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1.
Chinese Journal of Neurology ; (12): 1109-1118, 2021.
Article in Chinese | WPRIM | ID: wpr-911843

ABSTRACT

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

2.
Chinese Journal of Radiology ; (12): 1172-1177, 2021.
Article in Chinese | WPRIM | ID: wpr-910281

ABSTRACT

Objective:To explore the application value of the method of judging the density of small shadows in the lung area by using CT and CT reference films for pneumoconiosis.Methods:The chest imaging data of 244 employees of a large copper company in Tongling City, Anhui Province who underwent occupational physical examination at Tongling Municipal Hospital in Anhui Province from January 2016 to December 2019 were retrospectively analyzed. Totally 244 cases underwent chest CT scan and chest DR radiography at the same time. The shape and size of the small shadows (the size of the circular and quasi-circular nodules in the lung area were represented by p, q, r, and the size of the irregular small shadows were represented by s, t, u), the overall density, the density of small shadows in each lung area, the large shadows, and the diagnosis stage were observed and compared. The small shadow density of each lung area was judged by the method of judging the small shadow density of CT lung area and the reference film, and other observation indicators were judged according to GBZ70-2015 Diagnosis of Occupational Pneumoconiosis. Results:There was a significant difference between CT and DR in judging s-shaped small shadows and no small shadows ( P<0.05), and there was no statistically significant difference in judging p, q, r, t, and u-shaped small shadows ( P>0.05). CT and DR had medium to high consistency in the judgment of the overall density of small shadows (Kappa=0.692, P=0.001), and the diagnostic coincidence rate was 82.38% (201/244). There was moderate to high agreement between CT and DR in the density of small shadows shown in the right upper, right lower, left upper, left middle, and left lower lung regions (Kappa ranged from 0.40 to 0.75, P<0.05), and the consistency in the right middle lung region was poor (Kappa=0.381, P=0.001). Eleven large shadows were detected in 8 cases by DR, 31 large shadows were detected in 23 cases by CT, and 20 (8.20%) large shadows were detected more frequently by CT than DR. The agreement between CT and DR for the diagnosis and staging of silicosis was excellent (Kappa=0.843, P=0.001), and the diagnostic coincidence rate was 91.80% (224/244). Conclusion:Applying the method of determining the density of small shadows in the lung area of pneumoconiosis and reference films, combined with GBZ70-2015 Diagnosis of Occupational Pneumoconiosis, can make a more accurate diagnosis of silicosis.

3.
Article in Chinese | WPRIM | ID: wpr-884833

ABSTRACT

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

4.
China Pharmacy ; (12): 364-369, 2021.
Article in Chinese | WPRIM | ID: wpr-872691

ABSTRACT

OBJECTIVE:To provide reference for the ra tional use of carbap enems in tuberculosis patients. METHODS :Totally 12 576 tuberculosis inpatients were collected from our hospital. Multi-disciplinary team (MDT) model was adopted for carbapenems management in aspects of policy intervention ,technical support and staff training. Average hospitalization duration , mortality,nosocomial infective rate ,use and drug resistance of carbapenems were compared before (Mar. 2016-Mar. 2017)and after management (Apr. 2017 to Mar. 2019). Interrupted time series (ITS)analysis was used to analyze the utilization rate of carbapenems,DDDs,the proportion of carbapenems ’DDDs in the total antibiotics ’DDDs,the proportion of carbapenems ’cost in the total antibiotics ’cost before and after management. Pearson correlation analysis was conducted for DDDs of carbapenems with medical quality indicators and detection rate of carbapenems-resistant bacteria. RESULTS :After the management ,average hospitalization stay ,the cost of antibiotics ,DDDs of carbapenems ,the proportion of carbapenems ’DDDs in the total antibiotics ’ DDDs,the proportion of carbapenems ’cost in the total antibiotics ’cost,the utilization rate of carbapenems ’,and the drug resistance rate of some bacteria to carbapenems were significantly lower than those before the management (P<0.05). ITS analysis results showed that after management ,the utilization rate of carbapenems ,DDDs,the proportion of com carbapenems’DDDs in the total antibiotics ’DDDs and the proportion of carbapenems ’cost in the total antibiotics ’cost hhyyzj@126.com were decrease d by 4.491% ,220.276,6.535% ,11.747% , with statistical significance (P<0.05). Co mpared with before management ,above indexes were decreased by 0.330%,17.625, 0.308%,0.304% monthly,among which the utilization rate and DDDs of carbapenems were decreased significantly (P<0.05). Before management ,drug resistance rate of Pseudomonas aeruginosa to carbapenems was 21.80%,and those of Acinetobacter baumannii to meropenem and imipenem were both 4.60%;after management ,drug resistance rate of P. aeruginosa to imipenem was 13.00%,and those of A. baumannii to meropenem and imipenem were both 16.30%,with statistical significance before and after management (P<0.05). There was no statistical significance in drug resistance rate of Enterobacteriaceae (P>0.05). Pearson correlation analysis showed that carbapenems ’DDDs was significantly positively correlated with average hospitalization duration and antibiotics ’cost(P<0.05);imipenem’s DDDs was positively correlated with drug resistance rate of P. aeruginosa (P<0.05). CONCLUSIONS: MDT management can effectively standardize the use of carbapenem in tuberculosis patients , shorten hospitalization duration ,and reduce drug cost ,DDDs and drug resistance rate of some bacteria.

5.
Article in English | WPRIM | ID: wpr-888510

ABSTRACT

To explore the effects of pre-pregnancy body mass index (BMI), weight gain and blood lipid level during pregnancy on pregnancy outcome in patients with and without gestational diabetes mellitus(GDM). A total of 12 650 singleton pregnant women without history of hypertension and diabetes who were admitted at Women's Hospital, Zhejiang University School of Medicine for delivery from January 2018 to April 2019 were enrolled in the study. There were 2381 cases complicated with gestational diabetes (GDM group) and 10 269 cases without GDM (non-GDM group). The pre-pregnancy BMI and weight gain during pregnancy were documented in two groups. The factors related to perinatal outcome were analyzed. In both GDM and non-GDM pregnant women, pre-pregnancy overweight and excessive weight gain during pregnancy were independent factors of large for gestational age infant (LGA), small for gestational age infant (SGA) and first cesarean section (<0.01 or <0.05). Excessive weight gain during pregnancy was also an independent risk factor of preeclampsia (<0.05). Triglyceride levels in the second trimester were independently associated with multiple adverse pregnancy outcomes, such as LGA, preeclampsia, initial cesarean delivery, premature delivery. Controlling excessive or insufficient weight gain during pregnancy can significantly reduce the incidence of LGA and SGA. And controlling BMI before pregnancy can effectively reduce the incidence of LGA, preeclampsia and the first cesarean section. For non-GDM pregnant women, abnormal blood lipid levels in the second trimester may be closely related to multiple adverse pregnancy outcomes, and active dietary guidance or treatment is also required.


Subject(s)
Body Mass Index , Cesarean Section , Diabetes, Gestational/epidemiology , Female , Humans , Lipids , Pregnancy , Pregnancy Outcome , Weight Gain
6.
Article in English | WPRIM | ID: wpr-888507

ABSTRACT

To investigate the impact of family history of diabetes (FHD) on blood glucose, lipid levels and perinatal outcomes in pregnant women with gestational diabetes mellitus (GDM). A total of 1265 GDM women who gave childbirth in Women's Hospital, Zhejiang University School of Medicine during January to December 2019 were enrolled in the study, including 253 women with FHD and 1012 women without FHD. The -test or test were used to compare the blood lipid, blood glucose levels and perinatal outcomes including large for gestational age infant, small for gestational age infant, macrosomia, cesarean delivery, preeclampsia, preterm labor, postpartum hemorrhage, fetal distress. The correlation between FHD and perinatal outcomes were estimated by Logistic regression analysis. The high density lipoprotein level at third-trimester was significantly lower in GDM women with FHD (<0.05); and the women with FHD also had higher fasting blood glucose oral glucose tolerance test (OGTT)1 h, OGTT 2 h and glycosylated hemoglobin level (all <0.01). In GDM women, FHD was an independent risk factor for preeclampsia (=3.27, 95%: 1.39-7.68). GDM women with FHD have lower high density lipoprotein and higher glucose levels. FHD is an independent risk factor for preeclampsia in GDM women.


Subject(s)
Blood Glucose , Diabetes, Gestational , Female , Glucose Tolerance Test , Humans , Infant, Newborn , Lipids , Pregnancy , Pregnant Women , Risk Factors
7.
Article in English | WPRIM | ID: wpr-888502

ABSTRACT

To explore the correlation of mid-term oral glucose tolerance test (OGTT) and maternal weight gain with adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM). A total of 2611 pregnant women with GDM who were examined and delivered in Women's Hospital, Zhejiang University School of Medicine from July 1st 2017 to 30th June 2018 were enrolled in this study. According to the number of abnormal items of mid-term OGTT results or maternal gestational weight gain (GWG), patients were classified. The incidence of adverse perinatal outcomes in each group and its relation with OGTT results and GWG were analyzed. The incidence of gestational hypertension, premature delivery, macrosomia and large for gestational age infant (LGA) in three abnormal items GDM patients were significantly higher than those in one or two abnormal items GDM patients (all <0.017). The incidence of gestational hypertension and premature delivery in two abnormal items GDM patients were higher than those in one abnormal item GDM patients (all <0.017). The incidence of gestational hypertension and macrosomia in excessive GWG patients were significantly higher than those in inadequate and appropriate GWG patients (all <0.017), and the incidence of LGA were higher than that in inadequate GWG patients (all <0.017). The incidence of premature delivery and low birth weight infants in appropriate GWG patients were significantly lower than those in inadequate and excessive GWG patients, and the incidence of small for gestational age infant (SGA) were significantly lower than that in inadequate GWG patients (all <0.017). In one abnormal item GDM patients, inadequate GWG was a risk factor for premature delivery and SGA (=1.66, 95%: 1.10-2.52; =2.20, 95%: 1.07-4.53), and protective factor for LGA (=0.40, 95%: 0.27-0.59). And excessive GWG was a risk factor for gestational hypertension, premature delivery and low birth weight infants (=2.15, 95%: 1.35-3.41; =1.80, 95%: 1.20-2.72; =2.18, 95%: 1.10-4.30).In two abnormal items GDM patients, inadequate GWG was a protective factor for macrosomia and LGA (=0.24, 95%: 0.09-0.67; =0.54, 95%: 0.34-0.86), while excessive GWG was risk factor for premature delivery (=1.98, 95%: 1.23-3.18).In three abnormal items GDM patients, there was no significant relationship between GWG and adverse pregnancy outcomes. For GDM women with one or two items of elevated blood glucose in OGTT, reasonable weight management during pregnancy can reduce the occurrence of adverse pregnancy outcomes. For those with three items of elevated blood glucose in OGTT, more strict blood glucose monitoring and active intervention measures should be taken in addition to weight management during pregnancy.


Subject(s)
Blood Glucose , Blood Glucose Self-Monitoring , Body Mass Index , Diabetes, Gestational/epidemiology , Female , Gestational Weight Gain , Glucose Tolerance Test , Humans , Pregnancy , Pregnancy Outcome
8.
Article in Chinese | WPRIM | ID: wpr-799452

ABSTRACT

Objective@#To assess the superiority of 99Tcm-3SPboroxime (99Tcm-3SP for short) as a fast-myocardial perfusion imaging (MPI) tracer in normal and acute myocardial infarction (AMI) mini-swine.@*Methods@#99Tcm-3SP and 99Tcm-Teboroxime (99Tcm-TEBO for short) were prepared. Approximately 370 MBq 99Tcm-3SP or 99Tcm-TEBO was injected intravenously in 2 healthy mini-swine separately. Dynamic planar images were acquired immediately after injection and continued for 20 min using a standard SPECT camera. The radioactivity uptakes in the heart, liver, and lungs were measured, and heart/liver and heart/lung ratios over time were calculated. Dynamic SPECT studies were performed in 4 normal swine and 1 AMI-swine using cadmium zinc telluride-SPECT (CZT-SPECT). List mode acquisitions were immediately started and continued for 15 min after intravenous injection of approximately 370 MBq 99Tcm-TEBO and 99Tcm-3SP. The injection of two radiotracers in the same swine was completed within 2 d. The radioactivity uptakes in heart and liver were measured, and heart/liver ratio was calculated. Image quality was also evaluated. Paired t test was used to analyze the data.@*Results@#The radiochemical purity of 99Tcm-TEBO or 99Tcm-3SP were both above 95%. The initial heart uptake of 99Tcm-3SP was very close to that of 99Tcm-TEBO (planar image, 2 min postinjection: 309.32×103 vs 314.13×103 counts/MBq; SPECT image, 2 min postinjection (corrected): 7.96±0.87 vs 8.24±1.53, t=0.277, P>0.05), but the myocardial retention time was much longer than that of 99Tcm-TEBO (planar image, 20 min postinjection: 218.67×103 vs 143.19×103 counts/MBq; SPECT image, 15 min postinjection (corrected): 6.76±0.45 vs 5.06±0.33, t=-12.412, P=0.001). The uptake of liver and heart/liver ratio between 99Tcm-TEBO and 99Tcm-3SP were similar (t values: -1.332-1.101, all P>0.05 within 15 min). SPECT MPI images demonstrated uniform tracer distribution with clearly visualizable myocardial boundary in normal myocardium and intense perfusion defect in infarct myocardium. High quality SPECT images could be obtained in any of the 5 min imaging windows over the first 15 min after injection of 99Tcm-3SP in normal swine and AMI-swine.@*Conclusion@#99Tcm-3SP is a promising 99Tcm-labeled radiotracer for fast-MPI considering its high heart uptake, long myocardial retention time (20 min postinjection) and superior SPECT image quality.

9.
Article in Chinese | WPRIM | ID: wpr-867122

ABSTRACT

Objective:To explore the relationship between early maladaptive schemas, defense styles and mental health in patients with depression, and to investigate the mediating effects of defense styles between early maladaptive schemas and mental health.Methods:A total of 87 outpatients with depression were assessed with the Young schema questionnaire-short form 2(YSQ-SF2), defense style questionnaire(DSQ), symptom checklist-90(SCL-90) and Beck depression inventory(BDI). SPSS Process program and Bootstrap method were used to explore the mediating effect of defense styles.Results:The scores of abandonment/instability were higher in females than those in males (2(0.5, 4), 0(0, 1.25), Z=-2.963, P=0.003) while the score of emotional inhibition was higher in males than in females (1(0, 3), 0(0, 2), Z=-2.318, P=0.02). The total score of SCL-90 was positively predicted by vulnerability to harm or illness and emotional deprivation, with an explanatory variation rate of 27.7%.The number of SCL-90 positive items was positively predicted by social isolation/alienation and abandonment/instability, with an explanatory variation rate of 19.3%.Immature defense styles fully mediate the relationship between social isolation/alienation and mental health, as well as between abandonment/instability and mental health. Conclusion:Social isolation/alienation and abandonment/instability affect the mental health of patients with depression by the mediating effect of immature defense styles.

10.
Article in Chinese | WPRIM | ID: wpr-869131

ABSTRACT

Objective To assess the superiority of 99Tcm-3SPboroxime (99Tcm-3SP for short) as a fast-myocardial perfusion imaging (MPI) tracer in normal and acute myocardial infarction (AMI) mini-swine.Methods 99Tcm-3SP and 99Tcm-Teboroxime (99Tcm-TEBO for short) were prepared.Approximately 370 MBq 99Tcm-3SP or 99Tcm-TEBO was injected intravenously in 2 healthy mini-swine separately.Dynamic planar images were acquired immediately after injection and continued for 20 min using a standard SPECT camera.The radioactivity uptakes in the heart,liver,and lungs were measured,and heart/liver and heart/lung ratios over time were calculated.Dynamic SPECT studies were performed in 4 normal swine and 1 AMI-swine using cadmium zinc telluride-SPECT (CZT-SPECT).List mode acquisitions were immediately started and continued for 15 min after intravenous injection of approximately 370 MBq 99Tcm-TEBO and 99Tcm-3SP.The injection of two radiotracers in the same swine was completed within 2 d.The radioactivity uptakes in heart and liver were measured,and heart/liver ratio was calculated.Image quality was also evaluated.Paired t test was used to analyze the data.Results The radiochemical purity of 99Tcm-TEBO or 99Tcm-3SP were both above 95%.The initial heart uptake of 99Tcm-3SP was very close to that of 99Tcm-TEBO (planar image,2 min postinjection:309.32× 103 vs 314.13 × 103 counts/MBq;SPECT image,2 min postinjection (corrected):7.96±0.87 vs 8.24± 1.53,t =0.277,P>0.05),but the myocardial retention time was much longer than that of 99Tcm-TEBO (planar image,20 min postinjection:218.67× 103 vs 143.19× 103 counts/MBq;SPECT image,15 min postinjection (corrected):6.76±0.45 vs 5.06±0.33,t =-12.412,P =0.001).The uptake of liver and heart/liver ratio between 99Tcm-TEBO and 99Tcm-3SP were similar (t values:-1.332-1.101,all P>0.05 within 15 min).SPECT MPI images demonstrated uniform tracer distribution with clearly visualizable myocardial boundary in normal myocardium and intense perfusion defect in infarct myocardium.High quality SPECT images could be obtained in any of the 5 min imaging windows over the first 15 min after injection of 99Tcm-3SP in normal swine and AMI-swine.Conclusion 99Tcm-3SP is a promising 99 Tcm-labeled radiotracer for fast-MPI considering its high heart uptake,long myocardial retention time (20 min postinjection) and superior SPECT image quality.

11.
Article in Chinese | WPRIM | ID: wpr-797605

ABSTRACT

Objective@#To explore the socioeconomic status and psychological characteristics of the children with oppositional defiant disorder(ODD), and to provide evidence for revealing the pathogenesis of ODD.@*Methods@#General Conditions Questionnaire and Achenbach Children′s Behavior Checklist Scale (CBCL) were used to evaluate 44 cases of ODD children aged 8 to 14 years old who were first referred to the Eighth People′s Hospital of Zhengzhou City from August 2016 to January 2017, and 50 healthy children were randomly selected according to their grades from a primary school in Zhengzhou.Chi-square test and independent sample t test were used to analyze data.@*Results@#The father′s and mother′s education levels and family per capita income in ODD group were lower than those in healthy control group, and their academic achievements in ODD group were worse than those in healthy control group, and the diffe-rences were statistically significant(all P=0.000). The scores of schizoid (2.32±2.73), depression(4.48±6.12), social problems(3.09±3.34), compulsion(4.05±5.60), social withdrawal(2.39±3.20), hyperactivity(4.95±4.37), aggressive behavior(7.59±7.62) and rule-breaking(2.91±3.85) in ODD children were higher than those of the healthy control group(1.04±1.37, 1.48±2.06, 0.68±1.13, 0.78±1.46, 0.60±1.16, 1.70±1.98, 2.48±3.28, 0.62±1.58), and the differences were statistically significant(all P<0.05). The scores of social problems(2.85±3.33), compulsion(3.96±5.11), social withdrawal(2.63±3.16), hyperactivity(5.44±4.50) in male ODD children were higher than those in the male healthy children(0.80±1.05, 1.30±1.92, 0.95±1.50, 2.15±1.56), and the differences were statistically significant(all P<0.05). Compared with the female children(0.83±1.22, 1.10±1.84, 0.60±1.18, 0.43±0.92, 0.53±1.09, 0.37±0.80, 1.40±2.17, 1.87±2.14, 0.30±0.78), the scores of schizoid(2.24±2.64), depression(4.65±4.93), social problems(3.47±3.37), compulsion(4.18±6.38), somatic complaints(2.12±3.65), social withdrawal (2.00±3.26), hyperactivity(4.18±4.12), aggressive behavior (8.24±7.26) and rule-breaking(3.76±4.85) in female ODD children were significantly higher, and the differences were statistically significant(all P<0.05). There was no significant gender difference in the score of CBCL scale in ODD group(all P>0.05).@*Conclusions@#There are significant emotional and behavioral problems in ODD children whose family socioeconomic status is lower, and their psychological characteristics vary with gender differences.

12.
Chinese Journal of Hepatology ; (12): 527-532, 2019.
Article in Chinese | WPRIM | ID: wpr-810760

ABSTRACT

Objective@#To observe the expressional changes in Notch signaling pathway and toll-like receptor 4 (TLR4) and their interactions on the functions of CD14+ monocytes in chronic hepatitis C patients.@*Methods@#A total of 24 treatment-naïve chronic hepatitis C cases and 10 healthy individuals, who visited Shaanxi Provincial People's Hospital from August to October 2017, were enrolled. Selected CD14+ monocytes were stimulated by the Notch signaling pathway inhibitor DAPT or transfected with TLR4 siRNA, and the levels of Notch1, Notch2, Hes1 and Hes5 mRNA were detected by real-time quantitative PCR. TLR4 protein levels and phosphorylation of NF-κB was detected by Western blot. ELISA was used to detect the level of cytokines secreted from CD14+ monocytes. A t-test or paired t-test was used for comparison between groups.@*Results@#The relative expression of Notch1 mRNA (3.97 ± 2.03 vs. 0.91 ± 0.76, P < 0.01) and downstream of Notch signaling pathway (5.96 ± 2.31 vs. 0.99 ± 0.45, P < 0.01), Hes1 mRNA and Hes5 mRNA (4.31 ± 1.05 vs. 0.84 ± 0.20, P < 0.01) in CD14+ monocytes of chronic hepatitis C patients was significantly higher than that of healthy individuals. The relative expression of TLR4 mRNA (5.14 ± 1.09 vs. 1.27 ± 0.39) and protein level in CD14+ monocytes of chronic hepatitis C patients were significantly higher than those of healthy individuals (P < 0.01). An inhibition of Notch signaling pathway with DAPT had reduced the relative expression level of TLR4 mRNA (2.58 ± 1.36 vs. 4.34 ± 1.88, P < 0.05), protein expression and phosphorylation of NF-B in CD14+ monocytes of chronic hepatitis C patients. Furthermore, the secretion level of MCP-1 [(94.32 ± 23.59) pg/ml vs. (64.07 ± 9.39) pg/ml, P < 0.01] and IL-8 [(12.54 ± 4.89) pg/ml vs. (7.92 ± 3.01) pg/ml, P < 0.05] was significantly reduced. TLR4 siRNA transfection reduced the expressions of Notch1 mRNA (2.09 ± 1.72 vs. 3.73 ± 1.75, P < 0.05), Hes1 (2.87 ± 0.84 vs. 5.54 ± 0.97, P < 0.01), and Hes5 (2.89 ± 0.93 vs. 4.51 ± 1.54, P < 0.01) in CD14+ monocytes of chronic hepatitis C patients.@*Conclusion@#Interaction of Notch signaling pathway with TLR4 can promote the function of CD14+ monocytes in chronic hepatitis C patients.

13.
Article in Chinese | WPRIM | ID: wpr-752278

ABSTRACT

Objective To explore the socioeconomic status and psychological characteristics of the children with oppositional defiant disorder(ODD),and to provide evidence for revealing the pathogenesis of ODD.Methods General Conditions Questionnaire and Achenbach Children's Behavior Checklist Scale (CBCL) were used to evaluate 44 cases of ODD children aged 8 to 14 years old who were first referred to the Eighth People's Hospital of Zhengzhou City from August 2016 to January 2017,and 50 healthy children were randomly selected according to their grades from a primary school in Zhengzhou.Chi-square test and independent sample t test were used to analyze data.Results The father's and mother's education levels and family per capita income in ODD group were lower than those in healthy control group,and their academic achievements in ODD group were worse than those in healthy control group,and the differences were statistically significant(all P =0.000).The scores of schizoid (2.32 ± 2.73),depression(4.48 _± 6.12),social problems (3.09 ± 3.34),compulsion (4.05 ± 5.60),social withdrawal (2.39 ± 3.20),hyperactivity (4.95 ±4.37),aggressive behavior(7.59 ± 7.62) and rule-breaking(2.91 ± 3.85) in ODD children were higher than those of the healthy control group(1.04 ± 1.37,1.48 ± 2.06,0.68 ± 1.13,0.78 ± 1.46,0.60 ± 1.16,1.70 _± 1.98,2.48 ±3.28,0.62 ± 1.58),and the differences were statistically significant (all P < 0.05).The scores of social problems (2.85 ± 3.33),compulsion (3.96 ± 5.11),social withdrawal (2.63 ±3.16),hyperactivity (5.44 _± 4.50) in male ODD children were higher than those in the male healthy children (0.80 ± 1.05,1.30 ± 1.92,0.95 ± 1.50,2.15 ±1.56),and the differences were statistically significant (all P < 0.05).Compared with the female children (0.83 ±1.22,1.10 ±1.84,0.60 ± 1.18,0.43 ±0.92,0.53 ± 1.09,0.37 ±0.80,1.40 ±2.17,1.87 ±2.14,0.30 ±0.78),the scores of schizoid (2.24 _± 2.64),depression (4.65 ± 4.93),social problems (3.47 ± 3.37),compulsion (4.18 ±6.38),somatic complaints (2.12 ± 3.65),social withdrawal (2.00 ± 3.26),hyperactivity (4.18 ± 4.12),aggressive behavior (8.24 ± 7.26) and rule-breaking(3.76 ± 4.85) in female ODD children were significantly higher,and the differences were statistically significant(all P < 0.05).There was no significant gender difference in the score of CBCL scale in ODD group(all P > 0.05).Conclusions There are significant emotional and behavioral problems in ODD children whose family socioeconomic status is lower,and their psychological characteristics vary with gender differences.

14.
China Pharmacy ; (12): 2987-2992, 2019.
Article in Chinese | WPRIM | ID: wpr-817481

ABSTRACT

OBJECTIVE: To analyze the pathogenic characteristics and clinical features of patients with bloodstream infection in the First Affiliated Hospital of Baotou Medical College so as to provide reference for anti-infective treatment. METHODS: The positive rate of 6 052 blood culture specimens in our hospital collected during Jan 1st, 2016-Dec. 31st, 2018 were counted by retrospective study. WHONET 5.6 software was used to analyze clinical department, the distribution and drug resistance of pathogenic bacteria. The clinical data of 447 inpatients with bloodstream infection were collected in respect of gender, age, underlying disease, invasive operation, length of stay and prognosis (cured, uncured, dead). The patients were divided into two groups according to community acquired blood flow infection (CABSI) and hospital acquired blood flow infection (HABSI). The differences of the above clinical data between the two groups were analyzed by χ2 test. RESULTS: Total positive rate of     6 052 blood culture samples were 10.3% (623/6 052). The blood culture pathogens mainly came from infectious disease department (12.0%, 76/623), nephrology department (11.4%, 71/623), hematology department (10.8%, 67/623), surgery department (10.1%, 63/623). Of 623 strains of pathogens, Gram- negative bacteria accounted for 49.3%, Gram-positive bacteria accounted for 49.3%, and fungi accounted for 1.4%. The top six pathogens were Coagulase-negative Staphylococcus (36.5%), E. coli (26.6%), K. pneumoniae (13.0%), S. aureus (5.8%), Enterococcus (5.8%) and P. aeruginosa (2.9%). The detection rate of MRCNS was 75.3% in Coagulase-negative Staphylococcus (171/227) and that of MRSA was 25.0% in S. aureus (9/36), respectively. The sensitivity rate of Staphylococcus to rifampicin was higher than 90.0%, and the drug resistance rates of Enterococcus to penicillin G, ampicillin, high concentration of gentamicin, ciprofloxacin, levoflox acin and erythromycin were higher than or equal to 50.0%. No vancomycin-resistant gram positive bacteria were found. The prevalence of ESBLs-producing strains was 49.4% in E. coli (82/166) and 8.6% in K. pneumoniae (7/81). The sensitivity of E. coli to carbapenems was higher than 98.5%. The sensitivity rate of K. pneumoniae to carbapenems was 100%. The sensitivity rate of P. aeruginosa to carbapenems was higher than 90.0%. Among 447 hospitalized BSI patients, CABSI accounted for 49.2% and HABSI accounted for 50.8%. Distribution of underlying diseases (including diabetes mellitus, malignant tumor, hematological disease, urinary tract infection, liver disease, bitiary tract disease), invasive operation, the proportion of patients with length of hospital stay>2 weeks and death proportion were higher in HABSI group than CABSI group (P<0.05). CONCLUSIONS: The blood culture pathogens mainly came from infectious diseases department in our hospital. The most common pathogens were Coagulase negative Staphyococcus and E. coli. HABSI occurs more readily in immunocompromised patients and has a poor prognosis. Clinicians should reduce the use of invasive procedures and use appropriate antimicrobial agents for anti-infective treatment.

15.
Article in Chinese | WPRIM | ID: wpr-704109

ABSTRACT

Objective To explore the belief about medicines in patients with treatment-resistant de-pression ( TRD) and its influencing factors. Methods 106 patients with TRD were recruited to complete the survey of demographic characteristics,Hamilton Depression Scale-17 ( HAMD-17) and belief about Med-icine Questionnaire-Specific ( BMQ-S) . Results ①The score of BMQ-s was higher in TRD patients with medical insurance than that of patients with self-funded(rural social insurance(1.11±0.96),medical insur-ance(0.84±1.33),self expense(0.13±1.72),F=2.81,P<0.01).The score of BMQ-s was higher in TRD pa-tients with serious depression than that of patients with mild to moderate depression((1.07±1.19),(0.34± 1.41),t=2.77,P<0.01).The score of BMQ-s was higher in TRD patients with fewer episodes of depression than that of patients with more episodes of depression (0 time(1.10±0.99),once and twice(0.95±1.31),3 times and above(0.31±1.56),F=3.42,P<0.05).The score of BMQ-s was higher in TRD patients without stigma than those with stigma((1.03±1.21),(0.34±1.43),t=2.58,P<0.01).The score of BMQ-s was high-er in TRD patients with more knowledge about the antidepressant than that of patients with less knowledge (most of understanding(1.21±1.09),part of understanding(0.54±1.32),hardly understanding(0.33± 1.63) ,F=3.69,P<0.01) . The score of BMQ-s was higher in TRD patients without side effects of antidepres-sant than those with side effects ((1.04±1.24),(0.19±1.35),t=2.96,P<0.01). ②Stepwise multivariate linear regression analysis showed that payment methods,knowledge about the antidepressant,stigma about the antidepressant and episodes of depression were the influencing factors of BMQ-S in patients with TRD( all P<0.01) . Conclusion Different demographic characteristics and clinical features have different beliefs about antidepressant medication in patients with TRD.The payment methods,knowledge about the antidepressant, stigma about the antidepressant and episodes of depression are the influencing factors of BMQ in patients with TRD.

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Article in Chinese | WPRIM | ID: wpr-753828

ABSTRACT

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8% (134 951/190 610) and gram positive cocci 29.2% (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3% in S. aureus (MRSA) and 80.3% in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6% of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2% of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10% of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0% in 2005 to 20.9% in 2017, and meropenem-resistant K. pneumoniae increased from 2.9% in 2005 to 24.0% in 2017, more than 8-fold increase. About 66.7% and 69.3% of Acinetobacter (A. baumannii accounts for 91.5%) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.

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Article in Chinese | WPRIM | ID: wpr-735100

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Objective To explore the diagnosis and treatment of non-tuberculosis mycobacteria (NTM) infection after cosmetic injection via scientific debridement surgery combined with regular application of anti-NTM drugs.Methods 14 patients who were infected with NTM after cosmetic injection and were not cured over a long period of time in other hospitals from 2012 to 2016.The patients were treated with VSD thorough surgical debridement,the bacterial type of NTM was identified by bacterial culture and PCR identification and anti-NTM drugs were systematically used according to the results of drug sensitivity.Results Fourteen patients who were treated with scientific debridement surgeries combined with regular anti-NTM drug treatment in our hospital for 2-4 months were discharged after their skin lesions were cleared and healed and they were continually treated with antiNTM drugs for 12 months.Fourteen patients were completely cured by using the above treatments without severe side effects,such as liver and kidney dysfunction,nervous system disorders and so on.Only colpitis mycotica occurred in 3 patients.In addition,one patient presented the decrease of leukopenia after using anti-NTM drugs for 2 months and continued to complete the treatment after we adjusted the treatment plan to returning the level of leukopenia to the normal.These 14 patients were followed up for 1-5 years with no recurrence of the lesion.The facial appearance of 12 patients were almost normal with slight scars.The facial surgery area of 2 patients were uneven and nearly recovered to normal facial appearance by tissue transplantation and photoelectric therapy.Conclusions For the NTM patients caused by invasive procedures such as injection,the comprehensive treatment program,which combined scientific debridement surgery and systematically targeted drug treatment,not only can effectively cure NTM infection,but also minimize secondary injury and restore the patients' appearance,which is worthy of clinical application.

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Chinese Journal of Anesthesiology ; (12): 1099-1102, 2018.
Article in Chinese | WPRIM | ID: wpr-734630

ABSTRACT

Objective To evaluate the effect of ulinastatin on neuronal apoptosis in spinal cord af-ter peripheral nerve injury in mice. Methods A total of 225 healthy male SPF C57BL∕6J mice, aged 6-8 weeks, weighing 18-22 g, were divided into 3 groups ( n=75 each) using a random number table method:sham operation group ( group Sham), peripheral nerve injury group ( group PNI) and ulinastatin group ( group UTI) . The model of unilateral sciatic nerve transection was established in PNI and UTI groups. Uli-nastatin 10000 U∕kg was injected intraperitoneally once a day for 3 consecutive days in group UTI, while the equal volume of normal saline was given instead in Sham and PNI groups. The mice were sacrificed at 1, 3, 7, 14 and 28 days after administration ( T0-4 ) , and the L4-6 segments of the spinal cord were re-moved for examination of the pathological changes ( under the light microscope ) and for determination of neuronal apoptosis (by TUNEL) and expression of caspase-12, Bcl-2, Bax and activated caspase-3 (by Western blot) and expression of caspase-12 mRNA ( by real-time polymerase chain reaction) . Apoptosis in-dex ( AI) and Bcl-2∕Bax ratio were calculated. Results Compared with group Sham, AI was significantly increased, the expression of Bcl-2 was down-regulated, the expression of caspase-12, activated caspase-3 and Bax was up-regulated, and Bcl-2∕Bax ratio was decreased in PNI and UTI groups (P<0. 05). Com-pared with group PNI, AI was significantly decreased, the expression of Bcl-2 was up-regulated, the ex-pression of caspase-12, activated caspase-3 and Bax was down-regulated, and Bcl-2∕Bax ratio was in-creased in group UTI ( P<0. 05) . The pathological changes of the spinal cord were significantly attenuatedin group UTI than in group PNI. Conclusion Ulinastatin can inhibit neuronal apoptosis in the spinal cord after peripheral nerve injury in mice.

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Article in Chinese | WPRIM | ID: wpr-733995

ABSTRACT

Objective To explore the effect of oral-muscle biofeedback system training on the rehabilitation of cognitive dysfunction in patients with obstructive sleep apnea (OSA) after ischemic stroke.Methods A total of 60 cases of poststroke OSA patients with cognitive dysfunction admitted to the rehabilitation center of deAn hospital in changzhou city from June 2017 to March 2018 were selected.On the basis of routine rehabilitation treatment,the control group was given positive pressure ventilation treatment,and the observation group was given oral muscle biofeedback system training.The changes of polysomnography (PSG) parameters,Montreal cognitive assessment (MoCA) score,serum matrix metalloproteinase-9 (MMP-9) and plasma homcysteinemia (Hcy) expression levels in the two groups before and after treatment were compared.Results Apnea hypopnea index and maximum apnea time of the two groups were significantly decreased after treatment compared with those before treatment,and the lowest SpO2 and average SpO2 were significantly higher than those before treatment(P<0.05).After treatment,MoCA total score and the dimensions score of patients in the observation group were significantly higher than those in the control group at the same time (P<0.05).After treatment,the levels of Hcy((12.38±4.54) μmol/L) and MMP-9((124.52± 12.94) μg/L) in the observation group were significantly lower than those in the control group at the same time(Hcy(17.52±6.27) μmol/L,MMP-9(268.25±20.5 7)μg/L),and the difference was statistically significant (Hcy:t=3.637,P<0.05;MMP-9:t =32.395,P<0.05).Conclusions Positive pressure ventilation and oral muscle biofeedback system training have the same effect on OSA after stroke,but oral muscle biofeedback system training can also effectively improve patients' cognitive function.

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Article in Chinese | WPRIM | ID: wpr-510421

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Objective To analyze the application effect of standardized colostomy irrigation nursing in rectal cancer patients with Miles operation.Methods 126 rectal cancer patients underwent Miles operation were randomly divided into the observation group and the control group,63 cases in each group.The patients of the control group were treated with traditional colostomy natural defecation ostomy care model,and the patients of the observation group were given standardized colostomy irrigation nursing mode.Before and after nursing,the life quality function score,life quality score and individual total care expenses of the two groups were compared.Results Before nursing,the function score and quality of life event scale score between the two groups were compared,and the differences were not statistically significant(all P >0.05).After nursing,physical function[(97.84 ±3.83)points],cognitive function[(96.79 ± 8.77)points],emotional function[(94.57 ±8.76)points],role function[(96.57 ±1.57)points],social function [(92.77 ±6.17)points],nausea and vomiting[(0.56 ±0.23)points],insomnia[(2.64 ±1.78)points],pain [(1.48 ±0.63)points],fatigue[(5.13 ±2.47)points],loss of appetite[(1.76 ±0.83)points]of the observation group were significantly better than those of the control group [(90.22 ±3.79)points,(80.99 ±8.74)points, (83.26 ±13.83)points,(78.85 ±3.26)points,(83.67 ±3.45)points,(1.27 ±0.76)points,(12.25 ±3.61)points, (4.08 ±1.67)points,(6.76 ±2.98)points,(3.47 ±1.62)points],there were statistically significant differences between the two groups(t =11.22,10.13,5.48,38.87,10.22,7.10,18.95,11.56,3.34,7.46,all P <0.05).After nursing,the product cost[(1 488.78 ±102.49)yuan],nursing cost[(158.46 ±10.73)yuan],total cost[(1 638.79 ± 106.73)yuan]of the observation group were significantly lower than those of the control group [(2 070.17 ± 141.78)yuan,(311.17 ±99.32)yuan,(2 380.63 ±212.79)yuan],the differences were statistically significant (t =26.38,12.13,24.73,all P <0.05 ).Conclusion Standardized colostomy irrigation nursing can improve overall quality of life in patients of rectal cancer after Miles operation,reduce the economic and psychological burden,and its application effect is better.

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