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Objective To explore the diagnostic value of Young's modulus obtained by real-time shear wave elastography (SWE) for liver fibrosis in autoimmune hepatitis (AIH) patients. Methods A total of 75 AIH patients in the First Affiliated Hospital of Zhengzhou University from January 2013 to April 2022 were retrospectively enrolled. Scheuer scoring system was used to evaluate degrees of liver fibrosis (S0-S4). By using pathological examination of liver tissues as the golden standard, the receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was used to evaluate the diagnostic value of SWE for the significant fibrosis (≥S2), advanced liver fibrosis (≥S3), and liver cirrhosis (S4), respectively. Independent sample t test was used for comparison of continuous data with normal distribution between the two groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and Bonferroni method was used for further comparison between two groups. The Spearman correlation coefficient was used for correlation analysis. The logistic regression analysis was used to predict the impact factors in diagnosis accuracy. Results The Young's modulus measured by SWE was statistically significant different among various fibrosis groups ( H =35.186, P 0.05). The Young's modulus measurement was positively correlated with liver fibrosis ( r =0.675, P < 0.05). The AUCs of SWE in the diagnosis of≥S2, ≥S3, and S4 were 0.839, 0.820 and 0.898, respectively and the corresponding optimum cut-off values were 9.2, 10.9, and 14.4 kPa, respectively. The overall concordance rate of the liver Young' s modulus measurements vs . fibrosis stages was 57.33%. Moreover, the alkaline phosphatase level was an independent predictor for diagnostic accuracy of SWE for stage 0-1 fibrosis ( OR =1.009, 95% CI : 1.001-1.018, P =0.029). Conclusion The SWE possessed a diagnosis value for the significant fibrosis (≥S2), advanced liver fibrosis (≥S3) and liver cirrhosis (S4), although there was a low overall concordance rate in the liver Young's modulus measurements obtained using SWE vs. fibrosis stages.
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Objective To analyze the composition and influencing factors of the hospitalization expenses of patients with cardiovascular and cerebrovascular diseases who has participated in basic medical insurance, and to provide evidence for controlling excessive increase in the hospitalization expenses and reducing the financial burden of patients. Methods The hospitalization information of 14,271 insured patients with cardiovascular and cerebrovascular diseases from January 1, 2019 to December 31, 2019 in Xianning City, Hubei Province was retrospectively collected. The basic information of the patients and the composition of their hospitalization expenses were descriptively analyzed, and the influencing factors of hospitalization expenses of the patients were analyzed by univariate analysis and logistic regression analysis. Results Among the patients included in the study, coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension were the four main types of cardiovascular and cerebrovascular diseases with the largest proportion of hospitalization expenses, accounting for 26.18%, 20.29%, 11.82% and 9.94%, respectively. The largest proportion of hospitalization expenses was treatment expenses and drug expenses, accounting for 44.09% and 32.52%, respectively. Logistic regression analysis showed that age, length of stay, type of insurance, type of cardiovascular and cerebrovascular diseases, whether there were other comorbidities or complications, and whether they visited tertiary medical institutions were the influencing factors of hospitalization expenses for patients with cardiovascular and cerebrovascular diseases. Conclusion It is necessary to strengthen the disease prevention and control for the elderly and patients with cardiovascular and cerebrovascular diseases such as coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension, accelerate the integration of the basic medical insurance system, scientifically and reasonably shorten the length of hospital stay, and strengthen the promotion of the hierarchical medical system.
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Anaphylactic shock is a serious and rare adverse reaction， which can be life-threatening if not treated in time. COVID-19 vaccine is a newly marketed vaccine， and people pay high attention to its adverse reactions. This report summarized the investigation and management process of a case of anaphylactic shock after inoculation with COVID-19 vaccine， in order to provide reference for standardizing the diagnosis and management of anaphylactic shock after vaccination.
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Objective To explore the health-related quality of life and the influencing factors among community people after losing the only-child. Method A total of 300 people who came from 30 communities in 5 main urban districts of Kunming involved in the investigation using the medical outcomes study 36-item short form health survey (SF-36)by multistage stratified sampling during September and November 2016. Results The scores of physical component summary,mental component summary and 8 dimensions were significantly lower than those of the norm(all P<0.05).The physical component summary(64.72±18.38),which was higher than that of the mental component summary (51.86±22.95)(P<0.01).Multiple linear stepwise regression analysis showed that the higher the personal average monthly income in the recent year was and the longer after losing the only-child, the better the quality of life. Conclusions The health-related quality of life among community people after losing the only-child is lower,the personal average monthly income and the length after losing the only-child are the influencing factors.The community nurses should establish a community nursing service system for them and carry out individualized nursing interventions to improve their health-related quality of life.
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Objective To invetigate the clinical effect of Guyouling Liniment in the treatment of soft tissue contusion.Methods Sixty-three cases of soft tissue contusion in our hospital from October 2012 to January 2014 were selected and divided into the treatment group (n=32)and control group(n=31).The treatment group were treated with Guyouling Liniment and the control group adopted Indomethacin Liniment.The effects were compared between the two groups.Results Twenty-six cases(81.13％) in the treatment group were cured and 30 cases (93.75％) were effective;23 cases(74.19％) in the control group were cured and 27 cases (87.10％) were effective.The clinical effect of the treatment group was better than that of the control group with statistical difference(P＜0.05).Compared with the control group,the pain degree and stasis purple area in the treatment group were significantly alleviated,the difference was statistically significant(P＜0.05).Conclusion Guyouling Liniment has significant effect in the treatment of soft tissue contusion and is worthy of clinical promotion.
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Under the guidance of strengthening medical undergraduates' practical ability and their competence in future jobs, Dalian Medical University has established a clinical medical talents practical ability training mode. This model has implementedThree Turnsclinical skills training pattern to strengthen the three stage (before, during and after practice) clinical skills training and concentrated on humanistic quality education through overall evaluations and set up clinical skill examination system to evaluate teach-ing effectiveness comprehensively and truly , which has effectively improved the quality of education by perfecting safeguard mechanisms and guaranteeing teaching quality.
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Objective To introduce and translate the Coping-adaptation Processing Scale:Short Form-15 items (CAPS:SF) and evaluate the reliability and validity among people after losing the only-child. Methods CAPS:SF was translated into Chinese (CV-CAPS:SF) according to Brislin. A sample of 77 people after losing the only-child were recruited to complete the scale to evaluate the reliability and validity of scale. Results The scale-content validity index of the CV-CAPS:SF was 0.94;the Cronbachαwas 0.85 and split-half coefficient was 0.84. The score of coping was (38.60 ± 5.30) points. The take strength from spirituality or the successes of courageous people was the highest (3.44±0.50) points;the use humor in handling the situation was the lowest (2.05±0.58) points. Different age, education degree, marital status, occupation, average monthly income of latest year, the length after losing the only-child in the face of the difference was statistically significant (t/F=7.636-85.130, all P<0.05). Conclusions The CV-CAPS:SF is reliable and valid. It could be used to help the nursing staff understand coping among people after losing the only-child .
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Objective To investigate the direct economic losses caused by healthcare-associated infection(HAI)in patients with acute lymphoblastic leukemia (ALL)and acute non-lymphoblastic leukemia (ANLL).Methods All acute leukemia (AL)adult patients who were admitted to a hematology ward in a hospital between January 201 1 and December 2013 were included in the study,HAI group(case group)and non-HAI group (control group),ALL group and ANLL group were matched respectively in a 1:1 ratio,hospitalization expenses and length of hospital stay were compared.Results A total of 994 patients were included,166 were with ALL,828 with ANLL,there were 181 pairs of case group and control group,and 15 pairs of ALL group and ANLL group. Direct economic los-ses in ALL group and ANLL group were 13 089.0 ￥ and 21 565.0 ￥ respectively ;extension of length of hospital stay due to HAI were 10.5 and 10.0 days respectively,differences were statistically significant between case group and control group (both P<0.05). The total hospitalization expense,as well as fees for bed,consultation,treat-ment,laboratory examination,nursing,medicine,traditional Chinese medicine,and blood transfusion in ANLL group were all higher than ALL group,but there were no significant difference.Conclusion HAI in patients with AL can increase hospitalization cost and prolong length of hospital stay.
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Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.
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Objective To evaluate and compare the applicability and accuracy of POSSUM , P-POSSUM and Thora-coscore in predicting the postoperative mortality of thoracic surgery patients .Methods We collected the clinical data of 1 450 thoracic surgery patients during March 2012 to August 2013 in the Second Xiangya Hospital.We used the 3 kinds of risk sco-ring system to calculate the predicted postoperative mortality in these patients .Then we used H-L test and the area under the ROC curve to evaluate and compare their degrees of compliance and validities of identification independently .Results Within 1 450 cases,20 patients (1.4%) died in 30 days after surgery, POSSUM overestimated the mortality (3.84%,P0.05.The area under the ROC curve of POSSUM, P-POSSUM ( two kinds of death prediction formula ) and Thoracoscore to predict postoperative mortality in all thoracic surgery patients was 0.774,0.777,0.777 and 0.831 independently, P <0.05; the area under the ROC curve to predict postoperative mortality in patients after lung surgery was 0.755,0.771,0.771,0.849 independently, P<0.05; the area under the ROC curve to predict postoperative mortality of patients with esophageal surgery was 0.640,0.650,0. 650,0.764 independently, only Thoracoscore P<0.05;the area under the ROC curve to predict postoperative mortality of pa-tients with mediastinal and other surgical was 1.000,1.000,1.000,0.854 independently, only Thoracoscore P<0.05.Con-clusion Thoracoscore scoring system is the most suitable risk scoring system to predict postoperative mortality in thoracic sur-gery patients with high predictive accuracy and good identification validity .
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Experimental autoimmune encephalomyelitis ( EAE ) is a classic animal model for multiple sclerosis . After more than 2 centuries of development , EAE can be established in mice , monkeys and rats ,etc.Some animals can be immunized by different immune antigens which have different features in sensibility and clinical characteristics .In this pa-per, we will review the development of EAE , discuss the characteristics of EAE models produced by immunization of differ-ent animals with different antigens .In summary, we explore the development of animal models of EAE .
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Objective:To explore differential diagnosis value of changes of brain natriuretic peptide (BNP) and N ter‐minal pro brain natriuretic peptide (NT‐proBNP) concentrations in patients with dyspnea .Methods :A total of 150 patients with dyspnea at hospitalization were enrolled and divided into cardiogenic dyspnea group (CD group ,n=51) ,pulmonary dyspnea group (PD group ,n=47) and cardiogenic plus pulmonary dyspnea group (CPD group ,n=52) .Another 40 healthy subjects were regarded as normal control group .Concentrations of BNP and NT‐proBNP were observed and compared among all groups before and after treatment .Results:Before treatment ,compared with normal control group , there were significant rise in plasma concentrations of BNP and NT‐proBNP in CD group ,CPD group and PD group ,that of CD group was significantly higher than those of PD group and CPD group , and that of CPD group was significantly higher than that of PD group , P<0.01 all .Before treatment ,the NT‐proBNP content in CD group ,CPD group , PD group were [ (3356.6 ± 321.2) pg/ml vs . (3156.9 ± 239.8) pg/ml vs .(2563.7 ± 234.20) pg/ml] respectively , comparison among three groups , P<0.01 all .Compared with before treatment ,one week after discharge ,plasma concentrations of BNP and NT‐proBNP significantly reduced in CD group ,CPD group and PD group ,the plasma BNP and NT‐proBNP concentrations of CD group were the highest , those of PD group were the lowest ,and those of CPD group were the middle , P<0.01 all .Conclusion:Plasma BNP and NT‐proBNP concentrations are helpful to differential diagnose whether dyspnea belongs to cardiogenic or pul‐monary diseases .
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The gene of the caudal-type homeobox gene -2 ( CDX2), a member of the CDX family, is a principal regulator in the development of embryogenesis and haematogenesis . Recent studies have shown aberrant expression of CDX2 in each subtype of leukemia and its involvement in the genesis, progress and prognosis of leukemia as new gene. CDX2 may be a potential gene maker of leukemia in minimal residual disease detection.Studies also suggested that CDX2 be involved in leukemia by modulating HOX gene. To further investigate the mechanism of CDX2 in leukemia can be of great significance for the prediction of relapse and the individualized and targeted therapy.
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AIM:To determine the contents of euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae and Semen Euphorbiae Pulveratun from different habitats.METHODS:A kromasil C_(18) column(150 mm×4.6 mm,5 μm)was used with methanol-water(68:32)as the mobile phase and UV detection was at 280 nm.RESULTS:The linear ranges of euphorbiasteroid and lathyrol diadetate benzozte were from 0.200 μg to 1.200 μg and 0.206 μg to 1.651 μg(r = 0.999 7,r = 0.999 9).The contents of euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae from different habitats ranged from 0.450 8% to 0.625 1 % and 0.692 3% to 0.752 9%.The contents of two kinds of compositions in Semen Euphorbiae Pulveratun ranged from 0.156 8% to 0.221 1% and 0.232 2% to 0.283 0%.CONCLUSION:The method for quantitating euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae is accurate and reliable,and can be used to control the quality of toxicity Semen Euphorbiae and Semen Euphorbiae Pulveratun.
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OBJECTIVE To estimate the prevalence of nosocomial infections(NI)and the use of antibacterials in pediatric department,find the problems in management of hospital infection and provide the scientific basis for formulating prevention and control measures.METHODS By bed-visiting and patients' medical records checking,we filled out unified case questionnaire.All patients were investigated on August 22,2007.RESULTS Of the 86 patients investigated,the prevalence rate of NI was 4.65%.There were 19 kinds of antibiotics used daily.The daily antibiotics use rate was 95.35%;all of the infection sites were in upper respiratory tract and delivering rate of bacterial culture was only 14.63%.CONCLUSIONS Management and training should be strengthened on antibacterial drug in the pediatric department.The reasonable use of target antibiotics could prevent the abuse ment.
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Objective:To study the correlation of leucocyte level of peripheral blood with degree of pyretic pulmonary syndrome in different bacterial pneumonia patients and to provide evidence in clinical practice.Methods:To observe pneumonia patients that had been healed in our respiration department of The Jiangxi Province Chinese Medicine Hospital from January,2006 to December,2007 years,incorporating the non-foundation disease or the chronic obstuctive pulmonary disease or chronic cor corpulmonale,We were to summarize relation degree of pyretic pulnonary syndrome to the white blood cell countingthe neutral granular cell percentage relevance.Results:From the non-foundation disease's pneumonia patients group,degree of pyretic pulnonary syndrome and the peripheral blood white blood cell counting and the neutral granular cell level had obvious relevance(P
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OBJECTIVE:To study the preparation and the quality control of the compound lomefloxacin nose-drops MET_HODS:The first order derivative spectrophotometry was used to determine the content of lomefloxacin with no need of isolation The detecting wavelengths were 293nm and 315nm RESULTS:The correlation coefficient was 0 9 999 The average recovery was 100 77%,with RSD of 0 82% CONCLUSION:The preparation process of compound lomefloxacin nose-drops was simple,the first order derivative spectrophotometry for the determination was rapid,simple and accurate
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Quaternary ammonium glucosamine conjugatewas prepared by a two step procedure.First,condensation of glucosamine hydrochloride with chloro acetic chloride in the presence of potassium bicarbonate in aqueous medium at 0℃ provided the N chloroacetyl derivative in 74% yield.Subsequent reaction of this intermediate with pyridine at 40℃ for 3 days gave the pyridinium conjugate in 71% yield.The structures of compounds were confirmed by IR,NMR spectra and element analysis.
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Basic aluminium 6 ? (carboxylmethyl) chitosan was prepared by reacting the solution of 6 ? (carb?xylmethyl) chitosan in water with basic aluminium chloride 〔Al(OH) 2Cl〕. The structure of product was confirmed by IR and atomic absoption spectroscopy.
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Chitosan and it's derivatives have good biologic and particular physical and chemical properties. They have a wide applied foreground on drug preparations. This study introduced the recent advances of them based on widely researching the information and the actual works, and provided reference for the study of oral drug preparations.