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@#BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) can temporarily control traumatic bleeding. However, its prolonged use potentially leads to ischemia-reperfusion injury (IRI). Partial REBOA (pREBOA) can alleviate ischemic burden; however, its security and effectiveness prior to operative hemorrhage control remains unknown. Hence, we aimed to estimate the efficacy of pREBOA in a swine model of liver injury using an experimental sliding-chamber ballistic gun. METHODS: Twenty Landrace pigs were randomized into control (no aortic occlusion) (n=5), intervention with complete REBOA (cREBOA) (n=5), continuous pREBOA (C-pREBOA) (n=5), and sequential pREBOA (S-pREBOA) (n=5) groups. In the cREBOA and C-pREBOA groups, the balloon was inflated for 60 min. The hemodynamic and laboratory values were compared at various observation time points. Tissue samples immediately after animal euthanasia from the myocardium, liver, kidneys, and duodenum were collected for histological assessment using hematoxylin and eosin staining. RESULTS: Compared with the control group, the survival rate of the REBOA groups was prominently improved (all P<0.05). The total volume of blood loss was markedly lower in the cREBOA group (493.14±127.31 mL) compared with other groups (P<0.01). The pH was significantly lower at 180 min in the cREBOA and S-pREBOA groups (P<0.05). At 120 min, the S-pREBOA group showed higher alanine aminotransferase (P<0.05) but lower blood urea nitrogen compared with the cREBOA group (P<0.05). CONCLUSION: In this trauma model with liver injury, a 60-minute pREBOA resulted in improved survival rate and was effective in maintaining reliable aortic pressure, despite persistent hemorrhage. Extended tolerance time for aortic occlusion in Zone I for non-compressible torso hemorrhage was feasible with both continuous partial and sequential partial measures, and the significant improvement in the severity of acidosis and distal organ injury was observed in the sequential pREBOA.
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Objective:To explore the application value of silent MR angiography (MRA) in imaging of brain arteriovenous malformation (BAVM) in children.Methods:A total of 20 children with BAVM confirmed by digital subtraction angiography (DSA) were retrospectively collected. All children were imaged by silent MRA and time-of-flight MRA (TOF MRA) in the same examination. The image quality of feeding artery, nidus and drainage vein of BAVM was evaluated using the four-point method. Wilcoxon rank-sum test was utilized to compare the image quality scores between silent MRA and TOF MRA. Weighted Kappa statistics used to evaluate the inter-modality agreement of silent MRA and TOF MRA with DSA in displaying of angioarchitecture characteristics and determination of Spetzler-Martin grading.Results:Among the 20 BAVMs, significant differences in image quality scores of the nidus (2.75±0.55 versus 2.20±0.70) and drainage vein (2.60±0.68 versus 2.20±0.77) were observed between silent MRA and TOF MRA ( Z=-3.05, P=0.002; Z=-2.13, P=0.033, respectively). The agreement between silent MRA and DSA was excellent in nidus size grading, deep venous drainage, associated aneurysm and SM grading (Kappa 0.91, 1.00, 0.83 and 0.93, respectively); The agreement between TOF MRA and DSA was fair to moderate (Kappa 0.46, 0.59, 0.35 and 0.47, respectively). Conclusions:Silent MRA showes better image quality compared to TOF MRA and improves the evaluation of angioarchitecture characteristics and Spetzler-Martin grading of BAVMs in children.
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Objective: To analyze the influential factors of loneliness in the elderly aged ≥60 years in China. Methods: Data used in this study were obtained from participants aged ≥60 years from the China Longitudinal Aging Social Survey, with a sample size of 7 593. Loneliness was measured with loneliness scale, and the influence of subjective and objective factors on loneliness and their interaction were analyzed with stepwise linear regression model and simple slope test. SPSS 25.0 was used for statistical analysis. PROCESS 3.3 macro program was used for simple slope test. Results: A total of 8 926 participants were included. Among the objective factors, the elderly with poor family network have a higher level of loneliness (P<0.05), and community provision of elderly care services could reduce the loneliness of the elderly (P<0.05). Elderly people with subjective aging age ≤60 years old and poor social adaptation and emotional perception have higher levels of loneliness (all P<0.05). Subjective aging age plays a negative regulatory role in the impact of community elderly care services on loneliness (P<0.05), Social adaptation and emotional perception play a negative regulatory role in the impact of family network on loneliness (P<0.05). Conclusions: Elderly people aged ≥60 years of feeling of loneliness was affected by both subjective and objective factors and subjective factors play an important regulatory role in the influence of objective factors on elderly people's feeling of loneliness in China. Therefore, while creating a good aging environment to provide strong external support for the elderly, the subjective initiative of the elderly should also be fully mobilized, to alleviate the loneliness of the elderly from these two aspects.
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Objective To understand the current situation and explore the influencing factors of delay in seeking medical treatment for common symptoms of residents in the rural areas of Sichuan province. Methods In July 2019,multi-stage random sampling was carried out in Zigong city,Sichuan province,and the data were collected by face-to-face questionnaire interview.The residents who had lived at hometown for more than half a year in the past year and had seen a doctor in the most recent month were surveyed.Logistic regression was adopted to predict the influencing factors of delay in seeking medical treatment. Results A total of 342 subjects were enrolled,and the incidence of delay in seeking medical treatment was 13.45%(46/342).Compared with the young and middle-aged(<65 years)people,the elderly(≥65 years)people were more likely to have delay in seeking medical treatment (OR=2.187,95%CI=1.074-4.457,P=0.031).The rural residents who gave higher score of the overall quality of township health centers were less likely to have delay in seeking medical treatment (OR=0.854,95%CI=0.735-0.992,P=0.039). Conclusions The occurrence of delay in seeking medical treatment for common symptoms of rural residents in Sichuan province is low.Age and the overall quality evaluation of township health centers affect the occurrence of delay in medical treatment among the rural residents in Sichuan province.Efforts should be made to improve the awareness of disease prevention among the elderly in rural areas.The investment in health resources in township health centers should be increased to strengthen the introduction and training of talents.These measures can improve the health services in township health centers,guide residents to make timely use of health resources,and reduce the occurrence of delay in seeking medical treatment.
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Middle Aged , Aged , Humans , Surveys and Questionnaires , Logistic Models , Rural Population , China/epidemiologyABSTRACT
@#Abstract: Objective China was certified by World Health Organization as a malaria-free country in 2021. Malaria has become a rare infectious disease, and preventing the re-transmission of imported malaria and reducing deaths are the main challenges facing China after elimination of malaria. To analyze and clarify the characteristics of imported malaria deaths, and to provide prevention and treatment recommendations for overseas workers and health care workers. Methods The data of 17 imported malaria deaths in the analysis of malaria deaths from 2016 to 2020 by the National Severe Malaria Treatment Expert Group were collected, and the relevant clinical epidemiological data and disease course records were analyzed. Results The 17 malaria deaths were all imported from Africa with Plasmodium falciparum infection (malarial cerebral type), with no obvious regularity in the month of onset. Among them, 16 were male patients, 5 cases with underlying diseases such as diabetes mellitus, and 10 patients were first diagnosed in a second-level or lower hospital. Excluding patients who died of respiratory cardiac arrest in ambulances, the mean time difference between first onset and malaria diagnosis in 16 patients was 6.8 days (median 5.5 days), and the mean time between first onset and antimalarial treatment was 7.4 days (median 6 days), the mean time difference from initial onset to death was 10.3 days (median 8.5 days). Excluding cases with onset abroad and unknown time of return, all 14 patients developed the disease within 30 days after returning to China. Conclusion All the fatal cases were infected with Plasmodium falciparum imported from Africa. The patients' awareness of actively seeking medical treatment is weak, and the delay in seeking medical treatment caused by the insufficient diagnosis and treatment capacity of health institutions at the township level and below is the main reason for the deaths. It is recommended to strengthen the self-protection awareness of staff in malaria-endemic areas overseas and raise their awareness of malaria. For returnees from areas with high malaria risk, primary medical institutions should pay attention to the patient's travel history in Africa, improve the awareness of malaria diagnosis, malaria diagnosis and treatment capabilities.
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Objective:To establish a stable fragment-induced penetrating liver injury model in landrace pigs and evaluate the characteristics of deep tissue injury.Methods:According to the different positioning methods of aiming points, twelve healthy adult landrace pigs were divided into group A (the relative height "h" of the aiming point and the highest point of the body surface on the tracing line was set to 5 cm) and group B ("h" was set to 6 cm). Ultrasonography was used to determine the direction of fragment projection, and an experimental ballistic gun was used to project high-velocity fragments to cause injury to animals. The vital signs of the two groups were monitored, and whole blood cell count, blood gas analysis, and liver and renal function were tested. Damages to the liver and adjacent organs, as well as the amount of bleeding and survival time were analyzed.Results:For the overall analysis of the two groups, the liver hit rate of fragment simulating projectiles was 100% (right anterior lobe and right lateral lobe injury), the hit rate of other organs in the abdominal cavity was 25% (3/12), and the incidence of hemothorax or pneumothorax was 8% (1/12). The wounds were mainly characterized by liver lacerations, with total or partial disconnection of the distal liver lobe. There was no significant difference in wound length and bleeding amount between groups A and B [wound length (cm): 9.8±1.7 vs. 11.2±3.8, bleeding amount (g): 597.0±477.1 vs. 1 032.0±390.3, both P > 0.05]. The depth of liver parenchymal laceration in group B with the aiming point closer to the anterior median line was significantly longer than that in group A (cm: 2.8±0.4 vs. 1.9±0.6, P = 0.015). Mean arterial pressure (MAP), pH value, residual arterial blood base (BE), hemoglobin (Hb) and hematocrit (HCT) levels decreased after the fragment-induced injury, and then reached a trough level [MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 87.0±33.6, pH: 7.26±0.15, BE (mmol/L): -6.65±8.48, Hb (g/L): 9.86±1.10, HCT: 0.309±0.029, all P < 0.05] in the first hour. Blood lactate (Lac), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) levels increased over time, and reached a peak level [Lac (mmol/L): 10.21±4.40, LDH (U/L): 1 417.0±223.3, AST (U/L): 234.5 (162.5, 357.5), both P < 0.05] at 1 hour after injury. Pearson's correlation analysis showed that the total amount of bleeding was correlated with the depth of liver parenchyma laceration ( r = 0.684, P = 0.014). The Kaplan-Meier survival curve showed that the 3 hours survival rate in group A was higher than that in group B, but the difference was not statistically significant [83.3% (5/6) vs. 33.3% (2/6), P > 0.05]. Conclusions:The high-velocity fragment-induced penetrating liver injury model established by striking landrace pigs closer to the anterior median line with fragment simulating projectiles is reproducible and the degree of damage is controllable, and the model is applicable to further relevant research of hepatic ballistic trauma.
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Objective: To explore the impact of activities of daily living (ADL) on depression in the elderly and the role of social networks and children's support. Methods: Data used in this study were obtained as participants aged 60 and above from the "China Longitudinal Aging Social Survey 2018",with a sample size of 10 215. ADL, social network and depression were measured on scales. The moderated mediation model was used to analyze the role of social networks and children's support. The SPSS 25.0 software was used for statistical analysis, the PROCESS 3.3 macro program was used to test the moderated mediation effect. Results: A total of 10 760 participants aged 60 and above were included. Activities of daily living showed a direct impact on depression in the elderly (β=-0.090, P<0.01), with social network playing a mediating role (β=0.035, P<0.01; β=-0.064, P<0.05) and children's support played a moderating role (β=-0.029, P<0.05) in the relationship between the elderly's ADL and depression. Conclusions: The social network is an essential buffer to declining ADL's negative impact on depression of older adults. Children's support is a powerful supplement to enhance social networks' positive role and reduce the risk of elderly depression. Exerting the combined advantages of social networks and children's support are important ways to maintain the elderly's mental health.
Subject(s)
Aged , Child , Humans , Middle Aged , Activities of Daily Living , Aging/psychology , China/epidemiology , Social Networking , Social SupportABSTRACT
Objective We used standardized patients to evaluate the accuracy and explore the influencing factors of the diagnosis of unstable angina pectoris and type 2 diabetes by primary healthcare providers in Sichuan rural areas,aiming to provide a scientific basis for improving the diagnosis accuracy of primary healthcare providers for the two chronic diseases. Methods A multi-stage stratified random cluster sampling method was adopted to select 100 villages from 50 townships in 5 districts/counties in Zigong city,Sichuan province. General and internal medicine practioners who were on duty on the survey day were enrolled in the survey.Two rounds of data collection were conducted.In the first round,the basic information of providers from township health centers and village clinics was collected.One month after the the first survey,standardized patients were used to collect the information related to the diagnosis of unstable angina pectoris and type 2 diabetes by rural primary providers.Logistic regression was carried out to analyze the factors influencing the diagnosis accuracy. Results A total of 172 rural primary healthcare providers were enrolled in the survey,who completed 186 standardized patient visits and showed the correct diagnosis rate of 48.39%.Specifically,the correct diagnosis rates of unstable angina pectoris and type 2 diabetes were 18.68%(17/91) and 76.84%(73/95),respectively.The providers with medical practitioner qualifications were more likely to make correct diagnosis(OR=4.857,95%CI=1.076-21.933, P=0.040).The providers who involved more necessary consultation and examination items in the diagnosis process had higher probability of correct diagnosis(OR=1.627,95%CI=1.065-2.485, P=0.024).Additionally,the providers were more likely to make a correct diagnosis for type 2 diabetes than for unstable angina pectoris(OR=6.306,95%CI=3.611-11.013, P<0.001). Conclusions The overall diagnosis accuracy of unstable angina pectoris and type 2 diabetes was relatively low among primary healthcare providers in Sichuan rural areas.The training of diagnosis process can be taken as a key for improving providers' practice ability so as to increase the diagnosis accuracy of chronic diseases.
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Humans , Angina, Unstable , China , Chronic Disease , Diabetes Mellitus, Type 2/diagnosis , Health Personnel , Primary Health Care , Surveys and QuestionnairesABSTRACT
Background/Aims@#Growth hormone (GH) is the main regulator of somatic growth, metabolism, and gender dimorphism in the liver. GH receptor (GHR) signaling in cancer is derived from a large body of evidence, although the GHR signaling pathway involved in the prognosis of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related HCC, remains unclear. We aimed to explore the expression of GHR and analyze its association with clinicopathologic features and prognosis of patients with chronic hepatitis C and HCC. @*Methods@#The expression of GHR mRNA was investigated by quantitative real-time polymerase chain reaction in paired tumors and adjacent non-tumorous (ANT) liver tissues of 200 patients with chronic hepatitis C and HCC. Western blotting and immunofluorescence assays using the HCV-infected Huh7.5.1 cell model was performed. @*Results@#GHR mRNA was significantly lower in HCV-HCC tissues than in corresponding ANT liver tissues. GHR mRNA and protein levels also decreased in the HCV-infected Huh7.5.1 cell model. Notably, lower GHR expression was associated with age of >60 years (P=0.0111) and worse clinicopathologic characteristics, including alpha-fetoprotein >100 ng/mL (P=0.0403), cirrhosis (P=0.0075), vascular invasion (P=0.0052), pathological stage II–IV (P=0.0002), and albumin ≤4.0 g/dL (P=0.0055), which were linked with poor prognosis of HCC. Most importantly, the high incidence of recurrence and poor survival rates in patients with a low ratio of tumor/ANT GHR (≤0.1) were observed, indicating that low expression levels of GHR had great risk for development of HCC in patients with chronic hepatitis C. @*Conclusions@#Our study demonstrates a significant down-regulation of GHR expression as a new unfavorable independent prognostic factor in patients with chronic hepatitis C and HCC.
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Background/Aims@#Growth hormone (GH) is the main regulator of somatic growth, metabolism, and gender dimorphism in the liver. GH receptor (GHR) signaling in cancer is derived from a large body of evidence, although the GHR signaling pathway involved in the prognosis of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related HCC, remains unclear. We aimed to explore the expression of GHR and analyze its association with clinicopathologic features and prognosis of patients with chronic hepatitis C and HCC. @*Methods@#The expression of GHR mRNA was investigated by quantitative real-time polymerase chain reaction in paired tumors and adjacent non-tumorous (ANT) liver tissues of 200 patients with chronic hepatitis C and HCC. Western blotting and immunofluorescence assays using the HCV-infected Huh7.5.1 cell model was performed. @*Results@#GHR mRNA was significantly lower in HCV-HCC tissues than in corresponding ANT liver tissues. GHR mRNA and protein levels also decreased in the HCV-infected Huh7.5.1 cell model. Notably, lower GHR expression was associated with age of >60 years (P=0.0111) and worse clinicopathologic characteristics, including alpha-fetoprotein >100 ng/mL (P=0.0403), cirrhosis (P=0.0075), vascular invasion (P=0.0052), pathological stage II–IV (P=0.0002), and albumin ≤4.0 g/dL (P=0.0055), which were linked with poor prognosis of HCC. Most importantly, the high incidence of recurrence and poor survival rates in patients with a low ratio of tumor/ANT GHR (≤0.1) were observed, indicating that low expression levels of GHR had great risk for development of HCC in patients with chronic hepatitis C. @*Conclusions@#Our study demonstrates a significant down-regulation of GHR expression as a new unfavorable independent prognostic factor in patients with chronic hepatitis C and HCC.
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In order to systematically evaluate the safety of Sanfu acupoint herbal patching, CNKI, SinoMed, VIP, Wanfang, PubMed, Medline, EMbase, and Cochrane Library were searched in accordance with PICOS principles, with a time limit from database establishment to December 2019. Meta-analysis was used for a single-group rate analysis and a weighted combination of these two groups on rates of adverse reactions. A total of 9 articles meeting the inclusion criteria were included in the analysis, involving 2 119 patients. The single-group rate Meta-analysis showed that the adverse reactions incidence was 9% in the treatment group(OR=0.10,95%CI[0.06, 0.19], P<0.000 01), and 9% in the control group(OR=0.10, 95%CI[0.07, 0.13], P<0.000 01). In combined statistics of all samples OR=1.81, 95%CI[1.04, 3.15], P=0.04, the incidence of adverse reactions in the treatment group was slightly higher than that of the control group. In the subgroup analysis, the incidence of adverse reactions in terms of both single-group rate and weighed rate in the treatment group was higher than that in the control group in the asthma subgroup, rhinitis subgroup, ≥18 years old subgroup, and application time 2 h subgroup, with statistically significant differences(P<0.05). The results of the Meta-analysis and systematic review suggested that the incidence of adverse reactions in clinical use of the Sanfu acupoints herbal patching was relatively low. The main types of adverse reactions were skin ulcers, blisters and other skin symptoms. The symptoms were relatively mild, which could be relieved by drug withdrawal or symptomatic treatment. It shows that the safety of the Sanfu acupoint herbal patching was relatively high, and the occurrence of adverse reactions was related to the original disease and age, mainly in asthma and rhinitis or patients over 40 years old. Affected by clinical heterogeneity, the conclusions of the application time subgroup need to be further improved.
Subject(s)
Adolescent , Adult , Humans , Acupuncture Points , Asthma , Databases, Factual , Drugs, Chinese Herbal/adverse effects , Incidence , Randomized Controlled Trials as TopicABSTRACT
The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in commemoration of the International Day of Radiology in 2020, as well as the 200th anniversary of the Singapore General Hospital in 2021. This pictorial essay comprises gastroenterology, musculoskeletal and obstetrics and gynaecology cases from the archives.
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Antiviral Oral Liquid is modified on the basis of Baihu Decoction in Treatise on Febrility Diseases by ZHANG Zhongjing and Qingwen Baidu Yin in Qing Dynasty, with effects in clearing toxic heat, repelling dampness and cooling blood. It is widely used in clinical treatment of common colds, influenza and upper respiratory tract infection, mumps, viral conjunctivitis and hand-foot-mouth disease, with a good clinical efficacy and safety. Based on a questionnaire survey of clinicians and a systematic review of study literatures on Antiviral Oral Liquid, the international clinical practice guidelines development method was adopted to analyze the optimal available evidences and expert experiences in the "evidence-based, consensus-based and experience-based" principles. The consensus was jointly reached by more than 30 multidisciplinary experts nationwide, including clinical experts of traditional Chinese and Western medicine in the field of respiratory diseases and infectious diseases, and methodological experts. In the study, literatures were retrieved based on clinical problems in the clinical survey as well as PICO clinical problems. The GRADE system was used for the classification and evaluation of evidence, and fully combined with clinical expert experience, so as to reach expert consensus by the nominal grouping method. This expert consensus recommended or suggested indications, usage and dosage, course of treatment, intervention time for treatment, and the safety and precautions of Antiviral Oral Liquid for treatment of influenza, and can provide reference for the rational use of this drug in clinical practice.
Subject(s)
Humans , Antiviral Agents/therapeutic use , Consensus , Hand, Foot and Mouth Disease , Influenza, Human/drug therapy , Medicine, Chinese TraditionalABSTRACT
@#A 40-year-old man presented to the Hospital Sultanah Bahiyah, Alor Setar, Kedah, with constitutional and respiratory symptoms. Physical examination and echocardiogram demonstrated massive pericardial effusion. Patient required multiple attempts of pericardiocentesis due to recurrent pericardial effusion. Initial workup including pericardial fluids examination and computed tomography imaging did not reveal any apparent cause. Magnetic resonance imaging showed a suspicious mass infiltrating into the right atrium. Autoimmune screening was negative. Patient was subsequently treated as having tuberculous pericarditis. However, his disease progressed rapidly and he eventually passed away due to right atrial rupture. Postmortem revealed a ruptured right atrial tumour leading to massive haemothorax. Histopathological examination confirmed the diagnosis of primary pericardial angiosarcoma.
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The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in 2020 in commemoration of the 20th anniversary of the formation of SingHealth, the 55th National Day of Singapore, and the 125th anniversary of the International Day of Radiology. This pictorial essay comprises cardiovascular, respiratory and neurological cases from the archives.
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OBJECTIVE@#To detect the levels of Treg, Th17, Th9 cells and expression of transforming growth factor-β (TGF-β), interleukin-17 (IL-17) and interleukin-9 (IL-9) in peripheral blood of patients with immune thrombocytopenia (ITP) and to explore its role in the pathogenesis of ITP.@*METHODS@#Fifty-four patients with ITP (ITP group) and 40 healthy volunteers (control group) were selected in our hospital. The of Treg, Th17 and Th9 cells in peripheral blood of 2 groups were measured by flow cytometry, and the expression of cytokines, such as TGF-β, IL-17 and IL-9 in the peripheral blood of 2 groups were detected by enzyme linked immunosorbent assay (ELISA).@*RESULTS@#The level of Treg cells in the peripheral blood of the ITP group was significantly decreased in comparison with the control group, while the levels of Th17 and Th9 cells significantly increased in comparison with the control group (all P<0.01). The expression of cytokine such as TGF-β in the peripheral blood of the case group significantly decreased in comparison with the control group, while the expression levels of IL-17 and IL-9 significantly increased in comparison with the control group (P<0.01). The results of Pearson correlation analysis showed that there was a positive correlation between the level of Treg cells and platelet count (PLT) in peripheral blood of the ITP group (r=0.35, P<0.05), and there were negative correlation between the level rate of Th17, Th9 cells and Plt count (r=-0.37, -0.43, P<0.05); there was a positive correlation between the expression of the TGF-β in the ITP group and Plt count (r=0.46, P<0.05), while the expression of IL-17 and IL-9 showed negative correlation with PLT (r=-0.48, -0.54, P<0.05).@*CONCLUSION@#The percentage of Treg, Th17 and Th9 cells in the peripheral blood of patients with ITP is abnormal, and the expression of TGF-β, IL-17 and IL-9 also is abnormal, which may play an important role in the pathogenesis of ITP.
Subject(s)
Humans , Flow Cytometry , Interleukin-17 , Interleukin-9 , Purpura, Thrombocytopenic, Idiopathic , T-Lymphocytes, Helper-Inducer , T-Lymphocytes, Regulatory , Transforming Growth Factor betaABSTRACT
OBJECTIVE: By analyzing the cases of accidental injuries among critically ill children in our hospital in recent years,we put forward feasible preventive measures to effectively reduce the occurrence of accidental injuries. METHODS: A retrospective analysis was performed on the clinical data of children who were admitted to the PICU in our hospital from May1,2015 to April 30,2018;the types of children with accidental injuries were analyzed,and the male-to-female ratio of the results was analyzed. Seasonal characteristics,age,and the proportion of deaths were analyzed. RESULTS: It was found that the top three causes of accidents in critically ill children were falling injuries(246,39.87%),traffic accidents(156,25.28%),and poisoning(57,9.23%). The incidence of accidental injuries for boys was significantly greater than that for girls;there were 375 boys and 242 girls,the ratio being 1.55∶1;severe accident injuries peaked in early childhood(1～4 years old);there was no significant difference between urban and rural areas. CONCLUSION: The accidental injuries in critically ill children have undergone tremendous changes. We should adopt preventive measures to reduce accidental injuries.
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To investigate the clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for sepsis, in order to promote the follow-up revision and further promotion of the Guidelines. Copies of 500 application evaluation questionnaire and 500 copies of applicability evaluation questionnaire were given to the clinicians who had used this Guideline in China, both in a form of registered questionnaire, and a database was established by Excel 2016 for descriptive statistical analysis. Copies of 211 application evaluation questionnaire and 211 copies of applicability evaluation questionnaire were collected. We can conclude from the survey that we should adjust the whole content and structure on the basis of better evaluation of the present recommendation scheme, update the prescription selection and clinical evidence of the recommendation scheme, and put forward the improvement measures for the hindrance factors in the application of the Guideline. Furthermore, in order to promote the Guideline more clearly, we should strengthen the doctor-patient education, improve guidance quality and increase the publicity, providing basis for the implementation and promotion strategies of the Guideline.
Subject(s)
Humans , Anti-Bacterial Agents , Therapeutic Uses , China , Medicine, Chinese Traditional , Sepsis , Drug Therapy , Surveys and QuestionnairesABSTRACT
Clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for sepsis is strictly in accordance with the latest diagnostic criteria for sepsis (sepsis-3) for the treatment of septic patients at different stages through syndrome differentiation. At present, the abuse of antibiotics and the prevalence of drug-resistant bacteria are very serious, without effective solutions. Thus, this is the first time to focus on traditional Chinese medicine combined with antibiotics to treat sepsis, in order to minimize the incidence of drug-resistant bacteria. This Guideline tends to systematically analyze the sepsis period, septic shock period as well as different clinical symptoms and traditional Chinese medicine measures for organ dysfunction in the sepsis process. By analyzing and interpreting the Guideline systematically, the clinicians could understand its purpose, significance and core ideas more thoroughly, and grasp the recommended specific interventions as well as their advantages and disadvantages, hoping to better implement the Guideline, provide guidance to clinicians and standardize the treatment of sepsis by traditional Chinese medicine.
Subject(s)
Humans , Anti-Bacterial Agents , Therapeutic Uses , Medicine, Chinese Traditional , Sepsis , Drug TherapyABSTRACT
The review aims to assess the effectiveness and safety of Zhengqing Fengtongning release tablets in treating ankylosing spondylitis (AS) systematically through searching relevant electronic databases and collecting relevant literature. Such Chinese databases as CNKI, VIP, Wanfang, and English databases as PubMed, EMbase and Cochrane Library, etc, were searched from the date of their establishment to September 2017. According to the inclusion and exclusion criteria, the methodology quality of included studies was evaluated by two independent reviewer using Cochrance evaluation system, and Meta-analysis on the clinical efficacy and safety of Zhengqing Fengtongning release tablets for AS was conducted with RevMan 5.3 software. Seven randomized control trials (RCTs) including 570 patients of AS were included, with 294 patients in Zhengqing Fengtongning treatment group and 276 patients in the western medicine control group. Meta-analysis showed that: Zhengqing Fengtongning alone treatment was superior to sulfasalazine groups in the effect on improving the total effective rate. Besides, as compared to sulfasalazine control group, the time of morning stiffness and the finger-to-floor distance were significantly shortened in Zhengqing Fengtongning treatment group. However, the cciput-to-wall distance， the chest expansion, Schober's test, disease activity score (DAS) in patients, disease activity score (DAS) in doctors, ESR, CRP showed no statistically significant differences. As compared with western medicine control group, Zhengqing Fengtongning combined with western medicine had a higher total effective, significantly shorten the time of morning stiffness, and increase Schober's test values; However, the cciput-to-wall distance, the finger-to-floor distance, the chest expansion, DAS in patients, DAS in doctors, ESR and CRP showed no statistically significant differences. Zhengqing Fengtongning had less adverse reactions in clinical application, and the main adverse reaction was skin rash or itching when used alone. The study showed: Zhengqing Fengtongning is effective for AS with high safety, but high quality clinical trials are still needed to further prove its clinical efficacy and safety.