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1.
Singapore medical journal ; : 732-738, 2023.
Article Dans Anglais | WPRIM | ID: wpr-1007328

Résumé

INTRODUCTION@#Musculoskeletal injuries are the most common reason for surgical intervention in polytrauma patients.@*METHODS@#This is a retrospective cohort study of 560 polytrauma patients (injury severity score [ISS] >17) who suffered musculoskeletal injuries (ISS >2) from 2011 to 2015 in National University Hospital, Singapore.@*RESULTS@#560 patients (444 [79.3%] male and 116 [20.7%] female) were identified. The mean age was 44 (range 3-90) years, with 45.4% aged 21-40 years. 39.3% of the patients were foreign migrant workers. Motorcyclists were involved in 63% of road traffic accidents. The mean length of hospital stay was 18.8 (range 0-273) days and the mean duration of intensive care unit (ICU) stay was 5.7 (range 0-253) days. Patient mortality rate was 19.8%. A Glasgow Coma Scale (GCS) score <12 and need for blood transfusion were predictive of patient mortality (p < 0.05); lower limb injuries, road traffic accidents, GCS score <8 and need for transfusion were predictive of extended hospital stay (p < 0.05); and reduced GCS score, need for blood transfusion and upper limb musculoskeletal injuries were predictive of extended ICU stay. Inpatient costs were significantly higher for foreign workers and greatly exceeded the minimum insurance coverage currently required.@*CONCLUSION@#Musculoskeletal injuries in polytrauma remain a significant cause of morbidity and mortality, and occur predominantly in economically productive male patients injured in road traffic accidents and falls from height. Increasing insurance coverage for foreign workers in high-risk jobs should be evaluated.


Sujets)
Humains , Mâle , Femelle , Enfant d'âge préscolaire , Enfant , Adolescent , Jeune adulte , Adulte , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Centres de traumatologie , Études rétrospectives , Singapour/épidémiologie , Polytraumatisme/épidémiologie , Durée du séjour
2.
Chinese Journal of Digestive Surgery ; (12): 25-28, 2022.
Article Dans Chinois | WPRIM | ID: wpr-990602

Résumé

Immunotherapy combined with targeted therapy can benefit the survival of patients with unresectable hepatocellular carcinoma. Atezolizumab combined with bevacizumab has achieved remarkable efficacy in patients with advanced hepatocellular carcinoma, but the efficacy of conversion therapy in patients with unresectable hepatocellular carcinoma still needs more evidences. The authors report the clinical efficacy of a case of unresectable hepatocellular carcinoma with hepatitis B virus related liver cirrhosis who was treated with immunotherapy plus targeted therapy combined with local treatment. Results show a good effect in patient without tumor recurrence after postoperative 9 months.

3.
Journal of Public Health and Preventive Medicine ; (6): 75-78, 2022.
Article Dans Chinois | WPRIM | ID: wpr-936440

Résumé

Objective To retrospectively analyze the distribution and drug resistance of pathogenic bacteria in urinary tract infection in Xiangyang Central Hospital from 2017-2019, so as to provide a basis for clinical treatment of urinary tract infection and rational use of antibiotics. Methods The pathogenic bacteria isolated from clinical urine culture in Xiangyang Central Hospital from January 2017 to December 2019 were collected, and BD PhoenixTM 100 was used for the identification of pathogens and antimicrobial sensitivity test. The WHONET 5.6 and GraphPad Prism 5.0 software were used for data analysis. Results A total of 3 056 strains of pathogens were isolated from 15 672 urine specimens (19.50%). Gram-negative bacteria accounted for 77.95%, of which E. coli was the most common (52.45%). Gram-positive bacteria accounted for 12.63%, including E. faecalis (4.80%) and E. faecium (4.80%). Fungi accounted for 9.50%. The clinical departments with the highest rates of urinary culture submission and positive detection were Urology (26.20%) and Endocrinology (41.90%), respectively. E. coli and K. pneumoniae had high resistance rates to piperacillin, compound trimethoprim, cefuroxime, ceftriaxone and cefazolin, all exceeding 50.00%, while P. aeruginosa was relatively sensitive to various antibiotics. The resistance rates of these three gram-negative bacteria to carbapenem antibiotics increased year by year. The isolated gram-positive cocci were mainly enterococcus faecalis and enterococcus faecalis. They were highly sensitive to linazolamide, vancomycin and teicoplanin, but the resistance rates to other types of antibiotics were quite different. The average detection rates of ESBLs-producing E. coli and K. pneumoniae were 52.90% and 59.00%, respectively. Conclusion The pathogens of urinary tract infections in Xiangyang Central Hospital from 2017 to 2019 are mainly gram-negative bacteria, and the resistance rate to carbapenem drugs is increasing year by year. The ESBLs-producing strains of E. coli and K. pneumoniae are highon should be strengthened in patients with high DOB value and smoking.

4.
Chinese Journal of Hospital Administration ; (12): 293-299, 2021.
Article Dans Chinois | WPRIM | ID: wpr-912745

Résumé

The " future hospital" information platform based on cloud architecture, through the deep integration of cloud computing, made full use of the high availability and strong scalability provided by the cloud computing platform, constructed an integrated hospital information platform, and realized the transformation and upgrading of the technical framework of hospital information platform in the era of big data, to meet the needs of homogeneous management and innovative service mode. In order to ensure the reliability of network transmission between cloud data center and hospital, and further ensure medical data security and patient privacy while using cloud computing, the " future hospital" information platform was migrated from the virtual private cloud(VPC)of public cloud to the local private cloud platform of the hospital, realized the hybrid cloud architecture mode of " future hospital" information platform with local proprietary cloud platform as the core and combined with public cloud VPC.

5.
Journal of Zhejiang University. Medical sciences ; (6): 531-536, 2020.
Article Dans Chinois | WPRIM | ID: wpr-828469

Résumé

Clinical trial management system is independently developed by our hospital, which basically realized the whole process management and data collection of clinical trials. Based on the platform, the functional architecture of data remote monitoring and auditing was established. By desensitizing and encrypting of data, the project and subject hologram were visualized to facilitate to review of data. The data remote monitoring and auditing cloud platform adopts the B/S architecture pattern. Users register to apply for an account through the cloud platform, and access to the account via HTTPS security protocol. The authorized users were able to view the relevant items online to ensure the secure data transmission and easy operating. The electronic management of data is the direction of future efforts. By compliance with laws and regulations, the remote monitoring/auditing can be realized, and the data security and personal privacy can be ensured with the application of information technology. In this paper, the feasibility of remote monitoring/auditing mode is explored, specific technical schemes and system functions are suggested, and the realization scenarios are conceived in case of major public health emergencies.

6.
China Journal of Orthopaedics and Traumatology ; (12): 312-316, 2020.
Article Dans Chinois | WPRIM | ID: wpr-828300

Résumé

OBJECTIVE@#To explore the feasibility of arthroscopic humeral ending insertion of rotator cuff, and to provide a scheme for the treatment of giant rotator cuff tears.@*METHODS@#From February 2014 to April 2018, 40 patients with giant rotator cuff tears were operated on and divided into two groups. The study group consisted of 20 patients, including 8 males and 12 females, aged 42 to 82(57.55±8.90) years, with a course of 1 h to 2 years;the treatment of giant rotator cuff tears was carried out by using the technique of rotator cuff moving inward at the humeral head stop and reconstructing complete rotator cuff. The control group consisted of 20 patients, including 10 males and 10 females, aged 45 to 75 (57.75±9.10) years, with a course of 1 h to 5 years;after traditional cleaning, part of the rotator cuff was sutured or in situ high tension suture was used to treat the huge rotator cuff tear. The clinical effect of the two groups was evaluated by VAS, constant and UCLA.@*RESULTS@#All patients were followed up for 12 to 14 months. The VAS, Constant score, UCLA score before operation of two groups were significantly improved compared with those before operation (<0.05);the VAS, Constant score, UCLA score and excellent effect of the study group were significantly better than those of the control group (<0.05).@*CONCLUSION@#Arthroscopic transposition of rotator cuff and humerus ending insertion is a feasible method for the treatment of giant rotator cuff tears, which relieves shoulder pain and improves function satisfactorily.


Sujets)
Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Arthroscopie , Amplitude articulaire , Coiffe des rotateurs , Lésions de la coiffe des rotateurs , Chirurgie générale , Résultat thérapeutique
7.
Acta Physiologica Sinica ; (6): 139-147, 2020.
Article Dans Anglais | WPRIM | ID: wpr-827074

Résumé

Increasing evidence suggests that stress may induce changes in hair color, with the underlying mechanism incompletely understood. In this study, female C57BL/6 mice subjected to electric foot shock combined with restraint stress were used to build chronic stress mouse model. The melanin contents and tyrosinase activity were measured in mouse skin and B16F10 melanoma cells. The enzyme-linked immunosorbent assay (ELISA) was used to determine the content of tumor necrosis factor α (TNF-α), interleukin- 1β (IL-1β) and interleukin-6 (IL-6) in the mouse skin. The content of nuclear factor κB (NFκB)/p65 subunit in mouse skins was valued by immunofluorescence staining. The results demonstrated that under chronic stress, the fur color turned from dark to brown in C57BL/6 mice due to the decrease of follicle melanocytes and tyrosinase activity in C57BL/6 mouse skin. Simultaneously, inflammatory responses in skins were detected as shown by increased NFκB activity and TNF-α expression in stressed mouse skin. In cultured B16F10 melanoma cells, TNF-α reduced the melanogenesis and tyrosinase activity in a dose-dependent manner. These findings indicate that chronic stress induces fur color change by decreasing follicle melanocytes and tyrosinase activity in female C57BL/6 mice, and TNF-α may play an important role in stress-induced hair color change.


Sujets)
Animaux , Femelle , Souris , Fourrure animale , Couleur , Mélanines , Mélanocytes , Mélanome expérimental , Souris de lignée C57BL , Monophenol monooxygenase , Métabolisme , Pigmentation , Peau , Stress physiologique
8.
Journal of Zhejiang University. Science. B ; (12): 703-715, 2020.
Article Dans Anglais | WPRIM | ID: wpr-1010549

Résumé

Oxidative stress and apoptosis are the key factors that limit the hypothermic preservation time of donor hearts to within 4-6 h. The aim of this study was to investigate whether the histone deacetylase 3 (HDAC3) inhibitor RGFP966 could protect against cardiac injury induced by prolonged hypothermic preservation. Rat hearts were hypothermically preserved in Celsior solution with or without RGFP966 for 12 h followed by 60 min of reperfusion. Hemodynamic parameters during reperfusion were evaluated. The expression and phosphorylation levels of mammalian STE20-like kinase-1 (Mst1) and Yes-associated protein (YAP) were determined by western blotting. Cell apoptosis was measured by the terminal deoxynucleotidyl-transferase (TdT)-mediated dUTP nick-end labeling (TUNEL) method. Addition of RGFP966 in Celsior solution significantly inhibited cardiac dysfunction induced by hypothermic preservation. RGFP966 inhibited the hypothermic preservation-induced increase of the phosphorylated (p)-Mst1/Mst1 and p-YAP/YAP ratios, prevented a reduction in total YAP protein expression, and increased the nuclear YAP protein level. Verteporfin (VP), a small molecular inhibitor of YAP-transcriptional enhanced associate domain (TEAD) interaction, partially abolished the protective effect of RGFP966 on cardiac function, and reduced lactate dehydrogenase activity and malondialdehyde content. RGFP966 increased superoxide dismutase, catalase, and glutathione peroxidase gene and protein expression, which was abolished by VP. RGFP966 inhibited hypothermic preservation-induced overexpression of B-cell lymphoma protein 2 (Bcl-2)-associated X (Bax) and cleaved caspase-3, increased Bcl-2 mRNA and protein expression, and reduced cardiomyocyte apoptosis. The antioxidant and anti-apoptotic effects of RGFP966 were cancelled by VP. The results suggest that supplementation of Celsior solution with RGFP966 attenuated prolonged hypothermic preservation-induced cardiac dysfunction. The mechanism may involve inhibition of oxidative stress and apoptosis via inactivation of the YAP pathway.


Sujets)
Animaux , Mâle , Rats , Acrylamides/pharmacologie , Apoptose/effets des médicaments et des substances chimiques , Cryoconservation , Diholoside/pharmacologie , Électrolytes/pharmacologie , Glutamates/pharmacologie , Glutathion/pharmacologie , Coeur/physiologie , Transplantation cardiaque/méthodes , Facteur de croissance des hépatocytes/antagonistes et inhibiteurs , Histidine/pharmacologie , Inhibiteurs de désacétylase d'histone/pharmacologie , Protéines et peptides de signalisation intracellulaire/antagonistes et inhibiteurs , Mannitol/pharmacologie , Stress oxydatif/effets des médicaments et des substances chimiques , Phénylènediamines/pharmacologie , Protéines proto-oncogènes/antagonistes et inhibiteurs , Rat Sprague-Dawley , Transduction du signal/effets des médicaments et des substances chimiques , Protéines de signalisation YAP
9.
China Journal of Chinese Materia Medica ; (24): 5124-5128, 2019.
Article Dans Chinois | WPRIM | ID: wpr-1008374

Résumé

Cultivated ginseng in the farmland would become the mainly planting mode of Panax ginseng. However,there are relatively few cultivation ginseng varieties for farmland in China. Correlative analysis of qualitity and agronomic traits of P. ginseng cultivation in the farmland could provide a reference for the selection of excellent germplasm and new variety breeding of P. ginseng. In this study,the main index of saponin and agronomic traits of 4-6 years' samples were analyzed by UPLC and measured. The results show that there was significant difference in agronomic indexes of Damaya. The coefficient of variation of the root length( CV = 41. 97%) and fresh weight( CV = 31. 81%) were maximum,and the coefficient of variation of the stems thickness( 16. 72%) and root thickness were minimum. There was a significant correlation between yield and root thickness( P<0. 05). There was significant difference in drug yield of different harvest years( P<0. 05),and the yield of 6-years was 31. 52%-39. 69% higher than 4-years. However,there wasn't significant difference in total ginsenosides between 4 and 6 years old P. ginseng,but there was significant difference in ginseng Rg2,Rc and Rb2( P<0. 05),and the ginsenoside contents of different harvesting years were accorded with the criterion standards of 2015 Chinese Pharmacopoeia. There was no significant correlation between the saponin and the agronomic trait,while there was positive correlation with root thickness( P < 0. 05). Therefore,the stem diameter was positive correlation with yield of P. ginseng. Selection of the stem thickness of seedlings is beneficial to the increase of the yield and breeding of P. ginseng.


Sujets)
Chine , Production végétale , Ginsénosides/analyse , Panax/composition chimique , Amélioration des plantes , Racines de plante/croissance et développement , Tiges de plante/croissance et développement
10.
Journal of Zhejiang University. Science. B ; (12): 928-932, 2019.
Article Dans Anglais | WPRIM | ID: wpr-1010500

Résumé

Hepatocellular carcinoma (HCC) is one of the most common types of liver cancer and is the second leading cause of cancer mortality with an estimated 745 500 deaths annually (Jemal et al., 2011). Although new therapeutic modalities including novel chemotherapeutic interventions and targeted therapy have been applied, the prognosis of HCC patients remains unsatisfactory due to the high incidence of intrahepatic and distal metastases (Siegel et al., 2018).


Sujets)
Femelle , Humains , Mâle , Protéines régulatrices de l'apoptose/physiologie , Marqueurs biologiques , Carcinome hépatocellulaire/anatomopathologie , Génome , Hypoxie , Tumeurs du foie/anatomopathologie , microARN/analyse , Stadification tumorale , Pronostic , Protéines de répression/physiologie
11.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 120-127, 2019.
Article Dans Chinois | WPRIM | ID: wpr-802010

Résumé

As a commonly used traditional Chinese medicine,Stellaria dichotoma var. lanceolata has a medicinal history of several hundred years, and been included in the Pharmacopoeia of the People's Republic of China. With a sweet fact and mild war nature, it enters liver and stomach meridians. With effects in clearing deficient heat and eliminating fever in infantile malnu, it has been used to treat such diseases as Yin deficiency fever, consumptive fever due to Yin deficiency and infantile chancre fever, and taken as the raw materials of Wuji Baifeng Wan and other traditional Chinese medicine preparations. In recent years,there have been increasing demands for S. dichotoma var. lanceolata from people. However, its wild resources have been over-excavated for a long time,leading to a serious shortage of wild strains. Furthermore, the quality of artificial S. dichotoma var. lanceolata medicine is far different from that of wild cultivars. Meanwhile,pesticide residues and excessive metal standards due to the irrational use of pesticides and chemical fertilizers in the production process, as well as the large number of counterfeits in the market seriously impact the quality,efficacy and drug safety of S. dichotoma var. lanceolata medicine. Therefore, the non-polluted production technology of S. dichotoma var. lanceolata is of great significance. The non-polluted production technology would be an effective mode for promoting the sound development of S. dichotoma var. lanceolata industry in the future and the key to solve the issues. This article summarizes the environment of suitable production area,plantation method, comprehensive soil improvement, field management and rational fertilization technology. It also proposes that the prevention and control of pollution-free safflower pests and diseases should follow the principle of giving priority to comprehensive prevention. The pollution-free and technical regulation system of S.dichotoma var. lanceolata cultivars is built to produce excellent,high-quality and non-polluted production with low content of pesticide residues and heavy metals,and promote the healthy and sustainable development of the global S.dichotoma var. lanceolata industry.

12.
Chinese Journal of Natural Medicines (English Ed.) ; (6): 481-489, 2019.
Article Dans Anglais | WPRIM | ID: wpr-776853

Résumé

American ginseng (Panax quinquefolius L.) is a well-known Asian traditional herbal medicine with a large market demand. The plant is native to eastern North America, and its main producing areas worldwide are decreasing due to continuous cropping obstacles and environmental changes. Therefore, the identification of maximum similarities of new ecological distribution of P. quinquefolius, and prediction of its response to climate change in the future are necessary for plant introduction and cultivation. In this study, the areas with potential ecological suitability for P. quinquefolius were predicted using the geographic information system for global medicinal plants (GMPGIS) based on 476 occurrence points and 19 bioclimatic variables. The results indicate that the new ecologically suitable areas for P. quinquefolius are East Asia and the mid-eastern Europe, which are mainly distributed in China, Russia, Japan, Ukraine, Belarus, North Korean, South Korea, andRomania. Under global climate change scenarios, the suitable planting areas for P. quinquefolius would be increased by 9.16%-30.97%, and expandingnorth and west over the current ecologically suitable areas by 2070. The potential increased areas that are ecologically suitable include northern Canada, Eastern Europe, and the Lesser Khingan Mountains of China, and reduced regions are mainly in central China, the southern U.S., and southern Europe. Jackknife tests indicate that the precipitation of the warmest quarter was the important climatic factor controlling the distribution of P. quinquefolius. Our findings can be used as auseful guide for P. quinquefolius introduction and cultivation in ecologically suitable areas.

13.
Journal of Experimental Hematology ; (6): 1772-1779, 2018.
Article Dans Chinois | WPRIM | ID: wpr-774387

Résumé

OBJECTIVE@#To explore the maintaining measures for the vitality of hematopoietic stem cells (HSC) in vitro, so as provide technical support for ultra long distance transport of HSC collected from unrelated donors.@*METHODS@#Peripheral blood hematopoietic stem cells (PBHSC) were treated by different methods according to various groups, then stored at 4 ℃ in the refrigerator. The percentage of CD34 cells, relative cell activity, relative cell proliferation rate, relative colony-forming rate, oxygen fraction and intracellular reactive oxygen species (ROS) were detected at 0, 24, 48 and 72 h after storage of PBHSC respectively.@*RESULTS@#The percentage of CD34 cells during 72 h storage did not altered. Along with the prolonging of storage time, the relative cell activity, relative cell proliferation rate and relative colony-forming rate gradually decreased in untreated PBHSC(control group), the related coefficients were -0.796, -0.883 and -0.815 respectively. Plasma dilution, antioxidants and oxygenation could improve the relative cell activity and relative cell proliferation rate, but oxygenation could decrease the relative colony-forming rate of PBHSC. The combination of 2 or 3 factors showed stronger protection effects on PBHSC. The intracellular level of ROS decreased gradually with the prolonging of storage time. Oxygenation of PBHSC could increase oxygen fraction, and also increase the intracellular level of ROS at the same time. The addition of antioxidants could reduce the level of ROS.@*CONCLUSION@#The percentage of CD34 cells can not serve as the indicator of PBHSC vitality. Plasma dilution, oxygenation and antioxidants can increase the survival and viability of PBHSC, but oxygenation can increase the intracellular ROS level and impair colony-forming ability of PBHSC. The combination of multiple factors can maintain the vitality of PBHSC better.


Sujets)
Antigènes CD34 , Antioxydants , Cellules souches hématopoïétiques , Espèces réactives de l'oxygène
14.
Chinese Journal of Medical Education Research ; (12): 563-566, 2018.
Article Dans Chinois | WPRIM | ID: wpr-700570

Résumé

The Surgery foundation is a course that emphasizes both theory and practice. It is an important part of surgical study and a compulsory basic course for medical students. The teaching quality of this course is directly related to the future level of clinical operation of medical students, and the good teaching methods and means are one of the key factors to determine the quality of the course. In this paper, the reform of teaching means and methods of this course are discussed, so as to further improve the teaching quality and summarize the experience and advice.

15.
Chinese Medical Equipment Journal ; (6): 29-32,38, 2018.
Article Dans Chinois | WPRIM | ID: wpr-700058

Résumé

Object To quantitatively analyze the rationality of medical support process and resource allocation on a certain model of ship.Methods Based on the queuing theory, the simulation model was built and analyzed by using simulation software. The medical system operational effectiveness was investigated through process parameters, such as the wounded waiting time, the resource utilization of major equipment.Results The simulation results showed that the design scheme of medical system was reasonable.Conclusion The quantitative process parameters of the system operating efficiency can be obtained at the design stage by using simulation analysis technology, which is of great practical value for the rationality of medical system design on ship.

16.
Chinese Medical Equipment Journal ; (6): 39-43, 2018.
Article Dans Chinois | WPRIM | ID: wpr-700036

Résumé

Objective To research the location,composition,zoning,flow and combination form of medical system of Model 920 hospital ship, and to provide theoretical support for the design of the hospital ship. Methods The layout of medical system of the hospital ship was constructed based on the theories of ship engineering design,hospital architecture design and naval health service as well as the requirements for height and internal environment of medical system.Results The mode combining multi corridor and single column was used to design 8 operating rooms and accessories in the midship of No.01 deck.Conclusion The multi-corridor single-column combination operating area occupies less ship space resources and the surgical treatment of wounded and sick patients is efficient, which is suitable for the platform of the ship and is worthy of reference for the design of the medical system of the large-scale rescue platform on the sea. [Chinese Medical Equipment Journal,2018,39(5):39-43]

17.
Journal of Kunming Medical University ; (12): 20-25, 2018.
Article Dans Chinois | WPRIM | ID: wpr-694492

Résumé

Objective To study the effect of Carthamin Yellow (CY) on cell proliferation, apoptosis, migration and invasion ability of breast cancer and its related molecular mechanisms. Methods CCK-8 assay was used to detect cell viability of MDA-MB-231 human breast cancer cells by different concentrations of CY at different time;flow cytometry was used to test the apoptosis rate of MDA-MB-231 cells treated by different concentrations of CY and transwell assay was used to investigate the effect of various concentrations of CY on MDA-MB-231 cell migration and invasion.After the intervention of different concentrations of CY on MDA-MB-231 cells, apoptosis-related protein Cleaved-Caspase-3, survival protein p-Akt and metastasis-related protein MMP2 were detected by western blot. Results (1) CY could inhibit the proliferation of MDA-MB-231 cells in a dose-and-time-dependent manner. (2) CY significantly promoted the apoptosis of breast cancer cells ( <0.01) . (3) CY could decrease the expression of p-Akt and increase the expression of Cleaved-Caspase-3. (4) CY impaired migration and invasion of MDA-MB-231 cells ( <0.01), and can inhibit the expression of MMP2. Conclusion CY could promote the apoptosis of breast cancer cells through activation of apoptosis signaling, and can inhibit breast cancer cell metastasis by suppressing MMP2. And CY may be a potential therapeutic drug for human breast cancer.

18.
Singapore medical journal ; : 190-198, 2018.
Article Dans Anglais | WPRIM | ID: wpr-687881

Résumé

<p><b>INTRODUCTION</b>Pneumonia is associated with considerable mortality. However, there is limited information on age-specific prognostic factors for death from pneumonia.</p><p><b>METHODS</b>Patients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups: 18-64 years, 65-84 years and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction.</p><p><b>RESULTS</b>A total of 1,902 patients were enrolled (18-64 years: 614 [32.3%]; 65-84 years: 944 [49.6%]; ≥ 85 years: 344 [18.1%]). Mortality rates increased with age (18-64 years: 7.3%; 65-84 years: 16.1%; ≥ 85 years: 29.7%; p < 0.001). Malignancy and tachycardia were prognostic of mortality among patients aged 18-64 years. Male gender, malignancy, congestive heart failure and eight other parameters reflecting acute disease severity were associated with mortality among patients aged 65-84 years. For patients aged ≥ 85 years, altered mental status, tachycardia, blood urea nitrogen, hypoxaemia, arterial pH and pleural effusion were significantly predictive of mortality. The Pneumonia Severity Index (PSI) was more sensitive than CURB-65 (confusion, uraemia, respiratory rate ≥ 30 per minute, low blood pressure, age ≥ 65 years) for mortality prediction across all age groups.</p><p><b>CONCLUSION</b>The predictive effect of prognostic factors for mortality varied among patients with pneumonia from the different age groups. PSI performed significantly better than CURB-65 for mortality prediction, but its discriminative power decreased with advancing age.</p>


Sujets)
Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Facteurs âges , Algorithmes , Infections communautaires , Diagnostic , Mortalité , Hospitalisation , Analyse multifactorielle , Admission du patient , Pneumopathie infectieuse , Diagnostic , Mortalité , Valeur prédictive des tests , Pronostic , Courbe ROC , Facteurs de risque , Sensibilité et spécificité , Indice de gravité de la maladie , Singapour , Épidémiologie
19.
Singapore medical journal ; : 528-533, 2018.
Article Dans Anglais | WPRIM | ID: wpr-687446

Résumé

<p><b>INTRODUCTION</b>Streptococcus agalactiae (Group B Streptococcus, GBS) is an uncommon cause of septic arthritis in the adult population. In recent years, there has been an increase in the incidence of GBS septic arthritis. This study aims to compare the clinical presentation, investigations, microbiology and outcome of management in patients with GBS and non-GBS septic arthritis.</p><p><b>METHODS</b>Retrospective review of hospital surgical records was done to identify all patients treated surgically at our institution from January 2011 to January 2016 for primary septic arthritis. Patients were categorised into two groups: those with culture-proven GBS septic arthritis and those with causative pathogens that were not GBS. Patients who were medically unfit for surgical intervention as well as those who declined interventional procedures were excluded from the study.</p><p><b>RESULTS</b>A total of 83 patients were included in the study: 62 (74.7%) had non-GBS septic arthritis and 21 (25.3%) had GBS septic arthritis. Patients with GBS septic arthritis were more likely to have polyarticular involvement (p < 0.001) and involvement of less common sites such as the elbow joint. They were also more likely to have elevated inflammatory markers (C-reactive protein > 150 mg/L; p = 0.017) and positive blood cultures (p = 0.02), and were typically healthy adults with no medical comorbidities (p = 0.012).</p><p><b>CONCLUSION</b>Patients with GBS septic arthritis were more likely to present with polyarticular involvement, positive blood cultures and higher levels of C-reactive protein on admission, and tended to be healthier individuals with no medical comorbidities.</p>

20.
China Journal of Chinese Materia Medica ; (24): 1427-1433, 2018.
Article Dans Chinois | WPRIM | ID: wpr-687281

Résumé

Planting pollution-free farmland is the main mode of industrialization of ginseng cultivation, fine management of nitrogen fertilizer ginseng pollution-free farmland cultivation technology system is one of the key factors. In order to investigate the effect of nitrogenous fertilizer on the accumulation of ginseng biomass and saponins synthesis in vegetative growth stage, two-years-old ginsengs were used as test materials in this study. The test materials were cultivated by Hoagland medium with different nitrogen concentration (0,10,20,40 mg·L⁻¹) for 40 days. During the cultivation, photosynthetic rate was measured four times. After 40 days cultivation, chlorophyll content, stem diameter and the spatiotemporal expression of saponin synthesis related genes PgHMGR and PgSQE were tested. The results showed that there were significant differences in the photosynthetic rate and chlorophyll content among different nitrogen concentrations. The relative expression level of PgHMGR gene and PgSQE gene in root, stem and leaves of ginseng were different. Ginseng seedlings cultivated by 20 mg·L⁻¹ nitrogen possess the highest photosynthetic rate and chlorophyll content, while PgHMGR and PgSE showed the highest gene expression level. The optimal nitrogen concentration for the growth of 2-years-old ginseng might be 20 mg·L⁻¹ with 57.14 g ammonium nitrate each plant or pure 20.00 mg nitrogen each plant. It is concluded that this concentration is the most suitable concentration for the ginsenoside synthesis. Pollution-free ginseng with fine nitrogen fertilizer cultivation is conducive to the production of high quality and efficient ginseng medicinal materials. It lays a theoretical foundation for the rational fertilization and environment-friendly sustainable ecological ginseng planting industry.

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