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1.
Article in Chinese | WPRIM | ID: wpr-995128

ABSTRACT

Objective:To analyze the changing trends in maternal mortality ratios (MMRs) and the main cause-specific MMRs in China from 2010 to 2020, evaluate the association between MMRs and pregnancy healthcare and predict the MMRs for the next five years.Methods:Data on MMRs, the main cause-specific MMRs, and maternal healthcare in China from 2010 to 2020 were collected from China Health Statistical Yearbook. Estimated annual percent changes (EAPCs) were used to analyze the trends in MMRs and the main cause-specific MMRs in China. Average growth rate was used to describe the trend of perinatal healthcare indicators, and spearman rank correlation was used to analyze the correlation between MMRs and perinatal healthcare indicators. GM (1,1) model was established to predict the MMRs for the following five years. Results:(1) From 2010 to 2020, the EAPCs were-5.16%,-6.24%, and-4.28%, respectively, indicating downward trends in MMRs in the whole nation, urban and rural areas ( t=-0.98,-12.42 and-8.96, all P<0.001). (2) From 2010 to 2020, the main cause-specific MMRs in China from obstetric hemorrhage, hypertension during pregnancy, amniotic fluid embolism, and liver disease were all in downward trends ( t=-12.42,-5.44,-3.98 and-3.63, all P<0.001). Except for the MMR from hypertension during pregnancy in urban areas (average growth rate =0.51%), all main cause-specific MMRs in both urban and rural areas decreased significantly, especially the MMRs from hepatopathy in urban and rural areas (average growth rate=-10.40% and-13.96%). (3) The nation wide MMR was negatively correlated with maternal system management rate ( r s=-0.80, P=0.003), prenatal examination rate ( r s=-0.97, P<0.001), postpartum visit rate ( r s=-0.82, P=0.002) and hospital delivery rate ( r s=-0.98, P<0.001). Negative correlations were also found between the MMR and hospital delivery rate in both urban ( r s=-0.82, P=0.002) and rural areas ( r s=-0.95, P<0.001). (4) The GM (1, 1) models for forecasting MMRs in the whole nation, urban and rural areas were established with an accuracy of level 1. The MMR was predicted to show a downward trend in the following five years. The MMRs in China were 15.86/100 000 in 2021 and 15.13/100 000 in 2022 through prediction, similar to the 16.1/100 000 and 15.7/100 000 as announced by the government. Conclusions:The overall MMR in China shows a downward trend, and it dropped faster in urban areas than the rural areas. In addition, it is predicted that the MMR will continue to decline in the following five years, but the gap between urban and rural areas will remain.

2.
Article in Chinese | WPRIM | ID: wpr-990220

ABSTRACT

Objective:To explore the construction and clinical practice of the training system for nurses in operating room subspecialty based on ORTCC model (including objectives, rules, training, assessment and culture), and to provide theoretical and practical guidance for the development of nursing subspecialty in operating room.Methods:This was a quasi-experimental study. The Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology was convenient to select 23 operating room nurses who rotated in orthopedic surgery rooms from January 2019 to June 2020 as the control group, and the traditional training model for specialized nurses in operating rooms was adopted. From July 2020 to December 2021, the 24 operating room nurses rotating orthopedic surgery rooms were selected as the experimental group, and ORTCC teaching mode was adopted. The degree of mastery of theoretical knowledge, standardization of operation skills, correct rate of standard preventive implementation and satisfaction rate of doctors of operating room nurses under two different training methods were compared.Results:The theoretical score of operating room nurses increased from (84.71 ± 5.70) points in the control group to (92.68 ± 3.64) points in the experimental group, and the skill score increased from (90.17 ± 4.69) points in the control group to (95.43 ± 2.61) points in the experimental group, with statistical significance ( t = 13.76, 5.64, both P<0.01). The satisfaction rate of surgeons to nurses′ surgical cooperation ability communication, cooperation ability and emergency treatment ability increased from 82.61%(19/23), 73.91%(17/23) and 78.26%(18/23) in the control group to 100.00%(24/24), 95.83% (24/24) and 100.00% (24/24) in the experimental group, respectively, with statistically significant differences ( t = 4.56, 4.45, 5.84, all P<0.05). Conclusions:The training system of operating room subspecialty nurses based on ORTCC model is conducive to improving the theoretical knowledge mastery, standard operation skills and doctor satisfaction rate of operating room nurses to the specialty and subspecialty, providing training basis for the development of operating room subspecialty, and worthy of clinical promotion.

3.
Article in Chinese | WPRIM | ID: wpr-1005494

ABSTRACT

【Objective】 Dyslipidemia has shown to be associated with cardiovascular, metabolic and renal diseases. This study aimed to investigate the association between residual cholesterol and the risk of subclinical renal damage (SRD). 【Methods】 A total of 2 342 participants were recruited from the previously established Hanzhong Adolescent Hypertension Study cohort. According to estimated glomerular filtration rate(eGFR) and urinary albumin-to-creatine ratio(uACR), the subjects were divided into SRD group and non-SRD group. The associations of residual cholesterol with eGFR, uACR, and the risk of SRD were analyzed by multiple linear and Logistic regression analyses. 【Results】 Residual cholesterol was positively correlated with uACR(r=0.081, P<0.001) but negatively correlated with eGFR (r=-0.091, P<0.001). Multiple linear regression analysis revealed that residual cholesterol was an influencing factor of uACR (β=0.075, P<0.001) and eGFR (β=-0.027, P<0.001) after adjustment for gender, age, smoke, alcohol, exercise, BMI, hypertension, diabetes and serum uric acid. In addition, Logistic regression analysis revealed that residual cholesterol was significantly associated with the risk of SRD independently of potential confounders [OR(95% CI)=1.387 (1.113-1.728), P<0.001]. Further subgroup analysis showed that residual cholesterol was significantly associated with the risk of SRD in women but not in men. 【Conclusion】 Residual cholesterol is a contributing factor in the risk of subclinical renal damage with gender-specific association.

4.
Article in Chinese | WPRIM | ID: wpr-1005496

ABSTRACT

【Objective】 Corin, a transmembrane serine protease that can cleave atrial natriuretic peptide precursor (pro-ANP) into atrial natriuretic peptide with smaller bioactive molecules, participates in the pathophysiological process of hypertension and cardiac hypertrophy. The purpose of this study was to explore the relationship of Corin gene variation with blood pressure responses to sodium and potassium dietary interventions. 【Methods】 In 2004, we recruited 514 participants from 124 families in 7 villages of Baoji, Shaanxi Province, China. All the subjects received a 3-day normal diet, a 7-day low-salt diet, a 7-day high-salt diet, and finally a 7-day high-salt and potassium supplementation. Fifteen single nucleotide polymorphisms (SNPs) of Corin gene were selected for final analysis. 【Results】 SNPs rs12509275 were significantly associated with diastolic blood pressure (DBP) response to low-salt diet, while rs3749584 was associated with pulse pressure (PP) response to low-salt diet.SNP rs3749584 and rs10517195 were significantly associated with PP response to high-salt diet. In addition,rs17654278 were significantly associated with systolic blood pressure (SBP) response to high-salt and potassium supplementation, rs2271037 was significantly correlated with DBP responses to high-salt and potassium supplementation, and rs4695253, rs12509275, rs2351783, rs36090894 were significantly associated with PP response to high-salt and potassium supplementation. 【Conclusion】 Corin gene polymorphisms were associated with blood pressure response to sodium and potassium, suggesting that Corin gene may be involved in pathophysiological process of salt sensitivity and potassium sensitivity.

5.
Article in Chinese | WPRIM | ID: wpr-1005497

ABSTRACT

【Objective】 4-like protein with down-regulated expression and development in neural precursor cells (NEDD4L) plays an important role in blood pressure (BP) regulation and sodium homeostasis by regulating epithelial sodium channel protein. In this study, we aimed to explore the relationship of NEDD4L gene polymorphisms with BP responses to sodium and potassium intake. 【Methods】 In 2004, 514 subjects from 124 families in Meixian County, Shaanxi Province, were recruited to establish a salt-sensitive hypertension study cohort. All the subjects received a 3-day baseline survey, a 7-day low-salt diet, a 7-day high-salt diet, and finally a 7-day high-salt and potassium supplementation. Their BP was measured and peripheral blood samples were collected at different intervention periods. The 14 gene polymorphisms of NEDD4L gene were genotyped and analyzed by MassARRAY platform. 【Results】 BP decreased on a low-salt diet, and significantly increased on a high-salt diet, and decreased again after potassium supplementation. NEDD4L SNPs rs74408486 were significantly associated with systolic BP, diastolic BP and mean arterial pressure responses to the low-salt diet. SNPs rs292449 and rs2288775 were significantly associated with pulse pressure response to the high-salt diet. In addition, SNPs rs563283 and rs292449 were significantly associated with diastolic BP, mean arterial pressure, and pulse pressure responses to high-salt and potassium supplementation diet. 【Conclusion】 NEDD4L gene polymorphisms were significantly associated with BP responses to sodium and potassium intake, suggesting that NEDD4L gene may be involved in the development of salt sensitivity and potassium sensitivity.

6.
Article in Chinese | WPRIM | ID: wpr-1005498

ABSTRACT

【Objective】 Based on our previously established salt-sensitive hypertension cohort, we aimed to examine the association of genetic variants in uromodulin with blood pressure(BP) responses to dietary interventions of sodium and potassium intake. 【Methods】 In 2004, 514 subjects from 124 families in Mei County, Shaanxi Province, were recruited to establish the salt-sensitive hypertension study cohort. Among them, 333 non-parent subjects were selected and sequentially maintained on a normal-diet for 3 days, low-salt diet for 7 days, then a high-salt diet for 7 days and a high-salt diet with potassium supplementation for another 7 days. Thirteen single nucleotide polymorphisms(SNPs) in the uromodulin gene were genotyped on the MassARRAY platform. 【Results】 BP levels decreased from the baseline to low-salt diet, increased from low-salt to high-salt diet, and decreased again from the high-salt diet to the high-salt plus potassium supplementation intervention. SNPs rs77875418 and rs4997081 of the uromodulin gene were significantly associated with diastolic BP(DBP) and mean arterial pressure(MAP) responses to high-salt diet. In addition, SNPs rs77875418, rs79245268, rs4293393, rs6497476, rs4997081, rs13333226, and rs12917707 were significantly associated with systolic BP(SBP), DBP, and MAP responses to high-salt diet with potassium supplementation. 【Conclusion】 Genetic variants in uromodulin gene are significantly associated with BP responses to sodium and potassium supplementation, suggesting that uromodulin may be mechanistically involved in BP sodium-sensitivity and potassium-sensitivity.

7.
Article in Chinese | WPRIM | ID: wpr-1005499

ABSTRACT

【Objective】 M3 muscarinic acetylcholine receptor(M3 receptor), encoded by CHRM3 gene, is widely distributed in the cardiovascular system and plays an important role in cardiac regulation. The aim of this study was to assess the association of genetic variants in M3 receptor with blood pressure(BP) responses to controlled dietary sodium and potassium interventions. 【Methods】 A total of 333 subjects from 124 families were recruited from the rural areas of northern China. After a three-day baseline observation, they were sequentially on a seven-day low-salt diet, a seven-day high-salt diet, and a seven-day high-salt diet plus potassium supplementation. Thirteen CHRM3 single nucleotide polymorphisms(SNPs) were selected for analysis. 【Results】 SNP rs10802811 of the CHRM3 was significantly associated with diastolic BP(DBP) and mean arterial pressure(MAP) responses to both low-salt and high-salt diets while SNPs rs6429147, rs373288072, rs114677844 and rs663148 showed significant associations with systolic BP(SBP) and MAP responses to high-salt diet. In addition, SNP rs6692904 was significantly associated with SBP, DBP and MAP responses to high-salt diet with potassium supplementation. 【Conclusion】 Genetic variants in M3 receptor are significantly associated with BP responses to sodium and potassium intervention, suggesting that M3 receptor may be mechanistically involved in BP salt and potassium sensitivity.

8.
Biomed. environ. sci ; Biomed. environ. sci;(12): 241-252, 2023.
Article in English | WPRIM | ID: wpr-970313

ABSTRACT

OBJECTIVE@#Programmed cell death 6 (PDCD6), a Ca 2+-binding protein, has been reported to be aberrantly expressed in all kinds of tumors. The aim of this study was to explore the role and mechanism of PDCD6 in hepatocellular carcinomas (HCCs).@*METHODS@#The expression levels of PDCD6 in liver cancer patients and HCC cell lines were analyzed using bioinformatics and Western blotting. Cell viability and metastasis were determined by methylthiazol tetrazolium (MTT) and transwell assays, respectively. And Western blotting was used to test related biomarkers and molecular pathway factors in HCC cell lines. LY294002, a PI3K inhibitor inhibiting AKT, was used to suppress the AKT/GSK3β/β-catenin pathway to help evaluate the role of this pathway in the HCC carcinogenesis associated with PDCD6.@*RESULTS@#The analysis of The Cancer Genome Atlas Database suggested that high PDCD6 expression levels were relevant to liver cancer progression. This was consistent with our finding of higher levels of PDCD6 expression in HCC cell lines than in normal hepatocyte cell lines. The results of MTT, transwell migration, and Western blotting assays revealed that overexpression of PDCD6 positively regulated HCC cell proliferation, migration, and invasion. Conversely, the upregulation of PDCD6 expression in the presence of an AKT inhibitor inhibited HCC cell proliferation, migration, and invasion. In addition, PDCD6 promoted HCC cell migration and invasion by epithelial-mesenchymal transition. The mechanistic investigation proved that PDCD6 acted as a tumor promoter in HCC through the AKT/GSK3β/β-catenin pathway, increasing the expression of transcription factors and cellular proliferation and metastasis.@*CONCLUSION@#PDCD6 has a tumor stimulative role in HCC mediated by AKT/GSK3β/β-catenin signaling and might be a potential target for HCC progression.


Subject(s)
Humans , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/pathology , Proto-Oncogene Proteins c-akt/metabolism , beta Catenin/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Glycogen Synthase Kinase 3 beta/metabolism , Cell Line , Cell Proliferation , Cell Line, Tumor , Gene Expression Regulation, Neoplastic , Calcium-Binding Proteins/metabolism , Apoptosis Regulatory Proteins/genetics
9.
Chinese Journal of Nephrology ; (12): 189-195, 2022.
Article in Chinese | WPRIM | ID: wpr-933854

ABSTRACT

Objective:To investigate the association between body mass index (BMI) trajectories in children and adolescents and subclinical renal damage (SRD) in adulthood.Methods:4 623 participants aged 6-18 years old were recruited from the ongoing cohort of Hanzhong adolescent hypertension study in 1987, and the subjects were followed up in 1989, 1992, 1995, 2005, 2013 and 2017, respectively. Group-based trajectory modeling was used to identify distinct BMI trajectories in longitudinal analysis. Generalized linear model was applied to examine the association between different BMI trajectories and SRD incidence in adulthood.Results:A total of 2 678 subjects from childhood to adulthood were enrolled in this study. All subjects were divided into three groups according to three distinct BMI trajectories: low-increasing BMI group ( n=1 017), moderate-increasing BMI group ( n=1 353), and high-increasing BMI group ( n=308). Over follow up for 30 years, a total of 248 participants (9.3%) developed SRD. Urinary albumin-to-creatinine ratio (uACR) in low to high-increasing BMI group was 0.9(0.6, 1.4), 1.0(0.7, 1.7), 1.6(0.8, 3.2), respectively ( P trend<0.001), and estimated glomerular filtration rate was 98.5(87.6, 111.6) , 96.2(86.4, 109.7), 95.3 (87.5, 125.0) ml·min -1·(1.73 m 2) -1, respectively ( P trend=0.025). The generalized linear model analysis showed that uACR was increased linearly from low to high-increasing BMI group [ β=3.16(95% CI 1.02-5.31), Ptrend=0.004]. There was no correlation or linear trend between BMI trajectory and estimated glomerular filtration rate [ β=-2.30(95% CI-5.18-0.57), Ptrend=0.117]. Compared with the low-increasing BMI group, the high-increasing BMI group had greater odds of experiencing SRD in adulthood after adjusting for multiple confounders such as age, gender, medical history and lifestyle ( OR=2.83, 95% CI 1.84-4.36, Ptrend<0.001). Conclusions:Higher BMI trajectorie is correlated with higher level of uACR and risk of SRD in middle age. Identifying long-term BMI trajectorie from early age may assist in predicting individuals′ renal function in later life.

10.
Article in Chinese | WPRIM | ID: wpr-1011542

ABSTRACT

【Objective】 To explore the relationship between plasma adiponectin levels and hypertension based on the Hanzhong adolescent hypertension cohort. 【Methods】 A total of 361 young individuals with normal renal function, aged 32 to 41 years old, were taken as the research subjects. We collected or measured data including general characteristics, blood pressure (BP), height, weight, pulse rate, and biochemistry indexes such as fasting glucose, blood lipid and plasma hs-CRP. The concentration of plasma adiponectin was determined by ELISA method. Binary logistic regression was performed to analyze the relationship between plasma adiponectin and hypertension. 【Results】 The plasma adiponectin level in patients with hypertension was significantly lower than that in normotensive patients [3.56 (2.57-5.02)) μg/mL vs. 4.82 (3.19-6.89) μg/mL, P=0.012]. Partial correlation analysis showed a weak correlation of plasma adiponectin level with systolic BP and diastolic BP (r=-0.155, P=0.003 and r=-0.144, P=0.006). Binary logistic regression analysis showed that after adjusting for confounding factors such as age, BMI, and high-sensitivity C-reactive protein, the risk of hypertension was 2.46 times higher in patients with plasma adiponectin in the lowest gender-specific tertile than those in the highest tertile (OR=2.46, 95% CI: 1.22-4.99). 【Conclusion】 Hypoaponectinemia is an independent risk factor for hypertension in young individuals with normal renal function.

11.
Article in Chinese | WPRIM | ID: wpr-1011586

ABSTRACT

【Objective】 To explore the effects of dietary salt intake on serum and urinary levels through the chronic salt loading intervention. 【Methods】 Eighty adults (18 to 65 years old) were screened from two villages in Liquan and Lantian counties to participate in a 2-week chronic salt intervention, including a 3-day baseline survey, a 7-day low-salt diet, and a 7-day high-salt diet. Uromodulin levels in serum and urine were determined by enzyme-linked immunosorbent assay (ELISA) kits. According to the baseline blood pressure levels, all subjects were divided into normotensive and hypertensive groups. Pearson or Spearman correlation analyzed the associations of 24 h urinary sodium excretions with serum and urinary levels of uromodulin. 【Results】 At the baseline, serum uromodulin in hypertensive subjects was significantly lower than that in normotensive subjects (26.7±9.9 vs. 57.9±9.7 ng/mL, P=0.033). Serum uromodulin levels were significantly lower on a high-salt diet than on a baseline diet [(54.9±8.8 vs. 28.3±4.5) ng/mL, P=0.007]. In addition, daily urinary excretions of uromodulin were lower on a high-salt diet [(28.4±6.6) ng/mL] than on a baseline diet [(282.1±70.0) ng/mL] and on a low-salt diet [(154.1±21.3) ng/mL]. The 24 h urinary sodium excretions were inversely correlated with urinary uromodulin excretions (r=-0.40, P<0.001) on both low-salt and high-salt diets, but not correlated with serum uromodulin levels. 【Conclusion】 Variations in dietary salt intake significantly affect plasma and urine uromodulin levels.

12.
Biomed. environ. sci ; Biomed. environ. sci;(12): 257-264, 2021.
Article in English | WPRIM | ID: wpr-878357

ABSTRACT

Objective@#The aim of the present study was to evaluate the performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one dried blood spot (DBS) as an alternative sample to plasma.@*Method@#A total of 571 paired DBS/plasma samples were collected from men who have sex with men (MSM) and injection drug users (IDUs), and serological and molecular assays were performed. Using plasma results as the reference standard, the performance of DBS tests for HIV-1 RNA, HIV-1 DNA, and HCV RNA was evaluated. Pearson's correlation coefficients and Bland-Altman analysis were performed to assess the correlation and concordance between DBS and plasma.@*Results@#Among paired plasma/DBS samples with detectable HIV-1 RNA and HCV RNA, five samples (5/32) were not detectable in DBS, while measurable HIV-1 RNA levels were present in plasma (1.44 to 3.99 log @*Conclusion@#The performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one DBS was acceptable. DBS, as an alternative sample to plasma, may be a viable option for the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA in resource-limited settings or for individuals living in areas that are difficult to access.


Subject(s)
DNA, Viral/analysis , Diagnostic Tests, Routine/methods , Dried Blood Spot Testing/methods , HIV Infections/diagnosis , HIV-1/isolation & purification , Hepacivirus/isolation & purification , Hepatitis C/diagnosis , RNA, Viral/analysis , Sensitivity and Specificity , Specimen Handling/methods , Syphilis/diagnosis , Treponema pallidum/isolation & purification
13.
Article in Chinese | WPRIM | ID: wpr-1006715

ABSTRACT

【Objective】 Based on our previously established salt-sensitive hypertension cohort, we conducted chronic salt loading and potassium supplementation interventions, aiming to examine the association between genetic variants in renalase and blood pressure (BP) responses to dietary interventions of salt and potassium intake. 【Methods】 In 2004, 514 subjects from 126 families were recruited in Shaanxi Province to establish the salt-sensitive hypertension study cohort. Among them, 334 non-parent subjects were selected and sequentially maintained on a low-salt diet for 7 days, then a high-salt diet for 7 days and a high-salt diet with potassium supplementation for another 7 days. Ten single nucleotide polymorphisms (SNPs) in the renalase gene were genotyped on the MassARRAY platform. 【Results】 SNP rs2576178 of the renalasegene was significantly associated with systolic BP (SBP) and mean arterial pressure (MAP) responses to low-salt intervention (SBP: β=-2.730, P<0.05; MAP: β=-1.718, P<0.05). In addition, SNP rs12356177 was significantly associated with diastolic BP response to low-salt diet (β=-1.608, P<0.05). However, we did not find any association for the renalase SNPs with BP response to high-salt diet with potassium supplementation reached nominal statistical significance. 【Conclusion】 Genetic variants in renalase gene are significantly associated with BP response to low-salt diet, suggesting that renalase may be mechanistically involved in BP salt-sensitivity.

14.
Chinese Journal of School Health ; (12): 1675-1677, 2020.
Article in Chinese | WPRIM | ID: wpr-837591

ABSTRACT

Objective@#To explore possible the mental health difference between freshmen upgrading from junior college and ordinary freshmen,to provide valuable reference for the targeted mental health educaiton and service.@*Methods@#A comparative analysis of the results of University Personality Inventory (UPI) 2016-2019 among freshmen upgrading from junior college and ordinary freshmen in one university in Nanjing was carried out .@*Results@#Among 11 955 freshmen, the detection rate of severe mental health problems (class Ⅰ) was 22.58%, scores of four indicators(physical symptoms, neurosis, depression, schizophrenia) and prevalence of class Ⅰ problems among freshmen upgrading from junior college were significantly lower than those of ordinary freshmen(P<0.05). Longitudinal comparison showed that there were significant differences in the proportion of class Ⅰ and the scores of the four indicators in each freshmen group in four years(P<0.05). After group interview with class Ⅰ, the proportion of type A and type B among freshmen upgrading from junior college were significantly higher than that of ordinary freshmen(χ2=4.12,9.23, P<0.05).@*Conclusion@#Mental health level of freshmen upgrading from junior college is higher than that of ordinary freshmen. Mental health of ordinary freshmen shows improving trend, while freshmen upgrading from junior college shows a non-linear decreasing trend,with high proportion of mental problems, which worth further attention.

15.
Zhongguo yi xue ke xue yuan xue bao ; Zhongguo yi xue ke xue yuan xue bao;(6): 319-326, 2020.
Article in Chinese | WPRIM | ID: wpr-826362

ABSTRACT

To evaluate the early and mid-term results after surgical repair of thoracoabdominal aortic aneurysm(TAAA)in patients with DeBakey typeⅠor Ⅲ aortic dissection. The clinical data of 130 patients who underwent TAAA repair for chronic DeBakey typeⅠ(groupⅠ, =47)or type Ⅲ(group Ⅲ, =83)aortic dissections in our center between January 2009 and December 2017 were retrospectively analyzed.Early postoperative results,midterm survival,and re-interventions were compared between these two groups. The 30-day mortality rate was 6.9%(=9)in the overall cohort,with no statistic difference between groupⅠand group Ⅲ(10.6% 4.8%;=0.803, =0.370).The incidence of major adverse events(38.3% 51.8%;=2.199, =0.138),5-year actuarial survival rate [(81.7±5.9)% (87.2±4.2)%;=0.483, =0.487],and 5-year actuarial freedom from all reinterventions [(84.5±6.7)% (85.5±4.8)%;=0.010, =0.920] showed no significant differences between these two groups. The early and mid-term outcomes after surgical repair of TAAA are similar for DeBakey typeⅠ and type Ⅲ patients.However,studies with larger sample sizes are still required.


Subject(s)
Humans , Aortic Dissection , Aortic Aneurysm, Thoracic , Blood Vessel Prosthesis Implantation , Hospital Mortality , Postoperative Complications , Retrospective Studies , Treatment Outcome
16.
Chin. med. j ; Chin. med. j;(24): 1285-1291, 2020.
Article in English | WPRIM | ID: wpr-827644

ABSTRACT

BACKGROUND@#Human epididymis secretory protein 4 (HE4) is a new ovarian cancer biomarker. The factors influencing HE4 levels are not clear, and the reference data in China are limited. Here, we aim to evaluate the effects of menopause and age on HE4 levels and to provide a possible reference value for HE4 in healthy Chinese people.@*METHODS@#A total of 2493 healthy females aged 40 years or older were recruited from March 2013 to March 2017 with the cooperation of four medical institutions across Beijing, China. The serum levels of HE4 and cancer antigen 125 (CA125) were measured by enzyme-linked immunosorbent assay. The Wilcoxon rank-sum test of variance and a stratified analysis were used to analyze the relationships among age, menopausal status, and levels of HE4 or CA125. Confidence intervals (5%-95%) were determined for reference ranges in different populations.@*RESULTS@#There was a statistically significant difference in median HE4 levels between the post-menopausal (n = 2168) and pre-menopausal groups (n = 325) (36.46 vs. 24.04 pmol/L, Z = -14.41, P < 0.001). HE4 increased significantly with age in the post-menopausal groups (H = 408.18, P < 0.001) but not in the pre-menopausal subjects (Z = -0.43, P = 0.67). The upper 95th percentile of HE4 levels were 44.63 pmol/L for pre-menopausal women, 78.17 pmol/L for post-menopausal women, and 73.3 pmol/L for all women. In the post-menopausal population, the HE4 reference ranges were 13.15 to 47.31, 14.31 to 58.04, 17.06 to 73.51, 24.50 to 115.25, and 35.71 to 212.37 pmol/L for different age groups from forty divided by decade. The CA125 level was affected mainly by menopausal status and not age.@*CONCLUSIONS@#Menopausal status and age were both important factors influencing the level of HE4, and age affected HE4 levels mainly in post-menopausal women. The HE4 level was higher in the post-menopausal population than in the pre-menopausal population and increased with age.

17.
Chinese Journal of Geriatrics ; (12): 880-884, 2019.
Article in Chinese | WPRIM | ID: wpr-755434

ABSTRACT

Objective To investigate the effect of Dexmedetomidine hydrochloride combined with Butorphanol tartrate on stress state in elderly patients with severe illness.Methods A total of 120 elderly patients with severe illness admitted into our hospital from March 2016 to March 2018 were randomized into group A,B and C(n=40,each).Group A was given intravenous Midazolam for analgesia,group B was treated with intravenous Medetomidine for analgesia,and group C received Dexmedetomidine combined with Butorphanol tartrate for analgesia.The differences in mean artery pressure(MAP),heart rate(HR),C-reaction protein(CRP),interleukin-6 (IL-6),visual analogue scale (VAS)score and Ramsay score were compared among the three groups.Results The levels of MAP,HR,CRP,IL-6 and VAS score after 24,48 and 72 hours of combined treatment of dexmedetomidine and butorphanol tartrate were lower in group C than in group B(P <0.05).There was no significant difference in the levels of MAP,HR,CRP,IL-6 and VAS score between group A and B after 24,48 and 72 hours of administration(P>0.05).Ramsay score was higher in group C (intravenous both Dexmedetomidine and Butorphanol tartrate) than in group B (intravenous Dexmedetomidine alone)at 24,48 and 72 hours after administration (P < 0.05).There was no significant difference in Ramsay score after 24,48 and 72 hours of administration between group A and B(P>0.05).The incidence of adverse reactions was lower in group C than in group A and B(10.0% vs.35.0% and 32.5%,x2 =7.168 and 6.050,P =0.007 and 0.014).There was no significant difference in the incidence of adverse reactions between group A and BCx2=0.056,P =0.813).Conclusions Dexmedetomidine hydrochloride combined with Butorphanol tartrate can effectively improve hemodynamics,and alleviate inflammatory reaction and pain in elderly patients with severe illness,with a good security.And it is worthy of clinical generalization.

18.
Modern Clinical Nursing ; (6): 29-32, 2018.
Article in Chinese | WPRIM | ID: wpr-698860

ABSTRACT

Objective To investigate the effect of collaborative assessment and management on skin of high-risk pressure ulcer patients by nurses from operating room and wards. Methods 709 high-risk pressure ulcer patients who underwent surgical operations in our hospital were selected as the control group from January to June 2016.The 3S pressure ulcer risk assessment form was used to evaluate the skin of the operated patients.Another 680 high-risk pressure ulcer patients were selected as the observation group from July to December in 2016.The skin evaluation and pressure ulcer protection measures in the observation group were the same as those in the control group.The assessment was done by the nurses from the operating room and the wards separately.According to the evaluation form, the nurses in the operating room explained the patient's skin condition to the ward nurses in details, and then they cooperated in managing the postoperative skin of the patients. The two groups were compared in respect of the incidence of pressure ulcers at the time points of postoperative 24h,48h and 72h. Results There was no significant difference in the incidence of pressure ulcers after operation between the two groups(P>0.05).The incidence of pressure ulcers in the observation group was significantly lower than that of the control group at the time points of 24h, 48h and 72h after operation (P<0.05). Conclusion The collaborative assessment and management of skin for surgical patients with high-risk pressure ulcer by the nurses from both operating room and wards can effectively prevent the occurrence and development of pressure ulcers,worthy of clinical application.

19.
Chin. med. j ; Chin. med. j;(24): 2339-2345, 2017.
Article in English | WPRIM | ID: wpr-248987

ABSTRACT

<p><b>BACKGROUND</b>Circulating endometrial cells (CECs) have been reported to be present in the peripheral blood of women with endometriosis (EM), providing clear and specific evidence of the presence of ectopic lesions. In this study, we established a method with a high detection rate of CECs, assessed the diagnostic value of CECs for EM and compared with serum CA125, and proposed a hypothesis for the pathogenesis of EM from the new perspective of CECs.</p><p><b>METHODS</b>The participants were enrolled prospectively from October 2015 to July 2016. The peripheral blood samples were collected from 59 participants, and the blood cells were isolated for immunofluorescence staining via microfluidic chips. The cells that were positive for vimentin/cytokeratin and estrogen/progesterone receptor and negative for CD45 were identified as CECs. The serum CA125 level was tested with electrochemiluminescence immunoassay.</p><p><b>RESULTS</b>The detection rate of CECs reached 89.5% (17/19) in the EM group, which was significantly higher than that of the control group (15.0% [6/40], P < 0.001) and was independent of menstrual cycle phases. Furthermore, a positive CEC assay detected 4/5 cases of Stage I-II EM. In contrast, a positive CA125 test had limited value in detecting EM (13/19, 68.4%) and detected only one case of Stage I-II EM.</p><p><b>CONCLUSION</b>CECs are promising biomarkers for EM with great potential for a noninvasive diagnostic assay.</p>

20.
Article in Chinese | WPRIM | ID: wpr-659486

ABSTRACT

Objective To investigte the direct medical expense for diagnosis and treatment of pulmonary tuberculosis (TB) patients and its financial burden on family in Minhang District,Shanghai,and to provide evidence for improving TB derating policy and reducing the economic burden.Methods A total of 347 pulmonary TB patients who had completed treatment were investigated by questionnaire.Their receipts on diagnosis and treatment of TB were collected.Ranksum test,linear regression and x2 test were used to analyze medical expenses,influencing factors and social economic burden.Results The median of TB patients' direct medical expenses was 5 657 yuan/person.Linear regression showed that direct medical expenses were related with census,main medical institutions and complications.The main medical institutions have a greater impact on direct medical expenses (β'=-0.217).In the patients,7.5 % had high medical expenditures after the deduction of medical reimbursement and derating.And they were mainly distributed among low-income people.Conclusions The diagnosis and treatment expenses of TB patients were relatively high,which resulted in a heavier financial burden to the patient's family.The elderly tuberculosis patients,patients with complications and poor groups should become the focus of medical reimbursement and derating policy.

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