Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 156
Filter
1.
Yonsei Medical Journal ; : 591-600, 2022.
Article in English | WPRIM | ID: wpr-927139

ABSTRACT

Purpose@#SOX12 is overexpressed in many cancers, and we aimed to explore the biological function and mechanism of SOX12 in thyroid cancer. @*Materials and Methods@#We first analyzed the expression of SOX12 in thyroid cancer using data in The Cancer Genome Atlas. Immunohistochemistry and qRT-PCR were performed to identify SOX12 expression in thyroid cancer tissue and cells. Thyroid cancer cells were transfected with small interfering RNA targeting SOX12, and cellular functional experiments, including CCK8, wound healing, and Transwell assays, were performed. Protein expression was examined by Western blot analysis. A xenograft model was developed to evaluate the effect of SOX12 on tumor growth in vivo. @*Results@#SOX12 expression was increased in thyroid cancer tissue and cells. SOX12 promoted cell proliferation, migration, and invasion and accelerated tumor growth in vivo. The expression of PCNA, Cyclin D1, E-cadherin, Snail, MMP-2, and MMP-9 was affected by SOX12 knockdown. Bioinformatic analysis showed that SOX12 could interact with the POU family. SOX12 knockdown inhibited the expression of POU2F1, POU2F2, POU3F1 and POU3F2, and SOX12 expression showed a positive correlation with POU2F1, POU3F1, and POU3F2 expression in clinical data. POU2F1 and POU3F1 were able to reverse the effect of SOX12 knockdown on thyroid cancer cells. @*Conclusion@#SOX12 affects the progression of thyroid cancer by regulating epithelial-mesenchymal transition and interacting with POU2F1 and POU3F1, which may be novel targets for thyroid cancer molecular therapy.

2.
China Pharmacy ; (12): 917-922, 2022.
Article in Chinese | WPRIM | ID: wpr-923592

ABSTRACT

OBJE CTIVE To provide reference for the adjustment and optimization of the policies related to traditional Chinese medicine(TCM)injection in China. METHODS The policies related to TCM injections issued at the national level were collected from Jan. 1,1990 to May 31,2021. Based on the perspective of policy tool ,the content analysis and quantitative analysis were used to classify ,code and analyze the policy terms according to “policy serial number-chapter number-specific terms ”. RESULTS & CONCLUSIONS Totally 30 policy documents related to TCM injection were included , with a total of 389 codes. Environment-based policy tools were the most widely used (79.95%),followed by supply-oriented policy tools ,accounting for 15.42%. Demand-based policy tools accounted for the least proportion (4.63%). Among environment-based policy tools ,the regulatory and control policy tools (38.05%) received more attention,and the policy publicity (2.06%) received fewer applications. Among supply-oriented policy tools ,there were more applications of science and technology support (10.80%), and fewer applications of capital investment (0.26%). Among demand- based policy tools ,organizational coordination was the most widely used (3.34%),followed by experience demonstration (1.29%),which had not yet involved the relevant policies of international exchange. In order to promote the development of TCM injection ,it is necessary to appropriately reduce the application of environment-based policy tools ,increase the application of policies such as policy publicity ,and improve the external environment for TCM injection ;optimize the internal combination of supply-oriented policy tools ,increase the use of capital investment tools ,and effectively play the role of policy boosting;emphasize the application of demand-based policy XJY21013) tools to form an effective policy pulling force for the healthy development of TCM injection.

3.
Article in Chinese | WPRIM | ID: wpr-942339

ABSTRACT

ObjectiveTo evaluate the methodological quality of traditional Chinese medicine (TCM) diagnosis and treatment guidelines/consensus of constipation with Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ)tool, and to study the attention situation of the included Chinese patent medicines in China's National Reimbursement Drug List in the guidelines/consensus. MethodThe data of CNKI,VIP,Wanfang Data,SinoMed,PubMed and Cochrane from the inception of the databases to October 2021 were searched to collect the TCM diagnosis and treatment guidelines/consensus of constipation. Then,the diagnosis and treatment standards and recommended Chinese patent medicines were extracted. Two researchers assessed the methodological quality of the guidelines/consensus with AGREE Ⅱ tool independently. The quality of reports was evaluated by Reporting Items for practice Guidelines in HealThcare (RIGHT) Statement. The recommended Chinese patent medicines in the guidelines/consensus were compared with those in the National Reimbursement Drug List. ResultEleven consensus and 2 guidelines were included,involving 794 experts. The scores of AGREE II were clarity of presentation(59.0%),scope and purpose(44.0%),stakeholder involvement(23.1%),rigor of development (12.1%),applicability (11.1%),and editorial independence (8.3%) from high to low. Five articles were recommended at B level(recommended after revision) and 8 articles were at C level (not recommended). The average scores of RIGHT Statement were as follows:basic information (93.59%),background (57.69%),evidence (18.46%),recommendations (20.88%),review and quality assurance (19.23%),funding,declaration and management of interests (0.00%), and other information (0.00%). The included guidelines/consensus recommended a total of 27 Chinese patent medicines,among which 20 were included in the National Reimbursement Drug List,with 4 species of Class A and 16 species of Class B, accounting for 74.1% of all recommended Chinese patent medicines. Ten purgative Chinese patent medicines in the National Reimbursement Drug List were recommended by the guidelines/consensus,accounting for 50% of all purgative drugs, and 8 were not recommended. There were prescriptions for purgation, for promoting digestion and removing food stagnation, for clearing heat and purging fire,and for warming the middle and dissipating cold,Tibetan medicine and Mongolian medicine. ConclusionBy the AGREE Ⅱ assessment,the methodological quality of the TCM diagnosis and treatment guidelines/consensus of constipation included in this study needed to be improved in the future. The report quality evaluated with RIGHT Statement was low. Most drugs included in the National Reimbursement Drug List were paid attention in the TCM diagnosis and treatment guidelines/consensus of constipation. Moreover,the drugs included in the National Reimbursement Drug List could basically fulfill the clinical needs reflexed from the guidelines/consensus recommendations. However, the reasons of some drugs failing to be included in the National Reimbursement Drug List needed to be studied in the future.

4.
Article in Chinese | WPRIM | ID: wpr-885514

ABSTRACT

Objective:To investigate the clinical characteristics of neonatal congenital tongue base cyst.Methods:This retrospective study involved 35 neonates with congenital tongue base cyst diagnosed in the neonatal intensive care unit (NICU) of Xi'an Children's Hospital from June 2013 to December 2019. General information, clinical manifestations, supplementary results, treatment and prognosis of these babies were described.Results:(1) The median age at the onset of the disease was 12.5 (0~28) d and the median age at admission was 15 (0~28) d for these babies. The main clinical manifestations were laryngeal stridor (28/35, 80.0%), inspiratory dyspnea and crying, especially when feeding (26/35, 74.3%) and choking and spitting with feeding (23/35, 65.7%). (2) Among the 35 cases, 15 (42.9%) required emergency endotracheal intubation due to significant dyspnea when were admitted to the NICU and five out of them were considered for having tongue base mass under laryngoscopy, while the other 10 cases underwent bedside electronic laryngoscopy after endotracheal intubation, in which space-occupying lesions were found. Tongue base cyst was considered in seven cases with laryngeal stridor complicated by protracted pneumonia using fiberoptic bronchoscopy. The other 13 cases were examined by electronic laryngoscope and considered as tongue base cyst. Thirty-five cases underwent cervical ultrasound and only five of them were considered as tongue base tumor. Thirty-two cases underwent cervical CT scan and only two of them were normal. Three cases were found to have tongue base cyst by cranial MRI. (3) Thirty-four cases were treated by radiofrequency ablation assisted with self-retaining microlaryngoscope and general anesthesia, while the other one firstly received puncture and drainage under direct laryngoscope due to the difficult intubation because of the huge tongue base cyst and then underwent surgery when stable. Only one case (2.9%) relapsed after surgical treatment during regular follow-up.Conclusions:Neonatal congenital tongue base cyst has an early onset and atypical clinical manifestations. Electronic laryngoscopy/fiberoptic bronchoscopy combined with neck CT or MRI examination should be performed promptly in patients with laryngeal stridor and inspiratory dyspnea to facilitate the accurate diagnosis and timely surgery is required for.

5.
Article in Chinese | WPRIM | ID: wpr-882944

ABSTRACT

Objective:To translate the Cardiac Symptom Survey and analyze its reliability and validity in the post-valvular heart replacement survey and to provide the basis for the clinical application of this scale.Methods:The symptoms of 233 patients after heart valve replacement were investigated in Suining Central Hospital by Chinese version of the Cardiac Symptom Survey. The reliability of the scale was evaluated by Cronbach'α coefficient and the split half coefficient, the validity of the scale was evaluated by exploratory factor analysis and content validity index.Results:The internal consistency coefficient of the Chinese version of the Cardiac Symptom Survey ranged from 0.875 to 0.968, both above 0.870.The split half coefficient was 0.699,which demonstrated better internal consistency.The content validity index of the Chinese version of the Cardiac Symptom Survey ranged from 0.84 to 1.00.Factor analysis got five factors, which explained 68.133% of the total variance.Conclusions:The Chinese version of the Cardiac Symptom Survey has good reliability and validity in the investigation of the symptoms of patients after heart valve replacement, and can be used for the investigation and management of the symptoms of patients after heart valve replacement.

6.
Article in Chinese | WPRIM | ID: wpr-877085

ABSTRACT

Objective To analyze the epidemiological characteristics of food poisoning in Shenzhen from 2009 to 2018, and to provide a scientific basis for formulating control strategies of food poisoning. Methods The data of food poisoning events in Shenzhen from 2009 to 2018 was analyzed with descriptive epidemiological methods. Results There were 182 reported food poisoning events, resulting in 1786 cases and 3 death. The incidence of food poisoning events had a seasonal peak during May to September, and a total of 119 reported food poisoning events (65.39%, 119/182) occurred in that period of time with 1156 cases (64.73%, 1156/1786). There were 77 food poisoning events (42.31%) occurring in collective canteens with 927 cases (51.91%), making them the most frequent locations for food poisoning. The main pathogenic factors were bacteria, poisonous plants and chemicals. Incidents of bacterial food poisoning were mainly caused by Vibro parahemolyticus (51.73%, 60/116), Salmonella (26.73%, 30/116), and Staphylococcus aureus enterotoxin (11.21%, 13/116), etc. Hyacinth bean toxin and mushroom were responsible for 33.33% of the incidents caused by poisonous plants. Incidents of chemical food poisoning were mainly caused by nitrite (8.33%). Conclusion The prevention and control of food poisoning in Shenzhen should be focused on reducing bacterial food poisoning such as Salmonella and Vibrio parahaemolyticus, and supervision of food safety of catering units and collective canteens should be strengthened. Additionally, health education on prevention and control of food poisoning should be targeted at the high-risk population to reduce the risk of food poisoning.

7.
Article in Chinese | WPRIM | ID: wpr-908347

ABSTRACT

Objective:To explore the effectiveness and safety of plasma exchange in the treatment of neonatal extremely severe hyperbilirubinemia.Methods:A retrospective analysis was performed on the data of 18 cases, who were all newborns with extremely severe hyperbilirubinemia and treated with plasma exchange in the NICU at Xi ′an Children′s Hospital from April 2019 to December 2019.The changes of serum total bilirubin, indirect bilirubin, albumin, white blood cells, red blood cells, platelets, hematocrit, hemoglobin, serum sodium, serum potassium, serum calcium, blood glucose, blood coagulation and mean arterial pressure were compared before and after plasma exchange.Results:A total of 18 eligible children were included.The peak value of total bilirubin was (571.2±113.3) μmol/L before treatment, and the value after treatment was (235.8±66.7) μmol/L, whose difference was statistically significant ( P<0.05). The exchange rate of bilirubin was (58.5±8.4)%.There were no statistically significant differences in the changes of white blood cells, platelets, hemoglobin, hematocrit, serum sodium, serum potassium, serum chloride, serum calcium, serum glucose, and albumin before and after plasma exchange (all P>0.05). There were no allergic reactions, hypotension, plasma separator or pipeline coagulation and other adverse reactions during plasma exchange. Conclusion:Plasma exchange therapy can remove serum bilirubin quickly, effectively and safely, and may be a new treatment for neonatal hyperbilirubinemia.

8.
Article in Chinese | WPRIM | ID: wpr-907266

ABSTRACT

Objective:To explore the expression and clinical significance of IL-1β and IL-1β receptor antagonist(IL-1ra)in persistent pulmonary hypertension of the newborn(PPHN)secondary to sepsis.Methods:The newborns with sepsis were enrolled in the Department of Neonatal Intensive Care Unit(NICU)of Xi′an Children′s Hospital from January 2018 to November 2020.The newborns with sepsis were divided into two groups: the newborns without PPHN( n=108)were the control group and the newborns with PPHN( n=44)were the experimental group.Clinical data, laboratory examination and bedside echocardiography of all the newborns were collected to analyze the differences between the two groups.The expression levels of IL-1β and IL-1ra in neonatal plasma of the two groups were detected by enzym-linked immunosorbination(ELISA), and their roles in neonatal sepsis with PPHN were further analyzed.The risk factors of neonatal sepsis with PPHN were analyzed by multivariate Logistic regression, and the early prediction value of the risk factors for neonatal sepsis with PPHN were evaluated by the receiver operating characteristic(ROC)curve. Results:There were no significant differences in gestational age[(39.11±0.55)w vs(38.85±0.72)w], birth weight[(3.30±0.49)kg vs(3.24±0.55)kg]and proportions of males[60(55.6%)vs 30(68.2%)]between the two groups( P>0.05). The right ventricular diameter[(9.57±0.35)mm], pulmonary artery pressure[(51.36±5.91)mmHg]and the level of N-terminal brain natriuretic peptide(NT-proBNP)[(25436.83±12343.18)ng/L)]significantly increased in the experimental group than those in the control group[(8.77±0.41)mm, (31.24±5.11)mmHg, (11267.09±4405.48)ng/L, respectively, P<0.05]. Before treatment, the expression levels of plasma IL-1β[(31.24±5.25)ng/L]and IL-1ra[(41.94±10.13)ng/L]in the experimental group were significantly higher than those in the control group[(18.27±4.47)ng/L, (21.47±8.76)ng/L, respectively, P<0.05]. The expression levels of plasma IL-1β[(10.46±3.17)ng/L]and IL-1ra[(10.58±2.94)ng/L]in the experimental group after treatment were significantly lower than those before treatment[(31.24±5.25)ng/L, (41.94±10.13)ng/L , respectively, P<0.05]. Multivariate Logistic regression analysis showed that IL-1β and NT-proBNP were the independent risk factors for neonatal sepsis with PPHN( P<0.05). ROC curve analysis showed that IL-1β and NT-proBNP had the good predictive value for the occurrence of neonatal sepsis with PPHN( P<0.05). IL-1β combined with NT-proBNP has the better predictive value for neonatal sepsis with PPHN. Conclusion:IL-1β combined with NT-proBNP have the high predictive value for PPHN of the newborns secondary to sepsis.

9.
Chinese Journal of School Health ; (12): 1720-1723, 2021.
Article in Chinese | WPRIM | ID: wpr-906576

ABSTRACT

Objective@#To analyze the impact of life satisfaction and parental rearing methods on accidental injuries of primary and secondary school students in rural areas, and to provide a therotical reference for injury prevention and intervention among primary and secondary school students in rural areas.@*Methods@#A stratified cluster random sampling method was used to select 2 045 rural primary and middle school students in Luliang County, Yunnan Province, questionnaire survey regarding injury, MSLSS and EMBU was administered.@*Results@#The incidence of accidental injury among rural primary and middle school students was 16.19 %, and the rate of boys (19.51%) were higher than that of girls (12.26%) ( χ 2=19.69, P <0.01). Multivariate Logistic regression analysis found that women, low injury risk behavior scores, and high life satisfaction scores were associated with less accidental injuries( OR =0.62, 0.98,0.81), while day to day school and father s overprotection were associated with more for accidental injuries( OR =1.50, 1.04, P <0.05).@*Conclusion@#Parents should pay more attention to children s safety education while creating a good living environment for their children, but they should pay attention to their own education methods to reduce accidental injuries.

10.
Article in Chinese | WPRIM | ID: wpr-866052

ABSTRACT

Objective:To investigate the prevalence of residents in a drinking water-borne endemic arsenism area in Togtoh County Inner Mongolia.Methods:In a drinking water-borne endemic arsenism area (Togtoh County of Inner Mongolia), eighty-five permanent residents (residence time ≥20 years) of Hedgehog Valley were selected as exposure group. In the same period, 58 people from a non-arsenism area (Lanjiayao of Helingeer County) were selected as the control group. The general situation of the respondents was investigated, and water arsenic, urine arsenic, blood glucose, blood lipids, blood pressure, liver function, renal function, electrocardiogram and abdominal B-ultrasound were analyzed in both groups. The exposure group was divided into the disease group and the non-disease group according to whether arsenic poisoning skin lesions occurred, and the general conditions and blood pressure changes in the two groups were analyzed.Results:In the exposure group and control group, there were no significant differences among the indicators such as sex, age, smoking, drinking and taking vitamin or calcium tablet ( P > 0.05). Arsenic concentration [Median (interquartile range)] in drinking water of the exposure group was 163.34 (35.34) μg/L, and in urine was 269.72 (152.54) μg/L. Arsenic concentration in drinking water of the control group was 2.96 (5.62) μg/L, and in urine was 24.21 (28.63) μg/L. There were no statistical differences in blood glucose, blood lipids between the exposure group and control group (χ 2 = 0.865, 0.886, P > 0.05); but liver function, renal function, sinus arrhythmia and fatty liver were significantly different statistically (χ 2 = 4.654, 4.355, 4.725, 12.423, P < 0.05); the detection rate of abnormal blood pressure in control group was higher than that of the exposure group (χ 2 = 16.289, P < 0.01). Skin lesions occurred in 24 patients (28.24%) in the exposure group and no skin lesions in 61 patients (71.76%). In disease group, 14 cases (58.33%, 14/24) smoked, the proportion of smoking was higher than that of cases in non-disease group(31.15%, 19/61, χ 2 = 5.360, P < 0.05); and the prevalence of hypertension (50.00%, 12/24) in cases of disease group was higher than that of cases in non-disease group (26.23%, 16/61, χ 2 = 4.406, P < 0.05). Conclusions:Long-term exposure to arsenic might injure liver function and renal function, and enhance the risk of arrhythmia and fatty liver. Smoking may be a risk factor for skin lesions in residents of drinking water-borne endemic arsenism area.

11.
Article in Chinese | WPRIM | ID: wpr-864957

ABSTRACT

Objective:To analyze the clinical features of moderate or severe neonatal hemophilia, and improve the understanding of this disease.Methods:Eleven cases of neonates with moderate or severe hemophilia admitted to our NICU from January 2012 to June 2019 were enrolled.The clinical features, laboratory data, treatments and prognosis of these 11 neonates were retrospectively analyzed.Results:All the neonates were male, and were diagnosed hemophilia A. Seven neonates presented with intracranial hemorrhage including one case complicated with cerebral hernia.Only two of these neonates with intracranial hemorrhage had neurological abnormalities.One case presented with right adrenal hematoma, and one case presented with retroperitoneal hematoma.Jaundice was observed in nine cases, and seven cases, jaundice appeared within two days after birth, whose earliest was 12 hours after birth, and the highest total bilirubin was 388 μmol/L.All cases had prolonged activated partial thromboplastin time.All neonates had decreased activity of coagulation factor Ⅷ including eight moderate and three severe neonatal hemophilia A. Four cases had genetic testing.Three cases infused with fresh frozen plasma and cryoprecipitate and the rest treated with coagulation factorⅧ infusion.Ten cases improved after treatment, and one case abandoned treatment.Conclusion:Moderate or severe hemophilia is often complicated with intracranial hemorrhage or abdominal hemorrhage, often accompanied with hyperbilirubinemia.Imaging examination should be performed to exclude occult bleeding, and coagulation function and coagulation factor activity should be detected as soon as possible.Blood coagulation factors are infused according to the different expected factors of different bleeding sites.

12.
Chinese Journal of Rheumatology ; (12): 234-239, 2020.
Article in Chinese | WPRIM | ID: wpr-868204

ABSTRACT

Objective:To study the patterns of tocilizumab (TCZ) use, its efficacy and safety in patients with rheumatoid arthritis (RA) in routine clinical practice.Methods:A total of 407 patients with RA were enrolled from 23 centers and treated with TCZ within 8 weeks prior to the enrollment visit, and were followed for 6-month. The patterns of TCZ treatment at 6 months, the effectiveness and safety outcomes were recorded. Statistical analysis was performed using SAS version 9.4.Results:A total of 396 patients were included for analysis, in which 330 (83.3%) patients received TCZ combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and 16.7%(66/396) received TCZ monotherapy. At baseline, TCZ was initiated in 56.6%(224/396) and 9.6%(38/396) of patients after failure of DMARDs and other biological agents (bDMARDs) respectively. During the 6-month follow-up period, the mean frequency of TCZ administration was (3.7±1.6), the mean TCZ dosage was (7.4±1.2) mg/kg, and the mean interval between doses was (40±13) days. 120(25.8%) patients were on TCZ treatment at the end of the study. Improvements in disease activity, systemic symptoms and patient report outcomes were observed at the end of the study. 22.7%(90/396) patients experienced at least one treatment related adverse event, and 8 patients experienced at least one serious adverse event.Conclusion:This study demonstrates that TCZ treatment is effective in patients with RA when being treated for 6 months with an acceptable safety profile. The duration of TCZ treatment needs to be extended.

13.
Chinese Critical Care Medicine ; (12): 731-736, 2019.
Article in Chinese | WPRIM | ID: wpr-754045

ABSTRACT

Objective To explore the effect of goal-directed therapy bundle based on pulse-indicated continuous cardiac output (PiCCO) parameters to the prevention and treatment of acute kidney injury (AKI) in patients after cardiopulmonary bypass cardiac operation. Methods A prospective observational study was conducted. The adult patients with selective cardiopulmonary bypass cardiac operation admitted to the Third People's Hospital of Chengdu from December 2015 to January 2018 were enrolled. All patients were divided into two groups based on informed consent for PiCCO monitor at the time of admission to the intensive care unit (ICU): regular monitoring and treatment group (group A) and goal-directed therapy group based on PiCCO parameters (group B). In group A, the restrictive capacity management strategy was implemented to maintain the mean arterial pressure (MAP) > 65 mmHg (1 mmHg = 0.133 kPa) and the central venous pressure (CVP) between 8 mmHg and 10 mmHg. In group B, volume and hemodynamic status were optimized depending on PiCCO parameters to a goal of cardiac index (CI) > 41.68 mL·s-1·m-2, global end diastolic volume index (GEDVI) > 700 mL/m2 or intrathoracic blood volume index (ITBVI) > 850 mL/m2, extravascular lung water index (EVLWI) < 10 mL/kg, and MAP > 65 mmHg. Then the changes in hemodynamics and different prognosis of the patients in two groups were observed. Risk factors affecting the AKI were analyzed by Logistic regression. Results 171 cases were included, with 68 in group A and 103 in group B. There were no significant differences in gender, age, pre-operative scores by European system for cardiac operative risk evaluation (EuroScore), operation ways, operation time, cardiopulmonary bypass time, intraoperative dominant liquid equilibrium quantity, the use of intra-aortic balloon counterpulsation (IABP) during operation, and serum creatinine (SCr) level at the time of admission to ICU between the two groups. There were no significant differences in CVP within 24 hours after admission to ICU between the two groups. MAP in group B was significantly higher than that in group A at 8 hours and 16 hours after ICU admission (mmHg: 68.9±6.3 vs. 66.7±5.1, 69.0±4.9 vs. 67.0±5.3, both P < 0.05). Sequential organ failure assessment (SOFA) score in group B was significantly lower than that in group A at 24 hours after ICU admission (5.7±2.2 vs. 6.9±2.8, P < 0.05). Dominant liquid equilibrium quantity in group B was significant higher than that in group A at 24 hours after ICU admission (mL/kg: 7.1±6.2 vs. -0.1±8.2, P < 0.01), but there was no significant difference of that between groups at 48 hours and 72 hours after ICU admission. Compared with group A, incidence of combination with AKI during 72 hours after ICU admission was significantly decreased in group B [48.5% vs. 69.1%; odds ratio (OR) =0.422, 95% confidence interval (95%CI) = 0.222-0.802, P < 0.05], and incidence of moderate to severe AKI was also significantly decreased in group B (19.4% vs. 35.3%; OR = 0.442, 95%CI = 0.220-0.887, P < 0.05). There was no significant difference in usage of continuous renal replacement therapy (CRRT) after ICU admission between both groups (group A was 4.4%, group B was 4.9%, P > 0.05). It was shown by correlation analysis that only MAP and CI at 8 hours after ICU admission were significantly negatively correlated with AKI (MAP and AKI: r = -0.697, P = 0.000;CI and AKI: r = -0.664, P = 0.000). It was shown by Logistic regressive analysis that the MAP and CI at 8 hours after ICU admission were independent risk factors that influence the incidence of AKI at 72 hours after ICU admission (MAP:OR = 0.736, 95%CI = 0.636-0.851, P = 0.000; CI: OR = 0.006, 95%CI = 0.001-0.063, P = 0.000). There were no significant differences in the duration of mechanical ventilation, the length of ICU stay, the post-operation complications (except AKI), 7-day and 28-day mortality between the two groups. Conclusions Goal-directed therapy bundle based on PiCCO parameters reduced the incidence of AKI in patients after cardiopulmonary bypass cardiac operation and improved the severity of systemic disease. However, it did not reduce the duration of mechanical ventilation, length of ICU stay, the incidence of complications (except AKI), short-term mortality. The MAP and CI at 8 hours after ICU admission were independent risk factors that influence the incidence of AKI in patients after cardiopulmonary bypass cardiac operation.

14.
Article in Chinese | WPRIM | ID: wpr-744761

ABSTRACT

Objective To explore the relationship among psychological flexibility,coping style and job burnout of nurses.Methods A total of 694 nurses from one district level grade A tertiary general hospital in Yunnan were assessed using acceptance and action questionnaire 2nd edition (AAQ-Ⅱ),simplified coping style questionnaire (SCSQ) and nursing burnout scale (NBS).The relationship among psychological flexibility,coping style and job burnout of nurses was analyzed using structural equation model and Bootstrap test.Results (1) Correlation analysis showed that the total scores of AAQ-Ⅱ (21.81 ± 8.23),job burnout (22.71 ± 6.60) and its three dimensions including emotional exhaustion (8.93 ± 2.87),depersonalization (6.64±2.30)as well as reduced personal accomplishment(7.14±2.52) were positively correlated with negative coping dimension of coping style (10.86±4.99) (r=0.324-0.510,all P<0.01),while negatively correlated with positive coping dimension(26.44±5.86) (r=-0.102--0.143,all P<0.01).(2) Structural equation model analysis showed that positive and negative coping dimension had partial mediating effects on the relationship between psychological flexibility and job burnout (x2/df=2.30,GFI =0.91,AGFI =0.90,NFI=0.90,IFI=0.93,TLI=0.92,CFI=0.93,RMSEA=0.04).(3) Bootstrap test showed that the mediating effect sizes for positive and negative coping were 3.8% and 8.9% respectively and totally mediating effect size of coping style was 12.7%.Psychological flexibility had much larger effects on job burnout,and the direct effect size was 87.3%.Conclusion Coping style plays a mediating role in the relationship between psychological flexibility and job burnout,but its effect is less important.Psychological flexibility plays a major role and more directly influences on job burnout.

15.
Article in Chinese | WPRIM | ID: wpr-800691

ABSTRACT

Objective@#To investigate the predictive value of thromboelastography (TEG) for early neurological deterioration (END) in patients with acute ischemic stroke.@*Methods@#Patients with acute ischemic stroke admitted to the Department of Neurology, Jiujiang Hospital Affiliated to Nanchang University from January 2018 to May 2019 were included as case group, and the healthy physical examinees in the same period were selected as control group. END was defined as an increase of ≥2 of the National Institutes of Health Stroke Scale score from baseline within 7 d after the onset of acute ischemic stroke. All subjects were routinely tested for traditional coagulation function, including prothrombin time, activated partial thromboplastin time, thrombin time, and plasma fibrinogen level. The reaction time (R value), coagulation time (K value), coagulation angle (α) and maximum amplitude (MA value) were monitored by TEG. Univariate analysis was used to compare the differences in clinical and laboratory results between the END group and the non-END group, and then multivariate logistic regression analysis was used to determine the independent risk factors for END.@*Results@#A total of 96 patients with acute ischemic stroke and 20 controls were included. Compared with the control group, the traditional coagulation parameters of the case group were not significantly different. For the TEG parameter, compared with the control group, the R value and K value of the case group were significantly shortened, and the α angle and MA value were significantly increased (all P<0.05). A total of 31 patients (32.3%) developed END, and the R and K values in the END group were significantly shorter than those in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that R value (odds ratio 1.192, 95% confidence interval 1.006-1.410; P=0.001) and K value (odds ratio 1.054, 95% confidence interval 1.012-1.150; P=0.001) shortening were the independent predictors of END.@*Conclusion@#The sensitivity of TEG in the monitoring of coagulation function in patients with acute ischemic stroke is higher than that of traditional coagulation indicators. The shortenings of R and K values are independent predictor of END in patients with acute ischemic stroke.

16.
Article in Chinese | WPRIM | ID: wpr-819361

ABSTRACT

Objective@#To explore the dietary patterns and related factors among urban middle school students in Guangzhou, and to provide the scientific reference for conducting nutritional education and intervention among the middle school students.@*Methods@#Questionnaire survey was conducted for students in two grades (grade 1 of 27 junior and senior high schools) and their parents along with the physical examination for urban primary and secondary school students in Guangzhou. Dietary patterns were established by exploratory factor analysis. Multinomial Logistic regression model was used for analyzing influencing factors of dietary pattern.@*Results@#Three major dietary patterns were identified. Type I (37.09%) was a healthy dietary pattern; type II (33.37%) and III (29.54%) were classified into western dietary patterns. Multinomial Logistic regression models showed that living on campus (ORⅡ=1.57, 95%CI:1.33-1.85; ORⅢ=1.28, 95%CI:1.07-1.52), screen time≥2 h/d (ORⅡ=2.89, 95%CI:2.51-3.33; ORⅢ=2.14, 95%CI:1.85-2.48) were positively associated with type II and III. The monthly household income per capita≥5 000 yuan (ORⅢ=1.31, 95%CI:1.14-1.51) was positively associated with type III. Senior students (ORⅡ=0.83, 95%CI:0.73-0.95; ORⅢ=0.74, 95%CI:0.64-0.85), the level of parental education (ORⅡ=0.64, 95%CI:0.52-0.79; ORⅡ=0.67, 95%CI:0.54-0.82; ORⅢ=0.72, 95%CI:0.58-0.90; ORⅢ=0.73, 95%CI:0.59-0.89) had a negative association with type II and III.@*Conclusion@#There are three dietary patterns among urban middle school students in Guangzhou. The main influencing factors include parental education, screen time, grade, resident situation, and monthly household income per capita.

17.
Article in Chinese | WPRIM | ID: wpr-708142

ABSTRACT

Objective To explore the CTV to PTV external expansion boundary and the effect of the dose of normal lung tissue under different fixed modes by a comparative analysis of combined body position and thermoplastic film fixed set-up error of radiation therapy for lung cancer. Methods From October 2016 to March 2018, the patients who received chest radiology at the Tangshan people's hospital were enrolled as subjects retrospectively divided into two groups, including 50 patients with lung cancer radiotherapy with combined body position fixation, and 40 patients with lung cancer with thermoplastic film fixation. The two groups of patients drew the target areas in accordance with the unified standard, and the set-up error of left and right, up and down, front and rear ( x, y, z axis) were recorded respectively after 1 time/week cone CT( CBCT) matched with the planned CT image and analyzed by t test. According to the MPTV =2. 5Σ+0. 7δ, CTV to PTV external expansion boundary in the combined body position group were calculated. And the V5、V20 and V30 of two groups of patients were calculated and analyzed by TPS system. Results The set-up error of the combined body position group and thermoplastic film group were respectively (1. 00 ± 0. 58) mm and (3. 28 ± 0. 43) mm on the x axis, (1. 42 ± 0. 28) mm on the y axis and (4. 03 ± 0. 41) mm, (1. 06 ± 0. 44) mm and (3. 18 ± 0. 34) mm on the z axis. The set-up errors of the two groups were statistically significant on x, y and z axis( t= -20. 740, -35. 596, -25. 015,P<0. 05). There was no significant difference in set-up errors between the central and peripheral lung cancer patients and between left and right lung cancer patients(P>0. 05). Through the MPTV =2. 5Σ+0. 7δ, CTV to PTV external expansion boundary in the combined body position fixation group was 2. 906 , 3. 746 and 2. 958 mm on x, y and z axis respectively. The comparison between group A and B showed that the mean values of V5 , V20 and V30 in group B were reduced by 1. 5%, 3. 1% and 4. 8% respectively compared with group A. Conclusions The combined body position technique can improve the accuracy of lung cancer patients after radiation therapy,and further reduce the boundary of CTV to PTV, which is of certain value to reduce the occurrence of radiation pneumonitis.

18.
Article in Chinese | WPRIM | ID: wpr-691282

ABSTRACT

<p><b>OBJECTIVE</b>To establish the tissue response grading (TRG) system following neoadjuvant chemotherapy and to investigate its application in the gastric cancer patients who received neoadjuvant chemotherapy.</p><p><b>METHODS</b>Data of 30 cT3-4N0-3M0 gastric cancer cases who received neoadjuvant chemotherapy and operation from May 2017 to February 2018 at Department of Gastrointestinal Surgery, West China Hospital were analyzed retrospectively. The edema degree of gastrointestinal tract and perigastric tissues, intraoperative effusion, and fibrosis of tumor and lymph nodes bearing tissues which could be divided into 4 categories constituted the core parameters of the TRG system following neoadjuvant chemotherapy. Four categories of edema: grade 0, no obvious tissue edema; grade 1, slight tissue edema and swelling, no obvious effusion when dissecting the capsule of connective tissues; grade 2, moderate tissue edema and swelling, a few effusion when dissecting the capsule of connective tissues; grade 3, severe tissue edema and swelling with high tension on the capsule of connective tissues, tension blister could be observed in some patients, continuous effusion when dissecting the capsule of connective tissues. Four categories of intraoperative effusion: grade 0, no obvious effusion; grade 1, slight effusion and a few intraperitoneal exudation; grade 2, moderate effusion and continuous intraperitoneal exudation necessitating interrupted suction; grade 3, severe effusion and continuous intraperitoneal exudation necessitating constant suction. Four categories of fibrosis: grade 0, no fibrosis; grade 1, slight fibrosis with threadiness fibrous bands, clear dissecting space could be found between the fibrous tissues and adventitia/normal tissues; grade 2, moderate fibrosis with flaky fibrous tissues, the difficulty of tissue and lymph nodes dissection increased although dissecting space could be found between the fibrous tissues and adventitia/normal tissues; grade 3, severe fibrosis with hard and flaky fibrous membrane, the difficulty of tissue and lymph nodes dissection increased extremely and the fibrous tissues merges with adventitia/normal tissues without dissecting space. The relationships of TRG system with tumor response evaluation by computed tomography (CT), tumor regression score, surgical duration, number of retrieved lymph nodes, number of metastatic lymph nodes, number of enlarged lymph nodes seen in the preoperative CT scans as well as postoperative complications were analyzed using t test, χ² test and logistic regression model.</p><p><b>RESULTS</b>Nineteen male and 11 female patients with a mean age of(59.1±9.4) years were enrolled. There were 17 cases of grade 1, 12 cases of grade 2 and 1 case of grade 3 for tissue edema, while the corresponding number was 14, 15 and 1 for intraoperative effusion and 15, 14 and 1 for fibrosis respectively. There were no significant differences among the different degrees of tissue edema, intraoperative effusion and fibrosis in terms of the tumor response evaluation by CT and tumor regression score (all P>0.05). The results of logistics regression showed that tumor response evaluation by CT was related with the degree of tissue edema (P=0.012) and intraoperative effusion (P=0.007), rather than the degree of fibrosis (P=0.527). However, tumor regression score was not related with the degree of tissue edema(P=0.345), intraoperative effusion (P=0.159) and fibrosis (P=0.207). Surgical duration of one case with all grade 3 in tissue edema, intraoperative effusion and fibrosis was 408 minutes, which was longer than those with grade 1 and grade 2 patients [(295.9±40.1) minutes and (293.1±34.3) minutes, respectively]; the number of retrieved lymph nodes, metastatic lymph nodes, and enlarged lymph nodes seen in the preoperative CT scans of this case with all grade 3 were 25, 4 and 1, which were all less than those with grade 1 and grade 2 (42.3±11.9 and 38.5±18.2, 7.3±9.1 and 8.1±9.7, 1.8±1.6 and 2.3±1.3, respectively). There were no significant differences between grade 1 and grade 2 of tissue edema, intraoperative effusion and fibrosis in terms of surgical duration, retrieved lymph nodes, metastatic lymph nodes and enlarged lymph nodes seen in the preoperative CT scans(all P>0.05). Four patients suffered from pulmonary complications and 2 patients experienced slight lymphatic, and all leakage were cured by conservative therapies. There were no significant differences among the different grades of tissue edema, intraoperative effusion and fibrosis in terms of the operation-associated complications (all P>0.05).</p><p><b>CONCLUSION</b>The tissue response grading system can assist the judgment of operation difficulty and reflect the effectiveness of neoadjuvant chemotherapy to some extent, which has the possibility of applications.</p>


Subject(s)
Aged , China , Female , Humans , Lymph Node Excision , Lymph Nodes , Male , Middle Aged , Neoadjuvant Therapy , Retrospective Studies , Stomach Neoplasms , Drug Therapy , General Surgery
19.
Clinical Medicine of China ; (12): 149-152, 2018.
Article in Chinese | WPRIM | ID: wpr-706638

ABSTRACT

Objective To study the surgical safety of retained glands for micro?papillary thyroid carcinoma(mPTC). Methods A total of two hundred patients with mPTC from June 2012 to June 2016 in Seventh People's Hospital of Shanghai University of TCM were enrolled in this study: single follow?up group (group A,40 cases),unilateral total lobectomy+isthmus resection group(group B,85 cases),unilateral total lobectomy+contralateral lobe subtotal resection group( group C,45 cases) ,bilateral total lobectomy ( group D,30 cases) ,then the clinical outcome was compared. Results The average follow?up time was about 26. 5 months, and there was no significant increase in tumor diameter in group A ( (6. 6±1. 5) mm vs. (6. 5±1. 3) mm,t=0. 326,P=0. 621) . The incidences of hypothyroidism in group B and C were significantly lower than that in group D ( 7. 1% vs. 30. 0%,χ2 =8. 366, P=0. 004, 11. 1% vs. 30. 0%,χ2 =4. 230, P= 0. 040 ) , while the differences in hypoparathyroidism,hypocalcemia,laryngeal nerve injury and total rate among group B,C and D were not statistically significant(P>0. 05). The median survival times in group B,C and D were significantly longer than that in group A (42. 2months,43. 5months,43. 6months vs. 32. 8months,P<0. 05),while there was no significant difference among group B,C and D ( P>0. 05) . There was no statistically significant difference in 3?year tumor mortality and recurrence rates among the three groups ( P>0. 05 ) . Conclusion Unilateral lobe resection + isthmus resection + ipsilateral central lymph node dissection can maintain the gland function,reduce complications,without reducing the survival,it is worthy of popularization and application.

20.
Chinese Medical Ethics ; (6): 24-27, 2018.
Article in Chinese | WPRIM | ID: wpr-706036

ABSTRACT

Evidence - based medicine emphasizes that clinical decision - making is based on the integration of evidence from external research, experience of doctors, and patient values. Therefore, the well - informed SDM of doctor - patient embodies the essence of evidence - based practice. The author have reviewed relevant domestic and international researches on SDM in clinical research and practice, found that the utilization of SDM in China is still not carried in research, lacking of related clinical evidence. The research of SDM in other countries has conducted some researches and put it into practice. The author discussed the bottleneck and countermeasure of SDM in clini-cal research to lay foundation to make it possible for further study.

SELECTION OF CITATIONS
SEARCH DETAIL