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Objective:To investigate the threshold of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), synovial fluid white blood-cell count (WBC) and polymorphonuclear cells (PMN) proportion in the diagnosis of periprosthetic joint infection (PJI) in patients with rheumatoid arthritis (RA).Methods:The clinical data of 246 patients with RA and osteoarthritis (OA) who had previously undergone total knee and hip arthroplasty from January 2006 to December 2019 was retrospectively analyzed. The patients were divided into four groups according to the disease type and whether PJI occurred, namely 46 patients in the RA-PJI group, 64 patients in the RA-non-PJI group, 72 patients in the OA-PJI group, and 64 patients in the OA-non-PJI group. The receiver operating characteristics (ROC) curve was used to determine the optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for diagnosing the RA-PJI and OA-PJI. The optimal cut-off values of serum and synovial fluid indexes were evaluated for the diagnostic efficacy of RA-PJI by comparing the area under curve (AUC) of each index. Further, the values were applied for joint test analysis.Results:For PJI prediction, the results of serological and synovial fluid indexes were different between RA-PJI group and OA-PJI group. The results of ROC curve analysis showed that the optimal cut-off values of each detection index were as follows. The optimal cut-off value of CRP for diagnosing RA-PJI was 14.4 mg/L, ESR was 39 mm/1 h, synovial fluid WBC was 3 654×10 6 /L, and PMN proportion was 0.659. The optimal cut-off value for diagnosing OA-PJI were 8.16 mg/L, 31 mm/1 h, 2 452×10 6 /L, and 0.625, respectively. In the RA-PJI group, the difference between the AUC of each detection index and AUC=0.5 was statistically significant ( P<0.05). Among them, the specificity of synovial fluid WBC was 92.3%, AUC was 0.879 (95% CI: 0.776, 0.982) with 87.8% positive predictive value and 10.21 positive likelihood ratio. These values were higher than those of CRP, ESR, and PMN proportion. The results of joint test analysis for the diagnosis of RA-PJI were as follows. The specificity of the series test was 100%, and the sensitivity of the parallel test was 100%; the specificity of the joint index diagnostic test was 100%, AUC was 0.926 (95% CI: 0.848, 1.000), the difference between AUC and AUC=0.5 was statistically significant ( P<0.05). Conclusion:The optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for the diagnosis of PJI in patients with RA are all higher than those of patients with OA. Their optimal cut-off values can be used as important auxiliary indexes for a clear diagnosis of PJI in patients with RA. Compared with other indexes, the synovial fluid WBC has strong predicting power and lower misdiagnosis rate, which could be the best detection index for identifying PJI in patients with RA. The joint test could improve the sensitivity or specificity of PJI diagnosis in patients with RA. The combination with multiple detection indexes could provide a reference for the early and accurate diagnosis of PJI in patients with RA.
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Objective To explore the medication closed-loop management of huangshi central hospital based on electronic medical records.Methods Diversified pharmaceutical information platform was constructed.The full coverage of all aspects of medication information,such as ordering/prescribing,transcribing,distributing,preparing,dispensing,administering,documenting,and monitoring was realized.Results The medication management and use had no information gap,and bias could be controlled to form a closed-loop management.Conclusion Application of the new information technology in the field of pharmaceutical care can improve work efficiency,reduce medication errors,broaden the vision of clinical pharmacists and scope of work,and improve the overall level of pharmaceutical care.
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Objective To analyze the effect of clinical pharmacists involving in JCI clinical care program certification-AMI(CCPC-AMI) on the compliance rates of clinical drug treatment guideline and the awareness rates of patient medication health education in cardiovascular.Methods Selected cases of acute myocardial infarction(AMI) from March to August in 2015 was as the former group,from September 2015 to March 2016 as the latter group in their hospital,then comparative analysis of two groups was done by statistical method.Results After clinical pharmacists involved in CCPC-AMI,the compliance rates of AMI clinical drug treatment guidelines (after the AMI diagnosis, the 10min was given aspirin, intensified statin therapy and dose selection, the use of ACEI/ARB before discharge and the use of beta blocker before discharge) were increased from 92.7% 67.9%,60.7%,51.8% to 98.1%,85.2%,94.4%,90.7%.The awareness rates of patient medication health education (awareness of safe medication, awareness of self-management, awareness of follow-up knowledge) were all increased to 100% from 75.0%,57.1%,82.1% before participation.Conclusion Clinical pharmacists who carried out pharmaceutical care,has played a critical role in quality control of AMI single disease through the preparing of CCPC-AMI evaluation.
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@#Objective To investigate the changes of non-linear dynamics characteristics of electroencephalogram(EEG) in patients with the stagnation of Liver-Qi syndrome.Methods 15 Liver-Qi stagnation syndrome patients and 15 normal persons were paired by sex and age.The data of EEG under three states(eyes closed,eyes opened,and mental arithmetic with eyes opened) were analyzed by the parameter of point-wise correlation dimension(PD2).Results PD2 of the stagnation of Liver-Qi syndrome group increased significantly compared with that of the healthy control group and always maintain high level.The difference of PD2 between two groups was gradually reduced along with the increase of stimulated condition.Conclusion Non-linear dynamic analysis is more appropriate for the study of mental functions changes of stagnation of Liver-Qi syndrome and can be used to investigate the brain mechanism of the stagnation of Liver-Qi syndrome.
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@# Electroencephalogram non-linear analysis is one of the methods to study brain electric signal complexity and the mutual connection of signals based on the non-linearity principle and method. It can provide condition such as the neural networks function, contact information, the changing trajectory cerebrum function activity. It can be used for nerve spirit disease studying, the depth anaesthetize monitor ,the sleep studies in modern medicine, it breaks the ice in traditional Chinese medicine just now. The application of electroencephalogram non-linear analysis has open up an exhibition further to cerebrum's research.
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@#Functional magnetic resonance imaging (fMRI) is an imaging method of function brain area by stimulate in magnetic resonance facility; it can exactitude reflect the nerve activity level of brain and confirm the function brain area in alive body; it is a new impersonality imagine method to evaluate the cognitive function of human. Cognitive function obstacle is a clinical syndrome of damaging cognitive function by manifold reasons and can be leaded by many diseases in clinic. Studying changed function brain area by fMRI can offer an impersonality and intuition imagine evidence to forepart prevent, diagnose and therapy of the diseases of cognitive function obstacle.
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@#Objective To explore the characteristics of patients with stagnation of liver-qi syndrome using brain functional imaging techniques.Methods10 patients with stagnation of liver-qi syndrome and 20 normal persons whom paired by sex and age were scanned with positron emission tomography(PET).Data analysis was carried out using SPM in MATLAB software.ResultsCompared with normal,some cerebral areas of the patients with stagnation of liver-qi syndrome showed glucose metabolism letdown(P<0.001),including right parietal lobe(postcentral gyrus,BA1/2),temporal lobe(middle temporal gyrus,BA37),frontal lobe(middle frontal gyrus,BA9/10)etc.,while some cerebral areas showed glucose metabolism heighten(P<0.001)including right frontal lobe(superior frontal gyrus,inferior fontal gyrus,BA22/28/44),right cingulated gyrus,double midbrain and cerebella,etc.ConclusionThe function of some cerebral areas can be changed undergoing stagnation of liver-qi syndrome.
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@#ObjectiveTo investigate the characteristics of personality in patients with depression. Methods24 patients with depression and 24 normal controls were measured with Minnesota Multiphasic Personality Inventory (MMPI) software. ResultsCompared with the control, patient with depression showed significantly difference in neuroticism, extraversionn-introversion, anxiety, repression, manifest anxiety scale, ego strength, dependency, dominance (P<0.05). the T score of N and repression is higher than the Chinese usual score. ConclusionThe depression patients show their personality as repression, inferiority, melancholy, anxiety, bad tolerance, overstrung and dependent.
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Objective To investigate the loss of heterozygosity (LOH) of 3p D3S1300 and D3S1289 loci of plasma DNA of lung cancer (LC) patients and evaluate its value for a tumor marker of lung cancer.Methods Two microsatellite markers,D3S1300 and D3S1289,were analyzed by PCR and silver staining to investigate LOH of the plasma DNA and cancer tissue DNA from 69 cases of primary lung cancer,and the plasma DNA from 40 control subjects.Results The percentages of D3S1300 LOH detected in the tumor tissue and plasma DNA of LC patients were 40.6% and 29.0% respectively,while the percentages of D3S1289 LOH were 31.9% and 24.6% respectively.In contrast,only 2 cases of D3S1300 LOH and 3 cases of D3S1289 LOH were found in plasma DNA of control group (P
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Objective:To explore the effect of Naoshuning on the protein expression of Matrix metalloproteinases(MMPs) in experimental injuried brain tissue of rats. Methods:Immunohistochemistry was used to determine the changes of protein expression of MMPs. Brain tissue water content,permeability and ultramicrostructure of blood-brain barrier(BBB) were also observed. Results:Compared with the sham group,the brain tissue water and EB content of injured side and the level of MMP-2 and MMP-9 protein expression in brain tissue around contusion in model group increased obviously(all P
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@#ObjectiveTo investigate the dynamic change of cerebral aquaporin 4 (AQP4) expression level during traumatic brain injury (TBI) in rats and the relationship between AQP4 expression and traumatic brain injury and edema. MethodsThe experimental TBI model was established by bumpiness of free falling body according to Feeney's. The changes of brain water content (BWC) and permeability of blood-brain barrier (BBB) were measured by the methods of wet and dry weight and Evans blue fluorometry. Immunohistochemistry was used to determine the change of expression of AQP4 during different periods after TBI. Results6 h after TBI, water content of brain tissue and EB content in the contusion side significantly increased, and the protein expression of AQP4 in contusion marginal region began to increase. They reached summit 24 h after operation and did not come back normal level 5 d after operation. There was significantly positive correlation between protein expression of AQP4 and change of EB content (r=0.957486,P<0.05). ConclusionThe dynamic change of cerebral AQP4 expression level closely related to the destruction of BBB and the formation of cerebral edema during traumatic brain injury.
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@#ObjectiveTo observe the protective effects of Chinese medicine Naoshuning on neurological deficits following traumatic brain injury (TBI) in rats.MethodsCerebral contusion was produced by dropping weight,the beam-walking task was employed to observe neurological functional changes,water content in the brain tissue and neuropathological changes were also evaluated.ResultsWithin one week the ability to process in beam-walking task was significantly lessened,the outcome of beam-walking task of Naoshuning group was significantly better than that of the model group.Water content in the brain tissue and neuropathological changes were also alleviated in Naoshuning group compared with that in model group.ConclusionEarly alleviating brain edema,protecting brain tissue may be one of the mechanism of Chinese medicine to ameliorate the behavior deficits following TBI in rats.