A model to predict nosocomial infections among inpatients in emergency intensive care units / 预防医学

Objective@#To create a model to predict nosocomial infections in emergency intensive care units (EICU), so as to provide insights into early identification and interventions among patients with nosocomial infections. @*Methods@#All nosocomial infections were collected from patients hospitalized in the EICU of a large tertiary hospital from 2017 to 2020. The 2017-2019 data were selected as the training set to create a logistic regression model, and the fitting effectiveness of the predictive model was evaluated using Hosmer-Lemeshow test. The 2020 data were selected as the test set to evaluate the external validation of the predictive model. In addition, the value of the model for prediction of nosocomial infections was examined using the receiver operating characteristic (ROC) curve analysis. @*Results @#Totally 1 546 inpatients in EICU were enrolled, and the prevalence of nosocomial infections was 7.18%. Multivariable logistic regression analysis identified hospital stay duration of >7 days (OR=21.845, 95%CI: 7.901-60.398), use of ventilators (OR=3.405, 95%CI: 1.335-8.682), and surgery (OR=1.854, 95%CI: 1.121-3.064) as risk factors of nosocomial infections. The predictive model was p=ey/(1+ey), y=-6.105+(3.084×duration of hospital stay)+(1.225×use of ventilators)+(0.617×surgery). The area under ROC curve was 0.806 (95%CI: 0.774-0.838) for the training set and 0.723 (95%CI: 0.623-0.823) for the test set, and if the 0.065 cut-off of the predictive model created by the training set was included in the test set, the predictive value yield a 0.739 sensitivity and 0.642 specificity for prediction of nosocomial infections among patients hospitalized in EICU. @*Conclusion@#The created predictive model for nosocomial infections among patients hospitalized in EICU presents a high accuracy, which shows a satisfactory predictive value for high-risk nosocomial infections.

Risk factors of progression to hepatocellular carcinoma in patients with hepatitis B cirrhosis under nucleoside/nucleotide analogue therapy / 中华临床感染病杂志

Objective:To explore the risk factors of hepatocellular carcinoma (HCC) in patients with hepatitis B cirrhosis receiving nucleoside/nucleotide analogues (NAs) antiviral therapy.Methods:The clinical data of 253 patients receiving NAs antiviral therapy in Zhejiang Provincial People’s Hospital from November 2014 to October 2019 were retrospectively analyzed. During treatment, HCC occurred in 116 patients. Multivariate logistic regression was used to analyze the risk factors of progression to HCC in patients with hepatitis B cirrhosis.Results:Multivariate logistic regression analysis showed that age( OR=1.094, 95% CI 1.034-1.158, P<0.01), smoking history( OR=5.056, 95% CI 1.453-17.594, P<0.05), family history of hepatocellular carcinoma( OR=6.763, 95% CI 1.253-36.499, P<0.05), Lamivudin (LAM) resistance( OR=6.097, 95% CI 1.370-27.134, P<0.05), fasting blood glucose(FBG)level( OR=7.219, 95% CI 3.716-14.024, P<0.01) were independent risk factors for the progression of hepatitis B cirrhosis to HCC; while HBV DNA negative conversion( OR=0.028, 95% CI 0.006-0.137, P<0.01) was a protective factor. Conclusions:For hepatitis B cirrhosis patients receiving antiviral therapy, drug resistance, HBV DNA, FBG levels should be closely monitored, intervention measures such as quitting smoking should be taken and NAs with high drug resistance gene barrier should be selected to prevent the occurrence of HCC.

Effect of polycystic ovary syndrome treated with the periodic therapy of acupuncture / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects differences for polycystic ovary syndrome (PCOS) between periodic therapy of acupuncture and diane-35 and to explore its mechanism.</p><p><b>METHODS</b>Sixty patients were randomly assigned into an acupuncture group and a western medication group, 30 cases in each one, 29 patients finally included with one case dropping out respectively. In the acupuncture group, periodic therapy was mainly used at bilateral Sanyinjiao (SP 6), Dahe (KI 12), Guilai (ST 29), Guanyuan (CV 4), Zhongji (CV 3), with different acupoints in the postmenstrual, intermenstrual, premenstrual periods, once every other day, 3 times a week. EA (2 Hz/100 Hz) was used at bilateral Dahe (KI 12) and Guilai (ST 29). If treatment, FSH increased and LH, LH/FSH, T decreased in the two groups (all<0.05), but T level and the different value before and after treatment in the western medication group were better than those in the acupuncture group (both<0.05).</p><p><b>CONCLUSIONS</b>Periodic therapy of acupuncture is probably one of the effective methods for PCOS, which can improve patients' clinical symptoms, sex hormone level, and menstrual cycle. there was no discomfort during menstrual period, no treatment was given. In the western medication group, diane-35 was prescribed orally for 21 days as a course, with 7 days at interval, one tablet a day. All the treatment was started on the fifth day of the menstrual circle, for continuously 3 months. The indexes were observed before and after treatment, including the menstrual circle, acne score, body mass index (BMI), serum follicle stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH and testosterone (T). The effects of the two groups were compared.</p><p><b>RESULTS</b>The total effective rate was 75.9% (22/29) in the acupuncture group, which was not significantly different from 79.3% (23/29) in the western medication group (>0.05). The menstrual cycles were shorter after treatment in the two groups (both<0.05), with better effect and different value before and after treatment in the acupuncture group (both<0.05). BMI in the acupuncture group after treatment was lower than that before treatment (<0.05) and that after treatment in the western medicine group (<0.01), with better different value before and after treatment in the acupuncture group (<0.05). The acne scores after treatment decreased in the two groups (both<0.05), without significant difference after treatment between the two groups (>0.05). After treatment,FSH increased and LH,LH/FSH,T decreased in the two groups (all<0.05),but T level and the different value before and after treatment in the western medication group were better than those in the acupuncture group (both<0.05). Conclusion Periodic therapy of acupuncture is probably one of the effective methods for PCOS,which can improve patients' clinical symptoms,sex hormone level,and menstrual cycle.</p>

Preliminary Analysis of Common Parameters for Acupuncture Treatment of Cancer Pain / 上海针灸杂志

Objective To explore the characteristics of common parameters for acupuncture treatment of cancer pain by sorting out the domestic and foreign literature.Method This article collected and sorted out literature on acupuncture treatment of cancer pain in Chinese databases: Chongqing VIP, CNKI and Wanfang Data and English database PubMed. Main Chinese search keywords were针刺,电针,耳穴,针灸,癌痛,癌症and疼痛. English search keywords were acupuncture, electroacupuncture, auricular, cancer pain, neoplasms and pain. The search range was limited to literature collected in large databases since2010. The article type was limited to clinical case studies. Result s: Forty-four pieces of literature were retrieved after repeated literature was excluded. Conclusion s: Combined acupuncture and medicine and composite therapy are mainly selected for acupuncture treatment. Regularities in point selection for acupuncture are often acupuncture at pain points and acupoint selection according to primary diseases. Needle retention time is often between 20 and 30 min. Electroacupuncture stimulation waveforms aremainly sparse-dense waves, the stimulation intensity is as high as the patient can adapt and the treatment frequency is often once daily.

"Analysis on Neiguan in""Great Compendium of Acupuncture and Moxibustion""" / 浙江中医药大学学报

[Objective] By means of study of related literature records about Neiguan points in Great Compendium of Acupuncture and Moxibustion, it is intended to provide a theoretical foundation for the application of Neiguan points in modern clinical acupuncture and moxibustion. [Method] Collect articles with regard to Neiguan points inGreat Compendium of Acupuncture and Moxibustion , and systematically analyze its location, needling and moxibustion techniques, as well as clinical application law. To investigate the clinical application of differences between ancient and modern Neiguan. [Results] InGreat Compendium of Acupuncture and Moxibustion, Neiguan points are located at 2-inch above palm strips. Needle can be penetrated into 3/10 inch, 1/2 inch, and 1.2inch between two tendons. Neiguan point is a collateral-connecting acupoint for pericardium meridian, and mainly treats cardiothoracic excess and deficiency related diseases. If matching with yangchi point, it can be called Yuan-primary point and collateral-connecting point combination that can treat triple energizer meridian related diseases. The Neiguan point is also regarded as the eight confluence point connecting Yinwei meridian that can treat mental diseases, Yinwei vessel is associated three yin meridians of foot diseases, conception vessel diseases and Yangming Channel penetration diseases. [Conclusion] It is concluded the location, needling therapy and clinical application law of Neiguan points in Great Compendium of Acupuncture and Moxibustion, which is of reference significance to the application of Neiguan points in modern clinical acupuncture and moxibustion.

Observe the Clinical Effect on Abdominal Acupuncture Combined with Body Acupuncture Treating Chloasma of Stagnation of the Liver-type / 浙江中医药大学学报

Objective]To observe the effect of abdominal acupuncture combined with body acupuncture on chloasma of stagnation of the liver-type. [Method] 30 patients were randomized into treatment group and control group, 15 in each. Treatment group were given abdominal needle combining acupuncture treatment, control group were only given acupuncture treatment. Each group were treated once a day, 5 times made a course, after each course had a rest for 2 days. After 4 courses, to observe the effect and the skin color score, and area score and declined index. [Results]After treatment, the two groups were effective, but the treatment group was more obvious, and scores difference compared with the control group was statistically significant(P<0.01). The total effective rate was 93.3% in the treatment group 86.67% in the control group, there was a significant difference between the two groups(P<0.05). [Conclusion]Abdominal hepatic stagnation type treated by acupuncture combined with body acupuncture on chloasma treatment, no pain or abdominal pain to a lesser degree, even more easily accepted by patients, is better than body acupuncture.

Clinical Efficacy of Moxibustion on Allergic Asthma and Research in Molecular Immunology Mechanism / 浙江中医药大学学报

[Objective] To explore the affecting of moxibustion on allergic asthma immune function and mechanism by observing the serum level of immunoglobulin E (IgE),interleukin-4(IL-4),interleukin-13(IL-13).[Methods] 30 cases of allergic asthma were distributed randomly and respectively into groups A,B and C,and another 10 healthy subjects were chosen as controls.Serum IgE,IL-4,IL-13 were measured by ELISA.[Result] The efficiency of groups A,B,C were 80%、90% and 40% respectively.Serum IgE and IL-4,IL-13 levels were significantly lower in groups A and B by the treatment(P0.05).There was significant difference between the three groups and controls (P