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1.
Journal of Chinese Physician ; (12): 185-190, 2024.
Article in Chinese | WPRIM | ID: wpr-1026075

ABSTRACT

Objective:To explore the drug resistance of pathogens in puerperal infection of pregnant women with diabetes mellitus (GDM), and analyze the influence of puerperal infection on the expression of toll like receptor 4 (TLR4) inflammatory pathway in peripheral blood monocytes.Methods:A retrospective selection was conducted on 120 GDM postpartum women who underwent regular prenatal check ups and delivery at the 903th Hospital of the PLA (People′s Liberation Army) Joint Logistic Support Force from January 2020 to October 2022. The postpartum infection status, pathogenic characteristics of the infected pathogens, and drug resistance of the mothers were analyzed; According to the postpartum infection situation, the parturients were divided into an infected group and an uninfected group. Logistic regression analysis was used to analyze the relevant factors affecting postpartum infection, and the TLR4 protein and mRNA expression levels of peripheral blood mononuclear cells in the two groups were compared.Results:Among 120 GDM pregnant women, 21 cases (17.50%) developed post infection, including 8 cases (38.10%) of incision infection, 6 cases (28.57%) of uterine cavity infection, 4 cases (19.05%) of urinary system infection, and 3 cases (14.28%) of blood infection; A total of 43 pathogenic bacteria were detected, including 26 Gram negative bacteria (60.46%), 14 Gram positive bacteria (32.56%), and 3 fungi (6.98%). Among the main Gram negative bacteria, escherichia coli had the highest resistance rate to ceftazidime and tetracycline, and had not developed resistance to meropenem; Pseudomonas aeruginosa had the highest resistance rate to ceftazidime and gentamicin. Among the main Gram positive bacteria, staphylococcus aureus had the highest resistance rate to penicillin G and ceftazidime, and had not developed resistance to vancomycin; Enterococcus faecalis had the highest resistance rate to clindamycin. The results of multivariate logistic regression analysis showed that postpartum hemorrhage, premature rupture of membranes, and poor control of prenatal blood sugar were independent risk factors for postpartum infection in GDM mothers (all P<0.05). The expression rate of TLR4 protein, relative expression level of TLR4 mRNA, and levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1, and IL-10 in the infected group were significantly higher than those in the non infected group (all P<0.05). Conclusions:The distribution and drug resistance of pathogenic bacteria in postpartum infections of GDM mothers have certain characteristics. Postpartum hemorrhage, premature rupture of membranes, and poor control of prenatal blood sugar are independent risk factors affecting postpartum infections in GDM mothers; The TLR4 inflammatory pathway in peripheral blood mononuclear cells may be involved in the occurrence and development of postpartum infection in GDM mothers.

2.
Article in Chinese | WPRIM | ID: wpr-1026821

ABSTRACT

Objective To investigate the protective effect and mechanism of Danshen Tongluo Jiedu Decoction medicated serum for hypoxia/reoxygenation rat myocardial microvascular endothelial cells(CMECs)by regulating MALAT1.Methods Rats CMECs cells were cultured in vitro to establish a model of hypoxia/reoxygenation damaged cells,and were transfected overexpressing/silencing blank MALAT1 slow virus,cells were divided into overexpressed blank + TCM group,overexpressed MALAT1 + TCM group,overexpressed MALAT1 group,silenced blank + TCM group,silenced MALAT1 group,and silenced MALAT1 + TCM group.They were cultured with corresponding serum separately.Beclin-1 protein expression was detected by immunofluorescence method,and SRPK1,SRSF1,VEGF and Bax protein expressions were detected by Western blot,MALAT1,SRPK1 and SRSF1 mRNA expressions were detected by RT-PCR.Results Compared with the overexpressed blank + TCM group,Beclin-1 protein expression increased in the overexpressed MALAT1 + TCM group,the protein expressions of SRPK1,SRSF1 and Bax significantly increased(P<0.05,P<0.01),VEGF protein expression significantly decreased(P<0.01),while MALAT1,SRPK1 and SRSF1 mRNA expressions significantly increased(P<0.05,P<0.01).Compared with the overexpressed MALAT1 group,the protein expression of Beclin-1 in overexpressed MALAT1 + TCM group decreased,the expressions of SRPK1,SRSF1 and Bax protein significantly decreased(P<0.01,P<0.05),the expression of VEGF protein significantly increased(P<0.01),the mRNA expressions of MALAT1,SRPK1 and SRSF1 significantly decreased(P<0.05).Compared with the silenced blank + TCM group,the protein expression of Beclin-1 in silenced MALAT1 + TCM group decreased,the expressions of SRPK1,SRSF1 and Bax protein significantly decreased(P<0.01),while the expression of VEGF protein significantly increased(P<0.01),the mRNA expressions of MALAT1,SRPK1 and SRSF1 significantly decreased(P<0.01).Compared with the silenced MALAT1 group,the protein expression of Beclin-1 in silenced MALAT1 + TCM group decreased,the expressions of SRPK1,SRSF1 and Bax protein significantly decreased(P<0.05),the expression of VEGF protein significantly increased(P<0.01),the mRNA expressions of MALAT1,SRPK1 and SRSF1 significantly decreased(P<0.01,P<0.05).Conclusion Upregulation of MALAT1 expression can promote autophagy in hypoxia/reoxygenation model CMECs,while Danshen Tongluo Jiedu Decoction medicated serum can inhibit MALAT1 expression,thus inhibiting autophagy and promoting angiogenesis,and the mechanism may be related to the downregulation of SRPK1 and SRSF1 expressions.

3.
Article in Chinese | WPRIM | ID: wpr-981802

ABSTRACT

OBJECTIVE@#To assess the diagnostic value of whole exome sequencing (WES) for patients with intellectual disability (ID) or global developmental delay (GDD).@*METHODS@#134 individuals with ID or GDD who presented at Chenzhou First People's Hospital between May 2018 and December 2021 were selected as the study subjects. WES was carried out on peripheral blood samples of the patients and their parents, and candidate variants were verified by Sanger sequencing, copy number variation sequencing (CNV-seq) and co-segregation analysis. The pathogenicity of the variants was predicted based on the guidelines from the American College of Medical Genetics and Genomics (ACMG).@*RESULTS@#A total of 46 pathogenic single nucleotide variants (SNVs) and small insertion/deletion (InDel) variants, 11 pathogenic genomic copy number variants (CNVs), and 1 uniparental diploidy (UPD) were detected, which yielded an overall detection rate of 43.28% (58/134). The 46 pathogenic SNV/InDel have involved 62 mutation sites in 40 genes, among which MECP2 was the most frequent (n = 4). The 11 pathogenic CNVs have included 10 deletions and 1 duplication, which have ranged from 0.76 to 15.02 Mb. A loss of heterozygosity (LOH) region of approximately 15.62 Mb was detected in 15q11.2q12 region in a patient, which was validated as paternal UPD based on the result of trio-WES. The patient was ultimately diagnosed as Angelman syndrome.@*CONCLUSION@#WES can detect not only SNV/InDel, but also CNV and LOH. By integrating family data, WES can accurately determine the origin of the variants and provide a useful tool for uncovering the genetic etiology of patients with ID or GDD.


Subject(s)
Humans , Exome Sequencing , Intellectual Disability/genetics , DNA Copy Number Variations , Mutation , Loss of Heterozygosity
4.
Article in Chinese | WPRIM | ID: wpr-1009275

ABSTRACT

OBJECTIVE@#To assess the value of non-invasive prenatal testing (NIPT) for the identification of numerical and structural chromosomal abnormalities and copy number variations (CNVs) in fetuses.@*METHODS@#46 197 pregnant women undergoing NIPT at the Prenatal Diagnosis Center of Chenzhou First People's Hospital from January 2018 to December 2021 were selected as the study subjects. Positive cases were subjected to chromosomal karyotyping and copy number variation sequencing (CNV-seq) following amniocentesis.@*RESULTS@#Nearly 50% of common chromosomal aneuploidies were found in the elder pregnant women. Among these, sex chromosome aneuploidies were mainly found in pregnant women with advanced age as well as borderline risks by serological screening. Rare autosomal aneuploidies and CNVs were mainly found in those with borderline or high risks by serological screening. The positive predictive values (PPV) for fetal chromosomal abnormalities indicated by NIPT were as follows: T21 (92.37%, 109/118), T18 (53.85%, 14/26), sex chromosome aneuploidies (45.04%, 59/131), T13 (34.62%, 9/26), CNVs (29.17%, 14/48), and rare autosomal aneuploidies (2.60%, 2/77).@*CONCLUSION@#NIPT has a high detection rate for T21, T18, T13 and sex chromosome aneuploidies. It can also detect rare autosomal aneuploidies and CNVs, including some rare structural abnormalities, though verification is required by analyzing amniotic fluid samples.


Subject(s)
Pregnancy , Female , Humans , DNA Copy Number Variations , Chromosome Aberrations , Chromosome Disorders/genetics , Aneuploidy , Fetus
5.
China Pharmacy ; (12): 251-256, 2022.
Article in Chinese | WPRIM | ID: wpr-913120

ABSTRACT

In order to further consolidate the national essential medicine system and establish and improve the selection and adjustment mechanism of the national essential medicine list ,the Department of Drug Policy and Essential Medicine of the National Health Commission of the People ’s Republic of China recently has issued the Measures for the Administration of the National Essential Medicine List (Revised Draft ). Under the background that China is in a critical period of improving the management procedures for the adjustment of the essential medicines list ,how to better design the adjustment procedure ,clarify the operation process and material requirements of each link ,ensure social participation and improve work transparency are important problems to be solved. By consulting the official websites of World Health Organization (WHO)and some typical countries with essential medicine system as well as related foreign literature ,the advanced practices of WHO and some typical countries in the adjustment procedures of the essential medicine list were summarized from 6 stages,such as start-up stage ,the material collection and summary stage ,the evaluation stage ,result publicity stage ,relief stage and application and promotion stage. It is suggested that China can learn from the relevant successful international experience ,scientifically set the adjustment cycle ,establish a normalized feedback mechanism with multi-agent participation ,design a standardized material collection process and a scientific and efficient evaluation process ,and improve the transparency and social identity of the publicity of the selection results of essential medicines , so as to build a more scientific and perfect adjustment procedure of essential medicine list.

6.
Article in Chinese | WPRIM | ID: wpr-930453

ABSTRACT

Objective:To explore the application of microvascular flow imaging (MVFI) combined with high-frequency ultrasonography in children with haemophilic arthropathy A (HAA).Methods:Retrospective study.A total of 82 children diagnosed with HAA in the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2020 were recruited.The elbow, knee and ankle joints of each child were examined by high-frequency ultrasonography.The numbers of thickened synovial joints were recorded.Blood flow signals of the thickening of synovial joints was checked by the MVFI and power Doppler ultrasound (PDUS), respectively.Color flow signals were graded by the semi-quantitative scoring systems.The chi- square test and independent multi-group ordinal multi-category rank-sum test were used to compare the differences of MVFI and PDUS in the display of thickened synovial blood flow. Results:A total of 254 joints were involved in 82 children with HAA, including synovial hypertrophy in 188 joints, hydrops articuli in 146 joints, fibrotic septa in 66 joints, cartilage damage in 63 joints, haemosider indeposition in 45 joints, bone erosion in 25 joints, osteophytes in 15 joints and bone remodeling in 8 joints.Grade Ⅱ synovial thickened joints were the most common.The proportion of blood flow signals detected by PDUS in thickened synovial membranes was significantly higher than that detected MVFI (52.66% vs.70.21%, χ2=12.225, P<0.05). Numbers of grade 0 and Ⅰ joints with thickened synovial membranes detected by MVFI were less than those of PDUS, while the opposite result was obtained in detecting grade Ⅱ and Ⅲ joints ( H=21.158, P<0.05). Compared with PDUS, MVFI more sensitively visualized the blood flow of the thickened synovial membrane. Conclusions:MVFI can more prominently detect the thickened synovial blood flow in children with HAA.A combined application of MVFI and high-frequency ultrasonography contributes to the evaluation of children with HAA.

7.
Chinese Journal of Epidemiology ; (12): 354-359, 2019.
Article in Chinese | WPRIM | ID: wpr-804879

ABSTRACT

Objective@#To investigate the antimicrobial resistance and molecular epidemiology of foodborne Yersinia (Y.) enterocolitica in Pudong New District of Shanghai.@*Methods@#Four kinds of raw food samples were collected in retail circulation sites in Pudong from 2012 to 2016. Cold enrichment method was used to isolate Y. enterocolitica and further detection of biotype, serotype, virulent genes, antimicrobial susceptibility of the isolates and pulsed field gel electrophoresis (PFGE) were conducted.@*Results@#A total of 3 900 raw food samples were collected during this period, including poultry product (n=590), livestock product (n=1 074), aquatic product (n=1 488), vegetable (n=748), in which 111 (2.8%) were contaminated by Y. enterocolitica. The detection rates of Y. enterocolitica in poultry product samples (5.3%, 31/590) and livestock product samples (4.5%, 48/1 074) were higher than those in aquatic product samples (1.6%, 24/1 488) and vegetable samples (1.1%, 8/748). The predominant biotype was 1A (95.5%) and predominant serotype was O∶8 (42.3%). All the strains lacked ail, ystA, yadA and virF genes, which encoded pathogenic Y. enterocolitica. Seventy six (68.5%) strains harbored ystB gene, in which 35 (31.5%) belonged to 1A/O∶8/ystB pattern. Most strains were resistant to ampicillin (74.8%) and amoxicillin/clavulanic acid (70.3%), and non-sensitive rate to Cefoxitin was over 50.0%. No third generation cephalosporin or fluoroquinolone resistant strains were detected, but 38.7% (43/111) strains were multidrug resistant (MDR). Serotype O∶8 and O∶5 strains had 44 and 18 PFGE patterns, respectively.@*Conclusions@#The main foodborne exposure sources of Y. enterocolitica in raw food were poultry and livestock products in Pudong New District. 1A/O∶8/ystB was the predominant pattern with potential pathogenicity despite lacks of typical pathogenic virulent genes. The antimicrobial resistant rates of Y. enterocolitica were at a low level, but MDR strains still existed. Molecular types of the isolates showed highly genetic diversity.

8.
Article in Chinese | WPRIM | ID: wpr-756290

ABSTRACT

Objective To evaluate the disinfect effects of glutaraldehyde, ortho-phthalaldehyde ( OPA ) and peracetic acid on gastroscopy disinfection. Methods Relevant literature from PubMed, Cochrane Library, web of science, Embase, CNKI, CBM, VIP were retrieved to collect the randomized controlled trials on disinfection by glutaraldehyde, OPA and peracetic acid on gastroscope. Literature was selected according to the inclusion and exclusion criteria. The RevMan 5. 3. 4. 0 statistic software was used to extract data and a meta-analysis was performed. Results A total of 18 RCT were included. There were significant differences in the disinfect effects between the OPA group and the glutaraldehyde group ( OR=2. 02, 95%CI:1. 88-1. 27, P<0. 00001), and between the peracetic acid group and the glutaraldehyde group ( OR = 2. 79, 95%CI:1. 52-5. 11, P = 0. 0009 ) . There were no significant differences in the disinfection effect between the OPA group and peracetic acid group ( OR=1. 30,95%CI:0. 62-2. 73, P=0. 49) . Conclusion The disinfect effects of OPA and peracetic acid are similar, which are superior to glutaraldehyde. Compared with OPA and glutaraldehyde, peracetic acid is a better choice considering its good disinfect effect and low cost.

9.
Article in Chinese | WPRIM | ID: wpr-807877

ABSTRACT

Objective@#To explore the psychological experience of the caregivers of Hepatocellular Carcinoma with Hepatitis B virus.@*Methods@#Semi-structured Interviews were performed in a total of 12 main caregivers of Hepatocellular Carcinoma with Hepatitis B in the Chinese Academy of Medical Sciences from October 2016 to March 2017, and the original data was analyzed according to the Colaizzi 7-step method.@*Results@#A total of five topics were extracted, including Awareness of relief stress when the diagnosis was informed, Indebtedness and self-blame, fear and sadness of possible loss of loved ones, stressful anxiety (stress of economy, loss of function, worrying about being infected), and joint stigma.@*Conclusions@#Many psychological experiences of main caregivers of patients with hepatocellular carcinoma combined with hepatitis B coexist in the course of care. Exploring and providing effective care support based on the psychological experience and needs of caregivers is one way to improve physical and mental health and the quality of care for patients.

10.
Chinese Journal of Geriatrics ; (12): 765-769, 2017.
Article in Chinese | WPRIM | ID: wpr-611614

ABSTRACT

Objective To explore the correlation between volumetric capnography(VCap)and traditional pulmonary function in chronic obstructive pulmonary disease(COPD),so as to assess whether VCap can be used as alternative indicators for the evaluation of COPD severity when some of the elderly COPD patients do not accomplish the traditional pulmonary function tests.Methods 960 patients admitted to Fujian Geriatric Hospital from June 2008 to June 2015 and undergoing pulmonary function tests were included in the study.They were divided into 2 groups of the COPD group(640 cases)and the control group(320 cases).The pulmonary function of COPD group was divided into 4 subgroups(Ⅰ~Ⅳ).All persons received tests of traditional pulmonary function and VCap.The correlations between VCap and traditional pulmonary function indexes and between VCap and COPD severity were observed.Results The differences in Vm25-50/VT,Vm50-75/VT,dC/dV3,SR23 of VCap between the 4 subgroups(COPDⅠ~COPDⅣ)and control group were statistically significant(all P0.05).The difference in CO2 max between the COPD Ⅲ group(severe or more severe group)and control group was statistically significant(t=6.91 and 4.65,all P0.555,P<0.05).The specificity of Vm25-50/VT of VCap for the diagnosis of COPD was best,but its sensitivity was poor than other indexes of VCap.The indexes with both high sensitivity and high specificity were Vm50-75/VT and dC/dV3.Conclusions When the patients with COPD manifest the mild airflow limited,Vm25-50/VT,Vm50-75/VT,dC/dV3 and SR23 of VCap are gradually increased with abnormal VCap figures when the illness progressed.The CO2max of VCap might be one of the indexes for assessing the severity of severe or more severe COPD.

11.
Article in Chinese | WPRIM | ID: wpr-507791

ABSTRACT

Objective To observe the impact of different surgical procedures on ovarian reserve and analge-sic effects of drug use in patients with uterine fibroids.Methods 100 patients with uterine fibroids were randomly divided into two groups.50 patients in control group were implemented traditional open surgery.50 cases in the obser-vation group received laparoscopic myomectomy.The ovarian reserve changes were compared before and after surgery, pain medication use and changes in the degree of pain conditions.Results The levels of follicle stimulating hormone and luteinizing in the control group one,three months after operation were significantly higher than before surgery and the observation group,the level of estrogen was significantly lower than before surgery and observation group,the differences were statistically significant(t=10.23,14.58,9.78,11.76,9.83,9.92,10.07,11.23,all P<0.05).The postoperative first pain time of the observation group was significantly longer than the control group,the difference was statistically significant[(513.74 ±284.52)min vs.(61.38 ±37.21)min,t=92.34,P<0.05].The postoperative analgesic usage of the observation group was significantly lower than the control group,the difference was statistically significant(14.0% vs.58.0%,χ2 =7.83,P<0.05).The pain scores 3d,4d,5d,6d and 7d after operation of the observation group were significantly lower than the control group(t=2.11,2.30,2.58,7.03,6.46,all P<0.05). Conclusion The patients with uterine fibroids laparoscopic myomectomy for treatment will not cause great impact on the patients'ovarian reserve,and can effectively reduce the use of analgesics,and it is worthy of further promotion.

12.
Article in Chinese | WPRIM | ID: wpr-492277

ABSTRACT

Objective To analyze type of irrational outpatient infusion prescriptions returned by clinical pharmacists'pre -prescription review and intervention in our hospital.Methods Outpatient infusion prescriptions reviewed by clinical pharmacists in 2014 were statistically analyzed in terms of type,constitution and rate of qualified prescriptions.Results Type of unstandard writing or input errors prescriptions accounted for 35.19%,which was the great majority of the irrational outpatient infusion prescriptions.The rate of qualified prescriptions was 99.15%,which was higher than 91.53% in 2011 when pre -prescription review and intervention had not implemented.Conclusion Pre -prescription review and intervention could improve the quality of outpatient infusion prescriptions.Finally,safety and effectiveness of outpatient infusion could be guaranteed.

13.
Article in Chinese | WPRIM | ID: wpr-468967

ABSTRACT

From January 2014 to June 2014,a total of 178 primiparas and biparas scheduled for a 42-day postpartum follow-up visit at our hospital were examined.And their pelvic floor dysfunctions were evaluated according to the surveys of incontinence impact questionnaire,short form (IIQ-7),pelvic floor impact questionnaire-7 (PFIQ-7) and pelvic organ prolapse/urinary incontinence sexual questionnaire (PlSQ.12).And 130 primiparas and 48 biparas lacked an understanding of performance,prevention and treatment for postpartum pelvic floor dysfunction.And two groups showed no significant difference.The selfdiscovery and detection rates of decreased pelvic myodynamic were 9.2% and 14.6% in primiparas versus 10.4% and 16.7% in biparas.The self-discovery and detection rates of pelvic organ prolapse were 0.8% and 2.3% in primiparas versus 0.0% and 8.3% in biparas.And the difference was statistically significant.Most related knowledge came from parents and colleagues in 53.1% (95/178) and doctors and nurses in 15.5% (27/178).Only about 44.4% (12/27) women with prominent symptoms of pelvic floor dysfunction requested treatments.Therefore the related knowledge of postpartum pelvic floor dysfunction should be strengthened.

14.
Article in Chinese | WPRIM | ID: wpr-426162

ABSTRACT

Hypofractionated three-dimensional confornul radiotherapy (3DCRT) makes it possible to further improve loeal control,overall survival and the quality of life for the patients with non-small-cell lung cancer (NSCLC).But the dose-fractionation and total dose are not yet clear,which need further study.Hypofractionated stereotactic body radiotherapy (SBRT) for early-stage NSCLC patients is well tolerated and results in excellent local control and overall survival.SBRT is expected to become a new standard treatment in patients with early stage NSCLC.

15.
Article in Chinese | WPRIM | ID: wpr-380469

ABSTRACT

clinical applications, especially suitable for large-scale cervical screening and epidemiology investigation.

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