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Objective:To improve the understanding of cervical papillary squamous cell carcinoma (PSCC), and to provide evidence for the diagnosis and treatment of PSCC.Methods:The clinicopathological and follow-up data of 18 patients diagnosed PSCC by preoperative cervical biopsy in Tangshan Gongren hospital were collected, the correlation of preoperative biopsy, liquid-based cells, and human papilloma virus (HPV) with postoperative pathology and prognosis was analyzed.Results:The concordance rate between preoperative biopsy and postoperative pathology was 50% (9/18). 4 patients showed the characteristic features of PSCC in their liquid-based cells of the 9 patients who were diagnosed as PSCC postoperatively (4/9), the HPV infection rate was 44.4% (4/9), the International Federation of Gynecology and Obstetrics stage were IA1-IB1, no lymph node metastasis, recurrence or death occurred in all patients.Conclusions:Cervical biopsy before operation has certain limitations in the diagnosis of PSCC, which requires a clear diagnosis by postoperative pathology. The HPV infection rate is lower, the stage is earlier and the prognosis is better in PSCC. Some patients can choose a less invasive surgical method than radical surgery.
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Objective:To explore the relation among self-esteem, psychological flexibility and mental health in medical students, and to provide scientific reference for mental health education for medical students.Methods:A total of 788 medical students selected from a medical university in Chongqing City were investigated with the symptom checklist 90 (SCL-90), self-esteem scale (SES), acceptance and action questionnaire-Ⅱ (AAQ-Ⅱ), and cognitive fusion questionnaire-fusion (CFQ-F). SPSS 22.0 software was used for statistical analysis. T test, ANOVA, correlation analysis and tests for mediation effects were conducted. Results:There were significant differences in self-esteem and mental health level among medical students in gender and different grades ( t=-2.55, P<0.05; F=6.53, P<0.05). Mental health, self-esteem and psychological flexibility of medical students were correlated in pairs ( r=-0.528-0.694, P<0.01). Psychological flexibility played a partial mediation role between self-esteem and mental health of medical students, and the mediating effect accounted for 60.03% of the total effect. Conclusion:Self-esteem can directly predict the mental health of medical students, and can also indirectly affect mental health through psychological flexibility. Medical universities should carry out psychological education and promotion work with pertinence.
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【Objective】 To identify the main unqualified items in the external audit of blood station quality management system (referred to as external audit), in order to take necessary measures to continuously improve the quality system. 【Methods】 Unqualified items(data) in the national and Shandong provincial blood safety technical audits (referred to as national and provincial audits) and four blood station blood safety technical joint audits (referred to as inter station mutual audits) from 2017 to 2019 were collected and analyzed by Excel and Pareto curves (graphs). Corresponding corrective and preventive measures were developed and implemented, and then tracked and evaluated by the quality management department three months after the external audit to verify their effectiveness. 【Results】 In a total of 7 external audits of blood station quality management system that our blood station has participated in over the past 3 years (including 2 national audits, 2 provincial audits, and 3 inter station mutual audits), the main unqualified terms were "12 monitoring and continuous improvement" 11.90% (15/126), "13 blood donation services" 11.90% (15/126), "06 equipment" 10.32% (13/126), "11 records" 10.32% (13/126), "03 organization and personnel" 8.73% (11/126), "15 blood preparation" 7.94% (10/126), "08 safety and health" 7.14% (9/126), and "14 blood testing" 7.14% (9/126). Among them, "monitoring and continuous improvement" ranked first in two national audits and two provincial audits, with 16.67% (5/30) and 14.71% (5/34), respectively, and was 8.06% (5/62) in inter station mutual audit, and the difference between the three kinds of audits was not statistically significant (P>0.05). "Records" accounted the highest proportion in inter station mutual review of 19.35% (12/62), while was respectively 0 and 2.94% (1/34) in national and provincial audits, with statistically significant difference between the three kinds of audits (P<0.05). 【Conclusion】 External audit against unqualified items is important for quality improvement. By analyzing the unqualified terms, taking corresponding measures to improve weak links, and evaluating the effectiveness of those measures, it can effectively ensure the effective operation of blood station quality management system.
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Primary biliary cirrhosis/cholangitis is an autoimmune disease. Renal tubular acidosis is a common form in PBC cases, but Fanconi syndrome is rarely reported. The paper reported a 66-year-old female patient with fatigue, renal insufficiency and elevated bile duct enzymes. The patient presented with type 2 proximal renal tubular acidosis and complete Fanconi syndrome. Laboratory examinations showed high-titer-positive anti-mitochondrial antibodies, elevated serum IgM, and type 3 cryoglobulinemia. Renal biopsy revealed interstitial nephritis, and electron micrographs showed abnormal mitochondria in proximal tubular epithelial cells. The patient's renal function ameliorated, and acid-base imbalance and electrolyte disturbances were corrected after high-dose glucocorticoid treatment.
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Objective:To analyze the clinical and genetic features of the children with 5p15.1-5p15.33 duplication at the end of the short arm of chromosome 5 (5p).Methods:Clinical data of a 5p15.1-5p15.33 duplicative patient diagnosed in the Department of Pediatric Intensive Care Unit of West China Second University Hospital of Sichuan University in July 2021 were collected, and the characteristics of the patients of 5p duplication syndrome reported in the literatures were summarized and analyzed.Results:The boy was 1 year and 5 months old at the time of admission. The main clinical manifestations included growth restriction and developmental delay after birth, accompanied by craniofacial deformities. At 7 months old, he was diagnosed as epilepsy due to convulsive limbs. At present, he is 2 years old, still has recurrent convulsions, can not raise his head, sit alone, crawl and talk, with hypotonia. Repeated cranial magnetic resonance imaging showed agenesis of the corpus callosum. The child′s parents had normal phenotypes. His copy number variation sequencing results showed partial overlap of chromosome 5p15.1-5p15.33 (chr5:1934522-18905656), which was determined as pathogenic copy number variation according to copy number variations evaluation criteria, and no abnormality was detected in his parents. According to the retrieval strategy set in this study, 10 literatures (all in English, reporting 17 cases) were retrieved, and a total of 22 5p duplication syndrome patients (including this case and 4 cases included in databases) were included. Seventeen of the 22 patients were younger than 14 years old with a onset age of 7 (0, 18) years, and the male to female ratio was about 1.1∶1. Among the 22 patients, craniofacial malformation was found in 19 patients, developmental disorder in 18, bone/muscle dysplasia in 15, autism in 11, attention deficit hyperactivity disorder in 9, mental retardation in 8, obesity in 5, epilepsy in 5, congenital heart dysplasia in 2, hypotonia in 4, strabismus/hyperopia in 2, and corpus callosum dysplasia, endocrine dysfunction, inguinal hernia as well as umbilical hernia in 1, respectively. There were 19 cases of multiple malformation and 3 cases of single malformation.Conclusions:5p15.1-5p15.33 duplication may be the genetic cause of this child. Facial malformation, developmental delay, skeletal/muscular dysplasia, intellectual disability, autism spectrum disorder and attention deficit hyperactivity disorder are the main clinical phenotypes of 5p copy number duplication. Corpus callosum dysplasia may be an extended phenotype of chromosome duplication at this location.
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Objective:To explore the mediating effect of hardness on growth mindest and transition shock among nursing undergraduate interns, and to provide theoretical basis for promoting clinical adaptability of nurses.Methods:Totally 223 nursing undergraduates who practiced in five grade A hospitals in Shanghai city, Henan province and Jiangsu province were selected as the participants by convenient sampling from September to October 2022. General information questionnaire, Growth Mindset Scale (GMS), Hardness scale, and the Transition Shock of Newly Graduated Nurses (TSNGNS) were used in the questionnaire cross section survey.Results:Totally 210 valid questionnaires were retrieved. The scores of growth mindset, hardness and transition shock were (32.67 ± 4.52), (63.80 ± 13.51) and (86.97 ± 18.70), respectively. Growth mindset was positively correlated with hardness ( r=0.369, P<0.01), growth mindset was negatively correlated with transition shock ( r=-0.334, P<0.01), and resilience was negatively correlated with transition shock ( r=-0.346, P<0.01). Hardness had a partial mediating effect on the association between growth mindset and transition shock in nursing undergraduate interns, with 27.35% mediating effect. Conclusions:Growth mindset can affect the transition shock in nursing undergraduate interns through hardness. Nursing educators should pay attention to the development of growth mindset and the cultivation of hardness of nursing interns, and take targeted measures to reduce the transition shock and promote clinical adaptability.
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Cerebrovascular diseases and cardiovascular diseases are among the top causes of death worldwide. In recent years, the concept of "brain-heart co-treatment" has gradually gained popularity. Cerebrovascular and cardiovascular diseases have similar pathological foundations, pathogenesis, comorbidities, and treatment methods. However, there is currently limited research on whether the two have a chronological order of the first onset and which is the index event of the other. However, elucidating the above issues is of great significance for the secondary prevention of cardiocerebrovascular diseases. This article reviews the correlation of onset time and influencing factors for ischemic stroke and myocardial infarction.
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Objective To evaluate the construction effect of a national comprehensive prevention and control demonstration area for chronic diseases in a banner county in Inner Mongolia, and to provide a scientific basis for deepening the construction of the demonstration area and improving the formulation of chronic disease prevention and control strategies and measures. Methods Using the chronic disease nutrition monitoring data of residents aged 18 and over in a banner county in Inner Mongolia in 2015 and 2018, the prevalence, awareness, and management and treatment rates of the main chronic diseases of residents with different characteristics, as well as the changes in healthy behaviors and lifestyles were compared and analyzed. SPSS25.0 software was used for data analysis. The classification variables were mainly described by rate and composition ratio. The comparison of rates of various indicators between the two years was performed using 2 test. Multivariate logistic regression analysis was used to analyze statistical correlation between the continuous construction of the demonstration area from 2015 to 2018 and the various indicators. The test level was α=0.05. Results In 2015 and 2018, 621 and 600 residents aged 18 and above were investigated respectively. The prevalence of diabetes (8.17%) and the prevalence of dyslipidemia (28.13%) of residents in the demonstration area in 2018 were lower than those in the demonstration area in 2015 (12.08% and54.91%, respectively), and the differences were statistically significant (P<0.05). In 2018, the diabetes awareness rate (71.43%), diabetes treatment rate (71.43%), diabetes management rate (38.78%), and dyslipidemia awareness rate (51.50%) of residents in the demonstration area were higher than those in the demonstration area in 2015 (42.67%, 42.67%, 13.33%, and 31.09%, respectively), and the differences were statistically significant (P<0.05). In 2018, the current smoking rate (20.83%) of residents in the demonstration area, the drinking rate within one year (31.67%), insufficient intake of fresh vegetables (51.00%), and excessive intake of edible salt (47.83%) were all lower than those of residents in the demonstration area in 2015 (30.43%, 45.57%, 71.18%, and 78.42%, respectively), and the differences were statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that the continuous construction of the demonstration area was statistically correlated with dyslipidemia (OR=0.31, 95%CI: 0.24-0.39), diabetes awareness (OR=3.92, 95%CI: 1.68-9.12), diabetes treatment (OR=4.53, 95%CI:1.75-11.70), diabetes management (OR=5.82, 95%CI: 1.94-17.52), awareness of dyslipidemia (OR=1.57, 95%CI: 1.04-2.38), current smoking (OR=0.60, 95%CI:0.44-0.82), drinking within one year (OR=0.46, 95%CI: 0.35-0.61), and insufficient intake of fresh vegetables (OR=0.45, 95%CI: 0.35-0.58). Conclusion The construction of a national demonstration zone for comprehensive prevention and control of chronic diseases can significantly reduce the prevalence of major chronic diseases among residents in a banner county in Inner Mongolia, improve the self-management level of patients with chronic diseases, and promote the development of healthy behaviors and lifestyles.
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A young female patient presented with fever, arthralgia, and rash was diagnosed with adults still's disease. When treated with glucocorticoid steroid, the above patient progressed to anuria, sudden, and confusion. After a teamwork involving different departments, the patient was finally diagnosed with atypical hemolytic uremic syndrome (aHUS) and treated with good outcome. aHUS is a rare disease, while Eculizumab is an orphan drug. The diagnosis and treatment of the patient reveals the importance of multidisciplinary team on the diagnosis and treatment of rare and difficult diseases.
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OBJECTIVE To study the triterpenoid saponins from Anemone rivularis var. flore-minore and their antitumor activities. METHODS The n-butanol extract of 70％ ethanol extract from rhizome of the plant was separated. The triterpenoid saponins were separated and purified by normal silica gel column chromatography ，reversed phase ODS column chromatography ， Sephadex LH- 20 gel column chromatography and semi-preparation high performance liquid chromatography. The structures of these saponins were identified by spectral analysis （NMR and MS ）and physical and chemical properties. MTT assay was used to test the proliferation inhibitory activity of the compounds against five kinds of human tumor cells （HL-60 cells，A549 cells，HepG2 cells，HeLa cells and U 87MG cells ）. The apoptosis inducing effect of compound 7 on U 87MG cells was evaluated by flow cytometric Annexin V-FITC/PI staining test. RESULTS：Sixteen triterpenoid saponins were obtained and identified as 3 β-O-β-D-xylopyranosyl-（1→2）-α-L-arabinopyranosyl-oleanolic acid-28-O-α-L-rhamnopyranosyl- （1→4） -β-D-glucopyranosyl-（1→6）-β-D-glucopyranoside（1），3β-O-L-arabinopyranosyl oleanolic acid- 28-O-β-D-glucopyranoside（2），saponin B （3）， 163.com oleanolic acid- 3β-O-β-D-glucopyranosyl-（1→2）-α-L-arabino- pyranoside（4），HN-saponin F （5），clematoside S （6），prosapogenin CP 4（7），cussonside B （8），pulsatilla saponin C （9）， clemastanoside D （10），3 β-O-β-D-glucopyranosyl-（1→2）-β-L-arabinopyranosyl-hederagenin-28-O-β-D-glucopyranoside（11）， ciwujianoside C 3（12），ciwujianoside A 1（13），huzhangoside D （14），kalopanaxsaponin B （15）and hederacolchiside E （16）. Compounds 3，4，6-9 displayed inhibitory activities on the proliferation of tumor cells to different extent ，and compound 7 had the strongest activity ；compound 7 induced the apoptosis of U 87MG cell so as to inhibit the proliferation of cancer cells in a time-dependent manner. CONCLUSIONS The obtained 16 saponins are all identified as oleanolane-type ，among which compound 1 is a new compound. The monodesmosidic saponins ，the sugar chain of which attached at C- 3 and a free carboxyl at C- 28， possess stronger antitumor activity than others.
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Objective@#To explore the prevalence of health risk behaviors and the association between locus of control and health risk behaviors among college students, and to provide reference for the formulation of health risk behavior intervention for college students.@*Methods@#A multi stage cluster random sampling method was used to select 2 provinces from the east, central and west regions of China, respectively. Two universities were then randomly selected from each selected province. A total of 3 951 college students from 12 universities completed the electronic and anonymous questionnaires, which included demographic characteristics, Multidimensional Health Locus of Control Questionnaire (MHLC) and Health Risk Behaviors Questionnaire. Chi square test and binary Logistic regression were applied to analyze data.@*Results@#Totally 2 287(57.88%) students reported having three or more kinds of health risk behaviors. The prevalence of excessive screen time, insufficient physical exercise, poor eating behaviors, drinking and smoking were 97.34%(3 846), 74.72%(2 952), 72.21%(2 853), 13.62%(538) and 5.57%(220). Internal locus of control was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98) and inadequate physical activity ( OR =0.93) and associated with higher risk of smoking ( OR =1.07). The powerful others was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98), drinking ( OR =0.95) and unhealthy eating behavior ( OR =0.97). And the chance was associated with higher risk of three or more kinds of health risk behavior ( OR = 1.04 ), drinking ( OR =1.04) and inadequate physical activity ( OR =1.03)( P <0.01).@*Conclusion@#College students have serious health risk behavior problems, the locus of control is associated with health risk behaviors among college students. Which might be helpful to prevent the occurrence of health risk behaviors, and improve overall health of college students.
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Objective:To determine the epidemiology of hyperkalemia and influencing factors in a general population in Pinggu district of Beijing city.Methods:This study was a cross-sectional survey. The subjects were from the epidemiological survey population of chronic diseases in Pinggu district of Beijing city from March to May 2014. All participants completed a questionnaire, anthropological measurement, and venous blood samples collection to detect serum creatinine and potassium and so on. First void morning urine was collected to detect the albumin-creatinine ratio. Hyperkalemia and hypokalemia were defined as serum potassium level>5.0 mmol/L and≤3.5 mmol/L, respectively. Logistic regression analysis method was used to analyze the influencing factors of hyperkalemia.Results:Of the 10 252 people in this study, the prevalence of hyperkalemia was 6.17%(95% CI 5.70%-6.67%), the prevalence of hypokalemia was 0.61%(95% CI 0.47%-0.79%), and the prevalence of participants with serum potassium>5.5 mmol/L was 0.53%(95% CI 0.40%-0.69%). Multivariate logistic regression analysis results showed that males ( OR=1.269, 95% CI 1.074-1.498, P=0.005), diabetes ( OR=1.226, 95% CI 1.008-1.490, P=0.041), increased total cholesterol ( OR=1.219, 95% CI 1.119-1.329, P<0.001), and decreased estimated glomerular filtration rate ( OR=0.971, 95% CI 0.965-0.977, P<0.001) were significantly correlated with the increased risk of hyperkalemia. Usage of renin-angiotensin-aldosterone system inhibitors and diuretics were not found to be significantly associated with the risk of hyperkalemia ( OR=1.018, 95% CI 0.751-1.380, P=0.908; OR=0.638, 95% CI 0.229-1.781, P=0.391). Conclusions:The prevalence of HK in the general population is 6.17%. The male, decreased estimated glomerular filtration rate, diabetes, and increased total cholesterol are influencing factors of hyperkalemia.
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Objective:To analyze the clinical and pathological characteristics, treatment and prognosis of renal changes in patients with Kimura disease and improve the clinicians′ understanding on renal manifestations of Kimura disease.Methods:The clinical data of Kimura disease patients with definite diagnosis and detailed data in Peking Union Medical College Hospital from January 1980 to August 2020 were retrospectively analyzed. The patients were divided into renal impairment group and non-renal impairment group according to whether the kidney was involved or not and the related clinical data between the two groups were compared. The patients presenting with nephrotic syndrome were followed up.Results:There were 60 patients with Kimura disease confirmed by pathological diagnosis with 48 males. The median age was 33(3, 62) years old, and the median duration was 36(12, 111) months. There were 18 cases complicated with renal injury in 49 patients with complete routine urine and renal function examination and the main manifestations of renal injury were proteinuria and/or microscopic hematuria. There was no significant difference at age, sex and absolute value of eosinophils between the two groups (all P>0.05). Compared with the renal inpairment group, patients in non-renal inpairment group had longer course of disease, higher levels of hypersensitive C-reactive protein and erythrocyte sedimentation rate, and lower median values of total eosinophils and total IgE, but there was no statistically significant difference (all P>0.05). Among the patients with renal involvement, 6 patients met the diagnostic criteria for nephrotic syndrome, and 5 of them completed renal biopsies. The renal pathological diagnosis was membranous nephropathy in 2 cases and minimal change disease in 3 cases, and no interstitial eosinophil infiltration was found in renal biopsy tissues. These patients had a good response to glucocorticoids and/or immunosuppressive therapy, and achieved complete remission of nephrotic syndrome; at the same time, lymphadenopathy caused by Kimura disease could be well controlled. Conclusions:Kimura disease can combine with various renal lesions, and the pathology of nephrotic syndrome can be membranous nephropathy or minimal change nephropathy. After energetic treatment of glucocorticoids and/or immunosuppressive therapy, nephrotic syndrome can be completely relieved, and lymphadenopathy can be well controlled. The relationship between Kimura disease and renal disease needs further study.
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A 43-year-old male patient with onset of edema caused by nephrotic proteinuria and low titer of anti-M type phospholipase-A 2-receptor (PLA 2R) antibody was diagnosed as idiopathic membranous nephropathy by renal biopsy. Administrated with prednisone 40 mg once a day and cyclosporine 100 mg twice a day as front-line regimen, the patient relapsed after transient partial remission. When treatment was combined with cyclophosphamide 100 mg once a day, the 24-hour total urine protein and titer of anti-PLA 2R antibody were even elevated. Therefore, the patient received rituximab 1 g intravenously in April 2019, October 2019 and October 2020 respectively. CD19 positive B lymphocytes in peripheral blood were eliminated from 71/μl to zero. Immunosuppressants and corticosteroids were withdrawn successively. On the last follow-up in November 2020, the anti-PLA 2R antibody was negative, and the 24-hour total urine protein and serum albumin was 4.4 g and 34 g/L, respectively. This case suggested the potential efficacy of rituximab for refractory membranous nephropathy. Further studies should explore whether the titer of anti-PLA 2R antibody indicates the dose of rituximab.
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Objective:To explore the influence of elastic band aerobics training on cardiovascular risk factors in adults.Methods:Twenty-four health management centers participated in the competition. Each individual participant learned elastic band aerobics through video and tested their own indexes before and after intervention. Height, body weight (BW), muscle content (MC), fat content (FC), waist circumference (WC), hip circumference (HC), body fat rate (BFR), resting systolic and diastolic blood pressure (SBP and DBP) were measured. A paired samples t-test was used to analyze pre-and post-test results.Results:After 8 weeks of elastic band aerobics training, there were significant differences in body weight, body mass index (BMI), waist circumference, body fat content, systolic and diastolic blood pressure for male contestants before and after training ( P<0.01). These decreased by 1.39%, 1.45%, 0.98%, 3.61%, 2.28%, 2.34%, and 3.05% respectively. Weight, waist circumference, hip circumference, waist hip ratio, body fat content and rate of female contestants decreased by 1.25%, 1.59%, 0.65%, 0.99%, 4.22%, and 2.38% respectively ( P<0.01). There were significant differences in absenteeism between the top 10 and bottom 14 teams ( P<0.05). Average absenteeism rates were 2.8% and 10.7% respectively. Overall attendance rate of participants was 92.6%, higher than the clinical standard of an 80% level of compliance. Conclusions:Eight-week elastic band aerobics training can significantly improve body composition of adults, reducing body fat rate and waist circumference. Using competition as an opportunity to exercise promotes implementation and persistence of sports training programs.
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Objective:To understand the current situation of clinical application and management of food for special medical purpose (FSMP) in China's medical institutions.Methods:A questionnaire was developed based on literature review, consultation with experts and multiple discussions to investigate the application and management of FSMP in hospitals. The survey was conducted in secondary and tertiary general or specialized hospitals in China. The accountable person of Clinical Nutrition Department in each hospital filled in the questionnaire with the guidance from provincial quality control center.Results:A total of 592 hospitals across 30 provinces/municipalities participated in the survey. The majority (40.5%) of prescription for FSMP with approved batch number was given by clinical nutrition departments, nutritional risk screening was conducted before using FSMP as enteral nutrition in 64.0% of the hospitals, consent from patients or their families prior to initial FSMP use was required in 94.8% of the hospitals, follow-up after FSMP use was carried out in 86.5% of the hospitals, 79.2% of the hospitals maintained electronic or paper documentation of the clinical application of enteral nutrition preparations, 41.6% of the hospitals had no organization or institution to supervise the standardized application of FSMP.Conclusion:In the future, we should strengthen the construction of FSMP professional team, establish convenient and efficient nutrition diagnosis and treatment information module, and set up special institutions to implement FSMP standardized management.
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Objective:To explore the role of clinical pathway teaching in the practice teaching of respiratory medicine.Methods:A total of 51 intern students in the Department of Respiratory Medicine from January 2019 to June 2020 were selected as the research objects, and they were divided into a control group (25 cases) and a study group (26 cases). The control group adopted traditional clinical teaching, and the research group adopted clinical path teaching; the two groups' assessment results, comprehensive quality scores and satisfaction evaluations were compared respectively. SPSS 22.0 was used for t test and chi-square test. Results:In terms of evaluation results: including theoretical knowledge, case analysis, practical ability, and coping ability, the study group was higher than the control group, with significant differences ( P<0.05); in comprehensive quality: including the improvement of learning interest, the scores in 6 aspects, including expanded knowledge, professional diagnosis and treatment level, self-study ability, clinical thinking ability, teamwork ability, etc., were higher in the study group than in the control group, and the difference was statistically significant ( P<0.05); the number of people satisfied with the teaching in the study group was more than the control group. Conclusion:The role of clinical pathway teaching in the practice teaching of respiratory medicine is better than that of traditional teaching. By clarifying the teaching objectives and standardizing the teaching process, it can effectively improve students' assessment scores, overall quality and teaching satisfaction, which is worthy of further promotion.
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Objective:To investigate the predictive value of fasting blood glucose on clinical outcome after intravenous thrombolysis in patients with severe acute ischemic stroke (AIS).Methods:From January 2016 to November 2020, consecutive patients with severe AIS receiving intravenous thrombolysis in the Department of Neurology, Shengli Oilfield Central Hospital were enrolled retrospectively. Severe AIS was defined as the baseline National Institutes of Health Stroke Scale (NIHSS) score ≥15. The primary endpoint was the clinical outcome evaluated according to the modified Rankin Scale at 90 d after onset. 0-2 was defined as a good outcome and a score of >2 were defined as a poor outcome. The secondary endpoint events were any intracranial hemorrhage and symptomatic intracranial hemorrhage (sICH). Intracranial hemorrhage was defined as any local or distant parenchymal hemorrhage shown by craniocerebral imaging during the hospitalization. sICH was defined as any intracranial hemorrhage and the NIHSS score increased by ≥4 within 7 d after treatment. Univariate and multivariate logistic regression analysis were used to determine the independent influencing factors of various endpoint events. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of fasting blood glucose levels for endpoint events. Results:A total of 113 patients with severe AIS treated with intravenous thrombolysis were included, and 73 (64.6%) had a poor outcome; 29 (25.7%) had intracranial hemorrhage, of which 10 (8.8%) were sICH. Multivariate analysis showed that fasting blood glucose was the independent risk factors for poor outcome (odds ratio [ OR] 1.451, 95% confidence interval [ CI] 1.053-2.000; P=0.023) and sICH ( OR 1.235, 95% CI 1.013-1.504; P=0.036). The ROC curve analysis showed that the area under the curve of fasting blood glucose predicting poor clinical outcome at 90 d after onset was 0.731 (95% CI 0.637-0.824), the optimal cut-off value was 6.25 mmol/L, and the corresponding sensitivity and specificity were 63.0% and 82.5% respectively. The area under the curve of fasting blood glucose predicting sICH was 0.728 (95% CI 0.577-0.878), the optimal cut-off value was 7.98 mmol/L, and the corresponding sensitivity and specificity were 70.0% and 77.7% respectively. Conclusion:Fasting blood glucose is an independent predictor of sICH and poor outcome at 90 d after onset in patients with severe AIS receiving intravenous thrombolysis.
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Objective To describe the development status of the prevention and control of chronic non-communicable diseases (hereinafter referred to as "chronic diseases") at home and abroad, and to explore coping strategies suitable for the prevention and control of chronic diseases in China. Methods Through literature review relevant data on chronic diseases as well as the prevention and control strategies and measures were collected. A comprehensive analysis on the data was conducted. Results The epidemic trend of chronic diseases is relatively serious both in China and in the world. To cope with the rapid development and epidemic of chronic diseases, China and many other countries have implemented relevant policies to curb the growth and development of chronic diseases and have achieved different results to a certain extent. Conclusion Chronic diseases have become the main cause of death and health threats in human society. The implementation and practice of chronic disease prevention and control strategies should be strengthened, in combination with successful experience at home and abroad, to rapidly develop the strategies for the prevention and control of chronic diseases in line with national conditions in China.
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Onset with fever and back pain, an 81-year-old man had sudden oliguria and progressively elevated serum creatine from normal range to 660 μmol/L within 1 week after receiving contrast agents, various antibiotics, and several nonsteroidal anti-inflammation drugs. Urine output recovered after supportive treatment. However, his serum creatinine level rose again soon after a temporary decline accompanied by gross hematuria with almost normal morphology, nephrotic proteinuria, and hypoalbuminemia. Renal biopsy revealed necrotizing glomerulonephritis. Methylprednisolone was intravenously administrated 500 mg per day for 3 days, followed by oral glucocorticoids and cyclophosphamide. Gradually the patient′s serum creatinine descended to 144 μmol/L.