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【Objective】 To explore the application effect of target management combined with intelligent display system on apheresis platelet donor recruitment. 【Methods】 Control group: 317 apheresis platelet donors were recruited according to the conventional appointment mode of intelligent display system from October 2020 to March 2021, with a total of 1 073 donations. Experimental group: 404 apheresis platelet donors were recruited using quantitative target management plus the intelligent display system from April 2021 to September 2021, with a total of 1 308 donations. The number of first-time donors, repeated donors, recalled donors after first-time donation, and their corresponding donations, as well as the double-dose collection rate, and the transfer-in/-out of platelet product were analyzed and compared. 【Results】 The number of first-time donors increased from 89 (28.08%) to 179 (44.31%) while repeated donors decreased from 228 (71.92%) to 225 (55.69%), all P0.05.The cumulative number of first-time and repeated platelet donors increased from 149 (13.89%) to 331 (25.31%), and 924 (86.11%) to 977 (74.69%), respectively(all P0.05). The double-dose collection rate decreased from 24.70% (265/1 073) to 13.46% (176/1 308)(P<0.05). The proportion of transfer-in platelets decreased from 3.64% (48/1 317) to 1.52% (22/1 452), while transfer-out platelet increased from 0.23% (3/1 317) to 2.34% (34/1 452)(all P<0.05). 【Conclusion】 The intelligent display system is conducive to facilitate the development of platelet donor recruitment and ensure the clinical supply of apheresis platelets.
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As a new therapeutic method, music therapy has a good clinical effect on improving the motor dysfunction of patients with stroke. This article reviews the concept, main forms of music therapy and its role in motor function recovery of patients with stroke.
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【Objective】 To strengthen the detail management of plateletpheresis venipuncture so as to reduce repeated puncture and further retain apheresis donors. 【Methods】 1 930 donations, involving 324 donors(including 92 first-time donors), with conventional venipuncture from October 1, 2018 to September 30, 2019 (controls) were compared with 1 873 donations, involving 353 donors(including 101 first-time donors), with optimized venipuncture from October 1, 2019 to September 30, 2020(experiment). The repeated puncture rate of the two groups and that contributed by rotating and fixed phlebotomists, respetively, the profile of donors suffered several repeated puncture and the re-donation rate of first-time apheresis donors were analyzed. 【Results】 The rate of secondary puncture in the experimental group(1.07%, 20/1 873) was lower than that in the control group(3.52%, 68/1 930)(P0.05). Control group fixed blood collection nurses had secondary puncture rate(1.85%, 16/863)lower than rotation blood collection nurses(4.87%, 52/1 067)(P<0.05). Experimental group of the same blood donor observation period occurred 1, 2 and above the rate of secondary puncture [5.10%(18/353)、0.28%(1/353)] were lowerthan the control group [10.19%(33/324)、4.01%(13/324)] (P<0.05). the re-donation rate of first-time platelet donors(67.33%, 68/101)was higher in experimental group than in control group(50.00%, 46/92)(P<0.05). 【Conclusion】 The repeated puncture rate has been significantly decreased by strengthening the detail management of apheresis venepuncture, which promotes, caring for blood donors and conducive to the recruitment and retention of apheresis donors.
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Objective To study the clinical efficiency and adverse reactions of simultaneous modulated accelerated radiotherapy (SMART)and intensity-modulated radiation therapy (IMRT)in advanced cervical cancer. Methods Sixty patients with advanced cervical cancer were collected from April 2011 to April 2017 in our hospital. The 60 patients were randomly divided into experimental group (30 cases)and control group (30 cases)by using stratified randomization method. The two groups were given intracavitary irradiation and concur-rent chemotherapy. The patients in experimental group were treated with SMART and the patients in control group were treated with IMRT. 95％ planned target volume was 50. 4 Gy/ 28 F in the two groups and the dose for IMRT with simultaneous integrated boost was 64. 4 Gy/ 28 F to the planning target volume. Disease progres-sion,survival time and adverse reactions of the two groups were compared. Results At the end of radiothe-rapy,the experimental group had 23 patients with complete response (CR),4 patients with partial response (PR),2 patients with unaltered stable disease (SD),1 patient with progressive disease (PD),and the control group had 22 patients with CR,3 patients with PR,3 patients with SD,2 patients with PD. The overall effi-ciency of the experimental group was slightly higher than that of the control group (90. 0％ vs. 83. 3％),but the difference was not statistically significant (χ2 = 0. 144,P = 0. 704). After 3 months of radiotherapy,the experimental group had 28 patients with CR,1 patient with PR,1 patient with PD,and the control group had 22 patients with CR,2 patients with PR,3 patients with SD,3 patients with PD. The overall efficiency of the experimental group (96. 7％)was higher than that of the control group (96. 7％ vs. 80. 0％),but the diffe-rence was not statistically significant (χ2 = 2. 588,P = 0. 108). The median overall survival time of the experi-mental group and control group were 43 months and 38 months,and the difference was statistically significant (χ2 = 7. 087,P = 0. 008). The 1-year survival rates of the two groups were 96. 6％ and 85. 7％,and the 3-year survival rates were 86. 2％ and 60. 7％,respectively. There were no significant differences in the inci-dences of gastrointestinal reaction (66. 7％ vs. 63. 3％,χ2 = 0. 073,P = 0. 787),urinary system reaction (33. 3％ vs. 30. 0％,χ2 = 0. 077,P = 0. 781)and bone marrow suppression (83. 3％ vs. 86. 7％,χ2 =0. 000,P = 1. 000)between the two groups. Conclusion The efficiency of advanced cervical cancer patient treated with SMART is better than IMRT,and the adverse reactions are tolerable,which is worthy of clinical promotion.
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Objective To observe the clinical effect of arthroscopic surgery on patients with rotator cuff tear injury. Methods One hundred and twenty patients with rotator cuff tears admitted to the Department of Orthopaedic of the First Hospital of Changsha from January 2013 to September 2015 were enrolled. Sixty patients treated with traditional conservative methods were assigned in a control group, the whole arthroscope or shoulder arthroscope was used to assist performing microsurgical incisions for another such 60 patients in the observation group. Visual analogue scale (VAS) of pain was applied to evaluate the pain of the patients with rotator cuff injury before and after treatment in both groups. The function of the shoulder joints and recovery situation were evaluated by using the shoulder functional system score and the American shoulder and elbow surgeon score (ASES). Results The results showed that all patients had no postoperative complications such as secondary fracture of the rotator cuff tear, infection, incision non-healing, etc. Compared with those before treatment, in both groups, the VAS scores were obviously lowered after treatment, while ASES and shoulder function system scores after treatment were significantly higher than those before treatment, and the changes in the observation group were more pronounced than those in the control group (VAS: 0.82±0.11 vs. 2.20±0.59, ASES: 82.21±10.81 vs. 70.53±6.21, pain score: 9.81±0.21 vs. 9.11±0.51, function score: 9.70±0.09 vs. 8.80±0.40, anterior flexion score: 4.59±0.41 vs. 4.20±0.61, all P ＜ 0.05). Conclusion The clinical effect of arthroscopic surgical treatment of patients with rotator cuff tear injury is relatively satisfactory and worthy to be deeply studied clinically.
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Objective To observe the clinical curative effect of enteral nutrition (EN) liquid rich in omega-3 polyunsaturated fatty acids (ω-3PUFA) for patients suffering from acute respiratory distress syndrome (ARDS) and treated with mechanical ventilation.Methods A prospective study was conducted, 40 patients with ARDS admitted and treated in the intensive care unit (ICU) and respiratory department in the Traditional Chinese Medicine Hospital of Huzhou from May 2007 to October 2016 were enrolled, and they were randomly divided into a study group and a control group, each group 20 cases. The same heat EN support of different prescriptions was given respectively in the two groups, nasal feeding with EN emulsion rich in ω-3PUFA (TPF-T) was applied in the study group, while in the control group, nasal feeding with EN suspension liquid of protein fiber type (TPF) was given, and the target energy established for the two groups was 104.0 - 125.5 kJ·kg-1·d-1. In the two groups, before and after treatment for 7 days, the changes of nutrition indexes [total protein (TP), albumin (ALB)], inflammatory index [C-reactive protein (CRP)], immune indexes (T cell subgroup CD4, CD8 and CD4/CD8), blood gas analysis indexes [arterial blood oxygen partial pressure (PaO2), oxygenation index (PaO2/FiO2)] and mechanical ventilation time, the length of stay in ICU and fatality rate were observed; the occurrences of false aspiration, feeding tube obstruction, high blood sugar, excessive water, diarrhea, constipation, etc. complications related to the process of the treatment were observed in the two groups. Results After treatment, the levels of TP, ALB, CD4, CD4/CD8, PaO2, PaO2/FiO2 in two groups were higher than those before treatment, the levels of CRP and CD8 were lower than those before treatment, and the improvement degrees of indexes in study group were superior to those in the control group [TP (g/L): 59.9±4.8 vs. 58.6±4.1, ALB (g/L): 31.9±3.4 vs. 31.1±4.4, CRP (mg/L): 25.8±18.5 vs. 38.1±24.9, CD4: 0.30±0.05 vs. 0.28±0.04, CD8: 0.21±0.03 vs. 0.19±0.04, CD4/CD8: 1.57±0.39 vs. 1.55±0.42, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 152.7±15.8 vs. 140.6±22.2, PaO2/FiO2 (mmHg): 304.5±32.1 vs. 280.2±44.1]; the survival patient mechanical ventilation time (days: 7.1±2.2 vs. 9.2±3.5) and length of stay in ICU (days: 10.4±2.8 vs. 12.6±3.6) were significantly shorter in study group than those in control group (allP < 0.05), and fatality rate was 15.0%in both groups.Conclusion The EN liquid rich in ω-3PUFA is more beneficial to the recovery of respiratory function than EN of protein fiber type in patients with ARDS, and the former EN also can shorten the mechanical ventilation time and the length of stay in ICU.
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Objective To investigate the effects of thyroid hormone on extremely severe traumatic brain injury (TBI).Methods A retrospective case-control study was conducted to analyze the treatment of 105 patients with extremely severe TBI admitted from July 2010 to April 2014.There were 79 males and 26 females,with an average age of 32.9 years.The patients were divided into conventional treatment group (Group A,35 cases),conventional treatment ± thyroxine treatment group (Group B,35 cases) and thyroxine treatment group after the condition that thyroxine level was low (Group C,35 cases) according to the random number table method.The incidence of low T3 and T4,incidence of hypotension,the dosage of vasoactive drugs,function evaluation of liver and kidney damage,Glasgow outcome scale (GOS),and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) within 20 days after admission,and mortality rate within 30 days after admission were compared and analyzed.Results Within 20 days after admission,the rates of low thyroxine levels and hypotension of the Group B (22.9％,77.1％) were significantly lower than those in the other two groups (Group A:40％,100％;Group C:37％,100％) (all P ＜ 0.05).The doses of dopamine and norepinephrine in Group B was significantly lower than the other two groups and the combination rate of vasopressors in Group B was significantly lower than the other two groups (P ＜ 0.05),while there was no significant difference between Group A and Group C (P ＞ 0.05).The corresponding data in Group A and Group C had no statistically significant difference (P ＞ 0.05).The liver and renal dysfunction rates of Group B (29％,31％) were significantly lower than those of the other two groups (Group A:49％,51％;Group C:43％,51％) (all P ＜ 0.05).The corresponding data in Group A and Group C had no statistically significant difference (P ＞ 0.05).GOS in Group B [(4.8 ± 1.9) points] was significantly higher than that in Group A [(3.3 ± 0.2) points] (all P ＜ 0.05) within 30 days after admission and significantly higher than that of itself at the beginning [(3.6 ± 1.1) points] (P ＜ 0.05).The APACHE Ⅱ in Group A was significantly higher than those in other two groups as well as that in Group A at admission (P ＜ 0.05).Mortality rates in Group B (31％) and Group C (29％) were significantly lower than that in Group A (69％) within 30 days after admission (P ＜ 0.05).Conclusions Thyroxine can reduce the incidence of hypotension,liver and kidney injury rate in extremely severe TBI.Prevention is better than the supplementary treatment after severe TBI.Thyroxine can also reduce the mortality of extremely severe TBI within 30 days after admission.
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Four compounds were isolated from the lateral roots of Aconitum carmichaeli by Al2O3,silica gel and preparative HPLC.Their structures were identified as:(13R,15S,19S)-13,15,19-triol-hetisan (1),fuziline (2),neoline (3) and beiwutine (4),by methods of NMR,MS spectroscopy as well as single crystal X-ray crystallography.Among them,compound 1 was considered as a new diterpenoid alkaloid.
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After the characteristics and significance of domestic and foreign open access publication were analyzed, the open access publication environments in domestic and foreign academic journals were compared in aspects of open access policy, scientific research management evaluation system and awareness of open access publication in persons engaged in scientific research, journal management system and journal management model, open access publication journals and open access publication papers in order to know the advantages of open access publication and the difficulties it is faced.Certain suggestions were proposed for its future development.
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Reliable data support, information technology and its products are needed to achieve the target of big data-based precision medicine.The mature clinical decision supporting products , such as seamless information product and nursing decision supporting products (my cancer genome and Watson) and studies on their related evi-dence in foreign countries were thus described in this paper with suggestions put forward for scientific achievements in genomes and in docking and integrating clinical electronic medical records, such as training learned bioinformatics professionals, sharing medical data, working out need-guided research strategies, constructing basic bioinformatics framework and cancer knowledge network.
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Objective To explore the effects of Rab11 on biological functions of human cervical cancer cell line HeLa through regulating the expression levels of Rab11. Methods The Rab11 siRNA was transfected into HeLa cells and the expression of Rab11 was detected by Western blot. CCK8 assay, colony formation experiments, EdU assay and Transwell assay were adopted to observe the effect of Rab11 on HeLa cells proliferation and invasion. Results The expression of Rab11 was decreased significantly in HeLa cells transfected with Rab11 siRNAs than that in control siRNA (1.096 ±0.091 vs 1.735 ±0.084, P< 0.01). The proliferation was markedly inhibited in Rab11 siRNA group compared with that in control siRNA group (48 h:0.721±0.092 vs 1.090±0.099; 72 h: 0.956±0.105 vs 1.482±0.096; 96 h: 1.231±0.099 vs 1.720±0.174, P< 0.01), the number of colonies was lower than that in control siRNA group (36±1 vs 75±8, P< 0.01) and so was proliferation rate [(33.880±1.902) % vs (45.570±2.025) %, P< 0.05]. The cell invasion rate of Rab11 siRNA group was lower than that of control siRNA group [(38.6 ±0.8) % vs (100.0 ±0.2) %, P< 0.01]. Conclusion Down-regulation of Rab11 expression can inhibit the growth of HeLa cells.
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Objective To investigate the effect of anisodamine on oxygen metabolism and organ function in dogs with sepsis.Methods Twenty beagles were divided into sepsis group (n =8) and anisodamine-treated group (n =12) according to the random number table.The sepsis model was established by cecal ligation and puncture.Changes in thrombomodulin (TM),arterial oxygen partial pressure (PaO2),oxgen uptake rate (ERO2) and lactate were mearsured before and 1,3,8 and 24 h after operation.Wet/dry ratio of lung tissues and incidence of multiorgan dysfunction syndrome (MODS) were detected 24 h after operation.Results Level of TM was increased progressively after operation,which was significantly higher in sepsis group than in anisodamine-treated group at 3,8 and 24 h [(28.7±15.9) vs (19.5 ±10.6)ng/ml,(36.5±20.8) vs (21.9±12.8)ng/ml,(52.6±32.7)vs (31.3 ± 18.4)ng/ml respectively] (P ＜ 0.05).The PaO2 decreased slowly after operation,with the decrease more significant in sepsis group than in anisodamine-treated group at 24 h [(65.6 ± 14.5) vs (83.3 ± 16.3)mmHg] (P ＜0.05).The ERO2 had a rise-and-fall trend after operation,with the level lower in sepsis group than in anisodamine-treated group at 24 h [(16.7 ± 3.1) ％ vs (21.7 ± 2.9) ％] (P ＜ 0.05).Level of blood lactate increased gradually,with the level higher in sepsis group than in anisodamine-treated group at 24 h [(4.4 ± 1.2) vs (3.1 ± 0.8) mmol/L] (P ＜ 0.05).Wet/dry ratio of lung tissues in sepsis group was (510 ± 80) ％ versus (370 ± 50) ％ in anisodamine-treated group at 24 h (P ＜ 0.05).Incidence of MODS in sepsis group was 38％ versus 17％ in anisodamine-treated group at 24 h (P ＜ 0.05).Conclusion Anisodamine may ameliorate the injury to vascular endothelial cells and oxygen metabolism disorder after sepsis and hence contributes to the reduction of sepsis-induced MODS.
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The article presents the contents of marketing of medical information services,explores the model of the marketing of medical information services suitable for the Medical Library of Chinese PLA,discusses the meaning of the marketing of medical information services,the status in this field in China and other countries,and the efforts we need to make next.The purpose is to match the information services to the information needs,support the innovation of medical science.
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Oncolytic adenoviruses have been used in cancer gene therapy because of their ability to selectively transfect and repli-cate in tumor cells. However, systemically administering oncolytic adenoviruses is often inefficient because the host's immunity also at-tacks the viruses. Delivering oncolytic adenoviruses by loading them into mesenchymal stem cells effectively solves this problem. Mes-enchymal stem cells have been described to possess a tumor-homing ability, as well as the capacity to deliver oncolytic adenoviruses. This review discusses the current challenges faced by oncolytic adenovirus delivery via mesenchymal stem cells.
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Objective To evaluate the recent clinical efficacy and safety of recombinant human adenovirus-p53 (rAd-p53) combined with radiochemotherapy in treatment for cervical squamocellular cancer (Sqc).Methods 21 patients with cervical squamous cell carcinoma were randomly divided into 2 groups:experiment group (10 patients received treatment with rAd-p53 intratumor injection combined with radiochemotherapy) and control group (12 patients treated with radiochemotherapy alone).The recent efficacy of the two groups were compared at the end of treatment,and major drug toxicity between the two group were compared during the treatment.Results In treatment group,2 cases recieved CR,6 cases PR,2 cases SD,and the rate of total effective was 80.0 ％.In control group,3 cases recieved CR,6 cases SD,2 cases PD,and the rate of total effective was 27.3 ％.The rate of total effective in treatment group is superior to that in control group (x2 =76.00,P ＜ 0.05).The major reaction of rAd-p53 were transient fever after rAd-p53 administration.The two groups of bone marrow inhibition reaction rate with no statistical difference (x2 =119.50,P ＞ 0.05).Conclusion rAd-p53 combined with radiochemotherapy in treatment of advanced cervical squamocellular carcinoma has a synergistic effect.It is a safe,effective and convenient treatment method for rAd-p53 intratumor injection.
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Objective To evaluate the possibility and reliability of laparoscopic management of cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice. Methods Eleven patients with cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice who underwent laparoscopic management were retrospectively studied.Results Ten cases were successful with laparoscopic management,among the total,4 patients were underwent laparoscopic cholecystectomy (LC),6 cases were experienced LC and laparoscopic common bile duct exploration (LCBDE).One case was converted to open operation.No serious complications were observed.All the patients were cured after the operative treatment.None of the complications could be traced after follow-up for 6 months. Conclusions Cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice is a challenge to laparoscopic surgeons.Intraoperative diagnosis is very difficultly,but very important.It is better prognosis by careful and skilled operators and reasonable operative method to be chose.
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Oncolytic adenoviruses are genetically altered to replicate within tumor cella while exhibiting a high degree of infectivity,good safety and specificity.The use of oncolytic adenoviruses to treat malignant brain tumors has been proved to be a promising mode of cancer therapy.Local injection of adenoviral vectors fails to reach scattered infiltrative tumor cells within the brain parenchyma and the therapeutic effect of intracereberal injections of oncolytic adenoviruses is only seen in the vicinity of the injection site.To remedy this and prevent possible tumor recurrence,stem cells have been explored as vehicles for gene therapy in brain tumors given that they possess an intrinsic tropism for brain glioma.
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After several thousand years of development,TCM has formed its own sets of research methods.such as observation,comparison,classification,trial and error,and deduction,etc.Based on the unique TCM theory,experiences of clinical diagnosis and treatment of TCM,the author put forward that the research of TCM should combine macrophenomenon and microphenomenon,quality and quantity,and"Zheng"and"Xie",emphasize locality feature for the purpose of promoting the science research level.
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Objective To evaluate the efficacy and safety of single intra-articular etanercept injection in patients with rheumatoid arthritis (RA) and spondyloarthropathy (SpA) who had knee arthritis.Methods This was a randomized, single-blind, parallel, controlled clinical trial. The subjects were the RA or SpA patients with the knee arthritis without deformity, moderate or severe bone erosion and obvious joint space narrowing in radiography in the target knees, who had taken at least 6-week therapy with routine dosage of disease modifying anti-rheumatic drugs (DMARDs) before the study. The subjects were randomized in 2:1 ratio to receive either single intra-articular 25 mg etanercept injection or 2 ml compound betamethasone to the target knees joint after their synovial fluid being drawn away at baseline. They were followed up four weeks after injection. The primary end-point was the 4-week change in the modified Hospital for Special Surgery (HSS) knee score for the target knee. Results Forty-seven subjects in the experimental group and twenty-three subjects in the controlled group were included in the trial. The modified HSS knee score for the experimental group was baseline mean 65.6 ± 14.0, follow-up 84.3 ±11.1 (P ＜0.0001 ), the controlled group baseline mean 68.2 ± 11.4, follow-up 79.4 ± 15.5(P =0.0015). A mean (34.9 ±38.9)% improvement on the modified HSS knee score was achieved in the experimental group, while ( 17.9 ±24.5)% improvement on the modified HSS knee score was achieved in the controlled group (P =0.0467). Adverse events were observed in eight patients (19.0% ) in the experimental group and eight patients (44.4%) in the controlled group. No serious adverse event had been observed. Conclusions Single intra-articular 25 mg etanercept injection had a better efficacy than 2 ml compound betamethasone. It was an effective and safe therapeutic option for SpA and RA patients who had knee arthritis without obvious change in radiography.
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AIM: To investigate the effect of ulinastatin plus thymosin - a, therapy on improving immune function in septic patients. METHODS: 70 patients were divided into two groups. One group was classical treatment group ( CT) with regular therapy and another group was classical treatment plus immunotherapy group ( CIT) with ulinastatin plus thymosin -a, for a week. The immune index before and after treatment on day 0,1,3 and 7 was observed, including the clinical and survival data. RESULTS: The most common pathogen of sepsis was bacteria, and infection by fungi was in rare. The common locations of bacteria observed were sputum and abdominal drainage. The level of TNF - α was significant lower in CIT group than that in CT group (P <0.05). IL - 10 level was significantly higher in CIT group than that in CT group (P < 0.05 ). IgG level was significant lower in CIT group than that in CT group (P < 0.05 ). No significant difference in the levels of IgA, IgM, C_3 and C_4 between two groups was observed (P > 0.05 ). CD4~+ T lymphocytes were significant higher in CIT group than those in CT group (P < 0.05 ). From day 7 to day 28, the lymphocytes and level of HLA -DR in CD14~+ monocytes were significant higher in CIT group than those in CT group (P < 0.05). The time of mechanical ventilation and vasopressors used in CIT group was shorter than those in CT group ( P < 0.05 ). But the length of stay and the cost in ICU showed no significant increase between these two groups (P >0.05). During hospitalization, 20 patients died in the CT group and 13 patients died in CIT group ( P < 0.05 ). The long - term survival time in CIT group was longer than that in CT group ( P < 0.05 ). CONCLUSION: Immunotherapy in septic patients can decrease TNF - α level and increase IL - 10 level. Immunotherapy in septic patients can increase IgC level slightly, CD4~+ T lymphocyte, and HLA - DR in CD14~+ monocytes, which improve the immune paralysis in septic patients. Immunotherapy can shorten the time of mechanical ventilation and vasopressors used, but it doesn't increase the length of stay and the cost.