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Objective@#To explore the association between dietary inflammatory index (DII) and metabolic syndrome (MetS) and its components among children aged 6-14 years in Beijing, so as to provide a reference for preventing MetS.@*Methods@#A cross sectional study was carried out in 2 086 records of 1 832 children from the 2017 and 2019 Nutrition and Health Surveillance in Primary and Secondary school students of Beijing (NHSPSB). Three day consecutive 24 hour dietary recalls combined with weighing household cooking oils and condiments were used to collect dietary intake and calculate DII. MetS was diagnosed according to "Definition and Suggestion on the Metabolic Syndrome of Chinese Children and Adolescent". The Generalized estimating equations (GEEs) models were used to analyze the association between DII and the presence of MetS and its components (abdominal obesity, high triglyceride, low high density lipoprotein cholesterol, hypertension, and hyperglycemia).@*Results@#The mean DII score was (1.64±1.07) for the included children. No significant association was found between DII scores and the likelihood of MetS (per 1 point increment: OR =1.16, 95% CI =0.92-1.48, P >0.05). In terms of the components of MetS, DII scores were positively associated with the odds of high triglyceride (per 1 point increment: OR =1.17, 95% CI =1.01-1.36, P <0.05). There was no statistically significant difference in the association among different age groups ( P >0.05). No significant associations were observed between DII and other MetS components( P >0.05).@*Conclusion@#DII scores may not be correlated with the risk of MetS, but proinflammatory diet might increase the risk of high triglyceride. DII score in childhood should be emphasized to identify and prevent MetS as soon as possible.
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Objective:To systematically evaluate the life experience of patients with postpartum depression.Methods:PubMed, web of science, EMBASE, Scopus, PsychINFO, the Cochrane Library, CNKI, VIP, Wanfang and China biomedical database were searched for qualitative studies on life experience of patients with postpartum depression from the establishment to January 2021. The quality of articles was evaluated by the quality evaluation standard of JBI evidence-based health care center (2016) in Australia, and the results were summarized for meta integration.Results:A total of 23 studies were included, 50 complete results were extracted, 9 new categories were summarized, and 3 integrated results were obtained. Integration result 1: negative psychological emotion experience and coping style; integration result 2: personal role change and social environment influence; integration result 3: needs and obstacles.Conclusions:To improve the public′s cognition of postpartum depression, get the understanding of relatives and the attention of medical staff; pay attention to the life experience of patients with postpartum depression, give all-round support, meet the needs of pregnant women, promote the adaptation of mother′s role, and provide reference for medical staff to give humanized intervention.
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After the completion of the pilot work of traditional Chinese medicine formula granules （TCMFGs）， the national and provincial medical products administrations have published and implemented about 440 varieties of TCMFGs standards. Based on the previous work， this paper analyzed technical problems encountered in the review and evaluation of Shandong TCMFGs standards， mainly involving the executive standards and distinguishing technologies of raw materials， the adding process of excipients in the procedure item， the rationality of quality control methods， the information content and reproducibility of characteristic chromatograms， the nomenclature and accessibility of reference materials， etc. The common problems such as the coverage of standards， specification differences， and the integrity of quality control items of current TCMFGs standards were discussed deeply. It is proposed to promote the upgrading of provincial standards to national standards， accelerate the research and development of reference materials， advocate the use of high-quality raw materials， explore the evaluation methods of high-quality products， and strengthen the quality supervision of the whole process. Suggestions of this paper is hoped to provide references for the formulation of national and provincial TCMFGs standards， promote the continuous improvement of TCMFGs standard system， and ensure the healthy and orderly development of the TCMFGs industry.
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Objective:This work aims to assess the distribution of peripheral blood monocyte subsets, the expression level of the functional markers in rheumatoid arthritis (RA) patients, and analyze the correlation between the above indexes and the onset of RA.Methods:Peripheral blood mononuclear cells were collected and isolated from 62 RA patients, 52 healthy control (HC) and 12 disease control group′s patients via density centrifugation. The enrolled patients were attended or underwent physical examination in East Hospital, Tongji University from June 2020 to December 2021. Monocytes could be classified into classical (CM), intermediate (IM) and non-classical (NCM). Then, the flow cytometry was performed to examine the distribution of monocyte subsets and the measure the expression level of human leukocyte antigen DR (HLA-DR), intracellular tumor necrosis factor α (TNF-α) in peripheral blood monocytes. The statistical methods in this study mainly include: Kruskal-Wallis H test, Chi-Square test, Mann-Whitney U test, Wilcoxon matched-pairs signed ranks test, Spearman correlation coefficient test and Logistic regression analysis. The diagnostic value of IM proportion in RA was analyzed by ROC curve. Results:The monocytes number and monocytes proportion in white blood cells were much higher in RA [0.40 (0.40, 0.50), 7.60% (5.97%, 8.53%)] and disease control [0.40 (0.40, 0.68), 8.20% (5.85%, 10.28%)] compared with HC [0.30 (0.30, 0.40), 5.80% (5.03%, 6.38%)] ( H=24.733, P<0.001; H=27.469, P<0.001). A statistic-significant difference was detected among the proportion of CM[85.49%(76.91%,89.21%),88.94%(86.36%,91.72%),90.26%(80.25%, 92.56%)],IM[11.65%(8.47%,17.89%),7.89%(5.36%,10.75%), 5.56%(4.17%, 8.27%)], NCM[2.22%(1.39%, 3.74%), 2.49%(1.74%, 4.66%), 5.13%(3.39%, 9.85%)] in RA group, HC group and disease control group ( H=11.389, P=0.003; H=20.815, P<0.001; H=10.640, P=0.005). The proportion of CM was lower in RA and the IM proportion was increased in RA( P=0.003; P=0.003). The intracellular TNF-α level of monocytes in all three groups revealed the trend that IM>NCM>CM. The intracellular TNF-α in IM of RA was positively associated with serum TNF-α ( r=0.376, P=0.041). The HLA-DR expression in IM subsets were higher than CM and NCM subsets in all RA,HC and disease control groups. The expression of HLA-DR of IM in RA group and disease control was higher than HC group [8 611.50 (6201.3, 9890.8), 10 295.0 (7 899.0, 13632.0), 6 278.00(4 057.8, 9522.0), H=10.495, P=0.005]. There were no correlations between the proportion of peripheral blood IM and clinical characteristics CRP ( r=0.119, P=0.359), RF ( r=0.204, P=0.112) and ESR ( r=0.153, P=0.236). Logistic regression analysis showed that the proportion of IM ( OR=1.169, 95% CI 1.003-1.363, P=0.046), CRP ( OR=1.277, 95% CI 1.000-1.631, P=0.050), RF ( OR=1.179, 95% CI 1.080-1.287, P<0.001) are positively correlated with RA onset. The area under ROC curve for diagnosis of RA with IM proportion was 0.687, and the 95% confidence interval was 0.590-0.784, P<0.001. Conclusions:The distribution of monocyte subsets in peripheral blood of RA patients is abnormal. The increase in the proportion of IM, the enhanced antigen-presenting ability, and the increased level of TNF-α secretion in RA patients may play an important role in the pathogenesis of RA.
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【Objective】 To explore the application of capillary ultracentrifugation technology in accurate identification of Rh phenotype and clinical blood transfusion. 【Methods】 132 samples, presenting mixed field agglutination during Rh phenotyping in our laboratory from May 2019 to February 2020, were separated using capillary ultracentrifugation technology, and the proximal and distal red blood cells were taken for Rh phenotype test, and then blood donors with the same Rh phenotype as the proximal cells were selected for cross matching. 【Results】 132 samples were subjected to capillary ultracentrifugation, and new red blood cells were successfully isolated from the proximal side in 128 (96.97%)cases, and the Rh phenotype was accurately identified, i.e. CcDEe in 47 cases (36.72%), CcDee in 12(9.38%). ), ccDEEin 11 (8.59%), CCDee in 52(40.63%), ccDEe in 5 (3.91%), and ccDee in 1(0.78%). 4 cases of mixed field reaction remained after centrifugation, and all of them had a history of blood transfusion within 2 days. For the 128 patients whose Rh phenotype was accurately identified, blood donors with the same type of Rh phenotype were selected, and 4 patients whose Rh phenotype could not be determined, donors with CCDee phenotype were selected based on the frequency of phenotype distribution and the principle of reducing antigen exposure. The cross-matched blood of all patients were consistent. 【Conclusion】 Capillary ultracentrifugation technology can effectively separate the new red blood cells, improve the accurate identification of Rh phenotype, and provide safety guarantee for clinical targeted blood transfusion.
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【Objective】 To establish the multiple regression equation based on R language in order to guide scientific and reasonable blood preparation for clinicians before liver transplantation. 【Methods】 Basic clinical information, including gender, age and disease types, of 183 liver transplant patients were collected, and results of preoperative blood routine(MCV, MCHC, Hct, RBC, Hb and Plt), prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB), international normalized ratio(INR) and D dimer and antithrombin Ⅲ(AT Ⅲ), operation time, as well as intraoperative transfusion volume of red blood cells, plasma, cryoprecipitates and platelets were analyzed using R language analysis.The correlation between blood component transfusion volume and analysis factors was calculated by generalized linear function, and the regression equation for predicting blood preparation was obtained by Poisson regression analysis. 【Results】 Intraoperative transfusion rates of RBC, plasma, platelets and cryoprecipitates in liver transplantation patients were 85.79%(8.35±8.78 U), 100%(1 083±742.80 mL), 18.58%(0.26±0.60 treatment dose), and 12.02%(2.49±7.51 U), respectively. According to the analysis factors with good correlation, the prediction equations for the volume of each blood component were as follows: RBC: 3.348+ 1.276×Time-0.02×Hct-0.16×RBC-0.006×Hb, plasma: 6.901+ 0.826 ×Time-0.003×Hb, platelets: -1.275+ 1.866×Time-0.013 Hb+ 0.025×TT, and cryoprecipitates: -7.183+ 2.888×Time + 0.067×MCV+ 0.029×TT. 【Conclusion】 It is of great clinical significance to use R language to carry out multivariate regression analysis and establish the prediction regression equation of blood preparation before liver transplantation, which can provide scientific, reasonable and sufficient blood supply in operation.
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Objective:To explore the clinical significance of combined detection of the promoter methylation of plasma free Septin9, SDC2 and BCAT1 genes in peripheral blood for the diagnosis of colorectal cancer. Methods The data of patients admitted to the Department of Gastroenterology, Shanghai East Hospital Affiliated to Tongji University from January to September 2019 were retrospectively analyzed. They were divided into colorectal cancer group (62 cases of colon cancer, 59 cases of rectal cancer), precancerous lesions group (77 cases of colorectal adenoma, 5 cases of high-grade intraepithelial neoplasia), interference group (61 cases of colorectal cancer and advanced adenoma negative but suffered other intestinal lesions, 17 cases of non-colorectal cancer) and healthy group (94 cases). The methylation status of three genes (Septin9, SDC2 and BCAT1) in peripheral blood plasma was detected simultaneously by fluorescence PCR. The relationship between the positive rate of three genes detected jointly and the clinic pathological characteristics of colorectal cancer was analyzed and compared with serum carcinoembryonic antigen (CEA) positive rate. The colorectal cancer group was divided into stage Ⅰ, Ⅱ, Ⅲ and Ⅳ according to TNM stage, and the colorectal cancer group was analyzed and counted by grade. The diagnostic efficiency of detection methods was analyzed by receiver operating characteristic (ROC) curve, and the area under ROC curve (AUC) was compared.Results:The positive rate of combined detection of SDC2 and BCAT1 gene methylation was higher than other three groups (χ 2 =237.246, P<0.001). The positive rate of combined detection of plasma Septin9, SDC2 and BCAT1 gene methylation was higher than CEA in colorectal cancer group ( P<0.001). The positive rates of the combined detection of plasma Septin9, SDC2 and BCAT1 gene methylation in stage Ⅰ-Ⅳ of colorectal cancer group were 73%(16/22), 87%(34/39), 86%(30/35) and 96%(24/25), respectively. Compared with CEA group, the positive rate of combined detection of plasma Septin9, SDC2 and BCAT1 gene methylation in stage Ⅰ-Ⅲ of colorectal cancer group was higher than serum CEA ( P<0.001), but the positive rate of stage Ⅳ was not statistically significant compared with CEA group ( P>0.05). ROC curve analysis showed that the AUC of Septin9, SDC2 and BCAT1 was 0.857(95% CI 0.810-0.903),0.819(95% CI 0.768-0.871)and 0.862(95% CI 0.816-0.909), respectively. The AUC of combined detection of three gene methylations was 0.889 (95% CI 0.846-0.933), and the AUC of combined detection with serum CEA was 0.913 (95% CI 0.874-0.951). There was no significant difference in the positive rate of combined detection of Septin9, SDC2 and BCAT1 gene methylation among different gender, age and cancerous site of colon cancer patients (all P>0.05). Conclusion:The combined detection of the promoter methylation of plasma free Septin9, SDC2 and BCAT1 genes in peripheral blood plasma is helpful for the early diagnosis of colorectal cancer. The positive rate in stage Ⅰ-Ⅲ of colorectal cancer group is higher than serum CEA. The combined diagnosis of the three genes can improve the diagnostic efficiency.
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Objective:To investigate the relationships of expectation gap of postpartum support with perceived stress and postpartum depression, and the mediating role of the former in the association between the latter two.Methods:A total of 278 convenient sample of puerperas at 6-8 weeks after delivery from June to August in 2019 in Shenzhen Hospital of Southern Medical University were investigated with the Perceived Stress Scale, the Chinese version of the Postpartum Social Support Questionnaire, and the Edinburgh Postnatal Depression Scale. Structure equation model was established and Bootstrap method was used to explore the direct and indirect effects of these variables.Results:The perceived stress score, and expectation gap of postpartum support score were (26.50±2.50), (25.30±5.79), respectively; and the postpartum depression score was (14.60±2.10). The incidence of postpartum depression(defined as postpartum depression score ≥10) was 37.4%(104/278). Path analysis showed that the model was well fitted (χ 2/ df was 0.265, Tucker-Lewis index was 1.0, comparative fit index was 1.0,root mean square of approximate error was 0, root mean square of standard deviation and residual error was 0.04). Perceived stress positively correlated with expectation gap of postpartum support, and postpartum depression ( P<0.05). Expectation gap of postpartum support positively correlated with postpartum depression ( P<0.05). The effect of perceived stress on postpartum depression was partially mediated by expectation gap of postpartum support (Estimate was 0.285, 95% CI 0.197-0.352). Conclusions:Perceived stress had direct or indirect effect via expectation gap of postpartum support on postpartum depression. This indicated that the medical staff can build a comprehensive support system, reduce the experience of perceived stress among puerperas, improve social support satisfaction, and thus reduce the incidence of postpartum depression.
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OBJECTIVE@#To evaluate the influence factors of different compression modes on restoration of spontaneous circulation (ROSC) and outcomes in patients with cardiac arrest.@*METHODS@#Based on the national database of emergency cardiac arrest treatment, the clinical data of 517 patients with cardiac arrest admitted to 14 teaching hospitals in 7 provinces from July 2015 to July 2017 were enrolled. According to the way of compression, the patients were divided into mechanical compression group and hands-only compression group. The demographic data, resuscitation parameters [compression frequency, monitored ventilation frequency, duration of resuscitation, drug usage] and physiological parameters [end-expiratory partial pressure of carbon dioxide (PETCO2), pulse oxygen saturation (SpO2)] were collected. The ROSC rates and 24-hour, 7-day, 28-day survival rates were compared between the two groups. Multivariate Logistic regression model was used to analyze the influencing factors of ROSC according to whether the duration of resuscitation was longer than 60 minutes.@*RESULTS@#Of 517 patients, 24 were excluded because of incomplete data. A total of 493 patients were enrolled in the analysis with 214 patients in the mechanical compression group, and 279 in the hands-only compression group. Compared with hands-only compression group, the patients in mechanical compression group had higher age, proportion of chronic obstructive pulmonary disease (COPD) and PETCO2, fewer un-shockable rhythm, less compression rate, more epinephrine and sodium bicarbonate usage, and longer duration of cardiopulmonary resuscitation (CPR). Although the rate of ROSC in the mechanical compression group was higher than that in the hands-only compression group [36.9% (79/214) vs. 30.5% (85/279)], there was no significant difference in the rate of ROSC between the two groups [odds ratio (OR) = 1.10, 95% confidence interval (95%CI) = 0.68-1.76, P = 0.693], even after adjusted for con-variables by multivariate Logistic regression (OR = 1.21, 95%CI = 0.54-1.88, P = 0.054). Furthermore, 24-hour, 7-day, and 28-day survival rate also showed no significant difference in both univariate model and multivariate model. Comparisons of resuscitation parameters and physiological parameters between the two groups showed that when the duration of CPR < 60 minutes, the pressing frequency of the mechanical compression group was lower, ventilation frequency and adrenaline dosage were higher; and when the duration of CPR ≥ 60 minutes, the adrenaline dosage and PETCO2 of the mechanical compression group were higher. Multivariate Logistic regression analysis showed that among patients with a duration of CPR < 60 minutes, un-shockable rhythm (OR = 0.29, 95%CI = 0.05-0.75, P = 0.015), compression rate > 120 times/min (OR = 0.39, 95%CI = 0.24-0.64, P < 0.001), ventilation frequency > 40 times/min (OR = 0.50, 95%CI = 0.31-0.84, P = 0.034) were independent risk factors for ROSC; while PETCO2 ≥ 20 mmHg (1 mmHg = 0.133 kPa) was protective factor for ROSC (OR = 2.79, 95%CI = 1.88-4.49, P < 0.001). However, for patients with CPR duration ≥ 60 minutes, ≥ 65 years old (OR = 0.33, 95%CI = 0.15-0.67, P = 0.018), admission at night (OR = 0.74, 95%CI = 0.59-0.94, P = 0.035), un-shockable rhythm (OR = 0.38, 95%CI = 0.25-0.65, P = 0.001), non-cardiogenic cardiac arrest (OR = 0.35, 95%CI = 0.25-0.48, P = 0.013), previous history of diabetes mellitus (OR = 0.46, 95%CI = 0.27-0.82, P = 0.015) were independent risk factors for ROSC, and cardiac arrest occurred in emergency room (OR = 2.02, 95%CI = 1.02-2.92, P = 0.023), mechanical compression (OR = 1.41, 95%CI = 1.12-1.75, P = 0.043), PETCO2 ≥ 20 mmHg (OR = 2.94, 95%CI = 1.34-4.54, P = 0.012), previous history of acute coronary syndrome (ACS; OR = 2.47, 95%CI = 1.15-3.78, P = 0.043) were protective factors for ROSC.@*CONCLUSIONS@#Mechanical compression CPR had no significant differences in the rate of ROSC and 24-hour, 7-day, 28-day survival rates for cardiac arrest patients in the emergency departments compared with hands-only compression CPR. For those who undergone CPR duration more than 60 minutes, mechanical compression was associated with a higher rate of ROSC.
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Anciano , Humanos , Reanimación Cardiopulmonar/métodos , Paro Cardíaco/terapia , Presión , Pronóstico , Factores de RiesgoRESUMEN
Objective To evaluate the influence factors of different compression modes on restoration of spontaneous circulation (ROSC) and outcomes in patients with cardiac arrest. Methods Based on the national database of emergency cardiac arrest treatment, the clinical data of 517 patients with cardiac arrest admitted to 14 teaching hospitals in 7 provinces from July 2015 to July 2017 were enrolled. According to the way of compression, the patients were divided into mechanical compression group and hands-only compression group. The demographic data, resuscitation parameters [compression frequency, monitored ventilation frequency, duration of resuscitation, drug usage] and physiological parameters [end-expiratory partial pressure of carbon dioxide (PETCO2), pulse oxygen saturation (SpO2)] were collected. The ROSC rates and 24-hour, 7-day, 28-day survival rates were compared between the two groups. Multivariate Logistic regression model was used to analyze the influencing factors of ROSC according to whether the duration of resuscitation was longer than 60 minutes. Results Of 517 patients, 24 were excluded because of incomplete data. A total of 493 patients were enrolled in the analysis with 214 patients in the mechanical compression group, and 279 in the hands-only compression group. Compared with hands-only compression group, the patients in mechanical compression group had higher age, proportion of chronic obstructive pulmonary disease (COPD) and PETCO2, fewer un-shockable rhythm, less compression rate, more epinephrine and sodium bicarbonate usage, and longer duration of cardiopulmonary resuscitation (CPR). Although the rate of ROSC in the mechanical compression group was higher than that in the hands-only compression group [36.9% (79/214) vs. 30.5% (85/279)], there was no significant difference in the rate of ROSC between the two groups [odds ratio (OR) = 1.10, 95% confidence interval (95%CI) = 0.68-1.76, P = 0.693], even after adjusted for con-variables by multivariate Logistic regression (OR = 1.21, 95%CI = 0.54-1.88, P = 0.054). Furthermore, 24-hour, 7-day, and 28-day survival rate also showed no significant difference in both univariate model and multivariate model. Comparisons of resuscitation parameters and physiological parameters between the two groups showed that when the duration of CPR < 60 minutes, the pressing frequency of the mechanical compression group was lower, ventilation frequency and adrenaline dosage were higher; and when the duration of CPR ≥ 60 minutes, the adrenaline dosage and PETCO2 of the mechanical compression group were higher. Multivariate Logistic regression analysis showed that among patients with a duration of CPR < 60 minutes, un-shockable rhythm (OR = 0.29, 95%CI = 0.05-0.75, P = 0.015), compression rate > 120 times/min (OR = 0.39, 95%CI = 0.24-0.64, P < 0.001), ventilation frequency > 40 times/min (OR = 0.50, 95%CI = 0.31-0.84, P = 0.034) were independent risk factors for ROSC; while PETCO2≥20 mmHg (1 mmHg = 0.133 kPa) was protective factor for ROSC (OR = 2.79, 95%CI = 1.88-4.49, P < 0.001). However, for patients with CPR duration ≥ 60 minutes, ≥ 65 years old (OR = 0.33, 95%CI = 0.15-0.67, P = 0.018), admission at night (OR = 0.74, 95%CI = 0.59-0.94, P = 0.035), un-shockable rhythm (OR = 0.38, 95%CI = 0.25-0.65, P = 0.001), non-cardiogenic cardiac arrest (OR = 0.35, 95%CI = 0.25-0.48, P = 0.013), previous history of diabetes mellitus (OR =0.46, 95%CI = 0.27-0.82, P = 0.015) were independent risk factors for ROSC, and cardiac arrest occurred in emergency room (OR = 2.02, 95%CI = 1.02-2.92, P = 0.023), mechanical compression (OR = 1.41, 95%CI = 1.12-1.75, P = 0.043), PETCO2≥ 20 mmHg (OR = 2.94, 95%CI = 1.34-4.54, P = 0.012), previous history of acute coronary syndrome (ACS;OR = 2.47, 95%CI = 1.15-3.78, P = 0.043) were protective factors for ROSC. Conclusions Mechanical compression CPR had no significant differences in the rate of ROSC and 24-hour, 7-day, 28-day survival rates for cardiac arrest patients in the emergency departments compared with hands-only compression CPR. For those who undergone CPR duration more than 60 minutes, mechanical compression was associated with a higher rate of ROSC.
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Curriculum integration has become the core content of the current medical education reform.With the rapid development of information technology,how to reflect the teaching and learning effects and to further improve them,is one of the difficulties in the reform of the integrated curriculum.In view of the problems of single form of assessment model,separate classroom teaching and extracurricular teaching evaluation,low utilization of network and electronic teaching resources,we make full use of network methods to carry out reform on the current formative teaching evaluation system.With the purpose of formative assessment and evaluation,the "Blackboard network teaching system" of the curriculum has been built,and the evaluation indexes of classroom teaching and extracurricular teaching have been established.And at the same time,the formative assessment index has been enriched and perfected in a diversified form,and the formative assessment model adapted to the integrated curriculum is preliminarily explored.
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Objective To investigate the effect of different ventilation modes on the ventilation rate and prognosis in patients with cardiac arrest after advanced airway placement. Methods Based on the national database of emergency cardiac arrest treatment, patients treated with advanced airway placement during cardiopulmonary resuscitation (CPR) were enrolled in PUMCH Emergency Department from December 2013 to June 2018. The physiological parameters, such as electrocardiograph waveform, pulse oximetry plethysmographic waveform and capnography, were recorded at least 18 minutes. The demographic data and resuscitation parameters were collected. Waveform capnography was used for calculating ventilation rate (VR) and the VR between 8 to 12 breaths/min was defined as the qualified ventilation rate (QVR). According to the ventilation modes, patients were divided into the bag-mask group (BMG) and mechanical ventilation group (MVG). According to the VR, patients in the mechanical ventilation group were divided into two subgroups, the high-frequency ventilation subgroup (HFV subgroup) with the VR more than 20 breaths/min and the low-frequency VR subgroup (LFV subgroup) with the VR less than 20 breaths/min. VR, the qualified ventilation rate ratio (QVRR), the return of spontaneous circulation (ROSC), and 24-h and 7-day survival were compared between the two groups and subgroups. Result A total of 90 patients were enrolled in the analysis with 22 patients in the bag-mask group and 68 patients in the mechanical ventilation group. The total rate of ROSC was 35.6％, 24-h survival was 1.1％ and 7-day survival was 0. The first 18 minutes ventilation data were collected and added up to 1620 min. The median VR was 16.5 (12.0, 26.0) breaths/min and the QVRR was 30％. Compared with the mechanical ventilation group, the VR in the bag-mask group were lower (10 breaths/min vs 21 breaths/min) and the QVRR was higher (88.9％ vs 11.5％). The ROSC, 24-h survival and 7-day survival had no statistical differences between the two groups. In the mechanical ventilation group, the ratio of VR more than 20 breaths/min was 52.6％. Between the two subgroups, there was no statistical difference in ROSC, 24-h survival and 7-day survival. Conclusions Compared with the mechanical ventilation during CPR, the VR is lower with bag-mask ventilation, and the QVRR is higher. But there was no statistical difference on the outcomes. There was no difference on the outcomes between the two mechanical ventilation subgroups.
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OBJECTIVE:To provide reference for understanding the significance of drug proportion control deeply and future direction of hospital reform. METHODS:The data were collected from the relevant statistical reports of our hospital in August 2016,June and August 2017. The data were analyzed statistically and compared in respects of drug proportion,income,medical cost,ratio of essential medicine types,prescription amount(outpatient and emergency department),utilization rate and utilization density(AUD)of antibiotics in whole hospital,outpatient and emergency department,inpatient department. RESULTS:The drug proportion of our hospital was decreased significantly in Aug. 2017(after drug price reform),which fell by 13.35% from the previous month and 17.58% year-on-year. Hospital revenues were on the rise,which increased by 6.92% from the previous month and 11.45% year-on-year. Outpatient and emergency income was decreased slightly from the previous month(by 2.73%). Inpatient income was increased significantly from the previous month(by 9.76%). Per capita medical cost in outpatient and emergency department were increased,which increased by 4.01% from the previous month and 9.62% year-on-year;per capita medical cost of inpatients were declined,which fell by 0.91% from the previous month and 3.11% year-on-year. The ratio of essential medicine types in the whole hospital was decreased slightly from the previous month but increased by 17.79% year-on-year. Drug amount of outpatient and emergency prescriptions was decreased by 11.34% from the previous month and prescription amount decreased by 9.16% year-on-year. The utilization rate of antibiotics in the whole hospital was decreased by 8.10% from the previous month;AUD was decreased by 3.88% from the previous month and 13.88%year-on-year. CONCLUSIONS:After drug price reform,drug proportion of our hospital is effectively controlled,which has a positive influence on the operation of medical service system and patient medical cost. At the same time,some problems that need to be solved are also exposed,such as increase in per capita medical costs and the decrease in the number of outpatient and emergency patients. So,drug proportion control is only the first step in deepening hospital reform,and the follow-up motivation still needs to be provided continuously through strengthening rational drug use.
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OBJECTIVE:To study the antioxidant activity in vitro of neutral polysaccharides and its graded component from 3samples of white ginseng and red ginseng. METHODS:The decoction method was used to extract the crude polysaccharides fromwhite ginseng,100 ℃ and 120 ℃ processed red ginseng;the crude polysaccharides were further separated through ion exchangecolumn to extract neutral polysaccharides;Sephadex G-75 gels filter column was used to grade the neutral polysaccharides accordingto the molecular weight,antioxidant activity in vitro of 9 samples in 3 neutral polysaccharides and were detected by DPPH andOH free radical scavenging test and reduction capacity test(FRAP value),and vitamin C was used as positive control. RESULTS:The 3 neutral polysaccharides all obtained component Ⅰ and component Ⅱ after grading. Neutral polysaccharides and its gradedcomponent showed certain antioxidant activity in vitro in a certain concentration range,and increased by concentration increasing.The activity of neutral polysaccharides and component Ⅱ from 120 ℃ processed red ginseng was the strongest,of which 50% inhibitoryconcentration(IC50)on DPPH free radical was 0.258 g/L and 0.253 g/L,on OH free radical was 7.157 g/L and 6.845g/L,FRAP values were 2.8 and 3.0 mmol/L(when concentration was 1.2 g/L),respectively. CONCLUSIONS:The antioxidant activityin vitro from 120 ℃ processed red ginseng is higher than that of 100 ℃ processed red ginseng and white ginseng,in whichcomponent Ⅱ makes important contribution to the antioxidant activity.
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Hypoxia-induced factors(HIFs)are the main regula-tors for the response of hypoxic environment.They are involved in hypoxia-related lung tissue cell damage and abnormal cell pro-liferation,among which,HIF-1αand HIF-2αplay the most im-prominant roles.This paper reviews the current researches of HIF-1αand HIF-2α,focusing on their structural and functional similarities and diversities,as well as their roles in the patho-genesis of hypoxic pulmonary hypertension.
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ABSTRACT:Objective To evaluate the curative effect of tension-free vaginal tape-obturator (TVT-O)and modified TVT-O in treating female stress urinary incontinence (SUI).Methods We selected 1 1 3 female patients diagnosed with SUI from January to December 2013 in our department and divided them into standard TVT-O group (group A,5 6 cases)and modified TVT-O group (group B,5 7 cases).We evaluated prospectively the safety,short-term efficacy and complications of operation in the two groups.Results The length from bilateral obturator membrane to the puncture point in the skin was greater in group A than in group B.The average intraoperative blood loss was more in group A than in group B.The median NRS score of postoperatie thigh pain in group A was higher than in group B (P0.05).Conclusion Both TVT-O and modified TVT-O techniques are effective in treating female SUI.Modified TVT-O has a short path to get through the adductor muscles and less intraoperative blood loss;therefore,it can significantly reduce the complications such as postoperative pain to enhance the quality of life after operation.
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Objective: To investigate the curative effect of low-frequency therapeutic instrument of hepatopathy combined with Reduning injection in clinical treatment for patients with scarlet fever and hepatitis injury. Methods: 94 patients with scarlet fever and hepatitis injury were divided into observation group (47 cases) and control group (47cases). Patients of control group received the therapy of Reduning injection combined with tablet of adefovir dipivoxil, while the patients of observation group received the therapy of therapeutic instrument of hepatopathy combined with the therapy of control group. The changes of curative effect, indicator of hepatic fibrosis and response rate between two groups were observed. Results: The total effective rate of the observation group (95.7%) was significantly higher than that of control group (70.2%) (x2=7.283, P<0.05). In observation group, the hepatic fibrosis hyaluronic acid, III type procollagen, IV type collagen and laminin of post-treatment were significant improvement than that of pre-treatment (t=3.42, t=2.83, t=2.74, t=2.52, P<0.05). While in control groups, only the laminin of post-treatment was significant improvement than that of pre-treatment (t=2.15, P<0.05). After treatment, CR, VR, BR and HBeAg of observation group were significant higher than that of control group (x2=5.235, x2=5.623, x2=4.993, x2=6.823, P<0.05). Conclusion: The combination of low-frequency treatment of hepatopathy and Reduning injuection for the treatment of patients with scarlet fever and hepatic injury has significant effect, and it can effectively enhance the conversion rate of HBeAg, and improve liver function of patients. Therefore, it is worthy to be further promoteed in the clinical application.
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Objective To investigate the clinical effect of montelukast sodium in the treatment of cough vari-ant asthma in children,to provide reference for clinical treatment.Methods 128 cases of children with cough variant asthma were randomly divided into observation group and control group of 64 cases.The control group with routine measures for the treatment of asthma in children for treatment,the observation group in the control group based on the treatment regimen,plus montelukast sodium chawing treatment.The changes of the two groups were compared after 12 weeks of treatment,the clinical efficacy and lung function indexes before and after treatment.Through 6 months of follow -up,the recurrence of the disease between the two groups after treatment.Results The effective rate in the observation group was 43.75%,the total effective rate was 93.75%,which were significantly higher than those of the control group (χ2 =4.53,P <0.05);the two groups after treatment of FEV1 ,FVC,FEV1 /FVC,PEF and PEF during the day at night were significantly higher than those before treatment (t =4.11,3.23,3.82,5.12,3.12,5.54,4.31, 4.98,6.22,4.45,all P <0.05);After treatment,the FEV1 [(3.08 ±0.43)L],FVC[(3.89 ±0.52)L],FEV1 /FVC [(75.95 ±6.51)%],PEF day[(3.24 ±0.91 )L/s],PEF for the night[(3.51 ±1.01 )L/s]of the observation group were significantly higher than those of the control group (t =3.67,3.10,3.43,2.92,3.01,all P <0.05);The recurrence rate of the observation group was 3.13%,which was significantly lower than that of the control group (χ2 =4.82,P <0.05).Conclusion The clinical efficacy of montelukast can significantly improve cough variant asthma in children,improve children's lung function,reduce the recurrence rate of cough variant asthma.
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Objective To discuss the curative effects and clinical safety of high -dose glucocorticoids (GCS)combined with short -range hormone therapy for myasthenia gravis(MG).Methods The clinical data of 68 patients with MG were retrospectively analyzed.They were divided into the control group and the observation group (34 cases in each group)according to different treatment methods.The control group was treated by high -dose GCS combined with long -term hormone therapy,while the observation group received large doses of GCS short -range hormone treatment combined with other immunosuppressive therapy.Before and after treatment,curative effects and adverse reactions of the two groups were recorded and compared.Results The onset time of the control group and the observation group was respectively (7.8 ±3.5)days,(8.2 ±4.2)days;Before treatment,and after 4 weeks,8 weeks, 12 weeks treatment,the clinical absolute scores of the control group were (24.7 ±10.5)points,(15.4 ±6.3)points, (6.8 ±5.4)points,(7.1 ±4.5 )points,which of the observation group were (25.2 ±11.1 )points,(16.9 ± 7.1)points,(7.4 ±4.8)points,(8.3 ±5.5)points.The onset time and clinical absolute scores of the two groups had no statistical differences(t =0.978,0.925,0.897,1.213,all P >0.05);After 4 weeks of treatment and 12 weeks of treatment,the total effective rates in the control group were 85.3%,94.1% respectively,which of the observation group were 76.5%,91.2% respectively,the two groups had no statistically significant differences (χ2 =0.856, 0.216,all P >0.05);The incidence rate of adverse reactions in the control group (38.2%)was significantly higher than 14.7% in the observation group(χ2 =4.836,P <0.05).Conclusion Large dose of GCS combined with short-range hormone has adequate curative effects compared with large dose of GCS long -range hormone for the treat-ment of myasthenia gravis,but it had the lower incidence of adverse reactions,which is worthy of clinical promotion.
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Objective To study the clinical efficacy and safety of Yanhuning injection in the treatment of bronchial pneumonia in children.Methods 102 cases of bronchial pneumonia were randomly divided into the observation group and the control group,51 cases in each group.The control group was given conventional treatment, the observation group was given Yanhuning injection on the basis of the treatment of control group.The clinical efficacy after treatment,clinical symptoms and signs disappeared time and adverse drug reaction were compared between the two groups.Results In the observation group after treatment,the cured,improvement,invalid cases were 27 cases, 23 cases,1 case,the total effective rate was 98.04%,which in the control group were 18 cases,25 cases,8 cases,the total effective rate was 84.31%.The total effective rate of the observation group was significantly higher than that of the control group (χ2 =5.97,P 0.05).Conclusion Yan-huning injection for the treatment of children with bronchial pneumonia can significantly improve the clinical curative effect,shorten the disappearance time of the clinical symptoms and signs,the curative effect is reliable,high security.