (r=0.80, P<0.01). Using ROC curve analysis to differentiate the CD fibrosis from acute inflammation, the area under the curve (AUC) of MTR and ADC were 0.97 and 0.96 ,respectively. Conclusions Both MTI and DWI can be used to assess the properties of intestinal wall, which has the same diagnostic efficacy to identify the acute inflammation and fibrosis.
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Objective To construct a neonatal intensive care unit (NICU) nurses′humanistic care ability evaluation index system based on knowledge, attitude, belief, practice model, thus to provide quantitative basis for the NICU nurses′ ability of humanistic care evaluation. Methods Through semi-structured interviews summed up the nursing care behavior item pool based on the knowledge, attitude, belief, practice model, used Delphi method to construct the NICU nurses′ humanistic care ability index system. Results The recovery rate of the two rounds were 87.5% (28/32) and 100.0% (32/32) respectively. The humanistic care ability included knowledge, belief, caring behavior and caring sense,11 secondary indicators and 30 level 3 indicators. The variation coefficient was 0.094-0.286. Conclusions This study scientificly and reliablly establish NICU nurses′humanistic ability index system, which can be used to evaluate and to study the status of NICU nurses′ humanistic care ability, and to strengthen the humanity quality education, to reduce the dispute of nurses and patients has important significance.
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Objective To construct a neonatal intensive care unit (NICU) nurses′humanistic care ability evaluation index system based on knowledge, attitude, belief, practice model, thus to provide quantitative basis for the NICU nurses′ ability of humanistic care evaluation. Methods Through semi-structured interviews summed up the nursing care behavior item pool based on the knowledge, attitude, belief, practice model, used Delphi method to construct the NICU nurses′ humanistic care ability index system. Results The recovery rate of the two rounds were 87.5% (28/32) and 100.0% (32/32) respectively. The humanistic care ability included knowledge, belief, caring behavior and caring sense,11 secondary indicators and 30 level 3 indicators. The variation coefficient was 0.094-0.286. Conclusions This study scientificly and reliablly establish NICU nurses′humanistic ability index system, which can be used to evaluate and to study the status of NICU nurses′ humanistic care ability, and to strengthen the humanity quality education, to reduce the dispute of nurses and patients has important significance.
ABSTRACT
[Objective] To analyze the image findings of MR enterography (MRE) and diffusion weighted imaging (DWI) in Crohn disease (CD) and to discuss the diagnostic value of MRI for evaluating the activity of CD.[Methods] 26 patients proved by clinical,imaging and pathological data were enrolled in this study.The intra-/extra-intestinal image features of CD were retrospectively analyzed,and the intestinal lesions were evaluated by MRE+DWI scoring system.The differences in image features of active and inactive CD were compared.[Results] 26 bowel segments were evaluated and included active (n =20) and inactive CD (n =6).The intestinal performance of CD included wall thickening,T2WI hyperintensity and hyperenhancement.The pathological changes of active CD were more serious when comparing with that of inactive CD.DWI showed hyperintensity in the affected bowel wall.ADC of active C D [(0.9 ± 0.2) × 10-3 mm2/s] was significantly lower than that of inactive CD [(1.5 ± 0.4)× 10-3 mm2/s] (P ＜ 0.001).Extra-enteric performance of active CD included comb sign,lymphadenectasis of mesentery,mesenteric exudation,fistula and abdominal abscess.[Conclusion] MRE combined with DWI can accurately assess CD activity and diagnose extra-enteric complications.