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1.
Article in Chinese | WPRIM | ID: wpr-912838

ABSTRACT

Cloud technology and the Internet of things ( IOT) technology can be used in building the patient-centered critical care medical information platform.The platform could inenable medical staff to efficiently obtain critical care medical information, and raise critical patients′ cure rates. The authors introduced the critical process of rapidly building and improving the urgent care medical information integration platform in a campus of the First Affiliated Hospital of Zhejiang University Medical School.The IOT platform could effectively interconnect a variety of critical care medical equipments, and features such functions as vital signs monitoring and life support, bedside treatment data retrieval, remote diagnosis and treatment, and cloud sharing. The platform featured the advantages of complete information integration, fast construction, and satisfactory system extensibility. It could improve the medical work efficiency, improve the effect of critical care, and reduce the frequency of contact with patients, hence providing references for rapidly establishing a vital care treatment platform for public health events.

2.
Article in Chinese | WPRIM | ID: wpr-912786

ABSTRACT

Objective:To analyze the salary level, change trend and salary satisfaction of nurses in tertiary public hospitals in China.Methods:The data was derived from three round third-party evaluation of the China Healthcare Improvement Initiative at 136 tertiary public hospitals from December 2017 to January 2018, March 2019 and January to March 2021. The self-reported salary, expected salary and salary satisfaction rate of nurses were analyzed.Results:The sample sizes of the three evaluations were 27 575, 27 568 and 25 197, representing the salary situation in 2017, 2018 and 2020 respectively. In 2017, 2018 and 2020, the actual average annual salary of nurses was 81 600 yuan, 100 000 yuan and 110 000 yuan respectively, the expected average annual salary was 140 000 yuan, 160 000 yuan and 160 000 yuan respectively, and the ratio of expected salary to actual salary was 1.72, 1.60 and 1.45 respectively. In 2017, 2018 and 2020, the proportion of nurses satisfied with their current income was 34.0%, 33.7% and 43.6% respectively. In 2020, nurses in the eastern region, other specialized hospitals, senior professional titles and graduate degrees had highest annual salary.Conclusions:The salary level and satisfaction rate of nurses in tertiary public hospitals in China show a slow growth trend, and the gap between actual salary and expected salary is gradually narrowing.

3.
Article in Chinese | WPRIM | ID: wpr-912784

ABSTRACT

Objective:To investigate the patient satisfaction at tertiary cancer hospitals in China, and explore its determinants.Methods:Based on the fifth third-party evaluation of China Healthcare Improvement Initiative, an inpatient satisfaction survey was conducted from January 2021 to March 2021 in 33 tertiary cancer hospitals in China. Inpatient satisfaction was analyzed, and Chi-square test and binary multivariate logistic regression were run, using the level of overall inpatient satisfaction as a dependent variable.Results:A total of 5 417 inpatients in tertiary cancer hospitals was recruited with 49.8% men. The inpatient at the age of 35-59 accounted for 56.0%, and they were 52.8±13.9 years old. The level of overall inpatient satisfaction was 98.90%. The inpatient satisfaction rates of meal service, waiting time for admission and psychological counseling service provided by hospital were relatively poor, which were 78.75%, 92.40% and 94.11%, respectively. The regression showed that level of overall inpatient satisfaction in the central and western regions(compared with eastern area), with urban and rural residents basic medical insurance or other type(compared with urban employee basic medical insurance), of breast cancer patients(compared with other disease), with unsured postoperative metastasis(compared with non-postoperative metastasis), with low self-rated health score(compared with the score of between 81 and 100)was lower.Conclusions:The inpatients in tertiary cancer hospitals in China is highly satisfied with the care provided. In the future, more attention should be paid to the dimension of lower patient satisfaction, such as diet and psychological counseling.

4.
Article in Chinese | WPRIM | ID: wpr-912782

ABSTRACT

Objective:To summarize the progress and achievement of inpatient experience improvement in public hospitals in China from 2016 to 2021, so as to provide basis for further improving hospitalization experience and raising inpatient satisfaction.Methods:Based on the five Third-party Evaluations of China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on inpatient process, cost and inpatient satisfaction, and the inpatient satisfaction in different regions and different types of institutions was compared.Results:The overall satisfaction of hospitalized patients in the fifth evaluation in 2021(98.5%)was higher than that in the first evaluation in 2016(96.2%). The western region and maternal and child institutions had the most obvious improvement in the comparison of regional and institutional types. The improvement of inpatients′ satisfaction with diet was not obvious. Inpatients were most dissatisfied with " high medical expenses" , " cumbersome procedures" and " long waiting time for bed" .Conclusions:From 2016 to 2021, the satisfaction of hospitalized patients has been consistently improved, but there is still room for improvement in non-medical services. Hospital meals for inpatient and relief of inpatient healthcare financial burden are the priorities for healthcare improvement and raising hospitalization satisfaction in the next stage.

5.
Article in Chinese | WPRIM | ID: wpr-912781

ABSTRACT

Objective:To summarize the progress and achievement of outpatient experience improvement in tertiary public hospitals from 2016 to 2021, so as to provide basis for further improving outpatient experience and raising outpatient satisfaction.Methods:Based on 5 round third-party evaluations of the China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on the outpatient process and outpatient satisfaction, and stratified analysis was conducted on patient satisfaction in different regions and different types of institutions.Results:One hundred and thirty-six core sample hospitals were included in the 5 round evaluation, and 30 153 valid questionnaires were collected in the fifth evaluation in 2021.From 2016 to 2021, the overall satisfaction of outpatients in the 5 round evaluations was 91.4%, 87.3%, 90.1%, 91.1% and 95.4%, respectively. The satisfaction of outpatients to the medical services continued to improve. Outpatient treatment process has been continuously optimized, appointment registration has become the most commonly used way of outpatient registration. The satisfaction of outpatients to the process and environment of treatment in the western region was significantly improved.Conclusions:From 2016 to 2021, the overall satisfaction of outpatients has been consistently improved. Informatization helps to optimize the treatment process, but it is recommended that hospitals should provide special support for elderly outpatients.

6.
Article in Chinese | WPRIM | ID: wpr-912780

ABSTRACT

Objective:To explore the change trend of patients′ recognition of the medical reform effect and medical staff′s occupation and its relationship with medical experience, since the implementation of the China Healthcare Improvement Initiative(CHII), so as to provide reference for exploring the breakthrough point of consolidating the reform effect.Methods:Four indicators of the third-party assessment of patients were selected, which were " I think the medical reform has benefited patients" , " I think the doctor-patient relationship is improving in the past three years" , " I think medical personnel deserve social respect and recognition" , and " I am willing to let my children join the medical profession" . Descriptive and trend analysis were carried out on the survey results, and correlation analysis was carried out between the survey results and patients′ medical experience.Results:Compared with the baseline evaluation results(76.9% and 69.9%for outpatients, 87.3% and 85.6%for inpatients), the patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship in the fifth evaluation(86.2% and 89.1%for outpatients, 91.4% and 92.6%for inpatients)were significantly improved. The proportion of patients who thought the medical staff was worthy of respect and willing to let their children work in the hospital in the fifth evaluation(97.4%, 79.1%for outpatients, 98.7%, 85.1%for inpatients)were higher than the baseline evaluation results(92.3%, 71.0%for outpatients, 98.1%, 81.6%for inpatients). The above indicators were positively correlated with the patient′s medical experience.Conclusions:Since the implementation of CHII, patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship has been continuously improved, and patients′ respect and recognition of professional identity of medical personnel is at a high level and continues to improve. Improving medical experience has a positive effect on the improvement of patients′ sense of medical reform.

7.
Article in Chinese | WPRIM | ID: wpr-912778

ABSTRACT

Objective:To assess the progress and impact of the China Healthcare Improvement Initiative(CHII) from 2015 to 2020, which aimed at improving patients healthcare experiences.Methods:Five rounds of evaluation surveys were conducted from December 2015 to March 2021 among 136-214 tertiary public hospitals. Structured questionnaires to measure hospital actions and performance, satisfaction of patients and medical staff were designed, and the data were collected by the national and provincial survey teams via onsite inspection, face-to-face/telephone interviews and self-administered cellphone APPs respectively. After data cleaning, the results of five round evaluations were analyzed and compared.Results:The sampled hospitals demonstrated high participation rate in the CHII, and their overall performance turned out to be satisfactory. And the patient healthcare experiences consistently improved over the period of CHII. In contrast to the high satisfaction rate with clinical quality of the sampled hospitals, patients were less satisfied with the non-clinical services such as food and supporting services. The job satisfaction of doctors and nurses experienced mild improvements, while the problems of heavy workload, low salary, and poor health were not effectively solved yet.Conclusions:The implementation of CHII from 2015 to 2020 has played a significant role in promoting patient-centered service models in hospitals, but continuous inputs and coordinated efforts are still required in the future. The improvement of non-clinical services still needs to be addressed to further enhance patient satisfaction. The job satisfaction and well-being of doctors and nurses remain at low level, and effective measures need to be taken to maintain the stability of the medical staff.

8.
Article in Chinese | WPRIM | ID: wpr-912772

ABSTRACT

Objective:To analyze original medical humanities articles written by staff of the hospital and extract key elements of hospital culture for staff perception, for recommendations on homogenous development of multiple campuses of the hospital.Methods:Original medical humanities articles written by staff of the hospital were collected from the WeChat accounts, websites and printouts of a tertiary hospital in Beijing from January 2013 to December 2019, with text mining made by Python3.7; Bert and Tencent open-source 8 million Chinese word dataset were used as entity identification training dataset; K-Means cluster analysis was used to analyze and select cluster results of higher degree of fitting; TextRank was used to screen keywords of each clustered category. Significance of each category was summarized in the end based on keywords following the screening.Results:Among the 341 articles collected, high frequency words were work, hospital, patient, sick person, development, medicine, medical treatment, doctor, outpatient service and clinic. The words fell into ten categories: process recall, work attribute, work responsibility, diagnosis and treatment behavior, growth experience, team cooperation, professionalism, management innovation, doctor-patient communication and others.Conclusions:Research on hospital staff culture perception is conducive to identifying the cultural content of the hospital. In the homogenous development of multiple campuses of the hospital, it is imperative to nurture the staff′s sense of identify and belonging to the hospital, enhance their sense of gain and happiness, and strengthen the scientific management system centering on patients.

9.
Article in Chinese | WPRIM | ID: wpr-912299

ABSTRACT

Objective:To compare the mid-term result of two different valve-sparing root replacement techniques in acute type A aortic dissection: including reimplantation and remodeling.Methods:From March 2009 to December 2019, 41 patients with acute type A dissection and root involvement, who underwent a valve-sparing root replacement using reimplantation(36 cases) or remodeling(5 cases) were retrospectively analyzed in current study. The average age was(44.63±11.34) years old, 36 males. The differences of perioperative variables, postoperative aortic insufficiency and postoperative survival were compared between the two groups.Results:Thirty-day mortality for two groups was 2.8% and 20%( P=0.23). Remodeling group was significantly inferior to reimplantation group in terms of blood consumption(red blood cells, plasma and platelets), postoperative mechanical ventilation time, reoperation for bleeding and hemofiltration for acute renal failure. The median follow-up time of 39 discharged survivors was 34.56(3-121) months, and the follow-up rate was 100%. There was no follow-up death, no bleeding or embolism events, and no cardiovascular reoperation. Grade 2 or sever aortic regurgitation in remodeling group was significantly higher than that in reimplantation group( P=0.02). A Cox regression analysis identified that the remodeling technique was the independent risk factors of postoperative aortic regurgitation. Conclusion:Compared with remodeling technique, reimplantation technique has better perioperative and mid-term results in patients with acute type A aortic dissection. The rate of reoperation for bleeding, the blood consumption and the postoperative aortic regurgitation are significantly reduced. The long-term results need further follow-up.

10.
Chinese Journal of Digestion ; (12): 671-676, 2021.
Article in Chinese | WPRIM | ID: wpr-912223

ABSTRACT

Objective:To explore the curative effect of surgical treatment for Crohn′s disease (CD), to investigate the timing of surgical intervention and the choice of surgical methods.Methods:From January 1, 2016 to August 31, 2020, at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, the clinical data of 123 patients with CD and receiving surgical treatment were retrospectively analyzed, which included the type of lesion, the location of lesion, clinical manifestation, surgical method, preoperative inflammatory and nutritional indicators, postoperative recovery of digestive tract function, and the development and treatment of postoperative complications. CD was diagnosed according to Consensus opinion on diagnosis and treatment of inflammatory bowel disease ( Beijing 2018). Patient was classitied according to the Montreal Classification. Postoperative complications were graded according to the Clavien-Dindo Criteria. Mann-Whitney U test was used for statistical analysis. Results:Among 123 patients, according to the Montreal classification, two cases (1.6%) were diagnosed at ≤16 years old (type A1), 66 cases (53.7%) were diagnosed at 17 to 40 years old (type A2), and 55 cases (44.7%) were diagnosed at >40 years old (type A3). The lesions were 52 cases (42.3%) of terminal ileum (L1) type, 20 cases (16.3%) of colon (L2) type, and 51 cases (41.5%) of ileocolon (L3) type. Four cases (3.2%) were non-stenosis and non-penetrating (B1) type, 87 cases (70.7%) were stenosis (B2) type, and 32 cases (26.0%) were penetrating (B3) type. Eighteen patients (14.6%) underwent emergency surgery due to complete intestinal obstruction (10 cases), gastrointestinal perforation (five cases), gastrointestinal bleeding (two cases), and rectovesical fistula complicated with septic shock (one case). One hundred and five patients (85.4%) received selective surgery due to poor conservative treatment effects. 51 cases (41.5%) underwent traditional open surgery and 72 cases (58.5%) underwent laparoscopic surgery. Nineteen patients (15.4%) received temporary or permanent ostomy. The preoperative C reactive protein level of patients with emergency surgery was higher than that of patients undergoing selective surgery ((39.23±24.13) mg/L vs. (11.48±2.68) mg/L), while the levels of plasma albumin (ALB) and pre-ALB were lower than those of patients receiving selective surgery ((29.90±10.60) g/L vs. (38.38±8.30) g/L, (146.00±125.49) mg/L vs. (209.06±61.19) mg/L), and the differences were statistically significant ( Z=9.603, 8.754 and 7.111, all P<0.01). During the follow-up, a total of 23 cases (18.7%) developed postoperative complications, including one case of postoperative intra-abdominal hemorrhage and underwent re-operation (Clavien-Dindo grade Ⅲ complication); four cases of anastomotic leakage after operation; six cases of postoperative paralytic ileus; 11 cases of surgical site infection, all of which were Clavien-Dindo grade Ⅱ complications, and one case of deep venous thrombosis of lower extremity. No patient with severe intraoperative complication was observed, and no patients died during the operation or hospitalization. The postoperative exhaust time of patients was (3.2±1.4) d, the time of open fluid diet was (5.8±0.8) d, the length of hospital stay was (18.0±14.1) d, and the length of postoperative hospital stay was (11.2±8.8) d. Conclusions:The concept of multidisciplinary collaboration should be emphasized in the treatment of CD. Surgical treatment can effectively control the complications and improve the quality of life of patients, but the timing of operation and the choice of surgical methods should be decided prudently after perioperative treatment, multi-disciplinary participated and regulation of the internal environment. The standardized and targeted treatments for the surgical difficulties of inflammatory bowel disease should be conducted.

11.
Article in Chinese | WPRIM | ID: wpr-910334

ABSTRACT

Objective:To study the effects of radiotherapy and the prognostic factors in hepatocellular cancer (HCC) patients with cardiophrenic angle or superior diaphragmatic lymph nodes metastasis (LNM).Methods:We retrospectively analyzed 56 HCC patients with cardiophrenic angle or superior diaphragmatic LNM who were treated with or without external beam radiation therapy (EBRT) in Zhongshan Hospital of Fudan University from Jan 2010 to Aug 2020. Patients were divided into two groups according to whether they received radiotherapy, EBRT group and non-EBRT group, and each group had 28 patients. Radiation fields included or excluded primary tumor in EBRT group, and the cardiophrenic angle or superior diaphragmatic LNM did not receive any local treatment in non-EBRT group. The response rate, survival rate, local control rate, prognostic risk factors of the two groups were studied.Results:After EBRT, the partial response rate and complete response rate were 32.1%(9/28) and 32.1%(9/28). The median survival rate of EBRT group was 16.1 months (95% CI 9.00-23.21, RR=3.63) vs. 6.9 months (95% CI 4.63-8.77, RR=1.06) for the non-EBRT group, with statistically significant difference ( χ2=15.53, P<0.05). Cardiophrenic angle or superior diaphragmatic lymph nodes 1-year local control rate for EBRT group and non-EBRT group were 37.0% vs. 10.7%, with statistically significant difference ( χ2=5.28, P<0.05). Since diagnosis of cardiophrenic angle or superior diaphragmatic LNM, 4 patients (14.3%) in the EBRT group vs. 13 patients (46.4%) in the non-EBRT group had higher alpha-fetoprotein (AFP) level after 3 months compared with the AFP before EBRT ( χ2=6.84, P<0.05). Multivariate analysis showed that multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L, no EBRT were poor prognostic factors. Conclusions:EBRT can prolong overall survival and improve the control rate of lymph node of HCC patients with cardiophrenic angle or superior diaphragmatic LNM. Patients with multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L and no EBRT have poor prognosis.

12.
Article in Chinese | WPRIM | ID: wpr-908584

ABSTRACT

Objective:To propose and evaluate the cycle-constraint adversarial network (CycleGAN) for enhancing the low-quality fundus images such as the blurred, underexposed and overexposed etc.Methods:A dataset including 700 high-quality and 700 low-quality fundus images selected from the EyePACS dataset was used to train the image enhancement network in this study.The selected images were cropped and uniformly scaled to 512×512 pixels.Two generative models and two discriminative models were used to establish CycleGAN.The generative model generated matching high/low-quality images according to the input low/high-quality fundus images, and the discriminative model determined whether the image was original or generated.The algorithm proposed in this study was compared with three image enhancement algorithms of contrast limited adaptive histogram equalization (CLAHE), dynamic histogram equalization (DHE), and multi-scale retinex with color restoration (MSRCR) to perform qualitative visual assessment with clarity, BRISQUE, hue and saturation as quantitative indicators.The original and enhanced images were applied to the diabetic retinopathy (DR) diagnostic network to diagnose, and the accuracy and specificity were compared.Results:CycleGAN achieved the optimal results on enhancing the three types of low-quality fundus images including the blurred, underexposed and overexposed.The enhanced fundus images were of high contrast, rich colors, and with clear optic disc and blood vessel structures.The clarity of the images enhanced by CycleGAN was second only to the CLAHE algorithm.The BRISQUE quality score of the images enhanced by CycleGAN was 0.571, which was 10.2%, 7.3%, and 10.0% higher than that of CLAHE, DHE and MSRCR algorithms, respectively.CycleGAN achieved 103.03 in hue and 123.24 in saturation, both higher than those of the other three algorithms.CycleGAN took only 35 seconds to enhance 100 images, only slower than CLAHE.The images enhanced by CycleGAN achieved accuracy of 96.75% and specificity of 99.60% in DR diagnosis, which were higher than those of oringinal images.Conclusions:CycleGAN can effectively enhance low-quality blurry, underexposed and overexposed fundus images and improve the accuracy of computer-aided DR diagnostic network.The enhanced fundus image is helpful for doctors to carry out pathological analysis and may have great application value in clinical diagnosis of ophthalmology.

13.
Article in Chinese | WPRIM | ID: wpr-908191

ABSTRACT

Objective:To summarize the perioperative nursing points of percutaneous kyphoplasty (PKP) in elderly patients with osteoporotic vertebral compression fractures assisted by robots, so as to provide reference for orthopedic nursing.Methods:From July 2019 to February 2021, the data of 72 patients undergoing robot-assisted PKP in the spinal surgery of the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed. The perioperative nursing points were summarized, and the nursing experience was summarized. The nursing under the new measures of precise minimally invasive treatment was analyzed and discussed. The length of hospital stay, postoperative ambulation time, complications and satisfaction survey results of patients were collected and recorded. The Numerical Rating Scale(NRS) score, Self-rating Anxiety Scale(SAS) score and Oswestry Disability Index (ODI) score before and after surgery were compared. The correlation analysis of the scores of various factors was combined to comprehensively evaluate the surgical and nursing effects.Results:All patients had no complications related to machine use during and after operation, and their symptoms were improved to varying degrees. Fifty-seven cases of indwelling catheter, catheter time (19.00±14.24) h. The preoperative hospitalization time was (6.16±2.22) d, and the postoperative hospitalization time was (1.94±0.99) d. Postoperative bed time was (16.34±6.81) h. Postoperative nursing satisfaction was (98.55±2.44)%.The postoperative NRS and SAS scores were (1.00±0.55) and (32.06±5.33) points, respectively, which were lower than those before operation (3.51 ± 0.71) and (39.08±8.86) points, and the differences were statistically significant ( t values were 33.976, 8.184, P<0.01). There were statistically significant differences in six indicators of ODI scores before and after surgery, including low back pain, walking, standing, sitting, sleep and self-care ( P<0.01). Correlation analysis showed that there was a strong correlation between the six ODI score factors and the NRS score. The four factors of sitting, walking, low back pain and standing were highly correlated with SAS. Conclusions:The implementation of good perioperative nursing management for patients with PKP assisted by robot can effectively promote the rehabilitation of patients, reduce the incidence of complications and improve patient satisfaction.

14.
Article in Chinese | WPRIM | ID: wpr-908081

ABSTRACT

Objective:To summarizes the diet management of one child with GSD I and severe hyperlipidemia.Methods:Key points of diet management include: making an individual diet plan, correcting parents' dietary misunderstanding, adjusting dietary and keeping following up regularly and keeping a food diary.Results:Following up for 11 months, the children basically formed a stable diet pattern, the blood glucose level was basically maintained between 4~6 mmol/L, the indicators of hyperlipidemia, hyperlactic acid and liver function were significantly improved compared with the previous period, and the height increase was guaranteed, while the weight gain was effectively controlled.Conclusions:It shows that individualized dietary guidance has a significant effect on the maintenance of blood glucose level, improvement of growth and development status and metabolic control in children with GSD I.

15.
Article in Chinese | WPRIM | ID: wpr-907648

ABSTRACT

Objective:Response surface methodology was used to optimize the optimal extraction conditions of red ginseng polysaccharide and to study the antioxidant activity of red ginseng polysaccharide.Methods:Supercritical CO 2 extraction method was used to extract polysaccharides from red ginseng. The effects of solid-liquid ratio, extraction time, extraction temperature and extraction pressure on the extraction of polysaccharides from red ginseng were investigated. Box-behnken Design method was used to optimize the extraction process of red ginseng polysaccharide, and Logit method was used to calculate the semi-inhibitory concentration of red ginseng polysaccharide on DPPH clearance (half maximal inhibitory concentration, IC 50). Results:The optimal extraction conditions were as follows: extraction temperature 61.12 ℃, extraction pressure 20.64 MPa, extraction time 128.37 min, solid-liquid ratio 1∶25.61 g/ml, and the extraction yield of red ginseng polysaccharide was 36.89%. The results of three groups of repeatability tests showed that the relative error of polysaccharide yield of red ginseng was in the range of 5%. When the mass concentration of red ginseng polysaccharide was 25 μg/ml, it had better antioxidant activity and IC 50 was 10.97 μg/ml. Conclusion:The optimized extraction conditions of red ginseng polysaccharide were reasonable and reliable, and the antioxidant activity of red ginseng polysaccharide was strong, which could provide reference for the follow-up research.

16.
Article in Chinese | WPRIM | ID: wpr-907270

ABSTRACT

Congenital heart disease(CHD)is one of the most common congenital defects that caused by fetal cardiovascular dysplasia.The global incidence rate is about 9/1 000 and is still rising.Previous reports have shown that congenital heart disease(CHD)incidence can be influenced by genetic etiology and environmental risk factors.And the gene-environmental interaction can affect the development and differentiation of myocardium through epigenetic regulation by means of DNA methylation, histone and RNA modification, etc.In this paper, we review the epigenetics of congenital heart disease to discuss the current progress and point out future direction of the etiology of congenital heart disease.

17.
Article in Chinese | WPRIM | ID: wpr-906468

ABSTRACT

Objective:In order to systematically clarify the chemical composition of Jiechangyan Qixiao granules, the main chemical components in this preparation were rapidly identified and assigned by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF/MS<sup>E</sup>). Method:ACQUITY UPLC BEH C<sub>18</sub> column (2.1 mm×100 mm, 1.8 μm) was employed for UPLC analysis with the mobile phase of 0.1% formic acid aqueous solution (A)-acetonitrile (B) for gradient elution (0-2 min, 5%B; 2-16 min, 5%-21%B; 16-30 min, 21%-95%B; 30-33 min, 95%B; 33-34 min, 95%-5%B; 34-37 min, 5%B). The flow rate was 0.3 mL·min<sup>-1</sup>, the column temperature was 30 ℃, and the volume of sample injection was 2 μL. Electrospray ionization (ESI) was applied for scanning under positive and negative ion modes with the scanning range of <italic>m</italic>/<italic>z</italic> 60-1 200. MS<sup>E</sup> mode was used to collect mass spectral data. The ion peaks were identified by comparing with the information of control substances, literature references and self-built database. Result:A total of 102 chemical components were separated and identified in Jiechangyan Qixiao granules, including organic acids, flavonoids and its glycosides, triterpenes, phenylethanoid glycosides, tannins, iridoid glycosides and other components, among which flavonoids and its glycosides were from Drynariae Rhizoma and Crataegi Fructus, phenylethanoid glycosides and iridoid glycosides were from Plantaginis Semen, triterpenoids and tannins were from Crataegi Fructus and Chebulae Fructus. Among the identified chemical constituents, there were 28 from Drynariae Rhizoma, 31 from Plantaginis Semen, 53 from Chebulae Fructus and 58 ingredients from Crataegi Fructus. Conclusion:The established UPLC-Q-TOF/MS<sup>E</sup> can comprehensively and rapidly analyze the chemical constituents in Jiechangyan Qixiao granules, and preliminarily elucidates the chemical composition profile of this granules, which can lay a foundation for further research on the pharmacodynamic material basis and quality control of Jiechangyan Qixiao granules.

18.
Article in Chinese | WPRIM | ID: wpr-906207

ABSTRACT

Objective:To determine the therapeutic effect of <italic>in vitro</italic> cultivation of bezoar on a mouse model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. Method:BALB/c mice were randomly divided into six groups according to their weight grade: normal group, HCoV-229E infection group, cold and damp group, a mouse model combining disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome, and high and low dose group of <italic>in vitro</italic> cultivation of bezoar. The combination model of human coronavirus pneumonia with Yidu Xifei syndrome mice was established by the method of cold dampness condition stimulation+coronavirus HCoV-229E infection. <italic>In vitro</italic> cultivation of bezoar (0.128,0.064 g·kg<sup>-1</sup>) was administrated by gavage for 3 days from the day of infection. The observation indexes included: general state observation of mice, inhibition rate of lung index and lung index of mice. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect the viral load in the lung tissues of mice. Serum levels of motilin(MTL), gastrin (GAS), and cytokines interleukin(IL)-10,IL-6, tumor necrosis factor-<italic>α</italic>(TNF-<italic>α</italic>)and interferon-<italic>γ</italic>(IFN-<italic>γ</italic>) in lung tissue of mice were determined by enzyme-linked immunosorbent assay(ELISA). The percentages of CD4<sup>+</sup> T lymphocytes,CD8<sup>+</sup> T lymphocytes and B lymphocytes in the blood of mice were determined by flow cytometry. Result:The high and low dose group of <italic>in vitro</italic> cultivation of bezoar can significantly improve the general condition of model mice. Compared with blank group, model group mice lung index increased significantly (<italic>P</italic><0.01), nucleic acids significantly increased expression of lung tissue in mice (<italic>P</italic><0.01), significantly higher serum MTL content in mice, GAS content significantly decreased (<italic>P</italic><0.05,<italic>P</italic><0.01), lung tissue cells in the immune factor TNF-<italic>α</italic>, IL-10 and IL-6 were significantly increased (<italic>P</italic><0.01), peripheral blood lymphocyte CD4<sup>+</sup> T cells in mice, The percentages of CD8<sup>+</sup> T cells and B cells were significantly decreased (<italic>P</italic><0.01). Compared with model group, <italic>in vitro</italic> cultivation bezoar mice lung index of high and low dose group were significantly lower (<italic>P</italic><0.01), the lung tissue of mice express nucleic acid decreased significantly (<italic>P</italic><0.01), MTL content decreased significantly (<italic>P</italic><0.01), the lung tissue of mice in the IL-6, IL-10, the TNF-<italic>α</italic>, IFN-<italic>γ</italic> levels were significantly lower (<italic>P</italic><0.01), <italic>in vitro</italic> cultivation bezoar high dose group can significantly increase the CD4<sup>+</sup> T cell percentage (<italic>P</italic><0.05), <italic>in vitro</italic> cultivation bezoar can to a certain extent reduce model mice lung inflammatory exudation, pulmonary interstitial edema, as well as blood stasis symptoms. Conclusion:<italic>In vitro</italic> cultivation of bezoar has a significant therapeutic effect on a mice model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. It can be treated by reducing the lung index of the model mice, improving the pathological damage of the lung tissue, adjusting the immune effective and inhibiting the clearing of inflammatory factors, and to provide a laboratory basis for clinical medication.

19.
Article in Chinese | WPRIM | ID: wpr-905165

ABSTRACT

Objective:To study the behavior of seeking medical care for people with disabilities under the background of Health Poverty Alleviation. Methods:Descriptive statistics method was used to analyze the behavior of seeking medical care for people with disabilities based on the data of the National Health Poverty Alleviation Dynamic Management System. Results:The Three Batch action plan mainly focuses on contracted services for chronic diseases; the number of visits for people with disabilities gradually increases, the proportion of visits within the county increases, and the proportion of hospitalizations decreases. The hospitals visited are mainly secondary hospitals, township health hospitals and community health service centers, and the medical expenditure is relatively high. These phenomena are different among disability conditions. Conclusion:The behavior of people with disabilities was remarkably improved after Health Poverty Alleviation. In the future, we should consolidate the achievements of Health Poverty Alleviation, increase the prevention of chronic diseases for people with disabilities, and further improve the accessibility of medical services and the level of medical security for people with disabilities.

20.
Article in Chinese | WPRIM | ID: wpr-921722

ABSTRACT

The editorial group of the clinical practice guideline for postmenopausal osteoporosis(PMOP) with traditional Chinese medicine(TCM)(hereinafter referred to as "guideline") is composed of experts specialized in TCM orthopedics, TCM gynecology, clinical epidemiology, etc. The guideline was formulated through registration, collection and selection of clinical issues/outcome indicators, evidence retrieval and screening, preparation of systematic reviews, evaluation of evidence quality, formation of recommendations, drafting, and peer review. The syndromes and treatment of PMOP are elaborated in detail. Specifically, Liuwei Dihuang Pills and Zuogui Pills are recommended for PMOP with Yin deficiency in the liver and kidney, Qing'e Pills for PMOP with kidney deficiency and blood stasis, Yougui Pills and Jingui Shenqi Pills for PMOP with Yang deficiency in the spleen and kidney, and Er'xian Decoction for PMOP with Yin and Yang deficiency in the kidney. In addition, Duhuo Jisheng Decoction can be used to relieve pain. The commonly used Chinese patent medicines include Xianling Gubao Capsules, Qianggu Capsules, Jintiange Capsules, Gushukang Capsules, Hugu Capsules, Jinwu Gutong Capsules, and Guyuling Capsules. Acupuncture and moxibustion are also effective approaches for PMOP. The rehabilitation and daily management were carried out by exercise therapies such as Baduanjin(eight-section brocade), Wuqinxi(five-animal exercises), and Taijiquan(Tai Chi), Chinese medicine diet, health education, and fall prevention. The promotion and application of this guideline will facilitate the implementation of TCM prevention and treatment of PMOP, ensure the quality of life of PMOP patients, provide effective and safe TCM treatment measures for PMOP, and reduce the risk of fracture complications.


Subject(s)
Animals , Drugs, Chinese Herbal/therapeutic use , Female , Humans , Medicine, Chinese Traditional , Osteoporosis, Postmenopausal/drug therapy , Quality of Life , Systematic Reviews as Topic , Yin Deficiency
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