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1.
Article in Chinese | WPRIM | ID: wpr-996079

ABSTRACT

Objective:To study the influences of patients′ online medical service from willingness to behavior based on Anderson′s health service utilization model, and to provide reference for improving the utilization rate of internet medical services.Methods:A total of 66 270 patient data were selected from a self built internet medical platform of a tertiary hospital in Zhejiang province in 2021. Indicators such as time of visit, location of visit, doctor′s online activity, doctor′s title, doctor′s age, doctor′s gender, and disease type were subjected to chi-square test and logistic regression analysis to clarify the impact of different indicators on online medical treatment from willingness to behavior.Results:Of the 66 270 people having a willingness to seek online medical treatment, 39 996 people, accounting for 60.35%, achieved online diagnosis and treatment. Online medical services could break through the constraints of time and space and to promote the patient′s seeking medical treatment online from willingness to behavior in a limited way; Doctor′s title had a non-linear effect on patients′ online medical treatment from willingness to behavior; Doctor′s online activeness significantly promoted online medical treatment from willingness to behavior; Female doctors and middle-aged and young doctors promoted online medical treatment from willingness to behavior; Different types of diseases affected online medical treatment in different ways.Conclusions:Among the factors that affect the patient′s transformation from online medical willingness to behavior, the patient′s enabling resources have a facilitative effect, and need factors have a direct impact.

2.
Article in Chinese | WPRIM | ID: wpr-995840

ABSTRACT

Objective:To study the time consumption of clinical trial projects in each link of contract signing in medical institutions and its influencing factors, to provide a reference for further optimizing the clinical trial management process and improving the efficiency of contract signing.Methods:All of the review records of projects that signed clinical trial contracts at Peking Union Medical College Hospital from January 1st, 2018 to December 31st, 2021 were retrospectively analyzed by comparing the time consumption in each link before signing the contracts and the frequency of contract reviews. Multiple linear regressions were applied to multivariate analyze the influence of different factors on contract signing.Results:A total of 761 clinical trial contracts signed at Peking Union Medical College Hospital from 2018 to 2021 were included in this study, and the average time consumption of contract signing was 127.0 days, among which the consumption of contract review by the hospital was 10.5 days and by sponsors was 99.0 days. The time consumption of contract signing has been decreasing in recent 4 years, from 154.0 days in 2018 to 104.0 days in 2021. The phase of clinical trials, category of sponsors, frequency of contract reviews, and different policies of the institutions were the main influencing factors for contract signing time ( P<0.05). Conclusions:Clinical trial institutions should optimize the contract approval progress, provide agreement templates and targeted service, and strengthen propaganda and information system construction, to improve the efficiency of reviewing and signing clinical trial contracts.

3.
Article in Chinese | WPRIM | ID: wpr-995726

ABSTRACT

Objective:To evaluate the performance of an artificial intelligent (AI)-based automated digital cell morphology analyzer (hereinafter referred as AI morphology analyzer) in detecting peripheral white blood cells (WBCs).Methods:A multi-center study. 1. A total of 3010 venous blood samples were collected from 11 tertiary hospitals nationwide, and 14 types of WBCs were analyzed with the AI morphology analyzers. The pre-classification results were compared with the post-classification results reviewed by senior morphological experts in evaluate the accuracy, sensitivity, specificity, and agreement of the AI morphology analyzers on the WBC pre-classification. 2. 400 blood samples (no less than 50% of the samples with abnormal WBCs after pre-classification and manual review) were selected from 3 010 samples, and the morphologists conducted manual microscopic examinations to differentiate different types of WBCs. The correlation between the post-classification and the manual microscopic examination results was analyzed. 3. Blood samples of patients diagnosed with lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms were selected from the 3 010 blood samples. The performance of the AI morphology analyzers in these five hematological malignancies was evaluated by comparing the pre-classification and post-classification results. Cohen′s kappa test was used to analyze the consistency of WBC pre-classification and expert audit results, and Passing-Bablock regression analysis was used for comparison test, and accuracy, sensitivity, specificity, and agreement were calculated according to the formula.Results:1. AI morphology analyzers can pre-classify 14 types of WBCs and nucleated red blood cells. Compared with the post-classification results reviewed by senior morphological experts, the pre-classification accuracy of total WBCs reached 97.97%, of which the pre-classification accuracies of normal WBCs and abnormal WBCs were more than 96% and 87%, respectively. 2. The post-classification results reviewed by senior morphological experts correlated well with the manual differential results for all types of WBCs and nucleated red blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils, immature granulocytes, blast cells, nucleated erythrocytes and malignant cells r>0.90 respectively, reactive lymphocytes r=0.85). With reference, the positive smear of abnormal cell types defined by The International Consensus Group for Hematology, the AI morphology analyzer has the similar screening ability for abnormal WBC samples as the manual microscopic examination. 3. For the blood samples with malignant hematologic diseases, the AI morphology analyzers showed accuracies higher than 84% on blast cells pre-classification, and the sensitivities were higher than 94%. In acute myeloid leukemia, the sensitivity of abnormal promyelocytes pre-classification exceeded 95%. Conclusion:The AI morphology analyzer showed high pre-classification accuracies and sensitivities on all types of leukocytes in peripheral blood when comparing with the post-classification results reviewed by experts. The post-classification results also showed a good correlation with the manual differential results. The AI morphology analyzer provides an efficient adjunctive white blood cell detection method for screening malignant hematological diseases.

4.
Article in Chinese | WPRIM | ID: wpr-994597

ABSTRACT

Objective:To evaluate the clinical efficacy of laparoscopic splenectomy and azygoportal disconnection (LSD) with intraoperative endoscopic variceal ligation (LSDL) in the treatment of esophagogastric variceal bleeding (EVR).Method:In this study,90 cirrhotic patients with esophagogastric variceal bleeding (EVB) were divided to receive either LSD ( n=45) or LSDL ( n=45) from Jan 2020 and Dec 2021. Results:There were no significant differences in estimated blood loss, incidence of blood transfusion, time to first flatus, off-bed activity and postoperative hospital stay between the two groups (all P>0.05). Compared with LSD group, operation time was longer in LSDL group[ (140±21) min vs. (150±19) min, t=2.420, P=0.018]. LSDL was associated with significantly decreased EVR rate in one year follow-up (2% vs. 18%, P=0.030). Univariate analysis and multivariate logistic regression revealed that LSDL was a significant independent protective factor for EVR as compared with LSD ( P<0.05). Conclusion:LSDL procedure is not only technically feasible and safe, it also contributed to lower postoperative EVR risk than single LSD.

5.
Chinese Journal of Geriatrics ; (12): 848-853, 2023.
Article in Chinese | WPRIM | ID: wpr-993904

ABSTRACT

Objective:To investigate the individual and combined effects of calf circumference and vitamin D levels on all-cause mortality risk in community-dwelling older adults based on the Chinese Longitudinal Healthy Longevity Survey.Methods:The calf circumference was measured in the baseline survey in 2012 and 2014.Low calf circumference was defined as <34 cm for men or 33 cm for women at screening.Vitamin D deficiency was defined as plasma 25-hydroxyvitamin D[25(OH)D]levels <50 nmol/L.All participants were followed up until 2018, when death outcomes and survival time were collected.Cox proportional hazard regression models were used to analyze the effects of calf circumference and 25(OH)D levels on the risk of all-cause mortality.Results:A total of 3 052 older adults were included in the analysis, of which 1 960(64.22%)had low calf circumference and 2 245(73.56%)had vitamin D deficiency.After 10 559.9 person-years of follow-up period, 1 312 death events were recorded.After adjusting for sociodemographic characteristics, physical activities, cognitive function, and multiple chronic diseases, calf circumference and 25(OH)D levels were negatively associated with the risk of all-cause mortality(both P<0.05). In the combined analysis, compared with the normal group, the risk of death was highest in the participants with both low calf circumference and vitamin D deficiency, which was higher than those with low calf circumference or vitamin D deficiency alone, with a hazard ratios( HR)(95% CI)of 2.51(1.81-3.45), 1.71(1.22-2.42)and 1.53(1.09-2.15), respectively.There was a significant additive interaction between low calf circumference and vitamin D deficiency on mortality(RERI>0). Conclusions:Low calf circumference and vitamin D deficiency are associated with higher mortality.Older adults with combined conditions had a even higher risk of death.Attention should be paid to joint screening and comprehensive intervention for older adults with both low calf circumference and vitamin D deficiency.

6.
Article in Chinese | WPRIM | ID: wpr-993381

ABSTRACT

Objective:To evaluate whether vagus nerve-guided robotic splenectomy and azygoportal disconnection (VNRSD) is feasible and safe and to determine whether VNRSD can be competent for well protecting vagus nerve.Methods:In this prospective clinical study, 12 cirrhotic patients with portal hypertension, hypersplenism and esophagogastric variceal bleeding (EVB) who accepted VNRSD at the Clinical School of Medicine of Yangzhou University between January 2022 and March 2022 were included, including 5 females and 7 males, aged (56.6±11.6) years old. Clinical data such as visual analog scale (VAS) pain score, conversion to laparotomy, esophagogastric variceal bleeding, and death were collected. The patients were asked to reexamine in the outpatient department 1 month after the operation, and the diarrhea, delayed gastric emptying and epigastric fullness were followed up.Results:VNRSD was successfully performed in all patients. There was no conversion to open or laparoscopic operations. The operation time was (170.0±16.8) min, blood loss was (60.8±11.3) ml, VAS pain score on the first day was (2.2±0.9) scores, and the postoperative hospital stay was (7.7±0.7) d, the four patients had main portal vein system thrombosis on the 7th day after operation. At the first day after operation, all patients were mange to take semi-fluid and off-bed activity. There were no incisional complications, pneumonia, gastric fistula, pancreatic fistula, and abdominal infection. No patients suffered from diarrhea, delayed gastric emptying, and epigastric fullness. None of the patients suffered from esophagogastric variceal bleeding, hepatic encephalopathy or death after operation and one month after operation, and the esophagogastric variceal were significantly improved. And no patient complained of abdominal distension or diarrhea.Conclusion:VNRSD procedure is not only technically feasible and safe, but also effectively protects anterior and posterior vagal trunks and all their branches, completely eradicating digestive system complications.

7.
Clinical Medicine of China ; (12): 112-117, 2023.
Article in Chinese | WPRIM | ID: wpr-992476

ABSTRACT

Objective:To investigate the expression of soluble CD40 ligand (sCD40L) in serum of children with Kawasaki disease at acute stage and its diagnostic value in coronary artery disease (CAL).Methods:This study adopts case-control study method. Select 127 children with Kawasaki disease admitted to Xuzhou Children's Hospital affiliated to Xuzhou Medical University from August 2021 to August 2022. They are divided into CAL group and non-CAL group according to the degree of coronary artery involvement. Select 30 healthy children who have physical examination in this hospital at the same time as the healthy control group, and select another 30 children with acute upper respiratory tract infection and fever admitted to this hospital at the same time as the fever control group.Compare the sex, age and laboratory indicators of children with Kawasaki disease with or without CAL, and compare the difference between the serum sCD40L level of children with Kawasaki disease with or without CAL and the fever control group and the healthy control group, the serum sCD40L level of children with different degrees of coronary artery dilation, and analyze the correlation between the serum sCD40L and various laboratory indicators of children with Kawasaki disease and the influencing factors of children with Kawasaki disease complicated with CAL, To evaluate the screening effect of serum sCD40L for Kawasaki disease complicated with CAL. The measurement data with normal distribution is expressed by xˉ± s, the comparison between the two groups adopts independent sample t-test, the comparison between multiple groups adopts one-way ANOVA, and the comparison between two groups adopts LSD method and Bonferroni correction; The measurement data of non-normal distribution is expressed by M( Q1, Q3), and the comparison between the two groups is conducted by Mann-Whitney U test. Pearson method and Spearman mothod were used for correlation analysis. Logistic regression model was used to analyze the influencing factors of children with Kawasaki disease complicated with CAL. The diagnostic value of serum sCD40L level in Kawasaki disease complicated with CAL was analyzed by drawing the ROC curve. Results:All 127 children with Kawasaki disease were divided into CAL group (45 cases) and non-CAL group (82 cases) according to the presence or absence of CAL. The serum level of sCD40L in CAL group was higher than that in non-CAL group, healthy control group and fever control group ((7.03±0.91) μg/L vs (4.66±1.23), (1.73±0.96), (2.21±1.08) μg/L), the difference was statistically significant (all P<0.001). The serum level of sCD40L in children with coronary artery dilation in CAL group was lower than that in children with small CAA, medium CAA and large CAA ((6.04±0.22) μg/L vs (6.95±0.69), (8.02±0.57), (8.23±0.26) μg/L), the difference was statistically significant (all P<0.001). Serum sCD40L level and platelet count (PLT), C-reactive protein (CRP), N-terminal pro brain natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), IL-8 and tumor necrosis factor (TNF-α) in children with Kawasaki disease All were positively correlated ( r=0.31, P<0.001, r=0.32, P<0.001, r=0.26, P=0.003, r=0.58, P<0.001, r=0.27, P=0.002, r=0.39, P<0.001). Serum sCD40L, IL-6 and NT-proBNP were the risk factors of complicated CAL in children with Kawasaki disease (odds ratio 1.21, 1.06 and 1.01, 95% confidence interval 1.03-1.43, 1.01-1.12, 1.00-1.01, P values were 0.022, 0.011 and 0.039, respectively). The area under the curve of serum sCD40L in diagnosing Kawasaki disease complicated with CAL was 0.928 (95% confidence interval: 0.885-0.971), and the optimal critical value was 5.60 μg/L, the sensitivity was 97.8% and the specificity was 79.3%. Conclusions:The level of serum sCD40L increased in children with Kawasaki disease in acute phase, especially in children with CAL. The level of serum sCD40L increased with the severity of CAL, which is a risk factor for Kawasaki disease complicated with CAL, and has certain diagnostic value for Kawasaki disease complicated with CAL.

8.
Article in Chinese | WPRIM | ID: wpr-991410

ABSTRACT

Objective:To explore the status of medical students' sense of school belonging and its relationship with depression and anxiety symptoms in the context of COVID-19 prevention and control.Methods:An online questionnaire survey was conducted among 1 629 full-time students from 8 medical universities. The 18-item psychological sense of school membership scale (PSSM-18), 9-item patient health questionnaire (PHQ-9), and 7-item generalized anxiety disorder scale (GAD-7) were used as measurements. Spearman correlation coefficients were used to analyze the correlations between PSSM-18, PHQ-9, and GAD-7 scores. Logistic regressions were used to analyze the impact of lack of school belonging on depression and anxiety symptoms.Results:The mean score of school belonging was (77.31±14.12), and the detection rates of depression and anxiety symptoms were 25.97% (423/1 629) and 21.92% (357/1 629), respectively. PSSM-18 score was negatively correlated with PHQ-9 scores ( r=-0.52, P<0.001) and GAD-7 scores ( r= -0.49, P < 0.001). After adjusting for covariates, students with low school belongingness had 4.33 times the risk of depression symptoms ( OR=4.33, 95%CI=2.48-7.43) and 5.85 times the risk of anxiety symptoms ( OR= 5.85, 95%CI=3.76-8.15) compared to students with high school belongingness. Conclusion:Lack of school belonging increases the risk of depression and anxiety symptoms. Under the normalization of COVID-19 prevention and control, the school should strengthen health education and support services to improve the students' sense of belonging and alleviate their mental health problems.

9.
Article in Chinese | WPRIM | ID: wpr-986990

ABSTRACT

OBJECTIVE@#To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology.@*METHODS@#The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package.@*RESULTS@#Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031).@*CONCLUSION@#EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.


Subject(s)
Humans , Neuroma, Acoustic/complications , Electroencephalography , Patients , Probability
10.
Article in Chinese | WPRIM | ID: wpr-976528

ABSTRACT

Objectives To provide scientific basis for the quality control of different species of Baishouwu by establishing the HPLC fingerprint of domestic of Baishouwu and determining the main active components of acetophenones. Methods HPLC-DAD method was used to determine the HPLC fingerprints of domestic of Baishouwu. Then, the content of 4 kinds of acetophenones in Baishouwu was determined. The column was Diamonsil C18(250mm×4.6mm, 5μm)with the mobile phase of methanol and 0.1% phosphoric acid at a flow rate of 1.0 ml/min. The detection wavelength of p-Hydroxyl acetophenone, baishouwu benzophenone, 2',4'-Dihydroxy acetophenone was set at 260 nm and 2',5'-Dihydroxy acetophenone at 280 nm respectively. Results The similarity and cluster analysis in HPLC fingerprint showed that the constituents were significantly different among C. bungei, C. auriculatum and C. wilfordii. The content of total acetophenones in C. wilfordii was significantly higher than that in other localities of C. auriculatum and C. bungei. Conclusions Acetophenone could be used as the evaluation index to evaluate the quality of Baishouwu in different origins. The content of total acetophenone in C. wilfordii is the highest, which could be used as the best quality resource of Baishouwu.

11.
Article in Chinese | WPRIM | ID: wpr-970903

ABSTRACT

OBJECTIVE@#To explore the prevalence and clinical manifestations of ring chromosomes among children featuring abnormal development.@*METHODS@#From January 2015 to August 2021, 7574 children referred for abnormal development were selected, and their peripheral blood samples were subjected to G-banded chromosomal karyotyping analysis.@*RESULTS@#Twelve cases of ring chromosomes were detected, which have yielded a prevalence of 0.16% and included 1 r(6), 2 r(9), 1 r(13), 1 r(14), 2 r(15), 1 r(21) and 3 r(X). The children had various clinical manifestations including growth and mental retardation, limb malformation, and congenital heart disease. For two children with r(9) and two with r(15) with similar breakpoints, one child with r(9) and one with r(15) only had growth retardation, whilst another with r(9) and another with r(15) also had peculiar facies and complex congenital heart disease. The r(X) has featured some manifestations of Turner syndrome.@*CONCLUSION@#Ring chromosomes are among the common causes for severe growth and mental retardation in children with diverse clinical phenotypes. Clinicians should pay attention to those with developmental anomalies and use chromosomal analysis to elucidate their genetic etiology.


Subject(s)
Humans , Ring Chromosomes , Intellectual Disability/genetics , Turner Syndrome/genetics , Phenotype , Heart Defects, Congenital/genetics
12.
Chinese Journal of Biotechnology ; (12): 500-515, 2023.
Article in Chinese | WPRIM | ID: wpr-970388

ABSTRACT

As a widespread pollutant in the environment, research on microplastics have attracted much attention. This review systematically analyzed the interaction between microplastics and soil microorganisms based on existing literatures. Microplastics can change the structure and diversity of soil microbial communities directly or indirectly. The magnitude of these effects depends on the type, dose and shape of microplastics. Meanwhile, soil microorganisms can adapt to the changes caused by microplastics through forming surface biofilm and selecting population. This review also summarized the biodegradation mechanism of microplastics, and explored the factors affecting this process. Microorganisms will firstly colonize the surface of microplastics, and then secrete a variety of extracellular enzymes to function at specific sites, converting polymers into lower polymers or monomers. Finally, the depolymerized small molecules enter the cell for further catabolism. The factors affecting this degradation process are not only the physical and chemical properties of the microplastics, such as molecular weight, density and crystallinity, but also some biological and abiotic factors that affect the growth and metabolism of related microorganisms and the enzymatic activities. Future studies should focus on the connection with the actual environment, and develop new technologies of microplastics biodegradation to solve the problem of microplastic pollution.


Subject(s)
Microplastics , Plastics , Soil , Polymers , Biodegradation, Environmental
13.
China Pharmacy ; (12): 837-843, 2023.
Article in Chinese | WPRIM | ID: wpr-969581

ABSTRACT

OBJECTIVE To evaluate the cost-effectiveness of clopidogrel versus aspirin monotherapy regimens for secondary prevention of ischemic stroke and to provide economic evidence and reference for clinical medication and decision-making. METHODS Based on the CAPRIE trial, a Markov model was constructed; the probabilities of risk events, health utility values, and costs of risk event management were obtained from relevant literature. The cycle length was 6 months, and the time horizon was 10 years. A discount rate of 5% per year was applied. The primary outcomes were total costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Cost-utility analysis was performed for above 2 regimens by using TreeAge Pro software. The one-way sensitivity analysis, probabilistic sensitivity analysis and scenario analysis were conducted to validate the robustness of the analyses. RESULTS Compared with the aspirin regimen (325 mg/d of CAPRIE trial dose), the ICER values of clopidogrel regimen for secondary stroke prevention for 10 years, 20 years and 30 years were 4 284.06, 4 201.20 and 3 986.78 yuan/QALY, respectively, which were E-mail:liuxiaoyanrj@sjtu.edu.cn all less than the willing-to-pay (WTP) threshold of one time 。 China’s per capita gross domestic product (GDP) in 2021. E-mail:scilwsjtu-wb@yahoo.com Compared with the aspirin regimen (clinically recommended dose in China, 100 mg/d), the ICER values of clopidogrel regimen for stroke secondary prevention for 10 years, 20 years and 30 years were 58 238.27, 42 164.72 and 36 164.77 yuan/QALY, respectively, which were all less than WTP threshold. When comparing with aspirin regimen of 325 mg/d, results of one-way sensitivity analysis showed that the cost of clopidogrel and aspirin, probability of the first recurrence of ischemic stroke were sensitive factors of model. Results of probabilistic sensitivity analysis showed that when WTP was set at one time GDP per capita in China in 2021, clopidogrel had a probability of being cost- effective of about 66.5%. Results of scenario analysis showed that neither changing the time horizon to 10, 20 or 30 years nor using different doses of aspirin (50, 100, 150, 200 or 250 mg/d) would not alter any conclusions. CONCLUSIONS Compared with aspirin monotherapy, clopidogrel monotherapy is more cost-effective for secondary prevention of ischemic stroke.

14.
Article in Chinese | WPRIM | ID: wpr-971421

ABSTRACT

Objective: To evaluate the effect of Wendler Glottoplasty to elevate vocal pitch in transgender women. Methods: The voice parameters of pre-and 3-month post-surgery of 29 transgender women who underwent Wendler Glottoplasty in department of otorhinolaryngology head and neck surgery of Beijing Friendship Hospital from January, 2017 to October, 2020 were retrospectively analyzed. The 29 transgender women ranged in age from 19-47 (27.0±6.3) years old. Subjective evaluation was performed using Transsexual Voice Questionnaire for Male to Female (TVQMtF). Objective parameters included fundamental frequency (F0), highest pitch, lowest pitch, habitual volume, Jitter, Shimmer, maximal phonation time (MPT), noise to harmonic ratio (NHR) and formants frequencies(F1, F2, F3, F4). SPSS 25.0 software was used for statistically analysis. Results: Three months after surgery, the score of TVQMtF was significantly decreased [(89.9±14.7) vs. (50.4±13.6), t=11.49, P<0.001]. The F0 was significantly elevated [(152.7±23.3) Hz vs. (207.7±45.9) Hz, t=-6.03, P<0.001]. Frequencies of F1, F2 and F3 were significantly elevated. No statistical difference was observed in the frequencies of F4. The highest pitch was not significantly altered while the lowest pitch was significantly elevated [(96.8±17.7) Hz vs. (120.0±28.9) Hz, t=-3.71, P=0.001]. Habitual speech volume was significantly increased [(60.0±5.2) dB vs. (63.6±9.6) dB, t=-2.12, P=0.043]. Jitter, Shimmer, NHR and MPT were not obviously altered (P>0.05). Conclusions: Wendler Glottoplasty could notably elevate the vocal pitch, formants frequencies and degree of vocal femininity in transgender women without affecting phonation ability and voice quality. It can be an effective treatment modality for voice feminization.


Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Transgender Persons , Retrospective Studies , Speech Acoustics , Voice Quality , Phonation
15.
Chinese Journal of Lung Cancer ; (12): 265-273, 2023.
Article in Chinese | WPRIM | ID: wpr-982156

ABSTRACT

BACKGROUND@#Since the popularization of computed tomography (CT) technology, the detection rate of pulmonary ground glass nodules (GGNs) with imaging follow-up as the main management method has increased significantly. The purpose of this study is to quantitatively analyze the changes of pulmonary GGNs during the follow-up process with three-dimensional reconstruction technology, explore the natural progression of pulmonary GGNs, and provide effective basis for clinical guidance for patients to conduct reasonable management of nodules.@*METHODS@#A total of 115 cases of pulmonary GGNs with regular follow-up in the Combined Outpatient Department of Zhoushan Hospital from March 2015 to November 2022 were enrolled. Quantitative imaging features of nodules were extracted by semi-automatic segmentation of 3D Slicer software to evaluate the growth of nodules and clinical intervention during follow-up.@*RESULTS@#The average baseline age of the patients was (56.9±10.1) yr. The mean follow-up time was (48.8±18.9) months. The two-dimensional diameter of baseline CT scan was (7.9±2.9) mm, and the maximum three-dimensional diameter was (10.1±3.4) mm. The two-dimensional diameter of the last CT scan was (9.9±4.7) mm, and the maximum three-dimensional diameter was (11.4±5.1) mm. A total of 27 cases (23.5%) showed an increase during follow-up, with a median volume doubling time of 822 days and a median mass doubling time of 1,007 days. 32 cases were surgically resected, including 6 cases of invasive adenocarcinoma (IAC), 16 cases of minimally invasive adenocarcinoma (MIA), 8 cases of adenocarcinoma in situ (AIS) and 2 cases of atypical adenomatous hyperplasia (AAH). Five nodules underwent surgical intervention due to the progression of two-dimensional diameter, which was pathologically confirmed as pre-invasive lesions, but their three-dimensional maximum diameter showed no significant change. Nodular morphology, lobulated sign, spiculated sign and vacuole signs all promoted the growth of nodules in univariate analysis. There were significant differences in age, baseline diameter, mean CT value, median CT value, 10% and 90% percentile CT number between the growth group and the stable group (P<0.05). Multivariate Logistic regression analysis showed that age and average CT value were risk factors for nodule growth (P<0.05). Receiver-operating characteristic (ROC) curve analysis results indicated that the age ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU were more likely to accelerate the growth of GGNs. The maximum three-dimensional diameter ≥14.4 mm and the average CT value ≥-495.7 HU may be a higher malignant probability.@*CONCLUSIONS@#GGNs show an inert growth process, and the use of three-dimensional measurements during follow-up is of greater significance. For persistent glass grinding nodules ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU are more likely to increase. However, most nodules still have good prognosis after progression, and long-term follow-up is safe.


Subject(s)
Humans , Middle Aged , Lung Neoplasms/pathology , Imaging, Three-Dimensional , Neoplasm Invasiveness , Retrospective Studies , Multiple Pulmonary Nodules/pathology , Adenocarcinoma/pathology
16.
Article in Chinese | WPRIM | ID: wpr-981510

ABSTRACT

In this study, the authors cloned a glycosyltransferase gene PpUGT2 from Paris polyphylla var. yunnanensis with the ORF length of 1 773 bp and encoding 590 amino acids. The phylogenetic tree revealed that PpUGT2 belonged to the UGT80A subfamily and was named as UGT80A49 by the UDP-glycosyltransferase(UGT) Nomenclature Committee. The expression vector pET28a-PpUGT2 was constructed, and enzyme catalytic reaction in vitro was conducted via inducing protein expression and extraction. With UDP-glucose as sugar donor and diosgenin and pennogenin as substrates, the protein was found with the ability to catalyze the C-3 hydroxyl β-glycosylation of diosgenin and pennogenin. To further explore its catalytic characteristic, 15 substrates including steroids and triterpenes were selected and PpUGT2 showed its activity towards the C-17 position of sterol testosterone with UDP-glucose as sugar donor. Homology modelling and molecule docking of PpUGT2 with substrates predicted the key residues interacting with ligands. The re-levant residues of PpUGT2-ligand binding model were scanned to calculate the corresponding mutants, and the optimized mutants were obtained according to the changes in binding affinity of the ligand with protein and the surrounding residues within 5.0 Å of ligands, which had reference value for design of the mutants. This study laid a foundation for further exploring the biosynthetic pathway of polyphyllin as well as the structure of sterol glycosyltransferases.


Subject(s)
Ligands , Glycosyltransferases/genetics , Sterols , Phylogeny , Ascomycota , Liliaceae/chemistry , Melanthiaceae , Diosgenin , Sugars , Glucose , Uridine Diphosphate
17.
Article in Chinese | WPRIM | ID: wpr-984531

ABSTRACT

ObjectiveTo observe the clinical efficacy of the Modified Tongmai Anshen Formula (通脉安神方加减, MTAF) in the treatment of stable angina pectoris (SAP) with sleep disorders. MethodsA total of 148 patients suffering from SAP with sleep disorder were included and randomly divided into control group and treatment group, with 74 patients in each group. The control group received conventional western medicine, and the treatment group additionally received MTAF (1 dose per day), both for 4 weeks. The changes in angina pectoris symptoms, traditional Chinese medicine (TCM) syndromes, sleep quality, quality of life, serological indicators including serum intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), brain-derived nerve growth factor (BDNF) and tyrosine kinase receptor B (TrkB) were compared between groups before and after treatment, and the safety was evaluated. ResultsIn the treatment group and the control group, the total effective rates of TCM syndromes(82.43% vs 52.70%), angina pectoris (79.73% vs 64.86%) and sleep (89.19% vs 68.92%) showing significant difference (P<0.001). After treatment, the total TCM syndrome score, primary symptom score, secondary symptom score, and secondary symptoms sleeplessness, restlessness, tiredness and fatigue individual score, angina pectoris score, PSQI total score and each item score were all significantly reduced in both groups, while the SF-36 single item score significantly increased (P<0.05). The total TCM syndromes and primary symptom scores, secon-dary symptoms sleeplessness, restlessness, tiredness and fatigue individual score, angina pectoris score, time to fall asleep, sleep quality, hypnotic medication, sleep disturbance, daytime dysfunction score and PSQI total score were significantly lower in the treatment group than those in the control group after treatment (P<0.05), while the somatic pain, general health status, social functioning, emotional functioning, mental health, and health change were significantly higher in the treatment group (P<0.05). After treatment, ICAM-1 and VCAM-1 level significantly decreased (P<0.05), and BDNF and TrkB levels increased (P<0.05) in the treatment group, while BDNF level significantly decreased in the control group (P<0.05). The TrkB level was significantly higher in the treatment group compared to the control group after treatment (P<0.05). A total of four adverse events occurred during the treatment, none of which were considered to be related to this study. ConclusionMTAF can significantly improve angina pectoris symptoms, TCM syndromes, sleep quality and quality of life in patients suffering from SAP with sleep disorders, the mechanism of which may be related to the protection of vascular endothelial function and central neurons.

18.
Article in Chinese | WPRIM | ID: wpr-958623

ABSTRACT

Objective:To analyze the laboratory parameters and clinical characteristics of TTP patients, so as to provide reference for the timely diagnosis and death risk assessment or TTP.Methods:83 patients with TTP from June 2016 to March 2022 in our hospital were analyzed retrospectively. They were divided into survival and death groups. The differences in general information, clinical symptoms and laboratory parameters were compared between the two groups. The prognostic prediction score was constructed by combining parameters which differ between the two groups to calculate the corresponding mortality risk.Results:83 patients were included in the study, of whom 81.1% (60/74), 91.1% (72/79) and 86.2% (50/58) had increased AST, IBIL and cTnI results, and all (78/78) had higher LDH at admission. Hb was decreased in 97.5% (79/81) patients, and PLT of 97.5% (79/81) patients was less than 30×10 9/L. There were no significant differences in gender, age, blood type, presence of fever, ADAMTS-13 activity and PLASMIC score between the survival group (58 cases) and the death group (25 cases), but the proportion of neurologic symptoms in the death group was significantly higher than that in the survival group. AST, IBIL, cTnI and APTT at admission were significantly higher in the death group than in the survival group ( P<0.05). The risk of death was 4.86, 9.74, 3.71, and 5.33 for those with high AST, IBIL, APTT, and cTnI levels, respectively, compared with those with low levels at admission. At last, AST, IBIL, APTT, cTnI and neurological symptoms were included to construct a score model. For each 1 point increase, the risk of short-term death in TTP patients was 3.24. Conclusions:Multiple laboratory markers have high negative exclusion value for TTP. For TTP patients with high AST, IBIL, cTnI and APTT and neurologic symptoms, more attention and active treatment should be paid to reduce mortality.

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Chinese Journal of Geriatrics ; (12): 714-719, 2022.
Article in Chinese | WPRIM | ID: wpr-957286

ABSTRACT

Objective:To explore the significance of proactive healthy living index(PHLI)to provide a reference for the elderly to maintain function through healthy daily life.Methods:The functional status of the elderly was defined based on gait speed and cognitive function.Logistic regression model was used to select the daily life indicators which could be the risk factors for the functional status, and a nomogram was graphed for its visualization.PHLI was formed according to the result of the nomogram.Receiver operating characteristic curve(ROC)was plotted according to the functional status of the elderly, and the cut-off value of PHLI was determined based on the principle of the maximum sum of sensitivity and specificity.Results:A total of 4 971 participants with an average age of (70.9±7.5)years were included in the cross-sectional study, of whom 2 649 cases(53.3%)maintained normal function.The Logistic regression analysis showed that the housework had the most significant effect on the functional status of the elderly, followed by positive psychology( OR=2.04, 1.92; both P<0.001), increasing the likelihood of maintaining normal function by 104% and 92%, respectively.Regular life patterns, adequate protein intake, sleep quality and so on also influenced functional status of the elderly(all P<0.05). The PHLI median score of the elderly was 7.3(5.9, 8.3)points.The area under the curve(AUC)was 0.70(95% CI: 0.68-0.71), and the cut off value of PHLI was 6.8 points. Conclusions:The PHLI is associated with the maintenance of functional capacity in the elderly, which can be applied as a simple tool to provide reference for old people to keep functional health through living a proactive healthy daily life.

20.
Chinese Critical Care Medicine ; (12): 653-654, 2022.
Article in Chinese | WPRIM | ID: wpr-956028

ABSTRACT

The management of drainage tube is an important part of nursing work. Patient restraint and tube fixation cannot effectively prevent unplanned extubation (UEX) when the tube is accidentally pulled by violence. The nursing innovation team of Henan Provincial People's Hospital designed a medical drainage tube anti-pull device in order to change the existing technology of preventing drainage tube disconnecting by means of restraint and fixation, and to interfere with the basic cause of drainage tube disconnection, and obtained the national utility model patent (patent number: ZL 2020 2 2843025.1). The design of sleeve and clasp is that when the drainage tube is pulled by accidental violence, the friction fastener clamps the drainage tube mechanically to achieve the purpose of braking the drainage tube and prevent the drainage tube from coming out. Card sleeve ring fracture design can be applied to drainage tubes of different diameters, and the buzzer device at the instant of the snap ring into the card set warning medical staff to the occurrence of risk events, so that the nurse can come in the first place for effective treatment, which is a fuse for surgical drainage tubes and is to timely and effectively prevent UEX.

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