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Objective To investigate the characteristics of blood routine,chest computed tomography(CT)imaging and short-term evolution of hemodialysis patients infected with Omicron variant of severe acute respiratory syndrom coronavirus 2(SARS-CoV-2).Methods A total of 204 patients diagnosed with Omicron variant infection in the First Hospital of Hohhot from September 2022 to September 2023 were retrospectively reviewed.Among them,89 patients with end-stage renal disease(ESRD)who were receiving hemodialysis were included in the hemo-dialysis group.The remaining 115 patients were control group,and the first blood routine results chest com-puted tomography(CT)imaging data were observed.Thirty-four patients in the hemodialysis group and 29 patients in the control group had complete pulmonary CT imaging data on the day of admission,5-6 days and 10-12 days after admission.The characteristics and chest CT scores of all cases were analyzed.Results 1)The percentage of monocytes,neutrophils,neutrophil/lymphocyte ratio and chest CT score of the hemo-dialysis group were higher than those of the control group,while the white blood cells,lymphocytes and lymphocyte percentage were lower than those of the control group.2)The positive rate of first chest CT was 49.4%in hemo-dialysis group and 35.7%in control group.3)The chest CT scores of the hemo-dialysis group and the control group on day 5 and day 6 were higher than those of first check.Chest CT was reexamined on days 10-12,and scores were higher in the hemo-dial-ysis group than in the control group.Conclusions Hemo-dialysis patients with COVID-19 have higher blood routine indexes,higher positive rate of lung CT and slower absorption than non-hemodialysis patients.
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BACKGROUND:Achilles tendon adhesion after Achilles tendon injury can lead to decreased biomechanical properties,weakened healing ability,and ultrastructural changes of Achilles tendon,which further affects patients'daily life and work ability.Therefore,how to effectively deal with and prevent Achilles tendon adhesion has become a hot and difficult problem in clinical treatment. OBJECTIVE:To analyze the effects of biological amniotic membranes on postoperative Achilles tendon adhesion,biomechanics,and ultrastructural changes in rats with Achilles tendon rupture. METHODS:Sixty 6-week-old SD rats were selected to establish bilateral Achilles tendon rupture models and divided into two groups(n=30 per group)by the random number table method.In the model group,the severed end of the tendon was sutured directly.In the amniotic membrane group,the biological amniotic membrane was wrapped around the broken anastomosis and fixed by a suture.The adhesion,biomechanics,morphology,and structure of the Achilles tendon and the expression of p38 and ERK1/2 protein were evaluated 1,2,and 4 weeks after surgery. RESULTS AND CONCLUSION:(1)1 week after operation,the Achilles tendon and peritendinous tissues of the two groups were mildly edema,and the adhesion of the Achilles tendon tissues in the model group was more obvious.2 weeks after the intervention,the Achilles tendon and peritendinous tissues of the model group still had edema,and the adhesion degree between the Achilles tendon and the surrounding tissues was heavier than that of the amniotic membrane group.4 weeks after operation,there was no edema around the Achilles tendon in both groups,and the healing was well.The adhesion degree of the Achilles tendon in the amniotic membrane group was less than that in the model group.The maximum tension of Achilles tendons in the amniotic membrane group was higher than that in the model group at 2 and 4 weeks after operation(P<0.001).(2)Hematoxylin-eosin staining and transmission electron microscopy revealed that 1 week after operation,the tendon structure of rats of the two groups was disordered and the collagen fibers were sparsely arranged,in which the model group demonstrated obvious inflammatory reaction and adhesion to the Achilles tendon.Two weeks after operation,the model group still demonstrated obvious inflammatory response,adhesion of Achilles tendon,and irregular ordering of collagen fibers.The amniotic membrane group exhibited an orderly arrangement of collagen fibers and expansion of the endoplasmic reticulum of fibroblasts.At 4 weeks after operation,the collagen fibers of the Achilles tendon in the model group were thickened and disordered,and the rough endoplasmic reticulum was less in the fibroblasts,while the collagen fibers in the amniotic membrane group were ordered and thin,and the fibroblasts contained a large number of rough endoplasmic reticulum.(3)Four weeks after operation,western blot assay exhibited that the expressions of p38 and ERK1/2 protein in the Achilles tendon tissue of rats in the amniotic membrane group were lower than those in the model group(P<0.05).(4)The results confirm that the biologic amniotic membrane can promote the healing and inhibit the adhesion of Achilles tendon after the operation of the ruptured Achilles tendon,which may be associated with the regulation of the MAPK/ERK signaling pathway.
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BACKGROUND:Osteoporotic vertebral compression fracture is a common fracture secondary to osteoporosis.At present,there is no effective prediction index and method for osteoporotic vertebral compression fracture. OBJECTIVE:To investigate the predictive effect of the comprehensive index of lumbar vertebral body bone strength on osteoporotic vertebral compression fracture. METHODS:233 patients with osteoporosis were divided into a fracture group and a non-fracture group according to whether a vertebral fracture occurred.The demography,body mass index,vertebral bone mineral density and other details were collected.Lateral X-ray films of the lumbar spine were photographed.The vertebral body width,vertebral body length,sacral slope,pelvic tilt,pelvic incidence,lumbar compressive strength index and the lumbar impact strength index were measured,calculated,and analyzed by univariate and multivariate,and the receiver operating characteristic curve was analyzed.The survival analysis was conducted according to the cut-off value. RESULTS AND CONCLUSION:(1)All patients were followed up for 2-4 years,with an average of 3.1 years.During the follow-up period,99 cases(38 cases of L1 vertebral body,61 cases of L2 vertebral body)had fractures(fracture group),and 134 cases(52 cases of L1 vertebral body,82 cases of L2 vertebral body)had no fractures(non-fracture group).Univariate analysis showed that there was no significant difference in age,sex,height,body mass,body mass index and fracture segment between the two groups(P>0.05).(2)Lumbar compressive strength index and lumbar impact strength index in the fracture group were lower than those in the non-fracture group(P<0.05).Pelvic incidence and pelvic tilt in the fracture group were higher than those in the non-fracture group(P<0.05).(3)Multivariate analysis showed that lumbar compressive strength index,lumbar impact strength index and pelvic tilt were risk factors for osteoporotic vertebral compression fractures(P<0.05).(4)Receiver operating characteristic curve analysis showed that the cutoff values of vertebral bone mineral density,lumbar compressive strength index,lumbar impact strength index,pelvic tilt and pelvic incidence were 0.913 5 g/cm2,1.932,0.903,21.5° and 55°,respectively;areas under the curve were 0.630,0.800,0.911,0.633 and 0.568,respectively.(5)According to the survival analysis(with osteoporotic vertebral compression fracture as the end point),the average survival time of the patients with lumbar impact strength index≥0.903 was significantly longer than that of the patients with lumbar impact strength index<0.903(P<0.05).(6)These findings conclude that the comprehensive index of lumbar vertebral body bone strength is more accurate than the bone mineral density of the vertebral body and spine-pelvis sagittal parameters in predicting osteoporotic vertebral compression fractures,which is helpful for early prevention and treatment of osteoporotic vertebral compression fractures.
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BACKGROUND:Osteoporosis vertebral compression fracture is a common fracture secondary to osteoporosis,and there is currently a lack of effective predictive indicators and methods for osteoporosis vertebral compression fracture. OBJECTIVE:To investigate the predictive effects of paravertebral muscle degeneration,functional cross-sectional area,and percentage of fat infiltration on osteoporotic vertebral compression fractures. METHODS:The 224 patients with osteoporosis diagnosed from January 2018 to June 2022 were included.They were followed up for more than 2 years.They were divided into fracture group and non-fracture group according to the presence and absence of vertebral fracture.The detailed information of demographics,body mass index,bone mineral density and so on were collected.The functional cross-sectional area and percentage of fat infiltration of bilateral Psoas major muscle and extensor dorsi(Erector spinae muscles muscle and multifidus muscle)at the level of lower endplate of L2 vertebral body were measured and calculated. RESULTS AND CONCLUSION:(1)224 patients were ultimately included,of which 126 had fractures as the fracture group and 98 had no fractures as the non-fracture group.There was no statistically significant difference in age,gender,height,body mass,body mass index,and fracture segment between the two groups(P>0.05).(2)The bone mineral density of the fracture group was significantly lower than that of the non-fracture group(P<0.05).Functional cross-sectional areas of Psoas major muscle and extensor dorsi in the fracture group were significantly lower than those in the non-fracture group(P<0.05).The percentage of fat infiltration of the extensor dorsi in the fracture group was significantly higher than that in the non-fracture group(P<0.05).There was no significant difference in percentage of fat infiltration of Psoas major muscle between the two groups(P>0.05).(3)Receiver operating characteristic analysis showed that the vertebral bone mineral density,percentage of fat infiltration of extensor dorsi,functional cross-sectional area of extensor dorsi and percentage of fat infiltration of Psoas major muscle were 0.903 g/cm2,35.426%,418.875 mm2,and 6.375%,respectively.The areas under curve were 0.634,0.755,0.876,and 0.585,respectively.(4)These findings indicate that paravertebral muscle degeneration is strongly associated with the occurrence of osteoporotic vertebral compression fractures.The functional cross-sectional area of extensor dorsi muscle can effectively predict the occurrence of osteoporotic vertebral compression fractures,which is helpful for early prevention and treatment of osteoporotic vertebral compression fractures.
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Objective:To improve the perception of computed tomography(CT)images in detecting fine fracture through multi-task network of global attention,and to realize the detection of the target of fine fracture at case level through multi-task,and to quickly and accurately identify and locate fracture from a large number of CT images,so as to assist doctors to timely conduct treatment.Methods:A grouped Non-local network method was introduced to calculate the remote dependency relationship between each position of CT image continuous sections and channel.A single-stage detector of multi-objective detection model three dimension(3D)RetinaNet was integrated with the medical image semantic segmentation architecture(3D U-Net).A end-to-end multi-task 3D convolutional network was realized,which realized the detection of case level for fine fracture through multi-task collaboration.Select 600 CT scan images from the Rib Frac Dataset of rib fractures provided by the MICCAI 2020 Challenge,and they were divided into training set(500 cases)and test set(100 cases)as the ratio of 5:1 to test the precise performance of multi-task 3D convolutional network.Results:The precise performance of multi-task 3D convolutional network method was better than that of single-task FracNet,3D RetinaNet and 3D Retina U-Net in detection,which average precision was respectively higher 7.8%and 11.4%than 3D RetinaNet and 3D Retina U-Net.It was better than two kinds of single-task network detection method included 3D Faster R-CNN and 3D Mask R-CNN,and the average precision of that was respectively higher 6.7%and 3.1%than them.Conclusion:The integrated different modules of global attention multi-task network can improve the detection performance of fine fracture.The introduction of grouped Non-local network method can further improve the precise performance for the targets of fine fractures in detection.
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The electronic nursing clinical pathway was fully applied, and the evidence-based practice achievements of cancer patient symptom management was integrated into the electronic nursing clinical pathway in Fudan University Shanghai Cancer Center. Taking " comprehensive evaluation before chemotherapy" , " chemotherapy-related nausea and vomiting" , " chemotherapy-related diarrhea" as examples, the authors introduced the application of evidence-based practice project in nursing clinical pathway. Through the implementation of the project, a standardized operation flow of electronic nursing clinical pathway was formed; The nurses introduced new nursing tools, new processes and new technologies in the process of project implementation; Meanwhile, the project reduced the incidence of adverse symptoms and shortened the hospitalization time of patients. The project achieved the goal of " win-win" to reduce the burden of patients′ disease and improve the efficiency of tumor care.
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Unreasonable growth of total health expenditure at various extent has been found to be prevalent among many countries for a long time. Thus how to deal with this global public health challenge has become a hot topic among the consumers, providers, and payers alike. Echoing the global trend of value-based healthcare, value-based management of total health expenditure could be a direction of cost containment in the future. Through promoting the rational development of healthcare industry, assisting the decision-making of health insurance authority, improving health authority′s supervision of health technology allocation and utilization, maximizing resource utilization efficiency at hospitals, standardizing physician practices, guiding patients′ medication preferences and behaviors, health technology assessment could mobilize stakeholders′participation in the value-based management of total health expenditure and serve as an important decision-making tool to optimize the allocation and utilization of scarce health resources, reducing and avoiding waste in healthcare sector, and promoting high-value and sustainable development of total health expenditure.
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Unreasonable growth of total health expenditure at various extent has been found to be prevalent among many countries for a long time. Thus how to deal with this global public health challenge has become a hot topic among the consumers, providers, and payers alike. Echoing the global trend of value-based healthcare, value-based management of total health expenditure could be a direction of cost containment in the future. Through promoting the rational development of healthcare industry, assisting the decision-making of health insurance authority, improving health authority′s supervision of health technology allocation and utilization, maximizing resource utilization efficiency at hospitals, standardizing physician practices, guiding patients′ medication preferences and behaviors, health technology assessment could mobilize stakeholders′ participation in the value-based management of total health expenditure and serve as an important decision-making tool to optimize the allocation and utilization of scarce health resources, reducing and avoiding waste in healthcare sector, and promoting high-value and sustainable development of total health expenditure.
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With the rapid economic development and dramatic changes in lifestyle, the prevalence of overweight and obesity in China has been increasing significantly and become a serious public health threat. This article introduced the main contents of "China Blue Paper on Obesity Prevention and Control", aiming to facilitate understanding and applications of the "China Blue Paper on Obesity Prevention and Control" by policymakers, researchers and practitioners in related fields. Built upon these, recommendations were made for obesity screening, diagnosis, treatment and management, prevention and control policies and strategies, and future research priorities in China.
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Objective: To explore the relationship between meat consumption and metabolic syndrome (MS) in Chinese adults aged ≥18 years. Methods: The data were obtained from 2010- 2012 National Nutrition and Health Survey. A total of 34 923 subjects who completed the dietary survey, the physical examination and had the testing results of blood sugar and blood lipid levels were enrolled in this study. MS was defined according to the diagnostic criteria of China Diabetes Society 2013. The prevalence ratios of MS and each form of MS and related 95%CI were calculated after post stratification weight according to the population data (2009) released by the national bureau of statistics. Results: The average meat intake among subjects was 94.8 g/d. People who had meat consumption between 100 g/d and 199 g/d had the lowest prevalence of MS, abdominal obesity and hyperglycemia. As the meat consumption increased, the prevalence of MS in men increased. Men who had meat consumption of ≥300 g/d had a higher risk of MS than those who had low level of meat consumption, with prevalence ratio equaled to 1.46 (95%CI: 1.14~1.87). Similar trend was not observed in women. Conclusion: Moderate intake of meat is associated with reduced risk of MS in Chinese adults.