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1.
Article in Chinese | WPRIM | ID: wpr-885958

ABSTRACT

Talents constitute core resource in the development of healthcare sector. Based on the situation of the talent team in the Affiliated Hospital of Qingdao University, the authors systematically constructed the hierarchical and classified system for talent cultivation, centering on three key areas of talent cultivation, evaluation and assessment. The authors analyzed the achievements since the implementation in 2016, namely the innovation of talent evaluation, the construction of discipline echelon, and the communication and inter-departmental cooperation. At the same time, the authors further put forward targeted suggestions to promote the development of talent teams in terms of transforming the human resource management model, increasing policy support and funding, implementing refined management, and improving talent evaluation indicators by the levels and types.

2.
Chinese Journal of Digestion ; (12): 336-343, 2021.
Article in Chinese | WPRIM | ID: wpr-885754

ABSTRACT

Objective:To screen the differentially co-expressed genes in the mRNA expression profile of colon cancer by combined application of weighted gene co-expression network analysis(WGCNA) and differential gene expression analysis, and to analyze the relationship between differentially co-expressed genes and prognosis.Methods:The transcriptomics data of the cancer genome atlas (TCGA)-colon adenocarcinoma (COAD) dataset and chip expression profile data of GSE68468 dataset were downloaded from TCGA and gene expression omnibus (GEO) databases based on bioinformatics methods, and differentially expressed gene (DEG) and the most significantly related weighted gene modules between normal tissues and colon cancer tissues were screened. Then, the differentially co-expressed genes related to colon cancer were screened out according to the intersection of differential genes and weighted genes. A protein-protein interaction (PPI) network was constructed, and the top ten core differentially co-expressed genes according to the maximal clique centrality (MCC) score were screened out by MCC calculation method. The expression of core genes in normal tissues and colon cancer tissues were further verified by TCGA-COAD dataset. Kaplan-Meier survival analysis was used to investigate the correlation between core genes and overall survival time and disease-free survival time of patients. The survival-related differentially co-expressed genes were verified by immunohistochemical staining in human protein atlas (HPA) database.Results:A total of 3 481 DEG of the TCGA-COAD dataset and 7 275 DEG of the GSE68468 dataset were screened out, and totally 237 differentially co-expressed genes were obtained. Ten core differentially co-expressed genes were obtained by the MCC calculation method of the PPI network, which were chloride channel accessory 1 ( CLCA1), mitogen-activated protein kinase 3, glucagon ( GCG), solute carrier family 26 member 3 ( SLC26 A3), nuclear receptor subfamily 1 group H member 4 ( NR1 H4), fatty acid binding protein 1 ( FABP1), guanylate cyclase activator 2A ( GUCA2 A), uridine diphosphate glucuronosyltransferase family 2 member A3 ( UGT2 A3), carnitine palmitoyltransferase 2 ( CPT2) and membrane spanning 4-domains A12 ( MS4 A12). Compared with those of the normal tissues, CLCA1, GCG, SLC26 A3, NR1 H4, FABP1, GUCA2 A, UGT2 A3, CPT2 and MS4 A12 of colon cancer tissues of the TCGA-COAD dataset were all down-regulated (all P<0.05). Among them, the overall survival time and disease-free survival time of patients with colon cancer with high expression of CLCA1 were both longer than those with low expression (both P<0.05). The results of immunohistochemical staining also verified the accuracy of the results at the protein level. Conclusions:CLCA1 may play a key role in the development of colon cancer, and it can be used as a potential biomarker for further diagnosis and treatment.

3.
Article in Chinese | WPRIM | ID: wpr-885572

ABSTRACT

Antenatal corticosteroid administration to women at risk of preterm delivery within 34 gestational weeks can effectively reduce the incidence of respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis in preterm infants. Due to concerns that antenatal corticosteroids may impair the development of the newborn's nervous system, there is a controversy regarding the use of antenatal corticosteroids in pregnant women ≥34 gestational weeks and those with complications. This article reviews the short- and long-term effects of antenatal corticosteroid administration on the nervous system of neonates born to women at different gestational ages and with comorbidities. More and higher-quality evidence is required for routine application of antenatal corticosteroids in pregnant women ≥34 gestational weeks.

4.
Article in Chinese | WPRIM | ID: wpr-885160

ABSTRACT

One 51 years old man was admitted to the rheumatology department with a history of prominent eyes, headache and blurred vision for half year. The main manifestations included retrobulbar inflammatory pseudotumor and retroperitoneal fibrosis. He was initially diagnosed as granulomatosis with polyangiitis. Prednisone and cyclophosphamide were administrated and effective. New mass of dura mater and osteosclerosis presented during follow up. Finally Erdheim Chester disease(ECD) was diagnosed by biopsy and pathological examination. Vemurafenib, a v-raf murine sarcoma viral oncogenes homolog B1 (BRAF) inhibitor, 480 mg was given twice a day. The patient′s condition is stable and still in follow-up. Although ECD is a rare histiocytosis, clinicians should pay attention to its manifestations and differential diagnoses.

5.
Chinese Journal of Urology ; (12): 233-236, 2021.
Article in Chinese | WPRIM | ID: wpr-884996

ABSTRACT

In recent years, with the development of sequencing technology and research on molecular changes in different races of prostate cancer, it has been found that the pathogenesis of prostate cancer showed obvious ethnic differences. This article reviewed the research progress of ETS fusion genes, FOXA1, SPOP, IDH1 and other driver genes in prostate cancer. And the research of molecular typing of prostate cancer showed different patterns of molecular changes in Chinese and western populations. The molecular changes of prostate cancer in western populations were dominated by ETS fusion gene, while those in Chinese populations were dominated by gene mutations, mainly FOXA1 and SPOP mutations. Moreover, the dominant fusion gene in Chinese prostate cancer was not ETS fusion gene, but SCHLAP1-UBE2E3.

6.
Chinese Journal of Geriatrics ; (12): 524-527, 2021.
Article in Chinese | WPRIM | ID: wpr-884921

ABSTRACT

WHO proposed the concept of intrinsic capacity in the World Report on Aging and Health in 2015.As the basis of functional ability in the elderly, intrinsic capacity plays an important role in maintaining the quality of life and promoting healthy aging.However, research on intrinsic capacity is still in its infancy.This article reviews research progress on intrinsic capacity, including the concept, domains, screening methods and its impact on the health of the elderly, in order to provide a reference for further research on this subject.

7.
Chinese Journal of Geriatrics ; (12): 397-400, 2021.
Article in Chinese | WPRIM | ID: wpr-884902

ABSTRACT

With the acceleration of the aging process in China, the incidence rates of coronary heart disease and cerebral infarction have significantly increased.And iodine contrast agent is often used in imaging diagnosis and percutaneous intervention therapy.The contrast medium is filtered from the glomerulus in its original form and is not absorbed by renal tubules.However, the accumulation of iodine contrast medium in the kidney can lead to acute kidney injury.Kidney is one of the most important excretory and endocrine organs in human body.The prevention and treatment of contrast-induced nephropathy(CIN)have been widely concerned.The incidence rate of contrast-induced renal damage is higher and the prognosis is poorer in the elderly than in the non-elderly due to the decline of organ function in the elderly.At present, the mechanism of action for oxygen free radicals in CIN of the elderly is still unclear.This article reviews the researches on the role of oxygen free radical in CIN of the elderly studied by domestic and foreign scholars in recent years.

8.
Chinese Journal of Geriatrics ; (12): 147-152, 2021.
Article in Chinese | WPRIM | ID: wpr-884857

ABSTRACT

Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.

9.
Chinese Journal of Geriatrics ; (12): 34-38, 2021.
Article in Chinese | WPRIM | ID: wpr-884836

ABSTRACT

Objective:To investigate the relationship between sarcopenia and early renal dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 198 elderly patients with T2DM aged over 60 years undergoing treatment in the Geriatric Department of Beijing Hospital from July 2018 to July 2019 were enrolled in this retrospective case-control study.The estimated glomerular filtration rate(eGFR)is calculated according to the CKD-EPI Cr-Cys formula.Based on the eGFR, the patients were divided into normal renal function group(n=63, in CKD 1 stage)and mild renal dysfunction group(n=135, in CKD 2-3a stage). All subjects underwent physical examination, laboratory examination and dual energy X-ray bone density examination. Results:The age, weight, body mass index, abdominal circumference, serum creatinine, cystatin C, uric acid, diastolic pressure, the proportions of diabetes and hypertension were lower, and the high-density lipoprotein cholesterol, appendicular skeletal muscle mass(ASM)and skeletal muscle mass index(SMI)were higher, in the normal renal function group than in the mild renal dysfunction group( P<0.05 or 0.01). Spearman correlation analysis showed that eGFR was positively correlated with SMI( r=0.343, P<0.01). Logistic regression analysis showed that body weight( OR=1.318, 95% CI: 1.091-1.594), uric acid( OR=1.007, 95% CI: 1.001-1.012), diastolic blood pressure( OR=1.072, 95% CI: 1.033-1.112), years of diabetes( OR=1.075, 95% CI: 1.013-1.142)were risk factors, and the LSM( OR=0.136, 95% CI: 0.047-0.392)and SMI( OR=0.778, 95% CI: 0.703-0.860)were protective factors for the early renal dysfunction in elderly patients with T2DM. Conclusions:Elderly patients with T2DM are often co-existed with sarcopenia.Sarcopenia is associated with early renal dysfunction in elderly patients with T2DM.

10.
Article in Chinese | WPRIM | ID: wpr-884834

ABSTRACT

Objective:To analyze the distribution of clinically isolated fungal strains and their resistance to common antifungal drugs in Shandong province.Methods:Through the Shandong Children’s Bacterial & Fungal Drug Resistance Surveillance and Research Collaborative Network, a total of 1 030 fungi were collected in 46 hospitals of Shandong province from January 1 to December 31, 2018. The source and type of strains were analyzed, and antifungal drug sensitivity tests were performed by using the micro-dilution method. Whonet 5.6 and SPSS 22.0 were applied to analyze the data.Results:The overall main strains were Candida albicans (38.74%, 399/1 030), Candida tropicalis (16.99%, 175/1 030) and Candida parapsilosis (16.41%, 169/1 030); the main fungi strains in child patients were C. albicans (52.50%, 63/120), C. parapsilosis (12.50%, 15/120) and C. tropicalis (9.17%, 11/120); the main fungi strains in adult patients were C. albicans (36.37%, 331/910), C. tropicalis (17.03%, 155/910) and C. parapsilosis (15.27%, 139/910). The isolation rate of main Candida strains from January to March and August to December was much higher than that of other months. The drug resistance rates of C. albicans to fluconazole and voriconazole were 7.14% and 7.43%, respectively, and the drug resistance rates to itraconazole were 50.44%. The resistance rates of C. tropicalis to fluconazole, voriconazole and itraconazole were 29.05%, 23.29% and 48.65%, respectively. The sensitivity rates of C. parapsilosi to fluconazole, voriconazole and itraconazole were 93.06%, 93.75% and 94.44%, respectively. Candida glabrata showed a dose-dependent sensitivity rate of 2.33% to fluconazole. Analysis of 244 blood fungi strains showed that non-candida albicans bacteremia accounted for 70.08%. In the pathogen spectrum covering 92.22%, fluconazole was sensitive to 64.65% of the pathogens, voriconazole was 68.88%, and amphotericin B was 88.75%. After quantification, the effective rates of fluconazole, voriconazole and amphotericin B in the clinical treatment of fungal bacteremia were 70.10%, 74.69% and 96.23%, respectively. Among them, the sensitivity rate of voriconazole to C. tropicalis was lower than that of fluconazole. Conclusions:Candida is the main clinical fungus isolates in hospitals of Shandong province. The resistance rate of C. tropicalis to azole antifungal drugs is on the rise, and the sensitivity of other Candida species to clinically used antifungal drugs is basically stable.

11.
Chinese Journal of Orthopaedics ; (12): 149-156, 2021.
Article in Chinese | WPRIM | ID: wpr-884699

ABSTRACT

Objective:To explore the application of high-throughput sequencing (HTS) technology in pathogens detection for spinal infection.Methods:From January 2019 to May 2020, a total of 41 patients including 31 males and 10 females with an average age of 59.7±11.9 years (29-75 years) were suspected of spinal infections. There were 37 patients with local pain, 15 with fever (≥38 ℃) and 18 with neurological dysfunction. The infected sites were as follows, 4 cases of cervical spine, 8 cases of thoracic spine and 29 cases of lumbar spine. There were 36 patients met the surgical indications and underwent open debridement, bone grafting, fusion and internal fixation, while the other 5 patients underwent conservative treatment (three received drug therapy and two were transferred to the internal department for chemotherapy). Lesions obtained from open surgery patients were underwent pathology and HTS examination. In 5 cases with conservative treatment, two of them underwent CT guided percutaneous puncture for samples, while one case underwent ultrasound guided percutaneous puncture for pus, one case for venous blood, and one case received lumbar puncture for cerebrospinal fluid. The samples were sent for pathological and HTS examination, while liquid specimens were sent for bacterial culture and HTS. The sensitivity and specificity of HTS results were determined according to pathological examination which was regarded as the "gold standard". Based on HTS results combined with the clinical manifestations, imaging examination and pathological results of the patients, targeted antibiotics or anti-tuberculosis drugs were selected for postoperative drug therapy. Patients with bacterial infection received anti-infection treatment for 3 months after operation. For tuberculosis patients, "tetrad" (isoniazid+rifampicin+pyrazinamide+ethambutanol) anti-tuberculosis treatments were underwent for one year. Inflammation indicators from the blood samples were observed before and after treatment, including white blood cell count (WBC), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). These indicators were used to monitor disease progression and the curative effects. All patients were followed up for at least 3 months after surgery.Results:A total of 41 patients with suspected spinal infection were included in this study. The HTS pathogen detection results were obtained within 48 h. For the initial 5 patients, first-generation sequencing verification was conducted with coincidence rate 100%. Further, no further verification was conducted in the rest patients. Among the 41 cases, a total of 26 cases had positive results with a positive rate of 63.4%(26/41). Among them, thirteen cases were with mycobacterium tuberculosis (31.7%) and 6 cases with staphylococcus (14.6%). Fungi and Brucellosis were diagnosed in 2 cases respectively, accounting for 4.9% respectively. The test were negative in 15 patients (36.6%), including 2 patients with tumor or tumor-like lesions (1 hematologic tumor and 1 eosinophilic granuloma). A total of 38 patients underwent pathological examination, which confirmed 7 cases of suppurative infection, 12 cases of tuberculosis, 2 cases of tumor or tumor-like lesions and the remaining 17 cases of inflammatory lesions. The sensitivity and specificity of HTS were 80%(16/20) and 55.6% (10/18) with positive predictive value (PPV) 66.7% (16/24) and negative predictive value (NPV) 71.4% (10/14). All patients were followed up for 3 months. The inflammation indicators of blood at 3 months were all lower than that at admission. WBC decreased from (7.50±3.26)×10 9/L at admission to (6.22±2.53)×10 9/L at 3 months after treatment without statistically significant difference ( t=1.082, P=0.290). The CRP decreased from (32.2±34.1) mg/L to (4.5±10.5) mg/L, and ESR from (44.2±26.5) mm/1 h to (18.6±12.1) mm/1 h with statistically significant difference ( t=8.963, P<0.001; t=5.421, P<0.001). Conclusion:High-throughput sequencing technology can be used in detection of spinal infection pathogens, due to its relatively high positive rate, satisfied sensitivity and good diagnostic value.

12.
Article in Chinese | WPRIM | ID: wpr-884550

ABSTRACT

Objective:To compare magnetic resonance imaging (MRI)-based and computed tomography (CT)-based target volume delineation and dose coverage in partial breast irradiation (PBI) for patients with breast cancer, aiming to explore the application value of MRI localization in PBI after breast-conserving surgery.Methods:Twenty-nine patients with early breast cancer underwent simulating CT and MRI scans in a supine position. The cavity visualization score (CVS) of tumor bed (TB) was evaluated. The TB, clinical target volume (CTV), planning target volume (PTV) were delineated on CT and MRI images, and then statistically compared. Conformity indices (CI) between CT- and MRI-defined target volumes were calculated. PBI treatment plan of 40 Gy in 10 fractions was designed based on PTV-CT, and the dose coverage for PTV-MRI was evaluated.Results:The CVS on CT and MRI images was 2.97±1.40 vs. 3.10±1.40( P=0.408). The volumes of TB, CTV, PTV on MRI were significantly larger than those on CT, (24.48±16.60) cm 3vs. (38.00±19.77) cm 3, (126.76±56.81) cm 3vs. (168.42±70.54) cm 3, (216.63±81.99) cm 3vs. (279.24±101.55) cm 3, respectively, whereas the increasing percentage of CTV and PTV were significantly smaller than those of TB. The CI between CT-based and MRI-based TB, CTV, PTV were 0.43±0.13, 0.66±0.11, 0.70±0.09( P<0.001), respectively. The median percentage of PTV-MRI receiving 40 Gy dose was 81.9%(62.3% to 92.4%), significantly lower than 95.6%(95.0%~97.5%) of PTV-CT. Conclusions:The CVS between CT and MRI is not significantly different, but the MRI-based TB, CTV, PTV are significantly larger than CT-based values. The PTV-MRI is of underdose if PBI treatment plan is designed for PTV-CT. As a supplement of CT scan, MRI can enhance the accuracy of TB delineation after breast-onserving surgery.

13.
Chinese Journal of Radiology ; (12): 231-238, 2021.
Article in Chinese | WPRIM | ID: wpr-884416

ABSTRACT

Objective:To investigate the contents of paranasal sinus CT reports about clinically pertinent lesions and anatomic variations in patients with chronic rhinosinusitis and analyze the lesions and the anatomic variations less described in CT reports to improve the quality of paranasal sinus CT reports.Methods:A national questionnaire survey on radiologists interpreting paranasal sinus CT was conducted online in March, 2020. Questions were focused on the frequency of the lesions or anatomic variations of the paranasal sinuses described in paranasal sinus CT reports, and the results were analyzed and compared among radiologists by different levels of the hospital, professional titles, years of CT reading experience, subspecialties, and education backgrounds.Results:A total of 6 525 valid questionnaires were obtained, in which 97.7%, 97.7%, and 92.8% of radiologists described mucosal thickening, hypertrophy of turbinate or deviation of the nasal septum, and space occupying lesions within paranasal sinuses in CT reports, respectively. Only 35.0%, 26.9%, and 22.5% of radiologists described frontal recess lesions, dehiscence of foramen rotundum or pterygoid canal, and anterior/posterior ethmoid artery anatomy in CT reports, respectively. The anatomic variations that predisposed patients to major surgical complications or recurrent rhinosinusitis were more frequently documented in CT reports by radiologists with experience of head and neck radiology, senior titles or more than 30 years of radiological experience in tertiary hospitals than other radiologists.Conclusions:Lesions within the paranasal sinus were almost documented in all paranasal sinus CT reports. However, the anatomic variations that predisposed patients to major surgical complications or recurrent rhinosinusitis were infrequently described, which needs to be optimized by improving the quality of paranasal sinus CT reports.

14.
Article in Chinese | WPRIM | ID: wpr-884344

ABSTRACT

Objective:To investigate the feasibility of ultrasound-guided percutaneous endomyocardial septal cryoablation of in vitro porcine hearts and to compare its effect with the percutaneous endomyocardial radiofrequency ablation.Methods:Experiment 1: Six in vitro porcine hearts were divided into 1 min ( n=2), 3 min ( n=2) and 5 min ( n=2) groups according to the cryoablation time, and all were subjected to ultrasound-guided percutaneous intra-myocardial septal cryoablation at 100% power respectively. After cryoablation, ultrasound images, the size of the solid dissection of the ice ball, and the size of the necrotic area after melting of the frozen ice ball were measured. Experiment 2: The in vitro porcine hearts were divided into cryoablation group ( n=3) and radiofrequency ablation group ( n=3), and ultrasound-guided percutaneous endomyocardial septal cryoablation and radiofrequency ablation were performed with 100% cryo power and 40 W radiofrequency power, and the extent of complete necrotic area and incomplete necrotic area were compared between the two ablation methods after 1 min. Results:Experiment 1: In the 1 min cryoablation time group ( n=2), the short diameter of the puck measured by ultrasound was (8.00±0.84)mm, the short diameter of the puck measured by solid was (8.38±1.19)mm, and the short diameter of the necrotic zone measured by solid was (8.35±0.83)mm; in the 3 min group ( n=2), the short diameter of the puck measured by ultrasound was (19.4±0.28)mm, and the short diameter of the puck measured by solid was (19.03±0.33)mm, solid measurement of the short diameter of the necrotic zone was (19.16±0.25)mm; in the 5 min group ( n=2), the short diameter of the puck measured under ultrasound was (26.4±2.54)mm, solid measurement of the short diameter of the puck was (26.01±0.24)mm, and solid measurement of the short diameter of the necrotic zone was (24.82±0.25)mm. Randomized blocks analysis of variance was performed on this data and the difference of block Factor b (freezing time: 1 min, 3 min, 5 min) among the three groups was statistically significant( F=505.884, P<0.001). The SNK- q test showed that all three groups differed from each other(all P<0.05). The analysis results for the treatment factors K (measurement modality-ultrasound image measurements, solid anatomical measurements of the puck, and measurements of the necrotic area after melting of the frozen puck) was not statistically significant ( F=0.470, P=0.635). Experiment 2: In the RF ablation group ( n=3), the ratio of incomplete necrotic zone to the radius of the RF ablation area was 0.64±0.01; in the cryoablation group ( n=3), the ratio of incomplete necrotic zone to the radius of the ablation area was 0.26±0.02. The difference was statistically significant( P=0.002) and it can be considered that the incomplete necrotic zone of cryoablation was smaller than that of RF ablation. Conclusions:Percutameous intramyocardial septal cryoablation is controllable in scope, ultrasound image evaluation of ablation area is more accurate and incomplete necrosis area is small, which may have potential applications in cardiac ablation.

15.
Article in Chinese | WPRIM | ID: wpr-884231

ABSTRACT

Objective:To explore the factors related to functional recovery of the knee in patients with tibial plateau fracture complicated with intercondylar ridge fracture.Methods:Included in this retrospective study were 63 patients who had been treated at Emergency Center of Trauma, The Third Hospital of Hebei Medical University from January to June 2019 for tibial plateau fracture complicated with intercondylar ridge fracture. They were 43 males and 20 females, aged from 18 to 66 years (average, 43.9 years). According to our comprehensive classification of tibial plateau fractures, there were 27 simple ones (20 cases of type Ⅰ and 7 cases of type Ⅱ) and 36 complicated ones (16 cases of type Ⅲ, 17 cases of type Ⅳ, one of type Ⅴ and 2 cases of type Ⅵ). To screen out major influencing factors, a multiple linear regression model was used to analyze the 12 factors that might affect functional recovery of the knee by the Hospital for Special Surgery (HSS) scoring: age, gender, occupation, fracture type, way of medical payment, cause of injury, operation method, starting time for rehabilitation, postoperative brace installation, time from injury to operation, length of hospital stay, and presence or absence of a free intercondylar ridge fracture fragment.Results:The 63 patients were followed up for 6.0 to 7.1 months (average, 6.1 months). The HSS knee scores ranged from 45 to 100 points (average, 92.4 points). The HSS knee scores were significantly different between different fracture types ( P<0.05). The HSS scores were significantly higher for the patients without a free intercondylar ridge fracture fragment than for those with ( P<0.05). Multiple linear regression model analysis of the 5 variables with P<0.02 in the single factor analysis (age, fracture type, way of medical payment, hospital stay and presence or absence of a free intercondylar ridge fracture fragment) and HSS scores showed that only fracture type and presence or absence of a free intercondylar ridge fracture fragment had a significant impact on the knee function. Their regression equation was Y=125.591-7.790a-17.277b (Y indicates HSS score, a indicates fracture type and b indicates presence or absence of a free intercondylar ridge fracture fragment). Conclusions:The short-term prognosis for tibial plateau fractures of comprehensive types Ⅰ&Ⅱ (simple ones) may be better than that for tibial plateau fractures of comprehensive types Ⅲ, Ⅳ, Ⅴ&Ⅵ (complicated ones). For patients with a free intercondylar ridge fracture fragment on their lateral knee X-ray film, effective reduction and fixation is indicated but is not for those without.

16.
Article in Chinese | WPRIM | ID: wpr-883926

ABSTRACT

Objective:To detect the potential biomarkers in the serum of adolescents with depressive disorder and provide the basis for clinical diagnosis of depression.Methods:A total of 45 adolescents with depression who met the inclusion criteria and 47 healthy controls (HC group) were screened.Patients with depression were treated with sertraline (100 mg/d) for 4 weeks.The patients before sertraline treatment were called DN-MDD group and then were called DT-MDD group after sertraline treatmant.Hamilton Depression Scale (HAMD) was used to evaluate the efficacy of the two groups before and after treatment.The serum was collected for UPLC-MS/MS to determine the changes in profiles of endogenous metabolites.And the software of SPSS 21.0, XCMS and Analyst 3.0 were used to analyze the data.The reliability and feasibility of clinical diagnosis were further analyzed by ROC via GraphPad 8.0.Results:After 4 weeks of sertraline treatment, the patients' HAMD score decreased (before: 19.71±1.72, after: 15.36±1.91) and the effective rate reached 51% ( P<0.01). Multivariate statistical analysis showed that HC group and DN-MDD group and DT-MDD group had significant differences in metabolic profile.Compared with healthy controls, 11 different metabolites were found in the plasma of DN-MDD group including glycerate, adenosine, creatine and so on.After treatment, concentrations of glucose, glutamate, aspartate, sucrose, creatine, pyruvate and adenosine were significant changes in serum of adolescent depression patients.Area under ROC curve of glucose and glutamic acid were >0.9, and the AUC of aspartic acid, sucrose, creatine, pyruvate and adenosine were >0.7, suggesting that these 7 metabolites had different degrees of diagnostic ability. Conclusion:There are different metabolic profiles between adolescents with or without depression, and the antidepressant sertraline is helpful to maintain the level of substance metabolism which can be used as one of the treatment methods for adolescent depression.Our research may support the new strategy for clinical diagnosis and treatment of adolescent depression.

17.
Article in Chinese | WPRIM | ID: wpr-883549

ABSTRACT

Objective:To explore the application value of clinical case-based learning in medical imaging teaching.Methods:A total of 145 clinical medical students from three classes in the third year were enrolled and they were divided into three classes. One class took case-based learning, one class took traditional teaching, and one class took both. The teaching content was the preclinical medical professional course—Medical Imaging. Continuous variables were expressed in accordance with normal distribution (mean standard deviation). Differences in mean and median values were evaluated by using t test and the Mann-Whitney U test, respectively. Categorical data were compared using the chi-square test. Results:There was a significant difference between the combined teaching class and the case-based learning class or the traditional teaching class in the final exam ( P=0.002). There was also a significant difference between the combined teaching class and the traditional teaching class in the film reading quiz ( P=0.035). More than 70% of students recognized the case-based learning. Conclusion:Case-based learning is helpful to improve students' flexible application of relevant knowledge and skills of analysis and communication.

18.
Article in Chinese | WPRIM | ID: wpr-883357

ABSTRACT

Objective:To evaluate the efficacy and safety of dexamethasone intravitreal implant (Ozurdex) in treating the refractory macular edema caused by retinal vein occlusion (RVO).Methods:An observational case series study was conducted.Twenty-one eyes of 21 patients diagnosed as refractory macular edema secondary to RVO and treated with Ozurdex implant in Beijing Aier-Intech Eye Hospital from March 2016 to September 2019, who was with a course lasting longer than 3 months and received at least 2 times of anti-VEGF treatments, had recurrent macular edema and no visual improvement or even deteriorated, were included.Best corrected visual acuity (BCVA) was examined using standard visual chart and was converted to logarithm of the minimal angle of resolution (LogMAR) units and intraocular pressure (IOP) was examined.Optical coherence tomography (OCT) was used to measure central retinal thickness (CRT) in all eyes before and at 1, 2, 3 and 6 months after intravitreal injection of Ozurdex.The changes of BCVA, IOP and CRT before and after Ozurdex injection were observed and analyzed.During the 6-month follow-up, re-injection of Ozurdex or ranibizumab was adopted among those with macular edema recurrence or poor efficacy according to the subjects' conditions.Ocular adverse effects and potential systemic complications were observed.This study followed the Declaration of Helsinki and the study protocol was approved by an Ecthics Committee of Beijing Aier-Intech Eye Hospital (No.BJAIER2020IRB01).Results:The mean CRT at 1, 2, 3, 6 months after Ozurdex injection was (295.76±49.19), (280.33±39.44), (321.29±73.46), (300.29±75.10)μm, respectively, which were significantly decreased in comparison with (458.52±174.61)μm at baseline (all at P<0.05). There was no significant difference in mean BCVA at different time points before and after Ozurdex injection ( F=1.975, P>0.05). During the follow-up, 10 eyes had macular edema recurrence at 2 to 6 months after first Ozurdex injection, with an average of (4.1±1.5) months.Among them, 8 eyes received second Ozurdex injection, and CRT was significantly reduced and BCVA was significantly improved at 6 months after the second Ozurdex injection in comparison with those at recurrence ( t=5.254, P=0.001; t=4.277, P=0.004). The IOP was significantly elevated at 2 months after first Ozurdex injection in comparison with that at baseline ( P=0.01). Ocular hypertension (IOP≥25 mmHg) was oberserved in 3 (14.3%) eyes during the follow-up period but were well controlled after local application of eye drops.No vitreous hemorrhage, retinal detachment, endophthalmitis or other serious adverse effects or systemic complications were observed. Conclusions:One dose of intravitreal Ozurdex injection can significantly improve the structure and function of macula in refractory macular edema caused by RVO for 4 to 6 months and maintain the baseline visual acuity.Second administration of Ozurdex is still effective for recurrent RVO macular edema.Transitional IOP elevation is the main adverse event.

19.
Article in Chinese | WPRIM | ID: wpr-882565

ABSTRACT

Objective:To explore the rules of prescription and medication of Traditional Chinese Medicine (TCM) syndrome differentiation treatment for insomnia.Methods:We screened the medical records related to insomnia from the ancient medical cases, modern medical cases, famous medical cases and shared medical record database, and then we put data into the Ancient and Modern Medical Case Cloud Platform (V 1.5.7). The platform software Data mining was applied and performed by frequency analysis, correlation analysis, and drug pair analysis. Results:This study collected 664 cases related to insomnia, like difficulty in falling sleep, early waking up, easy to wake up, dreaminess. The top 5 syndromes included internal phlegm-heat, imbalance between heart-yang and kidney-yin, liver stagnation transforming into fire, heart and spleen deficiency, restless mind. There were 664 prescriptions, 414 TCM medications, where the top 5 medications included Glycyrrhizae Radix et Rhizoma, Poria, Rehmanniae Radix, Ziziphi Spinosae Semen, Angelicae Sinensis Radix. The effect of high-frequency medications were nourishing the heart and calming the mind, clearing heat and dissipating phlegm, soothing the liver and relieving depression, and nourishing yin and yang. The top five drug-combinations included Ostreae Concha- Longgu, Poria- Glycyrrhizae Radix et Rhizoma, Citri Reticulatae Pericarpium- Poria, Angelicae Sinensis Radix- Rehmanniae Radix, Bupleuri Radix- Glycyrrhizae Radix et Rhizoma. Conclusions:TCM syndrome differentiation for insomnia focus on the heart. The medications are mainly to nourish the heart and calm the mind, supplemented by clearing heat, replenishing heart and spleen, soothing the liver and relieving stagnation, nourishing yin and blood for the symptoms relief, with treatment priciple of seeking both temporary and permanent solutions.

20.
Acta Pharmaceutica Sinica ; (12): 1606-1611, 2021.
Article in Chinese | WPRIM | ID: wpr-881563

ABSTRACT

Attenuated Salmonella VNP20009 specifically colonizes and proliferates within tumor tissues and inhibits tumor growth. It has been used as drug delivery vehicle or in combination with other therapies (such as chemotherapy), which shows a good application potential in tumor therapy. In this paper, study was conducted to determine the physiological changes of growth curve and formation of bacterial biofilm of VNP20009 under various environmental stresses, such as temperature, pH, and H2O2. The results showed that VNP20009 could grow normally under the conditions of 42 ℃, pH 6.5, and 1 mmol·L-1 H2O2. Furthermore, the weak acid environment was beneficial to the biofilm formation of VNP20009. This study provides a basis for in-depth study of the survival mechanism and application of attenuated Salmonella.

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