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Objective:To analyze the incidence and risk factors of acute kidney injury in children with biliary atresia after liver transplantation.Methods:The retrospective case-control study was conducted.The clinical data of 115 children with biliary atresia who received liver transplantation for the first time in Beijing Friendship Hospital Affiliated to Capital Medical University from December 2018 to November 2020 were collected.The patients were divided into AKI group ( n=39) and non-AKI group ( n=76) according to the diagnostic criteria of the Kidney Disease Improving Global Outcomes(KDIGO). The differences of clinical indicators between the two groups were compared, and multivariate logistic regression analysis was performed for statistically significant variables ( P<0.05) to further determine the independent risk factors for AKI after liver transplantation. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups.Measurement data with non-normal distribution were represented by M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups.Count data were expressed as cases and percentage, and comparisons between groups were made using Chi-square test or Fisher′s exact test. Results:The incidence of AKI in biliary atresia patients after liver transplantation was 33.9%. Univariate analysis showed that there were statistically significant differences in age ( OR=0.721, 95% CI: 0.553-0.938, P=0.014), preoperative infection ( OR=3.307, 95% CI: 1.294-8.468, P=0.013), PELD score ( OR=1.065, 95% CI: 1.031-1.101, P<0.001), serum creatinine numerical value ( OR=0.745, 95% CI: 0.657-0.858, P<0.001), intraoperative red blood cell transfusion ( OR=1.034, 95% CI: 1.028-1.051, P<0.001) and intraoperative plasma transfusion ( OR=1.055, 95% CI: 1.025-1.086, P=0.002) between the AKI group and the non-AKI group ( P< 0.05). Multivariate logistic regression analysis was performed on the selected indicators by univariate analysis, and the results showed that preoperative infection ( OR=3.763, 95% CI: 1.185-11.945, P=0.025) and low serum creatinine ( OR=0.685, 95% CI: 0.570-0.823, P<0.001), intraoperative red blood cell transfusion ( OR=1.033, 95% CI: 1.015-1.056, P=0.028) was independently associated with postoperative AKI ( P<0.05). The inpatient treatment time in ICU and in hospital between the two groups were statistically significant ( P<0.05). Conclusions:Preoperative infection, low creatinine numerical value and intraoperative red blood cell transfusion are independent risk factors for postoperative AKI in children with biliary atresia. AKI may prolong the time in ICU and in hospital.
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This paper introduces the historical development, training contents, the inspection mechanism and management regulations of obstetrics and gynecology residents training in Taiwan region, China. Drawing lessons from the experience and ideas of the standardized residency training system of obstetrics and gynecology in Taiwan region, combined with the present situation and deficiencies of the training system in the mainland China, this paper puts forward constructive suggestions for the standardized residency training of obstetrics and gynecology, so as to obtain more efficient and satisfactory training results and provide ideas for cultivating excellent obstetrics and gynecology specialists in mainland China.
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Objective To study mechanical properties of the anisotropy for pig trachea and main bronchi, and determine the constitutive model of trachea deformation by finite element numerical simulation. Methods The pig tracheas were collected and cut through in their axial directions and expanded into two-dimensional planes. Then, by setting the length direction of the trachea aortas as 0°, each planar trachea was anticlockwisely cut into 6 samples with orientation of 30°,60°,90°,120°,150° and 180°, respectively. Uniaxial tensile tests were applied on the specimen in 6 angular directions by using the electronic universal test machine, to obtain stress and strain of the specimen in different directions. Nonlinear fitting to the experimental data was performed by using the Mooney-Rivilin hyperelastic model, in order to obtain the material characteristic parameters. Finite element models of the trachea and the main bronchi were established, and tensile numerical simulation was carried out.Results Samples at different angles showed different stress-strain curves. In the trachea, the stresses of samples with angle of 30°, 120° and 150° were in the range of 1.0-1.5 MPa, the stresses of samples with angle of 60° and 90° were in the range of 0.5-1.0 MPa, and the stresses of samples with angle of 180° were in the range of 2.5-3.0 MPa. In the main bronchi, the stresses of samples with angle of 30°, 120° and 150° were in the range of 0.8-1.0 MPa, the stresses of samples with angle of 90° and 180° were in the range of 1.4-1.8 MPa, and the stresses of samples with angle of 120° were in the range of 0.4-0.6 MPa. There was an obvious difference between the trachea and the main bronchi. The finite element simulation verified that the Mooney-Rivilin constitutive model was suitable for describing small deformation behavior of the trachea. Conclusions The pig trachea exhibits strong anisotropy. Meanwhile, the Mooney-Rivilin model can characterize small tracheal deformations. The results provide theoretical references for tracheal resection and reconstruction in clinical treatment and intervention with surgical instruments such as bronchoscopy.
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Objective:To investigate the predictive effect of intraoperative selective lymph node frozen pathological examination on central lymph node metastasis in thyroid papillary carcinoma (PTC).Methods:A total of 721 PTC patients who underwent primary radical thyroidectomy and central lymph node dissection in Xuanwu Hospital of Capital Medical University from January 2015 to June 2019 were selected. All patients underwent intraoperative selective lymph node frozen pathological examination. According to the paraffin section pathological diagnosis results, there were 449 cases of thyroid micropapillary carcinoma (PTMC) and 272 cases of non-PTMC. The association of the frozen pathological examination results of intraoperative prelaryngeal lymph nodes, anterior tracheal lymph nodes and paratracheal lymph nodes with the pathological results of postoperative central lymph nodes was analyzed in all patients and those with central lymph node positive confirmed by postoperative pathological examination in different groups stratified by tumor long diameter, including 192 cases in PTMC group, 142 cases in long diameter >1 cm and <2 cm group and 55 cases in long diameter ≥2 cm group; postoperative paraffin pathological results were treated as the gold standard. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis were calculated.Results:There were 42.8% (192/449) and 72.4% (197/272) of PTMC patients and non-PTMC patients with central lymph node metastasis, respectively. Among 192 PTMC patients with central lymph node metastasis, the sensitivity of prelaryngeal lymph nodes, paratracheal lymph nodes and anterior tracheal lymph nodes was 28.1% (47/167), 61.4% (70/114) and 53.8% (91/169), respectively based on the intraoperative frozen pathological diagnosis. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis was 72.4% (139/192) and 27.6% (53/192), respectively. Among 197 non-PTMC patients with central lymph node metastasis, the sensitivity of prelaryngeal lymph nodes, paratracheal lymph nodes and anterior tracheal lymph nodes was 49.7% (82/165), 51.6% (96/186) and 64.7% (112/173), respectively based on the intraoperative frozen pathological results. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis was 84.8% (167/197) and 15.2% (30/197), respectively. The sensitivity of intraoperative lymph node frozen pathological results in the diagnosis of central lymph node metastasis for patients with thyroid capsule involvement in PTMC group, long diameter > 1 cm and < 2 cm group and long diameter ≥ 2 cm group was 81.7% (116/142), 81.7% (103/126) and 92.2% (47/51), respectively.Conclusions:Cervical central lymph node metastasis of PTC is common. Intraoperative frozen pathological examination of prelaryngeal lymph nodes, anterior tracheal lymph nodes and paratracheal lymph nodes can effectively predict whether the central lymph nodes are involved, and this hint is more obvious when the tumor long diameter is more than 2 cm and the thyroid capsule is involved.
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Taking case discussion of clinical treatment options of primary liver cancer during clinical internship as an example, the course design of basic elements of case-based learning (CBL) was discussed. The purpose of clinical practice is to cultivate the clinical thinking ability of "selecting the best one from multiple treatment options", which is suitable for taking CBL teaching method. The design of CBL course includes 8 elements: teaching object, purpose, objectives, course content, implementation plan, key points for assessment, course evaluation and reference materials. The core points of the design of CBL course are that: ①The teaching objectives include knowledge, ability and professionalism; ②The course content should includes the training of decision-making organizations and clinical thinking ability of selecting the best one from multiple treatment options; ③The general CBL teaching procedure can be adopted in the implementation of the scheme that focuses on the decision-making issues defined in each decision-making step. The teaching practice of CBL on primary liver cancer cases discussion shows the basic design of CBL course is universal, which is helpful for teachers to design and implement CBL course on clinical treatment options.
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Objective:To compare the efficacy and prognosis of elective nodal irradiation (ENI) combined with nedaplatin chemotherapy and involved field irradiation (IFI) combined with nedaplatin chemotherapy in the radical radiotherapy treatment of patients with cervical or upper thoracic esophageal cancer.Methods:Seventy-eight patients with cervical or upper thoracic esophageal cancer in Hai'an Traditional Chinese Medicine Hospital from February 2017 to February 2020 were selected and divided into ENI group and IFI group according to random number table method, with 39 cases in each group. The ENI group was treated with ENI combined with nedaplatin chemotherapy, while the IFI group was treated with IFI combined with nedaplatin chemotherapy. After 2 months of treatment, the therapeutic effect and the dose of lung irradiation were compared between the two groups, and the occurrence of adverse reactions and prognosis were compared.Results:The total effective rate and disease control rate were 69.23% (27/39) and 82.05% (32/39) in IFI group, and 64.10% (25/39) and 74.36% (29/39) in ENI group, there was no significant difference between the two groups ( χ2 = 0.23, P = 0.631; χ2 = 0.68, P = 0.411). The lung irradiation doses of V 5 Gy and V 20 Gy in IFI group were lower than those in ENI group (both P < 0.05). The incidence rates of bone marrow suppression and radiation lung injury in IFI group were lower than those in ENI group (all P < 0.05). By the end of follow-up, the survival rates of IFI group and ENI group were 76.92% (30/39) and 66.67% (26/39), respectively. There was no significant difference in overall survival between the two groups ( χ2 = 1.06, P = 0.300). Conclusions:ENI and IFI combined with nedaplatin chemotherapy in the radical radiotherapy treatment of cervical and upper thoracic esophageal cancer have similar efficacy and prognosis, but IFI can reduce the lung radiation dose and the incidence of adverse reactions.
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From September 2020 to August 2021, 34 general practice trainees in Xuanwu Hospital, Capital Medical University were were randomly divided into the control group and trial group with 17 in each group. The control group adopted the traditional clerkship method for outpatient clinical teaching; the trial group independently received patients with the supervision of clinical instructors, and the Leicester assessment package (LAP) was used for evaluation and training. The performance of two groups were assessed using the Beijing General Practitioner's Graduation Assessment and Admissions Patient Score Sheet. The LAP training was also given to control group at the late stage of the study, and the application of LAP was assessed with a questionnaire survey in two groups of trainees. The results showed that the performance of trial group was better than that of control group in terms of medical history collection [(23.12±1.05) vs. (21.18±0.88), t=-5.82, P<0.01 ], physical examination [(24.88±1.62) vs. (23.12±1.58), t=-3.22, P< 0.01 ], case analysis [(22.94±0.90) vs. (20.82±0.73), t=-7.55, P<0.01 ] and total score [(86.59±2.65) vs. (80.12±2.45) t=-7.40, P<0.01]. For assessment of LAP, all 34 trainees gave 5 points in items of improving patient care, knowledge and skills, communication skills, professional quality, reception skills, clinical thinking, clinical judgment, decision-making skills, and learning interest with the application of LAP in outpatient clinical teaching; the satisfaction of the trainees on the pertinence, teaching effect and LAP training method of the instructing physicians was 100% (34/34). It is suggested that the application of LAP for evaluation and implementation in general practice outpatient teaching will help to improve the teaching quality and the patient receiving ability of general practitioners.
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Incentive system is an indispensable means in the process of standardized residency training, which plays an important role in improving the work efficiency and service quality of residents, teachers and other participants. Based on the analysis of the problems existing in the holistic incentive system, we have implemented a set of personalized incentive measures for the training of residents in department rotation and achieved preliminary results, which provides ideas for exploring personalized incentive system for standardized residency training.
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OBJECTIVE：To provide sugge stions for improving the variety of pediatric drugs and ensuring the safety of pediatric drug use in China. METHODS ：The historical evolution of laws and regulations on the marketing approval of pediatric drugs in the United States and the implementation results of relevant policies were summarized. Combined with the current situation of the development of pediatric drugs in China ，some suggestions were put forward to ensure the accessibility and safety of pediatric drug use in China. RESULTS & CONCLUSIONS ：Since 1994，the United States had issued a series of laws and regulations to encourage the development of pediatric drugs. At present ，the marketing approval of pediatric drugs were mainly based on the two laws of Best Pediatric Drug Act（BPCA）and Pediatric Research Equality Act （PREA）. From 1998 to 2019，the amount of supplements of pediatric drug information in drug instructions of the United States showed a fluctuating growth. As of April 2020，854 kinds of drugs had been modified in pediatric instructions ，792 of which had been carried out post marketing pediatric clinical research ，and the problem of incomplete pediatric instructions had also been greatly improved. At present ，China’s policies on pediatric drugs mainly included encouraging R&D innovation ，giving priority to review and approval ，and strengthening R&D technical guidance. Although certain achievements had been made ，there were still some problems ，such as imperfect policies and regulations ，and great difficulties carrying out pediatric drug clinical trials. It is suggested that our country should draw lessons from the American regulations on pediatric drugs ，pediatric research and the catalogue of pediatric drugs ，and establish a system and catalogue of ped iatric drug use suitable for China ’s national conditions ，so as to improve the effectiveness ，safety and accessibilityof pediatric drugs.
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Fracture healing is a complex physiological process involving osteoblasts,osteoclasts and other cells and molecules.Typical fracture healing can be divided into four stages:inflammatory response,soft callus formation,hard callus formation,and bone remodeling.Osteoclasts play a leading role in hard callus formation and bone remodeling.Alendronate can inhibit osteoclast activity and bone loss in patients with osteoporosis,but it may also inhibit fracture healing.Therefore,whether alendronate can be used after osteoporotic fracture is controversial.In recent years,it has been found that alendronate can not affect the fracture healing,but also reduce the risk of secondary fracture and improve the prognosis of patients.In this article,the mechanism of alendronate and its effect on osteoporotic fracture healing by systemic and local use are reviewed,which can provide a reference for clinical selection of therapeutic drugs.
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Resident standardized training is the indispensable way to develop the medical and health services in China, and the construction of resident standardized training base is the basis of this work. Under the current situation of the supply and demand of the resident standardized training base and the resident who need to participate in the standardized training, the cooperative base development plays a very good auxiliary role in the work of the national standardized training base for residents. In the process of coordination, the hospital leaders should attach great importance to the development, and we also should promote effective communication among base managers, integrate the training base management system, improve the teaching quality, establish the mechanism of training and supervision, and build a systematic construction bridge between the bases. The most important part of the base coordination is to integrate the advantageous residential training base, professional base, department and professional group, explore the new management model, actively learn from the excellent experience of other bases, as well as increase the training quality and the number of residents.
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Fracture healing is a complex physiological process involving osteoblasts, osteoclasts and other cells and molecules. Typical fracture healing can be divided into four stages: inflammatory response, soft callus formation, hard callus formation, and bone remodeling. Osteoclasts play a leading role in hard callus formation and bone remodeling. Alendronate can inhibit osteoclast activity and bone loss in patients with osteoporosis, but it may also inhibit fracture healing. Therefore, whether alendronate can be used after osteoporotic fracture is controversial. In recent years, it has been found that alendronate can not affect the fracture healing, but also reduce the risk of secondary fracture and improve the prognosis of patients. In this article, the mechanism of alendronate and its effect on osteoporotic fracture healing by systemic and local use are reviewed, which can provide a reference for clinical selection of therapeutic drugs.
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Objective To systematically evaluate the effect of FMS﹣like tyrosine kinase 3 (FLT3) mutations on prognosis of acute promyelocytic leukemia. Methods The databases of CNKI, Wanfang, VIP, China Biology Medicine disc, PubMed, EMBase, and Cochrane Library were retrieved, and the cohort studies and case﹣control studies published from the establishment of the databases to December 2017 were selected according to the inclusion and exclusion criteria. The quality assessment and data extraction was performed and the statistical analysis was performed by using RevMan 5.3 software. Results Twenty﹣three studies were included, covering a total of 2 632 patients. Meta﹣analysis showed that patients with FLT3 internal tandem duplication (FLT3﹣ITD) mutation had lower complete remission rate ( RR＝0.92, 95% CI 0.86-0.99, P＝0.02), 3﹣year overall survival rate ( RR＝0.72, 95% CI 0.60-0.88, P＝0.001) and 5﹣year overall survival rate ( RR＝0.89, 95% CI 0.81-0.99, P＝ 0.03), while the proportion of high﹣risk group ( RR＝ 3.13, 95% CI 2.26-4.35, P< 0.01), the early mortality rate ( RR＝ 2.26, 95% CI 1.75-2.90, P< 0.01) and the recurrence rate ( RR＝1.50, 95% CI 1.11-2.02, P＝0.008) were relatively high, and the differences were statistically significant. The patients with FLT3 tyrosine kinase domain (FLT3﹣TKD) mutation had higher early mortality rate ( RR＝ 3.00, 95% CI 1.74-5.20, P< 0.01), and the difference was statistically significant. Conclusion The FLT3 mutations can influence the prognosis of acute promyelocytic leukemia, which contributes to the research direction of better prognosis stratification, perfect treatment regimen and improved prognosis.
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Objective To observe the effect of oxycodone for postoperative patient-controlled intravenous analgesia of laparoscopic total hysterectomy with or without background infusion.Methods Seventy five patients, aged 40-65 years, BMI 18-24 kg/m2, ASA physical statusⅠ orⅡ, scheduled for elective laparoscopic total hysterectomy surgery under general anesthesia were randomly assigned into 3 equal groups (n = 25 each) using a random number table:morphine group (group M), oxycodone with background infusion group (group O1) and oxycodone without background infusion group (group O2).The anesthesia was induced by intravenous fentanyl 4μg/kg, propofol 2-2.5 mg/kg and cisatracurium 0.2 mg/kg.Group M was given morphine 50 mg+ondanstron 8 mg in100 ml normal saline, groups O1 and O2 were given oxycodone 50 mg+ ondanstron 8 mg in 100 ml normal saline.The PCIA pump of group M and group O1 were set up with a 0.5 ml bolus dose, a 5 min lockout interval and background infusion at a rate of 2 ml/h.Group O2 was set up with a 4 ml bolus dose, a 5 min lockout interval and without background infusion.The NRS scores of three groups at 4, 8, 12, 24 and 48 hafter operation were recorded.The total morphine or oxycodone consumption, and the number of rescue analgesia within 48 hafter surgery were recorded.The adverse events within 48 hafter surgery were also observed.Results Compared with group M, the NRS scores at rest were significantly decreased at 4, 8, and 12 hafter operation (P<0.05), and the NRS scores at movement were significantly decreased at 4 and 8 hafter operation (P<0.05), and the number of rescue analgesia within 48 hafter surgery was significantly decreased in groups O1 and O2 (P<0.05).The total analgesic consumption and the incidence of adverse event within 48 hafter surgery in group O2 were significantly lower than those in groups M and O1 (P<0.05).Conclusion Compared with morphine, oxycodone for patient-controlled intravenous analgesia can obtain more satisfactory effects after laparoscopic total hysterectomy surgery.Meanwhile, the total consumption of oxycodone and the incidence of nausea and vomiting are significantly decreased.
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Juvenile idiopathic arthritis (JIA)is a type of chronic rheumatism in children. It is mainly charac-terized by joint damage,accompanied by systemic symptoms and result in significant morbidity. The application of bio-logical agents has altered the traditional treatment pattern of JIA and significantly improved the condition of JIA pa-tients. JIA is a heterogeneous disease. Treatment recommendations issued by American College of Rheumatology(ACR) in 2011 have become an important reference for JIA treatment. There is a best response window for JIA treatment. Thus, the clinic application of biological agents should be used as soon as possible after the diagnosis of JIA. Meantime,it should be noted when a preparation is invalid,it need to use another possible biological agent in time to control disease progression.
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Objective To investigate the clinical and pathological characteristics of Henoch-Sch?nlein purpura nephritis with diffuse capillary endothelial cell proliferation as pathological manifestation. Methods The clinical manifestations and pathology of capillary endothelial proliferative purpura nephritis (DEP-HSPN) diagnosed by renal biopsy were retrospectively analyzed in 50 children in recent 5 years. Results The pathological lesions in 50 cases included simple DEP-HSPN in 11 cases (7 males and 4 females) and capillary endothelial cell proliferation combined with crescents formation (non-simple DEP-HSPN) in 39 cases (27 males and 12 females). There was no significant difference in the course of disease and age between the two groups (P>0.05). The clinical type of 11 cases of simple DEP-HSPN was type Ⅲ. In 39 cases of non-simple DEP-HSPN, 16 cases were type Ⅲ and 23 cases were type Ⅴ. All of the children had hematuria and proteinuria. The incidence of gross hematuria, urine red blood cell count, 24 h urine protein, and serum creatinine levels in children with non-simple DEP-HSPN were significantly higher than those in simple DEP-HSPN group, but the plasma albumin level was significantly lower than that in simple DEP-HSPN group. It was easy to have crescent formation in DEP-HSPN, and the rate of crescent formation was 11.1％ (5.0％-27.6％). The incidence of segmental lesions and renal tubular interstitial damage was low. All children had non simple IgA deposits in the mesangial area. In the 50 children treated for 1 year, 22 had complete remission, 28 had asymptomatic hematuria, and none had active nephropathy and renal insufficiency. In 32 cases of non-simple DEP-HSPN, the 24 h urinary protein, plasma albumin level, and the incidences of gross hematuria and microscopic hematuria were statistically different before treatment and 1, 3, 6, 12 months after treatment (P<0.01). The 24 h urine protein and gross hematuria gradually decreased with the prolongation of treatment, while the level of plasma albumin was gradually increased. Conclusions DEP-HSPN is characterized by gross hematuria and proteinuria. The onset is acute and it is easy to have crescent formation. When combined with crescent formation, the clinical symptoms are more severe. The combination of strong immunosuppressive agents and long-term sequential follow-up treatment is effective in acute stage. The prognosis is good.
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Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.
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Objective To investigate the effects of saturated fatty acids and unsaturated fatty acids on proliferation and autophagy of human lung cancer cells. Methods The lung cancer cells A549 were treated with stearic acid (saturated fatty acid) and doconexent (DHA, unsaturated fatty acid), respectively, in concentrations of 0, 30, 60, 120 and 240μmol/L. MTT test and cell clone formation assay were performed to detect the proliferation of A549 cells. The morphology of A549 autophagy was observed by confocal laser scanning microscopy after A549 cells were treated with stearic acid or DHA for 24 hours. Western blotting assay was used to detect the expression of autophagy-related protein after A549 cells were treated with stearic acid or DHA for 12, 24 and 36 hours, respectively. Results 30-240μmol/L stearic acid or DHA both inhibited the proliferation of A549 cells (P<0.05). Both stearic acid and DHA induced autophagy of A549 cells, meanwhile, down-regulated Phospho-mTOR (ser2481) and up-regulated LC3Ⅱ/LC3Ⅰ of A549 cells (P<0.05). Conclusions Both saturated fatty acid and unsaturated fatty acid can inhibit the proliferation and induce autophagy of lung cancer cells. The mechanisms of autophagy may be related to Phospho-mTOR (ser2481) signaling pathway.
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Objective To apply the big data on medical equipment quality inspection to scientific management of medical equipment.Methods The big data on medical equipment metrological verification and quality control were analyzed,and medical equipment performance curve was drawn based on the function on data standard deviation and time.Results The big data provided support for medical equipment bidding and purchase,preventive maintenance and precision benefit analysis.Conclusion Medical equipment big data is of great significance to enhance medical support ability,and contributes to the management of medical equipment and strategic equipment.
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Objective To observe efficacy of different acupuncture and moxibustion methods for treatment of nausea and vomiting caused by chemotherapy. Methods One hundred and sixty-three cases were randomly divided into electroacupuncture group (42 cases), warm acupuncture combined with electroacupuncture group (37 cases), ginger moxibustion group (44 cases) and control group (40 cases). All groups received postoperative adjuvant chemotherapy. Three acupuncture and moxibustion groups received electroacupuncture, warm acupuncture combined with electroacupuncture, ginger moxibustion to stimulate bilateral Zusanli (ST36), Neiguan (PC6), respectively, once a day. The control group was given tropisetron hydrochloride 5 mg+normal saline 100 mL, 30 min before chemotherapy intravenously, once a day to the end of chemotherapy. The number and degree of vomiting and the serum 5-HT content were tested, and the safety test was conducted. Results The complete control rate and effective control rate of acute vomiting of electroacupuncture group and warm acupuncture combined with electroacupuncture group were higher than those of ginger moxibustion group and control group (P<0.05). The complete control rate of delayed vomiting in warm acupuncture combined with electroacupuncture group was significantly higher than that of electroacupuncture group, ginger moxibustion group and control group (P<0.05); The effective control rate was higher than that of ginger moxibustion group and control group (P<0.05); Electroacupuncture group and Ginger moxibustion group were higher than the control group (P<0.05). The scores of acute vomiting in electroacupuncture group and warm acupuncture combined with electroacupuncture group were lower than others (P<0.05). In delayed vomiting, warm acupuncture combined with electroacupuncture group's score was lower than other groups, with statistical significance (P<0.05); Electroacupuncture group and ginger moxibustion group were lower than that incontrol groups, with statistical significance (P<0.05). The levels of serum 5-HT in electroacupuncture group and ginger moxibustion group were higher than warm acupuncture combined with electroacupuncture group (P<0.05), but lower than the control group (P<0.05). No obvious adverse reactions were found in each group. Conclusion Different acupuncture methods had different clinical effects on acute vomiting and delayed vomiting caused by chemotherapy.