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Objective:To investigate the efficacy of double S-shaped elastic stable intramedullary nailing in the treatment of paediatric fractures of the distal tibia diaphyseal metaphyseal junction.Methods:From January 2018 to January 2022, a total of 25 children with fracture of the distal tibia diaphyseal metaphyseal junction were treated at Department of Pediatric Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University. All of them were treated with closed reduction and double S-shaped elastic stable intramedullary nailing. There were 16 males and 9 females with an average age of (10.4±3.3) years, and 14 left sides and 11 right sides. The operation time, imaging results and complications were recorded after operation. At the last follow-up, the American Orthopaedic Foot & Ankle Society (AOFAS) scoring was used to evaluate the efficacy.Results:Closed reduction succeeded in all patients. The operation time was (55.6±23.7) min. Follow-up lasted (20.5±4.7) months for this cohort. Bony union was achieved in all patients after (11.5±2.7) weeks. No postoperative complications occurred in the patients, like infection, loss of reduction, disparity in length of lower limbs, delayed union or non-union. The AOFAS scoring at the last follow-up yielded 23 excellent and 2 good cases, and an excellent and good rate of 100% (25/25).Conclusion:In the treatment of paediatric fractures of the distal tibia diaphyseal metaphyseal junction, double S-shaped elastic stable intramedullary nailing is a safe, effective and feasible option.
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Coronavirus disease 2019(COVID-19)is highly infectious,severe and critically ill patients have high mortality and lack specific treatment,so it is urgent to find safe and effective treatment methods.Mesenchymal stem cells(MSCs)have biologi-cal properties such as immune regulation,tissue repair,regeneration,migration and homing,antiviral and anti-inflammatory.At present,studies on use of MSCs in treatment of COVID-19 have been gradually carried out.This paper reviews pathogenesis of 2019 novel coronavirus(2019-nCoV),potential regulatory mechanisms and challenges of MSCs in treatment of COVID-19.
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Objective:To explore the features of self-serving bias among adolescents with different tspes of high self-esteem.Methods:A total of 1 027 adolescents were sampled.Among them 230 adolescents with explicit high self-esteem were selected with the Rosenberg Self Esteem Scale(RSES),36 adolescents with secure high self-esteem and 36 adolescents with fragile high self-esteem were selected with the Implicit Self-esteem Test(IAT).A 2x2 two factors mixed experimental design by using Face Working Memory Task was conducted to study the self-serving bias of 72 different high self-esteem adolescents.Results:The self-serving bias of different high self-esteem adolescents had statistically significance[F(1,35)=85.41,P＜0.001,η2=0.23].Secure high self-esteem adoles-cents did not show self-serving bias with correct[t(35)=-6.51,P＜0.001,d=5.44]and wrong feedback[t(35)=-10.79,P 0.001,d=6.50].Similarly,fragile high self-esteem adolescents did not show self-serving bias with correct feedback[t(35)=-2.85,P＜0.05,d=2.5],but they showed self-serving bias with wrong feedback[t(35)=6.99,P＜0.001,d=4.49].The interaction between heterogeneous high self-esteem groups and feedback types was significant[F(1,35)=28.65,P＜0.001,η2=0.14].Conclusion:The adolescents with fragile high self-es-teem show obvious self-serving bias with false feedback.The heterogeneity differentiation of high self-esteem is the factor for different self-serving bias among adolescents.
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ObjectiveTo investigate the effect of daily soft brace wearing on plantar dynamics during walking in patients with chronic ankle instability (CAI). MethodsA total of 52 patients with unilateral chronic ankle instability (CAI) in Beijing Rehabilitation Hospital from February, 2021 to January, 2023 were randomly divided into control group (n = 26) and experimental group (n = 26). Both groups underwent an eight-week exercise training program. The control group wore placebo brace during daily activities, while the experimental group wore soft ankle brace. Plantar dynamic parameters were measured using a pressure plate system during walking, including peak plantar pressure and plantar impulse before and after intervention. ResultsSix participants dropped out in the control group and five in the experimental group, resulting in a final inclusion of 41 participants. After intervention, there was no significant difference in peak plantar pressure and impulse on the affected side in the control group among different areas (P > 0.05). In the experimental group, the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas increased (|t| > 4.192, P < 0.001), while the peak pressure and impulse in the midfoot and lateral forefoot areas decreased (t > 2.984, P < 0.05); the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas were higher in the experimental group than in the control group (|t| > 2.126, P < 0.05), and the peak pressure and impulse were lower in the midfoot and forefoot lateral areas (t > 2.133, P < 0.05). ConclusionWearing a soft brace during daily activities may optimize the distribution of peak plantar pressure and plantar impulse on the affected side in patients with CAI, which may prevent recurrence of sprains.
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Objective To analyze the effects of fat mass and obesity-associated (FTO) gene, IL-6, and HSP-60 gene polymorphism on the incidence rate and prognosis of breast cancer (BCa) for patients with type 2 diabetes mellitus (T2DM). Results A total of 1551 patients with BCa were included in the experimental group and 1605 women of the same age who participated in physical examination were included in the control group. The clinical data of the 3156 participants were collected through the baseline data questionnaire, and the genotypes of FTO, IL-6, and HSP-60 single-nucleotide polymorphism (SNP) were determined through blood sample detection. The predictive value of the three SNPs for the incidence risk of BCa for T2DM patients was evaluated. The OS of 1168 patients with BCa was obtained through follow-up, and the effects of the three SNPs and T2DM on OS of BCa patients were evaluated. Results The three loci were FTO rs3751812, IL-6 rs1800796, and HSP-60 rs2605039. The BCa incidence rate for T2DM women with wild homozygous SNP genotype was significantly higher than that for non-T2DM women (FTO: χ2=3.530, P=0.013; IL-6: χ2=6.288, P=0.029; HSP-60: χ2=4.926, P=0.005). The three wild homozygous genotypes were independent risk factors that influenced the incidence rate of BCa (all P < 0.05). Patients with HSP-60 rs2605039 (GT+TT) genotype had better OS (P=0.031). Conclusion FTO, IL-6, and HSP-60 gene polymorphisms have certain value in BCa prediction for T2DM patients. Patients with BCa and HSP-60 rs2605039 GT+TT genotype have high OS.
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Objective:To study the clinical value of lung ultrasound score (LUSsc) within 2 h after birth for pulmonary surfactant (PS) use in preterm infants with respiratory distress syndrome (RDS).Methods:From July 2019 to May 2021, preterm infants with RDS hospitalized in our hospital and received pulmonary ultrasound within 2 h after birth were prospectively enrolled. 12-area LUSsc was calculated. The infants were assigned into <32 weeks group and 32-36 weeks group according to gestational age (GA). Simple random sampling was carried out in each group with 1/5 as the validation set and the other 4/5 as the training set. The infants were also assigned into PS group and non-PS group according to PS usage within 24 h after birth. Receiver operator characteristic (ROC) curve of LUSsc predicting PS usage was drawn and validated.Results:A total of 857 RDS infants were enrolled, including 313 in <32 weeks group and 544 in 32-36 weeks group. For <32 weeks group, area under curve (AUC) of LUSsc>8.5 predicting PS use was 0.779 (95% CI 0.722-0.837), with 76.4% sensitivity and 81.4% specificity. The accuracy of using LUSsc>8.5 as cut-off predicting actual clinical PS application was 82.3% (Kappa value 0.692, P<0.05, McNemar's test P>0.05).For 32-36 weeks group, AUC of LUSsc>9.5 predicting PS use was 0.785 (95% CI 0.723-0.848), with 71.1% sensitivity and 81.7% specificity. The accuracy of using LUSsc>9.5 as cut-off predicting actual clinical PS application was 92.6% (Kappa value 0.772, P<0.05, McNemar's test P>0.05). Conclusions:LUSsc within 2 h after birth is independent predictor of PS use in preterm infants with RDS. For <32 weeks group, LUSsc>8.5 suggests PS application and for 32-36 weeks group the cut-off is LUSsc>9.5.
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Objective:To investigate the prognostic significance of anemia in elderly patients with stable coronary artery disease treated by percutaneous coronary intervention(PCI).Methods:In this retrospective cohort study, 180 patients with stable coronary artery disease aged ≥60 years undergone percutaneous coronary intervention and with complete clinical data, admitted to Nanjing Meishan Hospital between June 2016 and December 2017, were selected.Baseline clinical data of the patients were collected, including hemoglobin, C-reactive protein, lipids, fasting glucose, glycated hemoglobin, blood creatinine, and left ventricular ejection fraction on cardiac color ultrasound.The endpoints of the follow-up included major adverse cardiac events(MACE), such as all-cause death, non-fatal myocardial infarction, and non-fatal stroke.According to the hemoglobin level, participants were divided into an anemia group(n=32)and a non-anemia group(n=148). Clinical data of the two groups were compared, and the Kaplan-Meier method and multivariate analysis with the Cox regression method were used to evaluate the effect of anemia on the occurrence of MACE in elderly patients with stable coronary artery disease treated by PCI.Results:The median duration of the follow-up of the 180 patients was 702.5 days and MACE occurred in 27(15.0%). Compared with the non-anemia group, the anemia group had a higher age, C-reactive protein level and MACE ratio, lower levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol and the glomerular filtration rate, and higher proportions of patients with smoking history and patients with dyslipidemia( P<0.05). Kaplan-Meier curves suggested that the incidence of MACE in the anemia group was higher than that in the non-anemia group[37.5%(12/32) vs.10.1%(15/148), P<0.05]. Multivariate analysis with the Cox regression method showed that the risk of MACE in the anemia group was 2.91 times higher than that in the non-anemia group( HR=2.91, 95% CI: 1.13-7.48, P<0.05). Conclusions:Anemia is an independent predictor of MACE in elderly patients with stable coronary artery disease after PCI.
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The performance appraisal for tertiary public hospitals provides means for the rational management of drug use in public hospitals. Starting from October 2021, Hospital Z had established a drug performance appraisal system based on the relevant requirements for rational drug use in the performance appraisal for tertiary public hospitals, in view of the actual situation. The system included four indexes: weighted outpatient per capita drug cost, weighted inpatient per capita drug cost, rational drug use rate, and intensity of antibacterial drug use. Different scores were assigned to each indexi and scoring methods were developed. By dividing all drugs in the hospital medication catalog into three categories A, B, and C and assigning them different weights, as well as setting reasonable target values for each indexi, the hospital guided clinical departments to use drugs rationally. The proportion of drugs in hospital Z decreased from 28.75% in 2020 to 25.44% in 2022, the proportion of medical service revenue increased from 22.97% to 28.40%, the per capita outpatient drug cost decreased from 170 yuan to 166 yuan, and the per capita inpatient drug cost decreased from 7 318 yuan to 5 983 yuan. The number of departments with a 100% reasonable drug use rate increased from 11 in September 2021 to 16 in September 2022, and the intensity of antibacterial drug use decreased by 35.84%. The opplication of this drug performance appraisal system partly optimized the hospital′s income structure, controlled the growth of drug costs, promoted the rational use of drugs, so as to provid references for the rational drug use management of tertiary public hospitals.
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Objective:To explore the relationship and underlying mechanism between exosomes derived from doxorubicin-resistant osteosarcoma cells and MDR1 and miRNAs. Methods:MG63 and U2OS cell lines were selected to construct doxorubicin-resistant strains, and the 50% inhibitory concentration (half maximal inhibitory concentration, IC 50) of drug-resistant and sensitive strains was detected by MTT, and fluorescence staining was performed at intervals of 15 min between 15 and 120 min to detect the change of fluorescence intensity. RT-PCR and Western Blot were used to detect the expression levels of MDR1 P-gp to verify the drug resistance of osteosarcoma cells. Exosomes were identified by particle size analysis and Western Bolt detection. The endocytosis of PKH26-labeled exosomes from doxorubicin-resistant cells was observed, and the proliferation level and migration of exosomes from doxorubicin-resistant cells co-cultured with osteosarcoma cells were detected by MTT assay and cell scratch assay. The differential expression levels of miRNAs in osteosarcoma-sensitive and drug-resistant cells were verified by sequencing and bioinformatics analysis and RT-PCR assay. Tumor growth, serum exosome identification and mRNA expression level of miR-21-5p in tumor-bearing nude mice between normal osteosarcoma cell group and drug-resistant group, drug-resistant+normal exosome group, drug-resistant+drug-resistant+drug-resistant exosome group were observed. MDR1 expression level in tumor tissue was detected by RT-PCR, Western Blot and immunohistochemistry. Results:The IC 50 of two adriamycin resistant strains were 2.21 vs. 11.81 μg/ml and 0.93 vs. 11.81 μg/ml, respectively, and the fluorescence intensity decreased faster than that of normal strains. The relative mRNA expression levels of MDR1 in two cell lines were normal 1.12±0.16, 1.02±0.11 and drug-resistant 2.15±0.10, 2.127±0.12, respectively. The relative protein expression of P-gp was normal 0.92±0.11, 0.73±0.10 and drug-resistant 0.46±0.03, 0.30±0.04, the differences were statistically significant ( P<0.05). Drug-resistant exosomes can enter osteosarcoma cells through endocytosis and concentrate in the cytoplasm when co-cultured with normal strains. Osteosarcoma cells were co-cultured with drug-resistant exosomes at 2, 4, 6, and 8 μg/ml adriamycin, respectively. Compared with normal group, the proliferation level in drug-resistant group was significantly increased. Compared with the normal cell group 35.95±3.92, 6.72±3.55 and the normal exosome group 51.22±5.55, 19.31±1.93, the drug-resistant cell group 54.20±9.32, 19.24±2.88 and drug-resistant exosome group 76.40±5.41, 30.26±4.87, all had significantly higher cell mobility, the difference was statistically significant ( P<0.05). Exosome sequencing and biogenic analysis of 10 highly upregated miRNAs to validate mRNA expression differences between normal and drug-resistant strains by RT-PCR, showing a significant increase in miR-21-5p expression level of drug-resistant strains (5.89±0.26 vs. 0.99±0.06; 1.05±0.07 vs. 8.80±0.93, P<0.05), the difference was statistically significant ( P<0.05). In MG63 and U2OS, the normal cell group and drug-resistant cell group, and the normal exosome group and drug-resistant exosome group were compared, the tumor volume and the terminal tumor weight of nude mice were increased to varying degrees. MRNA relative expression levels of miR-21-5p in serum exosomes of nude mice after drug intervention were 0.86±0.07 and 0.86±0.05 in normal cell group, respectively. The values were 1.13±0.12, 1.14±0.12 in drug-resistant cell group, 0.71±0.05, 0.75±0.03 in normal exosome group, and 0.90±0.07, 0.93±0.04 in drug-resistant exosome group. Compared with normal and drug-resistant strains, the expression levels of normal and drug-resistant exosome groups were increased, with statistical significance ( P<0.05). Conclusion:The exosomes of drug-resistant cells in osteosarcoma could enhance the proliferation level and migration ability of cells through intercellular transfer of MDR1 and miRNAs. The expression of MDR1 and miR-21-5p in drug-resistant cells and tumor-forming nude mouse serum and tumor tissues were up-regulated which suggested that it might be involved in regulating the drug resistance process of osteosarcoma.
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Objective:To detect the levels of γ-glutamyl transferase (GGT) in the amniotic fluid of normal pregnancies at 19-23 +6 gestational weeks and to analyze the changes in GGT level with gestational age. Methods:This study retrospectively collected the amniotic fluid supernatant from 383 singleton pregnant women (102, 103, 82, 68 and 28 cases at 19-19 +6, 20-20 +6, 21-21 +6, 22-22 +6, 23-23 +6 weeks of gestation, respectively) who underwent amniocentesis for prenatal diagnosis but had normal genetic diagnosis results in Cheeloo Hospital of Shandong University from January 2021 to September 2022. The levels of GGT in the amniotic fluid supernatant were tested and the statistical parameters including xˉ± s, min-max, median ( M), P1, P2.5, P5, P95, P97.5 and P99 values of GGT levels at each gestational week were calculated. GGT were non-normal data and converted into natural logarithms (lnGGT), and a least square linear regression equation was established to analyze the relationship between lnGGT and gestational week. Results:At 19-19 +6, 20-20 +6, 21-21 +6, 22-22 +6, and 23-23 +6 gestational weeks, the xˉ± s of amniotic fluid GGT were (385.8±235.7), (331.8±219.4), (253.7±197.9), (226.7±166.4), and (155.3±96.8) U/L, and the weekly declines were 14.0%, 23.5%, 10.6%, and 31.5%, respectively; the M values were 311.0, 288.0, 199.0, 160.5, and 105.5 U/L, and the weekly declines were 7.4%, 30.9%, 19.3%, and 34.3%, respectively; the P1- P99 were 67.1-1 404.5, 63.2-1 189.1, 36.0-849.8, 44.0-787.3, and 32.0-375.6 U/L, respectively. lnGGT was negatively correlated with gestational age ( R 2=0.148, P<0.001). Conclusions:In normal pregnancies at 19-23 +6 gestational weeks, GGT levels in amniotic fluid decrease with gestational age. Therefore, gestational age should be considered when establishing the reference value for amniotic fluid GGT in normal pregnancies.
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Objective:To investigate the role of cervical core muscle group exercise and massage in the change of cervical spine curvature during radiotherapy for head and neck tumors and the effect on set-up errors.Methods:A total of 40 patients with head and neck tumours receiving radiotherapy in the First Affiliated Hospital of Air Force Military Medical University from March 2020 to July 2021 were prospectively selected, and all of them underwent different degrees of changes in cervical spine curvature during radiotherapy. The cervical core muscle exercise and manual massage were used to do treatment intervention on the change in the cervical spine curvature. Changes in cervical spine curvature at the time of the curvature change of the cervical spine and at 1 d, 3 d and 5 d after the intervention were observed by using cone beam CT, and then data were recorded in 3 dimensions. The set-up error when cervical spine curvature changed was compared with that after the muscle group exercise and manipulation, and Pearson was used to analyze the linear correlation of set-up errors in each direction.Results:There were 23 males and 17 females, with a median age of 41 years (26-62 years). The significant improvement of cervical curvature at 1 d, 3 d and 5 d after the intervention could be found in 2 cases (5.0%), 20 cases (50.0%) and 39 cases (97.5%). Using the cervical 4 vertebrae as the matching standard, the set-up errors at the time of change in cervical spine curvature and at 1 d, 3 d and 5 d after treatment were (1.3±0.9) mm, (1.2±0.8) mm, (1.3±0.7) mm and (1.3±0.7) mm in the left-right direction respectively; (2.0±0.7) mm, (1.7±0.8) mm, (1.8±0.7) mm and (1.9±0.8) mm in the head-foot direction respectively; (4.9±0.7) mm, (4.6±0.7) mm, (3.4±0.7) mm, (1.7±0.6) mm in the anterior-posterior direction respectively. The set-up error in the anterior-posterior directions at 3 d and 5 d after treatment intervention was lower than that at the time of change in cervical spine curvature and at 1 d after treatment intervention (all P < 0.01), and that at 5 d after treatment intervention was lower than that at 3 d after treatment intervention ( P < 0.01). There were no statistically significant differences between the left-right direction and head-foot direction at each time point (all P > 0.05). There was no correlation between left-right direction and head-foot direction ( r = 0.049, P = 0.540), between left-right direction and anterior-posterior direction ( r = 0.041, P = 0.607), and between head-foot direction and anterior-posterior direction ( r = 0.003, P = 0.931) in terms of set-up errors. Conclusions:Core cervical muscle group training and massage could improve the change in cervical spine curvature, increase the repeatability of the set-up, which provides a favourable guarantee for accurate treatment.
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OBJECTIVE@#To investigate the association between the glucose-to-lymphocyte ratio (GLR) and prognosis of patients with sepsis-associated acute kidney injury (SA-AKI).@*METHODS@#Based on the Medical Information Mart for Intensive Care-IV (MIMIC-IV), SA-AKI patients aged ≥ 18 years were selected. According to the tertiles of GLR, the patients were divided into GLR1 group (GLR ≤ 4.97×10-9 mmol), GLR2 group (4.97×10-9 mmol < GLR < 9.75×10-9 mmol) and GLR3 group (GLR ≥ 9.75×10-9 mmol). Patients with SA-AKI were divided into survival group and death group according to whether they survived 28 days after admission. The patient's gender, age, vital signs, laboratory test results, comorbidities, sequential organ failure assessment (SOFA), acute physiology score III (APS III) score and treatment measures were extracted from the database. Kaplan-Meier survival analysis was used to make the survival curves of patients with SA-AKI at 28 days, 90 days, 180 days and 1 year. Multivariate Logistic regression analysis model was used to explore the independent risk factors of 28-day mortality in patients with SA-AKI. Receiver operator characteristic curve (ROC curve) was used to analyze the predictive efficacy of GLR for the prognosis of patients with SA-AKI.@*RESULTS@#A total of 1 524 patients with SA-AKI were included, with a median age of 68.28 (58.96, 77.24) years old, including 612 females (40.16%) and 912 males (59.84%). There were 507 patients in the GLR1 group, 509 patients in the GLR2 group and 508 patients in the GLR3 group. There were 1 181 patients in the 28-day survival group and 343 patients in the death group. Grouping according to GLR tertiles showed that with the increase of GLR, the 28-day, 90-day, 180-day and 1-year mortality of SA-AKI patients gradually increased (28-day mortality were 11.64%, 22.00%, 33.86%, respectively; 90-day mortality were 15.98%, 26.72%, 40.55%, respectively; 180-day mortality were 17.16%, 28.29% and 41.73%, and the 1-year mortality were 17.95%, 29.27% and 42.72%, respectively, all P < 0.01). According to 28-day survival status, the GLR of the death group was significantly higher than that of the survival group [×10-9 mmol: 9.81 (5.75, 20.01) vs. 6.44 (3.64, 10.78), P < 0.01]. Multivariate Logistic regression analysis showed that GLR was an independent risk factor for 28-day mortality in patients with SA-AKI [when GLR was used as a continuous variable: odds ratio (OR) = 1.065, 95% confidence interval (95%CI) was 1.045-1.085, P < 0.001; when GLR was used as a categorical variable, compared with GLR1 group: GLR2 group OR = 1.782, 95%CI was 1.200-2.647, P = 0.004; GLR3 group OR = 2.727, 95%CI was 1.857-4.005, P < 0.001]. ROC curve analysis showed that the area under the ROC curve (AUC) of GLR for predicting 28-day mortality in patients with SA-AKI was 0.674, when the optimal cut-off value was 8.769×10-9 mmol, the sensitivity was 57.1% and the specificity was 67.1%. The predictive performance was improved when GLR was combined with APS III score and SOFA score, and the AUC was 0.806, the sensitivity was 74.6% and the specificity was 71.4%.@*CONCLUSIONS@#GLR is an independent risk factor of 28-day mortality in patients with SA-AKI, and high GLR is associated with poor prognosis in patients with SA-AKI.
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Masculino , Femenino , Humanos , Glucemia , Glucosa , Curva ROC , Pronóstico , Sepsis/diagnóstico , Lesión Renal Aguda , Estudios Retrospectivos , Unidades de Cuidados IntensivosRESUMEN
Objective:To estimate and summarize the evidence for the blood pressure in patients with ruptured intracranial aneurysm bleeding, to provide valuable reference for clinical care and improve the prognosis of patients.Methods:BMJ Best Practice, UpToDate, Chinese Guideline Website, Cochrane Library, PubMed, American Stroke Association, Chinese National Knowledge Infrastructure, Wanfang Database and VIP Database were utilized for screening out evidences of blood pressure management strategies for patients with ruptured intracranial aneurysm bleeding from database establishment to December 8, 2020. The source of evidences included guidelines, evidence summarization, information brochure of optimal clinical practice, recommended practice, systematic review and original research. Upon the assessment of the included literature, the evidences meeting the enrollment criterion would be identified and extracted.Results:There were 9 articles involved in this research and 20 evidences possessing clinical applicability were extracted. The evidences involved in clinical assessment, regulation tenets, intervention protocol, and nursing to prevent complications in patients with ruptured intracranial aneurysm bleeding.Conclusions:To summarize, we suggested strongly to evaluate the individual differences in age, underlying diseases and pharmacological tolerance, and to effectivelly control blood pressure in patients with ruptured intracranial aneurysm bleeding through scientific nursing methods, which could improve the nursing qualification.
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Ureaplasma is an opportunistic pathogen with a high population carrying rate.Maternal ureaplasma infection is related to adverse pregnancy outcomes such as premature birth etc.Ureaplasma infection in neonates can cause central nervous system inflammation and eventually lead to poor nervous system prognosis.Although the incidence of invasive central nervous system infection in newborns is low, due to the presence of immune escape in the body, atypical clinical manifestations after ureaplasma infection, and insensitivity to routine detection methods, the central ureaplasma infection in newborns is often unable to diagnose and treat properly in time, so it can easily lead to delayed treatment, which can lead to serious complications.This review aimed to explain the pathogenesis, clinical manifestations and complications of central nervous system inflammation caused by ureaplasma infection, and share diagnosis methods, as well as successful treatment experience in related cases, so as to provide the basis for early diagnosis and reasonable treatment, thereby reducing the occurrence of adverse neurological outcomes caused by ureaplasma infection.
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Objective:To investigate the psychological status and the influential factors of postpartum depression in primiparae subjected to cesarean section and provide evidence for the prevention and treatment of postpartum depression in primiparae.Methods:A total of 288 primiparae underwent a psychological status survey in Hangzhou Seventh People's Hospital from January 2016 to January 2020 and were included in this study. We evaluated their psychological status using the Self-rating Depression Scale (SDS) and the Edinburgh Postnatal Depression Scale (EPDS). The factors that affect postpartum depression were analyzed.Results:The incidence of depression post-cesarean section was 25.00% in primiparae. The scores of SDS and EPDS were (61.23 ± 7.83) points and (12.47 ± 3.14) points in primiparae with a depressive status, which were significantly higher than those in primiparae without a depressive status [(41.39 ± 3.21) points, (8.39 ± 1.22) points, t1 = 15.30, P < 0.001; t2 = 15.87, P < 0.001). Univariate analysis results showed there was a significant difference in postpartum depressive psychological status in terms of maternal education level, family relationship, mother-in-law and daughter-in-law relationship, mental health education, depressive status during pregnancy, intrapartum psychological status, and spouse's education level (all P < 0.05). Logistic regression analysis results showed that postpartum depressive status in primiparae was related to family relationships, mother-in-law/daughter-in-law relationships, the depressive status during pregnancy, intrapartum psychological status, and spouse's education level are independent risk factors for postpartum depression in primipara after cesarean section ( P < 0.05). Conclusion:The incidence of postpartum depression is high in primiparae subjected to cesarean section. Family relationships and spouse's education level are the influential factors of depression. Family-oriented early psychological intervention should be strengthened to provide more counseling during pregnancy and promote maternal mental health.
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Objective To investigate the effect of Ganshuang granule combined with entecavir on portal vein thrombosis (PVT) in patients with hepatitis B cirrhosis. Methods A total of 356 patients with hepatitis B cirrhosis who attended and were hospitalized in The Third People's Hospital of Kunming from January 1, 2018 to December 31, 2020 were enrolled and randomly divided into combination group with 191 patients and control group with 165 patients. The patients in the combination group received Ganshuang granule combined with entecavir, and those in the control group received entecavir alone. The course of treatment was at least 24 weeks. The t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to analyze the cumulative incidence rate of PVT in both groups, and the log-rank test was used for comparison between two groups. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the influencing factors for PVT in patients with hepatitis B cirrhosis. Results The 191 patients in the combination group were followed up for 296.25 person-years in total, with a mean follow-up time of 1.55±0.65 years, and there were 8 patients with PVT, with an incidence rate of 4.19% and an incidence density of 1.41 per ten-thousand person-years. The 165 patients in the control group were followed up for 253.25 person-years in total, with a mean follow-up time of 1.53±0.67 years, and there were 20 patients with PVT, with an incidence rate of 12.12% and an incidence density of 4.79 per ten-thousand person-years. There was a significant difference in the incidence rate of PVT between the two groups ( χ 2 =7.687, P =0.006). The cumulative incidence rate of PVT plotted by the Kaplan-Meier method showed that the combination group had a significantly lower cumulative incidence rate of PVT than the control group ( χ 2 =7.226, P =0.007), with a relative risk of 3.155 (95% confidence interval [ CI ]: 1.351-7.370). The univariate Cox analysis showed that hypertension, alanine aminotransferase, aspartate aminotransferase (AST), albumin (Alb), cholinesterase, estimated glomerular filtration rate, alpha-fetoprotein, D-dimer (D-D), Child-Pugh class, and Ganshuang granule combined with entecavir were influencing factors for PVT (all P < 0.05); the multivariate Cox analysis showed that AST (hazard ratio [ HR ]=1.002, 95% CI : 1.000-1.004, P =0.025), and D-D ( HR =1.907, 95% CI : 1.554-2.338, P < 0.001) were independent risk factors for PVT in patients with hepatitis B cirrhosis, while Alb ( HR =0.844, 95% CI : 0.755-0.944, P =0.003) and Ganshuang granule combined with entecavir ( HR =0.350, 95% CI : 0.144-0.851, P =0.021) were independent protective factors against PVT in patients with hepatitis B cirrhosis. Conclusion Ganshuang granule combined with entecavir can significantly reduce the incidence rate of PVT in patients with hepatitis B cirrhosis, thereby exerting a certain preventive effect against PVT.
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Objective:To explore the potential mechanism of Jiajian Xuezheng Decotion in infiltrative gastric cancer by network pharmacology and proteomics.Methods:The Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) database was used to find the compounds and their targets of Jiajianxuezhengtang, and the targets of invasive gastric cancer were determined by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). The predicted target gene of Jiajian Xuezheng Decotion and the target protein data of infiltrative gastric cancer were analyzed by Venny to obtain the target gene. The target gene set was analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment by the David. The protein interaction network diagram (PPI) was obtained by the String method, displaying the prescription-drug-compound-gene network in Cytoscape software.Results:69 active ingredients and 215 drug targets were screened from Jiajian Xuezheng Decotion; 660 proteins were significantly up-expressed in infiltrative gastric cancer, and 10 drug targets and gene targets were the common targets. There were 10 protein nodes in the PPI network, of which 3 core nodes were CASP3, BCL2L1 and STAT1. The 11 KEGG pathways were significantly enriched such as include PI3K-Akt signaling pathway, p53 signaling pathway, proteoglycan in cancer, apoptosis, Jak-STAT signaling pathway and other pathways.Conclusions:Jiajian Xuezheng Decotion plays an anti-infiltrative gastric cancer effect possibly regulated apoptosis through PI3K-Akt signaling pathway, p53 signaling pathway and Jak-STAT signaling pathway. This study provides a theoretical basis for further research on the mechanism of Jiajian Xuezheng Decotion in the treatment of invasive gastric cancer.
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Objective:To evaluate the competence of head nurses by using the in-basket test for establishing a hierarchical training system for these nurses.Methods:A set of in-basket test was independently designed to evaluate the head nurses of a tertiary hospital in September 2021.Fourteen competency indicators, including positive initiative, coordination and communication ability, and leadership, problem solving ability, motivation, empowerment, attention to quality and order, etc, were selected to analyze the answers of the in-basket test and score their competency level. The measures were described by Mean±SD and M(IQR), and the counts were described by rates and percentages. The rank sum test and multiple linear regression were used to analyze the influencing factors of competency scoring of head nurses. Results:A total of 133 head nurses were tested, with a total competency scoring of 30.0(5.5). The highest indicators were talent cultivation 3.0(2.0), positive initiative 3.0(1.0), coordination and communication ability 3.0(1.0), while those with lower scores were empowerment 1.0(1.0) and motivation 1.5(1.5). The rank sum test analysis showed that age, position, job position character and working seniority were the influencing factors of competency score( P<0.05). The multiple linear regression analysis showed that, working seniorities of 16-20 years( β=0.583, P=0.013), 21-25 years( β=0.732, P=0.008), 26-30 years( β=0.632, P=0.026) were the influencing factors of competency score of head nurses. Conclusions:The in-basket test is practical to evaluate the competence of head nurses as a basis for their targeted training in the future.
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Objective:To evaluate the effectiveness of Evidence-based Nursing Practice Guideline for Enteral Nutrition of Infants with Congenital Heart Disease application on improving the nutritional status of infants with congenital heart disease (CHD) in the target population, and to explore the effective strategies of evidence implementation in the process of dissemination, implementation and integration into clinical practice. Methods:This was an implementation study. Promoting Action on Research Implementation in Health Services Integrated Framework (i-PARIHS) was used as a theoretical model. Infants with CHD who received cardiac surgery from the heart ICU of Children ′s Hospital of Fudan University from January 2019 to February 2020 were selected as the study subjects. January to June 2019 and September to February 2020 were the pre and post implementation phase respectively. For medical staff, communication strategy, implementation process strategy, integration strategy and capacity-building strategy were used to advance the implementation process. According to the implementation strategy of children, the 26 best practice recommendations in the guide were translated into operable nursing processes and enteral nutrition programs, which were implemented in four stages: admission to the hospital, pre operation, post operation cardiac care room, post operation ward recovery, and pre discharge. Implementation Results Variable Assessment Form was used to evaluate effectiveness of the implementation strategies; hospitalization weight and upper arm circumference, serum albumin and pre-albumin before discharge were used to evaluate effectiveness of the interventions. Results:Scores of eight aspects of Implementation Results Variable Assessment reached more than 75% of the total score. Pre-albumin of post-implementation was (166.53 ± 42.57) g/L, which was statistically significantly higher than (148.41 ± 30.66) g/L before discharge ( t=-3.21, P<0.01); the weight loss of pre-implementation was 0.00 (0.41) kg, while the weight change of post-implementation was -0.10 (0.40) kg, the difference was statistically significant ( Z=-2.90, P<0.01). Conclusions:The strategies of diffusing, implementing, integrating the CHD enteral nutrition protocol based on guide could improve the implementation results and the nutrition status of infants with CHD.
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BACKGROUND: Agkistrodon acutus, a traditional Chinese medicine, clinically used in the treatment of rheumatism, tumor, and cardiovascular and cerebrovascular diseases. Due to the unique medicinal value and the difficulty of artificial breeding of Agkistrodon acutus, the supply of Agkistrodon acutus on the market exceeds the demand, and a large number of its adulterants are found on the market. In this study, the cytb gene sequences of Agkistrodon acutus and 9 snakes were compared and analyzed, specific primers were designed, and specific PCR methods were established to detect Agkistrodon acutus medicinal samples on the market. RESULTS: This method was successfully applied to distinguish the snake from other adulterated species, and tested 18 Agkistrodon acutus samples randomly purchased from six cities. Twelve samples were counterfeit and six were genuine. The standard reference material of Agkistrodon acutus was cloned by molecular cloning and sequencing, and the gene sequence difference with other species was significant. It shows that the region could be used as the fingerprint region of the target species. CONCLUSIONS: The proposed method can be used as a species-specific marker and can be highly distinguished from other adulterated snake species, which is helpful to effectively avoid the problem of false sale of Agkistrodon acutus.