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OBJECTIVE:Percutaneous sacroiliac screw internal fixation has become the main surgical procedure for the treatment of posterior pelvic ring fractures;however,the unassisted closure operation requires high operator experience and repeated fluoroscopy increases the radiation hazard for patients and medical personnel.This article compares the clinical efficacy of robot-assisted versus unassisted percutaneous sacroiliac screw placement for posterior pelvic ring fractures by meta-analysis. METHODS:Computer searches of CNKI,WanFang,VIP,CBM,PubMed,Embase,Cochrane Library and ClinicalTrials.gov were conducted from the time of database inception to December 2022.The literature on the clinical efficacy of robot-assisted versus freehand percutaneous sacroiliac screw placement in the treatment of posterior pelvic ring fractures was collected in and outside China.The data were independently screened and extracted by two investigators according to the inclusion and exclusion criteria,respectively.The quality of randomized controlled trials was evaluated using Cochrane risk assessment criteria.The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale.Meta-analysis was performed using RevMan 5.4 software for inclusion metrics.Outcome metrics included operative time,intraoperative bleeding,fluoroscopy time,fluoroscopy frequency,number of holes drilled,Majeed postoperative function score,the excellent and good rates of Matta fracture reduction,the excellent and good rates of Gras screw position,fracture healing time and complications. RESULTS:(1)A total of 13 publications were included,2 were randomized controlled trials both referring to randomized methods,11 non-randomized controlled studies were evaluated for quality of literature according to the Newcastle-Ottawa Scale,1 scored 8,9 scored 7;and 1 scored 6;the quality of literature was good.A total of 748 patients were included,including 430 in the robot-assisted group and 318 in the freehand group.(2)The results of the meta-analysis showed that the operative time(MD=-28.30,95%CI:-40.20 to-16.40),intraoperative bleeding(MD=-6.36,95%CI:-10.06 to-2.66),intraoperative fluoroscopy time(MD=-12.13,95%CI:-19.54 to-4.72),intraoperative fluoroscopy frequency(MD=-17.39,95%CI:-29.00 to-5.78),number of intraoperative needle drillings(SMD=-9.50,95%CI:-14.27 to-4.73)and the excellent and good rates of Gras screw position(OR=8.65,95%Cl:3.26-22.92)in the robot-assisted group were significantly better than those in the freehand group(P<0.05).(3)In the robot-assisted group,the overall postoperative complication rate was significantly reduced(OR=0.10,95%Cl:0.02-0.48,P<0.05).(4)No significant difference was detected in fracture healing time(MD=-0.08,95%CI:-0.21,0.06),the excellent and good rates of Matta fracture repositioning rate(OR=2.06,95%Cl:0.97-4.39),and Majeed functional score(MD=0.91,95%CI:-0.31-2.13)between both groups(P>0.05). CONCLUSION:Compared with freehand sacroiliac joint nailing,robotic assistance shortens the operative time,reduces intraoperative bleeding,decreases radiation damage to patients and medical staff,improves the excellent and good rate of screw position,and reduces the overall incidence of postoperative complications in patients,but there was no significant improvement in fracture reduction quality,fracture healing time,and postoperative function.In the future,more large-sample,multicenter,and high-quality randomized controlled trials are still needed to verify.
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BACKGROUND:Previous studies on cervical instability failed to explain the dynamic and static interaction relationship and pathological characteristics changes in the development of cervical lesions under the traditional imaging examination.In recent years,the emerging nuclear magnetic resonance imaging(MRI)radiomics can provide a new way for in-depth research on cervical instability. OBJECTIVE:To investigate the application value of MRI radiomics in the study of cervical instability. METHODS:Through recruitment advertisements and the Second Department of Spine of Wangjing Hospital,China Academy of Chinese Medical Sciences,young cervical vertebra unstable subjects and non-unstable subjects aged 18-45 years were included in the cervical vertebra nuclear magnetic image collection.Five specific regions of interest,including the intervertebral disc region,the facet region,the prevertebral muscle region,the deep region of the posterior cervical muscle group,and the superficial region of the posterior cervical muscle group,were manually segmented to extract and screen the image features.Finally,the cervical instability diagnosis classification model was constructed,and the effectiveness of the model was evaluated using the area under the curve. RESULTS AND CONCLUSION:(1)A total of 56 subjects with cervical instability and 55 subjects with non-instability were included,and 1 688 imaging features were extracted for each region of interest.After screening,300 sets of specific image feature combinations were obtained,with 60 sets of regions of interest for each group.(2)Five regions of interest diagnostic classification models for cervical instability were initially established.Among them,the support vector machine model for the articular process region and the support vector machine model for the deep cervical muscle group had certain accuracy for the classification of instability and non-instability,and the average area under the curve of ten-fold cross-validation was 0.719 7 and 0.703 3,respectively.(3)The Logistic model in the intervertebral disc region,the LightGBM model in the prevertebral muscle region,and the Logistic model in the superficial posterior cervical muscle region were generally accurate in the classification of instability and non-instability,and the average area under the curve of ten-fold cross-validation was 0.650 4,0.620 7,and 0.644 2,respectively.(4)This study proved the feasibility of MRI radiomics in the study of cervical instability,further deepened the understanding of the pathogenesis of cervical instability,and also provided an objective basis for the accurate diagnosis of cervical instability.
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Objective To investigate the current status about personal mastery in paediatric nurses in a tertiary hospital in Changchun and to analyse the influencing factors.Methods A total of 340 paediatric nurses in the hospital were enrolled in the investigation with the methods of general data questionnaire,personal mastery scale(PMS),nurses'perceived professional benefits scale(NPPBS)and practice environment scale(PES).Results 321 paediatric nurses complete the research.The total score of personal mastery among the paediatric nurses was found at(27.63±1.99)and was at a middle-high level.Multiple linear regression analysis showed the overall independent factors that affected the overall personal mastery of the paediatric nurses included type of job contract,average monthly income,working experience,number of night shifts per month,the perceived professional benefits and practice environment of the nurses(P<0.05).Conclusion Personal mastery among the paediatric nurses is at a middle-high level.Nursing managers should take targeted and pertinent measures to the identified influencing factors in order to improve the personal mastery,relieve work related pressures,reduce job burnout,enhance professional identity and thereby promote the stability and development the workforce in paediatric nursing.
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Objective To investigate the dyadic coping experience of patients undergoing cancer surgery and their spouses.Methods Sixteen cancer patients who were initially diagnosed with cancer and underwent cancer surgery in a general hospital in Henan province as well as and their spouses were selected as the study subjects by objective sampling method.All the patients and their spouses were included in the postoperative follow-up for dyadic coping experiences though a 3 months interview.The acquired data were summarised and analysed by Colaizzi's phenomenological method to identify relevant themes.Results A total of eight themes were identified,including three themes over the phase of confirmed diagnosis,strong stress response,coping with stress alone and consistent attitude towards seeking medical treatment;two themes over the perioperative phase,lack of coping ability and change in relationship;and three themes over the phase of home recovery,lack of disease information,poor communication skills and post-trauma growth of both patient and spouse.Conclusions The dyadic coping experience of patients who undergo cancer surgery and their spouses varies with the stages across the treatment.Therefore,medical staff should offer targeted nursing care according to the dyadic coping experience at different stages,hence to improve the physical and mental health of the cancer patients and their spouses.
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Objective To develop an undergraduate curriculum for nursing engineering hence to provide a reference for establishing an innovative thinking of nursing undergraduates and cultivating innovative talents with interdisciplinary knowledge in nursing and engineering.Methods Based on literatures review,the primary undergraduate curriculum for nursing engineering was drafted through the expert focus method.With the Delphi method,20 experts were engaged in two rounds of correspondence consultation to finalise the curriculum.Results The response rate from two rounds of expert consultation was 100.00%,with an expert authority coefficient of 0.855.Of the first and second round of consultations,the coefficient of variation of each item was 0.09-0.28 and 0.08-0.24,respectively,and the Kendall coordination coefficient was 0.130-0.210 and 0.152-0.350,respectively(all P<0.01).The average importance of each item for the first round of consultation was 3.45 to 4.68,with a standard deviation from 0.51 to 1.14,and it was 3.80 to 4.85 for the second round with a standard deviation from 0.37 to 0.99.Finally,the undergraduate curriculum for nursing engineering was finalised.It included 4 primary indicators,10 secondary indicators and 38 tertiary indicators.Conclusions The developed undergraduate curriculum for nursing engineering meets the requirement of clinical medicine and development in nursing science.The curriculum is authoritative and scientific,therefore it can provide a reference for the training of innovative talents with interdisciplinary knowledge of nursing and engineering in China.
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Objective To investigate the current situation of preoperative nursing trust in total knee replacement patients and analyze the influencing factors.Methods Using convenience sampling method,138 patients who underwent total knee ar-throplasty in our department from October 2020 to September 2021 were selected as the research objects.The patients were inves-tigated by general information questionnaire,nurse-patient relationship trust scale(NPTs),self-rating Anxiety Scale(SAS)and knee American Special Surgery scale(HSS),to explore the current situation and influencing factors of patient-nurse trust in pa-tients undergoing total knee arthroplasty.Results The total score of preoperative trust of patients(136.75±7.93);Pearson correlation analysis showed a negative correlation with total anxiety score(r =-0.419,P<0.01)and no correlation with knee function score(r=0.063,P>0.05).The results of the multiple linear regression analysis showed that the educational level,previous experience of hospitalization,and preoperative anxiety entered the regression equation(P<0.05)explained 66.9% of the total variation.Conclusion In this group,the trust between nurses and patients in patients undergoing total knee arthroplas-ty is at the upper middle level,and is affected by education level,previous hospitalization experience and preoperative anxiety.Nurses should focus on patients with low education level,no previous hospitalization experience and high anxiety level,and carry out targeted intervention for theme,so as to reduce postoperative anxiety and improve postoperative function,Promote doctor-pa-tient relationship,reduce medical disputes and help patients recover as soon as possible.
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Objective:To analyze the clinical characteristics of eosinophilic gastroenteritis in children under 6 years old.Methods:The clinical data,laboratory examinations,imaging examinations,gastrointestinal endoscopy,histopathology,treatment,and prognosis of patients under 6 years old with eosinophilic gastroenteritis who were hospitalized in the Department of Gastroenterology,Beijing Children's Hospital from January 1,2016 to December 31,2022 were collected and analyzed.Results:A total of 31 children under 6 years of age with eosinophilic gastroenteritis were enrolled in the study,including 14 cases≤3 years old and 17 cases>3 years old, and 38.71% (12/31) of them had multiple sites involved. The main clinical manifestations were abdominal pain(20/31,64.52%),vomiting(11/31,35.48%),hematochezia(7/31,22.58%),and diarrhea(7/31,22.58%).The children with eosinophilic duodenitis and eosinophilic colitis were more likely to have abdominal pain, with an incidence of 83.33%(10/12)( P<0.05). Eosinophilia increased in 70.97%(22/31)of children,which was more common in children >3 years of age(88.24% vs. 50.00%, P<0.05).Anemia was seen in 29.03%(9/31)of the patients,and it was more common in children under 3 years of age(50.00% vs. 11.76%, P<0.05).Hypoalbuminemia was found in 22.58%(7/31)of patients. Specific IgE(sIgE)was positive in 73.33%(22/30)of children. Milk,egg,and wheat were the most common allergens. Gastrointestinal endoscopy showed mucosal edema(29/31,93.55%),erythema(26/31,83.87%),roughness(12/31,38.71%),ulcer(10/31,32.26%),et al.All children were treated with the elimination diet. Besides,10 cases were treated with omeprazole, 16 cases were treated with montelukast, and 17 cases were treated with glucocorticoid. The incidence of relapse or steroid resistance was 32.26%(10/31),and 70.00%(7/10)of them occurred within one year of treatment. Conclusion:Eosinophilic gastroenteritis in children under 6 years of age may involve single or multiple sites.Abdominal pain is the most common clinical manifestation. Children may have elevated peripheral blood eosinophils,anemia,or hypoalbuminemia.Most children have food allergens. Nearly one-third of children experience relapse or steroid resistance.
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Objective:To study the effects of endoplasmic reticulum stress (ERS) and autophagy mechanisms in the pathogenesis of necrotizing enterocolitis (NEC).Methods:A total of 39 newborn SD rats were randomly assigned into 3 groups: the NEC group (NEC model: artificial feeding+hypoxic stimulation+intragastric injection of lipopolysaccharides), the ERS antagonist group (NEC model+intraperitoneal injection of 4-phenylbutyric acid) and the ERS inducer group (NEC model+intraperitoneal injection of tunicamycin). After successful modeling, the rats were sacrificed and intestinal tissues were obtained. The intestinal pathology was observed using electronic microscope. Intestinal fatty acid binding protein (I-FABP) was detected using ELISA. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to examine mRNA levels of glucose-regulated protein 78 (GRP78) and oxygen-regulated protein 150 (ORP150). Western-blot was used to detect p62 and autophagy-related proteins (microtubule-associated protein 1 light chain 3 (LC3)Ⅱ and LC3Ⅰ) and LC3Ⅱ/LC3Ⅰ ratio was calculated.Results:(1) For all 3 groups, the pathological scores of rat intestines were≥2. (2) The ERS inducer group showed significantly higher clinical score, pathological score, I-FABP level, GRP78 and ORP150 mRNA levels and LC3Ⅱ/ LC3Ⅰ ratio than the NEC group and ERS antagonist group, and the NEC group higher than the ERS antagonist group ( P<0.05). The p62 level in the ERS inducer group was significantly lower than the NEC group and the ERS antagonist group, and the NEC group lower than the ERS antagonist group ( P<0.05). (3) The LC3Ⅱ/ LC3Ⅰ ratio was positively correlated with clinical score, pathological score and I-FABP level ( P<0.05). The p62 level was negatively correlated with clinical score, pathological score and I-FABP level ( P<0.05). The mRNA levels of GRP78 and ORP150 were positively correlated with clinical score, pathological score and I-FABP level ( P<0.05). LC3Ⅱ/ LC3Ⅰ ratio was positively correlated with the mRNA levels of GRP78 and ORP150 ( P<0.05). The p62 level was negatively correlated with the mRNA levels of GRP78 and ORP150 ( P<0.05). Conclusions:ERS is associated with the pathogenesis of NEC. Inhibition of ERS can reduce autophagy and improve intestinal barrier function and clinical symptoms of NEC.
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Objective:To study the clinical characteristics and risk factors of necrotizing enterocolitis (NEC) in one of the premature twins.Methods:A retrospective study was conducted on twin premature infants who were admitted to the Department of Neonatology at the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2022 and only one got NEC. The twins were divided into NEC group and control group, the clinical data were collected and analyzed by SPSS 26.0 statistical software.Results:This study enrolled 109 pairs of premature twins, 109 cases in the NEC group, and 109 cases in the control group. Univariate analysis showed that birth weight, pre NEC white blood cell count were lower in NEC group than those in the control group, while the proportion of smaller than gestational age (SGA), donor of twin-to-twin transfusion syndrome, feeding intolerance, incomplete enteral feeding, start feeding time >48 h, red blood cell transfusion 72 h before NEC onset and the neutrophils ratio were higher in the NEC group than that of the control group, the difference was statistically significant ( P<0.05). Multivariate logistic analysis showed that low birth weight ( OR=1.558, 95% CI1.197-2.142), SGA ( OR=1.721, 95% CI 1.217-2.536), feeding intolerance ( OR=3.798, 95% CI 1.347-10.706), and incomplete enteral feeding ( OR=4.319, 95% CI 1.673-11.149) were independent risk factors for NEC ( P<0.05). Conclusions:Low birth weight, small for gestational age, feeding intolerance, and incomplete enteral feeding are independent risk factors for NEC in one of the premature twins.
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Objective To investigate whether long-chain non-coding ribonucleic acid HAGLR(LncRNA HAGLR)can affect lipopolysaccharide(LPS)-induced apoptosis and expression of inflammatory factors of retinal pigment epithelium(RPE)cells by targeted regulation of the expression of micro ribonucleic acid-625-5p(miR-625-5p),so as to lay an experi-mental foundation for revealing the mechanism of retinopathy.Methods LPS-induced human retinal pigment epithelial(ARPE-19)cells were set as the LPS group,and normally cultured ARPE-19 cells were assigned to the Con group.Quanti-tative real-time polymerase chain reaction was used to detect the expression levels of LncRNA HAGLR and miR-625-5p.Based on different transfection reagents,the cells were divided into the LPS+sh-NC group,LPS+sh-HAGLR group,LPS+miR-NC group,LPS+miR-625-5p group,LPS+sh-HAGLR+anti-miR-NC group,and LPS+sh-HAGLR+anti-miR-625-5p group.Flow cytometry was used to detect apoptosis rate;enzyme-linked immunosorbent assay was used to detect the lev-els of interleukin-6(IL-6)and interleukin-1β(IL-1β);the targeting relationship between LncRNA HAGLR and miR-625-5p was verified;Western blot was used to detect the protein levels of activated cysteinyl aspartate specific proteinase 3 and 9(cleaved-Caspase 3 and cleaved-Caspase 9).Results Compared with the Con group,the LPS group showed an increase in the expression level of LncRNA HAGLR and a decrease in the expression level of miR-625-5p(both P<0.05),and there were increases in apoptosis rate,protein levels of cleaved-Caspase 3 and cleaved-Caspase 9,and levels of IL-6 and IL-1β(all P<0.05).Compared with the LPS+sh-NC group,the LPS+sh-HAGLR group showed decreases in apoptosis rate,protein levels of cleaved-Caspase 3 and cleaved-Caspase 9,and levels of IL-6 and IL-1β(all P<0.05);LncRNA HAGLR could negatively regulate the expression level of miR-625-5p(P<0.05).Compared with the LPS+miR-NC group,the LPS+miR-625-5p group showed an increase in the expression level of miR-625-5p and decreases in apoptosis rate,protein levels of cleaved-Caspase 3 and cleaved-Caspase 9,and levels of IL-6 and IL-1β(all P<0.05).Compared with the LPS+sh-HAGLR+anti-miR-NC group,the LPS+sh-HAGLR+anti-miR-625-5p group showed a decrease in the expression level of miR-625-5p and increases in apoptosis rate,protein levels of cleaved-Caspase 3 and cleaved-Caspase 9,and levels of IL-6 and IL-1β(all P<0.05).Conclusion Interference on LncRNA HAGLR expression can realize the targeted regulation of miR-625-5p expression to inhibit the apoptosis and inflammatory factor expression,reducing LPS-induced injury of ARPE-19 cells.
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Objective To explore the eye behaviors and myopia-related risk factors among primary and secondary school students in Tianjin,in order to carry out targeted eye health education and guidance.Methods A cross-sectional study was conducted.In December 2021,an eye health questionnaire was distributed to primary and secondary school students in Tianjin to investigate their eye habits;combined with the campus vision screening data in the second half of 2021,a multivariate logistic regression analysis model was constructed to explore the risk factors related to myopia.Re-sults A total of 821 459 questionnaires were collected,including 701 104 valid questionnaires.The usage time of electron-ic learning products and electronic entertainment products for primary school students was mostly less than 1 hour(ac-counting for 57.74%and 40.98%,respectively).The population of junior high school students who spend more than 2 hours using electronic learning products and electronic entertainment products(accounting for 26.61%and 35.05%,re-spectively)significantly increased compared to primary school students(accounting for 11.21%and 20.93%,respective-ly).Most senior high school students spend more than 2 hours daily using electronic devices for learning and entertainment purposes,as well as reading paper materials.51.59%of primary school students do not meet the standard for sleep dura-tion,while the rate of reaching the standard sleep duration of junior high and senior high school students was 60.09%and 64.99%,respectively.Most(55.74%)primary and secondary school students have an average outdoor activity duration of 1-2 hours daily.The results of multivariate logistic regression analysis showed that the risk of myopia in primary school students was correlated with the time spent using electronic products(including learning and entertainment),the time spent reading paper materials at a close range,outdoor activities,time to fall asleep,and sleep duration(all P<0.05);the risk of myopia among junior high school students was related to the time spent using electronic entertainment products,reading paper materials at a close range,outdoor activities,and sleep duration(all P<0.05);the risk of myopia among senior high school students was only related to the time spent reading paper materials at a close range and the duration of outdoor activities(both P<0.05).Conclusion The proportion of primary school students,junior high school students and senior high school students in Tianjin who use electronic products for more than 2 hours is gradually increasing,and the rate of reaching the standard sleep duration is gradually increasing.The risk of myopia among these students is related to the time spent reading paper materials at a close range and outdoor activities.Science popularization should be carried out and management of eye behaviors should be strengthened in the whole society to reduce myopia rates in children and adolescents in China.
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Objective To investigate the common symptoms and associated disease characteristics of hyperhomocysteinemia in cere-bral infarction patients and the correlation analysis of influencing factors.Methods A total of 151 participants with blood homocysteine≥15μmol/L and 86 participants with blood homocysteine<15μmol/L were identified as the hyperhomocysteinemia with cerebral infarction group(H group)and the normal cerebral infarction group(N group),respectively.The symptoms and influence factors in the two groups were compared.Results Among cerebral infarction patients,patients in H group were older(P=0.049),more male(P=0.002),had a history of smoking(P=0.025),diabetes(P=0.008),hyperlipidemia(P=0.034),folate deficiency(P=0.002)and associated cognitive impairment(P=0.009)and language barrier(P=0.043).Binary Logistic regression analysis showed that age(P=0.023),diabetes(P=0.018),folate deficiency(P=0.026),and cognitive impairment(P=0.019)were independent related factors of in-creased blood homocysteine level.Conclusion Cerebral infarction patients with hyperhomocysteinemia are elderly,and most of them have diabetes,folate deficiency,and cognitive impairment.
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Objective To investigate the effect of inhibiting autophagy induced by endoplasmic reticulum stress(ERS)on necrotiz-ing enterocolitis(NEC)in neonatal rats.Methods First,the NEC model of neonatal rats was established.Then,the intestinal epitheli-al cells were isolated and divided into three groups:control group,inhibition group and induction group.The control group was cultured normally,the inhibition group was added with 4-phenylbutyric acid,and the induction group was added with tunicamycin for 24hours.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of the cellular inflammatory cytokines tumor necrosis factor-α(TNF-α)and intestinal fatty acid binding protein(I-FABP)in each group.Real-time quantitative polymerase chain reac-tion(RT-qPCR)was used to detect the mRNA expression level of the markers of ERS glucose regulated protein 78(GRP78)and oxy-gen-regulated protein 150(ORP150).Western blot was used to detect the expression of autophagy related proteins LC3 Ⅱ/Ⅰ and p62.Results Compared with the control group,the expression of p62 in the inhibition group increased significantly,the expression of TNF-α,I-FABP,GRP78,ORP150,LC3 Ⅱ/Ⅰ in the inhibition group was significantly decreased,while the expression of p62 in the induc-tion group was significantly decreased,the expressions of TNF-α,Ⅰ-FABP,GRP78,ORP150,LC3 Ⅱ/Ⅰ were significantly increased,and the differences were statistically significant(P<0.05).Conclusion Inhibition of ERS induced autophagy activation can alleviate intestinal mucosal injury and inflammatory response in neonatal rats with NEC and improve intestinal barrier function.
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Background and purpose:Trastuzumab has a relatively low incidence of drug resistance,which can be used as an adjuvant treatment to improve clinical efficacy.It has been used to treat breast cancer in the past,but its application in other cancers has been less studied.This study aimed to explore the effects of trastuzumab assisted modified DOF fortnightly regimen on serum tumor markers and survival rate in cisplatin-resistant gastric cancer patients,in order to provide more references for the selection of clinical treatment methods for cisplatin-resistant gastric cancer.Methods:Eighty patients with cisplatin-resistant gastric cancer treated in Harison International Peace Hospital from January 2017 to January 2019 were selected as the study objects,and they were divided into observation group and control group according to random number table method.All of them received improved DOF fortnightly treatment,and trastuzumab adjuvant treatment was added to the observation group on this basis.The serum tumor markers[serum carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),CA72-4],serum neovascular markers[vascular endothelial growth factor(VEGF),pigment epithelial derived factor(PEDF),angiopoietin-2(Ang-2)],biochemical indicators[N-terminal pro B type natriuretic peptide(NT proBNP),aspartate transaminase(AST),blood urea nitrogen(BUN),alanine aminotransferase(ALT)],adverse reactions and survival rate were compared between two groups.This study was approved by the Ethics Committee of Harison International Peace Hospital(number:20160511).Results:After treatment,CEA,CA19-9 and CA72-4 in both groups decreased,and CEA,CA19-9 and CA72-4 levels were lower in the observation group than in the control group with statistical significance(P<0.01).After treatment,VEGF,PEDF and Ang-2 in two groups decreased,and the difference was statistically significant(P<0.01).The levels of VEGF,PEDF and Ang-2 were compared between the two groups before and after treatment,and there was no significant difference(P>0.05).The levels of NT-proBNP,AST,BUN and ALT were compared between the two groups before and after treatment,and there was no statistically significant difference(P>0.05).The number of patients with fatigue,gastrointestinal reaction and myelosuppression and the total incidence of adverse reactions were compared between the two groups,and there was no statistically significant difference(P>0.05).At 5 years after treatment,11 cases(27.5%)survived and 29 cases(72.5%)died in the observation group.There were 3 cases(7.5%)of survival and 37 cases(92.5%)of death in the control group.The median survival was 2 years(95%CI:1.8-2.2)in the observation group and 1 year(95%CI:0.6-1.4)in the control group.The survival rate of 1-5 years was higher in the observation group than in the control group.The difference was statistically significant(log-rank χ2 = 13.853,P = 0.001).Conclusion:In the clinical treatment of cisplatin-resistant gastric cancer,trastuzumab assisted modified DOF fortnightly regimen suggests that it can reduce the expression levels of serum tumor markers,improve the 5-year survival rate of patients,and has certain drug safety.
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Objective To investigate a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae(CRKP)healthcare-associated bloodstream infection(HA-BSI),provide reference for effective control of CRKP in-fection.Methods The characteristics of CRKP infected patients and the risk factors for the event transmission in an adult hematology department of a teaching hospital in June 2022 were obtained by field epidemiological investigation.The specimens of environmental target strains were co-llected by blood nutrient agar inoculation,the removal status of environmental microorganisms and the effect of infection control after implementing control measures were com-pared.Results There were a total of 6 cases of CRKP HA-BSI,with an attacking rate of 1.29%(6/464),which was significantly higher than 0 during the same period in 2021,and difference was statistically significant(P=0.011).In environmental hygiene monitoring,the detection rate of CRKP was 2.27%(1/44),which was from the surface of bed curtain in the living unit of infected patients,homology analysis with CRKP detected from 2 patients revealed that the 16s RNA of 3 CRKP strains was completely identical,with a similarity of 100%.Seven house-keeping genes of 3 CRKP strains were all identical and belonged to the ST11 type.Comprehensive control measures were taken:appropriate closure of the ward,centralized isolation of patients,terminal disinfection of the ward,reg-ular health care workers and relative restriction of their activity areas.After the measures were taken,the qualified rate of microbial colony count in the ward increased compared to before taking the measures(2.27%vs 68.89%,P<0.001),with a statistically significant difference,there were no more CRKP infected cases after the intervention,indicating that the control measures were effective.Conclusion This outbreak was caused by ST11 type of common CRKP in China,and laminar bed curtains are carriers of pathogen transmission.It is speculated that non-standard cleaning and disinfection,as well as inadequate implementation of hand hygiene are the main causes for transmis-sion.Adopting an appropriate strategy of closing the ward and concentrating patient isolation can quickly and effec-tively prevent the transmission of the event.
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Proteasome activator PA28γ,also known as Ki antigen,REGγ or PSME3,is first found as Ki antigen in the serum of a patient with systemic lupus erythematosus,which belongs to 11S proteasome activator family together with PA28α and PA28β.In the amino acid sequence,PA28γ has 25%homology with PA28α and PA28β and its seven-subunit homomer is a 20S proteasome acti-vator,which mainly exists in the nucleus and participates in ubiquitin and ATP-dependent or independent protein degradation.More and more studies have reported the role of PA28γ in human immune-related diseases.This article reviews the function of PA28γ as a proteasome activator and its role in immune-related diseases including cancer,inflammation and virus infection-related diseases and other diseases in recent years,so as to reveal the role of PA28γ in the occurrence and development of immune-related diseases and its potential as a target for immunotherapy.
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Objective:On the basis of post evaluation,the hospital pharmacy posts are scientifically classified and stratified,and the performance evaluation standard of pharmacy posts is constructed.Methods:The hospital pharmacy posts are classified and stratified by factor comparison method and the post value coefficient is determined.Delphi method and analytic hierarchy process are used to construct the performance evaluation index system of pharmaceutical posts and determine the performance evaluation standards.Results:Pharmacy posts in hospitals are divided into 5 categories,including clinical pharmacists,research pharmacists,static pharmacists,dispensing pharmacists and purchasing pharmacists.The indexes and weights of pharmaceutical post performance evaluation are determined from 4 dimensions:service,process,quality and cost,and the evaluation standard of pharmaceutical post performance oriented to rational drug use is established.Conclusion:The construction of pharmaceutical performance evaluation system meets the requirements of the reform of public hospitals for the transformation and development of pharmaceutical services,which is conducive to enhancing the enthusiasm of pharmaceutical personnel and improving the efficiency and benefit of pharmaceutical services.
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Objective:To compare the effects of high-power and conventional power atrial fibrillation ablation on intraoperative acute pulmonary vein isolation, postoperative troponin levels, and atrial fibrillation recurrence.Methods:A retrospective selection was conducted on 105 patients with paroxysmal atrial fibrillation admitted to the Baoding NO.1 Central Hospital from January 2017 to December 2020. According to different treatment methods, they were divided into a high-power ablation group of 52 cases and a conventional power ablation group of 53 cases. The intraoperative rate of single circle acute pulmonary vein isolation, the recovery of electrical conduction after acute pulmonary vein isolation, and the location and number of points that need to be added were compared between the two groups; At the same time, two groups were compared in terms of surgical time, ablation time, surgical radiation exposure time and radiation dose, intraoperative complications postoperative cardiac troponin levels at 12 hours, and recurrence of atrial fibrillation within 1 year after ablation.Results:The intraoperative single loop pulmonary vein isolation rate and postoperative troponin levels in the high-power atrial fibrillation ablation group were higher than those in the conventional atrial fibrillation ablation group (all P<0.05). The surgical time, ablation time, and the number of sites and points that need to be added during surgery were less than those in the conventional atrial fibrillation ablation group (all P<0.05). There was no statistically significant difference in the incidence of intraoperative complications and postoperative atrial fibrillation recurrence between the two groups (all P>0.05). Conclusions:High power atrial fibrillation ablation has a higher single loop acute pulmonary vein isolation rate, fewer patch sites and points, shorter surgical time, and greater ablation damage compared to conventional ablation, and the clinical efficacy of the two groups is similar after surgery.
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The study explores the thermal dose of experimental animals exposed in electromagnetic field.The simulation environment containing electromagnetic and thermal doses is established based on the bioheat equation and the three-dimensional rat model,and the effects of specific absorption rate,metabolic rate and boundary condition on temperature distribution and variation are assessed.The result shows that the core temperature rises with increasing whole body average specific absorption rate(WBASAR).At WBASAR of 4 W/kg,the midbrain and testes have higher specific absorption rates due to the skin effect,resulting in a more significant temperature rise in organ tissues than in the core;and at WBASAR of 0.4 W/kg,the temperature variation of the shallow organs caused by the sudden changes of metabolic and external environment reaches 1℃,which is much larger than that of the core.The experiment demonstrates target organs such as the head and testicles as critical subjects in thermal dose assessment.The experimental conditions should be regulated to reduce the effects of metabolic rate and boundary condition on thermal dose.The study has guiding significance for bioelectromagnetic experimental design and effect evaluation on thermal dose.
ABSTRACT
Objective To establish a bidirectional fluid-structure interaction model of the venaflow acting on the lower limb for investigating its pressure and depressure modes,and analyzing the velocity distribution of venous flow in the lower limb and therapeutic efficacy,thereby providing guidance for the resonable setting of working parameters of the Veneflow.Methods The right lower limb of a 24-year-old healthy man was taken as the object.The outer contour was obtained with a 3D scanner,and the inner diameters,wall thicknesses and resting blood flow velocities of the great saphenous vein,small saphenous vein and posterior tibial vein were measured with color Doppler ultrasonography.A 3D solid model of the lower limb was built with SolidWorks,and a bidirectional fluid-structure interaction model of the venaflow acting on the lower limb was constructed with Ansys Workbench.Results The velocity distributions of venous flow in the lower limb in the pressure and depressure modes of the venaflow were obtained.Conclusion Through the analysis with the bidirectional fluid-structure interaction model of the venaflow acting on the lower limb,the pressure and depressure modes of the venaflow are optimized,which can enhance the therapeutic efficacy and improve the safety.