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Objective To enhance the triage efficiency of patients with acute heart failure(AHF)by improving emergency severity index(ESI)score,and to achieve stratified care for patients with AHF.Additionally,the aim is to improve the combination of stratified scores and nursing care in emergency departments to address the limitations of current studies.Methods A retrospective nested cohort study was conducted on 120 patients with AHF admitted to the Affiliated Hospital of Guizhou Medical University from January 1,2019 to December 30,2021.According to the clinical outcomes of the patients,the patients were divided into subgroup A(71 cases,recovered after treatment,no serious complications during treatment),subgroup B[35 cases,discharged after treatment,multiple organ dysfunction syndrome(MODS),acute respiratory distress syndrome(ARDS),shock and other serious complications occurred during treatment],and subgroup C(14 cases,cardiac death during treatment).A prospective randomized controlled study involving 106 patients with AHF admitted to our hospital from January 1 to December 30,2022,was conducted,and the patients were divided into control group(53 cases)and stratified care group(53 cases)according to the random number table method.The control group received routine nursing care,while patients in the stratified care group received stratified care based on the ESI scoring clinical care pathway.The early warning score model of elderly patients with AHF was constructed with risk threshold as warning signal.The improved ESI scoring criteria were used to score AHF patients,with a total score of 25 points.The higher the score,the higher the risk.0-10 is divided into Ⅰ level risk,>10-20 is divided into Ⅱ level risk,>20 is divided into Ⅲ level risk.Implement nuring at grades Ⅲ,Ⅱ,and Ⅰ,respectively.The changes of modified ESI scores in subgroup A,subgroup B and subgroup C were observed,and Spearman correlation coefficient was used to evaluate the correlation between modified ESI scores and clinical outcomes of different severity of disease.Receiver operator characteristic curve(ROC curve)was drawn to evaluate the effectiveness of the risk threshold classification method of different nursing plan designs in the stratified nursing group and the control group,and to compare the efficiency differences of emergency nursing rescue time,rescue success rate,and stay time in the emergency department,and the incidence of complications such as MODS,ARDS,shock and nursing satisfaction during treatment between the stratified nursing group and the control group.Results The modified ESI score in subgroup C was the highest,significantly higher than that in subgroup B and A(19.6±1.7 vs.17.8±1.5,15.3±1.3,all P<0.05).Spearman correlation analysis showed that the modified ESI score was significantly positively correlated with the occurrence of complications,the occurrence of cardiac death,and the recovery after treatment(r values were 0.623,0.635,0.322,P values were 0.004,0.003,0.012,respectively).Therefore,an improved ESI score has a certain early warning effect on complications and cardiac death of patients.ROC curve analysis showed that the area under the ROC curve(AUC)of routine care for stratified care was 0.710 and 0.620,and the 95％ confidence interval(95％ CI)was 0.620-0.750 and 0.580-0.690,respectively,with Pvalues of 0.023 and 0.034.It shows that the difference between the two nursing methods is significant,and further indicates that the risk threshold classification method designed in this study is effective.With the increase of risk,the rescue time and emergency stay time of the two groups were gradually extended,and the success rate of rescue was gradually decreased,the rescue time and emergency stay time of grade Ⅲ risk were the longest and the success rate of rescue was the lowest,and the rescue time and emergency stay time of the stratified nursing group were significantly shorter than those of the control group(minutes:59.6±6.3 vs.76.5±7.2 and 57.6±5.4 vs.68.2±7.1,both P<0.05),the success rate of rescue was significantly increased[(68.7±6.1)％ vs.(54.6±5.2)％,P<0.05],and the difference of rescue time between grade Ⅰ risk and grade Ⅲ risk was the largest.There were significant differences in the success rate of rescue and the duration of emergency stay in grade Ⅲ risk.The incidence of complications such as MODS,ARDS and shock in stratified care group was significantly lower than that in control group[incidence of MODS:13.2％(7/53)vs.18.9％(10/53),incidence of ARDS:15.1％(8/53)vs.22.6％(12/53),incidence of shock:13.2％(7/53)vs.20.8％(11/53),all P<0.05],satisfaction of patients with service attitude,operation technique,comfort and timeliness were significantly improved compared with the control group[service attitude:28.3％(15/53)vs.18.9％(10/53),operation technology:30.2％(16/53)vs.20.8％(11/53),comfort:32.1％(17/53)vs.24.5％(13/53),timeliness:32.1％(17/53)vs.24.5％(13/53),all P<0.05].Conclusion Based on the modified ESI score,early risk warning thresholds are divided and stratified nursing is conducted,which is beneficial for timely intervention in AHF,effectively ensuring the clinical nursing value of patients during the implementation of medical measures,and has broad application prospects.
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Objective:To observe the effect of Jiuwei Chushi Decoction on sex hormone level of serum and Kisspeptin protein expression in hypothalamus of Central Precocious Puberty (CPP) rats model.Methods:After sixty female rat were breeded from SD rats, they are randomly divided into six groups, which are normal control group, model group, Gonadorelin group, and high, medium and low dose group of Jiuwei Chushi Decoction, 10 in each group. In addition to the normal control group, the other groups were subcutaneously injected with N-methyl-DL-aspartic acid to establish CPP model. Gonadorelin group was subcutaneously injected with Gonadorelin 100 μg/(kg·d), and high, medium and low dose group of Jiuwei Chushi Decoction were intragastrated with Jiuwei Chushi Decoction extract at 5.75, 2.87 and 1.43 ml/(kg·d) respectively. The levels of Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH),Estradiol (E 2) were detected by ELISA, and the protein expressions of Gonadotropin-releasing Hormone (GnRH) and Kisspeptin in hypothalamus were detected by Western Blot. Results:Compared with the model group, the levels of LH and E 2 of the low, medium and high dose group of Jiuwei Chushi Decoction were significantly decreased ( P<0.05), while the FSH level was significantly increased ( P<0.05). The relative protein expression of GnRH (0.657±0.110, 0.536±0.152 vs. 0.912±0.219) and Kisspeptin (0.508±0.035,0.347±0.073 vs. 0.659±0.030) in the medium and high dose group of Jiuwei Chushi Decoction was lower than that of model group. Conclusion:Jiuwei Chushi Decoction could affect hypothalamic Kisspeptin protein expression, inhibite hypothalamic GnRH expression, and decrease LH and E 2 levels in the serum of CPP rats.
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Breast cancer is globally the most common invasive cancer in women and remains one of the leading causes of cancer-related deaths. Surgery, radiotherapy, chemotherapy, immunotherapy, and endocrine therapy are currently the main treatments for this cancer type. However, some breast cancer patients are prone to drug resistance related to chemotherapy or immunotherapy, resulting in limited treatment efficacy. Consequently, traditional Chinese medicinal materials (TCMMs) as natural products have become an attractive source of novel drugs. In this review, we summarized the current knowledge on the active components of animal-derived TCMMs, including Ophiocordycepssinensis-derived cordycepin, the aqueous and ethanolic extracts of O.sinensis, norcantharidin (NCTD), Chansu, bee venom, deer antlers, Ostreagigas, and scorpion venom, with reference to marked anti-breast cancer effects due to regulating cell cycle arrest, proliferation, apoptosis, metastasis, and drug resistance. In future studies, the underlying mechanisms for the antitumor effects of these components need to be further investigated by utilizing multi-omics technologies. Furthermore, large-scale clinical trials are necessary to validate the efficacy of bioactive constituents alone or in combination with chemotherapeutic drugs for breast cancer treatment.
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Animaux , Femelle , Humains , Tumeurs du sein/traitement médicamenteux , Points de contrôle du cycle cellulaire , Chine , Cervidae , ImmunothérapieRÉSUMÉ
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a kind of highly malignant tumor in the hematological system, which is characterized with low incidence, diverse clinical manifestations, strong invasiveness and poor prognosis, however, currently there has no standard treatment yet. This paper reviews the recent research progress of BPDCN.
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BACKGROUND: Hip arthroplasty and internal fixation with intramedullary cannulated screws are mainly used for senile femoral neck fractures. However, osteoporosis can usually lead to failure in internal fixation.OBJECTIVE: To analyze the joint function after fixed with intramedullary cannulated screws in elderly patients with femoral neck fractures, and to explore the factors related to functional recovery.METHODS: Clinical data of 89 patients with femoral neck fractures undergoing internal fixation with intramedullary cannulated screws after 2-year follow-up were analyzed retrospectively. The sex, age, Garden type, bone mineral density, body mass index, screw distribution, reduction index, operation time, bearing time and Harris hip scores were analyzed. Rank related analysis and accumulative Logistic regression analysis were performed on SPSS18.0 software. RESULTS AND CONCLUSION: (1) Normal Q-Q plot and normality test results indicated that the Horris scores in all patients after 2-year follow-up presented with skewed distribution (P=0.000). (2) Rank related analysis showed that age,Garden type, bone mineral density, and reduction index were related with Harris score (P < 0.05 or P < 0.01). (3) Accumulative Logistic regression analysis showed that the independent variables including age, Garden type, bone mineral density, and reduction index made significant effect on Harris hip scores. (4) To conclude, age, Garden type,bone mineral density, and reduction index are important factors for functional recovery of the hip after fixed with intramedullary cannulated screws.
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Background The ultrasonography for silicone tamponade eye is a problem in diagnosis and treatment of eye diseases,especially for the calculation of intraocular lens (IOL) power.IOL Master is usually used to the biometric measurement of the silicone tamponade eye in well-equipped hospital,but it is still disabled in serious cataractous eyes.Corrective B or A-type ultrasound methods have been used for a fewer years,but these measured results are incomparable probably due to the difference of viscosity of silicone oils.Objective This study attempted to investigate the accuracy of B-type ultrasonography for ocular axial length (AL) measurement in silicone tamponade eyes.Methods The transmitting speed of ultrasonic wave in the silicone oil was determined by comparing the outcomes between balance solution mesuring and 5 500 mPas silicone oil,and a calculating formula for corrective ocular AL in 5 500 mPas silicone filled eyes was further established.Thirty-two eyes of 30 patients who received 5 500 mPas silicone oil tamponade due to complex retinal detachment were enrolled in Qingdao Hiser Medical Group from May 2012 to March 2014.The eyes were assigned to the AL＜26 mm group (18 eyes of 16 patients) and AL≥26 mm group (14 eyes of 14 patients).B-scan ultrasound and IOL Master were used to measure the AL before the removal of the silicone oil,and the Als were measured again using A-scan ultrasound and B-scan ultrasound 3 months after the removal of the silicone oil.The outcomes were compared and the correlations were evaluated among different measuring methods.The vitrous length values before and after removal of the oils,and the diopters before and after intraocular pressure (IOP) implantation were compared to varify the results of B-type sonography for 5 500 mPas silicone-tamponade eyes.Results The transmitting speed of sound wave in 5 500 mPas silicone oil was 1 023 m/second with the conversion factor 0.668 between silicon oil eyes and vitreous cavity,and the corrected formula for AL measurement was:the length form cornea apex to the posterior pole of lens or the center of the capsular membrane+ 0.668×the length form posterior pole of lens or the center of the capsular membrane to the macular area.No significnant differences were found in the AL values among the corrective-B scan,IOL Master method,postoperative Bscan method and A-scan method both in the AL＜26 mm group and the AL≥26 mm group (AL＜26 mm:F=0.108,P =0.955;AL ≥ 26 mm:F =0.011,P =0.998),and the AL values by corrective B-scan was significantly correlated with that by IOL Master,postoperative B-scan and A-scan,respectively (AL＜26 mm group:r =0.876,0.921,0.809,all at P＜0.01;AL ≥ 26 mm group:r =0.943,0.956,0.955,all at P＜0.01).The vitreous cavity depth was (20.78 ±2.13)mm by corrective B-scan in 1 day before the removal of silicone,and that in 3 months after removal of silicone was (20.89±2.16) mm,without statistical diference between them (t =0.795,P =0.219).The actual postoperative refraction in 16 eyes with IOL was (-1.25 ± 1.69) D,and preoperative refrection was (-1.50 ±0.00) D,the difference was not statistically significant (t =0.585,P =0.284).Conclusions The biometry of B-scan ultrasonography for silicone-tamponade eye is accurate and simple,with a good feasibility in clinical measurement.
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Objective:To investigate the expression patterns of E-cadherin and P-cadherin in murine-tooth germs at early developmental stages .Methods:Mandible samples of CD 1 mice from embryonic day 12 .5 to postnatal day 3 .5 were collected .The expressions of E-cadherin and P-cadherin in murine man-dibular first molar germs were detected by immunofluorescence and observed under confocal fluorescence microscope .HE staining was performed for tissue morphology .Results:Both E-cadherin and P-cadherin were widely expressed in the epithelial tissues through early developmental stages .The E-cadherin ex-pression was increased in polarizing pre-ameloblasts , whereas the P-cadherin expression declined .The expression of the P-cadherin could be detected in epithelial tissues before bud stage , and expressed in mature ameloblasts at secretory stage .Conclusion:The E-cadherin and P-cadherin expressed in different spatiotemporal expression patterns , indicating their individual functions during tooth development .P-cad-herin might function in the secretion and mineralization of enamel .
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OBJECTIVE To discuss the importance of communication in infection control.METHODS To eliminate the obstacles in infection control,we used different communication skills and manners to gain the aid from the leadership.RESULTS Both the leadership and everyone else in the hospital supported our work in infection prevention and control,for they had known the importance of infection control,especially in hospital.We communicated with them about the knowledge in this aspect in different means.CONCLUSIONS The professional technician should take different ways in communication to solve the problems in every department in the daily work,which can help us to achieve success in infection control.
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Objective To evaluate the value of two-dimensional (2D) and color Doppler ultrasonography and B-blood flow (B-flow) in quick screening for venous diseases of the lower extremities in late pregnant women. Methods Sixty late pregnant women excluding other-cause blood vessel diseases were recruited during September 2007 to January 2008 and underwent 2D and color Doppler ultrasonography and B-blood flow examinations for diameter and blood flow velocity of the veins in their both lower extremities during prenatal and postnatal periods to record intravenous condition, activities of the venous valve and venous valvular regurgitation in detail. Results Diameters of the veins in beth lower extremities of the late pregnant women widened significantly during prenatal period, as compared to that in postnatal period [(11.5±1.5) mm vs. (8.4±1.0) mm, t =7.14, P <0.01] and their blood flow velocity slowed down significantly in prenatal period than that in postnatal period [(11.5±4.0) cm/s vs. (29.7±6.9) cm/s, t =-15.74, P <0.01]. Spontaneous enhancement phenomenon could be shown in their veins in 57 of 60 (95%) pregnant women by 2D and color Doppler ultrasonography, but could not be shown by 2D and color Doppler uhrasonography in the poplitel veins in 21 pregnant women (35%) or in the small and great saphenous veins in 39 pregnant women (65%), which should be activated by B-flow. Venous valvular regurgitation occurred in the great saphenous veins and the superficial femoral veins in 24 percent of pregnant women during prenatal period, and small venous valve bag thrombus formed in 20 percent of the superficial femoral veins and 10 percent of the great saphenous veins, but disappeared two weeks after delivery, without formation of pulmonary embolism. Conclusion Tow-dimentional and color Doppler ultrasonography and B-blood flow examinations can be used in late pregnant women to quickly screen for venous diseases in their lower extremities.
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The paper analyzes the supply, demands and market mechanism characteristics of medical full - text databases frequently used in college and university libraries. Some suggestions are proposed according to current status of medical full - text database market, including establishing science and technology information center, discovering more channels to get more free full - text and regulating the market by government guide.
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Objective To investigate the effect of atorvastatin on expression of ABCA1(mRNA,protein) and LXR? mRNA in THP-1 macrophages induced by PMA.Methods Cultured THP-1 cells were induced to differentiate into macrophages by PMA for 48 hours.The macrophages were incubated with atorvastatin in different concentions for 24 or 48 hours.We determined the changes of ABCA1 mRNA,protein and LXR? mRNA by reverse trancriptase polymerase chain reaction(RT-PCR) and immuno-histochemistry.Results The expression level of ABCA1 mRNA(ratio of relative expression 1.21 vs 1.48) and protein as well as LXR? mRNA(0.87 vs1.12) were decreased in THP-1macrophages when cultured with atorvastatin(10 ?mol/L) for 24 h.Conclusion Atorvastatin inhibits the expression of ABCA1 mRNA and protein as well as LXR? mRNA of THP-1macrophages in vitro.
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Objective To evaluate the clinical value of self-designed big cup membranate stent on restenosis after stenting for carcinoma of esophago-cardia. Methods 12 cases of restenosis after stenting for carcinoma of esophago-cardia were involved in the study. Self-designed big cup membranate stent made by Nanjing Weichuang Company(the length of the cup was 3.5 cm)was placed into the constricted stent under guidance of fluoroscopy. Clinical effect, restenosis, and complications were observed during followed up. Results All the 12 cases of big cup membranat stent placement went along smoothly without indigitation of the cup of the stent. Follow-up of 1.5-8 months showed that 2 cases developed severe restenosis on the big cup of the stent, resulting in third grade difficult deglutition. Among them, one occurred 1 month after stenting, caused by hyperplasia of large amount of granulation tissue; another occurred 6 months after stenting, caused by growth of tumor tissue. 3 cases developed mild to moderate restenosis, 2.3-7 months(mean: 4.6 months)after stenting, with result of first grade difficult deglutition. The remaining 7 cases(mean5.6 months follow-up) did not have difficulty during deglutition. Conclusions Application of big cup membranate stent on restenosis after stenting for carcinoma of esophago-cardia can effectively prevent the stent from moving downwards and thus lower down the rate of restenosis, and postpone the occurrence of restenosis.
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<p><b>BACKGROUND</b>To study the effect of gene amplification and selection system with DHFR plus GS and DHFR or GS gene on the foreign gene expression.</p><p><b>METHODS</b>Using the N-terminal truncated hTPO(T184) gene as target gene, two plasmidsre were constructed: pDC- T184 and pGC-T184 where DHFR and GS gene were used respectively as the selective amplification marker. They were cotransfected into CHO dhfr cells to establish dual gene amplification and selection system of DHFR plus GS gen and respectively transfected to establish single gene amplification and selection system of DHFR or GS gene. Three selective methods in dual selective system to compare expression efficiency of hTPO were designed: the first method (DG) was to use drug pressure of MTX, then use MSX; the second method (GD) was reversed; the third method was simultaneously to use MTX and MSX as drug pressure.</p><p><b>RESULTS</b>DHFR+GS dual system had not only higher gene amplification efficiency but also higher level expression. There was no distinct affect in different method of drug pressure.</p><p><b>CONCLUSIONS</b>MTX plus MSX dual drug pressure in dual selection system was an efficient and simple method to increase the expression of foreign gene in mammalian cells.</p>
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Animaux , Cricetinae , Cellules CHO , Amplification de gène , Expression des gènes , Glutamate-ammonia ligase , Génétique , Méthotrexate , Pharmacologie , Plasmides , Génétique , Dihydrofolate reductase , GénétiqueRÉSUMÉ
Objective To evaluate the clinical application of multi-slice spiral CT(MSCT)for foreign body of trachea or bronchus in children.Methods Twenty cases suspected foreign body were examined with MSCT.The post-processing reconstruction included multiple planar reconstruction(MPR),CT virtual bronchoscopy(CTVB),shaded surface display(SSD),minimum intensity projection(MinIP),and volume rendering(VR).Results The foreign bodies located at trachea in 1 case and at bronchia in 19 cases.The foreign bodies included 18 fragments of peanut and melon seeds,one shrimp and one plastic-tube.All cases were confirmed by fiberoptic bronchoscopy or course of diseases.The position and form of foreign bodies,as well as the relationship between foreign bodies and bronchial muous membrane could be showed by MPR,CTVB,SSD,MinIP and VR.Conclusion MSCT scanning is a significant noninvasive and sensitive diagnostic technique in detecting the foreign body in trachea or bronchus.