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Objective:To investigate the prognostic value and related factors of heart-type fatty acid binding protein (H-FABP) in patients with heart failure.Methods:A total of 877 consecutive patients who were admitted to heart failure care unit of Fuwai hospital and diagnosed as heart failure from July 2015 to July 2017 were enrolled in this study. Baseline serum H-FABP concentration was measured by fluorescence lateral flow immunoassay. According to serum H-FABP levels, patients were divided into three groups: low H-FABP group (H-FABP≤4.04 ng/ml, n=292), middle H-FABP group (H-FABP 4.04-7.02 ng/ml, n=292) and high H-FABP group (H-FABP≥7.02 ng/ml, n=293). The general clinical characteristics were collected and compared among the three groups. According to whether heart failure was caused by coronary artery disease or not, patients with heart failure were divided into ischemic heart failure and non-ischemic heart failure. Multivariate linear regression analysis was performed to explore the independent risk factors of H-FABP. The primary endpoint events were the composite of all-cause death or heart transplantation. Multivariate Cox regression analyses, receiver operating characteristic (ROC) curves, risk prediction tests with multivariate Cox regression model and Kaplan-Meier analyses were conducted to investigate the relationship between H-FABP and the prognosis of heart failure. Results:Multivariate linear regression analysis showed that age, coronary artery disease, alanine aminotransferase, uric acid and N-terminal pro-B type natriuretic peptide (NT-proBNP) were positively associated with H-FABP (β=0.012, 0.238, 0.001, 0.345 and 0.063 respectively,all P<0.05), while female, hemoglobin, albumin, sodium, and estimated glomerular filtration rate (eGFR) were negatively associated with H-FABP (β=-0.184, -0.006, -0.016, -0.034 and -0.006 respectively, all P<0.05). One hundred and nineteen patients (13.6%) lost to follow-up, and 246 patients (32.5%) suffered from all-cause death or heart transplantation during the median follow-up duration of 931 (412-1 185) days. Multivariate Cox regression analysis showed that baseline H-FABP (log 2H-FABP) level was the independent predictor of all-cause death or heart transplantation in patients with heart failure ( HR=1.39, P<0.001). ROC curves showed that baseline H-FABP was a predictor of all-cause death or heart transplantation in patients with heart failure within 3 months, 1 year and 2 years (areas under the curves were 0.69, 0.69 and 0.71 respectively), and the best cut-off values were 5.85 ng/ml, 6.54 ng/ml and 6.54 ng/ml respectively. Risk prediction test with multivariate Cox regression model showed that baseline H-FABP could provide additional prognostic value in predicting all-cause death or heart transplantation for patients with heart failure on top of basic model and baseline NT-proBNP ( P<0.001). Taking 6.54 ng/ml and trisected levels of H-FABP as cut-off values respectively, Kaplan-Meier analyses showed that the survival rates were significantly different among the two or three groups ( P<0.001). Subgroup analyses showed that baseline H-FABP (log 2H-FABP) level was an independent predictor of all-cause death or heart transplantation in patients with ischemic heart failure ( HR=1.74, P<0.001), as well as in patients with non-ischemic heart failure ( HR=1.28, P=0.027). Conclusions:Age, sex, coronary artery disease, hemoglobin, albumin, alanine aminotransferase, sodium, eGFR, uric acid and NT-proBNP are associated with H-FABP level. Baseline H-FABP level is an independent predictor of all-cause death or heart transplantation in patients with heart failure. On top of basic model and baseline NT-proBNP, baseline H-FABP could provide additional prognostic value in predicting adverse events for patients with heart failure.
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Atherosclerosis is the pathological basis of a variety of cardiovascular and cerebrovascular diseases. Its complicated etiology and chronic course seriously threaten human health. The prevention and treatment of atherosclerosis have been the focus of traditional Chinese and western medicine. This paper reviews the pathogenesis characteristics of atherosclerosis, and holds that deficiency of vital qi is the pathogenesis basis of atherosclerosis, which involves deficiency of heart, spleen and kidney, mutual knot of phlegm and blood stasis, and obstruction of veins. In clinical treatment, the common treatment were summarized on the principle of "replenishing deficiency and removing phlegm and blood stasis". In order to understand the relationship between deficiency and phlegm and blood stasis and atherosclerosis from the perspective of Traditional Chinese Medicine. The paper provides a theoretical basis for Traditional Chinese Medicine prevention and treatment for atherosclerosis.
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Objective:To investigate the clinical significance of detecting serum 25-hydroxyl-vitamin D [25(OH)D] level and albumin/fibrinogen ratio (AFR) in patients with rheumatoid arthritis (RA).Methods:This retrospective study included 131 patients (95 patients with RA and 36 with arthralgia excluding autoimmune diseases), who were treated in Bozhou People′s Hospital from May 2017 to January 2020. Forty healthy controls underwent health checkups during the same period served as healthy control. RA group was divided into high (>5.1, 25 cases), medium (3.2<DAS28-CRP≤5.1), 40 cases and low (≤3.2, 30 cases) subgroups by disease activity (DAS28-CRP) based on 28 joint counts and the level of C-reactive protein(CRP). RA patients were further divided into normal (≥30 ng/ml, 17 cases), insufficient (20 ng/ml ≤ 25(OH)D<30 ng/ml, 31 cases) and deficient (<20 ng/ml, 47 cases) subgroups according to the serum 25(OH)D concentration; 4 age subgroups (≤44 years of 21 cases, 45-59 years of 43 cases, 60-74 years of 21 cases and ≥75 years of 10 cases); 2 sex subgroups (79 female and 16 male). Serum 25(OH)D, albumin and fibrinogen levels were measured in all patients and healthy controls. The general clinical and laboratory indexes were collected and analyzed. Multivariate logistic regression analyses were performed to determine the independent risk factors of RA.Results:The serum 25(OH)D concentration and albumin/fibrinogen ratio were lower ( P<0.05) in rheumatoid arthritis patients than those in other groups, and serum 25(OH)D insufficiency or deficiency was evidenced in 82.11% (78/95) rheumatoid arthritis patients. Among patients with rheumatoid arthritis, the levels of 25(OH)D were apparently different in various age groups ( P<0.05) and significantly lower in female than those in male ( P<0.05). In addition, a significant negative correlation was found between AFR and DAS28-CRP ( r=-0.497, P<0.01). Logistic regression analysis showed that 25(OH)D ( OR=0.852, 95% CI: 0.768-0.944, P=0.002) and AFR ( OR=0.626, 95% CI 0.480-0.817, P=0.001), RF-IgM ( OR=1.044, 95% CI 1.019-1.069, P<0.001) and anti-CCP antibodies ( OR=1.017, 95% CI 1.002-1.032, P=0.030) were independent risk factors for disease activity in RA patients. Conclusions:The serum 25(OH)D and AFR levels are significantly reduced and 5(OH)D insufficiency or deficiency is common in RA patients, suggesting that low levels of 25(OH)D and AFR may be the risk factors reflecting the RA disease activity.
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Objective:To analyze the efficacy and safety of Daratumumab for the treatment of primary AL light chain systemic amyloidosis.Methods:Twenty one patients who were diagnosed as primary AL light chain systemic amyloidosis and treated with Daratumumab from 7 centers were retrospectively analyzed. Daratumumab was administrated as first line therapy in seven patients and 14 patients with relapsed settings. Hematological response, safety and survival were analyzed.Results:All 7 patients achieved very good partial response (VGPR) or better with first-line application of daratumumab. Three patients died, and the other four achieved organ remission. Among 14 relapsed patients, 2 patients had a difference of free light chain (dFLC) less than 20 mg/L before treatment, and 9 with a dFLC of more than 50 mg/L. All patients reached partial response (PR) or better, including 4 patients with complete response (CR), 3 with VGPR and 2 with PR. The response rate was 100% in 3 patients with dFLC 20-50 mg/L at baseline. The organ remission rate was 50% in patients with heart involvement and 58.3% in patients with kidney impairment. The overall median follow-up period was 5.3 months, and 11 months in surviving patients. One patient died of severe infection and disseminated intravascular coagulation (DIC) with stable amyloidosis. One patient switched to other regimens because dFLC elevated but did not fulfill progressive disease after 2 year application. As to safety, no grade 3/4 infusion reaction developed, and grade 1 infusion reaction occurred in 3 cases during the first infusion. Lymphocytopenia was seen in 75% patients including grade 3 or more in 30% patients.Conclusion:Daratumumab is effective to eliminate serum free light chain in both newly diagnosed and relapsed patients with systemic amyloidosis.
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Background and Objectives@#Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is highly prevalent in in-hospital HF patients and contributes to worse prognoses. However, the risk of VTE in out-patients with HF in long-term period is controversial. This study aimed to evaluate the associations between HF and the risk of VTE in a long-term follow-up duration. @*Methods@#We searched for studies investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020, in PubMed, MEDLINE, and Embase databases. Cohort studies and post hoc analysis of RCTs were eligible for inclusion if they reported relative risk of VTE, DVT or PE in patients with HF in more than 3-month follow-up period. @*Results@#We identified 31 studies that enrolled over 530,641 HF patients. Overall, patients with HF were associated with an increased risk of VTE (risk ratio [RR]=1.57, 95% confidence interval [CI]=1.34–1.84) and PE (RR=2.00, 95% CI=1.38–2.89). However, the risk of DVT was not significantly increased in HF patients (RR=1.33, 95% CI=0.67–2.63). Subgroup analysis showed that patients with chronic HF (RR=1.54, 95% CI=1.32–1.80) had a higher risk of VTE than those with acute HF (RR=0.95, 95% CI=0.68–1.32). @*Conclusions@#In conclusion, HF was an independent risk for VTE and PE but not DVT in a longterm follow-up period. Patients with chronic HF were prone to suffer from VTE than acute HF.
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Background and Objectives@#Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is highly prevalent in in-hospital HF patients and contributes to worse prognoses. However, the risk of VTE in out-patients with HF in long-term period is controversial. This study aimed to evaluate the associations between HF and the risk of VTE in a long-term follow-up duration. @*Methods@#We searched for studies investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020, in PubMed, MEDLINE, and Embase databases. Cohort studies and post hoc analysis of RCTs were eligible for inclusion if they reported relative risk of VTE, DVT or PE in patients with HF in more than 3-month follow-up period. @*Results@#We identified 31 studies that enrolled over 530,641 HF patients. Overall, patients with HF were associated with an increased risk of VTE (risk ratio [RR]=1.57, 95% confidence interval [CI]=1.34–1.84) and PE (RR=2.00, 95% CI=1.38–2.89). However, the risk of DVT was not significantly increased in HF patients (RR=1.33, 95% CI=0.67–2.63). Subgroup analysis showed that patients with chronic HF (RR=1.54, 95% CI=1.32–1.80) had a higher risk of VTE than those with acute HF (RR=0.95, 95% CI=0.68–1.32). @*Conclusions@#In conclusion, HF was an independent risk for VTE and PE but not DVT in a longterm follow-up period. Patients with chronic HF were prone to suffer from VTE than acute HF.
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Objective@#To examine the association of health literacy (HL) and screen time (ST) with non-suicidal self-injury (NSSI) in middle school students, and to provide guidance for prevention on self-injuries in adolescents.
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Objective:To observe the clinical effect of hernia ring filling tension-free hernia repair on adult inguinal hernia.Methods:From March 2016 to March 2019, 100 adult patients with inguinal hernia who received surgical treatment in Zhoushan Maternal and Child Health Hospital were divided into two groups according to the random number table method, with 50 cases in each group.The control group received the chip without tension hernia repair, and the study group received hernia ring filling type without tension hernia repair.The operation time, length of hospital stay, use of analgesic ratio, ratio of postoperative patients with local foreign body sensation, incidence of adverse reactions (incision infection rate, rate of seroma, scrotal edema rate) were compared between the two groups.Results:The operation time [(0.86±0.22)h] and hospital stay [(5.11±1.56)d] in the study group were shorter than those in the control group [(1.44±0.76)h and (9.87±1.33)d] ( t=5.183, 16.418, all P<0.05). And the ratio of use analgesics (20.00%), the ratio of local foreign body sensation (2.00%), the incidence of adverse reactions (incision infection rate: 2.00%, seroma rate: 4.00%, scrotal edema rate: 2.00%) and other indicators in the study group were lower than those in the control group (36.00%, 18.00%, 8.00%, 10.00%, 8.00%)(χ 2=5.183, 16.418, 3.174, 7.111, 5.740, all P<0.05). Conclusion:Application of the hernia ring filling tension-free hernia repair in the treatment of adult inguinal hernia can shorten the operation time, hospital stay and decrease the incidence rate of adverse reactions.
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Objective:The outbreak of novel coronavirus raised many problems in the auxiliary information system of epidemic prevention and control, which including the need to prevent key data from being illegal modification, traceability, lack of decision support systems at different levels, barriers to cross regional cooperation and low automation of case diagnosis.Methods:In this paper, artificial intelligence, security computing supporting privacy protection, block chain and other emerging technologies are introduced into the epidemic prevention and control auxiliary information system.Results:This paper discusses how to utilize modern cryptography and block chain technology to establish a traceability system that could assure the security of epidemic information; design a distributed decision support system; solve the privacy-preserving problems of Federated Learning based on SGX technology, and present a group architecture to alleviate the performance cost of SGX.Conclusions:The schemes above can help to achieve the security and traceability of epidemic information, also improve the automation and decision-making efficiency of the auxiliary information system for epidemic prevention and control.
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Objective@#The outbreak of novel coronavirus raised many problems in the auxiliary information system of epidemic prevention and control, which including the need to prevent key data from being illegal modification, traceability, lack of decision support systems at different levels, barriers to cross regional cooperation and low automation of case diagnosis.@*Methods@#In this paper, artificial intelligence, security computing supporting privacy protection, block chain and other emerging technologies are introduced into the epidemic prevention and control auxiliary information system.@*Results@#This paper discusses how to utilize modern cryptography and block chain technology to establish a traceability system that could assure the security of epidemic information; design a distributed decision support system; solve the privacy-preserving problems of Federated Learning based on SGX technology, and present a group architecture to alleviate the performance cost of SGX.@*Conclusions@#The schemes above can help to achieve the security and traceability of epidemic information, also improve the automation and decision-making efficiency of the auxiliary information system for epidemic prevention and control.
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Objective@#To explore the association between co-consumption of takeaway fast foods and sodas with depressive symptoms among Chinese adolescents, and to provide a reference for reducing the occurence of depression among adolescents.@*Methods@#A multi-center population-based survey was conducted in 32 schools in 4 provinces across China. A total of 14 500 adolescents completed eligible questionnaires. Depressive symptoms were assessed by using Children’s Depression Inventory(CDI), while consumption of takeaway fast foods and sodas was collected using the semi-quantitative Food Frequency Questionnaire(FFQ).@*Results@#27.26%(3 952/14 500) of adolescents were reported of depressive symptoms. The low, middle, and high-frequency consumption of takeaway fast foods (a OR=1.12, 1.73, 1.56, P<0.05) and sodas (a OR=1.64, 2.17, 3.54, P<0.01) were associated with depressive symptoms, and dose-response relationships were observed in all association(P<0.01). Meanwhile, positive additive interactions were observed in the association(a OR=2.46, P<0.01). The relative excess risk, attribution ratio and the interaction index of synergy was 0.45(0.12-0.77), 0.18(0.06-0.30) and 1.44(1.10-1.89), respectively.@*Conclusion@#Co-consumption of takeaway fast foods and sodas significantly associates with depressive symptoms by synergistic effect among Chinese adolescents.
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Objective To explore the effect of micro-lecture-CPT teaching method (case,problem and team-based learning,CPT) used in pathology teaching.Methods 236 medical imaging undergraduates from Grade 2015 were selected and divided into two groups equally.The experimental group (118 people) used the micro-lecture-CPT teaching method,and the control group (118 people) used the traditional teaching method.The students in the experimental group used the interactive platform on the internet to share the resource in combination with pathological theory and experiment,including curriculum,microlecture,multimedia courseware,clinical case and the related questions before class.In class,the questions were discussed in groups based on "student centered,teacher guide".Questionnaire survey and test scores were used to collect data and analyze the differences between the two groups.SPSS 13.0 was applied to processing the data.Measurement data were expressed as mean plus or minus standard deviation,and t test was used in the comparison between groups.Results The average score of basic theoretical examination in the experimental group was lower than that of the traditional teaching group [(57.86-± 2.32) vs.(58.23 ±2.06)];While the case score and experimental score in the experimental group were significantly higher than those of the traditional teaching group [(11.27 ± 1.24) vs.(7.40 ± 0.90);(18.04 ± 0.87) vs.(14.75 ± 0.93)].And the differences were statistically significant (P＜0.05).Questionnaire survey demonstrated that the experimental group students' evaluation on the learning of micro-lecture-CPT teaching was higher than the control group's evaluation on traditional teaching in the aspects of improving students' learning interest,promoting autonomous learning and problem solving skills,cultivating clinical thinking ability and team cooperation spirit.Conclusion Micro-lecture-CPT teaching method conforms to the trend of modem teaching reform and achieves good effect in pathology teaching,so it is worth recommending and popularizing.
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Objective Based on Chinese guidelines for the management of ischemic stroke, a standardized stroke management program was performed to provide intensive education and training for medical physicians, aiming to enhance their knowledge and ability for ischemic stroke prevention and treatment, thereby reducing patients′ in-hospital cost and length of stay, and improving patients′ clinical prognosis. Methods This study was conducted in 20 general hospitals throughout Hainan province. A total of 163 physicians from 20 hospitals involved in the management of stroke patients were trained by highly experienced physicians based on the Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2014 and the Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack 2014. Prior to and post the standardized stroke management training, the data of 3218 and 3367 patients with ischemic stroke were respectively collected. Quality of life assessments including the Barthel index (BI) and the modified Rankin Scale (mRS) score of all patients were recorded at baseline and after discharge. The length of stay and in-hospital cost were directly collected from the hospital information system. Results Physicians′ knowledge and ability manifested as testing scores were significantly improved after training (78.2 ± 15.5 vs 55.6 ± 10.7, t=69.1, P<0.01). The average length of stay of post-training patients was significantly shorter than that of pre-training patients ((8.7 ± 0.9) vs (11.7 ± 1.5) days, t=97.9, P<0.01). The average in-hospital cost of post-training patients was significantly less than that of pre-training patients ((7681.7 ± 1397.7) vs (11846.2 ± 2514.6) Yuan, t=82.5, P<0.01). Both BI (68.2 ± 3.2 vs 43.5 ± 5.3, t=227.7, P<0.01) and mRS score (2.74±0.51 vs 3.65±0.71, t=59.5, P<0.01) were significantly improved for post-training patients. Multivariate linear regression analysis illustrated that standardized stroke management was negatively associated with in-hospital cost (r=-0.461, P<0.01), length of stay (r=-0.357, P<0.01) and mRS score (r=-0.298, P<0.01), and was positively associated with levels of BI (r=0.376, P<0.01). Conclusion Standardized stroke management program might be a cost-effective choice for the management of ischemic stroke as it reduces the in-hospital cost and improves patients′BI and mRS levels.
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Purpose 18F-FDG PET/CT,pathological and immunohistochemical analysis are adopted to explore the value of PET/CT in the early-stage calcification examination of atherosclerosis in rabbits and effects of Pioglitazone in treating early-stage calcification.Material and Methods Sixteen New Zealand male rabbits were randomly divided into two groups:Pioglitazone group and control group,witheight rabbits in each group.Atherosclerosis model was established.Rabbits in Pioglitazone group received gavage with Pioglitazone and were raised with high-fat diet for 20 weeks.Blood was drawn to exam high sensitivity C-reactive protein and matrix metalloproteinase-9.PET/CT was used to measure mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax).Rabbit aorta received immunohistochemical,the plaque area,density of macrophage,percentage of calcification area and apoptosis index between the two groups were determined and compared.Results On 20 week,high sensitivity C-reactive protein in Pioglitazone group (4.27±0.43 vs.6.51 ±0.91,P＜0.01),matrix metalloproteinase-9 (41.52± 1.99 vs.62.21 ±3.60,P＜0.05),SUVmean (0.55±0.18 vs.0.68±0.21,P＜0.01)and SUVmax (0.70±0.19 vs.0.82±0.30,P＜0.05) were obviously lower than those in control group.Plaque area,density of macrophage,percentage of calcification area and apoptosis index in control group were obviously higher than those in Pioglitazone group.Plaque area of related artery section was positively correlated with SUVmean (r=0.28,P＜0.01) and SUVmax (r=0.25,P＜0.05).Density of macrophage was positively correlated with SUVmean (r=0.50,P＜0.01) and SUVmax (r=0.46,P＜0.01).Percentage of calcification area was positively correlated with SUVmean (r=0.50,P＜0.01) and SUVmax (r=0.47,P＜0.01).Apoptosis index was positively correlated with SUVmean (r=0.61,P＜0.01)and SUVmax (r=0.60,P＜0.01).Conclusion Inflammation and macrophage apoptosis are of great importance in the early-stage of atherosclerosis.18F-FDG PET/CT imaging can be used to assess minor calcification.Pioglitazone can reduce inflammatory level of atherosclerosis of the experimented animals,inhibiting early-stage calcification.
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<p><b>OBJECTIVE</b>This study aims to investigate the association between interleukin (IL)-10-597 (C/A) single-nucleotide polymorphisms and chronic periodontitis of Moyu Uygur population in Xinjiang Uygur Autonomous Region of China.</p><p><b>METHODS</b>In accordance with the inclusion and exclusion criteria, the buccal swabs of 300 subjects were randomly selected from the epidemiological investigation of Uygur adults in Moyu county on April and May 2013. The study was conducted on a healthy control group, a mild chronic periodontitis group, and a moderate-to-severe chronic periodontitis group, with each comprising 100 samples. The IL-10-597(C/A) site in the promoter sequences was analyzed using the tetra-primer amplification refractory mutation system-polymerase chain reaction method to test the genotype and allele distributions. Statistical analysis was performed using Chi-squared test and ordinal classification Logistic regression analysis.</p><p><b>RESULTS</b>The genotype and allele frequencies of the IL-10-597(C/A) site in the healthy control group, mild chronic periodontitis group, and moderate-to-severe chronic periodontitis group exhibited no significant difference (P>0.05). The age of all the samples was associated with chronic periodontitis. The risk of chronic periodontitis in the people of 55-65 years old was 25 times in the people under the age of 35 (OR=25.56, P<0.001).</p><p><b>CONCLUSIONS</b>The IL-10-597 (C/A) single-nucleotide polymorphisms in the gene promoter are not associated with chronic periodontitis in Uygur adult population.</p>
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Objective This study used multivariate regression analysis to study the prevalence of malnutrition and the impact of malnutrition on independence in activities of daily living,health outcomes,chronic disease and healthcare cost among older Chinese adults.Methods This study was based on data from the 2013 China Health and Retirement Longitudinal Survey(CHARLS).The CHARLS data covers information on demographics,family,health status and functional limitations,health insurance,employment and earnings among mid-aged and older community-dwelling Chinese.This research focused on older Chinese adults aged 60 years and over.As a result,over 5,900 subjects were included.This study defined malnutrition based on body mass index,weight loss and reduced handgrip strength.Functional status was assessed via adapted versions of the Katz index of independence in basic activities of daily living (ADL)and the Lawton-Brody index of independence in instrumental activities of daily living (IADL).Health outcomes included self reported health status.Then multivariate regression analysis was used to investigate the relationship between malnutrition and various health outcomes.Results Thirty percent of older Chinese adults were malnourished.Malnutrition was associated with significantly lower IADL (OR =0.868,P ＜ 0.05),poorer health status(OR =0.675,P＜0.001),as well as higher probability of having stroke(OR =1.399,P＜0.05)and chronic stomach disease(OR =1.241,P＜0.001).As a significant contributor of poorer self-reported health status,malnutrition,in turn,increased hospital cost by ￥214 (14％increase,P＜0.01)per person per year.Conclusions Malnutrition leads to functional limitations and worse health outcomes among community-dwelling older Chinese adults.These results imply that nutrition interventions such as nutrition screening and assessment,making scientific and personal nutrition support plans,and providing timely adequate nutrition support therapy can improve the health status and lower the healthcare cost of older adults living in the community.
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Objective To investigate the effect of pretend play training based on Learn to Play program on pretend play capabilities of children with autism. Methods The researchers referred some training strategies in Learn to Play program, and designed a pretend play train-ing which adapted to autistic children's level of development. And then they conducted the pretend play training on three autistic children for four weeks. After that they used Child-Initiated Pretend Play Assessment to assess the effect of the intervention before, after and two weeks after training. Results The percentage of pretend play actions, the number of object substitutions and the number of imitated actions in-creased in some degrees in the children. Conclusion The pretend play training based on Learn to Play program can promote the pretend play capabilities of children with autism.
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Objective To investigate the current status of healthcare-associated infection(HAI) management professionals in county and above levels of traditional Chinese medicine(TCM) institutions in a province.Methods The uniform questionnaires were adopted to investigate the basic status of HAI professionals in county and above levels of TCM institutions in a province.Results There were 117 county and above levels of TCM institutions in this province,85 TCM institutions participated the investigation,there were a total of 128 professionals,including 82 professionals in 65 secondary hospitals,and 46 in 20 tertiary hospitals.Among the investigated TCM hospitals,83 (97.65 ％) set up HAI management committees,77 (90.59％) set up independent HAI management departments,55 (64.71％) assigned HAI professionals that met The Requirements of HAI Surveillance Guideline,27 (31.76 ％) exclusively engaged in management of HAI,58 (68.24 ％) were also responsible for other management besides HAI management.Among investigated professionals,91.41％ were nursing staff,55.47％ received undergraduate course or above,54.69％ had intermediate professional titles,61.72％ were at the age of 41-50,45.31 ％ engaged in HAI management for 1-3 years,115 professionals had management certificates.Conclusion The infec tion management in provincial traditional Chinese medicine institutions are understaffed,professional structure is unitary,professional quality is low,leaders in different levels of TCM institutions should enhance HAI management awareness,strengthen the construction of professional quality,and cultivate multi-disciplinary talents as soon as possible.
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To investigate the effect of MMP-26 on human glioma angiogenesis and the possible mechanism.Methods The MMP-26 plasmid and empty plasmid pcDNA3.1 were stably transfected into U251 cells to establish a nude mice xenograft model,and then an in vitro human tumor tissue-based three-dimensional angiagenic model.Tissue disks were visually assessed over time to determine the percentage of wells that developed an angiogenic response(I％) and the density and length of neovessel growth were graded at intervals using a semiquantitative visual growth-rating scheme (angiogenic index,AI,0-16scale) in groups of MMP-26 transfected U251 cells (U251-MMP-26),pcDNA3.1 vector-transfected U251 cells (U251-pcDNA3.1) and non-transfected U251 cells (U251).RT-PCR and immunohistochemistry were used to detect the expression of mRNA and protein of MMP-26 and VEGF in groups of U251-MMP-26,U251-pcDNA3.1 and U251.Immunohistochemical localization of CD31 was determined in the endothelial tubes invading the fibrin-thrombin clot matrix.Results Immunohistochemical endothelial cell markers CD31 was positive in the vascular tubes invading the fibrin-thrombin clot matrix,confirming their endothelial origin.The angiogenesis results showed that difference of length of micro capillaries,density of branches,and the area occupied between U251-MMP-26 groups and control groups were significant.The percentage of tumor implants that developed invasion (I％) and the angiogenic index AI in U251-MMP-26 group on day 14 were higher than those of U251-pcDNA3.1 group and U251 group (P ＜ 0.05).The trends of I％ and AI in 14 days were significant compared with those in control groups.The expression of mRNA and protein of MMP-26and VEGF in U251-MMP-26 group was significantly higher in U251-MMP-26 group than those in U251-pcDNA3.1 group and U251 group(P ＜0.01).Conclusion The effect of MMP-26 on promoting glioma angiogenesis may be related to the increased expression of VEGF,which can be used as targets for anti-tumor therapy.
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Objective: Heart failure (HF) patients are usually associated with liver function impairment, Child-Turcotte-Pugh (CTP) scores can evaluate liver function, but its effect in HF patients has been unclear. We want to study the application of CTP scores in predicting the risk of death for in-hospital HF patients. Methods: A total of 1180 consecutive in-hospital HF patients were enrolled. According to CTP scores evaluated liver function at admission, the patients were divided into 3 groups: CTP grade A group, n=951, CTP grade B group, n=206 and CTP grade C group, n=23. The endpoint of this study was all-cause death. Results: There were 180 patients died at 1 year follow-up period, the in-hospital and 1 year mortalities were increased with the elevated CTP grades accordingly: for in-hospital mortalities in CTP grade A, B and C groups were (0.8%, 11.7% and 56.5%) respectively, P Conclusion: CTP scores may independently predict the risk of death for in-hospital HF patients, the levels of CTP scores might be used for evaluating the efficacy of in-hospital treatment.