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1.
Article in Chinese | WPRIM | ID: wpr-911404

ABSTRACT

Objective:To analyze the impact of rare bacteria infection on clinical outcome in patients with diabetic foot ulcer(DFU).Methods:A total of 288 cases infected with single strains bacteria were selected. Data were grouped according to the 15 bacteria infection identified. The outcomes of healing, amputation, cardio and cerebrovascular events, and death were collected, and risk factors to the outcome were analyzed.Results:The rare infected bacteria were acinetobacter baumannii, staphylococcus epidermidis, morgan morganella, staphylococcus haemolyticus, streptococcus lactis, streptococcus agalactiae, enterobacter cloacae, and serratia marcescens.There were significant differences in age, albumin, HbA 1C, body mass index, condition of foot ulcer, degree of infection, healing, and minor amputation among these groups. Severe lower extremity arterial disease and age over 70 years were the main risk factors for the healing of ulcers. Wagner grade over 3 and infected with streptococcus lactis were the main risk factors for minor amputation. Severe lower extremity arterial disease, hemoglobin(Hb)≤90 g/L, and albumin(ALB)≤30 g/L were the main risk factors for major amputation. Estimated glomerular filtration rate <60 ml·min -1·(1.73 m 2) -1 and Hb≤90 g/L were the main risk factors for heart failure. Age over 70 years and ALB≤30 g/L were the main risk factors for death(All P<0.05). Conclusion:There exist significant differences in general condition, foot ulcer, and outcome in DFU patients infected with rare bacteria strains.

2.
Article in Chinese | WPRIM | ID: wpr-910554

ABSTRACT

Objective:To investigate the sensitivity of the Catalyst HD in monitoring different skin colors, and assess the effect of skin color on the setup uncertainties using this system in radiotherapy.Methods:The standard cards guiding skin color and the cylinder model guiding quality control in radiotherapy were utilized to simulate the patients’ positioning. During the first monitoring, Catalyst HD was employed to acquire the image of the phantom as the reference image after conventional positioning (indoor laser+ phantom marking). When it was not the first monitoring, the couch was moved (-5 to 5 mm, step length of 2 mm) and Catalyst HD was adopted to obtain the surface image after conventional positioning. The bed deviation and corresponding setup errors monitored by Catalyst HD for different skin colors were recorded in the anterior-posterior (AP), superior-inferior (SI) and left-right (LR) direction, respectively.Results:During Catalyst HD monitoring, the integration time and gain were increased with the darker color. The logarithm of integration time and gain was significantly linearly negatively correlated with the same color ( R2>0.9). When the color difference with 1Y01SP was ΔE≤189, there was a significant correlation between the bed deviation and corresponding setup errors monitored by Catalyst HD in the SI and LR directions (R SI>0.5, R LR>0.5, R AP>0.9). The Catalyst HD monitoring was rapid and stable. When 218≤ΔE≤253, the correlation coefficients of them in the LR were R LR<0.3 and the Catalyst HD monitoring was stable. When 254≤ΔE≤285, the Catalyst HD failed to monitor stably. When ΔE>318, it failed to monitor this skin color. Conclusions:Gain, integration time and color have a certain correlation. The Catalyst HD can accurately monitor the setup errors within a specific range of skin color.

3.
Article in Chinese | WPRIM | ID: wpr-908993

ABSTRACT

Objective:To explore the application value of "5M1E" (man, machine, material, method, environment, measurement) analysis method combined with humanistic care education mode to standardized training of ophthalmic nurses.Methods:A total of 48 nurses who attended standardized training in Ophthalmology Department in The First Affiliated Hospital of Air Force Medical University from July 2015 to July 2020 were included in the study and divided into control group and research group according to the order of training, with 24 people in each group. The control group adopted the traditional clinical one-to-one teaching mode, while the research group adopted the "5M1E" analysis method combined with humanistic care education mode. After the training, the assessment scores and overall evaluation of teaching were compared between the two groups. SPSS 22.0 was used for t test and chi-square test. Results:The scores of theoretical assessment, ophthalmological operational skills assessment, comprehensive nursing ability assessment and humanistic care awareness assessment of nurses in the research group were significantly higher than those in the control group, with statistical significance ( P<0.001). As the teaching feedback of ophthalmology standardized training, in the control group, there were 17 general, 5 good and 2 excellent nurses; in the study group, 4 were general, 7 good, and 13 excellent. The differences between groups were statistically significant ( χ2=16.448, P<0.001). Conclusion:"5M1E" analysis method combined with humanistic care education mode is helpful to improve the theory knowledge, specialized operation skills, comprehensive nursing ability and humanistic care awareness of standardized training of ophthalmic nurses, and is of very important significance to improve the teaching quality of ophthalmic nurses.

4.
Article in Chinese | WPRIM | ID: wpr-908004

ABSTRACT

Micronutrients, as coenzymes and cofactors for many metabolic processes, play an important role in parenteral nutrition, but the guidelines and expert consensus published cannot fully solve the problem with clinical application of micronutrients.Parenteral Provision of Micronutrients to Pediatric Patients: an International Expert Consensus Paper, released in September 2020 in the Journal of Parenteral and Enteral Nutrition, presented recommendations about common clinical questions for the assessment of micronutrients deficiency in children and the parenteral provision of micronutrients.The main content of International Expert Consensus Paper was interpreted in this article.

5.
Article in Chinese | WPRIM | ID: wpr-906111

ABSTRACT

Objective:To investigate the effect of total ginsenoside ginseng root on the learning and memory impairment and anxiety of hindlimb suspension rats by detecting the performance of rats in the water maze, elevated plus maze, and the expression of hypothalamic-pituitary-adrenal (HPA) axis, inflammatory factors and tryptophan pathway related factors through the intervention of ginsenosides in hindlimb suspension rats. Method:The Wistar male rats were divided into normal group, hindlimb suspension model group, Huperzine A group (0.1 mg·kg<sup>-1</sup>), and total ginsenoside ginseng root low and high dose groups (100, 200 mg·kg<sup>-1</sup>), with 8 rats in each group. Except for the normal group, the rats in the other groups maintained a -30° hindlimb suspension state for 24 h. The normal group and the model group received intragastric administration of 10 mL·kg<sup>-1</sup> pure water . After 28 days of continuous administration, the water maze and elevated plus maze behavioral tests were performed. After the tests, blood was taken from the abdominal aorta, and the rat brain cortex was peeled off on ice, quenched with liquid nitrogen, and stored at -80 ℃ for later use. LC-MS/MS was used to detect neurotransmitter levels of dopamine, acetylcholine, glutamate, <italic>γ</italic>-aminobutyric acid and tryptophan pathway metabolites (tryptophan, 5-hydroxytryptamine, 5-hydroxyindoleacetic acid, kynurenine, 3-hydroxykynurenine, and kynurenine) in rat brain cortex. An enzyme-linked immunosorbent assay (ELISA) kit was used to detect the levels of inflammatory factors interleukin-6 (IL-6), interleukin-10 (IL-10, the HPA axis-related hormone corticotropin (ACTH), and the level of corticosterone (CORT). Result:Compared with the normal group, the escape latency in the water maze significantly increased, the number of crossings was significantly reduced, and the number of open-arm entry and the percentage of open-arm entry were significantly reduced in the elevated plus maze in model group (<italic>P</italic><0.05,<italic> P</italic><0.01), the content of dopamine, acetylcholine, glutamic acid, and <italic>γ</italic>-aminobutyric acid in the cortex decreased, kynurenine and kynurenic acid showed an upward trend, 3-hydroxykynurenine, 5-hydroxytryptamine, 5-hydroxyindole acetic acid showed a downward trend, and the levels of IL-6, IL-10, ACTH, and CORT in the serum significantly increased (<italic>P</italic><0.05, <italic>P</italic><0.01). Compared with the model group of rats, total ginsenoside ginseng root low and high dose groups group reduced the avoidance latency in the water maze, and increased the number of crossings and the number of open arms of the elevated plus maze, dopamine, acetylcholine, glutamate, and <italic>γ</italic>-aminobutyl content increased, while kynurenine and kynurenic acid showed a downward trend, 3-hydroxykynurenine, serotonin, and 5-hydroxyindole acetic acid showed an upward trend, and IL-6, IL-10, ACTH, and CORT factor levels were down-regulated(<italic>P</italic><0.05, <italic>P</italic><0.01). Conclusion:Hindlimb suspension for 28 days in simulated microgravity can impair the learning and memory ability of rats and cause anxiety-like behaviors. Total ginsenoside ginseng root can improve their learning and memory impairment and anxiety-like behaviors. The mechanism may be mainly related to inhibiting body inflammation and regulating HPA axis imbalance.

6.
Journal of Chinese Physician ; (12): 15-18, 2021.
Article in Chinese | WPRIM | ID: wpr-884002

ABSTRACT

Objective:To investigate the effect of ultrasound-guided early removal of indwelling catheter on recovery quality and catheter-related infection of patients with general anesthesia in post anesthesia recovery unit (PACU).Methods:From September 2019 to April 2020, 146 patients with gynecological benign diseases who underwent hysteroscopic surgery in the Department of Anesthesiology, Shenzhen Hospital of Southern Medical University were selected prospectively and randomly divided into two groups, with 4 cases excluded. The function of the bladder was evaluated by ultrasound in the anesthesia recovery room after operation. In the ultrasound group, 71 patients had no abnormality, and the catheter was removed after the residual urine of the bladder was drained. 71 patients in the control group were normal, and the catheter was removed 24 hours after operation. The residual urine volume, urine retention, incidence of restlessness, urinary tract infection rate, time to first walking and hospital stay were observed in the two groups after the first bladder emptying.Results:The incidence of agitation in PACU was 7.0%(5/71) in the ultrasound group and 22.5%(16/71) in the control group, with statistically significant difference ( P<0.01); the first postoperative walking time in the ultrasound group and the control group was statistically significant [(10.5±4.1)h vs (18.9±6.5)h, P<0.05]; the postoperative hospital stay in the ultrasound group and the control group was statistically significant [(3.2±1.3)d vs (5.1±2.5)d, P<0.05]. The incidence of urinary tract infection and urinary tract irritationin in ultrasound group was significantly lower than that in control group (1.4% vs 9.8%, 1.4% vs 14.0%, P<0.05). Conclusions:For uncomplicated patients after gynecological laparoscopic surgery, ultrasound evaluation of bladder function, extraction of residual urine immediately after the removal of catheter, is more conducive to the early recovery of patients than 24 hours after the removal of catheter.

7.
Article in Chinese | WPRIM | ID: wpr-880179

ABSTRACT

Primary immune thrombocytopenia (ITP) is a blood system disease mediated by autoimmune mechanism. Currently, the goal of treatment for primary ITP is to keep patients' peripheral platelet count at a safe level to prevent severe bleeding. Recently, avatrombopag and fostamatinib have been approved by the FDA for the treatment of primary ITP in adults, while new drugs such as rozanolixizumab, efgartigimod, PRTX-100, decitabine and atorvastatin have shown efficacy in early clinical trials. This review summarizes the current accepted therapies for the clinical treatment of primary ITP in adults, and briefly discuss the progress of new therapies.


Subject(s)
Adult , Hemorrhage , Humans , Platelet Count , Purpura, Thrombocytopenic, Idiopathic/drug therapy , Splenectomy
8.
Article in Chinese | WPRIM | ID: wpr-781458

ABSTRACT

OBJECTIVE@#To establish a novel flow cytometric immunobead array (FCIA) for detecting plasma von Willebrand factor antigen (vWF:Ag), and to analyze the clinical value of FCIA in predicting the prognosis of patients with ischemic stroke (IS).@*METHODS@#Anti-human vWF monoclonal antibody SZ29 IgG was coated on microspheres overnight, the diluted plasma was added after blocking, then incubated with FITC-conjugated sheep-anti-human vWF IgG polyclonal antibody, and finally detected by flow cytometry. The plasma vWF in 21 case of von Willebrand disease (vWD) and 105 controls (CTL) were detected by FCIA and ELISA, so as to carry out methodological assessment. Plasma vWF:Ag of 61 IS patients was detected by FCIA and the data of prognosis followed-up for 2-year were collected.@*RESULTS@#The linear fitting of FCIA was good (R2=0.99) without significant difference between FCIA and ELISA. The Bland-Altman bias was 1.12% with 95% limits of agreement that spanned from -45.06% to 47.30%, and the slope of the linear regression was 0.97 (r=0.86, P<0.01). Importantly, the FCIA method was faster than ELISA, and superior to the ELISA in the detection of low levels of vWF:Ag. The levels of vWF:Ag, vWF:GPIbR and vWF:CB in IS patients were significantly higher than those in healthy controls (Z=8.36, 8.71, 6.22, respectively, P<0.01).@*CONCLUSION@#The FCIA for detecting plasma vWF:Ag is not only an effective supplement to ELISA, but also the efficiency is faster and more sensitive, thus improves the diagnosis of type 3 vWD. Elevated levels of vWF: Ag in IS patients indicate the poor recovery of daily activities and prognosis.

9.
Article in Chinese | WPRIM | ID: wpr-798806

ABSTRACT

Objective@#To investigate the correlation between skin elasticity and setup error in optical surface image-guided radiotherapy.@*Methods@#The skin elasticity (R7) data of the head, chest and abdomen were extracted and analyzed its correlation with age by systematic literature review. Fifty-four patients diagnosed with nasopharyngeal carcinoma, breast cancer and cervical cancer were recruited in this study. Firstly, the patients were positioned based on the room laser and markers. Subsequently, the patient position was verified by the Varian On-Board Imager, and then C-Rad Catalyst was adopted to obtain surface images in two states (mask or non-mask) as reference images. In the subsequent fraction treatment, after initial positioning, the local calibration was performed by Catalyst, and setup errors in three directions were recorded. Meanwhile, the patient setup was verified by CBCT twice a week. The Pearson correlation analysis was performed to analyze the correlation between setup error and age.@*Results@#The skin elasticity was negatively correlated with aging (P<0.01). The correlation coefficient between random error and age in head-and-neck cancer were 0.645, 0.624 and 0.866 in the AP, SI and LR directions (all P<0.05) for male patients without mask, respectively. The system error was significantly correlated with age in the LR direction (P<0.05) for male patients, and in the AP direction (P<0.05) for female patients with head-and-neck cancer without mask. The setup error had a significant correlation with skin elasticity in male patients with head-and-neck cancer, and the sequence of absolute value of correlation coefficient was LR>SI>AP.@*Conclusion@#In optical surface-guided radiotherapy of head and neck cancer, skin elasticity may be a significant index for assessing the setup errors in male patients.

10.
Article in Chinese | WPRIM | ID: wpr-868547

ABSTRACT

Objective To investigate the correlation between skin elasticity and setup error in optical surface image-guided radiotherapy.Methods The skin elasticity (R7) data of the head,chest and abdomen were extracted and analyzed its correlation with age by systematic literature review.Fifty-four patients diagnosed with nasopharyngeal carcinoma,breast cancer and cervical cancer were recruited in this study.Firstly,the patients were positioned based on the room laser and markers.Subsequently,the patient position was verified by the Varian On-Board Imager,and then C-Rad Catalyst was adopted to obtain surface images in two states (mask or non-mask) as reference images.In the subsequent fraction treatment,after initial positioning,the local calibration was performed by Catalyst,and setup errors in three directions were recorded.Meanwhile,the patient setup was verified by CBCT twice a week.The Pearson correlation analysis was performed to analyze the correlation between setup error and age.Results The skin elasticity was negatively correlated with aging (P<0.01).The correlation coefficient between random error and age in headand-neck cancer were 0.645,0.624 and 0.866 in the AP,SI and LR directions (all P<0.05) for male patients without mask,respectively.The system error was significantly correlated with age in the LR direction (P<0.05) for male patients,and in the AP direction (P< 0.05) for female patients with head-and-neck cancer without mask.The setup error had a significant correlation with skin elasticity in male patients with head-and-neck cancer,and the sequence of absolute value of correlation coefficient was LR > SI > AP.Conclusion In optical surface-guided radiotherapy of head and neck cancer,skin elasticity may be a significant index for assessing the setup errors in male patients.

11.
Article in Chinese | WPRIM | ID: wpr-864547

ABSTRACT

Objective:To evaluate the clinical effects of painting therapy on fatigue, anxiety and depression in patients with hematological neoplasms undergoing chemotherapy.Methods:Totally 78 patients with hematological neoplasms admitted to the laminar flow ward in a tertiary hospital in Shanghai from October 2018 to May 2019 were enrolled. Patients who were included from October 2018 to January 2019 constituted the control group (39 cases), others from February to May 2019 constituted the intervention group (39 cases). Patients in both groups received routine health education and psychological care, and the intervention group received extra 4 weeks of painting intervention once a week. The Revised Piper Fatigue Scale (PFS-R), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess fatigue and emotional status of two groups during chemotherapy before the intervention, after the intervention and one month after the intervention. One case in control group was lost to follow-up while three cases in intervention group.Results:At 2 times points after painting therapy, total fatigue、anxiety and depression score in the intervention group were (4.04±0.91), (48.81±3.92), (46.06±4.53), (3.55±0.84), (47.47±4.33), (45.17±4.74) points; those in the control group were (5.34±1.18), (51.13±3.88), (50.63±4.36), (5.07±1.40), (52.74±4.04), (51.24±4.01) points.The time effect on fatigue of each dimension and total scores, anxiety and depression scores was significant ( F values were 48.859-126.096, P<0.05); the group effect and the interaction effect of intervention and time on sensory, emotional, behavioral and total fatigue scores, anxiety and depression scores were significant ( F values were 6.037-37.014, P<0.05; F values were 7.696-35.754, P<0.05). Conclusion:Painting therapy can effectively alleviate fatigue and relieve anxiety and depression in patients with hematological neoplasms undergoing chemotherapy.

12.
Article in Chinese | WPRIM | ID: wpr-863859

ABSTRACT

Acute pancreatitis (AP) is a common disease faced by clinicians. Severe acute pancreatitis (SAP) has a high mortality rate, so early identification of patients who may develop into SAP is of great significance for guiding treatment. Machine learning is a multi-layer representational learning algorithm that analyzes and obtains laws from existing data and uses these laws to make predictions on unknown data. This study established an SAP prediction scoring system based on machine learning, which can predict the SAP risk of patients within 24 hours. The prediction accuracy rate is as high as 87.36% and AUC 94.11%. The model can better assist clinical decision-making and treatment, and guide doctors to make relevant interventions earlier.

13.
Chinese Medical Journal ; (24): 425-430, 2020.
Article in English | WPRIM | ID: wpr-877916

ABSTRACT

BACKGROUND@#Previously, we developed a novel Coronary Artery Tree description and Lesion EvaluaTion (CatLet©) angiographic scoring system, which was capable of accounting for the variability in the coronary anatomy and assisting in the risk-stratification of patients with acute myocardial infarction (AMI). Our preliminary study revealed that the CatLet score better predicted clinical outcomes for AMI patients than the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score. However, the reproducibility of the CatLet score in both inter- and intra-observer remains to be evaluated.@*METHODS@#A total of 30 consecutive AMI patients, admitted in September of 2015, were independently assessed by two experienced interventional cardiologists to evaluate the inter-observer reproducibility of the CatLet score. Another set of 49 consecutive AMI patients, admitted between September and October in 2014, were assessed by one of the two interventional cardiologists on two occasions 3 months apart to evaluate the intra-observer reproducibility of the CatLet score. The weighted kappa was used to express the degree of agreement.@*RESULTS@#The weighted kappa values (95% confidence interval) for the intra- and inter-observer reproducibility of the CatLet Score were 0.82 (0.59-1.00, Z = 7.23, P 22). Regarding the adverse characteristics pertinent to lesions and dominance parameters, the kappa values for the inter-observer variability were 0.80 (0.56-1.00, Z = 6.47, P < 0.001) for total number of lesions, 0.57 (0.28-0.85, Z = 3.03, P < 0.001) for bifurcation, 0.69 (0.43-0.96, Z = 5.06, P < 0.001) for heavy calcification, 1.00 (0.72-1.00, Z = 6.93, P < 0.001) for tortuosity, 0.54 (0.26-0.82, Z = 3.78, P < 0.001) for thrombus, 0.69 (0.48-0.91, Z = 6.29, P < 0.001) for right coronary artery dominance, 0.69 (0.41-0.96, Z = 4.91, P < 0.001) for left anterior descending artery length, and 0.22 (0.06-0.51, Z = 1.56, P = 0.06) for diagonal size. Equivalent values for the intra-observer variability were moderate to almost perfect (range 0.54-1.00).@*CONCLUSIONS@#The reproducibility of the CatLet angiographic scoring system for evaluation of the coronary angiograms ranged from substantial to excellent. The high reproducibility of the CatLet angiographic scoring system will boost its clinical application to patients with AMI.


Subject(s)
Coronary Angiography , Coronary Artery Disease , Humans , Myocardial Infarction/diagnostic imaging , Observer Variation , Reproducibility of Results , Treatment Outcome , Trees
14.
Article in Chinese | WPRIM | ID: wpr-828656

ABSTRACT

OBJECTIVE@#To systematically summarize the clinical features of coronavirus disease 2019 (COVID-19) in children.@*METHODS@#PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Weipu Database, and Wanfang Database were searched for clinical studies on COVID-19 in children published up to May 21, 2020. Two reviewers independently screened the articles, extracted data, and assessed the risk of bias of the studies included. A descriptive analysis was then performed for the studies. Related indices between children with COVID-19 and severe acute respiratory syndromes (SARS) or Middle East respiratory syndrome (MERS) were compared.@*RESULTS@#A total of 75 studies were included, with a total of 806 children with COVID-19. The research results showed that the age of the children ranged from 36 hours after birth to 18 years, with a male-female ratio of 1.21 : 1. Similar to SARS and MERS, COVID-19 often occurred with familial aggregation, and such cases accounted for 74.6% (601/806). The children with COVID-19, SARS, and MERS had similar clinical symptoms, mainly fever and cough. Some children had gastrointestinal symptoms. The children with asymptomatic infection accounted for 17.9% (144/806) of COVID-19 cases, 2.5% (2/81) of SARS cases, and 57.1% (12/21) of MERS cases. The children with COVID-19 and MERS mainly had bilateral lesions on chest imaging examination, with a positive rate of lesions of 63.4% (421/664) and 26.3% (5/19) respectively, which were lower than the corresponding positive rates of viral nucleic acid detection, which were 99.8% and 100% respectively. The chest radiological examination of the children with SARS mainly showed unilateral lesion, with a positive rate of imaging of 88.9% (72/81), which was higher than the corresponding positive rate of viral nucleic acid detection (29.2%). Viral nucleic acid was detected in the feces of children with COVID-19 or SARS, with positive rates of 60.2% (56/93) and 71.4% (5/7) respectively. The children with COVID-19 had a rate of severe disease of 4.6% (31/686) and a mortality rate of 0.1% (1/806), the children with SARS had a rate of severe disease of 1.5% (1/68) and a mortality rate of 0%, and those with MERS had a rate of severe disease of 14.3% (3/21) and a mortality rate of 9.5% (2/21).@*CONCLUSIONS@#Children with COVID-19 have similar symptoms to those with SARS or MERS, mainly fever and cough. Asymptomatic infection is observed in all three diseases. Children with COVID-19 or SARS have milder disease conditions than those with MERS. COVID-19 in children often occurs with familial aggregation. Epidemiological contact history, imaging examination findings, and viral nucleic acid testing results are important bases for the diagnosis of COVID-19.


Subject(s)
Betacoronavirus , Child , Coronavirus Infections , Cough , Virology , Female , Fever , Virology , Humans , Male , Middle East Respiratory Syndrome Coronavirus , Pandemics , Pneumonia, Viral , Severe Acute Respiratory Syndrome , Virology
15.
Article in Chinese | WPRIM | ID: wpr-755694

ABSTRACT

Objective Most common infected bacteria were found to analyze their effects on clinical characteristics and 3-year outcome of patients with diabetic foot ulcer ( DFU ) . Methods Materials of cases with positive bacterial culture were selected from DFU patients. 203 cases were infected with the most common 6 strains of mono-bacteria, and 62 cases were infected with multi-bacteria. Data were grouped according to the most common 6 infected bacteria. The outcomes of healing, recurrence, amputation, cardiac events, cerebrovascular events and death were calculated of 3 years after hospitalization. Clinical characteristics of mono-and multi-infected groups and these 6 mono-bacterial infection groups, and risk factors to outcome were analyzed. Results No significant difference was found in baseline clinical characteristics, cardiac and cerebrovascular events, and death during follow-up between mono-and multi-infected groups. The most common 6 infected bacteria were staphylococcus aureus, pseudomonas aeruginosa, proteus, enterococcus faecalis, escherichia coli and klebsiella pneumoniae. Among these groups, there were no significant differences of baseline clinical characteristics and recurrence, cardiac and cerebrovascular events, and death except for the foot ulcer and foot ulcer related prognosis. In staphylococcus aureus infected group, severe lower extremity arterial disease (8.5%), Wagner grade 3-5 (48.9%), moderate and severe infection rate (34.0%) were significantly lower than other groups, and the healing rate ( 93. 6%) was higher than other groups ( all P<0.05). Severe lower extremity arterial disease, cardiac function grading over 3(NYHA), eGFR<60 ml·min-1· (1.73 m2)-1, duration of DFU over 30 days were the main risk factors for ulcers′healing. Wagner grade over 3 was main risk factor for minor amputation. Severe lower extremity arterial disease, Hb<90g/L were the main risk factors for major amputation. Cardiac function grading over 3 ( NYHA ) was main risk factor for cardiac events, and also for death. ALB<30 g/L was main risk factor for death (all P<0.05). Conclusion DFU patients infected with different strains of bacteria were significantly different in foot ulcer and healing rate, while not in cardiac and cerebrovascular events and death.

16.
Journal of Experimental Hematology ; (6): 1955-1961, 2019.
Article in Chinese | WPRIM | ID: wpr-781512

ABSTRACT

OBJECTIVE@#To establish a flow cytometric immunobead array assay (FCIA) to quantify platelet antibodies and to explore its application in the diagnosis and treatment of ITP.@*METHODS@#The guantitative standard curve was established by binding the human IgG of known concentration on antibody-coated microbeads; at the same time, the platelet-specific antigen and antibody complex was captured and levels of platelet antibodies were detected using the microbeads coated by 5 kinds of antibodies against platelets suca as GPIX (SZ1), GPⅠb (SZ2), GpⅢa (SZ21), GPⅡb (SZ22) and p-selection (SZ51). The fluorescence signal detected by flow cytometry were transformed into the conentration of platelet antibodies in samples through the quantitative standard curve, thereby establishing the method for quantititive detection of platelet-specific antibodies in plasm samples (FCIA), moreover the property, efficiency and clinical application of establishod FCIA method were evaluated.@*RESULTS@#The FCIA could detect 5 kinds of antibodies against GPIX, GPⅠb, GpⅢa, GPⅡb and β-selection within a broad range of 33.29-1280 ng/ml, 45.17-1280 ng/ml, 42.07-1280 ng/ml, 46.40-1280 ng/ml, 42.48-1280 ng/ml and 42.48-1280 ng/ml respectively, and their recovery rates were 115.23%, 112.58%, 117.47%, 107.64% and 112.67% respectively. The intra-assay coefficient of variation (CV) for anti- GPIX, -GPⅠb, -GpⅢa, -GPⅡb and p-selection antibodies was 3.54%, 3.63%, 4.66%, 6.43% and 6.67% respectively, and the inter-assay CV for above mentioned antibodies were 10.89%, 7.57%, 10.34%, 6.95% and 10.72% respectively. The detection showed that the levels of 5 kinds of platelet-specific antibodies in ITP group all were higher than those in non-ITP and healthy control groups (P<0.01). The sensitivity, specificity and accuracy of quantitatively detecting 5 kinds of antibodies for diagnosis of ITP by FCIA were 68.29%, 84.98% and 78.95% respectively, while the sensitivity, specificity and accuracy of detecting 5 kinds of antibodies by modified indirect MAIPA were 41.46%, 90.41% and 72.81% respectively.@*CONCLUSION@#The established quantitative FCIA for detection of antibodies provides a powerful tool for diaghosis and evaluation of therapeutic efficacy and prognosis of ITP patients.


Subject(s)
Antibodies , Autoantibodies , Blood Platelets , Flow Cytometry , Humans , Purpura, Thrombocytopenic, Idiopathic
17.
Acta Pharmaceutica Sinica ; (12): 2031-2038, 2019.
Article in Chinese | WPRIM | ID: wpr-780293

ABSTRACT

Polymyxin B and polymyxin E (colistin) are increasingly used as last-resort drugs for treatment of infections caused by multidrug-resistant gram-negative pathogens. Unfortunately, the application was limited due to the serious side effects, especially nephrotoxicity. Very recently, the need for developing more tolerated and more effective polymyxin analogues has grown. This study details the design, synthesis, and evaluation of two classes of polymyxin B analogues with varying hydrophobicity and bulkiness at the N-terminal fatty acyl chain or position 6 amino acid. 20 polymyxin B analogues were synthesized and the chemical structures of the analogues were confirmed by HR-MS and 1H NMR spectra. Compounds 7e (MIC: 0.5-4 μg·mL-1) and 7l (MIC: 0.25-2 μg·mL-1) showed similar or better antimicrobial activity against both susceptible and resistant strains of Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa compared to polymyxin B (MIC: 0.5-2 μg·mL-1). Besides, compound 7l (CC50: 217.1±13.2 μg·mL-1) displayed noticeably decreased renal cytotoxicity compared to polymyxin B (CC50: 120.3±6.0 μg·mL-1). This work establishes the base of further study on the structure-activity relationship of polymyxin B.

18.
Article in Chinese | WPRIM | ID: wpr-745281

ABSTRACT

Objective To evaluate the clinical application of Catalyst system in positioning patients during cervical cancer radiotherapy,and to analyze its correlation with the bladder volume and body mass index (BMI) of patients.Methods A total of 33 patients diagnosed with cervical cancer from July to December 2017 in our hospital were included in the study.All patients were auxiliary positioned by an optical surface imaging system (C-Pad Catalyst) before each treatment.The CBCT imaging was executed twice a week.The setup errors from Catalyst and CBCT in the anterior-posterior (AP),superior-inferior (SI) and leg-fight (LR) directions were recorded.Each patient's bladder volume and BMI were also recorded.Results The setup errors between Catalyst with masks and CBCT had the significant difference in SI (P<0.05) and LR (P<0.05).For Catalyst without masks,the setup errors with the bladder volume of 200-300 ml had the significant association in SI (R=-0.316,P<0.05).For the bladder volume of>300 ml,the setup errors for Catalyst with masks had the significant association in AP (R=-0.493,P<0.05),and that without masks had the significant association in SI and LR (R=0.335,P<0.05,R=-0.348,P<0.05).For patients of<25 kg/m2,setup errors for Catalyst with masks had the significant association with the BMI in LR (R=0.197,P<0.05);for ≥ 25 kg/m2,that with masks had the significant association in AP and SI (R =0.818,P<0.05;R=-0.498,P<0.05),that without masks had the significant association in AP and LR (R=0.652,P<0.05;R=-0.558,P<0.05).Conclusion Unlike CBCT system,the patient positioning by Catalyst system was easily affected by the bladder volume and BMI of patients.

19.
Article in Chinese | WPRIM | ID: wpr-774334

ABSTRACT

OBJECTIVE@#To establish a novel flow cytometric immunobead array (FCIA) for detecting plasma von Willebrand factor activity (vWF:GPIbR) and apply it in ischemic stroke (IS).@*METHODS@#Microspheres coated with anti-human platelet glycoprotein Ibα (GPIbα) monoclonal antibody SZ151 IgG, were incubated with recombinant fragment of GPIbα, then added ristocetin and plasma, finally incubated with FITC-conjugated sheep-anti-human vWF IgG polyclonal antibody, and detected by flow cytometry. vWF antigen (vWF:Ag), vWF:GPIbR, and vWF collagen binding assay (vWF:CB) were also included for evaluating vWF levels in IS patients.@*RESULTS@#The intra-assay coefficient variations (CVs) and inter-assay CVs of FCIA were 7.7% and 13.5%, respectively. The slope of the linear regression was 0.9739 (r=0.855, P<0.001), and the Bland-Altman bias was 9.95%, indicating a good correlation between FCIA and ELISA. The FCIA had better sensitivity, specificity and accuracy as compared with those by ELISA (P<0.05). The levels of vWF:Ag, vWF:GPIbR and vWF:CB in IS patients were significantly higher in comparison with those in healthy controls (H=7.8, 6.4, 6.2, respectively, P<0.01), the level of vWF:GPIbR in IS patients positively correlated with levels of vWF:Ag, high-sensitivity C-reactive protein, Autar score and hospitalization time.@*CONCLUSION@#The FCIA for detecting plasma vWF:GPIbR is more specific and accurate than ELISA. The vWF:GPIbR is involved in the paroxysm of IS, which could be used to evaluate the risk of thrombosis in IS patients.


Subject(s)
Animals , Brain Ischemia , Flow Cytometry , Humans , Prognosis , Sheep , Stroke , von Willebrand Diseases , von Willebrand Factor
20.
Article in Chinese | WPRIM | ID: wpr-803471

ABSTRACT

Objective@#To investigate the effect of cognitive behavioural therapy (CBT), which is dominated by nurses, on depression in patients with acute leukemia.@*Methods@#Patients with acute leukemia admitted to the Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were evaluated with a rapid depressive symptom (QIDS-SR16) self-rating scale. Patients with a score higher than 11 were psychiatrists from the Shanghai Mental Health Center. Interviews and Hamilton Depression Rating (HAMD-17) assessment and clinical stereotype examination (SCID-I) diagnostic screening were performed. Patients with significant depressive symptoms who met the inclusion criteria were included (without considering DSM-5 diagnosis for depressive disorder). The computer random number method was assigned to the control group (group C), the therapist-led group CBT group (group T), the group CBT group with the nurse as the main body and therapists as the supervisors (group N). The group C was given the conventional method and the group T and N was given the standardized group CBT once a week for 8 weeks. Interviews were performed at baseline (before intervention), 4 weeks, and 8 weekends to assess the HAMD scale score.@*Results@#Finally, 90 patients were enrolled, 30 in each group. At the end of the 4th week, the HAMD scale score (22.60±2.71) in the group T was lower than that before the intervention (25.77±2.93), and lower than the group N (24.57±2.82) and the group C (25.90± 3.88), the difference was statistically significant (t=5.395, 7.473, P<0.01 or 0.05). At the end of the 8th week, the group T (21.00±2.18) and the group N had a HAMD scale score (19.30±2.45) lower than the pre-intervention (25.77±2.93, 25.90±3.26), and were lower than the group C (24.80±3.56), the difference was statistically significant (t=6.192, 7.323, P<0.05 or 0.01).@*Conclusions@#CBT can improve the anxiety and depressive symptoms of patients with acute leukemia, and it is worthy of popularization and application.

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