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Objective:To analyze the characteristics of the circular cases violating the " nine prohibitions" in recent years, so as to provide a basis for further strengthening the moral culture construction of the healthcare industry.Methods:Data came from the reported cases released on official websites of the discipline inspection committees, supervision committees and health committees at all levels in China from December 2013 to August 2021, which were identified by searching the keyword " case or report or moral culture and nine prohibitions" . Descriptive analysis and frequency analysis were conducted on the reported time, region and province, as well as the involved units, departments, persons, punishment results and case classification data of all the cases.Results:A total of 102 cases violating the " nine prohibitions" were included, of which the cases from 2014 to 2015 topped the rest, accounting for 51.96%(53 cases). Top three regions of these cases were central China, east China and southwest China, with 31 cases, 27 cases and 18 cases respectively. The units involved were mainly tertiary medical institutions, accounting for 44.12%(45 cases). More medical staff(134 people) than administrative staff(85 people) were involved in the cases. The largest number of cases was receiving kickbacks, with 52 cases(50.98%). The punishment results of cases included judicial procedures(76 people), Party discipline and government discipline punishment(67 people) and organizational punishment(76 people).Conclusions:Moral culture problem in China′s healthcare sector is characterized in wide coverage, complexity, comprehensiveness and long-term. Relevant authorities should keep up their efforts in enhancing the awareness of medical workers, improving the synergy mechanism in this regard, and strengthening the internal management of medical institutions.
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OBJECTIVE To stu dy the effects of different processing me thods on the contents of the pharmacodynamic index components in Citrus aurantium and their antioxidant activity. METHODS According to the general principles of 2020 edition of Chinese Pharmacopoeia （volume Ⅳ） and the relevant processing methods in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province ，the samples of C. aurantium were prepared by steaming with water ，boiling with water ，stir-frying with vinegar ，stir-frying with wine ，stir-frying with bran ，processing with bran and processing with honey. The contents of moisture and ash in different products of C. aurantium were detected. The contents of naringin and neohesperidin in different products of C. aurantium were determined by high performance liquid chromatography. The antioxidant activity of different products was investigated by DPPH and ABTS + radical scavenging experiments and the total reducing power test. RESULTS The contents of moisture ，ash，naringin and neohesperidin were in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The content of naringin in descending order was as follow ： unprocessed sample ＞sample processed with honey ＞sample processed with bran ＞sample boiled with water ＞sample stir-fried with vinegar＞sample stir-fried with wine ＞sample stir-fried with bran ＞sample steamed with water. The content of neohesperidin in descending order was as follow ：unprocessed sample ＞sample boiled with water ＞sample processed with bran ＞sample processed with honey ＞sample stir-fried with vinegar ＞sample steamed with water ＞sample stir-fried with wine ＞sample stir-fried with bran. The samples after boiling with water ，processing with bran ，and stir-fried with bran had better DPPH radicals scavenging ability （IC50 were 7.49，8.37 and 10.22 mg/mL，respectively）. The samples after boiling with water ，steaming with water ，and processed with bran had better ABTS + radicals scavenging ability （IC50 were 1.76，2.03 and 2.72 mg/mL，respectively）. In addition ， compared with sample stir-fried with wine and processed with 发。E-mail：wanglu1286@163.com honey，unprocessed sample and other processed products of C.aurantium had bet ter total reducing ability. CONCLUSIONS After processing ，the contents of the main pharmacodynamic index components in C. aurantium have been reduced ，but they were also in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The antioxidant ability of some processed products has been enhanced.
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Background@#Bovine papillomatosis is a type of proliferative tumor disease of skin and mucosae caused by bovine papillomavirus (BPV). As a transboundary and emerging disease in cattle, it poses a potential threat to the dairy industry. @*Objectives@#The aim of this study is to detect and clarify the genetic diversity of BPV circulating in dairy cows in Xinjiang, China. @*Methods@#122 papilloma skin lesions from 8 intensive dairy farms located in different regions of Xinjiang, China were detected by polymerase chain reaction. The genetic evolution relationships of various types of BPVs were analyzed by examining this phylogenetic tree. @*Results@#Ten genotypes of BPV (BPV1, BPV2, BPV3, BPV6, BPV7, BPV8, BPV10, BPV11, BPV13, and BPV14) were detected and identified in dairy cows. These were the first reported detections of BPV13 and BPV14 in Xinjiang, Mixed infections were detected, and there were geographical differences in the distribution of the BPV genotypes. Notably, the BPV infection rate among young cattle (< 1-year-old) developed from the same supply of frozen sperm was higher than that of the other young cows naturally raised under the same environmental conditions. @*Conclusions@#Genotyping based on the L1 gene of BPV showed that BPVs circulating in Xinjiang China displayed substantial genetic diversity. This study provided valuable data at the molecular epidemiology level, which is conducive to developing deep insights into the genetic diversity and pathogenic characteristics of BPVs in dairy cows.
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Background@#Bovine papillomatosis is a type of proliferative tumor disease of skin and mucosae caused by bovine papillomavirus (BPV). As a transboundary and emerging disease in cattle, it poses a potential threat to the dairy industry. @*Objectives@#The aim of this study is to detect and clarify the genetic diversity of BPV circulating in dairy cows in Xinjiang, China. @*Methods@#122 papilloma skin lesions from 8 intensive dairy farms located in different regions of Xinjiang, China were detected by polymerase chain reaction. The genetic evolution relationships of various types of BPVs were analyzed by examining this phylogenetic tree. @*Results@#Ten genotypes of BPV (BPV1, BPV2, BPV3, BPV6, BPV7, BPV8, BPV10, BPV11, BPV13, and BPV14) were detected and identified in dairy cows. These were the first reported detections of BPV13 and BPV14 in Xinjiang, Mixed infections were detected, and there were geographical differences in the distribution of the BPV genotypes. Notably, the BPV infection rate among young cattle (< 1-year-old) developed from the same supply of frozen sperm was higher than that of the other young cows naturally raised under the same environmental conditions. @*Conclusions@#Genotyping based on the L1 gene of BPV showed that BPVs circulating in Xinjiang China displayed substantial genetic diversity. This study provided valuable data at the molecular epidemiology level, which is conducive to developing deep insights into the genetic diversity and pathogenic characteristics of BPVs in dairy cows.
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Objective:To analyze the correlation between 21-gene recurrence score (RS) and clinicopathological characteristics of patients with Lumina type breast cancer, and to explore its significance in individualized treatment.Methods:The clinicopathological data of 59 patients with surgical resection and pathological diagnosis of Lumina type breast cancer in Shanxi Provincial Cancer Hospital from May 2018 to May 2019 were retrospectively analyzed. Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of 21 gene and RS was calculated. According to the 21-gene RS, the patients were divided into low recurrence risk group (RS < 18 points), intermediate recurrence risk group (RS 18-31 points) and high recurrence risk group (RS > 31 points). Univariate and multivariate logistic regression analyses were made to evaluate the correlations between different recurrence risk and clinicopathological characteristics of patients and their influence on the choice of adjuvant chemotherapy.Results:Based on the 21-gene RS, 29 patients were in low recurrence risk group, 22 cases were in intermediate recurrence risk group, and 8 cases were in high recurrence risk group. Single-factor analysis showed that age ( P = 0.012), maximum mass diameter ( P = 0.031), histological grade ( P = 0.036), progesterone receptor (PR) level ( P = 0.015), Ki-67 positive index ( P = 0.049) and molecular typing ( P = 0.010) were influencing factors of 21-gene RS recurrence risk. Multivariate logistic regression analysis showed that the age and Ki-67 positive index were negatively correlated with 21-gene RS recurrence risk (both P < 0.05). After grouping according to the 21-gene RS, 17 patients in the intermediate recurrence risk group (according to the traditional postoperative recurrence risk grouping method for breast cancer) were classified as low recurrence risk group, and 4 patients in the low recurrence risk group were classified as intermediate recurrence risk group ( χ2 = 4.535, P = 0.033). After grouping based on 21-gene RS, the number of patients who needed chemotherapy in individualized treatment decreased. Of the 17 cases, 11 cases did not undergo postoperative chemotherapy, and the remaining patients received chemotherapy. The postoperative follow-up period was 11-22 months. As of March 2020, there was no recurrence or disease progress. Conclusion:The 21-gene RS can provide objective basis for the individualized precise treatment and prognosis prediction for patients with early-stage Lumina type breast cancer.
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Objective:To visualize the research hot spots and frontiers of non-surgical treatments for idiopathic scoliosis (IS) based on CiteSpace.Methods:The Web of Science Core Database and China National Knowledge Infrastructure from 1990 to 2020 were searched for studies of non-surgical treatments of idiopathic scoliosis. The time, distributions of nations, institutions, academic disciplines and keywords of literature were analyzed. With CiteSpace 5.7.R4 and Excel 2017, the visualized knowledge graphs and the data tables were generated.Results:A total of 822 studies including 548 articles in English and 274 articles in Chinese were retrieved, including 378 articles published during 2015—2020. The top three nations with higher number of published articles were USA (114 studies), Canada (77 studies) and China (68 studies). Studies covered 33 disciplines, including rehabilitation, engineering and orthopedics, and the betweenness centrality of rehabilitation medicine was the highest (0.59). The non-surgical treatment research was focused on adolescents (187 studies) and brace treatment (116 studies). From 1990 to 2014, the non-surgical treatment of IS mainly focused on the brace treatment (70.4%,69/98) in domestic studies. After 2014, comprehensive treatments such as exercise therapy and manual therapy gradually became the research trend in this field (61.3%,92/150). Research hotspots included different forms of brace treatment (betweenness centrality: 0.31), exercise (6 studies), manual therapy (3 studies), guide of medicine (2 studies), acupuncture therapy (2 studies) of non-surgical treatments. Among top 30 research institutions for domestic publication of Chinese literature, there were 22 tertiary hospitals, 1 secondary hospital, 5 schools, 1 comprehensive rehabilitation service organization, and 1 community health service center.Conclusion:The research content of non-surgical treatment for idiopathic scoliosis tends to be diversified, comprehensive treatment of exercise therapy, brace therapy, and manual therapy are currently the main research hotspots.
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Objective@#To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017.@*Methods@#Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five-stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top-down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression.@*Results@#In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (P<0.001).@*Conclusion@#The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.
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Objective@#To investigate the association of ORMDL3 gene polymorphism with the risk of bronchial asthma of Uygur people in Urumqi region. @*Methods@#Ten single nucleotide polymorphism (SNP) loci of ORMDL3 gene in 93 Uygur patients with bronchial asthma and 100 healthy controls were genotyped by the multiplex SNP (SNaPshot) technique, and the association of different genotypes and alleles with the risk of asthma of Uygur people was analyzed. @*Results@#There were significant differences in genotype and allele frequencies of rs7216389 and rs12603332 loci of ORMDL3 gene between asthma patients and healthy controls (P＜0.05). The detection data of SNP loci of ORMDL3 gene were all in accordance with Hardy-Weiberg law (P＞0.05). @*Conclusion@#The polymorphism of ORMDL3 gene is directly associated with the risk of asthma in Uygur people, and the rs7216389 and rs12603332 loci of ORMDL3 gene may be the susceptible sites of bronchial asthma in Uygur people.
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Objective To evaluate the value of human papillomavirus (HPV) 16/18 E6 protein detection in shunting and prognosis in patients with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL). Methods A total of 98 patients with ASCUS or LSIL from the Affiliated Cancer Hospital of Shanxi Medical University between May 2014 and May 2015 were selected as the subjects. All of them received the thin-cytologic test (TCT), HPV DNA, HPV16/18 E6 protein tests and colposcopy examination. After 3-year follow-up of patients with cervical intraepithelial neoplasia (CIN) grade Ⅰor bellow lesions diagnosed by biopsy and 30 negative controls, the above tests were performed again. The efficacies of all the tests were analyzed. The value of CIN grade Ⅱ or above was predicted. Results The sensitivity, specificity, positive predictive value and negative predictive value in predicting CIN grade Ⅱor above lesions of HPV16/18 E6 protein , HPV DNA and HPV16/18 DNA was 30.8％, 95.3％, 50.0％, 90.0％, respectively; 84.6％, 37.6％, 17.2％, 94.1％, respectively and 61.5％, 67.1％, 22.2％, 91.9％, respectively in shunting study. The relative risk (RR) of CIN grade Ⅱor above lesions in patients with positive HPV16/18 E6 protein, persistent positive HPV16/18 DNA and positive HPV16/18 DNA was 13.429, 10.231 and 8.343, respectively in the follow-up study. Odds ratio (OR) of HPV16/18 E6 positive protein presenting persistent positive HPV16/18 DNA was 34.833 (95％ CI 5.020-241.711). Conclusions In patients with ASCUS and LSIL, the specificity and positive predictive value of HPV16/18 E6 protein in predicting CIN grade Ⅱ or above lesions are higher than those of HPV DNA and HPV16/18 DNA. Moreover, these patients with HPV16/18 E6 protein positive have a higher risk of developing CIN grade Ⅱ or above lesions and persistent positive HPV16/18 DNA.
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Objective: To summarize the diagnosis and prognosis of adrenocortical carcinoma in children. Methods: Medical records of 10 pediatric patients with adrenocortical cancer treated in Children's Hospital of Nanjing Medical University from September 2010 to March 2018 were retrospectively reviewed, and their clinical manifestation, laboratory, auxiliary, and pathological examination results, and prognosis were analyzed. Results: The average age of all patients (5 male and 5 female pediatric patients) was (53.3+48.4) months. Clinical mani-festations included abdominal mass, hypertension, cortisol level, and peripheral precocious puberty. Laboratory tests showed that lactate dehydrogenase, neuroenolase, and cortisol levels were high in some patients, and sex hormones were abnormal. Auxiliary examination using the abdominal computed tomography enhancement showed irregular an adrenal gland, uneven density, necrosis, mass calcification, and some infiltration into the surrounding tissue. Pathological examination suggests tumor cell pleomorphism, more frequent pathological division, high mitotic index, abundant interstitial sinusoid, necrosis, tumor infiltration, vascular invasion, and Weiss score of≥3 points. Lactate acid dehydrogenase and cortisol levels; Weiss score; and tumor size, staging, and resection rate were not statistically different among prognostic factors. Conclusions: For pediatric patients with adrenal masses, the survival rate should be improved by combining the clinical manifestation, laboratory examination, and auxiliary examination for the early diagnosis of adrenocortical carcinoma and to select the appropriate treatment. Combined with pathological results, adrenocortical carcinoma can be well differentiated from other adrenal masses.
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With the reform of medical education ("5+3"), the clinical mentors usually need to guide three kinds of students who are at different stages of medical education at the same time. And we summed up the core concept of clinical thinking and problems in its training, such as the imperfect teaching mode, insufficient teacher teaching awareness, students' difficulties in adapting to role changes, thinking patterns, and relying on auxiliary examinations, etc. For the training targets of three kinds of students are different, we explored and constructed a "multi-level integrated" training mode and the evaluation system of clinical thinking from the building of professional thinking, lectures, heuristic rounds, multi-aspect thinking mode extension, group learning and case discussions. So far, they have made effective achievements among a small part of students, which are hopefully useful for clinical training.
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As an important zoonotic pathogen, Staphylococcus aureus has led to serious mastitis and endometritis in infected dairy cows. In this study, a total of 164 strains of S. aureus were isolated from dairy cows in Xinjiang Province, China, and subjected to assays to determine drug susceptibility and biofilm (BF) formation ability. Enterotoxin-related genes were detected, and the transcription levels of genes related to BF formation were determined by using reverse transcription-quantitative polymerase chain reaction. Moreover, the pathogenicity of isolates with different BF formation abilities was determined by measuring their hemolysis activity, half lethal dose (LD₅₀) and organ bacterial load. The results showed that 86.0% of S. aureus isolates could form BF. Among them, 42.1% of the strains had weak BF formation ability, and most strains with a strong BF formation ability were ica gene carriers. The S. aureus isolates displayed multidrug resistance and their drug resistance was positively correlated with their BF formation ability. Moreover, 96.3% of the S. aureus isolates carried enterotoxin genes. Among them, the detection rates of the novel enterotoxin genes were higher than those of conventional enterotoxin genes. Furthermore, isolates with a strong BF formation ability had higher LD50 but lower hemolysis ability and organ bacterial load than those of the isolates with weak or no BF ability. However, isolates without BF ability produced more severe pathological changes than those of isolates with strong BF formation ability. These findings suggest that higher BF ability and presence of novel enterotoxin genes are important characteristics of S. aureus isolates from dairy cows in Xinjiang Province, China, and such isolates may pose potential threats to food safety.
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Bacterial Load , Biofilms , China , Drug Resistance , Drug Resistance, Microbial , Drug Resistance, Multiple , Endometritis , Enterotoxins , Female , Food Safety , Hemolysis , Lethal Dose 50 , Mastitis , Polymerase Chain Reaction , Staphylococcus aureus , Staphylococcus , VirulenceABSTRACT
Objective To study the application effect of ENCOR vacuum-assisted breast minimally invasive polypectomy system in the diagnosis and treatment of breast tumors. Methods Totally 86 breast cancer patients treated in the General Hospital of Yangmei Group from January 2017 to October 2017 were randomly divided into study group and control group,with 43 cases in each group. The study group was treated with ENCOR vacuum-assisted minimally invasive rotational atherectomy system,while the control group was treated by traditional breast excision. The operative conditions, postoperative complications and postoperative recurrence were observed and compared between the two groups. Results The intraoperative bleeding volume,operation time,scar length and postoperative recovery time in the study group were (5.1 ±1.2)mL,(15.9 ±3.5)min,(0.3 ±0.1)cm,(2.7 ±0.4)d,respectively, which in the control group were (12.7 ±2.3)mL,(26.8 ±4.6)min,(3.2 ±1.1)cm and (5.1 ±0.8)d,respectively, the differences between the two groups were statistically significant ( t=15. 579,14. 297,14. 108,13. 597,all P<0. 05). The total incidence rate of postoperative complications in the study group was 11. 63％,which was significantly lower than 30. 23％ in the control group (χ2 =5. 187,P<0. 05). During the follow-up of 12 months,in the study group,2 patients (4. 65％) had residual tumor,1 patient (2. 33％) developed recurrence; in the control group, 3 patients (6. 98％) had residual tumor,2 patients (4. 65％) developed recurrence. There was no statistically significant difference between the two groups (χ2 =1. 013,P >0. 05). Conclusion ENCOR vacuum - assisted breast minimally invasive revolving system in the treatment of breast tiny tumors has advantages of less trauma and pain,rapid recovery,etc,it is safe and effective.
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Objective To analyze the prognostic factors of adrenal tumor in children under 12 years of age. Methods A total of 90 children with 97 adrenal tumors admitted from June 2006 to August 2017 were selected in Children's Hospital of Nanjing Medical University.The age distribution,tumor type,biochemistry and tumor indicators, treatment,stage classification and prognosis were analyzed.Results There were 46 males and 44 females in 90 cases. Ages ranged from 4 days to 11 years and 1 month,with an average of (38.1 ± 31.3)months.The main clinical mani-festations were abdominal mass,fever and abdominal pain.Eighty cases (82.5%)underwent surgery,while 17 cases (17. 5%)did not.Open resection was performed in 48 cases,open partial resection in 11 cases,laparoscopic surgery in 10 cases,and just biopsy in 11 cases.The pathological examination showed 43 cases with neuroblastoma,13 cases with ganglioneuroblastoma,8 cases with ganglioneuroma,5 cases with adrenocortical carcinoma,3 cases with teratoma,1 case with pheochromocytoma,1 case with malignant rhabdoid tumor.Statistical analysis revealed that neuron－specific eno-lase(NSE)value of neuroblastoma and lactate dehydrogenase(LDH)value of cortical cancer increased significantly. The age was correlated with tumor stage,and patients had older age on stage Ⅳ.Complete resection in surgery was correlated with the stage of the tumor,as tumor in lower tumor stage seemed easier to be completely removed.Fifty－three cases (58.9%)were followed up for 2 months up to 11 years and 4 months.Forty－four cases survived and 9 ca-ses died.Higher tumor stage predicated worse prognosis.Conclusions Adrenal gland tumors need early diagnosis and active treatment.Earlier onset of age,complete surgical resection with patients have better prognosis.Complete resection of the disease was a key factor in the prognosis.
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Objective To discuss the efficacy of laparoscopic ureteroureterostomy for upper pole hydronephro-sis and ureteral dilatation in children with complete duplex kidney.Methods The clinical data of 14 patients (15 units in total)who underwent laparoscopic ureteroureterostomy from April 2016 to October 2017 were retrospectively analyzed. Nine out of 14 cases had repeated urinary tract infections(UTI)and other symptoms[6 cases in group A:patients without vesicoureteral reflux(VUR)but presenting urinary tract infection (UTI)symptoms,3 cases in group C:patients diagnosed with VUR];5 cases of asymptomatic patients were selected as group B.All the 14 cases had upper pole hydronephrosis and ureteral dilatation.Preoperative examinations included ultrosonograpy,urinary magnetic resonance urography(MRU), intravenous pyelography (IVP),voiding cystourethrogram(VCUG),and nuclear renal scanning.It was found that 4 cases had ureterocele;3 cases had recurrent cystoureteral reflux (group C)before operation,and 1 case had cystoureteral re-fluxed after replantation.Results Laparoscopic surgery was successful in all of 14 children.None of them were shifted to open surgery because of abdominal viscera injury bleeding.The operation duration was 85－140 min.The average posto-perative hospital stay was 5.58 days.There was neither urinary anastomotic leakage nor UTI.Fourteen cases were followed up and the postoperative follow－up period was 7－23 months.No cases developed urinary tract infection except 2 cases with vescioureteral reflux.Ultrasound examination showed that the upper renal parenchyma of 5 children was thicker,ul-trasonography showed that upper pole hydronephrosis was better and ureteroceles were smaller.There was no complication such as lower pole hydronephrosis.The symptoms of urinary tract infection disappeared after operation.Conclusions Laparoscopic ureteroureterostomy can treat renal duplication with less trauma,and it is safe and effective.It can be one of therapeutic regimen to treat low－functional upper pole hydronephrosis and ureteral dilatation in renal duplication.Howe-ver,this procedure cannot be used for vescoureteral reflux cases because of high rate of stump infection.
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Splenic lymphoma with villous lymphocytes (SLVL) or splenic marginal zone lymphoma with circulating villous lymphocytes is rare, and prolymphocytic transformation of SLVL is rarer. At present, only one case of SLVL with t(8;14)(q24;q32) translocation has been reported. In this study, we report a case of B-lymphoproliferative disorder with villous lymphocytes harboring t(8;14)(q24;q32) chromosome translocation that we inclined to SLVL with a prolymphocytic transformation. A 73-year-old female showed marked hepatosplenomegaly and high lymphocytosis (lymphocytes > 200 × 10/L). The abnormal lymphocytes had short coarse villi and round nuclei with prominent nucleoli. The immunophenotypes showed CD19, CD20, HLA-DR, CD22, CD5, Kappa, CD25, CD71, Lambda, CD7, CD10, CD23, CD34, CD33, CD13, CD14, CD117, CD64, CD103, and CD11c. The karyotype showed complex abnormality: 46XX,+ 3,-10, t(8;14)(q24; q32)[11]/46XX[9]. The cytoplasmic projection, immunological characteristics, and trisomy 3 chromosome abnormality supported the diagnosis of SLVL. However, the presence of prominent nucleoli and high lymphocytosis suggested prolymphocytic transformation, probably as a result of t(8,14) chromosome translocation. In this report, we described an unusual case of B-lymphoproliferative disorder with villous lymphocytes harboring t(8;14)(q24;q32) translocation, which could provide help in the diagnosis and differential diagnosis of B-lymphocytic proliferative diseases.
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Aged , B-Lymphocytes , Pathology , Female , Humans , Immunophenotyping , Lymphoproliferative Disorders , Genetics , Pathology , Translocation, GeneticABSTRACT
Objective To observe the efficacy of sequential dialysis combined with hydroxyethyl starch in the treatment of patients with refractory edema of nephrotic syndrome.Methods Eighty-eight patients with refractory edema of nephrotic syndrome were randomly divided into control group (n =44) and combination group (n =44)according to the digital table.The control group was treated with hydroxyethyl starch,and the combination group was treated with sequential dialysis combined with hydroxyethyl starch.The levels of urinary NAG,urinary KIM-1 and serum ICAM-1,TNF-,IL-6 were compared.And the clinical efficacy of the two groups was evaluated.Results The improvement time of clinical symptoms in the observation group was significantly shorter than that in the control group,and the average weight loss of the observation group was significantly higher than that of the control group(t =7.099,9.279,all P ＜ 0.05).Before treatment,the 24h urine,24h urine protein,Scr and BUN between the two groups had no statistically significant differences (all P ＞ 0.05).Compared with before treatment,24h urine of the two groups after treatment was increased (tcombination group =36.266,P ＜ 0.05;tcontrol group =7.906,P ＜ 0.05),and the 24h urine protein,Scr and BUN levels of two groups were decreased after treatment (tcombination group =21.031,25.629,26.099,P ＜0.05;tcontrol group =9.263,6.544,5.716,all P ＜ 0.05),and the improvement of the above indicators of the combination group was more significant (t =28.672,17.639,19.057,16.507,all P ＜ 0.05).The effective rate of the combination group was higher than that of the control group(x2 =8.494,P ＜ 0.05).Compared with before treatment,the urinary NAG enzyme and urinary KIM-1 of the combination group were statistically significantly decreased (tcombination group =29.146,19.256,all P ＜ 0.05).There were no statistically significant differences in urinary NAG and urinary KIM-1 between before treatment and after treatment in the control group (all P ＞ 0.05).After treatment,the serum levels of ICAM-1,TNF-and IL-1 β in the combination group were significantly lower than those before treatment and those in the control group (tcombination group=15.655,16.882,16.091,all P ＜ 0.05),while there were no statistically significant differences in the serum levels of ICAM-1,TNF-and IL-1β between before treatment and after treatment in the control group (all P ＞ 0.05).Conclusion Sequential dialysis combined with hydroxyethyl starch in the treatment of refractory edema of nephrotic syndrome can improve the clinical curative effect and improve the renal function of patients.It is worthy to be further promoted.
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Objective To observe the effects of dexmedetomidine on intraoperative wake-up test in Brucellar spondylitis (BS) patients undergoing surgical operation.Methods Using the case control method,thirty-two patients undergoing BS surgical operation from January 2014 to December 2017 in Harbin the Fifth Hospital were enrolled in this study,the patients were randomly classified into the experimental group (n =16) and the control group (n =16).The two groups were anesthetized with midazolam,propofol,sufentanil and cisatracurium,then anesthesia was maintained with sevoffurane inhalation and a continuous intravenous infusion of remifentanil.In the experimental group,dexmedetomidine 0.4 μg· kg-1·h-1 was administered after tracheal intubation,while equal volume saline solution was given to control group.When the wake-up test was performed,the values of mean arterial pressure (MAP),heart rate (HR) and bispectral index (BIS) were recorded at the time points of preinduction (T0),just before wake-up (T1) and awakening (T2).The wake-up time,the amount of bleeding during the wake-up period,the wake-up quality rating and the sedation score were recorded.Results There was significant difference in HR and MAP at T0,T1 versus at T2 in control group [(98.8 ± 21.0) time/min vs (84.5 ± 8.1),(81.8 ± 1.7) time/min,(90.2 ± 7.5) mmHg vs (76.2 ± 5.7),(74.6 ± 8.5) mmHg,1 mmHg =0.133 kPa,P ＜ 0.05].In experimental group,HR and MAP were lower than those in control group at T2,and the difference between the two groups was statistically significant [(86.3 ± 12.3) time/min vs (98.8 ± 21.0) time/min,(77.9 ± 6.3) mmHg vs (90.2 ± 7.5) mmHg,t =-2.901,-4.995,P ＜ 0.05).The wake-up test quality was significantly better in test group than that in control group,the difference was statistically significant (excellent:13 cases vs 4 cases,good:2 cases vs 6 cases,poor:1 case vs 6 cases,x2 =4.571,P ＜ 0.05).The wake-up time and the amount of bleeding during wake-up period were less than that in control group,the difference was statistically significant [(14.5 ± 3.6) min vs (26.1 ± 4.5) min,(239.8 ± 53.9) ml vs (317.3 ± 54.8) ml,t =-7.980,-4.032,P ＜ 0.05].Conclusion Dexmedetomidine when continuous pumped at a rate of 0.4 μg· kg-1· h-1 could reduce the hemodynamic stress response during the wake-up test,improve the wakeup test quality,shorten the wake-up time and effectively improve the safety factor of operation during Brucellar surgical operation.
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The rapid development of aging has brought new challenges to the elderly nursing service.Traditional nursing education is difficult to meet the needs of elderly nursing personnel cultivation.The training experience of other countries will provide a reference for the training of elderly nursing talents in China,so as to meet the needs of the society.This paper analyzes the current status of the geriatric nursing personnel cultivation in the United States from three aspects:the elderly nursing education in the United States,the training of the senior practice nurses and the training of the elderly nursing teachers,and according to the national conditions of our country,it is pointed out that the training of elderly nursing personnel should pay attention to curriculum setting to cultivate senior nursing professionals,pay attention to professional qualification certification and train advanced specialist nurses in geriatric nursing,pay attention to evidence-based practice and train characteristic TCM nurses in geriatric nursing,pay attention to teachers' leadership and cultivate high-level talents especially elites in geriatric nursing.
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Objective To investigate the correlation between myocardial fibrosis evaluated by cardiac magnetic resonance (CMR)T1 mapping and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in elderly patients with ischemic cardiomyopathy (ICM).Methods The 56 hospitalized patients with ICM(ICM group)and 20 healthy volunteers(control group)were recruited in cardiology department of Henan Provincial People's Hospital from April 2014 to June 2017.Clinical data,serum NT-proBNP detection,CMR T1 mapping and contrast-enhanced scan were determined,retrospectively collected and compared between two groups.The differences in myocardial extracellular volume fraction(ECVF)and NT-proBNP levels were compared among the control group,the ICM group and the ICM subgroups with different degree of cardiac dysfunction.The correlation between ECVF and NT-proBNP level was analyzed.Results The levels of ECVF and NT-proBNP were significantly higher in ICM group than in control group[(35.1t6.2)％ vs.(25.3±2.2)％ for ECVF,and(3 902.7± 1 670.3)ng/L vs.(280.5± 140.5)ng/L for NT-proBNP,t =6.917 and 9.645 respectively,both P＜0.01].Along with NYHA Functional Class upgrade of Ⅱ to Ⅲ] to Ⅳ of the ICM subgroups,the levels of ECVF and NT-proBNP were significantly increased (F =18.372 for ECVF,61.82 for NT-proBNP,all P＜0.01).There was a positive correlation between ECVF and NT-proBNP level in ICM patients (r =0.666,P ＜ 0.05).Conclusions Serum NT-proBNP level is correlated with the degree of myocardial fibrosis,which might be used as an indicator of myocardial fibrosis in ICM patients.