Clinical values of morphology of hemophagocytes in infection associated hemophagocytic lymphohistiocytosis / 中华检验医学杂志

Objective:To study the morphology of hemophagocytosis (HPC) in bone marrow smears of patients with infection-associated hemophagocytic lymphohistiocytosis (IAHLH), and further analyse if there were differences in the clinical and laboratory features, the cytokines level and prognosisMethods:24 patients newly diagnosed with IAHLH from 2016-Dec-1 to 2021-Dec-31 in Beijing Friendship Hospital were included as study group, and 20 patients with infectious disease as non-HLH control group. In IAHLH group, mean age was 34±13 years, including 17(71%) males and7(29%) females. In Non-HLH group, mean agewas 43±16 years, including 14 (70%) males and6 (30%) females. Depending on re-checking phagocytic cell type on the initial bone marrow smear, the HPCs were divided into HPC-1, phagocytizing non-nucleated cells (mature erythrocyte or platelets), and HPC-2, phagocytizing nucleated cells. The differences in clinical presentations covered in HLH-2004 criteria, cytokines value(IL-6, IL-10, IL-18, IFN-γ) recommended in HLH-2022-China guideline, and the mortality within 1 year of diagnosis, were compared between IAHLH and non-HLH groups, between patients with or without HPC, and between patients with HPC-2 or only with HPC-1. For categorical variables, two groups were compared with the use of either the chi-square test or Fisher′s exact test. For non-normal distribution continuous variables, the difference between two groups variation was performed by using Mann-Whitney U test, and for normal distribution continuous variables, the difference was by the Independent Samples t-test.Results:The positive rates of fever, hepatomegaly and splenomegalyand the motrtality in IAHLH were 100% (24/24), 63% (15/24), 92% (22/24) and 46% (11/24), respectivelyin non-HLH were 55%(11/20),0(0/20),25% (5/20),0(0/20),and the differences between two groups were all statistically significant( P<0.01), but thedifferences between groups with and without HPC and between IAHLH patients with HPC-2 or only with HPC-1 were no statistically significanlly, ( P>0.05).In IAHLH group, IFN-γ in patients with HPC-2 was 400(246, 532)ng/L, significantly higher than 146(38, 180)ng/L in patients only with HPC-1 [ P=0.02, 95% CI was 233(75.8 to 397)], andthe other test parameters and cytokines level showed no obvious differences ( P>0.05).

Sinogram interpolation combined with unsupervised image-to-image translation network for CT metal artifact correction / 南方医科大学学报

OBJECTIVE@#To propose a framework that combines sinogram interpolation with unsupervised image-to-image translation (UNIT) network to correct metal artifacts in CT images.@*METHODS@#The initially corrected CT image and the prior image without artifacts, which were considered as different elements in two different domains, were input into the image transformation network to obtain the corrected image. Verification experiments were carried out to assess the effectiveness of the proposed method using the simulation data, and PSNR and SSIM were calculated for quantitative evaluation of the performance of the method.@*RESULTS@#The experiment using the simulation data showed that the proposed method achieved better results for improving image quality as compared with other methods, and the corrected images preserved more details and structures. Compared with ADN algorithm, the proposed algorithm improved the PSNR and SSIM by 2.4449 and 0.0023 when the metal was small, by 5.9942 and 8.8388 for images with large metals, and by 8.8388 and 0.0130 when both small and large metals were present, respectively.@*CONCLUSION@#The proposed method for metal artifact correction can effectively remove metal artifacts, improve image quality, and preserve more details and structures on CT images.

Inpatient Care Expenditure of Terminally Ill Patients in the Geriatric Ward of Peking Union Medical College Hospital / 中国医学科学院学报

Objective To describe the inpatient care expenditure of the terminally ill patients in the geriatric ward of Peking Union Medical College Hospital and facilitate future research on the economic outcomes of hospice and palliative care.Methods The histories of patients admitted to the Department of Geriatrics of Peking Union Medical College Hospital during 2018 were reviewed by trained doctors.According to the diagnosis and overall health state,terminally ill patients were selected and enrolled in the study.Demographics,health and disease information,prescriptions,and expenditure details were retrieved from the HIS system.Results In 2018,35 patients were terminally ill and eligible for hospice care,including 20 males and 15 females,with the average age of(78±8)years(59-91 years),the average age-adjusted Charlson Comorbidity Index of 10±3,and the median Barthel index of 40(10,70).These patients had malignant tumor(23 cases),heart failure(4 cases),end-stage renal disease(1 case),end-stage liver disease(2 cases),dementia(4 cases)and other severe diseases(3 cases).The patients received standard care within the scope of internal medicine and geriatrics.Finally,8 patients died during hospitalization,and 27 were discharged alive.The 35 patients had the median length of stay of 15(12,23)days,the median inpatient expenditure of CNY 21 500(13 800,37 600),and the median daily expenditure of CNY 1425(970,2503).The percentage of expenditure was(28.5±12.3)% for medication,(33.2±18.0)% for tests and examinations,and 11.5%(6.4%,15.8%)for accommodation and medical services.The medications for symptom control costed CNY(77±58)per day on average,accounting for(5.2±3.5)% of the total expenditure.Conclusions The inpatient expenditure for terminally ill patients in the tertiary grade A hospital was higher than that reported in community hospitals providing hospice care.In terms of expenditure constitution,the money spent on medications and tests/examinations were similar,and the percentage of expenditure on medications for symptom control was low.There is a need for further research on the economic impact of hospice and palliative care among terminally ill patients in China.

Daylight photodynamic therapy for the treatment of actinic keratosis / 中华皮肤科杂志

Actinic keratosis (AK) is a kind of precancerous skin lesions related to long-term light exposure, and photodynamic therapy is one of its main treatment methods. Compared with conventional photodynamic therapy, daylight photodynamic therapy (DL-PDT) with daylight as a light source has advantages of more convenient operation, less pain and higher patient acceptability, but it is liable to be affected by weather and other factors. DL-PDT is suitable for the treatment of grade Ⅰ or Ⅱ AK on the head and face, and its efficacy may be affected by pretreatment, photosensitizers, irradiation dose, etc. This review mainly elaborates the advantages of DL-PDT and introduces its operation methods to help clinicians choose the best treatment protocol for AK.

Investigation on the status of ICU nurses′ disaster preparedness and analysis of its influencing factors / 中国实用护理杂志

Objective To explore the status and related influencing factors of disaster preparedness for ICU nurses and provide reference for carrying out learning and training of the knowledge of specialized disaster rescue. Methods With convenience sampling of network questionnaire, ICU nurses in two Fujian province hospitals attended the investigation. Results A total of 347 valid questionnaires were recovered. The score of ICU nurses disaster preparedness score was 146.32 ± 38.71. located in the middle level. Sex, working years, educational background, disaster relief experience, disaster knowledge and skill training were the main factors influencing the disaster preparedness of ICU nurses (t=-4.190-2.682, P＜0.01). Conclusions The level of disaster preparedness degree for ICU nurses was not optimistic. It was necessary to actively formulate and improve targeted training of disaster nursing theory knowledge and disaster nursing skills drills, so as to effectively promote the disaster preparedness of ICU nurses.

Effects of health education using therapeutic lifestyle changes method in a population with dyslipidemia / 中华健康管理学杂志

Objective This study evaluated the effects of health education promoting therapeutic lifestyle changes in a population with dyslipidemia. Methods Patients with dyslipidemia were randomly assigned to one of four groups: the current group (CG) received conventional health guidance, the educational course (EC) group attended six lectures as part of an educational course, the phone call (PC) group received twice-monthly follow-up by telephone,and the comprehensive group(EC+PC)attended both the educational course and received follow-up telephone calls. Total cholesterol (TC), total triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL-C), and the knowledge, attitude, and behavior (KAP) score for blood lipids were compared within each group and among groups. Results A total of 214 patients were enrolled and completed the study: 62 patients in CG,49 patients in EC,56 patients in PC,and 47 patients in EC+PC.There were significant differences in the EC,PC,and EC+PC groups after the 24-week intervention. For example, pre- and post-intervention values for each group were as follows:EC group:(5.74±0.69)mmol/L and(5.14±0.87)mmol/L for TC,35.22±1.67 and 42.96±5.72 for KAP;PC group:(5.63±0.58)mmol/L and(5.22±1.07)mmol/L for TC, 34.54.±0.97and 39.41±5.03 for KAP;EC+PC group:(5.60±0.48)mmol/L and(4.00±0.79)mmol/L for TC,35.44±1.80 and 45.05±3.19 for KAP, respectively (P<0.05). The CG group showed no significant differences before and after treatment:(5.66±0.54)vs.(5.32±1.28)mmol/L for TC,34.37±0.65 vs.35.28±4.02 for KAP(P>0.05).In a comparison among the four groups,the EC and PC groups showed greater improvements than the CG group.Moreover, the EC+PC group showed statistically significant differences in the results compared with the other three groups (P< 0.05). Conclusion An educational course combined with telephone follow-up calls was more effective than a single intervention in improving blood lipids and enhancing the health awareness of patients with dyslipidemia.This combined health education model not only improves the effectiveness of treatment to some degree,but also plays a role in its supervision and management.Furthermore,it may also assist in the implementation of continuous nursing services in medical institutions.

Analysis of characteristics of abnormal eating behaviors and potential needs in patients with Alzheimer's disease / 中华护理杂志

Objective To investigate characteristics of abnormal eating behaviors in patients with Alzheimer's disease and explore the potential needs of the patients.Methods Based on the model of Need-driven Dementiacompromised Behavior (NDB),we used the list of eating behaviors in patients with Alzheimer's disease to observe and record the behaviors of 120 patients and extracted the characteristics of abnormal eating behaviors.Twelve caregivers were selected to participate in the individual in-depth interview using semi-structured interview method,and then 5 of them were involved in the focus group interview for richness and accuracy.Content analysis was used to analyze data.Results Abnormal eating behaviors were identified in 47.5％(57/120) of the patients with Alzheimer's disease.The most common abnormal eating behavior was verbal refusal to eat or stating "No more","Not hungry","I'm fu11"(64.9％),the second was spiting food out(63.2％),the simultaneous items were impatient behaviors prior to or during meal time(38.6％),being distracted from eating(38.6％),resisting help with meal(38.6％),refusal to open mouth (38.6％).Four potential needs were extracted,including desire for family,desire for companion,desire for eating dignity,and eagerness for a sense of inner security.Conclusion It is common for patients with Alzheimer's disease to show abnormal eating behaviors,which demonstrate their potential needs.Caregivers need to be trained to identify the abnormal behaviors of patients and reflected potential needs.Those needs should be met to improve patients' quality of care,and reduce burdens of caregivers.

The effects of liraglutide on the proliferation and differentiation of mouse pre-osteoblasts MC3T3-E1 / 中华内分泌代谢杂志

Objective To investigate the effects of liraglutide on the proliferation and differentiation of mouse pre-osteoblasts MC3T3-E1 exposed to higher glucose concentration. Methods MC3T3-E1 cells were cultured and divided into control group and liraglutide group. In liraglutide group, cells were treated with different liraglutide concentrations (10-9 mol/L, 10-8 mol/L, and 10-7 mol/L, respectively) for 48 hours. Cell proliferation was tested with CCK-8. The mRNA expressions of typeⅠcollagen (COL-Ⅰ), osteopontin (OPN), and alkaline phosphase ( ALP) were detected using semi-quantitative RT-PCR. Results ( 1 ) Compared to control group, the proliferation rate of different liraglutide concentration groups (10-9 mol/L, 10-8 mol/L, and 10-7 mol/L) increased significantly (all P<0. 05), the proliferation rate was the highest in 10-8mol/L liraglutide group. (2)The expression of COL-Ⅰ, OPN, and ALP mRNA in liraglutide groups were higher than those in control group (all P<0. 05). The optimal concentration of liraglutide was 10-8 mol/L. Conclusion Liraglutide within a certain concentration range may improve the proliferation and differentiation of mouse pre-osteoblasts MC3T3-E1.

Effect of glyburide on the proliferation, differentiation, and apoptosis of MC3T3-E1 osteoblasts under high glucose / 中华内分泌代谢杂志

After MC3T3-E1 cells were treated with 1,10,and 20 μmol/L glibenclamide for 48 h,the proliferation rate of cells was detected by CCK-8 assay.Flow cytometry was used to test cell apoptosis.The mRNA expressions of collagen I (COL-1) and osteopontin (OPN) were tested by realtime fluorescence quantitative PCR.Western blot was used to detect the expression levels of apoptosis-related proteins Bax and Bcl-2.The results showed that compared with the control group,the proliferation rate of MC3T3-E1 cells was gradually increased (P＜0.05),the apoptosis rate decreased (P ＜ 0.05),the expressions of COL-1 mRNA,OPN mRNA,and Bcl-2 protein were progressively raised (P＜0.05),and the expression of Bax protein were gradually decreased (P＜0.05) along with increasing concentration of glyburide.It suggested that glibenclamide could promote the proliferation and differentiation of MC3T3-E1 cells in high glucose and may inhibit apoptosis in a concentration-dependent manner within a certain range.

Effect of gliclazide on the proliferation and differentiation in mouse osteoblastic-like cells MC3T3-E1 / 中华内分泌代谢杂志

[Summary] To investigate the effect of gliclazide on the proliferation and differentiation in MC3T3-E1 cells exposed to normal glucose concentration by applying CCK-8 and RT-PCR. Gliclazide improved the proliferation and stimulated COL-I, OPN and Runx2 mRNA expression in MC3T3-E1 cells, the best concentration of gliclazide was 20μmol/ L, the expression of COL-1 and OPN mRNA had a significant positive correlation with Runx2 binding activity.

Transurethral enucleation plus pneumo-cystostomy rotary cut for large benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility, effectiveness and practicability of transurethral enucleation plus pneumocystostomy rotary cut (TUE + PCRC) for large benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We performed TUE + PCRC for 26 BPH patients aged 62 - 85 years with the prostate volume of 80 - 165 ml. We conducted transurethral enucleation of the hyperplastic prostate glands and pushed them into the bladder, followed by bladder puncture for pneumo-cystostomy rotary cut.</p><p><b>RESULTS</b>All the surgical procedures were successfully accomplished, with the mean surgical time of 41 (32 - 54) minutes and intraoperative blood loss < 60 ml in all the cases. Twenty-three of the patients were followed up for 2 - 8 months, which revealed no stricture of the urethra or any other severe complications. Compared with the preoperative baseline, significant improvement was achieved in the IPSS (6.5 +/- 2.2 vs 26.2 +/- 2.4), QOL (1.4 +/- 0.9 vs 4.6 +/- 1.2) and Qmax ([5.8 +/- 1.0 ] vs [19.6 +/- 2.8] ml/s) of the patients after surgery (P < 0.01).</p><p><b>CONCLUSION</b>TUE + PCRC, with its advantages of short operation time and less severe complications, is a safe and effective approach to the management of large BPH.</p>

X-ray guided internal urethroplasty with PlasmaKinetic electrodes for urethratresia / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate endourethral surgery for urethratresia under the X-ray guide.</p><p><b>METHODS</b>We performed transurethral urethroplasty for 11 patients with urethratresia using the PlasmaKinetic electrodes under the guidance of C arm xanthippe.</p><p><b>RESULTS</b>In the 11 cases, operations were all successful, 9 achieved smooth urination and 2 needed regular urethral dilation.</p><p><b>CONCLUSION</b>X-ray guided internal urethroplasty with PlasmaKinetic electrodes is a simple and efficient treatment for urethratresia.</p>