Analysis on Hemodynamic Characteristics of Individualized Carotid Aneurysms / 医用生物力学

Objective To construct an individualized fluid-solid coupling model, calculate and analyze the influence of different blood characteristics on hemodynamics in the aneurysm cavity, and further explore the influence on rupture of the cerebral aneurysm. Methods First, three-dimensional (3D) digital silhouette images were collected to construct an aneurysm model, and the influence of different blood flow characteristics on dynamic parameters of the carotid aneurysm was analyzed by computational fluid dynamic (CFD) method under the same boundary conditions. Finally, particle image velocimetry (PIV) experiment was performed on the simplified carotid aneurysm experimental model to verify reliability of the blood flow calculation method. Results For the fluid-structure coupling model with different blood flow characteristics, within a cardiac cycle, at the same time, obvious differences were found in the low velocity area of tumor cavity, the streamline distributions of tumor cavity, the wall shear stress (WSS) and deformation of the aneurysm wall. Through PIV experiments, it was found that the vortex position in tumor cavity changed with the velocity, which was consistent with flow trend of the simulation analysis results. Conclusions The two kinds of blood characteristics have small differences, but the non-Newtonian fluid is closer to true state of the blood, and the numerical results will be closer to true flow state.

Parameters indicative of persistence of valvular pathology at initial diagnosis in acute rheumatic carditis: the role of albumin and CD19 expression / Parâmetros indicativos de persistência de patologia valvular no diagnóstico inicial de cardite reumática aguda: o papel da albumina e da expressão de CD19

Abstract Objective: The aim of this study is to define the predictors of chronic carditis in patients with acute rheumatic carditis (ARC). Methods: Patients diagnosed with ARC between May 2010 and May 2011 were included in the study. Echocardiography, electrocardiography, lymphocyte subset analysis, acute phase reactants, plasma albumin levels, and antistreptolysin-O (ASO) tests were performed at initial presentation. The echocardiographic assessments were repeated at the sixth month of follow-up. The patients were divided into two groups according to persistence of valvular pathology at 6th month as Group 1 and Group 2, and all clinical and laboratory parameters at admission were compared between two groups of valvular involvement. Results: During the one-year study period, 22 patients had valvular disease. Seventeen (77.2%) patients showed regression in valvular pathology. An initial mild regurgitation disappeared in eight patients (36.3%). Among seven (31.8%) patients with moderate regurgitation initially, the regurgitation disappeared in three, and four patients improved to mild regurgitation. Two patients with a severe regurgitation initially improved to moderate regurgitation (9.1%). In five (22.8%) patients, the grade of regurgitation [moderate regurgitation in one (4.6%), and severe regurgitation in 4 (18.2%)] remained unchanged. The albumin level was significantly lower at diagnosis in Group 2 (2.6 ± 0.48 g/dL). Lymphocyte subset analysis showed a significant decrease in the CD8 percentage and a significant increase in CD19 percentage at diagnosis in Group 2 compared to Group 1. Conclusion: The blood albumin level and the percentage of CD8 and CD19 (+) lymphocytes at diagnosis may help to predict chronic valvular disease risk in patients with acute rheumatic carditis.

Resumo Objetivo: Definir os preditores da cardite crônica em pacientes com cardite reumática aguda (CRA). Métodos: Os pacientes diagnosticados com CRA entre maio de 2010 e maio de 2011 foram incluídos no estudo. Foram feitos os testes de ecocardiografia, eletrocardiograma, uma análise do subgrupo de linfócitos, provas de fase aguda, níveis de albumina plasmática, antiestreptolisina-O (ASO) na manifestação inicial. As avaliações ecocardiográficas foram repetidas no 6º mês de acompanhamento. Os pacientes foram divididos em dois grupos de acordo com a persistência da patologia valvular no 6º mês como Grupo 1 e Grupo 2 e todos os parâmetros clínicos e laboratoriais na internação foram comparados entre dois grupos de comprometimento valvular. Resultados: Durante o período do estudo de um ano, 22 pacientes apresentaram doença valvular; 17 (77,2%) apresentaram regressão da patologia valvular. Houve desaparecimento de regurgitação moderada inicial em oito pacientes (36,3%). Entre sete (31,8%) pacientes com regurgitação moderada inicialmente, a regurgitação desapareceu em três e quatro apresentaram melhoria para regurgitação leve. Dois pacientes com regurgitação grave inicialmente apresentaram melhoria para regurgitação moderada (9,1%). Em cinco (22,8%) pacientes o grau de regurgitação (regurgitação moderada em um [4,6%] e regurgitação grave em quatro [18,2]) continuou inalterado. O nível de albumina foi significativamente menor no diagnóstico no Grupo 2 (2,6 ± 0,48 gr/dL). A análise do subgrupo de linfócitos mostrou uma redução significativa no percentual de CD8 e um aumento significativo no percentual de CD19 no Grupo 2 em comparação com o Grupo 1. Conclusão: O nível de albumina no sangue e o percentual de linfócitos CD8 e CD19 (+) no diagnóstico podem ajudar a prever risco de doença valvular crônica em pacientes com cardite reumática aguda.

Breaking the silence of the lambs: integrating medical staff in prevention of human trafficking / Rompiendo el silencio de los corderos: integrar el personal médico en la prevención de tráfico humano / Quebrando o silêncio dos cordeiros: integrando o pessoal médico na prevenção do tráfico de seres humanos

Introduction: Human trafficking, including forced prostitution, is a form of human rights violation regarding right to life and respect for human dignity. The Physician-patient relationship may serve as a process for victim identification on the basis of physicians’ responsibilities to detect human trafficking. Method: This empirical study was based on a survey among physicians who may have been in contact with foreign sex workers. Almost eighty physicians in three health facilities were selected according to their high potentiality for coming into contact with foreign sex workers as patients. 228 physicians selected to that aim. 82 of them responded to the questionnaire which was performed in order to evaluate their perception and knowledge human trafficking and their attitudes towards sex work. Results: All physicians think that some women among the sex workers are exploited, exposed to violence and coerced to work against their will (100%). Almost all of them know that it is compulsory for the healthcare professionals to inform the security forces of the women who are exploited (80.0%). Nearly half of them have given medical care to a sex worker (46.9%) and 39.0 percent have thought that it may be related to human trafficking. The ones who have informed the police of a human trafficking case are only 10 per cent. Conclusions: We think that the professional should be equipped with ethical values encompassing both a patient’s dignity and general welfare. This may include the professional’s responsibility to make an assessment as to whether the patient is a victim or a sex worker. Furthermore human trafficking in sex work and sexual health are public health issues therefore it should be covered under standards of practice and ethical codes of conduct.

Introducción: El tráfico humano, incluyendo prostitución forzada, es una forma de violación de derechos humanos relacionada con el derecho a la vida y el respeto a la dignidad humana. La relación médico-paciente puede servir como un proceso para identificar víctimas, con base en la responsabilidad del médico de detectar tráfico humano. Método: Este estudio empírico se basó en un cuestionario aplicado a médicos que podían haber estado en contacto con trabajadores sexuales extranjeros. Se seleccionaron unos 80 médicos de tres centros de salud, de acuerdo con su alta probabilidad de entrar en contacto con trabajadores sexuales extranjeros como pacientes. Se seleccionaron 228 médicos para ese objetivo. De estos, 82 respondieron al cuestionario desarrollado para evaluar su percepción y conocimiento del tráfico humano y sus actitudes hacia el trabajo sexual. Resultados: Todos los médicos piensan que algunas mujeres trabajadoras sexuales son explotadas, expuestas a violencia y forzadas a trabajar en contra de su voluntad (100%). Casi todos saben que es obligatorio para el profesional de la salud el informar a las fuerzas de seguridad sobre las mujeres que son explotadas (80,0%). Casi la mitad han proporcionado cuidado médico a un trabajador sexual (46,9%) y 39,0% ha pensado que puede estar relacionado con el tráfico humano. Solo un 10% ha informado a la policía sobre un caso de tráfico humano. Conclusiones: Pensamos que los profesionales deberían formarse en valores éticos incluyendo tanto la dignidad del paciente como su bienestar general. Esto puede incluir la responsabilidad profesional de evaluar si el paciente es una víctima o un trabajador sexual. Además, el tráfico humano en el trabajo sexual y la salud sexual son temas de salud pública, por lo tanto debieran cubrirse de acuerdo con los estándares de la práctica y códigos éticos de conducta.

Introdução: O tráfico de pessoas, incluindo a prostituição forçada, é uma forma de violação dos direitos humanos sobre o direito à vida e o respeito pela dignidade humana. A relação médico-paciente pode servir como um processo para a identificação das vítimas, com base em responsabilidades dos médicos para detectar o tráfico de seres humanos. Método: Este estudo empírico foi baseado numa pesquisa entre os médicos que possam ter estado em contacto com os trabalhadores do sexo estrangeiros. Quase oitenta médicos em três unidades de saúde foram selecionados de acordo com sua alta potencialidade para entrar em contato com profissionais do sexo estrangeiros como pacientes. 228 médicos foram selecionados para esse objetivo. 82 deles responderam ao questionário que foi realizado com a finalidade de avaliar a sua percepção e o seu conhecimento sobre o tráfico de seres humanos e as suas atitudes em relação ao trabalho sexual. Resultados: Todos os médicos pensam que algumas mulheres entre os trabalhadores do sexo são exploradas, expostas à violência e coagidas a trabalhar contra a sua vontade (100%). A maioria deles sabe da obrigação dos profissionais de saúde de informar às forças de segurança sobre mulheres que são exploradas (80,0%). Quase metade deles tem dado assistência médica a trabalhadora do sexo (46,9%) e 39,0 por cento pensaram que isto pode estar relacionado ao tráfico de seres humanos. Os que informaram à polícia de um caso de tráfico de seres humanos são apenas 10 por cento. Conclusões: Nós pensamos que o profissional deve estar incorporado de valores éticos que abrangem tanto a dignidade do paciente como o bem-estar geral. Isso deve incluir a responsabilidade do profissional em avaliar se o paciente é uma vítima ou um profissional do sexo. Além disso o tráfico humano no trabalho do sexo e saúde sexual são questões de saúde pública, por isso, devem ser cobertos pelos padrões de prática e códigos éticos de conduta.

Factors influencing nursing students’ decision to choose nursing

Background: Nurses are the “front line” staff in most health systems and their contribution is recognised as essential in meeting development goals and delivering safe and effective care (ICN, 2007). Nurses are in high demand not only in developed countries but also in developing countries like Malaysia. However, more than 70% of Malaysian hospitals currently do not have adequate nursing staff. At least 174,000 nurses need to be trained by 2020 to meet WHO’s nurse-to-patient ratio of 1:200. The purpose of this study is to identify the main factors that influence the nursing students’ decision to choose nursing as their career. Method: A descriptive study guided by Self Determination Theory was used for this study. A 29- item questionnaire adapted from McCabe, Nowak and Mullen (2005) was distributed to all students in a nursing college (n=117). Results: The five main reasons for choosing nursing as a career were “ability to help others”, “training was provided on the job”, “ability to work closely with people”, “parental advice”, and “accommodation was provided while training”. The top three main domains that influenced the nursing students’ decision to choose nursing as their career include “travel opportunities of nursing”, “intrinsic attraction of nursing” and “immediacy of support on entry to nursing”. A total of 19 (0.2%) will not choose nursing if given a chance. The main reasons were “want to take another course”, “no time to spend with family” and “nursing is a stressful job”. Conclusion: The findings of this study provided valuable information regarding motivating factors which attract the current generation to join nursing. It is of concern that items representing nurses’ image were not rated highly

complication following the transcatheter closure of a muscular ventricular septal defect

Today, congenital heart diseases may be treated without surgery through advances in interventional cardiology. However, complications such as infection and thrombus formation may develop due to foreign materials used during these procedures. Surgical intervention may be required for the removal of the device utilized for the procedure. In this case report, we present the surgical treatment of a residual ventricular septal defect [VSD] that had developed in a 6-year-old patient with an apical muscular VSD closed with the Amplatzer muscular VSD device. The patient was admitted to the emergency room with complaints of abdominal pain and high fever 5 days after discharge without any cardiac symptoms. When she arrived at our clinic, she had a heart rate of 95 bpm, blood pressure of 110/70 mmHg, and temperature of 38.5 [degree]C. Examinations of the other systems were normal, except for a 3/6 pan-systolic murmur at the mesocardiac focus on cardiac auscultation. Echocardiography showed a residual VSD, and the total pulmonary blood flow to the total systemic blood flow ratio [Qp/Qs] of the residual VSD was 1.8. In the operating room, the Amplatzer device was removed easily with a blunt dissection. The VSD was closed with an autologous fresh pericardial patch. Following the pulmonary artery debanding procedure, the postoperative period was uneventful. The condition of the patient at the time of discharge and in the first postoperative month's follow-up was good. There was no residual VSD or infection

Analysis on changes of sclerotin volume during the self-repairing process of bone defect / 生物医学工程学杂志

Bone maintenance theory considers that the external load is the direct stimulating source of the bone remodeling. In this article, the method of experimental observation of self-repairing process of the bone defect and related results are introduced. Firstly, a hole was drilled in the rabbit thighbone so that the continuity of the bone was changed. Then bone defect model was established, and the thighbone data were obtained by using CT scanning, and the self-repairing process of bone defects caused by growth factor were observed and analyzed by MIMICS software. Finally, the relationship between volume changes of sclerotin was established, and scientific bases were provided for introducing the bionic topology optimization method to the remodeling process. The experimental results showed that the self-repairing of the each layer sclerotin of the young rabbits was faster than that of the adult ones under the same condition. In addition, the volume always changes contrarily between the spongy bone and enamel bone during the self-repairing process of bone defect.

Infracardiac total anomalous pulmonary venous drainage with unusual presentation.

Total anomalous pulmonary venous drainage (TAPVD) is a rare entity which forms approximately 0.4 to 2% of all congenital heart disease. The infracardiac type usually involve obstructions on pulmonary venous connections and comprising a quarter of all TAPVD cases. The clinical findings in patients with obstructed infracardiac TAPVD could mimic respiratuary distress of several different etiologies during first hours of life. In this article,we present a case of a neonate with infracardiac type of TAPVD presented with only distinct subcutaneous veins of abdominal and thoracic wall.

Geography and host distribution of Crimean-Congo hemorrhagic fever in the Tarim Basin / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the infective status and natural distribution of Xinjiang hemorrhagic fever (XHF; Crimean-Congo hemorrhagic fever, CCHF) in ticks, rodents and livestock in the Tarim Basin.</p><p><b>METHODS</b>The pathogenic materials of ticks or rodents' viscera and blood samples of sheep were inoculated into sucking mouse of 24 to 48-hour old. Materials with typical clinic symptoms were identified with RPHA and IFA. RT-PCR was taken to detect special S gene segment of Crimean-Congo hemorrhagic fever virus (CCHFV) in the objective material.</p><p><b>RESULTS</b>All the samples of ticks, rodents' viscera and blood samples of sheep from 21 counties (cities) in the Tarim Basin were divided into 422 groups and inoculated into sucking mouse at laboratory. 49 materials with typical clinic symptoms were obtained. The morbidity rate with typical clinic XHF was high in Bachu, Yuli, Yutian and Ruoqiang. There were 43 samples identified with RPHA with 6 positive samples and positive rate of 1.4%. The materials with positive RPHA were found in Yuli, Luntai and Yutian. 42 samples were identified with IFA and 13 positive samples with the positive rate of 3.1%. The positive materials of IFA were found in Bachu, Yuli, Minfeng, Luntai and Yutian. 32 samples were detected with RT-PCR and there were 31 samples with special S gene segment of CCHFV (329- 548 nt). The positive materials was widely distributed in Aksu, Awat, Bachu, Luopu, Yuli, Minfeng, Qiemo, Ruoqiang, Luntai and Yutian. The highest infective rate was in Hyalomma asiaticum kozlovi, and followed by sheep. S gene segment was detected in viscera of M. meridianus.</p><p><b>CONCLUSION</b>XHF relied on the river in the southern part of Xinjiang and distributed in the areas with Populus euphratica shrub in desert and oasis in the Tarim Basin. The main vector and host were Hyalomma asiaticum kozlovi. Livestock such as sheep, camel, L. yarkandensis, M. meridianus and Euchoreutes naso could serve as the deposited host of XHF.</p>

Examination of pH Tolerance Test of Two Alkalitolerant Yeasts / 微生物学通报

The purpose of this paper is to examine the pH adaptability range of two yeasts from our laboratory,and applied turbidimetry and Bradford methods to examine growth of Trichosporon asahii XJU-1 and Rhodotorula mucilaginosa XJU-1.It is shown that Trichosporon asahii XJU-1 grown between pH2.0 and pH13.0 and optimum pH is 8.0,whereas Rhodotorula mucilaginosa XJU-1 grown between pH3.0 and 12.0,optimum pH is 8.5.When turbidimetry was applied,it produced consensus results between pH4.0 and 10.0 with Bradford method.At the same time,produced senior distorted at pH