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Objective:To investigate the factors affecting postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after severe traumatic brain injury (sTBI).Methods:A case-control study was conducted to analyze the clinical data of 55 patients with prolonged disorders of consciousness after sTBI admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University and Seventh Medical Center of PLA General Hospital from September 2021 to September 2022. There were 33 males and 22 females, with the age range of 13-68 years [(43.0±15.5)years]. All patients were assessed for the consciousness level using the coma recovery scale-revision (CRS-R) preoperatively and within 48 hours postoperatively. A total of 33 patients were observed in vegetative state and 22 in minimally conscious state preoperatively. The consciousness level was found to be improved in 26 patients (consciousness- improved group), but not improved in the remaining 29 patients (consciousness-unimproved group). Indicators were documented including gender, age, cause of injury, Glasgow coma score (GCS) on admission, course of injury, preoperative consciousness level, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade, analgesic regimen and sedation maintenance drugs. A univariate analysis was conducted first to assess those indicators′ correlation with postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI. Multivariate Logistic regression analysis was then used to determine the independent risk factors for their postoperative short-term improvement of consciousness level.Results:Univariate analysis showed that GCS on admission, course of injury, preoperative consciousness level and analgesic regimen were correlated with short-term improvement of postoperative consciousness level in patients with prolonged disorders of consciousness after sTBI (all P<0.05), whereas gender, age, cause of injury, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade and sedation maintenance drugs showed no relation to the improvement of postoperative consciousness level (all P>0.05). Multivariate Logistic regression analysis showed that the GCS ≥7 points on admission ( OR=0.06, 95% CI 0.01, 0.36, P<0.01), preoperative minimally conscious state ( OR=0.09, 95% CI 0.02, 0.40, P<0.01) and intraoperative use of Sufentanil combined with Remifentanil ( OR=0.07, 95% CI 0.01, 0.43, P<0.01) were significantly correlated with postoperative improvement of consciousness level. Conclusion:The GCS on admission (≥7 points), preoperative minimally conscious state and intraoperative use of Sufentanil combined with Remifentanil are independent risk factors affecting short-term postoperative improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI.
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Objective To analyze the factors influencing the levels of occupational exposure in medical radiation workers in China, and to provide a scientific basis for determining the key points of radiation protection in the medical sector. Methods The individual monitoring data on occupational external exposure in medical radiation workers in 2021 were collected from the “National Individual Dose Registry”. The Chi-squared test and logistic regression were used to analyze the factors influencing the levels of occupational exposure in medical radiation workers. Results The Chi-squared test showed that gender, occupational category, medical institution category, region, number of radiation workers per thousand population, and regional per capita GDP were significantly associated with occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv and an annual effective dose limit of 20 mSv (χ2 = 21.456−262.329, 7.601−78.650, P < 0.05). The logistic regression analysis further showed that gender, occupational category, region, and number of radiation workers per thousand population were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 5 mSv (χ2 = 14.621−170.857, P < 0.05); gender, occupational category, region, and regional per capita GDP were factors influencing the occupational exposure in medical radiation workers exceeding the annual effective dose of 20 mSv (χ2 = 5.401−48.709, P < 0.05). Conclusion Male radiation workers in interventional radiology and in central China have high risks of exceeding annual effective doses of 5 and 20 mSv. Moreover, high number of radiation workers per thousand population and regional per capita GDP are associated with low risks. Medical institutions should maintain a sufficient number of radiation workers and strengthen training on radiation protection knowledge for male and interventional radiology workers to enhance their radiation protection awareness. Investigation of the factors contributing to the high occupational exposure in central China should be intensified, and targeted effective measures should be conducted to reduce the occupational exposure in medical radiation workers.
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Objective:To evaluate percutaneous mechanical thrombectomy (PMT) using Aspirex device for treating acute iliofemoral deep vein thrombosis (IFDVT).Methods:The clinical and follow-up data of 68 patients with IFDVT at our institution from Jan 2019 to Jun 2021 was retrospectively analyzed.Results:Twenty-six patients who had received PMT combined with auxiliary catheter directed thrombolysis (CDT) were included into group A, and 42 patients received CDT alone were into group B.The final thrombus clearance rates were more than 50%, and the clinical efficacy of thrombolysis was achieved. Group A associated a significant reduction in lysis duration and UK dosage and hospital days and degree of detumescence after 24 h compared with group B,and all aforementioned differences were statistically significant. Hospitalization costs in group A were more than group B. At one year follow-up, there were no significant differences between the two groups in the cumulative prevalence post-thrombotic syndrome (PTS) and the Villalta score and primary patency (92.0% vs. 90.0% , χ2=0.059, P=0.807). Conclusions:The application of PMT using the Aspirex device for acute IFDVT was safe and effective, which could accelerate the clearance of thrombus, and reduce UK dosage, lysis duration, hospital days. However, it increased the hospitalization costs.
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Objective:To explore the effects of miRNA-373-3p (miR-373-3p) on the proliferation of nephroblastoma G401 cells through targeted regulation of CD44 expression.Methods:Bioinformatic method was used to predict the possible targeted genes of miR-373-3p based on bioinformatic databases including miRDB, miRanda, PITA and DIANA-microT. G401 cells were taken and transfected with miR-373-3p mimic, mimic negative control, miR-373-3p inhibitor or inhibitor negative control, respectively. Cell proliferation ability was detected by using CCK-8 assay. The number of clones was detected by using clone formation assay. The relative expression level of CD44 mRNA was detected by using real-time fluorescent quantitative polymerase chain reaction (qRT-PCR), and the expression level of CD44 protein was detected by using Western blotting. The dual luciferase gene reporter assay was carried out in HEK-293T cells to vertify the target gene of miR-373-3p.Results:Bioinformatic analysis indicated that CD44 was a targeted gene of miR-373-3p. After 24 h transfection, the proliferation activity of G401 cells in miR-373-3p mimic group was decreased compared with that in mimic negative control group (all P < 0.05). After 48 h transfection, the proliferation activity of tumor cells in miR-373-3p inhibitor group was increased compared with that inhibitor negative control group (all P < 0.05). The formed number of clones in miR-373-3p mimic group was reduced compared with that in the mimic negative control group (55.3±2.5 vs. 90.7±2.9), and the difference was statistically significant ( t = 14.57, P < 0.01). The formed number of clones in miR-373-3p inhibitor group was more than that in inhibitor negative control group (115.0±2.7 vs. 92.0±2.4), and the difference was statistically significant ( t = 8.86, P < 0.01). The dual-luciferase gene reporter assay showed that CD44 was a direct targeted gene of miR-373-3p. The relative expression levels of CD44 mRNA in miR-373-3P mimic and mimic negative control group were 0.62±0.03 and 1.00±0.01, respectively, and the difference was statistically significant ( t = 11.28, P < 0.01). The relative expression levels of CD44 mRNA in miR-373-3p inhibitor and inhibitor negative control group were 1.31±0.02 and 1.00±0.00, respectively, and the difference was statistically significant ( t = 12.65, P < 0.01). The CD44 protein expression was decreased in miR-373-3p mimic group, while increased in miR-373-3p inhibitor group. Conclusion:miR-373-3p can inhibit tumor cell proliferation by targeting CD44 in nephroblastoma.
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Objective:To investigate the influence of unilateral periacetabular osteotomy (PAO) on the bony birth canal (BBC) in female patients with developmental dysplasia of the hip (DDH) by using pelvic 3D-CT maximum-inscribed-sphere (MIS) method.Methods:A total of 62 female DDH patients of childbearing age were included in the present study. The DICOM data of their pre- and post-operative pelvic CT was collected. The diameters of the MIS in 25 layers of the BBC were measured on the Medical Imaging Interaction Toolkit (MITK) platform. Lateral center edge angle (LCE), T?nnis angle and the distance between the medial margin of the femoral head and Kohler's line were measured on standing anteroposterior pelvic radiographs before and after unilateral PAO. Patients were divided into severe (LCE≤0°) and non-severe group (0°<LCE<20°) according to their LCE values.Results:After unilateral PAO, the BBC above the sciatic spine (1-20th layer) narrowed (0.86-5.95 mm, P<0.05). However, there was no change in levels below the sciatic spine (21-25th layer, P>0.05). The anterior margin of acetabular fragment (1-13th layer) narrowed significantly (4.23-5.95 mm) after unilateral PAO with the narrowest part (5.62-5.95 mm) locating at the inferior margin of pubic ramus and the region superior to the lateral margin of obturator foramen (5-10th layer). The narrowest part of BBC before and after the surgery occurred at the level of bilateral sciatic spines (20th layer). The diameter of MIS changed significantly from 105.34±7.16 mm pre-operatively to 104.47±7.06 mm post-operatively ( t=2.198, P=0.032). There was a positive correlation between the inward displacement of the hip center and the narrowing of the 1-20th layer of the BBC. The decrease of T?nnis angle was positively correlated with the narrowing of the 1-10th layer of the BBC. The increase of LCE was negatively correlated with the narrowing of 2-5th layer of the BBC ( P<0.05). The standardized coefficients were with statistical significance when comparing the distance between the Kohler's line and the medial margin of the femoral head to the size of the 1-20th layer of the BBC ( β=0.27-0.50, P<0.05). The height was positively correlated with the size of the narrowest part of the BBC before and after the surgery ( r=0.565, r=0.586, P<0.001). There was no difference between severe group and non-severe group in their extent of BBC narrowing before and after surgery ( t=-0.685-0.655, P>0.05). Conclusion:Unilateral PAO results in mild narrowing of the BBC superior to the sciatic spine. The narrowest part of the BBC is located at the sciatic spine. Unilateral PAO has slight effects on the narrowest position of the BBC. Normal delivery of a healthy fetus in female patients with DDH of childbearing age could not be affected by unilateral PAO in normal BBC settings.
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Bioactive peptides play important roles in promoting human health, such as lowering blood pressure, blood sugar and blood lipid, anti-obesity, and anti-cancer. Thus, exploring functional bioactive peptides and developing efficient production technologies are of crucial importance. Herein, we review the development of function discovery and production technology for natural bioactive peptides. Presently, the top-down and bottom-up approaches are mainly used for the function discovery and production of natural active peptides. The top-down approach includes the direct extraction and identification for functional discovery, and the direct extraction, enzymatic hydrolysis and microbial fermentation for production. The bottom-up approach includes the polypeptide modification and database mining for functional discovery, and the chemical synthesis, enzyme synthesis, recombinant expression and cell-free synthesis for production. The top-down approach is usually associated with complicated process, lower efficiency, higher cost, harder quality control, and uncertain functionality, while the bottom-up approach is more suitable for the development of peptide drugs but difficult to be used for functional foods. With the technology development of sequencing and mass spectrometry, it is easier to obtain the proteomic information of various organisms at the molecular level. Based on the proteomic information, the top-down and bottom-up approaches can be combined to overcome the disadvantages of using these two approaches alone, thus providing a new strategy for the rapid development and production of natural active peptides.
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Humans , Fermentation , Mass Spectrometry , Peptides/metabolism , Proteomics , TechnologyABSTRACT
Objective:To analyze the relationship between the developmental eye movement (DEM) test results and the vocabulary size in Chinese children with developmental dyslexia.Methods:A cross-sectional study was conducted.A total of 1 243 fifth grade students from 10 primary schools were enrolled from September to December 2019 in Tianjin, among which there were 664 males and 579 females, with the average age of (10.68+ 0.53) years old.The Chinese vocabulary test and intelligence test were carried out.Eighty-five dyslexic children with subaverage vocabulary size were selected as the experimental group and 54 normal children were selected as the control group.The DEM test was conducted in the two groups, and the vertical time, the horizontal adjustment time, the ratio of horizontal to vertical time and the total number of errors were recorded and analyzed.The differences in positive rate of dyslexia, various DEM test indicators between different genders and different groups were analyzed.The correlations between vocabulary size and vertical time, horizontal adjustment time, the ratio of horizontal to vertical time and the total number of errors were analyzed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of School of Optometry, Tianjin Vocational Institute (No.ysgxyll001). Written informed consent was obtained from the guardian of each subject.Results:The total positive rate of dyslexia was 6.83%(85/1 243), and the positive rate of 9.33%(62/664) in boys was higher than 3.97%(23/579) in girls, with a significant difference between them( χ2=13.974, P<0.001). There were no statistically significant differences in age, vocabulary size, vertical time, horizontal adjustment time, and the ratio of horizontal to vertical time between different genders in the control group (all at P>0.05). The vocabulary size of girls in the experimental group was larger than that of boys, showing a statistically significant difference ( t=-2.259, P=0.027). There was no significant difference in age, vertical time, horizontal adjustment time, and the ratio of horizontal to vertical time (all at P>0.05). The vertical time and horizontal adjustment time of the experimental group were longer than those of the control group, and the differences were statistically significant ( t=-4.848, -4.297; both at P<0.001). There was no statistically significant difference in the ratio of horizontal to vertical time between the two groups ( t=0.126, P=0.900). The total number of errors was 0(0, 1) in the experimental group, which was higher than the control group 0(0, 0), with a significant difference between them ( H=1.979, P=0.001). The vocabulary size of students in the two groups was negatively correlated with the vertical time, horizontal adjustment time and the total number of errors ( r=-0.397, P<0.001; r=-0.355, P<0.001; r s=-0.180, P=0.034), and was not obviously correlated with the ratio of horizontal to vertical time ( r=0.038, P=0.656). Conclusions:The DEM test scores of Chinese children with developmental dyslexia are higher than those of normal children, and there is no difference between different genders.The lower the scores of vocabulary size test, the higher the scores of DEM test.
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Tumor calcinosis(TC) has different clinical and biochemical patterns. The existence of chronic injury as well as calcium and phosphorus metabolism disorder has been gradually proved to be the important link in the occurrence of TC. In this paper, the related basic diseases with the pathophysiological mechanism of calcium and phosphorus metabolism disorder were reviewed, and the pathophysiological mechanism of phosphate metabolism disorder in various diseases was summarized.In addition, the phosphate homeostasis genes including GALNT-3, FGF-23 and α-KLOTHO were described. The relevant research results have showed that mutations in any of these three genes will lead to defects in the synthesis or action of FGF-23, which will increase the reabsorption of phosphate by renal tubules, resulting in hyperphosphatemia and severe ectopic calcification of soft tissue.At present, surgical resection is still the main treatment of TC. New technologies such as cinalcet peritoneal dialysis, ultrasound-guided aspiration of TC lesions and local injection of sodium thiosulfate (STS), as well as the successful application of lanthanum carbonate and other drugs, provide alternatives to TC treatment.In this paper, the research literatures on TC at home and abroad in recent years were introduced and the genetic susceptibility genes, related pathogenic factors and the latest treatment progress of TC were reviewed.
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Objective:To observe the morphological changes of the deep lumbar multifidus (DM) during rest and movement among persons with chronic low back pain (cLBP) using ultrasound imaging.Methods:Twenty-one cLBP patients and 30 pain-free healthy controls were studied. The resting thickness of the DM muscle was measured, and then its cross-sectional area and thickness during maximum voluntary isometric contraction (MVIC). The results were correlated with pain intensity and duration.Results:The cLBP patients showed significant reductions in the DM′s resting thickness, and in its cross-sectional area and thickness during a MVIC compared with the healthy controls. The resting thickness of the DM was positively correlated with pain duration, but not with pain intensity.Conclusions:These results suggest that cLBP patients have atrophy and less thickness change during an MVIC. This should be considered in planning clinical rehabilitation training.
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Objective:To evaluate the efficacy and safety of switch from prednisone (AA+ P) to dexamethasone (AA+ D) in metastatic castration-resistant prostate cancer patients (mCRPC) progressing on abiraterone plus prednisone.Methods:Between November 2016 and December 2019, 46 mCRPC patients were switched to AA+ D after progression on AA+ P at Sun Yet-sen University Cancer center. Median age was 72 years(50 to 89 years), with median androgen deprivation therapy (ADT) duration 14.6 months(2.1 to 168.5 months). PSA level at the time of diagnosis, the initiation of AA+ P treatment, the time of switch were 258.9 ng/ml, 56.6 ng/ml, 25.1 ng/ml, respectively. 42 (91.3%), 12(26.1%), 7(15.2%) patients had bone metastasis, lymph node metastasis, visceral metastasis, respectively. 28 patients had Gleason score ≥8, and 11 patients had Gleason score<8. The primary endpoint was progression free-survival (PFS). Secondary endpoints included PSA response rate of PSA decline ≥50% and ≥30% and safety. Patients were divided into different risk level groups according to PSA level at the time of switch and PFS on AA+ P.Results:The median follow-up of 46 patients was 4.9 months, 40 patients progressed at the last follow-up, the treatment was terminated in 1 patient because of cerebral infarction, 5 patients were still on the treatment of AA+ D. Median PFS on AA+ D of 46 patients was 3.7 (1.6-24.1) months. A total of 12 (26.1%) patients showed a PSA decline≥50% after treatment with AA+ D, and 21 (45.7%) patients showed a PSA decline ≥30%. The median PFS was 8.5 (2.7-24.1) and 3.0 (1.6-17.8) months for patients with PSA decline≥50% and PSA didn’t decline ≥50%, respectively. Four factors below were significantly associated with a longer PFS on AA+ D after steroid switch in univariate analysis: lower PSA level at the time of switch (<30 ng/ml, HR=0.30, 95% CI 0.14-0.64, P=0.002), longer ADT sensitivity duration (≥18 months, HR=0.55, 95% CI 0.28-1.06, P=0.045), longer AA+ P treatment PFS (≥8 months, HR=0.36, 95% CI 0.18-0.72, P=0.004), and greater PSA decline on AA+ D (≥50%, HR=0.30, 95% CI 0.17-0.75, P=0.007). The above mentioned factors were also independent prognostic factors associated with better PFS on AA+ D after steroid switch in multivariate analysis. Treatment with AA+ D was well tolerated in all patients, with no grade 3/4 toxicity reported. Conclusions:Switching from prednisone to dexamethasone is effective and safe in mCRPC patients progressing on abiraterone plus prednisone. Patients with lower PSA level at the time of switch, longer ADT sensitivity duration, longer AA+ P treatment PFS and greater PSA decline on AA+ D might gain better efficacy.
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Objective:To investigate the clinical features and prognostic factors in children with sepsis complicated with myocardial injury.Methods:The clinical data of children with sepsis complicated with myocardial injury from January 2017 to January 2019 in Department of Intensive Care Unit, Children′s Hospital of Kunming City, were retrospectively analyzed. The pediatric critical illness score (PCIS) at admission, gender, age, infection site, clinical outcome, mechanical ventilation and blood purification were recorded. The etiological results, creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB), myoglobin, hypersensitive cardiac troponin T (hs-cTnT), procalcitonin (PCT), lactate, left ventricular ejection fraction (LVEF), cardiac output, left ventricular truncation rate (LVFS) were recorded. According to the clinical results, the children were divided into improvement group and deterioration group, and the clinical data of each group were compared. The receiver operating characteristic (ROC) curve and multivariate Logistic regression were used to screen the relevant clinical indicators that could predict the prognosis of children.Results:A total of 138 children with sepsis complicated with myocardial injury were enrolled. Thirty cases died in 28 d, and the mortality of 28 d was 21.7%. The respiratory tract was the main infection site, and the main pathogens were gram-negative bacteria and virus. The 35.4% (28/79) of children were complicated with multiple infections. There were 102 cases in improvement group; and there were 36 cases in deterioration group, among whom 5 cases died in hospital and 31 cases was discharged without treatment. The proportion of the girls in deterioration group was significantly higher than that in improvement group: 63.9% (23/36) vs. 34.3% (35/102), and there was statistical difference ( P<0.01); there were no statistical differences in age, infection site, mechanical ventilation, blood purification and PCIS between 2 groups ( P>0.05). The hs-cTnT and lactate in deterioration group were significantly higher than those in improvement group: (1.87 ± 0.67) ng/L vs. (1.62 ± 0.51) ng/L and (0.46 ± 0.31) ng/L vs. (0.34 ± 0.27) ng/L, and there were statistical differences ( P<0.05); there were no statistical differences in CK, CK-MB, myoglobin, PCT, LVEF, cardiac output and LVFS between 2 groups ( P>0.05). ROC curve analysis result showed that the hs-cTnT and lactate were risk factors for predicting clinical prognosis in children with sepsis complicated with myocardial injury, the area under the curve were 0.623 and 0.613, the optimal value were 159.59 and 2.65 ng/L, with a sensitivity of 36.1% and 55.6%, and a specificity of 98.2% and 70.6%. Multivariate Logistic regression analysis result showed that the hs-cTnT and gender were independent risk factors for prognosis ( OR = 2.237 and 0.286, 95% CI 1.093 to 4.578 and 0.127 to 0.644, P = 0.028 and 0.003). Conclusions:The 28 d mortality in children with sepsis complicated with myocardial injury is higher, and the respiratory tract is the most common infection site. The increased hs-cTnT and lactate levels indicate that the prognosis is poor in children with sepsis complicated with myocardial injury. The hs-cTnT and and gender are independent risk factors of prognosis.
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Objective: To explore the influencing factors related to the quality of life of the patients with idiopathic interstitial pneumonia (IIP), and to provide the theoretical basis for improving the quality of life, preventing other complications, and improving the prognosis of the patients with IIP. Methods: St George' s Respiratory Questionnaire (SGRQ) was used to evaluate the quality of life of 300 hospitalization patients with IIP who met the inclusion criteria in the study. The differences of quality of life among different groups of people were compared. A general linear regression model was used to screen the independent influencing factors that may affect the scores of quality life of all dimensions. Results: Drinking, forced vital capacity (FVC) and 6 min walk test (6MWT) were the independent influencing factors of the symptom score of the IIP patients (P<0. 05); nation, family per capita monthly income, carbon monoxide diffusion capacity (DLCO), and 6MWT were the independent influencing factors of activity limit score of the IIP patients (P<0. 05); nation, family per capita monthly income, FVC, and 6MWT were the independent influencing factors of life impact score of the IIP patients (P<0. 05); nation, family per capita monthly income, FVC, and 6MWT were the independent influencing factors of the scores of quality of life of the IIP patients (P<0. 05). Conclusion: The activity limit of IIP patients is more obvious. Drinking, nation and family per capita monthly income, FVC, 6MWT and DLOC are the factors affecting the quality of life of the IIP patients in different dimensions.
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Objective@#To explore the characteristics of postural blood pressure changes in elderly inpatients and the related factors of orthostatic hypotension (OH).@*Methods@#This study was a clinical case control study. Two hundred and sixty-six elderly patients (≥60 years old), who were hospitalized between April 2016 and November 2017 in Geriatric Department of Peking University First Hospital, were included. They were divided into direct standing group and indirect standing group. Direct standing group involved 102 patients, they changed posture from supine directly to standing position, and the blood pressures at the moments of supine, immediately after standing and the first, second, and third minute after standing were recorded by continuous noninvasive arterial pressure (CNAP) system. Indirect standing group involved 164 patients, and they changed posture from supine to sitting for 3 minutes, and then changed to standing position. Blood pressures at the moments of supine, immediately after sitting, the third minute after sitting, immediately after standing and the third minute after standing was recorded by CNAP. Blood pressure changes after different postural changes mode and the rates of OH were compared. The related factors of OH was analyzed by binary logistic regression analysis.@*Results@#The lowest systolic blood pressures (SBP) mostly occurred immediately after postural change: immediately after standing for direct standing group (86.3%(88/102)), and immediately after sitting for indirect standing group (59.1%(97/164)). The lowest diastolic blood pressures (DBP) mostly occurred immediately after standing in the two groups: 87.3%(89/102) for direct standing group and 43.3% (71/164) for indirect standing group. The maximum SBP drop (SBP of supine minus the lowest SBP during postural changes) of direct standing group was significantly higher than indirect standing group (median 20.5(14.0, 29.3) vs. 18.0(11.0, 26.0) mmHg (1 mmHg=0.133 kPa, P<0.05). The rates of OH occurred immediately and within 3 minutes from supine to standing position were significantly higher in direct standing group than in indirect standing group (65.7% (67/102) vs. 43.9% (72/164), and 70.6% (72/102) vs. 49.4% (81/164), both P<0.05). Binary logistic regression analysis showed that brachial-ankle pulse wave velocity was positively associated with OH after a transition from supine to standing position (immediately and within 3 minutes, OR=1.002 (95%CI 1.000-1.004), 1.003 (95%CI 1.001-1.006), P=0.014, 0.006) in direct standing group.@*Conclusions@#OH is common in elderly hospitalized patients. The most obvious blood pressure changes are likely to occur immediately after position changes. Adding a sitting position during the transition of supine to standing position may decrease the amplitude of SBP drop. Brachial-ankle pulse wave velocity is associated with OH after the transition from the supine to standing position in the elderly inpatients.
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Objective@#To develop occupational radiation disease and occupational health monitoring system for radiation workers in order to identify the current status of occupational health management of radiation workers in China.@*Methods@#In compliance with the relevant laws, regulations and standards in China, the system design was completed according to wide variety of needs.@*Results@#An occupational health monitoring system for radiation workers was initially established. The system consisted of four modules and three levels of users to make sure.@*Conclusions@#Through the collection of data, some key risk points existing in radiology diagnosis and treatment have been identified in relation to occupational radiation disease, so as to provide scientific basis for health administrative department to carry out decision-making and revision of laws and regulations.
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Objective@#To construct a national medical radiation protection monitoring information system (NMRPMIS) based on the national radiation health information platform, support the national medical radiation protection monitoring project data reporting, and comprehensively understand the current situation of medical radiation protection.@*Methods@#According to the national radiation protection monitoring plan, laws, regulations and standards, HTML, CSS and JavaScript were used in the front end, JAVA language was used in the back end, SQL server was used in the platform database and Tomcat was used as the middleware. A data reporting and analysis system was set in the system through B/S structure, with statistical analysis of the 2017 annual monitoring data carried out.@*Results@#The business composition of the platform includes four levels: data acquisition (through various business systems), data resource integration (integration of business system public data), application, and display. The national medical radiation protection monitoring system with flexible structure, centralized information and convenient operation was implemented. The national medical radiation protection information was reported in 2017. The basic situation of radiation protection in 33 565 hospitals and the performance and protection information of 10 624 pieces of radiation diagnosis and treatment equipment were reported in 2017. A total of 95 statistical information reports were completed, describing the current situation of medical radiation protection in China from four dimensions: time, administrative geographic information, hospital level, and equipment types.@*Conclusions@#Medical radiation protection monitoring system helped achieve the design goal and successfully complete the data reporting in 2017. It provides data support for understanding the current situation of medical radiation protection and the protection management policymaking in China.
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Objective To develop occupational radiation disease and occupational health monitoring system for radiation workers in order to identify the current status of occupational health management of radiation workers in China. Methods In compliance with the relevant laws, regulations and standards in China, the system design was completed according to wide variety of needs. Results An occupational health monitoring system for radiation workers was initially established. The system consisted of four modules and three levels of users to make sure. Conclusions Through the collection of data, some key risk points existing in radiology diagnosis and treatment have been identified in relation to occupational radiation disease, so as to provide scientific basis for health administrative department to carry out decision-making and revision of laws and regulations.
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Objective To construct a national medical radiation protection monitoring information system (NMRPMIS) based on the national radiation health information platform, support the national medical radiation protection monitoring project data reporting, and comprehensively understand the current situation of medical radiation protection. Methods According to the national radiation protection monitoring plan, laws, regulations and standards, HTML, CSS and JavaScript were used in the front end, JAVA language was used in the back end, SQL server was used in the platform database and Tomcat was used as the middleware. A data reporting and analysis system was set in the system through B/ S structure, with statistical analysis of the 2017 annual monitoring data carried out. Results The business composition of the platform includes four levels: data acquisition ( through various business systems), data resource integration (integration of business system public data), application, and display. The national medical radiation protection monitoring system with flexible structure, centralized information and convenient operation was implemented. The national medical radiation protection information was reported in 2017. The basic situation of radiation protection in 33565 hospitals and the performance and protection information of 10624 pieces of radiation diagnosis and treatment equipment were reported in 2017. A total of 95 statistical information reports were completed, describing the current situation of medical radiation protection in China from four dimensions: time, administrative geographic information, hospital level, and equipment types. Conclusions Medical radiation protection monitoring system helped achieve the design goal and successfully complete the data reporting in 2017. It provides data support for understanding the current situation of medical radiation protection and the protection management policymaking in China.
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Increasing evidence suggests that vitamin D deficiency may play an important role in the pathogenesis of type 2 diabetes mellitus (T2DM).T2DM manifests as a result of insulin resistance,increased hepatic glucose production and β-cell failure.Vitamin D metabolites are thought to play an important role in increasing insulin sensitivity and facilitating insulin exocytosis which is mediated both by direct mechanism through the availability of vitamin D receptors in several tissues and indirect mechanism through the changes in calcium levels.Vitamin D has also been shown to decrease inflammatory cytokines which plays an important role in insulin resistance and β-cell apoptosis.Several studies have confirmed that vitamin D is closely related to the long-term complications of diabetes.Low levels of vitamin D can exacerbate diabetic peripheral neuropathy,nephropathy,and retinopathy.Although diabetic patients with vitamin D deficiency is widespread,the existence of vitamin D deficiency and diabetes complications is still controversial,this article will review the relationship between vitamin D and the microvascular complications of T2DM.
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In order to improve the clinical teaching quality of functional gastrointestinal diseases (FGIDs),the teachers tried to apply the Rome Ⅳ criteria in the clinical teaching of FGIDs,including ward rounds,case analysis,and clinical practice.This article firstly summarizes the necessity and importance of teaching based on the Rome Ⅳ criteria,then gives an interpretation of the Rome Ⅳ criteria,and finally establishes a problem-centered teaching mode in combination with discussion of typical FGID cases.The interpretation of the Rome Ⅳ criteria and clinical practice guided by experts help the students to understand the Rome Ⅳ criteria and use it to guide clinical practice and scientific research.This article also provides a theoretical basis for the application and promotion of the Rome Ⅳ criteria in the clinical teaching of gastroenterology.
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Diabetic microangiopathy is an vital reason of disabling and death in patients with diabetes.Long-term hyperglycemia and insulin resistance in type 2 diabetes mellitus can be involved in the formation of microangiopathy by aggravating mitochondrial damage,inflammation,and protein kinase C/glycosylation end product pathways.Besides,in recent years,several studies have shown that the activation of complement system plays an important role in the progression of diabetic vascular disease (including diabetic microvascular and macrovascular disease).This review is about to discuss the role and mechanism of the complement system in the development of diabetes and its microandioathy.