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Objective:To systematically evaluate the effects of low protein diet combined with α-keto acid on calcium and phosphorus metabolism and nutritional status in patients undergoing hemodialysis.Method:Randomized controlled Trials were searched in Cochrane Library, Web of Science, PubMed, Embase, CBM, CNKI, Wanfang and VIP databases from the establishment of respective database until July 2021, and meta-analysis is conducted using RevMan 5.4.Results:A total of 8 studies including 556 patients were selected. Meta-analysis showed that after receiving low protein diet combined with α-keto acid, patients demonstrated significantly reduced blood phosphorus [MD = -0.17, 95% CI (-0.25, -0.7), P < 0.01], calcium- phosphorus product [MD = -6.17, 95% CI (-6.67, -5.58), P < 0.01] and parathyroid hormone levels [MD = -35.36, 95% CI (-40.89, -29.83), P < 0.01]. There was no significant difference in serum calcium [MD = 0.03, 95% CI (-0.00, 0.07), P = 0.08] and serum albumin [MD = 0.41, 95% CI (-0.12, 0.95), P = 0.13]. Conclusion:Low protein diet combined with α-keto acid can reduce the levels of serum phosphorus, calcium-phosphorus product and parathyroid hormone in hemodialysis patients while the effects on serum calcium and serum albumin are undetermined and need further verification.
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Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.
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SARS-CoV-2 vaccines are effective in preventing COVID-19, but their efficacy in blocking virus transmission is controversial. Although SARS-CoV-2 vaccines can reduce the sources of infection and the possibility of secondary transmission from breakthrough infection cases, their effectiveness wanes over time. Moreover, the emergence of variants with stronger transmissibility and immune escape ability also poses huge challenges to the effectiveness of SARS-CoV-2 vaccines in blocking virus transmission. Therefore, ending the COVID-19 pandemic still requires the continuous research and development of new vaccines as well as the adoption of effective prevention and control measures.
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Objective:To compare the efficacy of stereotactic body radiotherapy(SBRT) and surgery in treating intrapulmonary recurrence of non-small cell lung cancer (NSCLC) after radical surgery.Methods:A retrospective analysis was conducted on NSCLC patients, who underwent radical surgery at the Cancer Hospital Affiliated to University of Chinese Academy of Sciences from November 2012 to December 2018 and then received SBRT or secondary surgery because of postoperative intrapulmonary recurrence. The survival rates of these patients were calculated using the Kaplan-Meier method. The comparison between the two groups was made using the Log-rank method, and the univariate and multivariate analysis was made using the Cox regression method.Results:Among 62 eligible patients, 33 received SBRT and 29 received secondary surgery, and they were divided into the SBRT group and the surgery group accordingly. For the SBRT and surgery groups, the median follow-up time was 45.8 months and 37.4 months, the 3-year locoregional control rate (LRCR) 79.8% and 90.2%, respectively ( P > 0.05), the progression-free-survival (PFS) 58.5% and 42.3%, respectively ( P >0.05), and the overall survival (OS) 78.0% and 85.5%, respectively ( P >0.05). The multivariate analysis suggested that treatment method, Charlson comorbidity index (CCI), and adjuvant drug therapy were independent prognostic factors for PFS ( P = 0.027, 0.013, 0.001). Conclusions:The efficacy of SBRT and surgery is comparable for patients with intrapulmonary recurrence of NSCLC after radical surgery.
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Objective To investigate the population differences of the newly named "metabolic associated fatty liver disease" (MAFLD) and the former name "nonalcoholic fatty liver disease" (NAFLD). Methods From November 2020 to January 2021, a cross-sectional survey was conducted among 624 elderly individuals aged above 65 years in a community in Beijing, China, and related data were collected, including demographic data, past history, laboratory markers, liver ultrasound, and liver elasticity. According to the presence or absence of fatty liver based on ultrasonic diagnosis, the individuals were divided into fatty liver group with 389 individuals and non-fatty liver group with 235 individuals. The independent samples t -test was used for comparison of normally distributed continuous data between the two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between the two groups; the chi-square test was used for comparison of categorical data between the two groups. Results Among the 389 patients with fatty liver, 387(99.5%) were diagnosed with MAFLD and 368(94.6%) were diagnosed with NAFLD, and there were 19 patients with a history of heavy alcohol consumption and 2 with positive surface antigen. A total of 366 patients met the diagnostic criteria for both MAFLD and NAFLD, accounting for 94.6% of the MAFLD patients and 99.5% of the NAFLD patients. Compared with the non-fatty liver group, the MAFLD group had significant increases in body mass index (BMI) ( t =-11.228, P < 0.05), waist circumference ( Z =-8.532, P < 0.05), hip circumference ( Z =-6.449, P < 0.05), waist-hip ratio ( Z =-5.708, P < 0.05), alanine aminotransferase ( Z =-5.027, P < 0.05), aspartate aminotransferase ( Z =-2.880, P < 0.05), platelet count ( t =-3.623, P < 0.05), triglyceride ( Z =-8.489, P < 0.05), fasting blood glucose ( Z =-3.516, P < 0.05), HbA1c ( Z =-2.884, P < 0.05), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) ( Z =-0.394, P < 0.05), high-sensitivity C-reactive protein ( Z =-4.912, P < 0.05), controlled attenuation parameter (CAP) ( t =13.744, P < 0.05), and liver stiffness measurement (LSM) ( Z =-7.69, P < 0.05), as well as a significant reduction in high-density lipoprotein cholesterol (HDL-C) ( t =6.348, P < 0.001). Meanwhile, MAFLD patients had more metabolic associated diseases, such as overweight, obesity, central obesity, dyslipidemia, and hypertension ( χ 2 =9.978, 65.472, 36.571, 9.797, and 5.128, all P < 0.05). In the MAFLD group, 30.7% of the patients had non-obese fatty liver disease (BMI < 25 kg/m 2 ), and 11.1% had lean fatty liver disease (BMI < 23 kg/m 2 ); compared with the obese MAFLD patients, the non-obese MAFLD patients had significantly lower age ( Z =-3.042, P < 0.05), BMI ( Z =-15.705, P < 0.05), waist circumference ( Z =-9.589, P < 0.05), hip circumference ( Z =-10.275, P < 0.05), HOMA-IR ( Z =-2.081, P < 0.05), CAP ( t =-3.468, P < 0.05), LSM ( Z =-3.630, P < 0.05), and NAFLD fibrosis score ( t =-4.433, P < 0.05). According to LSM value, advanced liver fibrosis accounted for 3.6% of the MAFLD population, and 10% of the MAFLD population could not be excluded for advanced liver fibrosis. Conclusion The diagnosis of MAFLD can basically cover the NAFLD population in the elderly people, and it is supposed that MAFLD can almost directly replace the concept of NAFLD in similar populations. However, further studies are needed to investigate its application in other populations.
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Biochemistry experiment is an experimental module associated with biochemistry curriculum. In the context of deepening the education reform on innovation & entrepreneurship, integrating the concept of innovation & entrepreneurship with the experimental course is an effective way for the biology discipline to foster professional talents with strong engineering ability and innovation & entrepreneurship ability. Outcome-based education (OBE) is a new concept for education. Guided by this concept, we encouraged students to propose and take part in research projects, redesigned the time frame for research project-based experiment teaching, and implemented a multi-dimensional evaluation system along the entire teaching process. Furthermore, we integrated the concept of innovation & entrepreneurship for training undergraduates during the teaching process of biochemistry experiment. These measures not only boosted the students' interest in research and innovation, but also guided the teachers to participate in the entire process, which helped improving the engineering ability and innovation & entrepreneurship ability of the students.
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Humans , Biochemistry/education , Curriculum , Entrepreneurship , StudentsABSTRACT
The purpose of this study is to provide a simple and reliable genetic typing approach for molecular drug susceptibility test of Mycobacterium tuberculosis, through the developing of fluorescence molecular marker of rifampicin resistance gene rpoB. Eleven fluorescent molecular markers of the rpoB gene were established by using the sequence difference between the amino acid positions 531, 526, 516, 511 and 513 of rpoB gene of rifampicin-resistant strains and the alleles of rifampicin-sensitive strains, combined with the PARMS technique (Penta-primer amplification refractory mutation system). We used 104 clinical isolates of Mycobacterium tuberculosis to validate this marker and it was verified by sequencing as 100% correct. These samples were also tested with proportional drug sensitivity test. The coincidence rate was 94.23%. The molecular markers had high reliability for genotyping of rpoB gene. It can also detect low-concentration drug-resistant samples (511/533 unit point mutations) whose phenotypic susceptibility cannot be detected. The eleven sets of fluorescent molecular markers could cover 92%-96% of rpoB gene mutation types of rifampicin-resistant strains, and provide new idea for rapid detection of rifampin-resistant Mycobacterium tuberculosis.
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Bacterial Proteins/genetics , DNA-Directed RNA Polymerases/genetics , Drug Resistance, Bacterial/genetics , Microbial Sensitivity Tests , Mutation , Mycobacterium tuberculosis/genetics , Reproducibility of Results , Rifampin/pharmacology , TechnologyABSTRACT
Objective:To evaluate the effectiveness of internal control of government procurement at public hospitals.Methods:Literature review and Delphi method were used to construct the internal control evaluation index system of government procurement at public hospitals, and the weight of the index system was determined by analytic hierarchy process. The index system was used to evaluate the internal control of government procurement in Hospital Z.Results:The evaluation index system of government procurement internal control of public hospitals covers all aspects of the whole process of government procurement, including 2 level-1 indexes of government procurement internal control unit level and government procurement internal control business level, 11 level-2 indexes and 27 level-3 indexes. The internal control of government procurement of Hospital Z was evaluated with an evaluation score of 81.37 points, an evaluation result relatively effective.Conclusions:The evaluation index system of government procurement internal control of public hospitals constructed in this study could quantitatively evaluate the effectiveness of each sector of government procurement internal control of public hospitals. It could meet the basic evaluation requirements of internal control of government procurement at public hospitals.
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Objective:To investigate the efficacy of triamcinolone acetonide injection behind the eyeball in the treatment of Purtscher disease and its effects on vision, inflammatory factors, nitric oxide (NO) and endothelin-1 (ET-1) of aqueous fluid.Methods:A total of 64 patients with Purtscher disease admitted to First People′s Hospital of Lanzhou City from January 2016 to January 2020 were selected and divided into two groups by random number table, with 32 cases in each group. The control group was given conventional treatment, and the observation group was injected with triamcinolone acetonide behind the eyeball on this basis. The total effective rate after 6 weeks of treatment, the best corrected visual acuity and hemodynamic indicators peak flow velocity (V max), end-diastolic flow velocity (V min), resistance index (RI) of ophthalmic artery and central retinal artery during systole, aqueous humor inflammatory factors tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-2, IL-6, NO, ET-1, and adverse reactions after 3 and 6 weeks of treatment were compared between the two groups. Results:After 6 weeks of treatment, the total effective rate in the observation group was higher than that in the control group: 96.9% (31/32) vs. 75.0% (24/32), and the difference was statistically significant ( χ2 = 4.655, P<0.05). After 3, 6 weeks of treatment, the best corrected visual acuity in the observation group was higher than that in the control group: 0.44 ± 0.13 vs. 0.35 ± 0.12, 0.88 ± 0.16 vs. 0.62 ± 0.15, and the difference was statistically significant ( P<0.05). After 3, 6 weeks of treatment, the V max and V min of the ophthalmic artery and central retinal artery in the observation group were higher than those in the control group: after 3 weeks of treatment: (29.42 ± 0.93) cm/s vs. (28.65 ± 0.90) cm/s, (8.04 ± 1.08) cm/s vs. (6.95 ± 1.12) cm/s, (8.42 ± 1.21) cm/s vs. (8.39 ± 1.19) cm/s, (4.05 ± 0.61) cm/s vs.(3.58 ± 0.57) cm/s; after 6 weeks of treatment: (31.72 ± 1.03) cm/s vs. (29.58 ± 0.95) cm/s, (9.81 ± 1.06) cm/s vs. (7.78 ± 1.15) cm/s, (12.01 ± 1.23) cm/s vs. (10.82 ± 1.07) cm/s, (4.65 ± 0.47) cm/s vs. (4.02 ± 0.36) cm/s; the RI of the ophthalmic artery and central retinal artery in the observation group were lower than those in the control group: after 3 weeks of treatment: 0.76 ± 0.06 vs. 0.80 ± 0.05, 0.70 ± 0.03 vs. 0.76 ± 0.04; after 6 weeks of treatment: 0.71 ± 0.05 vs.0.75 ± 0.04, 0.68 ± 0.04 vs.0.72 ± 0.03, and the differences were statistically significant ( P<0.05). After 3 and 6 weeks of treatment, the levels of TNF-α, IL-1β, IL-2, IL-6 of aqueous fluid in the observation group werelower than those in the control group: after 3 weeks of treatment: (2.61 ± 0.38) μg/L vs.(4.75 ± 0.41) μg/L, (3.45 ± 0.28) μg/L vs.(6.28 ± 1.05) μg/L, (6.28 ± 0.34) μg/L vs. (9.45 ± 1.14)μg/L, (9.82 ± 1.66) ng/L vs. (12.45 ± 2.31) ng/L; after 6 weeks of treatment: (0.98 ± 0.23) μg/L vs. (1.44 ± 0.27) μg/L, (1.11 ± 0.36) μg/L vs. (1.69 ± 0.38) μg/L, (3.68 ± 1.02) μg/L vs. (5.73 ± 1.15) μg/L, (4.11 ± 1.19) ng/L vs. (7.38 ± 1.06) ng/L, and the differences were statistically significant ( P<0.05). After 3, 6 weeks of treatment, the levels of NO in the observation group washigher than that in the control group: (56.49 ± 9.17) μmol/L vs. (50.22 ± 8.68) μmol/L, (60.18 ± 8.27) μmol/L vs. (53.24 ± 7.96) μmol/L; the levels of ET-1 waslower than that in the control group: (60.77 ± 9.61) ng/L vs. (65.02 ± 10.85) ng/L, (56.59 ± 7.22) ng/L vs. (61.18 ± 6.76) ng/L, and the differences were statistically significant ( P<0.05). The incidence of adverse reactions in the two groups had no statistical significance ( P>0.05). Conclusions:The injection of triamcinolone acetonide behind the eyeball to treat Purtscher disease can improve ocular hemodynamics, inhibit inflammation, improve vascular endothelial function and improve visual acuity. It has significant curative effect and certain safety.
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Objective:To investigate the relationship of interleukin (IL)-37, osteoprotegerin with coronary artery disease and its stenosisdegree.Methods:The prospective research method was used. From April 2018 to June 2019, two hundred and eleven suspected or diagnosed coronary artery disease patients who had chest pain or discomfort in Dalian Friendship Hospital were selected. The patients underwent selective percutaneous coronary angiography and completed coronary stenosis score (Gensini score). According to the degree of coronary stenosis, 211 patients were divided into the control group(coronary stenosis<50%, 45 cases), single-vessel stenosis group (single-vessel stenosis ≥ 50%, 52 cases), double-vesselstenosis group (double-vesselstenosis ≥ 50%, 58 cases), and triple-vessel stenosis group (triple-vessel stenosis ≥ 50%, 56 cases). The levels of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), lipoprotein a, uric acid, creatinine were measured by the automatic biochemical analyzer. The serum levels of IL-37 and osteoprotegerin were detected by enzyme-linked immunosorbent assay.Results:There were no statistical differences in FBG, uric acid, creatinine, TC, TG, LDL-C, HDL-C, ApoA1 and ApoB among 4 groups ( P>0.05). In the control group, single-vessel stenosis group, double-vessel stenosis group and triple-vessel stenosis group, lipoprotein a was (0.266 ± 0.060), (0.283 ± 0.070), (0.289 ± 0.066) and (0.307 ± 0.084) mg/L respectively; coronary stenosis score was (8.27 ± 7.08), (437.45 ± 98.47), (493.72 ± 125.19) and (522.61 ± 149.34) scores respectively; IL-37 was (342.27 ± 122.36), (437.45 ± 98.47), (493.72 ± 125.19) and (522.61 ± 149.34) ng/L respectively; osteoprotegerin was (378.29 ± 111.95), (458.39 ± 115.37), (502.50 ± 116.88) and (533.39 ± 139.83) ng/L respectively; and there were statistical differences among 4 groups ( P<0.05 or <0.01). IL-37, osteoprotegerin and lipoproteina were positively correlated with coronary stenosis score ( r = 0.43, 0.42 and 0.23, P<0.05), the osteoprotegerin was positively correlated with IL-37( r = 0.73, P<0.05). The multivariate linear regression analysis result showed that the IL-37 and osteoprotegerin were independent protective factors of coronary stenosis degree( β = 0.07 and 0.07, t = 2.72 and 2.57, P<0.01 or <0.05),and lipoproteina was independent risk factor of coronary stenosis degree ( β = 0.97, t = 2.89, P<0.01). Conclusions:IL-37 and osteoprotegerin are positively correlated with the degree of coronary stenosis. They are anti-inflammatory and protective factors of coronary heart disease.
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Objective:To investigate the levels of dose to eye lens of interventional radiology workers in China from 2017 to 2019.Methods:The monitoring data on eye lens doses to the interventional radiology workers in 28 provinces across the country were collected from National Individual Dose Registry. Monitoring was carried out using TLDs on their left eyes and evaluated in terms of the personal dose equivalent Hp(3). By using Mann-Whitney U test and Kruskal-Wallis H test, statistical analyses were made of the average annual lens doses to interventional radiology workers in the hospitals of different types at different levels for different years. Results:From 2017 to 2019, the data on eye lens doses to 2 981 interventional radiology workers were collected, with doses ranging from below the minimum detectable level (MDL) to 64.48 mSv, the average annual eye dose of 1.38 mSv, and the annual doses incurred by 0.97% monitored workers exceeding the recently recommended dose limits, 20 mSv per year. The average annual lens dose monitored in general hospitals and in cancer hospitals were 1.33 and 1.77 mSv, respectively, without statistically significant difference ( P>0.05). The average annual lens dose in tertiary hospitals was 1.39 mSv, significantly higher than that in secondary hospitals where the value was 1.16 mSv ( Z=2.894, P<0.05). Conclusions:The estimated annual eye lens doses to the interventional radiology workers during 2017-2019 were in accordance with the current national standard GB 18871-2002, but with a few exceptions exceeding the current international standards. This means that there exists, to a certain degree, a potential risk for the eye lens in this work category to exceed the international limits. It is suggested to continue in effort to enhance the monitoring of eye lens dose for these workers and to increase risk awareness, and take effective protective measures so as to lower the level of eye lens doses.
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Objective:To ascertain the levels of individual doses to radiation workers arising from occupationally external exposure in China in 2017, with an aim to provide basic data and scientific basis for prevention and control of occupational radiation sickness.Methods:Data on individual doses to monitored workers engaged in medical and industrial applications of radiation sources were collected through National Individual Dose Registry, with statistical analysis being carried out using Kruskal-Wallis H test, Mann-Whitney U test and Bonferroni method. Results:A total of 361 727 radiation workers were investigated in 2017, of which 81.6% was from medical application and 18.4% from industrial application, respectively. The average annual effective dose from medical and industrial applications were 0.353 and 0.270 mSv, respectively, with the former significantly higher than the latter ( Z=48.547, P<0.05). Furthermore, a statistically significant difference was seen in the average annual effective dose for each occupational category of medical application ( H=1 136.217, P<0.05), suggesting that the dose values for the monitored workers in nuclear medicine and interventional radiology were significantly higher than for other four medical categories ( Z=2.877-26.967, P<0.05). These dose values for the radiation workers was 0.361 mSv in tertiary hospitals, 0.397 mSv in secondary hospitals, and 0.308 mSv in primary and unrated hospitals, respectively. The dose values for the monitored workers in industrial radiography and well logging were significantly higher than for other five industrial categories of industrial applications ( Z=4.172-36.908, P<0.05). Conclusions:The average annual effective doses to the of monitored workers meet the relevant national standards. The exposure doses to the workers in nuclear medicine, interventional radiology, industrial radiography and well logging are relatively high. The necessary measures and devices for radiation protection should be further strengthened to reduce occupational exposure of workers.
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Objective:To evaluate the best preventive measures for hypothermia in patients undergoing hip and knee replacement.Methods:Cochrane Library, PubMed, CINAHL, Embase, Web of Science, CNKI, Wanfang, VIP and Chinese biomedical literature database were searched by computer. Randomized controlled trials on hypothermia prevention measures in hip and knee arthroplasty were searched, and back into the literature references, the retrieval time is from database establishment to December 2019; the two researchers independently conducted literature screening, quality evaluation, and data extraction according to the inclusion exclusion criteria, and used Revman5.3 software for meta-analysis of the included literature.Results:A total of 608 patients were included in 11 literatures. The results of Meta-analysis showed that: in terms of core temperature, the main outcome index, the Forced-air Warming System was superior to the non-Forced-air Warming measure such as electric blanket, electric heating pad and circulating water mattress ( SMD=0.59, 95% CI 0.27-0.92, P=0.0004); in terms of secondary outcome indexes, the Forced-air Warming System was better than the non-Forced-air Warming measure such as electric blanket, electric heating pad and circulating water mattress ( OR=0.28, 95% CI 0.14-0.58, P=0.0006); in terms of thermal comfort, the Forced-air Warming System had no significant effect ( SMD = 0.21, 95% CI-0.56-0.98, P=0.59). Conclusion:Compared with the Forced-air Warming System, the non-Forced-air Warming measure can effectively maintain the core temperature of patients undergoing hip and knee arthroplasty, reduce the occurrence of postoperative chills, but in the aspect of improve thermal comfort of patients is not obvious. However, due to the number of studies and their statistical heterogeneity, large sample and high-quality studies are needed to verify the results of this study.
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Objective To investigate the relationship between serum interleukin (IL)-33,osteoprotegerin and the severity of coronary artery disease in patients with coronary heart disease,and analyze the correlation between IL-33 and osteoprotegerin.Methods Two hundred and nineteen patients with coronary heart disease from April 2018 to June 2019 in Dalian Friendship Hospital were selected.The percutaneous coronary angiography was performed in all patients.Among them,acute myocardial infarction (AMI) was in 59 cases (AMI group),unstable angina pectoris (UAP) in 55 cases (UAP group),stable angina pectoris (SAP) in 55 cases (SAP group),and basically normal result was in 50 cases (control group).Serum IL-33 and osteoprotegerin levels were measured by enzyme-linked immunosorbent assay (ELISA),and the severity degree of coronary artery disease was assessed by Gensini scoring system.Results The IL-33 in SAP group,UAP group and AMI group was significantly higher than that in control group:(330.42 ± 82.56),(363.54 ± 61.36) and (448.62 ± 71.60) ng/L vs.(275.96 ± 74.34) ng/L,IL-33 in AMI group was significantly higher than that in SAP group and UAP group,and there were statistical differences (P ＜ 0.05).The osteoprotegerin in UAP group and AMI groupwas significantly higher than that in control group:(481.35 ± 101.68) and (558.29 ± 136.45) ng/L vs.(392.21 ± 109.57) ng/L,osteoprotegerin in AMI group was significantly higher than that in SAP group and UAP group:(558.29 ± 136.45) ng/L vs.(436.13 ± 121.84) and (481.35 ± 101.68) ng/L,and there were statistical differences (P＜ 0.05).The Gensini score in SAP group,UAP group and AMI group was significantly higher than that in control group:(23.31 ± 7.88),(44.37 ± 14.15) and (90.20 ± 42.01) scores vs.(7.17 ± 4.85) scores,Gensini score in UAP group was significantly higher than that in SAP group,Gensini score in AMI group was significantly higher than that in SAP group and UAP group,and there were statistical differences (P ＜ 0.05).Pearson correlation analysis result showed that serum IL-33 and osteoprotegerin levels were positively correlated with Gensini score (r =0.588 and 0.420,P ＜ 0.01),and serum IL-33 level was positively correlated with osteoprotegerin level (r =0.718,P ＜ 0.01).The receiver operating characteristic curve analysis result showed that the area under curve of IL-33 for the diagnosis of AMI was 0.887 (95％ CI 0.839 to 0.935,P ＜ 0.01),and the area under curve of osteoprotegerin for diagnosis of AMI was 0.754 (95％ CI 0.682 to 0.825,P＜0.01).Conclusions Serum IL-33 and osteoprotegerin levels are elevated in patients with coronary heart disease,and their elevated levels are positively correlated with the severity and instability of coronary artery disease and have a certain diagnostic value for AMI.
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Objective:To investigate the effects and the impact on maternal and infant outcome of Tianma-Gouteng Decoction combined low-dose aspirin for high-risk patients with pre-eclampsia (PE). Methods:A total of 94 high-risk patients who met the diagnose cretieria of PE from January 2017 to January 2019 in our hospital were divided into two groups by the random number table method, each group 47 cases. The control group based on symptomatic treatment, received daily 75 mg of aspirin enteric-coated metformin hydrochloride additionally; and the observation group took Tianma-Gouteng Decoction based on the control group. Both groups stopped taking medicine after 28th week of gestation. Immune turbidimetric method was used to detect D-dimer (D-D), the Claus method was used for detecting fibrinogen (Fib). The blood pressure meter was used to measure systolic blood pressure (SBP) and diastolic blood pressure (DBP). The poor maternal and infant outcomes were recorded. Results:After the treatment, the plasma D-D (0.50 ± 0.12 μg/L vs. 0.60 ± 0.30 μg/L; t=2.122, P=0.037), Fib (2.37 ± 0.22 g/L vs. 4.43 ± 0.56 g/L; t=23.473, P<0.01) in the observation group were significantly lower than the control group. The SBP (83.43 ± 4.01 mmHg vs. 96.30 ± 5.34 mmHg, t=13.212), DBP (113.77 ± 3.90 mmHg vs. 126.52 ± 4.43 mmHg, t=14.810) in the observation group were significantly lower than the control group ( P<0.01). The incidence of fetal and neonatal adverse outcomes in the observation group was 10.6% (5/47), the control group was 25.5% (12/47), and there was statistically significant between two groups ( χ2=3.519, P<0.05). The incidence of adverse outcome in the observation group was 31.9% (15/47), the control group was 55.3% (26/47), and there was statistically significant between two groups ( χ2=4.326, P<0.01). Conclusions:Tianma-Gouteng Decoction combined low-dose aspirin enteric-coated metformin hydrochloride can improve coagulation function, lower blood pressure, improve clinical efficacy, reduce the occurrence of advers outcomes for high-risk patients with PE.
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Objective@#To investigate the relationship between serum interleukin (IL)-33, osteoprotegerin and the severity of coronary artery disease in patients with coronary heart disease, and analyze the correlation between IL-33 and osteoprotegerin.@*Methods@#Two hundred and nineteen patients with coronary heart disease from April 2018 to June 2019 in Dalian Friendship Hospital were selected. The percutaneous coronary angiography was performed in all patients. Among them, acute myocardial infarction (AMI) was in 59 cases (AMI group), unstable angina pectoris (UAP) in 55 cases (UAP group), stable angina pectoris (SAP) in 55 cases (SAP group), and basically normal result was in 50 cases (control group). Serum IL-33 and osteoprotegerin levels were measured by enzyme-linked immunosorbent assay (ELISA), and the severity degree of coronary artery disease was assessed by Gensini scoring system.@*Results@#The IL-33 in SAP group, UAP group and AMI group was significantly higher than that in control group: (330.42 ± 82.56), (363.54 ± 61.36) and (448.62 ± 71.60) ng/L vs. (275.96 ± 74.34) ng/L, IL-33 in AMI group was significantly higher than that in SAP group and UAP group, and there were statistical differences (P<0.05). The osteoprotegerin in UAP group and AMI group was significantly higher than that in control group: (481.35 ± 101.68) and (558.29 ± 136.45) ng/L vs. (392.21 ± 109.57) ng/L, osteoprotegerin in AMI group was significantly higher than that in SAP group and UAP group: (558.29 ± 136.45) ng/L vs. (436.13 ± 121.84) and (481.35 ± 101.68) ng/L, and there were statistical differences (P<0.05). The Gensini score in SAP group, UAP group and AMI group was significantly higher than that in control group: (23.31 ± 7.88), (44.37 ± 14.15) and (90.20 ± 42.01) scores vs. (7.17 ± 4.85) scores, Gensini score in UAP group was significantly higher than that in SAP group, Gensini score in AMI group was significantly higher than that in SAP group and UAP group, and there were statistical differences (P<0.05). Pearson correlation analysis result showed that serum IL-33 and osteoprotegerin levels were positively correlated with Gensini score (r = 0.588 and 0.420, P<0.01), and serum IL-33 level was positively correlated with osteoprotegerin level (r = 0.718, P<0.01). The receiver operating characteristic curve analysis result showed that the area under curve of IL-33 for the diagnosis of AMI was 0.887 (95% CI 0.839 to 0.935, P<0.01), and the area under curve of osteoprotegerin for diagnosis of AMI was 0.754 (95% CI 0.682 to 0.825, P<0.01).@*Conclusions@#Serum IL-33 and osteoprotegerin levels are elevated in patients with coronary heart disease, and their elevated levels are positively correlated with the severity and instability of coronary artery disease and have a certain diagnostic value for AMI.
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OBJECTIVE: To analyze the results of occupational health monitoring on radiation workers in national medical institutions in 2018. METHODS: Through the National Radiation Health Information Platform Subsystem Occupational Radiation Diseases and Occupational Health Monitoring System, the monitoring data including the overview of radiological diagnosis and treatment institutions, occupational health management, and occupational health examination information across the country were collected for analysis in 2018. RESULTS: In 2018, there were a total of 55 902 radiological diagnosis and treatment institutions with 353 141 radiation workers nationwide. The radiation dose monitoring rate on individuals and hospitals was 94.6%(334 222/353 141) and 97.3%(91 051/93 559), respectively. The rate of health examination was 84.6%(298 914/353 141) and 95.4%(87 031/91 244) respectively.The monitoring rate on chromosomal aberration in peripheral blood lymphocytes was 0.3% in radiation workers. The rate of opacity under the posterior lens capsule was 4.3% and the rate of thyroid nodules was 25.7% in interventional radiology and nuclear medicine workers. CONCLUSION:s The personal dose monitoring rate and occupational health examination rate of radiation workers in medical institutions in China are maintained at a relatively high level. However, monitoring attention should also be paid to the analysis of chromosome aberrations in peripheral blood lymphocytes, the examination of eye lens and thyroid gland.
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Objective@#To investigate the clinical characters and diagnosis and treatment in patients with vesicoenteric fistula.@*Methods@#Two patients with vesicoenteric fistula were admitted to the Affiliated Hospital of Shanxi Datong University in 2012 and 2019, at the same time 64 cases with complete data referenced from China Journal Full-text Database from September 2001 to December 2018 were retrospectively studied. The pathogeny, main clinical manifestations, relevant examination, treatment methods and prognosis were analyzed, to explore the best diagnosis and treatment of vesicoenteric fistula.@*Results@#Among all of 66 patients, there were 49 males and 17 females. The pathogeny included intestinal cancer in 31 cases (46.97%), Crohn disease in 11 cases (16.67%), intestinal diverticulitis in 10 cases (15.15%), bladder cancer in 8 cases (12.12%), appendicitis and other inflammatory diseases in 5 cases (7.58%) and intraoperative injury in 1 case (1.52%). The main clinical feature included recurrent urinary tract infection in 45 cases (68.18%), fecaluria in 43 cases (65.15%), abdominal pain in 16 cases (24.24%) and pneumaturia in 16 cases (24.24%). Forty-one cases underwent CT examination, and the diagnostic rate was 58.54% (24/41); 47 cases underwent cystoscopy, and the diagnostic rate was 55.32% (26/47); 34 cases underwent cystography, and the diagnostic rate was 44.12% (15/34). Six cases (90.91%) were treated with surgery, and no perioperative death occurred. Twenty-eight cases were followed up, and the mean follow-up time was 4.1 years. Seven cases died of tumor recurrence and metastasis; 2 cases died of other basic diseases such as cardiovascular and cerebrovascular diseases. No other patients with benign vesicoenteric fistula died during follow-up.@*Conclusions@#The major cause of vesicoenteric fistula is intestinal malignancy, which shows emblematic clinical symptoms, and specific imaging characteristic. CT, cystoscopy and cystography are the main diagnostic technique. Surgical intervention is the major therapeutic choice, and the prognosis depends on the primary disease.
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Objective@#To develop occupational radiation disease and occupational health monitoring system for radiation workers in order to identify the current status of occupational health management of radiation workers in China.@*Methods@#In compliance with the relevant laws, regulations and standards in China, the system design was completed according to wide variety of needs.@*Results@#An occupational health monitoring system for radiation workers was initially established. The system consisted of four modules and three levels of users to make sure.@*Conclusions@#Through the collection of data, some key risk points existing in radiology diagnosis and treatment have been identified in relation to occupational radiation disease, so as to provide scientific basis for health administrative department to carry out decision-making and revision of laws and regulations.
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Objective@#To construct a national medical radiation protection monitoring information system (NMRPMIS) based on the national radiation health information platform, support the national medical radiation protection monitoring project data reporting, and comprehensively understand the current situation of medical radiation protection.@*Methods@#According to the national radiation protection monitoring plan, laws, regulations and standards, HTML, CSS and JavaScript were used in the front end, JAVA language was used in the back end, SQL server was used in the platform database and Tomcat was used as the middleware. A data reporting and analysis system was set in the system through B/S structure, with statistical analysis of the 2017 annual monitoring data carried out.@*Results@#The business composition of the platform includes four levels: data acquisition (through various business systems), data resource integration (integration of business system public data), application, and display. The national medical radiation protection monitoring system with flexible structure, centralized information and convenient operation was implemented. The national medical radiation protection information was reported in 2017. The basic situation of radiation protection in 33 565 hospitals and the performance and protection information of 10 624 pieces of radiation diagnosis and treatment equipment were reported in 2017. A total of 95 statistical information reports were completed, describing the current situation of medical radiation protection in China from four dimensions: time, administrative geographic information, hospital level, and equipment types.@*Conclusions@#Medical radiation protection monitoring system helped achieve the design goal and successfully complete the data reporting in 2017. It provides data support for understanding the current situation of medical radiation protection and the protection management policymaking in China.