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OBJECTIVE To evaluate the global cancer-associated thromboembolism risk assessment tools based on evidence- based methods， and to provide methodological reference and evidence-based basis for constructing a specific tool in China. METHODS A comprehensive search was conducted on 6 databases， including CNKI， Wanfang data， VIP， CBM， PubMed， and Embase， as well as on the websites of NCCN， ASCO， ESMO and so on with a deadline of June 30， 2022. Furthermore， a supplementary search was conducted in January 2023. The essential characteristics and methodological quality of included risk assessment tools were described and analyzed qualitatively， focusing on comparing each assessment stratification ability. RESULTS Totally 14 risk assessment tools were included in the study， with a sample size of 208-18 956 cases and an average age distribution of 53.1-74.0 years. The applicable population included outpatient cancer student@sina.com patients， lymphoma patients， and multiple myeloma patients，etc. The common predictive factors were body mass index， venous thromboembolism history， and tumor site. All tools had undergone methodological validation， with 9 presented in a weighted scoring format. Only seven tools were used simultaneously for specificity， sensitivity， negative predictive value （NPV）， positive predictive value （PPV） and area under the curve （AUC） or C statistical analysis. CONCLUSIONS The risk of bias in constructing existing tools is high， and the heterogeneity of tool validation results is significant. The overall methodological quality must be improved， and its risk stratification ability must also be investigated. There are still certain limitations in clinical practice in China.
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Objective To investigate the clinical characteristics,antibiotic susceptibilities and serotypes of Group B Streptococcus(GBS)isolated from neonatal meningitis to provide references for the prevention and treatment of neonatal GBS meningitis. Methods From June 2013 to June 2016,we surveyed the GBS strains iso-lated from purulent meningitis of < 90 days infants from Guangzhou Women and Children′s Medical Center. The GBS isolates were identified and the minimum inhibitory concentration of the antibiotics was determined by Vitek 2 Compact automatic bacterial identification system.GBS serotyping was performed using Strep-B-Latex?rapid latex agglutination test kit. Results A total of 46 cases of neonatal GBS meningitis,15 cases of early-onset infection and 31 cases of late-onset infection were diagnosed. 78.3% of GBS meningitis with varying degrees of complica-tions.Among 41 survivors with 3~24 months follow-up,50% of the early-onset and 44.8% of the late-onset GBS meningitis with varying degrees of neurological sequelae.Four capsular types were identified among the 46 isolates, serotype-Ⅲwas the most prevalent(73.9%),followed by Ib(19.6%),V(4.3%)and Ia(2.2%).All the isolates were susceptible to penicillins,cephalosporins,linezolid and vancomycin. Conclusion The highly pathogenic serotype-Ⅲ was the predominant serotype among neonatal GBS meningitis in Guangzhou,Therefore,it is neces-sary to strengthen the epidemiological surveillance of GBS invasive infection and the effective implementation of pre-ventive measures.
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Objective To explore the relationship between the red cell volume distribution width (RDW)in patients with ges-tational diabetes and insulin resistance(IR).Methods A total number of 160 pregnancies performed in Guangzhou Women and Children’s Medical Center from January to October 2016.Matching 80 patients with gestational diabetes (the GDM Group)with 80 healthy pregnancies according to their age,gestational weeks and times.Their inflammatory parameters (hs-CRP,neutrophil-to-lymphocyte ratio,RDW)were respectively examined.HOMA-IR was calculated by testing the level of FBG and FIns.The association of the red cell volume distribution width with insulin resistance was analyzed.Results The level of four inflammatory parameters (hs-CRP,WBC,neutrophil-to-lymphocyte ratio,RDW)were significantly higher than that the control group (t=5.695,5.232,3.337,7.814,all P<0.01).Pearson correlated analysis suggested that RDW had positive correlation with HOMA-IR (r=0.58,P<0.01).Conclusion The RDW level were elevated in the GDM patients and had positive correlation with HOMA-IR,which indicated that IR was associated with inflammation and provided proof to research mechanism of GDM.
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Objective To explore the change of red cell volume distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) in the patients with gestational diabetes mellitus (GDM ) .Methods A total number of 160 pregnant women in our center from January to October 2016 were selected as the research subjects .Eighty patients with GDM served as the GDM group and 80 normal pregnant women as the control group .The clinical data at the second trimester (24 to 28 gestational weeks) ,and changes of RDW and NLR were analyzed .Results The age ,gestational weeks ,gestational times and pre-pregnant BMI had no statistical differences between the GDM group and control group (P>0 .05) .There was no statistically significant differences in the hyperten-sion family history and fetal macrosomia incidence between the GDM group and control group .However ,the family history of diabe-tes ,premature rupture of membranes and incidence of premature birth had statistical difference between the two groups (P<0 .05) . The RDW and NLR levels of the GDM group were higher than those of the control group (P<0 .01) .Conclusion GDM has a cer-tain association with inflammation .
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Objective To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0%(127/165) and 66.0%(140/212) respectively, the differences had significance (χ2=5.4, P=0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1%(256/294) and 13.3%(11/83) respectively, and the differences had significance (χ2=170.7, P<0.001) . Among the 21 investigated clinical doctors, the numbers of the doctors who correctly diagnosed the suspected cases, probable cases and lab-confirmed cases were only 3, 0 and 8 respectively. All of the clinical doctors knew that it is necessary to report the brucellosis cases within 24 hours after diagnosis. Conclusion The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.
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Objective To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0%(127/165) and 66.0%(140/212) respectively, the differences had significance (χ2=5.4, P=0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1%(256/294) and 13.3%(11/83) respectively, and the differences had significance (χ2=170.7, P<0.001) . Among the 21 investigated clinical doctors, the numbers of the doctors who correctly diagnosed the suspected cases, probable cases and lab-confirmed cases were only 3, 0 and 8 respectively. All of the clinical doctors knew that it is necessary to report the brucellosis cases within 24 hours after diagnosis. Conclusion The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.
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Objective To know how large platelets influnece the platelet count difference of the optical and impedance methods so as to provide the support for the reasonable application of optical method and effectively increasing the accuracy of platelet count.Methods 132 blood routine specimens with normal RBC parameters were anaylzed by both electrical impedance and optical methods with the Sysmex-XE5000 fully automativ hematology analyzer.The data were divided into the large platelet group and the normal platelet group according to the platlet-large cell ratio(P-LCR)results.The RBC and platelet parameters were compared be-tween the two groups with the unpaired t-test and the platelet count results detected by the optical and electrical impedance methods were compared within group with the paired t-test.Results The extremely significant differences of platelet parameters existed be-tween the two groups.The P-LCR,MPV,PDW and IPF % of the large platelet group were significantly higher than those of the normal platelet group,but the RBC parameters had no obvious difference.The significant difference of the platelet count also existed between the electrical impedance and optical methods in the large platelet group(P <0.05 ),the platelet count results detected by the electrical impedance method was on the low side,but the normal platelet group had no significant difference.Conclusion P-LCR increase is related with the increase of immature platelet.The electrical impadence method conducts the differentiation according to the granular size,which is easy to exclude the large platelel with larger volume and leads to reduce the platelet count results.There-fore,when P-LCR is increased,the optical method should be adopted in conducting the platelet count for avoiding the false reduce caused by the electrical impedance method.
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Tetrandrinehasawiderangeofpharmacologicaleffectssuchasanti-inflammation,analgesiceffect,anti-tumor,anti-silicosis, lowering blood pressure and anti-arrhythmia. Up till now, only tablets and ordinary injections are on the market, which is hard to meet the clinical requirements. The paper reviewed the research progress in the new technology and dosage forms of tetrandrine to provide the basis for new dosage form development of tetrandrine.
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@#Objective: To study the effects of mm. abdominis exercise on lumbar spinal stenosis. Methods: 9 patients with lumbar spinal stenosis were treated with mm. abdominis exercises. The static and dynamic strength indexes, the sagittal diameter of canales spinalis tested by ultrasonography were observed and compared before and after treatment. Results: The effect of 3 patients was excellent, 5 good and 1 bad, and the strengths of mm. abdominis increased after treatment. The sagittal diameter of canales spinalis were 8.72±0.44mm and 10.78±0.44mm respectively before and after treatment. The difference was significant (P<0.001). Conclusion: It is suggested that mm. abdominis exercise is an effective technique in management of lumgar spinal stenosis.