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Aspiration is the entry of oropharyngeal or gastric contents into the lower respiratory tract through the glottis, a common and important cause of death in elderly patients due to lung infections.However, a lack of accurate and rapid clinical methods for the diagnosis of aspiration leads to misdiagnosis, missed diagnosis or delayed diagnosis of aspiration, especially aspiration pneumonia.In recent years, with further research into the mechanisms of aspiration syndromes, multiple aspiration biomarkers with potential and clinical translational value have been found, and may help early detection of aspiration and have important and practical significance for elderly health.Therefore, this article reviews aspiration biomarkers such as pepsin, α-amylase, bile acid and other potential biomarkers as well as current relevant research, detection methods, their clinical value and prospects concerning challenges and directions of innovation in future research.
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Objective:To explore the effect of potentially inappropriate medication (PIM) on frailty among community-dwelling elderly patients with mild cognitive impairment (MCI).Methods:From March to July 2021, a total of 252 elderly patients with MCI in Hefei community were selected.The data of basic information and PIM of subjects were collected.All subjects were assessed by the comprehensive frailty assessment instrument (CFAI), Montreal cognitive assessment scale-basic (MoCA-B), and the Barthel index (BI). The subjects were divided into PIM group ( n=136) and non-PIM group ( n=94) according to whether there was PIM.Taking the confounding factors as the matching condition, the subjects of the two groups were matched with 1∶1 propensity score.After matching, there were 52 in the PIM group and 52 in the non-PIM group.SPSS 23.0 was used for data analysis.Multivariate Logistic regression analysis was performed to analyze the effect of PIM on frailty of subjects. Results:(1)Before matching, the incidence of frailty in PIM group and non-PIM group were 80.9% and 19.1%, respectively, with statistically significant differences ( P<0.01). Logistic regression analysis revealed that PIM was a risk factor for the frailty ( β=1.704, OR=5.495, 95% CI=2.539-11.892). (2)After matching, the confounders of age, hearing status, chewing function, activities of daily living, Charlson comorbidity index, handgrip strength, and cognitive function were balanced and comparable between the two groups.The incidence of frailty in PIM group and non-PIM group were 67.9% and 32.1%, respectively.The differences remained statistically significant ( P<0.01). PIM remained a risk factor for frailty ( β=1.791, OR=5.998, 95% CI=2.393-15.032). Conclusion:PIM is a risk factor for the occurrence of frailty in elderly patients with MCI.Therefore, the accurate screening and standardized management of PIM will provide a new target for the frailty management of elderly patients with MCI.
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Objective:To assess the nosocomial infection risk events of neonatology experienced by a hospital, for identifying those events deserving high priority in infection prevention and control and critical rooms of improvement, hence minimizing such risks of the hospital.Methods:The hazard vulnerability analysis was called into play, along with literature review and clinical practices, while the hazard vulnerability analysis team of neonatology of the hospital preliminarily screened the indexes in brainstorming method. Then the individual indexes from such screening evaluated by means of questionnaires, and the risk evaluation index system for neonatal infection prevention and control was formed in combination with the risk value evaluation table of Kaiser model. On such basis, an evaluation questionnaire for the prevention and control was developed.In May 2020, the team members scored the possibility and severity of these risk indexes in the form of questionnaire, calculated the hazard risk value, and divided the risk zones by matrix analysis.Results:The risk assessment index system of neonatology was composed of 11 management indexes, 20 implementation indexes and 7 outcome indexes. The top 5 indexes of hazard risk value were: incorrect hand hygiene method(39.20%), inadequate cleaning and disinfection of environmental object surface(39.04%), the formula was not used immediately when ready(38.19%), nosocomial infection outbreak(38.02%), and low hand hygiene compliance(37.99%). The indexes with high severity and low readiness include three indexes related to formula feeding and three indexes related to cleaning and disinfection of object surface. The matrix analysis results showed that there were 9 indexes in the high-risk zone, 7 indexes in the medium risk zone and 22 in the low-risk zone.Conclusions:This study identified risk management events in hospital infection management in neonatology by means of hazard vulnerability analysis. The neonatology administrators are recommended to prioritize indexes in the high risk zone, make a root cause analysis of those indexes of high risk value and low readiness and take intervention measures in time, hence reducing the incidence of nosocomial infection and avoiding the outbreak of nosocomial infection.
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Objective:To observe the characteristics of resting-state brain activity in Parkinson disease (PD) patients with peak-dose dyskinesia, and to explore its pathogenesis.Methods:From March 2017 to November 2019, totally 27 PD patients with peak-dose dyskinesia (dyskinetic group), and 29 PD patients without dyskinesia (non-dyskinetic group) treated in the First Affiliated Hospital of Nanjing Medical University and 27 healthy controls from the community were recruited.Resting-state functional magnetic resonance imaging (rs-fMRI) and clinical scale data were collected.SPSS 26.0 software and REST software were used for data analysis.The whole brain amplitude of low-frequency fluctuation (ALFF) values were compared among the three groups.Correlation analysis was performed between ALFF values of the significant brain regions and the scale scores.Finally, receiver operating characteristic (ROC) curve was used to evaluate the efficacy of ALFF values of significant brain regions in identifying three groups of subjects.Results:The peak-dose dyskinetic group showed decreased ALFF in right inferior frontal gyrus(MNI: x=36, y=21, z=30; x=36, y=18, z=30)and increased ALFF in right supplementary motor area (MNI: x=9, y=0, z=69; x=6, y=-3, z=72)(all P<0.05, Alphasim correction) compared with non-dyskinetic group and healthy controls.ALFF value in right inferior frontal gyrus was negatively correlated with unified dyskinesia rating scale (UDysRS) scores ( r=-0.47, P=0.018). The ALFF value of the right inferior frontal gyrus was more effective in identifying peak-dose dyskinetic patients from non-dyskinetic patients and healthy controls, and the area under the curve of right inferior frontal gyrus were 0.881 and 0.787 (both P<0.01), respectively. Conclusion:Abnormal spontaneous brain activity in right inferior frontal gyrus and right supplementary motor area can be the neurobiological basis of peak-dose dyskinesia in PD patients.The severity of peak-dose dyskinesia is associated with abnormal brain activity of right inferior frontal gyrus.The ALFF value of right inferior frontal gyrus is a potential imaging marker for identifying peak-dose dyskinetic patient.
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Objective@#To analyze the epidemiological characteristics of pulmonary tuberculosis among students in Wuhan from 2011 to 2020, and to provide a basis for the scientific development of interventions and strategies.@*Methods@#Epidemiological distribution, time of onset and treatment, as well as treatment outcomes of student tuberculosis in Wuhan from 2011 to 2020 registered in the national tuberculosis information management system were described.@*Results@#During 2011-2020, 4 337 student tuberculosis patients in Wuhan were registered. The average annual incidence rate was 22.44/10 million, and the annual decreasing rate of 7.86% The incidence of male and female patients was 1.76:1, and the incidence rate of male was higher than that of female( χ 2=184.18, P <0.01). Most of patients aged 19-22 years old, accounting for 47.89%; Tuberculosis reports were highest during March to May, and September to November, and lowest during January to February, and July to August. Student patients were mainly concentrated in Hongshan District, Jiangxia District and Wuchang District, where schools were more distributed in Hongshan District, Dongxihu District, Wuchang District and Xinzhou District. The median duration from tuberculosis onset to treatment was 9(3, 21) days, which varied significantly by region, age, nationality, and patient residence ( Z =-9.25, 47.14, 9.88,43.96, P <0.01). The treatment and outcome of student tuberculosis patients were varied significantly by year and nationality( P <0.05).@*Conclusion@#The incidence of student tuberculosis in Wuhan City showed a slow downward trend. Most of student tuberculosis are college and high school students. Time and place of case detection are relatively fixed. The time of treatment and the outcome of treatment vary significantly. Tuberculosis prevention and control strategies should be formulated according to the local conditions according to the tuberculosis distribution characteristics, as well as enhancing surveillance, health promotion, active discovery and supervision management of tuberculosis in school settings.
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Primary ciliary dyskinesia (PCD) is a recessive genetic disorder of motile cilia with substantial genetic and phenotypic heterogeneity. Clinical features of PCD vary from one patient to another, and no single test has the sensitivity and specificity to accurately diagnose PCD. Genetic testing combined with other auxiliary tests can facilitate the confirmatory diagnosis of PCD. So far more than 40 genes have been associated with PCD, but most research have focused on common genes, which hinders our understanding of other rare PCD-genes. This review has summarized the PCD-associated genes and the corresponding characteristics of dysfunctional cilia, with an aim to provide a basis for early identification of such diseases.
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Humans , Cilia/genetics , Genetic Testing , Kartagener Syndrome/genetics , Sensitivity and SpecificityABSTRACT
Purpose@#The purpose of this study was to investigate the influences of sex comb on midleg like-2 (SCML2) on hepatocellular carcinoma (HCC) and potentially related mechanisms. @*Materials and Methods@#SCML2 expression in tumor tissues and cells was analyzed using the TCGA database and/or qRT-PCR. The proliferation of HCC cells was detected by CCK-8, colony formation, and EdU assays. The migration and invasion of HCC cells were detected by transwell and wound healing assays. Apoptosis of HCC cells was determined by flow cytometry. Additionally, qRT-PCR and Western blot were used to detect the expression of SCML2 and Wnt/β-catenin/epithelial–mesenchymal transition (EMT) signaling. A xenograft model in mice was established to verify the in vitro findings. @*Results@#We found that SCML2 was highly expressed in HCC tissues and cells and that high expression of SCML2 was correlated with poor prognosis in HCC patients. SCML2 overexpression promoted proliferation, invasion, and migration and repressed apoptosis of HCC cells. The reverse results were obtained in SCML2-silenced cells. Further, we found that SCML2 activated the Wnt/β-catenin/EMT pathway. SCML2 silencing reduced the protein levels of Wnt3a, β-catenin, N-cadherin, Vimentin, and Snail and enhanced E-cadherin protein expression both in vivo and in vitro. @*Conclusion@#SCML2 silencing inhibits the proliferation, migration, and invasion of HCC cells by regulating the Wnt/β-catenin/ EMT pathway.
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Objective:To investigate the short-term efficacy and safety of albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy in treatment of stage Ⅲ massive cervical cancer.Methods:The clinical data of 84 patients with massive cervical cancer admitted to Harbin Medical University Cancer Hospital from April 2019 to April 2020 were retrospectively analyzed. According to the different treatment regimens, patients were divided into the observation group and the control group, each with 42 cases. The observation group received albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy, and the control group received solvent-based paclitaxel combined with nedaplatin followed by concurrent radiotherapy. The short-term efficacy and adverse reactions of the two groups were compared.Results:The partial remission (PR) rate of the observation group and the control group at 1 month of treatment was 92.9% (39/42) and 35.7% (15/42), respectively, and the difference was statistically significant ( χ2 = 29.867, P < 0.01). The complete remission (CR) rate of the observation group and the control group at 1 month after treatment was 59.5% (25/42) and 38.1% (16/42), respectively, and the difference was statistically significant ( χ2 = 3.859, P = 0.049). The incidence of diarrhea of the observation group was lower than that of the control group [33.33% (14/42) vs. 54.8% (23/42)], and the difference was statistically significant ( χ2 = 3.913, P = 0.048). There were no statistical differences in the incidence of hematological adverse reactions and abnormal liver and kidney functions between the two groups (all P > 0.05). Conclusion:The albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy have a good short-term efficacy in treatment of stage Ⅲ massive cervical cancer, and the adverse reactions are tolerable.
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Objective:To examine the effects of individualized exercise rehabilitation prescriptions based on cardiopulmonary exercise tests on ambulatory blood pressure and cardiopulmonary function in elderly hypertension patients.Methods:This was a prospective randomized controlled study.Sixty essential hypertension patients hospitalized in our hospital from January 2020 to November 2020 and on regular antihypertensive medication were selected and divided using a random number table into the control group(30 cases)and the study group(30 cases). The control group received only conventional medication and the study group conducted individualized exercise rehabilitation in addition to medication, with no adjustment in anti-hypertensive medication for patients in either group.All enrolled patients underwent cardiopulmonary exercise testing and ambulatory blood pressure monitoring before treatment and 12 weeks after treatment.Changes in blood pressure and cardiopulmonary function in the two groups were compared.Results:Compared with the control group, the study group recorded reductions in the 24-hour average systolic blood pressure(135.6±8.7 mmHg vs.141.8±6.3 mmHg), 24-hour average diastolic blood pressure(79.3±9.4 mmHg vs.85.1±6.7 mmHg), daytime average systolic blood pressure(136.4±7.8 mmHg vs.140.2±6.6 mmHg), daytime average diastolic blood pressure(78.2±7.6 mmHg vs.84.4±7.2 mmHg), night-time average systolic blood pressure(125.0±9.6 mmHg vs.129.7±7.9 mmHg), and night-time average diastolic blood pressure(76.6±7.6 mmHg vs.84.5±6.7 mmHg)after 12 weeks of exercise( P<0.05 for all). Compared with pre-exercise levels, the study group achieved decreases in body mass index, resting heart rate, resting systolic blood pressure, resting diastolic blood pressure, peak systolic blood pressure, peak diastolic blood pressure( P<0.05 for all), and increases in maximum metabolic equivalent, peak oxygen uptake, maximum power and peak heart rate( P<0.05 for all), while the control group saw decreases in resting heart rate and resting diastolic blood pressure( P<0.05). After 12 weeks, the study group had lower levels than the control group in body mass index(24.5±2.0 kg/m 2vs.26.7±2.2 kg/m 2), resting systolic blood pressure(133.8±10.8 mmHg vs.139.3±9.0 mmHg)and resting diastolic blood pressure(79.4±8.0 mmHg vs.84.9±9.3 mmHg)( P<0.05)and higher levels in maximum metabolic equivalent(6.0±0.6 vs.5.2±1.1), peak oxygen uptake(22.0±2.7 ml·min -1·kg -1vs.20.3±3.7 ml·min -1·kg -1), maximum power(124.3±19.9 W vs.112.4±25.1 W)and peak heart rate(130.1±15.5 times/min vs.122.9±11.7 times/min)( P<0.05). Conclusions:Compared with antihypertensive drugs alone, the addition of individualized exercise prescriptions for rehabilitation based on cardiopulmonary exercise tests can effectively reduce blood pressure, improve cardiopulmonary function, and enhance exercise endurance and quality of life for elderly hypertension patients.
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We have adopted various smart tools and applied multiple teaching models to smoothly carry out our on-line teaching. Aiming at encouraging students' self-learning and independent thinking, the first task is to cultivate students' self-learning ability and independent thinking way of clinical microbiology. Our online teaching model is based on the asynchronous small private online course (SPOC) of the Chinese University MOOC, the core part of our teaching model, and supplemented by the Sojump questionnaire test and WeChat, the inter-action channels among teachers and students. All of these build up an integrated teaching system which fully embodies the "student-oriented" teaching concept and pushes forward the promotion and application of online teaching in college specialized courses.
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Objective:To explore the effects of competency-based diversified training on the bedside nursing comprehensive ability aand transition shock of newly recruited nurses.Methods:A total of 62 newly recruited nurses from the Second Affiliated Hospital of Zhengzhou University in June 2018 were selected as the control group, and 70 newly recruited nurses from June 2019 were selected as the experimental group by cluster sampling. The control group received routine pre-job training, and the experimental group received diversified training based on the control group. After one year of training, the differences in the scores of bedside nursing comprehensive ability, post competency and transition shock between the two groups of nurses were analyzed.Results:After 1 year of training, the total scores and the scores of nursing problems, nursing evaluation, nursing plan, nursing theory, nursing operation and bedside nursing comprehensive ability in the experimental group were 12.20±1.76, 24.29±2.38, 13.54±1.88, 9.77±1.35, 15.14±2.30 and 79.24±6.59, which were all higher than those of the control group (10.26±1.55,22.31±1.84,10.45±1.58, 8.56±1.80, 13.27±2.38 and 69.82±4.09), the differences were statistically significant ( t value was 4.582-13.679, P<0.05). The total scores and the scores of each dimension of the Post-competency the experimental group were 31.46 ±4.32, 51.03± 4.64, 20.27± 3.78, 17.86±3.99, 58.43± 4.44, 179.37±9.97, which were all higher than those of the control group 24.76±4.12, 40.56±5.55, 16.61±2.88, 15.15± 2.96, 49.74±3.07, 146.66±17.98, the differences were statistically significant ( t value was 4.466-13.197, P<0.05). The scores of psychological knowledge, skills, social culture and development and the total scores of Transition shock in the experimental group were 30.90±3.15, 19.69±2.74, 32.17±3.06, 103.81±12.24, which were all higher than those in the control group (25.69±2.76, 15.92±3.24, 27.50±4.15, 88.32±11.54), the differences were statistically significant ( t value was 7.237-10.040, P<0.05). Conclusions:competency-based diversified training can effectively improve the bedside nursing comprehensive ability and post competency, reduce their transition shock, and has strong clinical reference significance.
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Mild cognitive impairment is a transitional state between normal aging and dementia, which is the best intervention window to delay cognitive decline.As one of the adjustable risk factors affecting cognitive function, perceived stress significantly increases the risk of cognitive impairment by causing hypothalamic-pituitary-adrenal axis dysfunction and psychological disorders.Therefore, perceived stress management will become a new hot spot in the research and practice of non-drug intervention techniques for cognitive impairment.This paper reviews the current situation of perceived stress in MCI population, the relationship between perceived stress and cognitive function, and the evaluation techniques of MCI individual perceived stress.Further more, this paper summarizes the relevant influencing factors of perceived stress based on stress attribution model, and comments on the action mechanism and practical enlightenment of perceived stress intervention program on cognitive function management, in order to provide theoretical reference for cognitive function management of MCI population.
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Objective:To explore the quality of life and its influencing factors in patients with hyperthyroidism.Methods:From June 2017 to June 2019, patients with hyperthyroidism who were first diagnosed in the First Affiliated Hospital of Hainan Medical College were selected as the research objects, and the quality of life of the patients was assessed by the Chinese version of World Health Organization Quality of Life Brief Scale (WHOQOL-BREF). Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the psychological status of the patients. Univariate analysis was used to compare the differences of general information (age, gender, course of disease, marital status, education level, occupation, monthly family income, family relationship, thyroid ophthalmopathy, laboratory examination, thyroid crisis, anxiety level, and depression level) among patients with different quality of life. Multivariate logistic regression analysis was used to analyze the related factors affecting the quality of life of patients with hyperthyroidism.Results:There were 120 patients, aged (45.42 ± 6.38) years old, including 42 males and 78 females. The WHOQOL-BREF score was (76.58 ± 10.42) points, ranging from 25 to 106 points. Among them, 49 cases (40.83%) had high scores (≥80 points) and 71 cases (59.17%) had low scores (<80 points). Univariate analysis showed that there were differences in the quality of life among different marital status, education level, monthly family income, family relationship, thyroid ophthalmopathy, FT 3, FT 4, anxiety level and depression level ( P < 0.05). Multivariate analysis showed that thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression or anxiety, abnormal FT 4 and FT 3 were the risk factors affecting the quality of life of patients with hyperthyroidism ( P < 0.05). Conclusion:The overall quality of life of patients with hyperthyroidism is low, especially those with thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression, anxiety, FT 4 or FT 3 abnormalities.
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Objective:To investigate the status of glucolipid metabolism and insulin resistance in patients with first-episode non-medicated schizophrenia, and to explore their relationship with psychiatric symptoms and cognitive function.Methods:One hundred and seventeen patients with first-episode non-medicated schizophrenia admitted to Wenzhou Seventh People′s Hospital from January 2018 to August 2020 were included in case group, and 61 healthy subjects with physical examination during the same period were used as control group. The glucose metabolism, including serum fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG), fasting insulin (FINS), fasting C peptide; lipid metabolism, including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C); apolipoprotein A1 (Apo-A1) and homeostatic model assessment insulin resistance index (HOMA-IR) level were compared between 2 groups. The abnormal glucolipid metabolism and incidence rate of insulin resistance were counted in the two groups. According to the condition of abnormal glucolipid metabolism or insulin resistance in case group, the patients were divided into abnormal glucolipid metabolism group and non-abnormal group, and insulin resistance group and non-insulin resistance group. The psychiatric symptoms (positive and negative symptom scale, PANSS) and cognitive function (MATRICS consensus cognitive battery, MCCB) were compared between 2 groups. Pearson correlation analysis was used to explore the correlation between glucolipid metabolism and insulin resistance and psychiatric symptoms and cognitive function in case group.Results:The levels of glucolipid metabolism indexes of 2 h PBG, FINS, fasting C peptide, TG and HOMA-IR in case group were significantly higher than those in control group: (7.06 ± 1.88) mmol/L vs. (6.19 ± 1.53) mmol/L, (8.61 ± 2.46) mU/L vs. (6.25 ± 1.71) mU/L, (0.49 ± 0.16) nmol/L vs. (0.32 ± 0.09) nmol/L, (1.33 ± 0.47) mmol/L vs. (1.02 ± 0.24) mmol/L, 2.01 ± 0.71 vs. 1.51 ± 0.45 ( P<0.05); while the levels of HDL-C and Apo-A1 were significantly lower than those in control group: (1.19 ± 0.38) mmol/L vs. (1.57 ± 0.32) mmol/L, (1.21 ± 0.25) g/L vs. (1.43 ± 0.17) g/L ( P<0.05). The total incidence rate of abnormal glucolipid metabolism or insulin resistance in case group was significantly higher than that in control group: 62.39%(73/117) vs. 13.11%(8/61) ( P<0.05). The scores of dimensions of positive symptoms, negative symptoms and general psychopathology and total score of PANSS in combined group were significantly higher than those in non-abnormal group: (25.14 ± 5.09) scores vs. (22.95 ± 4.72) scores, (24.68 ± 5.25) scores vs. (22.05 ± 4.59) scores, (41.52 ± 5.85) scores vs. (38.12 ± 4.18) scores, (94.68 ± 11.64) scores vs. (85.43 ± 8.51) scores ( P<0.05). The above scores points in insulin resistance group were higher than points in non-insulin resistance group: (26.62 ± 4.18) scores vs. (23.62 ± 4.98) scores, (25.92 ± 5.07) scores vs. (23.02 ± 4.96) scores, (42.94 ± 5.26) scores vs. (39.43 ± 4.47) scores, (97.35 ± 10.07) scores vs. (89.37 ± 10.25) scores ( P<0.05). The scores of continuous performance test-identical pairs (CPT-IP), working memory (WM), brief visuospatial memory test-revised (BVMT-R) and Mayer-Salovey-Caruso emotional intelligence test (MSCEIT) of MCCB scale in abnormal glucolipid metabolism group were significantly lower than those in non-abnormal group: (23.82 ± 5.21) scores vs. (27.15 ± 4.69) scores, (21.72 ± 5.95) scores vs. (25.35 ± 5.14) scores, (19.56 ± 5.28) scores vs. (22.34 ± 5.43) scores, (22.62 ± 5.13) scores vs. (26.47 ± 4.96) scores ( P<0.05), and the scores in insulin resistance group were significantly lower: (22.26 ± 4.84) scores vs. (25.42 ± 5.12) scores, (20.35 ± 4.87) scores vs. (23.46 ± 5.08) scores, (18.05 ± 4.27) scores vs. (20.98 ± 5.71) scores, (21.15 ± 4.67) scores vs. (24.48 ± 5.02) scores ( P<0.05). Pearson correlation analysis showed that 2 h PBG in case group was positively correlated with PANSS positive symptoms ( P<0.05), and was negatively correlated with CPT-IP and MSCEIT in MCCB scale ( P<0.05). FINS and HOMA-IR were positively correlated with positive symptoms, negative symptoms and PANSS total score ( P<0.05), and were negatively correlated with CPT-IP, WM, BVMT-R and MSCEIT ( P<0.05). HDL-C was negatively correlated with positive symptoms ( P<0.05), and was positively correlated with CPT-IP, WM and MSCEIT ( P<0.05). Apo-A1 was negatively correlated with positive symptoms and negative symptoms ( P<0.05), and was positively correlated with CPT-IP and WM ( P<0.05). Conclusions:Abnormal glucolipid metabolism and insulin resistance have a higher detection rate in first-episode non-medicated schizophrenia, and have a certain relationship with the psychiatric symptoms and cognitive impairment of patients.
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Objective:To analyze the correlation between serum insulin-like growth factor binding protein-7(IGFBP7)levels and left ventricular diastolic function and exercise capacity in elderly heart failure patients with preserved ejection fraction(HFpEF).Methods:This was a prospective study.A total of 40 elderly patients in our hospital with HFpEF were selected as the HFpEF group, and 20 patients with normal left ventricular diastolic and systolic function were selected as the control group.Serum levels of IGFBP7 were measured by enzyme linked immunosorbent assay, while N-terminal pro-brain natriuretic peptide(NT-proBNP)was measured by chemi-lumin escence assay.The levels of biomarkers were compared between the two groups.Diastolic function was assessed by transthoracic echocardiography, exercise tolerance was assessed by cardiopulmonary exercise testing(CPET).Results:The levels of IGFBP7 in HFpEF group was significantly higher than control group[median value, 59.4 ng/L(52.2-70.6 ng/L) vs.50.8 ng/L(42.0-55.2 ng/L), P<0.01]. In multivariable analysis, NT-proBNP and IGFBP7 were independently associated with HFpEF(all P<0.05). The area under receiver operating characteristic curve of IGFBP7 and NT-proBNP for detecting HFpEF were 0.778 and 0.820, respectively(all P<0.01). Higher IGFBP7 was modestly correlated with NT-proBNP, left atrial volume index, early diastole velocity(E), E/peak late diastolic velocity(E/A), early mitral inflow velocity/annular diastolic velocity(E/e′), estimated right ventricular systolic pressure, peak oxygen uptake(VO 2 peak), anaerobic threshold and minute ventilation/earbon dioxide production(VE/VCO 2)(all P<0.05). Conclusions:In elderly patients with HFpEF, IGFBP7 may be a novel biomarker of diastolic function and exercise capacity.
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Objective:To compare the main clinical outcomes of Day 6 (D6) single blastocyst transplantation in fresh and frozen-thawed cycles.Methods:The data of fresh blastocyst transplantation patients and frozen-thawed blastocyst transplantation patients from January 2013 to December 2017 were retrospectively analysed. Fresh blastocyst transplantation and frozen-thawed blastocyst transplantation were matched in a ratio of 1∶3 by using propensity score matching, the matching factors included age, body mass index, thickness of endometrium and blastocyst grade. Totally 180 cases were included in the fresh cycle group and 540 cases in the frozen-thawed cycle group.Results:There was no significant difference in basal FSH between the two groups [(6.9±2.5) versus (6.4±3.8) U/L, P=0.334]. The positive rate of hCG in D6 blastocyst fresh cycle transplantation group [32.8%(59/180) versus 48.1%(260/540)], clinical pregnancy rate [28.9%(52/180) versus 43.5%(235/540)] and live birth rate [21.1%(38/180) versus 32.2%(174/540)] were lower than those of frozen-thawed cycle group (all P<0.05). The miscarriage rate was higher [26.9%(14/52) versus 24.7%(58/235)], but there was no statistical difference ( P>0.05). Conclusions:The clinical pregnancy outcome of D6 single blastocyst frozen-thawed cycle transplantation is better than that of fresh cycle. In order to obtain better clinical outcomes, frozen-thawed cycle transplantation of blastocysts formed on the 6th day is recommended.
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Objective:To evaluate the direct and sustained effects of multitask-process cognitive training program on cognitive function in the community elderly with mild cognitive impairment(MCI).Methods:Ninety-two participants with MCI who met the inclusion criteria were randomly selected from Huzhou community of Zhejiang province.According to the allocation ratio of 1∶1, the MCI participants were randomly divided into the cognitive training group and the control group, with 46 cases in each group.The participants in control group were received a cognitive function-health education program, and the participants in cognitive training group received an additional 10 weeks of multitask-process cognitive training.Respectively in three-time points of at baseline, after 10 weeks of training, and a 3-month follow-up to evaluate all participants with MCI executive function tested by trail making test A-B and Stroop color-word test, overall cognitive function tested by MoCA scale.Repeated measure ANOVA was used to compare the between-group variation, time effect and interaction effect of two groups at 3 time points.Results:The MoCA score of intervention group at T0, T1, T2 were 19.09±1.98, 21.09±1.41, 21.11±1.27 respectively, and the MoCA score of the control group were 18.24±2.22, 18.57±1.86, 18.07±1.90 respectively.Compared with the control group, the score of MoCA in the intervention group was significantly improved at T1 and T2 ( P< 0.05). Compared with control group, the Trail making test A-B, Stroop color-word interference test of intervention group were improved at T1, T2 ( P<0.05). Repeated measurement ANOVA shows that there were significant differences in Trail making test A-B, Stroop color-word interference test and MoCA between the two groups in terms of between-group effect, time effect and group-time interaction effect ( F=9.245~196.457, P<0.05). Simple effects analysis shows that compared with the control group, the multitask-process cognitive training had a positive direct effect on the Trail making test A-B, Stroop color-word interference test and MoCA, and these improvements maintained until the end of a 3-month follow-up ( F=2.757~201.829, P<0.05). During the research period, the compliance rate of the cognitive training group was 87.4%, and no adverse events occurred. Conclusion:The multitask-process cognitive training program positively promote the cognitive function of participants with MCI and provide a set of standardized and procedural nursing intervention program for the cognitive management of community participants with MCI.
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Objective:To explore the action path and the potential mediating effects of depression and physical diseases on the influencing factors of mild cognitive impairment(MCI) in community, and provide the theoretical basis for the construction of the strategy of cognitive regulation.Methods:A convenient sample survey was conducted on 252 mild cognitive impairment patients in the community undergoing screening using the general information questionnaire, Montreal cognitive assessment scale(MoCA) and geriatric depression scale(GDS-15)from January 2018 to June 2019. SPSS 22.0 and AMOS 22.0 softwares were used to conduct descriptive analysis, correlation analysis, structural equation model and confirmatory factor analysis.Results:The score of MoCA was 19.66±3.90 for all MCI patients. There were significant correlations among age, education, social frequency, physical exercise frequency and depression degree, the number of physical disease and MoCA( r=-0.440-0.487, P<0.01). The structural equation model fits well(χ 2/ df=2.476, TLI=0.885, CFI=0.916, GFI=0.919, AGFI=0.871, RMSEA=0.077). Mediation modeling analysis showed that age, education, social frequency physical exereise frequency had a direct effect on cognitive function(effect value was -0.183, 0.458, 0.237, 0.174, P<0.01). There were partly mediating effect of the number of physical disease between age, education, physical exercise frequency and cognitive function(effect value was -0.106, 0.078, 0.075, P<0.01), and there were partly mediating effect of depression degree between age, social frequency, physical exercise frequency and cognitive function(effect value was -0.075, 0.080, 0.050, P<0.01), and there were chain mediating effect of the number of physical disease-depression degree between age, education, physical exercise(effect value was -0.028, 0.031, 0.019, P<0.01). Conclusion:The cognitive management of MCI among community should focus on the elderly, low education level groups.In the implementation of exercise intervention to improve cognitive function of health management strategy, while to strengthen the effective management of physical diseases and negative emotion evaluation and dredging, to increase the effect of exercise intervention on cognitive function improvement.
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Objective:To compare the efficacy and safety between biphasic insulin aspart 30 injection and insulin glargine combined with repaglinide in the newly diagnosed type 2 diabetes in the elderly patients.Methods:A total of 60 elderly patients with type 2 diabetes who were newly diagnosed in the First Hospital Affiliated to Hebei Medical University were selected as study objects, and they were divided into group A and group B according to the random digital table method, with 30 cases in each group.Group A was treated with aspart 30 injection, and group B was treated with glargine combined with repaglinide tablets for 2 weeks.The BMI, FPG, 2hPG, HbA1c, 1, 5-AG were detected after treatment for 1 and 2 weeks, and the FCP, PCP were detected before and after treatment.Results:The FPG and 2hPG of the two groups decreased significantly after treatment for 1 week and 2 weeks, and the blood glucose of group A decreased significantly after 1 week of treatment compared with group B, and the difference was statistically significant(FPG t=2.58, 2hPG t=2.46, all P<0.05).1, 5-AG increased significantly at 1 week and 2 weeks after treatment.At 1 weekafter treatment, the increase was more significant in group A than group B, and the difference was statistically significant( t=8.93, P<0.05). After 2 weeks of treatment, the levels of FCP and 2hCP of both two groups were increased compared with before treatment, and the differences were statistically significant(FCP t=3.72, 3.45, 2hCP t=4.14, 3.54, all P<0.05). The time of blood glucose reaching the standard in group A was(10.35±4.10)d, which was shorter than that in group B [(12.38±4.22)d], and the difference was statistically significant( t=8.32, P<0.05). The dosage of insulin required by the patients in group A was(45.14±8.42) U·kg -1·d -1, which was higher than that in group B [(24.88±7.36)U·kg -1·d -1], and the difference was statistically significant( t=9.06, P<0.01). Conclusion:Both BIAsp30 and IG combined with repaglinide can effectively reduce FPG and 2hPG of patients with type 2 diabetes newly diagnosed in the elderly.Besides, the occurrence of hypoglycemia in the glargine group is lighter than that in the BIAsp30 group, and the time of blood glucose reaching the standard is longer than that in the aspart 30 injection group.Monitoring 1, 5-AG can be used as a reference for timely adjustment of hypoglycemia programs.
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Objective:To investigate the status of violence and aggression suffered by nurses in psychiatric hospitals in beijing-tianjin-hebei region and explore the development trend of violence assessment.Methods:A total of 539 psychiatric nurses from three top grade psychiatric hospitals (Beijing Huilongguan Hospital, Tianjin Anding Hospital, Mental Health Center of Hebei Province) in Beijing-Tianjin-Hebei region were surveyed by a general data questionnaire, Workplace Violence Frequency Measurement Scale (WVS), Violence Cognition Qquestionnaire, Knowledge and Needs on Violence Risk Management Questionnaire.Results:A high level of workplace violence (6.21±2.94) was found with nurses in different wards ( χ2 value was 32.149, P<0.05), being in different wards (χ 2 value was 32.149, P<0.05), whether participating psychiatric training ( χ2 value was 11.588, P<0.05) and whether working on different schedule ( χ2 value was 21.017, P<0.05), suffered from distinct level of workplace violence. Participants believed that the change in the patients′ condition (68.6%, 370/539) and symptom fluctuation (65.9%, 355/539) were the main factor of violence from patients′ aspect. While a lack of assessment (57.9%, 312/539) and poor communication among nurses (56.8%, 306/539) was cited as the main causes of violence from nurse′s point. Conclusion:The management and control of patients′ violence should be improved through staff training program, introduction and employment of validated assessment tools, the construction of violent prevention and control system. Only through the joint efforts above could we reduce the occurrence of psychiatry violence injuries and ensure a safety practice environment for the maintenance and improvement of nurses′ health in mental health department.