Influencing factors of early mortality after heart transplantation and constructing a prediction model / 中华器官移植杂志

Objective:To explore the risk factors for early mortality in heart transplant(HT)recipients and construct a nomogram prediction model.Methods:From 2018 to 2022, preoperative clinical data were retrospectively reviewed for 163 consecutive HT recipients.Risk factor variables were shortlisted by univariate correlation analysis based upon early(90-day)postoperative patient survival.Lasso regression was then employed for screening all variables and common variables were combined.A nomogram was constructed for predicting the probability of early mortality after considering actual circumstance.Receiver operating characteristic(ROC)curve, area under the ROC curve(AUC), Harrell's C-index and calibration curves were employed for evaluating and internally validate the performance of the model.Decision curve analysis was performed for assessing clinical utility of the model.Results:In survival and mortality groups, mechanical ventilation, nervous system lesions, use of extracorporeal membrane oxygenation, red blood cell count ≤3.52×10 12/L, mean pulmonary arterial pressure>27 mmHg, pulmonary vascular resistance>4.01 Wood Unit, albumin≤33 g/L, aspartate aminotransferase >50 U/L, hemoglobin ≤108 g/L, platelet count ≤109×10 9/L and total bilirubin>57 μmol/L demonstrated statistically significant differences( P<0.05). At the same time, according to actual situations and different variables, hemoglobin ≤108 g/L, albumin ≤33 g/L, platelet count ≤109×10 9/L, total bilirubin>57μmol/L, aspartate aminotransferase>50 U/L, nervous system lesions and average pulmonary arterial pressure >27 mmHg were seven variables.And a nomogram with relatively high reliability was constructed for predicting the probability of early mortality post-HT(nomogram model evaluation, AUC 0.917, C index 0.910 and good calibration curve). Decision curve analysis indicated that the nomogram could benefit HT recipients. Conclusions:Risk factors have been identified for early mortality in HT recipients.And the nomogram prediction model offers a simple and reliable tool for predicting early mortality post-HT.It has important implications for individualized treatment of HT candidates.

Interpretation of effectiveness of paediatric occupational therapy in children with disabilities: a systematic review(2019) / 中华实用儿科临床杂志

Occupational therapy can not only promote the development of motor and cognitive functions in children with developmental or other disabilities, but also improve their self-care ability, learning ability, participation skills and other activities.In 2019, the Aust Occup Ther J published a systematic review on the effects of occupational therapy interventions on disabled children, aiming to summarize the best evidence of occupational therapy and help occupational therapists and families to choose the effective treatment regimens.In this article, the systematic review was interpreted in light of the current status of domestic child occupational therapy, so as to allow clinicians to compare the pros and cons of different treatment methods and improve the efficacy.

Molecular mechanisms and relationship of M2-polarized macrophages with early response in multiple myeloma / 中华血液学杂志

Objective@#To investigate the relationship between M2-polarized macrophages and early response in multiple myeloma and its molecular mechanism.@*Methods@#Two hundred and forty bone marrow biopsy tissue were collected and M2-polarized macrophages were stained by anti-CD163 monoclonal antibody. In vitro M2-polarized macrophages were derived from human peripheral blood mononuclear cell or THP-1 cells and identified by flow cytometry. Two myeloma cell lines RPMI 8226 and U266 were co-cultured with M2 macrophages using a transwell system. We measured myeloma cells proliferation through CCK-8 method and the pro-inflammatory cytokines expression (TNF-α and IL-6) by ELISA. Real time PCR was applied to measure chemokines (CCL2 and CCL3) , chemokine receptors (CCR2, CCR5) , VEGF and their receptors. In addition, flow cytometry was used to analyze the apoptosis of myeloma cells induced by dexamethasone.@*Results@#①Patients with high percentage of M2 macrophage involvement in bone marrow showed poorer response (23.9% versus 73.0%, χ2=60.31, P<0.001). ② In vitro the proliferation of RPMI 8226 cells (P=0.005 at 24 h, P=0.020 at 36 h) or U266 myeloma cells (P= 0.030 at 24h, P=0.020 at 36h) co-cultured with M2-polarized macrophages was higher than control group. ③In vitro the apoptotic rate of RPMI 8226 cells (29.0% versus 71.0%, t=4.97, P=0.008) or U266 myeloma cells (24.9% versus 67.7%, t=6.99, P=0.002) co-cultured with M2-polarized macrophages was lower than control group. ④ In vitro M2-polarized macrophages promoted myeloma cells secreting higher level of IL-6, TNF-α and higher expression of CCL2, CCL3, CCR2, CCR5, VEGFA, VEGFR-1,-2 compared with the non-macrophage co-culture system.@*Conclusion@#M2-polarized macrophages promote myeloma cells proliferation and inhibit apoptosis through a very complex mechanism involving pro-inflammatory cytokines IL-6 and TNF-α, chemokines and related receptors such as CCL2, CCL3, CCR2, CCR3, and VEGF as well as related VEGFR.

Concept of Peabody Developmental Motor Scale-Fine Motor: Based on International Classification of Functioning, Disability and Health-Children and Youth Version / 中国康复理论与实践

@#Objective To analyze the concept of Peabody Developmental Motor Scale-Fine Motor (PDMS-FM). Methods Concept con-tained in each item of PDMS-FM was discussed and determined by 3 rehabilitation physicians or therapists. They were linked to the catego-ries of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) by 2 rehabilitation physi-cians according to the linking rules after discussion. Third party intervened informally if there was a disagreement. Results Ninety-eight items from the PDMS-FM linked to 21 categories of the 3rd level within 13 categories of the 2nd level, belong to b1 Mental Functions, b7 Neuromusculoskeletal and Movement-related Functions, d1 Learning and Applying Knowledge, d4 Activities and d5 Self-care, a total of 5 categories of the 1st level. Eighty items linked to d4, and 40 items linked to d1. Conclusion PDMS-FM mainly focuses on the activities, es-pecially Carrying, Moving and Handling Objects and Basic Learning of Learning and Applying Knowledge.

Investigation on the Effects of Pharmacy Trusteeship in Hospital on Employment Selection of Higher Voca-tional Students Majoring in Pharmacy-Taking Suzhou Health College as An Example / 中国药房

OBJECTIVE:To provide references for the revision of pharmaceutical talents training plan in higher vocational colleges. METHODS:Selecting parts of freshmen,sophomores and junior students majoring in pharmacy in our hospital as subjects, questionnaires were conducted for the effect of hospital“pharmacy trusteeship”policy on their employment selection,and the results were statistically analyzed. RESULTS:Totally 190,390,320 questionnaires were received from junior students,sophomores and freshmen. The surveyed students knew less about“pharmacy trusteeship”policy,only a maximum by junior students of 35.79%(comparison of different grades P0.05). The career direction of hospital pharmacy had the highest proportion of surveyed students in each grade(38.42%-53.13%),especially the freshmen(comparison of different grades P<0.05,comparison of different career direction in a same grade P<0.05). But after knowing the policy,the surveyed students had the lowest recognition for the original career direction,especially the junior students(64.38%)(comparison of different career direction P<0.05). The surveyed freshmen and sophomores were firstly concerned the stability and then the welfare and income of the job,the surveyed junior students were firstly concerned the welfare and income and then authorized strength and the stability of the job. CONCLUSIONS:The pharmacy trusteeship policy has not yet been fully implemented,its effect on employment selection of higher vocational students majoring in pharmacy is relatively backward and the deeper effects have not been appeared completely.

Detection of Listeria monocytogenes in CSF from Three Patients with Meningoencephalitis by Next-Generation Sequencing

BACKGROUND AND PURPOSE: Encephalitis caused by Listeria monocytogenes (L. monocytogenes) is rare but sometimes fatal. Early diagnosis is difficult using routine cerebrospinal fluid (CSF) tests, while next-generation sequencing (NGS) is increasingly being used for the detection and characterization of pathogens. METHODS: This study set up and applied unbiased NGS to detect L. monocytogenes in CSF collected from three cases of clinically suspected listeria meningoencephalitis. RESULTS: Three cases of patients with acute/subacute meningoencephalitis are reported. Magnetic resonance imaging and blood cultures led to a suspected diagnosis of L. monocytogenes, while the CSF cultures were negative. Unbiased NGS of CSF identified and sequenced reads corresponding to L. monocytogenes in all three cases. CONCLUSIONS: This is the first report highlighting the feasibility of applying NGS of CSF as a diagnostic method for central nervous system (CNS) L. monocytogenes infection. Routine application of this technology in clinical microbiology will significantly improve diagnostic methods for CNS infectious diseases.

The early diagnosis value of the serum surfactant protein a in critically ill acute lung injury of HFMD / 重庆医学

Objective To explore the early diagnosis clinical value of the serum surfactant protein-A (SP-A) against acute lung injury on HFMD (hand ,foot and mouth disease) in critically ill .Methods 60 cases of HFMD were selected in Xingtai People′s Hospital from August 2010 to December 2011 ,and they were divided into three groups .20 were ordinary cases ,28 were severe cases and 12 were critical cases(4 cases dead) .According to PaO2/FiO2 of ALI ,3 of critical cases (PaO2/FiO2 >300 mm Hg) were put into the non lung injury group and 9 (PaO2/FiO2 ≤300 mm Hg) were put into the lung injury group .Besides ,15 cases of healthy children were selected as the control group .The changes of the serum SP-A levels in these children were detected through ELISA methods after 24 h and 72 h .Results Contrasting the serum SP-A levels in the ordinary and severe groups separately with the ones in control group ,there was no statistical significance(P>0 .05) and so was contrasting the serum SP-A levels in the ordinary group with the ones in the severe group ,and the serum SP-A levels in the critical group after 24 h was significantly higher than the ordina-ry and severe groups (P0 .05) ,con-trasting with ones in the control group ;but the serum SP-A levels in the lung injury group after 24 h were significantly higher than ones in the control group and in the non lung injury group (P<0 .05) .Conclusion Detection of the serum SP A has clinical value of the early diagnosis of acute lung injury on HFMD in critically ill ,which is beneficial to guide the clinical treatment .Meanwhile , it can reduce the mortality rate and the sequela ,and help to diagnose the condition of acute lung injury and treat it .