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Objective:To investigate the patients with hepatocellular carcinoma suitable for transcatheter arterial chemoembolization (TACE) after radical resection who were screened based on microvascular invasion (MVI) and Ki-67 expression.Methods:Of 400 patients with hepatocellular carcinoma who underwent radical resection in the Affiliated Hospital of Qingdao University from January 2013 to December 2019 were included and analyzed retrospectively, including 324 males and 76 females, aged (59.7±9.8) years, ranging from 32 to 87 years. According to whether they received adjuvant TACE treatment after operation, they were divided into simple operation group ( n=210) and TACE + operation group ( n=190). The recurrence in the first year after operation was followed up by outpatient reexamination. Univariate and multivariate Cox regression analysis were used to analyze the influencing factors of recurrence free survival after surgical resection. Subgroup analysis was performed according to Ki-67 and MVI to compare the recurrence free survival. Results:Multivariate Cox regression analysis showed that patients with proportion of Ki-67 positive cells ≥27.5% ( HR=2.073, 95% CI: 1.433-3.000, P<0.001) and MVI positive ( HR=2.339, 95% CI: 1.584-3.456, P<0.001) had increased risk of recurrence after radical resection. The 1-year cumulative recurrence free survival rate in the simple operation group was 70.0%, and there was no significant difference compared with 67.9% in the operation + TACE group( χ 2=0.08, P=0.774). Subgroup analysis: in the low expression of Ki-67 combined with negative MVI group ( n=128), the cumulative recurrence free survival rate of one year after operation in the simple operation group ( n=84) was 91.7%, which was significantly higher than 72.7% in the operation + TACE group ( n=44)( χ 2=8.22, P=0.004). There was no significant difference in the 1-year cumulative recurrence free survival rate between the simple operation group and the operation + TACE group (both P>0.05) in patients of Ki-67 high expression combined with MVI negative or Ki-67 low expression combined with MVI positive. In the Ki-67 high expression combined with MVI positive group ( n=107), the cumulative one-year recurrence free survival rate in the simple operation group ( n=62) was 40.3%, which was significantly lower than 60.0% in the operation + TACE group ( n=45)(χ 2=4.22, P=0.040). Conclusion:High expression of Ki-67 (≥27.5%) combined with positive MVI are the prediction factors for postoperative TACE treatment. Low expression Ki-67 (<27.5%) combined with negative MVI was contraindicated for postoperative TACE treatment.
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Objective@#To evaluate the efficacy of self-made Jianpi-Tiaogan-Wenshen decoction in the treatment of diarrhea-predominant irritable bowel syndrome (IBS).@*Methods@#A total of 107 patients with diarrhea- predominant IBS who met the inclusion criteria were divided into control group (53 cases) and observation group (54 cases) by random number table method. On the basis of routine treatment, the control group was given Bifidobacterium triple viable powder and trimebutine maleate dispersible tablets, while the observation group was given self-made Jianpi-Tiaogan-Wenshen decoction. Both groups were treated for 4 weeks. The symptoms and signs were scored before and after treatment. The level of 5-hydroxytryptamine (5-HT) was measured by double antibody sandwich method. The mast cell count was observed under high power microscopy, and the clinical efficacy was evaluated.@*Results@#The total effective rate was 90.7% (49/54) in the observation group and 60.4% (32/53)in the control group, and there was significant difference between the two groups (χ2=13.406, P<0.01). After treatment, the levels of mast cell count (10.03 ± 2.19 pcs/Hp vs. 14.85 ± 1.98 pcs/Hp, t=11.935), 5-HT (7.06 ±1.37 mg/L vs. 9.67 ± 1.31 mg/L, t=10.069) significantly decreased in the observation group (P<0.05). After treatment, the VAS score, stool frequency score and stool character score of the observation group were significantly lower than those of the control group (t=11.560, 11.957, 20.539, respectively, P<0.05).@*Conclusions@#Self-made Jianpi-Tiaogan-Wenshen decoction can improve clinical symptomsof diarrhea-predominant IBS patients, reduce mast cell count and 5-HT level, and improve the clinical efficacy.
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The hospital took such measures as composing a hospital acquire infection committee, staffing office posts, and building a three-level network of hospital acquired infection management based on clinical departments'teams to improve the management. Full-time staff were appointed to launch monitoring of such infection, and work with clinical staff to supervise, while risk self-appraisal was used to identify risk exposure of such infection. By means of hospital acquired infection management committee, coordination meetings, infection control saloon and WeChat groups, effective communication is realized. Priority improvement programs made sustained quality improvement on risk exposures. All these measures furthered capacity of the hospital and clinical departments in infection control to the end of minimal hospital acquired infection.
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Fecal bacteria transplantation is the "intermediate zone" between clinical trials and clinic.The vulnerability of patient and the "uncertainty" of technology result in the challenge of traditional informed consent pattern in voluntary,capacity and the requirement of information.In order to achieve the informed consent of clinical intervention of fecal bacteria transplantation,it should integrate doctor's professional standard with patient's subjective standard at the standard level;pay attention to inform the long-term risk,technical essence and operation process,relevant information about the donor and the fact that lack of big data at the content level;pay attention to the aesthetic requirements and dynamics in the informing mode.
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Objective To evaluate hospital acquired infection control using the risk assessment method of hazard vulnerability analysis (HVA). Methods The HVA risk assessment method was used to screen out two hospital-level priority improvement projects in hospital acquired infection management in 2016, and assess the relative risk of the risk factors,for selective intervention according to the"20% -80% principle". 2015 was set as baseline survey, while the first and second half of 2016 as the outcome evaluation stage. The comparison of the count data was performed using the χ2test. Results Baseline survey of hand hygiene found the compliance rate and high-touch surface cleaning pass rate as 64.4% and 57.0% respectively. The first stage of evaluation found the rate as 69.0% and 73.7% respectively, while in the second stage rate was 72.9% and 82.4% respectively. These differences were statistically significant (P<0.001). Baseline survey found the incidence of hospital acquired infection and surgical site infection as 1.26% and 0.29% respectively, while the figures in the stage of evaluation were 1.07% and 0.22% respectively,figures being statistically significant (P<0.05). Conclusions The HVA risk management proves significant for the prevention and control of hospital acquired infection, as it can identify and assess risk factors of hospital acquired infection,for better risk control.
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The rapid development of human micro-ecology (human microbiome) in recent years has opened up new medical prospects for revealing the close relationship between microorganism and human health and disease.As the second genome of human,the special relationship between the microorganism and the host and its important function have brought new ethical and social problems,which requires to rethink and reform the existing ethical norms.This paper focused on the seven perspectives of “identity”,ownership,informed consent,risk benefit assessment,privacy,commercialization and public health,and demonstrated the importance to construct the ethics of micro-ecological research,which would enrich and expand the connotation of bioethics in theory and better guarantee the benign development of micro-ecology research in practice.
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Objective To evaluate the effect of targeted monitoring and comprehensive intervention measures on reducing the occurrence of catheter-associated urinary tract infection(CAUTI)in patients in non-intensive care unit(Non-ICU).Methods In quarter 4 of 2015,patients with indwelling urinary catheter in clinical departments were conducted a baseline survey(before intervention),risk factors for CAUTI in patients were analyzed,targeted monitoring programmes and comprehensive intervention measures were initiated in 2016(after intervention),incidence of CAUTI before and after intervention was compared.Results After taking intervention measures,hand hygiene compliance rate increased from 78.51%in quarter 4 of 2015 to 92.99%in quarter 3 of 2016 and 90.73%in quarter 4 of 2016(x2=7.342,3.998,respectively,both P<0.05),the correct disposal rate of patients' urinary catheterization system increased from 72.83%in quarter 4 of 2015 to 95.44%in quarter 4 of 2016(x2=30.267,P<0.05).A total of 12 067 patients with indwelling urinary catheter were monitored,incidence of CAUTI dropped from 1.03%(24/23 313)in quarter 4 of 2015(before intervention)to 0.53%(14/26 595)in quarter 4 of 2016(after intervention),difference was statistically significant(x2=4.126,P=0.042).Conclusion Improving the quality of urinary catheterization system in patients with indwelling catheter through targeted monitoring can effectively reduce the incidence of CAUTI in patients in Non-ICU.
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Objective To understand the risk factors for cardiovascular disease(CVD)and their clustering among middle aged and old people in Jilin province and provide evidence for the development of effective intervention measures. Methods A total of 13 914 people aged 35-79 years were selected from 32 counties (district) in 9 prefectures (municipality) of Jilin province through multi-stage stratified cluster sampling to conduct a face to face questionnaire survey and health examination. Complex weighted computation was conducted to analyze the survey results. Results The prevalence of hypertension,diabetes,dyslipidemia,smoking and overweight were 41.3%,11.5%, 42.8%,31.5%and 53.5%,respectively. Only 16.2%of the subjects surveyed were free of the 5 risk factors.≥1 risk factor and≥3 risk factors were found to clustering in 83.8%and 29.9%of the middle aged and old people. Compared with females,the odds ratios of ≥1,≥2 and ≥3 risk factors clustering in males were 3.18,4.28 and 5.58 times higher,respectively. Compared with urban residents,the odds ratios of≥1,≥2 risk factors clustering in rural residents were 1.22 and 1.20 times higher. In addition,the odds ratios of≥1,≥2 and≥3 risk factors clustering increased with age(all P<0.001). Conclusion High prevalence of major cardiovascular disease risk factors and their clustering were found in middle aged and old people in Jilin province. More attention and intervention should be given to the old males in rural areas.
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Objective To understand the risk factors for cardiovascular disease(CVD)and their clustering among middle aged and old people in Jilin province and provide evidence for the development of effective intervention measures. Methods A total of 13 914 people aged 35-79 years were selected from 32 counties (district) in 9 prefectures (municipality) of Jilin province through multi-stage stratified cluster sampling to conduct a face to face questionnaire survey and health examination. Complex weighted computation was conducted to analyze the survey results. Results The prevalence of hypertension,diabetes,dyslipidemia,smoking and overweight were 41.3%,11.5%, 42.8%,31.5%and 53.5%,respectively. Only 16.2%of the subjects surveyed were free of the 5 risk factors.≥1 risk factor and≥3 risk factors were found to clustering in 83.8%and 29.9%of the middle aged and old people. Compared with females,the odds ratios of ≥1,≥2 and ≥3 risk factors clustering in males were 3.18,4.28 and 5.58 times higher,respectively. Compared with urban residents,the odds ratios of≥1,≥2 risk factors clustering in rural residents were 1.22 and 1.20 times higher. In addition,the odds ratios of≥1,≥2 and≥3 risk factors clustering increased with age(all P<0.001). Conclusion High prevalence of major cardiovascular disease risk factors and their clustering were found in middle aged and old people in Jilin province. More attention and intervention should be given to the old males in rural areas.
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<p><b>OBJECTIVE</b>To understand the risk factors for cardiovascular disease (CVD) and their clustering among middle aged and old people in Jilin province and provide evidence for the development of effective intervention measures.</p><p><b>METHODS</b>A total of 13 914 people aged 35-79 years were selected from 32 counties (district) in 9 prefectures (municipality) of Jilin province through multi-stage stratified cluster sampling to conduct a face to face questionnaire survey and health examination. Complex weighted computation was conducted to analyze the survey results.</p><p><b>RESULTS</b>The prevalence of hypertension, diabetes, dyslipidemia, smoking and overweight were 41.3%, 11.5%, 42.8%, 31.5% and 53.5%, respectively. Only 16.2% of the subjects surveyed were free of the 5 risk factors. ≥ 1 risk factor and ≥ 3 risk factors were found to clustering in 83.8% and 29.9% of the middle aged and old people. Compared with females, the odds ratios of ≥ 1, ≥ 2 and ≥ 3 risk factors clustering in males were 3.18, 4.28 and 5.58 times higher, respectively. Compared with urban residents, the odds ratios of ≥ 1, ≥ 2 risk factors clustering in rural residents were 1.22 and 1.20 times higher. In addition, the odds ratios of ≥ 1, ≥ 2 and ≥ 3 risk factors clustering increased with age (all P < 0.001).</p><p><b>CONCLUSION</b>High prevalence of major cardiovascular disease risk factors and their clustering were found in middle aged and old people in Jilin province. More attention and intervention should be given to the old males in rural areas.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Age Distribution , Cardiovascular Diseases , Epidemiology , China , Epidemiology , Cluster Analysis , Diabetes Mellitus , Epidemiology , Dyslipidemias , Epidemiology , Hypertension , Epidemiology , Odds Ratio , Overweight , Epidemiology , Prevalence , Risk Factors , Rural Population , Sex Distribution , Smoking , Epidemiology , Surveys and QuestionnairesABSTRACT
Objective To study the effects of mitochondrial permeability transition (MPT) on hepatocyte apoptosis and mitochondrial damage,and investigate the effects of curcumin on MPT and the related mechanisms in septic rat.Methods Fifteen healthy male Sprague-Dawley (SD) rats were randomly divided into three groups:sham group,sepsis group and curcumin group,with 5 rats in each group.Septic rat model was reproduced by cecal ligation and puncture (CLP).The rats in sham group were flipped the cecum without perforation and ligation.The rats in the curcumin group were treated with curcumin 100 mg·kg-1·d-1 (dissolved in saline to 10 mL/kg) by oral gavage for 7 days,while the other groups were treated with normal saline.Tissue samples were harvested in each group at 12 hours after operation.Pathological changes in hepatic mitochondria were observed under electron microscopy,concentration of free calcium was examined with confocal laser scanning microscope.After Fluo-3/AM staining,protein and mRNA expression of active caspase-3,Bcl-2 and Bax were examined by Western Blot and reverse transcription-polymerase chain reaction (RT-PCR).Results Under the transmission electron microscope,intact cell membrane,adqulis cytoplasm,and normal and clear mitochondrion was found in the sham group.Mitochondria in sepsis group swelled obviously with mitochondrial cristae broken or disappearance,unclear bilateral membrane structure,while the curcumin group showed much less pathological changes,with few mitochondria swell,and smear bilateral membrane structure.The fluorescence intensity index of sham group,sepsis group and curcumin group was raised successively (417.33 ± 15.88,772.95 ± 42.37,1 560.84 ± 160.78,respectively,F=184.149,P=0.000).The protein and mRNA expression of active caspase-3 and Bax had the highest level in sepsis group,followed by the curcumin group,and that in the sham group was the lowest [active caspase-3 protein (gray scale):1.698 ± 0.061,0.694 ± 0.045,0.246 ± 0.027,F=1 289.667,P=0.000; active caspase-3 mRNA (2-Δ△Ct):1.031 ±0.135,0.578 ± 0.144,0.183 ±0.036,F=66.958,P=0.000; Bax protein (gray scale):1.826 ±0.126,1.254 ±0.140,0.623 ±0.901,F=94.536,P=0.000; Bax mRNA (2-ΔΔCt):2.774 ±0.338,1.661 ±0.226,0.656 ±0.114,F=124.710,P=0.000],all of these values had statistical significance among the three groups (all P＜0.01).While Bcl-2 protein and mRNA had the highest level in curcumin group and lowest level in the sham group [Bcl-2 protein (gray scale):0.716 ±0.091,1.328 ±0.147,1.656 ±0.104,F=84.918,P=0.000; Bcl-2 mRNA (2-△ΔCt):0.617 ±0.118,1.393 ±0.096,1.650 ±0.167,F=83.846,P=0.000].The protein and mRNA expressions of Bcl-2/Bax ratio were lowest in sepsis group,then sham group,and highest in curcumin group [Bcl-2/Bax protein (gray scale):0.726 ± 0.055,1.150 ± 0.043,1.333 ± 0.163,F=46.265,P=0.000; Bcl-2/Bax mRNA (2-Δ△Ct):0.505 ±0.041,0.944±0.097,1.006 ±0.168,F=12.211,P=0.001].Conclusions MPT can lead to mitochondrial dysfunction and further cause hepatocyte apoptosis.Mechanism of effect of curcumin on MPT may be related to reduction of intracellular calcium concentration,promotion of anti-apoptotic Bcl-2 gene expression,inhibition of caspase-3 activation and Bax gene.
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Objective To study the ages at natural menopause of the women in Jilin Province, and to illustrate its influencing factors among the women in Jilin Province.Methods Through multistage stratified cluster random sampling method,23 050 people aged from 18 to 79 years were drew from nine states(a total of 32 areas)of Jilin province.The data of these residents were collected with the questionnaire and physical examinations by face-to-face interview.The number of selected female sample was 11 098. Finally, 4 881 postmenopausal women were selected.Complex weighted computation was used to estimate the ages at natural menopause.One-way ANOVA was used to compare the ages at natural menopause of the women with different birth years. Multiple linear regression analysis were used to examine the influencing factors of the ages at natural menopause. Results The mean and median ages at natural menopause were (49.11±4.19)years and 50.00 years,respectively.There were 4 881 cases of postmenopausal women,among them the women with age at natural menopause<40 years,40 year≤age at natural menopause≤45 years,46 years≤ age at natural menopause≤53 years,age at natural menopause≥54 years and age at natural menopause missing accounted for 2.27%(111 cases),13.17%(643 cases),71.97%(3 513 cases),11.74% (573 cases),and 0.85%(41 cases),respectively.Converted to birth years by age,70-79 years old was 1933-1942 birth years,60-69 years old was 1943-1952 birth years and 57-59 years old was 1953-1955 birth years.The age at natural menopause in Jilin province was statistically significant among the women with different birth years(F=21.178,P<0.001).By SNK-q test among three different birth year groups, the age at natural menopause was different between any two groups among three different birth year groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.38 years,49.51 years and 48.81 years.The age at natural menopause in urban of Jilin province was statistically significant among the women with different birth years(F=16.633,P<0.001).By SNK-q test among three different birth year groups,the age at natural menopause was different between any two groups among three different birth year groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.77 years,49.73 years,and 48.85 years,respectively.The age at natural menopause in rural of Jilin province was statistically significant among the women with different birth years(F=7.400,P=0.001 ). By SNK-q test among three different birth year groups, the age at natural menopause was different between 1953-1955 birth year group and the other two groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.09 years,49.33 years,and 48.74 years,respectively.The multiple linear regression results indicated that BMI and exercise were positively correlated with the age at natural menopause,but smoking and mental health evaluation were negatively.Consumption frequency of vegetables,fruits,bean products,and meat was no correlated with the age at natural menopause.Conclusion The differences of the ages at natural menopause between the women with different birth years are statistically significant in Jilin Province;BMI, smoking, exercise,and mental health are the influencing factors of the age at natural menopause.
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ObjectiveTo test the expression of epidermal growth factor-like domain 7 (EGFL7),microvessel density (MVD) and foeal adhesion kinase pY397 (FAKpY397) in human glioma tissues,and to evaluate their relationship.MethodsThe expression of EGFL7 and FAKpY397 in 56 cases of human glioma and 8 cases of normal brain tissues were detected by immunohistochemistry test,and MVD was detected by CD34 staining.ResultsThere was a significant difference of the positive rates of EGFL7 between normal brain tissue (0) and gliomas (75％),χ2 =17.45,P ＜0.01.With the increased pathological grade,the expression level of EGFL7 increased (χ2 =26.24,P ＜ 0.01 ).There was a significant difference of the positive rates of FAKpY397 between normal brain tissue ( 12.5％ ) and gliomas (73.2％),χ2 =6.23,P ＜ 0.05.With the increased pathological grade,the expression level of FAKpY397 increased (χ2 =6.71,P ＜ 0.01 ). MVD on normal brain was( 15 ± 4 )/HP,on Ⅰ - Ⅱ grade and Ⅲ -Ⅳ grade gliomas was ( 27 ± 3 )/HPand ( 60 ± 4 )/HP respectively,there was a significant difference on MVD between normal brain tissue and gliomas (P ＜ 0.01 ).Higher level of MVD was found in gliomas with higher grade ( P ＜ 0.01 ).There was a positive correlation between EGFL7 and FAKpY397 expressions in gliomas (r =0.314,P ＜0.01 ).There was a significant difference on MVD between positive and negative expression of EGFL7 ( t =26.55,P ＜ 0.01 ). MVD was (56 ± 4 )/HP and (25 ± 3 )/HP respectively.ConclusionThe expression of EGFL7 of human gliomas has a favorable positive correlation with the degree of malignancy,MVD and FAKpY397.It is indicated that EGFL7not only palys an important regulative role in glioma neovascularization,but also it may participate directly in glioma occurrence and invasion.
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The development of biomedicine is based on animal experimentation.The author conducts a comparative study between animal experimentation and human experimentation from the perspectives of value,IQ,right and obligation and argues that animal experimentation could not be justified ethically.And the different attitudes towards the animal experimentation are due to the application of different ethical theories.The author concludes that it is necessary to develop relevant law or regulation to ensure the welfare and rights of animals.