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Objective:To investigate the effects of educational level on smoking cessation in patients with moderate to severe tobacco dependence, explore effective individualized smoking cessation methods, and increase smoking cessation rate.Methods:A total of 480 patients with moderate to severe tobacco dependence who were willing to quit smoking and received treatment in the Department of Respiratory and Critical Care Medicine, Shengli Oilfield Central Hospital from January to December 2020 were included in this study. They were divided into four groups ( n = 120/group) according to their educational level: group A (elementary school and below), group B (junior high school and senior high school), group C (technical secondary school or college), and group D (university and above). All patients were randomly assigned to undergo "5A" intervention alone or "5A" intervention combined with varenicline intervention (combined intervention). Patients' awareness of the health risks of tobacco smoking was compared among the four groups. The smoking cessation rate measured at different time points was compared between different intervention strategies. Results:The scores of health risk of tobacco smoking in groups D, C, B, and A were (806.5 ± 35.7) points, (710.8 ± 26.2) points, (643.6 ± 43.4) points, and (512.4 ± 30.1) points, respectively. Patients with high education levels had high awareness of the health risk of tobacco smoking ( F = 1 543.26, P < 0.001). At 1, 3, and 6 months, the smoking cessation rate of combined intervention was higher than that of "5A" intervention alone in each group (group A: χ2 = 3.85, 4.23, 4.10, group B: χ2 = 4.30, 4.09, 4.60, group C: χ2 = 6.81, 4.30, 4.03, group D: χ2 = 6.71, 6.51, 4.73, all P < 0.05). The smoking cessation rate after 6 months of "5A" intervention alone or combined intervention in group D was 60.0% and 78.3% respectively, which were significantly higher than 41.7% and 60.0% in group C, 23.3% and 41.7% in group B, and 20.0% and 36.7% in group A ( χ2 = 26.59, 26.12, both P < 0.001). At different time points, the smoking cessation rates of the "5A" intervention alone in group D were significantly higher than those of combined intervention in groups A and B ( χ2 = 9.25, 25.04, 7.29, all P < 0.05). Conclusion:Awareness of the health risks of tobacco smoking is related to a patient's educational level, and affects smoking cessation. Individualized smoking cessation interventions based on a patient's educational level can increase the rate of smoking cessation.
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【Objective】 To analyze the application effect of intelligent information system of transfusion reactions(referred to as the system) in the supervision and management of transfusion reactions. 【Methods】 A retrospective analysis was conducted on the clinical data of a total of 67 914 blood transfusion patients in our hospital from January 2018 to August 2023. The patients were divided into the control group (n =36 367, with conventional transfusion management) and the observation group (n =31 547, with management by the system).The incidence of adverse reactions, the supervision and management scores, reporting time and processing time of adverse reactions, and patient satisfaction with blood transfusion in the two groups was observed. 【Results】 The incidence of transfusion reactions in the observation group and the control group was 0.23% (72/31 547) and 0.24% (86/36 367), with no statistically significant difference (P>0.05). The quality scores of the reporting, registration, processing and supervision, and the total scores of the observation group were higher than those of the control group:(21.46±2.76) vs (17.38±2.74) points, (21.65±2.80) vs (16.98±3.20) points, (22.30±2.42) vs (18.80±3.15) points, (22.85±2.10) vs (18.55 ± 3.06) points, and (90.38±5.96) vs (75.26 ± 6.10) points, with statistically significant difference(P<0.05). The reporting time and processing time of transfusion reactions in the observation group were shorter than those in the control group: (3.26±0.45) vs (7.25±1.26) minutes, (10.38±2.96) vs (20.26±2.10) minutes, with statistically significant differences (P<0.05). The satisfaction rate with blood transfusion of the observation group was 99.95% (31 532/31 547), higher than 99.62% (36 229/36 367) of the control group, with significant difference (P<0.05). 【Conclusion】 The application of the system in the supervision and management of transfusion reactions has achieved ideal results, including improving the quality of monitoring and management, shortening the reporting and processing time of transfusion reactions, and improving patient satisfaction with transfusion, which is worth popularizing.
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Objective:To investigate the changes in gray matter volume (GMV) and abnormalities in structural covariant network (SCN) patterns in patients with chronic pontine infarction (PI).Methods:Patients with unilateral chronic PI (case group) with the first onset admitted to the First Affiliated Hospital of Zhengzhou University and Tianjin Medical University General Hospital from October 2014 to June 2021 were prospectively included. At the same time, healthy subjects matched with age, gender and education years (normal control group) were included. High-resolution three-dimensional T 1 structural MRI images and behavioral scores of the subjects were collected. The voxel-based morphometry and two-sample t test were used to explore the differences in GMV between the groups. Using GMV differential brain regions as seed points, SCN was constructed to explore the abnormality of structural covariant patterns in patients with PI. Spearman rank correlation analysis was used to analyze the correlation between GMV in differential brain regions and behavioral scores. Results:A total of 60 patients with PI were enrolled, including 33 left PI and 27 right PI, while 34 healthy controls were also enrolled. Compared with the normal control group, the GMV in bilateral posterior cerebellar lobe decreased significantly in the left PI group, and the GMV in left anterior and posterior cerebellar lobes and the right posterior cerebellar lobe decreased significantly in the right PI group (Gaussian random field correction with voxel level P<0.001 and cluster level P<0.05, cluster voxel >20), and there was a significant correlation between GMV values in the left anterior and posterior cerebellar lobes and the right posterior cerebellar lobe and the motor function score ( P<0.05). In addition, compared with the normal control group, the right PI group had broader covariate brain regions and a significant increase in the number of structural connections between covariate brain regions (family-wise error correction with voxel level P<0.05, cluster voxel >20). Conclusions:The GMV in bilateral posterior cerebellar lobe decreases significantly in patients with chronic PI, and were secondary to broader covariate brain regions and structural connections. This may be the neural mechanism of impaired behavioral function in patients with PI.
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OBJECTIVE@#To explore the genetic basis, clinical phenotype and pathogenesis for a child with mosaicism ring chromosome 4.@*METHODS@#Clinical data of the child was collected. Peripheral blood chromosomal karyotype G banding analysis, chromosomal microarray analysis (CMA), fluorescence in situ hybridization (FISH) were carried out for the child, in addition with a review of the literature.@*RESULTS@#The child was born full-term with low birth weight, facial dysmorphism, patent ductus arteriosus and ventricular septal defect. His karyotype was determined as mos46,XY,r(4)(p16.3q35.2)[259]/45,XY,-4[25]/47,XY,r(4)(p16.3q35.2), +r(4)(p16.3q35.2)[8]/46,XY,der(4)del(4)(p16.3)inv(4)(p16.3q31.1)[6]/46,XY,dic?r(4;4)(p16.3q35.2;p16.3q35.2)[4]/48,XY,r(4)(p16.3q35.2),+r(4)(p16.3q35.2)×2[3]/46,XY,r(4)(p1?q2?)[2]; CMA result was arr[GRCH37]4p16.3(68 345-2 981 614)×1; FISH result was 45,XY,-4[12]/45,XY,-4×2,+mar1.ish r1(4)(WHS-,D4Z1+)[1]/ 46,XY,-4,+mar1.ishr1(4)(WHS-,D4Z1+)[73]/46,XY,-4,+mar2.ishr2(4)(WHS-,D4Z1++)[1]/47,XY,-4,+mar1×2.ishr1(4) (WHS-, D4Z1+)×2[4]/46,XY,del(4)(p16.3).ish del(4)(p16.3)(WHS-,D4Z1+)[9].@*CONCLUSION@#In this case, the ring chromosome 4 as a de novo variant has produced a number of cell lines during embryonic development and given rise to mosaicism. The clinical phenotype of ring chromosome 4 is variable. The instability of the ring chromosome itself, presence of mosaicism, chromosome breakpoint and range of deletion and/or duplication may all affect the ultimate phenotype.
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Humans , Pregnancy , Female , Ring Chromosomes , In Situ Hybridization, Fluorescence , Karyotyping , Karyotype , MosaicismABSTRACT
【Objective】 To investigate HIV-1 subtype distribution and trend among Dalian blood donors between 2011 and 2020, in order to provide information to improve blood safety and HIV prevention. 【Methods】 HIV RNA was purified from plasma samples of Dalian blood donors with confirmed HIV infection, which were collected between 2011 and 2020. The HIV pol gene was amplified and sequenced. HIV-1 subtypes were determined by phylogenetic analysis. 【Results】 HIV RNA was successfully genotyped in 174 samples from HIV-infected donors. The main subtypes among Dalian blood donors were CRF01_AE(69.5%), CRF07_BC(17.2%), B(5.2%), CRF02_AG(2.9%), C(1.1%), CRF55_01B(1.1%), CRF08_BC(0.6%), CRF59_01B(0.6%) and CRF79_0107(0.6%). There were still 2 cases (1.1%) unclassified. Significant difference was observed when comparing with the published national data. The prevalence of CRF01_AE strains decreased over the years, while CRF07_BC increased significantly. CRF02_AG carriers differed from donors infected with other HIV subtypes by being mostly females (40.0% vs. 2.4%), aged (median: 35y vs. 26y) and lower educational background(junior school degree or below). And 96.7% of local CRF01_AE cases were related to HIV strains, which were reported to circulate in Northeast China and in the MSM population. 【Conclusion】 HIV-1 among Dalian blood donors had unique molecular epidemiology and the trends of 07_BC increasing and 01_AE decreasing lagged behind the overall national data. Donor education on blood safety and consultation services to high risk group before donation still need improvement.
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A 3-week practice-oriented training course on chronic obstructive pulmonary disease (COPD) management was conducted in December 2020, 34 primary care physicians from township or community health service centers attended the course. The impact of the training course on the knowledge levels of COPD management was evaluated with a questionnaire survey, the questionnaire contained the knowledge of COPD and its management. The survey showed that before the training, the participants had low knowledge levels on the definition of COPD and its risk factors; 67.6% (23/34) were not aware of COPD-related guidelines and new developments, and 17.6%(6/34) had conducted COPD follow-up assessments, pulmonary rehabilitation, and health education; only 8.8% (3/34) had used the improved British Medical Research Council Dyspnea Index (mMRC) and the chronic obstructive pulmonary disease assessment test (CAT) for patient self-assessment; there was no pulmonary function instrument in their units, and only 3 doctors (8.8%) had previously participated in pulmonary function training and knew indications and contraindications of the pulmonary function test, and complete report interpretation; all participants were unable to use common inhalation devices and master inhalation techniques completely and correctly; 11.8% (4/34) had assessed patients′ handling inhalation devices and performing inhalation. After the training, the knowledge levels of COPD clinical features, lung function and inhalation technique were significantly improved, and the scores were significantly increased compared with those before the training ( P<0.001). The study shows that primary care physicians have insufficient knowledge and management skill of COPD. The practice-oriented training can significantly improve the knowledge and skills of primary care physician for COPD management in the community.
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Objective:To explore a new technique for lung dose reduction in esophageal cancer radiotherapy based on the dose distribution characteristics of the half-field combined with intensity-modulated radiotherapy (IMRT) technique.Methods:A three-dimensional water tank was used to measure the dose distribution at the edge of the symmetrical field and half-field, which was then compared and analyzed. Twenty patients with the middle and lower thoracic esophageal cancer receiving radiotherapy with prescription doses of 50.4-60.0 Gy were selected. Based on the Varian Vital beam linear accelerator and Eclipse planning system, flattening filter (FF) technique symmetrical field and half-field beam design and the flattening filter-free (FFF) technique symmetrical field and half-field design were adopted to compare and analyze various dose data and treatment MU numbers for the target area and the endangered organs. The field settings were chosen in the front 1 and back 4 mode.Results:Compared with the symmetrical field plan, the half-field plan significantly improved the irradiated dose to the lung with a statistically significant difference ( P<0.05), and the half-field FFF was slightly better than the half-field FF mode. Compared with the total lung V 5Gy, V 20Gy, V 30Gy, and D mean dosimetric parameters (Gy), the FF symmetric field and FFF half-field were (49.64±5.39)% vs.(42.70±5.53)%, (15.99±3.93)% vs.(13.32±3.06)%, (9.24±2.77)% vs.(8.50±2.62)%, and (10.45±1.76)% vs.(9.50±1.53)%, respectively. There was a significant reduction in the volume dose values for all structures of the lung (all P<0.05). For other comparative data, the irradiated dose for the heart of the symmetrical field was better than that of the half-field mode ( P<0.05), and the differences in conformity index (CI) and homogeneity index (HI), number of treated MU, and spinal cord associated with the target area were not statistically significant (all P>0.05). Conclusions:During radiotherapy for esophageal cancer, target area coverage and dose volume data of the lung are the main parameters affecting the efficacy and side effects. IMRT treatment based on the half-field mode can give full play to the advantages of half-field and IMRT, and significantly improve the irradiated dose to the lung, which can offer an additional clinical option.
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Interference with quorum sensing(QS)represents an antivirulence strategy with a significant promise for the treatment of bacterial infections and a new approach to restoring antibiotic tolerance.Over the past two decades,a novel series of studies have reported that quorum quenching approaches and the discovery of quorum sensing inhibitors(QSIs)have a strong impact on the discovery of anti-infective drugs against various types of bacteria.The discovery of QSI was demonstrated to be an appropriate strategy to expand the anti-infective therapeutic approaches to complement classical antibiotics and antimicrobial agents.For the discovery of QSIs,diverse approaches exist and develop in-step with the scale of screening as well as specific QS systems.This review highlights the latest findings in strategies and methodologies for QSI screening,involving activity-based screening with bioassays,chemical methods to seek bacterial QS pathways for QSI discovery,virtual screening for QSI screening,and other potential tools for interpreting QS signaling,which are innovative routes for future efforts to discover additional QSIs to combat bacterial infections.
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ObjectiveTo understand the stress level of people seeking psychological counseling under the coronavirus disease 2019 （COVID⁃19） pandemic and to explore its related factors. MethodsAn online survey was conducted on 1 194 people who sought psychological counseling in Shanghai through the “health cloud” psychological counseling service platform. The questionnaire included demographic information，lifestyle and stress during the COVID-19 pandemic. ResultsParticipants with low，medium，high and very high stress levels accounted for 33.1% （395/1 194），34.6% （413/1 194），25.4% （303/1 194） and 7.0% （83/1 194），respectively. Women and participants aged 18 to 30 years had higher stress levels（Z=-5.368，P<0.001； Z=35.822，P<0.001） compared with other groups. Factors contributing to the rise in stress included reading too much information about COVID-19 （OR=2.057，95%CI：1.012‒4.181），large changes in sleep state （OR=3.496，95%CI：1.669‒7.325），lack of hobbies and interests （OR=2.852，95%CI：1.252‒6.500），and prone to anxiety/irritability/sadness （OR=4.098，95%CI：1.772‒9.480）. Conclusionpeople who sought psychological counseling show high levels of psychological stress during the COVID-19 pandemic. We should pay more attention to the vulnerable groups with the following characteristics： women，18‒30 years old， residents who pay too much attention to the pandemic information，sleep less， and almost lose interest in hobbies， and easily become anxious/irritable/sad.
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Objective:To analyze the changes of energy loss(EL) in systemic lupus erythematosus(SLE) patients and the relationship between EL and cardiac function by vector flow mapping(VFM).Methods:The intraventricular hemodynamics of 60 females with SLE(SLE group) and 61 healthy female controls(control group) who attended the First Affiliated Hospital of Nanjing Medical University from August 2015 to August 2019 were compared, and cardiac function changes were evaluated using VFM. The EL at each segment of the left ventricular chamber (total, basal, middle, and apical segments) during each period of the cardiac cycle (isovolumic contraction, rapid ejection, rapid filling, reduced filling, atrial contraction) were analyzed. Relationship between EL and clinical and echocardiographic parameters was analyzed.Results:In SLE group, EL decreased from basal to middle to apical segments, with significant difference (all P<0.01). Compared with the control group, EL in early, middle, late diastole and rapid ejection period in SLE group was significantly increased (all P<0.01). During the rapid filling period, the EL was positively correlated with septal E′ ( r=0.784, P<0.001), and during the atrial contraction period EL was positively correlated with septal E/e′ ( r=0.812, P<0.001) and A ( r=0.715, P<0.001). During isovolumic contraction period, EL was positively correlated with interval E/e′, peak A ( r=0.461, 0.672; all P<0.001). Conclusions:VFM of patients with SLE can comprehensively, rapidly, and efficiently evaluate changes of myocardial mechanics and intracardiac hemodynamics, and provide quantitative analysis of complex intracardiac blood flow.
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Objective:To explore the clinical efficacy of internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device for tibial plateau fractures of Schatzker type Ⅵ.Methods:A retrospective study was conducted of the 32 patients with tibial plateau fracture of Schatzker type Ⅵ who had been treated at Orthopaedic Department, Mindong Hospital Affiliated to Fujian Medical University from April 2018 to July 2021. Depending on their treatments, they were divided into 2 groups. In the control group of 16 cases subjected to open reduction and internal fixation with manual traction, there were 9 males and 7 females with an age of 50.0±11.7 years; in the observation group of 16 cases subjected to internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device, there were 8 males and 8 females with an age of 54.6±11.1 years. The operation time, fracture reduction time, total incision length, intraoperative blood loss, Rasmussen knee function score and maximum active range of knee motion were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between the groups ( P>0.05). The operation time [(158.6±26.0) min], fracture reduction time [(61.6±9.6) min], and total incision length [16.0 (13.3, 17.0) cm] in the observation group were significantly shorter than those in the control group [(199.9±60.9) min, (73.8±17.2) min, and 20.0 (17.0, 21.8) cm]; the intraoperative blood loss [175.0 (100.0, 200.0) mL] in the observation group was significantly less than that in the control group [200.0 (162.5, 387.5) mL]; the maximum active ranges of knee motion at one week and one month in the observation group were 94.9°±12.0° and 113.8°±14.1°, significantly larger than those in the control group (78.3°±14.6° and 96.8°±11.4°) (all P<0.05). Fractures achieved bony union at one year after operation in both groups. At 12 months after operation, there was no significant difference in the maximum active range of knee motion or the Rasmussen knee function score between the 2 groups ( P>0.05). Conclusion:In the treatment of Schatzker type Ⅵ tibial plateau fractures, compared with manual traction and open reduction, internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device can shorten operation time and total incision length, reduce intraoperative blood loss, and facilitate postoperative functional recovery of the knee for the patients.
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Objective:To evaluate the effect of self-made lithotomy heating mask on intraoperative and postoperative body temperature and short-term postoperative outcome indicators in patients undergoing radical resection of rectal cancer.Methods:Using the method of quasi experimental research design, 100 patients with open rectal cancer in Ningbo Huamei Hospital of the University of Chinese Academy of Sciences from February to July 2021 were selected as the research objects. The patients were divided into experimental group and control group with 50 cases in each group. The control group was kept warm by routine methods, and the experimental group was kept warm by self-made lithotomy heating hood. The changes of core temperature at different time points before, during and after operation were compared between the two groups. The incidence of accidental hypothermia and shivering, the recovery time of anesthesia, and the incidence of various complications within 48 hours after operation were compared between the two groups after operation from the beginning of the operation to 6 hours after returning to the ward.Results:From 30 minutes after anesthesia to 3 hours after entering the ward, the core temperatures of the experimental group at 10 time points were higher than that of the control group, and the differences were statistically significant ( t values were 3.48-37.30, all P<0.01). From the beginning of surgery to 6 h after returning to the ward, the incidence of perioperative accidental hypothermia in the experimental group was 2% (1/50), lower than 24% (12/50) in the control group, and the difference was statistically significant ( χ2=11.06, P<0.05) . The number of cases of shivering in the experimental group was 10, lower than that in the control group of 22, the difference was statistically significant ( χ2=6.62, P<0.05) . The recovery time, extubation time and stay time in anesthesia recovery room of the experimental group were (8.44 ± 2.83), (13.05 ± 4.72), (74.51 ± 11.82) min, which were shorter than those of the control group (15.35 ± 2.09), (17.62 ± 3.28), (89.14 ± 9.19) min, and the difference was statistically significant ( t=-13.89, -5.62, -6.91, all P<0.01). The number of cases of agitation, delirium and nausea and vomiting in the experimental group was 3, 1 and 2 respectively, which was lower than 13, 7 and 8 in the control group, and the difference were statistically significant ( χ2=7.44, 4.89, 4.00, all P<0.05). There was no significant difference in the incidence of adverse cardiac events between the two groups ( P>0.05). Conclusions:The application of self-made lithotomy heating mask in open rectal cancer surgery can effectively improve the risk of hypothermia at different time points during and after surgery, reduce the incidence of shivering, restlessness, postoperative nausea, vomiting and delirium, shorten the time of awakening and extubation, and prevent postoperative complications. It has practical value in clinic.
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Objective:To study the effect of medical social workers combined with ICU diary on the prevention and treatment of post-traumatic stress disorder in ICU traffic accident patients, and to explore the application of continuing nursing services and ICU diary to ICU traffic accident patients.Methods:A total of 47 patients who were admitted to the ICU of Suzhou Science and Technology City Hospital from January to December 2019 due to traffic accidents were selected by convenient sampling method. Twenty-three patients admitted to the hospital in the first 6 months were selected as the control group (before the introduction of medical social workers and ICU diaries) for routine ICU treatment and nursing mode. Twenty-four patients admitted to the hospital in the last 6 months were selected as the experimental group (after the introduction of medical social workers and ICU diaries), and the medical social workers combined with the ICU diary were intervened. The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were compared between the two groups of patients when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU. The incidence of post-traumatic stress disorder was evaluated and compared by the scores of the Impact of Event Scale-Revised of the two groups of patients one month after leaving the ICU, three months after leaving the ICU, and six months after leaving the ICU.Results:The scores of SAS in the experimental group were 58.67 ± 7.45, 44.13 ± 5.47 and 39.08 ± 5.52 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 58.17 ± 6.75, 50.87 ± 6.35 and 42.74 ± 4.85, respectively in the control group. There was no statistical difference in the scores of the SAS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups with time changes and different interventions ( Ftime = 110.98, P<0.01), there were also differences between groups ( Fbetween groups = 5.91, P<0.05). Compared with the control group, the SAS score of the experimental group decreased more significantly( Finteraction = 0.28, P<0.05). The scores of SDS in the experimental group were 57.75 ± 4.06, 45.29 ± 3.39 and 36.63 ± 3.49 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 57.48 ± 2.29, 49.04 ± 5.65 and 43.57 ± 4.07 respectively in the control group. There was no statistical difference in the scores of the SDS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups of patients with time changes and different interventions ( Ftime = 248.24, P<0.01), there are also differences between groups ( Fbetween groups = 24.39, P<0.05). Compared with the control group, the SDS score of the experimental group decreased more significantly ( Finteraction=10.44, P<0.05). The incidences of post-traumatic stress disorder in the experimental group were 9, 8, 6 cases at one month, three months and six months after leaving the ICU, which were lower than 12, 11, 8 cases in the control group. The generalized estimation equation showed that the difference was statistically significant ( χ2=4.21, P<0.05). Conclusions:The intervention model of medical social workers combined with ICU diary is conducive to the use of ICU diary and the development of continuous nursing, which improves patients′negative emotions and reduces the incidence of post-traumatic stress disorder.
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Objective:To evaluate the clinical efficacy of modified Qiwei Baizhu Powder combined with conventional therapy in the treatment of type 2 diabetes mellitus (T2DM) with abnormal lipid metabolism.Methods:A total of 96 patients with T2DM and abnormal lipid metabolism from March 2018 to March 2021 in Anhui Integrated Traditional Chinese and Western Medicine Hospital who met the inclusion criteria were divided into 2 groups according to the random number table method, with 48 in each group. The control group was treated with conventional western medicine, while the observation group was treated with modified Qiwei Baizhu Powder and treatment of the control group. Both groups were treated for 3 months. TCM syndrome scores were performed before and after treatment. Fasting blood glucose (FPG) and 2 hPG were detected by glucose oxidase method, HbA1c was detected by HPLC, TC, TG, HDL-C and LDL-C were detected by cholesterol peroxidase method, glycerophosphate oxidase method, direct inhibition method and direct surfactant clearance method. Adverse events during treatment were recorded and clinical efficacy was evaluated.Results:The total effective rate was 93.8% (45/48) in the observation group and 79.2% (38/48) in the control group, with a statistically significant difference between the two groups ( χ2=4.36, P=0.037). After treatment, the scores of dry mouth, fatigue, anorexia, dizziness, tongue, pulse and total scores in the observation group were significantly lower than those in the control group ( t values were 3.58, 3.17, 3.24, 3.59, 3.58, 2.76 and 8.44, respectively, all Ps<0.05); the levels of FPG, 2 hPG and HbA1c in the observation group were significantly lower than those in the control group ( t values were 3.37, 2.05 and 3.73 respectively, all Ps<0.05). After treatment, the levels of TC [(4.30±0.85) mmol/L vs. (4.78±0.94) mmol/L, t=2.62], TG [(3.00±0.37) mmol/L vs. (3.19±0.54) mmol/L, t=2.01], LDL-C [(2.60±0.71) mmol/L vs. (2.95±0.44) mmol/L, t=2.90] were significantly lower than those in the control group ( P<0.05). After treatment, the HDL-C [(2.07±0.63) mmol/L vs. (1.82±0.55) mmol/L, t=2.01] level was significantly higher than that of the control group ( P<0.05). Conclusion:Modified Qiwei Baizhu Powder combined with conventional therapy can improve blood glucose and blood lipid levels in T2DM patients with abnormal lipid metabolism, relieve clinical symptoms and improve curative effect.
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Objective:To explore the changes of brain network functional connection in neonates with different degrees of hypoxic-ischemic encephalopathy(HIE), and to understand its influence on brain function.Methods:Clinical data of full-term HIE children hospitalized in Neonatology Department of Changzhou Children's Hospital from January 2017 to May 2020 were collected by convenient sampling method. A total of 44 cases were scanned by conventional and functional magnetic resonance image.Twenty-four of them met the inclusion criteria, including 11 mild patients (PT1 group) and 13 moderate and severe patients (PT2 group). The amplitude of low frequency fluctuation (ALFF) was used to compare the differences of ALFF values between PT1 group and PT2 group, and the differences of functional connectivity (FC) between PT1 group and PT2 group were compared by the method of brain network connectivity analysis.Results:In the edge analysis, compared with the PT1 group, the FC of the right supplementary motor area and the right precentral gyrus ( Z1=0.39, Z2 =-0.08), the right lingual gyrus and the right hippocampus ( Z1=0.61, Z2=0.20), the left calcarine cortex and the right amygdala ( Z1=0.30, Z2=-0.02), the right pallidus and the right posterior cingulate cortex ( Z1=0.33, Z2=0.05) were decreased in the PT2 group (all P<0.001, uncorrected). In ALFF analysis, there was no significant difference between PT1 group and PT2 group ( P>0.05, FDR adjusted). Conclusion:There are changes in functional connections in some brain regions in children with moderate and severe HIE.These functional connections are related to motor function, emotional processing, language development, cognitive function, learning and memory, etcetera.
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Objective:To analyze the effects of multidisciplinary cooperative nutrition management model in acute stroke patients with dysphagia.Methods:From February 2019 to February 2020, 69 acute stroke patients with dysphagia were enrolled in this study. After exclusion of those unable to complete the trial, patients were randomized into control group ( n=30) and experimental group ( n=30). Patients in the control group were given routine nutrition management, while patients in the experimental group were treated under multidisciplinary cooperative nutrition management model. Nutritional indicators were compared between the two groups on Day 1, 7 and 14 after admission, including levels of albumin (ALB), pre-albumin (PALB), hemoglobin (HB), triceps skin-fold (TSF) thickness on the uninjured side, upper arm muscle circumference etc. Incidence of gastrointestinal complications and infectious complications was also recorded. Results:There was no difference between two groups in the levels of HB, TSF thickness and upper arm muscle circumference on the uninjured side (all P>0.05). However, the serum levels of ALB and PALB on Day 7 and 14 in the experimental group were higher than that in the control group(all P<0.05), The incidence of gastrointestinal complications ( P=0.015)and infectious complications ( P=0.016) in the experimental group was lower than that in the control group. Conclusion:Multidisciplinary collaborative nutrition management improved nutritional indicators, reduced the incidence of gastrointestinal complications and infectious complications in acute stroke patients with dysphagia, making multidisciplinary collaborative nutrition management model worthy of clinical promotion and application.
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Postoperative surgical site infection (SSI) can lead to adverse clinical outcomes in patients, such as prolonged hospital stay, increased medical costs, and severe economic burden on patients and on society.In addition, it may also cause nosocomial cross-infection.Therefore, it has aroused the high attention of medical workers.The development of SSI is closely related to a variety of factors, including patient factors, such as blood glucose levels, smoking, systemic use of steroids, obesity and malnutrition, and perioperative related factors, such as long preoperative hospital stay, preoperative skin preparation and prophylactic use of antibiotics of patients, hand hygiene and asepsis principles of medical staff, operation-related factors, anesthetic management and operation related factors, operating room environment factors and postoperative factors.Through reading a large number of relevant literatures published in recent years and according to the work characteristics of anesthesiologists, the author summarized the influential factors and preventive measures for postoperative SSI for the reference of fellow doctors.
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Objective:To study the expression of miRNA-7 in B lymphocytes of primary Sj?gren's syndrome (pSS) and its relationship with phosphatase andtensin homolog deleted (PETN) and disease activity.Methods:Twenty newly diagnosed outpatient and inpatient pSS patients were used as case group collected from January 2017 to December 2019 of Qinghai Provincial People's Hospital. Twentyhealthy persons were used as the control group. Disease-related indicators of the case group were collected. Quantitative polymerase chain reaction (RT-qPCR)was used to detect miRNA-7 and PETN mRNA expression in B lymphocytes of the two groups and the consistency between miRNA-7 expression in the plasma and B lymphocytes of the case group was analyzed. Western Blotting method was used to detect the PETN protein in B lymphocytes of the two groups. Correlation analysis was used to analyze the relationship between miRNA-7 expression in B lymphocytes and disease activity in the case group. Linear regression analysis was performed between miRNA-7 and PETN mRNA.Results:The expression of miRNA-7 (0.53±0.17) in the B cells increased and the expression of PTEN mRNA (0.88± 0.24) and protein (0.51±0.12) in the case group were reduced compared with that of miRNA-7(0.39±0.11), PTEN mRNA(2.32±0.30) and protein(1.03±0.21) of the control group. The above differences were statistically significant ( t=2.990, P<0.05; t=16.98, P<0.05; t=8.41, P<0.05). Linear regression showedthat PTEN miRNAwas negatively correlated with miRNA-7 ( b=-0.78, P<0.01), the expression of miRNA-7 in the case group was positively related with EULAR Sj?gren′s syndrome Disease Activity Index (ESSDAI), IgG, IgA, anti-SSB and was negatively correlated with C4 and WBC. Conclusion:There is a certain relationship between miRNA-7 and disease activity. MiRNA-7 may participate in the pathogenesis of pSS byregulating PETN in B cells of pSS. MiRNA-7 has certain clinical value for disease activity evaluation.
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Objective:To visually analyze the general situation and development of pre-oxygenation research abroad, and provide a reference for further development of pre-oxygenation in China.Methods:Using the WOS core data set as the data source, CiteSpace V software was used to visually analyze the literature published from January 1, 2000 to November 29, 2019.Results:The number of papers has shown a rapid upward trend since 2013, the US has the most papers. Research hotspots mainly focus on tracheal intubation, intensive care unit, apnea oxidation, non-invasive ventilation and complications.Conclusion:The United States is in the leading position in the study of pre-oxygenation, and China is still in the initial stage in the study of pre-oxygenation. We should strengthen cooperation and exchange with developed countries such as Europe and America. The application of pre-oxygenation outside the operating room and the selection of pre oxygenation tools are the direction of further research.
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Objective:To investigate the clinical characteristics of patients with lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia (LPL/WM), and the diagnosis and optimal treatment of LPL/WM.Methods:The clinical data of 13 LPL/WM patients treated in Zhongnan Hospital of Wuhan University from January 2013 to June 2018 were retrospectively analyzed, and the literature was reviewed.Results:The median age of 13 patients was 60 years old (35-79 years old). There were 12 males and 1 female. Initial symptom was fatigue or edema of both lower limbs for majority of patients. All patients had immunoglobulin M (IgM) monoclonal, 3 of them had elevated immunoglobulin G (IgG) level, including 1 patient with monoclonal IgG. LDH was increased in 2 patients. Coombs test was positive in 5 patients. MyD88 gene mutation status was detected in 8 patients, of which gene mutation in 5 patients was positive. Among 13 patients, 1 patient lost follow-up, 3 patients died, 9 patients were alive with the median survival of 36 months (19-81 months).Conclusions:Incidence of LPL/WM is relatively low with a generally indolent evolution, but heterogeneity is not negligible. Few patients have poor treatment response with a quick disease progress. The high-risk patients undergoing hematopoietic stem cell transplantation after remission-induction chemotherapy may improve the prognosis.