Intermediary effect of benefit finding in the mindfulness level and coping style of acute cerebral infarction patients who received interventional therapy / 中国实用护理杂志

Objective:To observe the level of mindfulness and coping style in patients with acute cerebral infarction (ACI) after interventional therapy, and analyze the intermediary effect of benefit finding between them, so as to provide a theorectical basis of implement mindfulness intervention in clinical practice.Methods:The 130 patients with ACI after interventional treatment in the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were included in this cross-sectional survey study. The general data questionnaire, Five-factor Mindfulness Scale (FFMQ), Benefit Finding Rating Scale (BFS), and Simple Coping Style Questionnaire (SCSQ) were used to analyze the relationship between benefit finding, mindfulness level and coping style, and the intermediary effect of benefit finding between them.Results:The total FFMQ score of 130 ACI patients after interventional therapy was (123.34 ± 5.14) points. The BFS score, positive coping score and negative coping score were (49.73 ± 3.41), (20.35 ± 2.25), (13.18 ± 1.45) points, respectively. The level of mindfulness and benefit were positively correlated with positive coping ( r=0.687, 0.737, both P<0.05). The level of mindfulness and benefit were negatively correlated with negative coping( r=-0.654, -0.779, both P<0.05). It was found that mindfulness level played a partial intermediatory effect on positive coping and negative coping in ACI patients after interventional therapy, with contribution rates of 49.71% and 64.58%, respectively. Conclusions:Benefit finding plays a partial intermediary effect on the level of mindfulness and coping style of patients with ACI after interventional therapy.

Relationship between ANKK1 gene polymorphism and atypical antipsychotic drug-induced metabolic syndrome / 中国药房

OBJECTIVE To explore the relationship between the ANKK1 rs1800497 polymorphism and atypical antipsychotic drug-induced metabolic syndrome （MS）. METHODS Totally 94 patients with schizophrenia were included， and ANKK1 rs1800497 genotypes of patients were detected by micro-fluorescence immunoassay； social demographic information， clinical characteristics and other data were collected. The χ2 test was used to compare the correlation between the sex of patients and the occurrence of MS， and the correlation between gene polymorphism and the occurrence of MS and its risk factors.RESULTS Totally 94 patients included 24 cases （25.53%） of GG， 51 cases （54.26%） of GA and 19 cases of AA （20.21%）. Among them， there were 45 cases （47.87%） of MS， and the incidence of MS in male was higher than that in female （P＜0.05）. Genotype analysis showed that ANKK1 rs1800497 polymorphism was not associated with MS （P＝0.452）. ANKK1 rs1800497 A allele was significantly associated with hyperglycemia （χ2＝4.379， P＝0.036）， while it was not related to abdominal obesity， hypertension， high level of TG and low level of HDL-C （P＞0.05）， suggesting that for patients with schizophrenia， allele A was a relative risk factor for inducing hyperglycemia [OR＝2.008，95%CI（1.039， 3.881）]. CONCLUSIONS ANKK1 rs1800497 polymorphism has no correlation with the induction of MS by atypical antipsychotics， while the schizophrenia patients with A allele are more likely to induce hyperglycemia. The incidence of MS in male patients is significantly higher than that in female patients.

Research progress in 2023 ASCO-GU prostate cancer / 现代泌尿外科杂志

The 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium unveiled numerous research advances which provide meaningful insights into the selection of treatment regimens of prostate cancer. Precision multi-treatment based on patients’ characteristics has become the predominant approach, including the use of a three-drug combination therapy for metastatic hormone-sensitive prostate cancer, and poly adenosine diphosphate ribose polymerase inhibitor therapy for metastatic castration-resistant prostate cancer. Nuclear medicine therapy and radiotherapy are also receiving significant attention. Integrated nuclear medicine diagnosis and therapy show immense potential for non-metastatic castration-resistant prostate cancer. Additionally, for localized prostate cancer, stereotactic body radiotherapy is a preferred alternative to surgery. This article sheds light on several key studies presented at the conference, focuses on prostate cancer treatment at different stages, and intends to enhance the therapeutic outcome for prostate cancer patients.

Dermatomyositis with kidney neoplasm: two cases report and literature review / 中华泌尿外科杂志

Objective:To investigate the clinical characteristics, diagnosis and treatment of dermatomyositis with kidney neoplasm.Methods:The data of two patients with dermatomyositis complicated with kidney neoplasm in Tongji Hospital from January to February 2022 were retrospectively analyzed. The first case was a 55-year-old female, who was admitted with the chief complaints of recurrent erythema of upper extremities for 2 months and facial erythema for 1 month. Physical examination: erythema can be seen on upper limbs and face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Mi-2 antibody and anti-SSA /Ro-52 antibody were positive. Contrast CT showed nodular uneven enhancement in the right kidney with a size of 50 mm×41 mm. The second case was a 58-year-old female, who was admitted with the chief complaints of kidney occupying for a month. Physical examination: flaky erythema on face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Ro-52 antibody and anti-MDA5 antibody were positive. Contrast CT showed a significantly uneven enhanced mass with a size of about 50 mm×41 mm on left kidney. Both patients were diagnosed with kidney neoplasm before surgery and underwent laparoscopic partial nephrectomy in Tongji Hospital.Results:Both patients received regular oral prednisone after surgery. The pathological presentation of case 1 was papillary renal cell carcinoma, the facial erythema subsided 1 month after surgery, and there was no tumor recurrence for 13 months. The pathological presentation of case 2 was clear cell renal cell carcinoma, facial erythema subsided 2 weeks after surgery, and there was no tumor recurrence for 12 months.Conclusions:The diagnosis of dermatomyositis should be combined with clinical manifestations and laboratory examination, and the possibility of malignant tumor should be excluded due to the high likelihood of concomitant malignancy. For patients with dermatomyositis with kidney neoplasm, the main treatment is still surgery, and supplemented with glucocorticoid therapy.

Monitoring results and influencing factors of clozapine plasma concentration in patients with mental disorders / 中国医师杂志

Objective:To analyze the influencing factors of clozapine plasma concentration in patients with mental disorders after oral administration, so as to provide reference for individualized treatment.Methods:Retrospective analysis was made on 221 inpatient reports of Clozapine blood concentration monitoring in the Therapeutic Drug Monitoring Laboratory (TDM) of the Pharmacy Department of the Chaohu Hospital Affiliated to Anhui Medical University from January to October 2021, and information such as patient gender, age, body mass index (BMI), smoking history, clozapine dose, combined drug use and blood concentration monitoring results were collected; Single factor analysis of variance and binary logistic regression were used to analyze the monitoring results of clozapine blood concentration in patients with mental disorders and its influencing factors.Results:Among 221 monitoring reports, 74 cases (normal concentration group) had clozapine plasma concentration within the effective plasma concentration range (350-600 ng/ml), 103 cases (low concentration group) were lower than the effective plasma concentration range (<350 ng/ml), and 44 cases (high concentration group) were higher than the effective plasma concentration range (>600 ng/ml). The results of single factor analysis of variance showed that there were statistically significant differences in daily dose of clozapine, standard dose, smoking history, course of disease, and abnormal liver function of patients in different blood concentration groups of clozapine (all P<0.05). The most frequently used antipsychotic drugs in 221 patients with clozapine were sodium valproate, amisulpride, aripiprazole and lithium carbonate in turn. The proportion of clozapine combined with ≥2 antipsychotics in the normal concentration group was higher than that in the low concentration group and the high concentration group, and the difference was statistically significant ( P<0.05). The results of binary logistic regression analysis showed that the combination of one antipsychotic drug and ≥ two antipsychotic drugs might help the blood concentration of clozapine in patients with mental disorders reach the target concentration (350-600 ng/ml), and the combination of two drugs was more beneficial [ OR(95% CI): 1.795(0.753-4.282)], with a statistically significant difference ( P<0.05). Conclusions:Clozapine plasma concentration varies greatly among individuals, and the therapeutic window is narrow. It is necessary to adjust the dosage in combination with the basic information and clinical information of patients, and regularly monitor the plasma concentration, so as to achieve the safety and effectiveness of individualized drug use.

Expression of TLR3 in human adenocarcinoma of the lung cells induced by respiratory syncytial virus and its significance in the diagnosis of pneumonia in children / 中国医师杂志

Objective:To study the expression of Toll like receptor 3 (TLR3) in human adenocarcinoma of the lung cells induced by respiratory syncytial virus (RSV) and its significance in the diagnosis of pneumonia in children.Methods:A549 cells were divided into RSV infection group [added 1 μg/ml Lipopolysaccharide (TLR3 agonist) transfected RSV virus after 150 μl intervention], Lipopolysaccharide stimulation group (added 1 μg/ml Lipopolysaccharide 150 μl intervention) and normal control group (normal culture). The mRNA expressions of tumor necrosis factor-α, interleukin 8, TLR3 protein and TLR3 in A549 Cells of different groups were compared. We prospectively selected 80 children with RSV infectious pneumonia admitted to Baoding Second Central Hospital from August 2019 to October 2021 as the RSV pneumonia group, and sixty children with common pneumonia were taken as the common pneumonia group, and 60 healthy children in our hospital were taken as the control group. The mRNA expression of serum TLR3 in different groups was compared, and the diagnostic efficacy of serum TLR3 in RSV pneumonia was evaluated by receiver operating characteristic.Results:There was a statistically significant difference in the expression of TLR3 protein among different groups of A549 cells ( P<0.001). The expression differences of TLR3 mRNA in different groups of A549 cells at different time points were statistically significant(all P<0.001). There was significant difference in the expression of tumor necrosis factor-α and interleukin 8 of A549 cells at different time points in different groups (all P<0.05). There was a statistically significant difference in the expression of serum TLR3 mRNA among the three groups of subjects ( F=155.237, P<0.001). The critical value for TLR3 gene diagnosis was 66.87, with corresponding sensitivity of 73.75%, specificity of 70.83%, and the area under curve (AUC) of 0.803(95% CI: 0.753-0.855). Conclusions:Respiratory syncytial virus induces human lung cancer cells and promotes disease progression through TLR3 expression; Serum TLR3 can be used for the diagnosis of RSV pneumonia.

(+)/(-)-Yanhusamides A-C, three pairs of unprecedented benzylisoquinoline-pyrrole hetero-dimeric alkaloid enantiomers from Corydalis yanhusuo

A chemical investigation on the aqueous extract of Corydalis yanhusuo tubers led to the isolation and structural elucidation of three pairs of trace enantiomeric hetero-dimeric alkaloids, (+)/(-)-yanhusamides A-C ( 1- 3), featuring an unprecedented 3,8-diazatricylco[5.2.2.02,6]undecane-8,10-diene bridged system. Their structures were exhaustively characterized by X-ray diffraction, comprehensive spectroscopic data analysis, and computational methods. Guided by the hypothetical biosynthetic pathway for 1- 3, a gram-scale biomimetic synthesis of (±)- 1 was achieved in 3 steps using photoenolization/Diels-Alder (PEDA) [4+2] cycloaddition. Compounds 1‒3 exhibited potent inhibition of NO production induced by LPS in RAW264.7 macrophages. The in vivo assay showed that oral administration of 30 mg/kg of (±)- 1 attenuated the severity of rat adjuvant-induced arthritis (AIA). Additionally, (±)- 1 induced a dose-dependent antinociceptive effect in the acetic acid-induced mice writhing assay.

Research progress on the regulation of cholesterol metabolism in the treatment of nonalcoholic fatty liver disease / 中华临床营养杂志

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide nowadays. Given the very complex pathogenesis, there are yet no effective pharmacological agents for the treatment of NAFLD. Accumulating evidence has shown that cholesterol metabolism dysregulation, resulting in excess cholesterol accumulation in the liver and subsequent hepatic inflammation and injury, is one of the most important causes for the occurrence and development of NAFLD. This suggests the application of cholesterol metabolism- targeting therapeutic strategy in NAFLD. This review firstly summarized the pathogenesis of NAFLD, then focused on the regulation of cholesterol metabolism and underlying mechanisms through which excess hepatic cholesterol contributed to NAFLD, and reviewed the research progress on cholesterol-lowering agents aimed at maintaining the cholesterol homeostasis to treat NAFLD, which would provide insights for novel strategies to treat NAFLD in both preclinical studies and clinical settings.

Research progress of advance care planning for elderly hemodialysis patients / 中国实用护理杂志

With the rapid development of hospice care, more and more people pay attention to the quality of life of patients at the end of life. Due to the dialysis-related complications, heavy burden of comorbidities and cognitive impairment, elderly hemodialysis patients have poor quality of life, which brings heavy physiological, psychological and economic burdens to patients, families and society. Advance care planning can improve patients′ quality of life and save limited medical resources. By referring to relevant literature at home and abroad, this paper reviewed the overview of advance care planning, the necessity of discussing advance care planning with elderly hemodialysis patients, the implementation status and the obstacle factors. The purpose was to provide theoretical reference for better implementation of intervention treatment in elderly hemodialysis patients in China in the future.

Diagnostic value of autophagy-related circular RNA circ_0020123 in ovarian cancer / 中华内分泌外科杂志

Objective:To investigate the expression level of circular RNA circ_0020123 in ovarian cancer (OC) , and then to evaluate the diagnostic value of circ_0020123 level in ovarian cancer.Methods:Fifty-five ovarian cancer patients who were diagnosed and treated in Hangzhou Linping District Maternal and Child Health Hospital from Oct. 2016 to Mar. 2017 were selected, and serum was collected for high-throughput gene expression sequencing analysis. The circ_0020123 level in serum of ovarian cancer patients and healthy controls was determined by real-time quantitative PCR, and the diagnostic efficacy of circ_0020123 level on ovarian cancer was evaluated by drawing receiver operating characteristic curve (ROC) . The correlation between the expression of circ_0020123 and the clinical characteristics of ovarian cancer patients was investigated by t-test. The survival curve was drawn to analyze the relationship between the serum circ_0020123 level and the prognosis and survival of ovarian cancer patients. Western blot was used to detect the expression levels of autophagy-related proteins LC3-II/LC3-I and p62.Results:Compared with the serum of healthy people (1±0.25) , the expression of circ_0020123 was significantly up-regulated in the serum of ovarian cancer patients (1.24±0.23) ( t=5.23, P<0.001) . The ROC curve showed that circ_0020123 had high diagnostic performance for the detection of ovarian cancer specimens (AUC=0.7579, P<0.001) . Comprehensive analysis of t test and logistic analysis showed that the high expression of circ_0020123 was significantly correlated with FIGO stage ( t=5.46, P<0.001) and tumor size ( t=6.37, P<0.001) . The measurement of survival data showed that the 5-year overall survival of the circ_0020123 high expression group was significantly shorter than that of the circ_0020123 low expression group ( P=0.019) . Knockdown of circ_0020123 in cells down-regulated the expression of autophagy-related proteins LC3-II/LC3-I (0.45±0.05) ( t=9.31, P=0.001) , and up-regulated the expression of p62 (1.94±0.11) ( t=12.62, P<0.001) . Conclusion:The results of this study indicate that circ_0020123 is an important ovarian cancer-related circular RNA, which provides a potential diagnostic, prognostic biomarker and therapeutic target for ovarian cancer patients.

Effect of aquatic treadmill training on bilateral abdominal muscle thickness and balance function in stroke patients with hemiplegia / 中国康复理论与实践

ObjectiveTo explore the effect of aquatic treadmill training on abdominal muscle thickness and balance function in patients with hemiplegia after stroke. MethodsFrom March to October, 2021, 60 patients with hemiplegia after stroke were randomly divided into control group (n = 20), suspension group (n = 20) and aquatic treadmill group (n = 20). On the basis of comprehensive rehabilitation training, the control group received treadmill training, the suspension group received skyrail suspension walking training, and the aquatic treadmill group received treadmill training in water, for four weeks. The curative effect was evaluated by musculoskeletal ultrasound with muscle thickness of bilateral external oblique, internal oblique and transverse abdominal muscles. And they were assessed with Postural Assessment Scale for Stroke Patient (PASS) and Timed 'Up & Go' Test (TUGT) before and after treatment. ResultsAfter treatment, the thickness of external oblique and internal oblique muscles on the unaffected side, the PASS score and the TUGT time improved in all the three groups (|t| > 2.135, P < 0.05); while the thickness of external oblique, internal oblique and transverse abdominal muscles in the aquatic treadmill training group increased (|t| > 5.567, P < 0.001). The PASS score, the TUGT time, and the thickness of external oblique and internal oblique muscles on the affected side improved more in the aquatic treadmill training group than in the control group and the suspension group (P < 0.05). ConclusionThe aquatic treadmill training is more effective in strenghthening abdominal muscle to improve balance function.

Effect of simple knee trainer on knee active flexion for hemiplegics after stroke / 中国康复理论与实践

@#Objective To observe the clinical efficacy of simple knee trainer on active knee flexion in patients with hemiplegia after stroke.Methods From March, 2020 to May, 2021, 46 hemiplegics after stroke in Beijing Bo'ai Hospital were randomly divided into control group (n = 23) and experimental group (n = 23). Both groups accepted routine rehabilitation training, and the experimental group accepted knee flexion exercise training in sitting position through the simple knee trainer, for eight weeks. They were measured active knee flexion angle in sitting position and maximum flexion angle in walking before and after training, as well as Holden Functional Ambulation Category (FAC).Results Both active knee flexion angle in sitting position and maximum flexion angle in walking significantly increased in both groups after training (|t| > 6.991, P < 0.001), and increased more in the experimental group than in the control group (t > 2.185, P < 0.05). The grade of FAC also improved in both groups (|Z| > 2.828, P < 0.01), and no significant difference was found between groups (Z = -0.821, P = 0.412).Conclusion The application of simple knee trainer can effectively improve the active range of motion of knee, which may be used in clinic- and community-based rehabilitation.

Expression of NDV HN protein in rice and development of a semi-quantitative rapid method for detection of antibodies / 生物工程学报

The aim of this study was to develop a semi-quantitative immunochromatographic method for rapid detection of Newcastle disease virus (NDV) antibodies by expressing HN protein in rice endosperm bioreactor. The recombinant plasmid pUC57-HN was digested by MlyⅠ and XhoⅠ to retrieve the HN gene, while the intermediate vector pMP3 containing promoter, signal peptide and terminator was digested by NaeⅠ and XhoⅠ. The HN gene and the linearized pMP3 were purified and ligated to form a recombinant plasmid pMP3-HN1. Subsequently, pMP3-HN1 and plant vector pCAMBIA1300 were digested by EcoRⅠ and Hind Ⅲ, and the HN1 gene was cloned into pCAMBIA1300. The recombinant plasmid pCAMBIA1300-HN1 was introduced into Agrobacterium tumefaciens EHA105 by electrotransformation, and the pCAMBIA1300-HN1 was transferred into rice callus by agrobacterium-mediated method. After dark culture, callus screening, differentiation, rooting and transplanting, transgenic rice seeds were obtained 4 months later. PCR identified that the HN gene has been inserted into the rice genome. SDS-PAGE and Western blotting indicated that the HN protein was successfully expressed in the positive rice endosperm. The purity of the HN protein was more than 90% by SP cation exchange chromatography and gel filtration chromatography. According to the national standards for the diagnostic techniques of Newcastle disease HI test (HI≥4log2, positive antibody reaction), a colloidal gold labeled purified HN protein was used to prepare a semi-quantitative test strip by double-antibody sandwich method for rapid detection of NDV antibody. The results showed that the test strip did not cross-react with positive sera against other viruses, and the sensitivity of the test strip reached 1:102 400 for standard positive sera of Newcastle disease. Testing of a total of 308 clinical sera showed that the compliance rate of the test strip with HI test was 97.08%, and the Kappa value was 0.942. In conclusion, high purity recombinant HN protein was obtained from rice endosperm, and a simple, rapid, highly sensitive and highly specific semi-quantitative immunochromatographic strip was developed. The test strip could be used for immune evaluation of the Newcastle disease vaccine.

Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective cohort study / 医学前沿

The Coronavirus disease 2019 (COVID-19) has spread globally. Although mixed liver impairment has been reported in COVID-19 patients, the association of liver injury caused by specific subtype especially chronic hepatitis B (CHB) with COVID-19 has not been elucidated. In this multi-center, retrospective, and observational cohort study, 109 CHB and 327 non-CHB patients with COVID-19 were propensity score matched at an approximate ratio of 3:1 on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, disease severity, and clinical outcomes were compared. Furthermore, univariable and multivariable logistic and Cox regression models were used to explore the risk factors for disease severity and mortality, respectively. A higher proportion of CHB patients (30 of 109 (27.52%)) developed into severe status than non-CHB patients (17 of 327 (5.20%)). In addition to previously reported liver impairment markers, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin, we identified several novel risk factors including elevated lactate dehydrogenase (⩾ 245 U/L, hazard ratio (HR) = 8.639, 95% confidence interval (CI) = 2.528-29.523; P < 0.001) and coagulation-related biomarker D-dimer (⩾ 0.5 µg/mL, HR = 4.321, 95% CI = 1.443-12.939; P = 0.009) and decreased albumin (< 35 g/L, HR = 0.131, 95% CI = 0.048-0.361; P < 0.001) and albumin/globulin ratio (< 1.5, HR = 0.123, 95% CI = 0.017-0.918; P = 0.041). In conclusion, COVID-19 patients with CHB were more likely to develop into severe illness and die. The risk factors that we identified may be helpful for early clinical surveillance of critical progression.

Application of Renaissance spinal surgical robot in middle and upper thoracic fractures / 中华骨科杂志

Objective:To explore the safety and effectiveness of the Renaissance spine surgery robot in the middle and upper thoracic spine fractures.Methods:62 patients with middle and upper thoracic vertebra fractures from March 2015 to March 2019 were prospectively analyzed. These patients were randomly divided into robot group (Renaissance robot-assisted nailing) and free hand group (unarmed nailing under perspective). There were 32 patients in robot group, including 25 males and 7 females with an average age of 43.1±8.91 years (range, 18-65 years). Body mass index (BMI) was 26.15±3.97 kg/m 2 (range, 16.3-41.7 kg/m 2). The preoperative Cobb angle was 20.9 °±2.83° (range, 10.7 °-33.9°). In the free hand group, there were 30 cases, including 24 males and 6 females; Age 44.2±9.10 years (range, 20-67 years), BMI 25.97±4.02 kg/m 2 (range, 17.1-43.2 kg/m 2); The preoperative Cobb angle was 21.3°±3.01° (range, 11.6°-35.1°). The 2 groups were compared in terms of accuracy of screw placement, one-time success rate of screw placement, completion time of screw placement, time of total operation and penetration rate of anterior vertebral margin. The robot group also compared the consistency of screw placement angle with preoperative planning. Results:All patients completed the operation successfully. The number of fractured vertebrae in the robot group was 37; the screw placement time was 16.11±5.82 min; the total number of screws was 230, of which 227 were successfully placed at one time, with a success rate of 98.70% (227/230); 1 screw was inserted through the anterior edge of the vertebral body, and the penetration rate was 0.43% (1/230). The number of fractured vertebrae in the free hand group was 35; the nail placement time was 21.09±7.31 min; the total number of screws was 216, of which 195 were successfully placed at one time, with a success rate of 90.28% (195/216); 12 screws was inserted through the anterior edge of the vertebral body, and the penetration rate was 5.56% (12/216). There were significant differences in the time, success rate and penetration rate between the two groups. There was no significant difference in the total operation time between the robot group and the unarmed nail group 137.23±12.68 min and 140.23±13.13 min, respectively. There was no significant difference in the angle of screw placement between pre-operative planning image and post-operative CT scan in the robot group.Conclusion:Renaissance spinal surgery robot in the treatment of middle and upper thoracic vertebra fractures has the advantages of high accuracy, low intraoperative risk, high safety and satisfactory effect of pedicle screw placement.

Impact of transcatheter aortic valve replacement on left atrial strain by two-dimensional speckle-tracking imaging / 中华超声影像学杂志

Objective:To evaluate the influence of transcatheter aortic valve replacement (TAVR) on left atrial strain by two-dimensional speckle tracking echocardiography.Methods:Thirty-five patients, who were admitted for TAVR in Zhongshan Hospital of Fudan University from September 2015 to July 2018, were recruited. Echocardiography was performed 1 day before and 12 months after TAVR. Traditional ultrasound results, including aortic valve area (AVA), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), left atrial volume index (LAVI), peak velocity of tricuspid regurgitation (Vtr), peak velocity of the lateral wall of mitral annulus in early diastolic period (e′) and the ratios of peak mitral orifice velocity in early diastolic period to e′ (E/e′), were recorded. Two-dimensional speckle tracking imaging derived left atrial strain, which included reservoir (LASr), conduction (LAScd) and contraction (LASct), were recorded as well. The differences between pre-operation and post-operation were analyzed.Results:Compared to pre-operation, aortic valve area was increased ( P<0.001). Left ventricular systolic function was improved significantly (LVEDV and LVESV were decreased, LVEF was increased, all P<0.001). As to the left ventricular diastolic function, although LAVI and Vtr were decreased (both P<0.05), e′ and E/e′ were hardly changed (both P>0.05). Meanwhile, left atrial strain, including LASr, LAScd and LASct, were improved significantly 1 year post-TAVR (all P<0.01). Conclusions:Left atrial strain is able to evaluate the left atrial function of reservoir, conduction and contraction.Left atrial strain can be a promising tool of assessing left atrial function in patients underwent TAVR.

Identification and diagnosis of autism spectrum disorder among Chinese children in early stage / 中国学校卫生

Objective@#To investigate and explore the changes of the diagnosis of Chinese children with autism spectrum disorder (ASD).@*Methods@#The families of two groups of children aged 1-6 and 6-16 years who were diagnosed with ASD were selected from ALSOLIFE platform, and the online questionnaire was used to investigate the symptoms and its diagnosis related information. ANOVA was applied to compare the mean values, and χ 2 analysis was taken to compare the differences of two groups in the time of finding symptoms, the time of the first diagnosis, the time of treatment, and the diagnosis delayment.@*Results@#The initial recognition age of symptoms was 26.05 months age (2.17 years) in the young group (1-6 years), and 30.76 months age (2.56 years) in the old group (6-16 years). The age of first visit doctor was 28.21 months age (2.35 years) in the young group and 34.29 months (2.86 years) in the old group, while the average delay was only 3.43 months, of which the average delay was 4.52 months in the old group and 2.78 months in the young group. The age of diagnosed as ASD was 38.01 months age (3.17 years) in the young group and 31.07 months age (2.59 years) in the old group, while the average delay from first diagnosis to last diagnosis was 3.16 months. The delay from first diagnosis to last one was 3.71 months age in old age group, and 2.83 for the younger age group, The above differences were statistically significant ( F =328.30, 535.64, 507.71, 103.03, 17.79, P <0.01). Most of the children were still in the top hospitals to get diagnosed, but the role of child care was becoming more and more important.@*Conclusion@#The diagnosis efficiency of ASD children has been greatly improved, the time of symptom identification and diagnosis is advanced, and the delay of seeing a doctor and diagnosis is shortened.

The significance of electron microscopy in the etiological diagnosis of respiratory tract infection / 国际儿科学杂志

At present, electron microscopy has played a more and more important role in the field of medicine.It is often used in the ultrastructure observation of various systems, mechanism research and clinical diagnosis of diseases.The role of electron microscopy in the etiological diagnosis of respiratory tract infection cannot be ignored, but its related review is less.By using electron microscopy, the morphological characteristics of respiratory tract pathogens can be accurately observed and the new respiratory tract infection pathogens can be classified and screened.In addition, through the combination of samples with patients′ serum and observation of immuno-electron microscopy, the host response to pathogens can also be understood.However, due to the high equipment requirements, technical difficulties, complex operation and other factors, electron microscopy is rarely used in conventional etiological diagnosis, and more used in laboratory basic research.In this paper, the advantages, disadvantages and significance of electron microscopy in the etiological diagnosis of respiratory tract are reviewed.

Research on the status and influencing factors of long-term care demand of the community elderly in Tai′an of Shandong Province / 中国实用护理杂志

Objective:To analyze the status and influencing factors of long-term care demand of the community elderly in Taian and in order to provide a theoretical basis for the government to formulate policies to meet the needs of the elderly.Methods:A self-designed questionnaire was used to investigate 294 elderly aged 60 years in three areas in Tai'an using Convenient sampling.Results:The total average score of long-term care demand was (2.67±0.46). The top three demand are economic, chronic disease rehabilitation, and dignity demand. Multiple linear regression showed that age, living conditions, place of residence, and chronic disease were the influencing factors of long-term care needs ( P<0.05). Conclusions:The long-term care needs of the elderly in Tai'an community were at a medium level, Age, living conditions, place of residence and chronic diseases have different effects on long-term care demand. It is suggested that the government and medical staff should pay more attention to the economic, rehabilitation and dignity needs of the elderly in the community, and formulate and implement relevant policies to meet the needs of the elderly in order to improve the quality of life and happiness of the elderly.

The role of elevated blood amylase in the assessment of diabetic ketoacidosis / 中华急诊医学杂志

Objective:To investigate therole of serum amylase elevation in the evaluation of diabetic ketoacidosis (DKA) patients and the related factors affecting serum amylase (AMS) levels in patients with diabetic ketoacidosis.Methods:A total of 249 patients with DKA who were admitted to the First Affiliated Hospital of Zhengzhou University from November 2011 to August 2018 were selected for this retrospective study. The patients were divided into the normal group ( n=176) and the elevated group ( n=73) according to the AMS level measured by fasting venous blood samples. The enumeration data such as sex, type of DM, diabetic vascular complications, number of deaths, number of ICU monitoring, and number of acute pancreatitis (AP) after discharge were analyzed by chi-square test or Fisher test, and the measurement data such as age, pH, HbA1c, CO 2CP, Ca 2+, BUN, and Scr were analyzed by independent sample t test to compare the difference between the two groups. Results:The intensive care unit (ICU) monitoring rate was 50.7%, the median length of stay in ICU was 4 days, the median length of hospital stay was 14 days, and the median treatment cost was 28 000 yuan, which were higher in the elevated group than those in the normal group ( P<0.05). There were no significant differences in mortality, AP during hospitalization, and the probability of AP after discharge between the elevated group and the normal group ( P>0.05). The duration of diabetes, the number of previous DKA, the incidence of diabetic vascular complications, HbA1c, pH, BUN, and Scr in the elevated group were all higher than those in the normal group ( P<0.01 or P<0.05). Conclusions:DKA patients with elevated AMS are more likely to be admitted to ICU, and the length of stay in ICU, total length of hospital stay and total cost of treatment are all increased. Where as the overall mortality rate during hospitalization and the likelihood of AP after discharge are not increased.