RESUMO
Objective:To construct an evaluation index system for core competence of nurses in the imaging department.Methods:The literature research and the opinions of the research team were integrated to develop indicators for core competence of imaging nurses at all levels. Delphi method was used to conduct 2 rounds of consultation with 20 experts, and analytic hierarchy process (AHP) was used to determine the index weights at all levels. The indicators were converted into a self-assessment scale, and 31 imaging in-service nurses in a third-level hospital were selected for questionnaire survey. SPSS 21.0 software was used to analyze the consultation results.Results:Through 2 rounds of consultation, the evaluation index system for core competence of nurses in the imaging department was formed, including 5 first-level indicators, 18 second-level indicators, and 78 third-level indicators. The effective response rates of the two rounds of expert consultation were 100%, and the authority coefficients were 0.933 and 0.923. In the second round, the expert opinion coordination coefficients of the first, second and third grade indexes were 0.46, 0.53 and 0.47, respectively ( P < 0.01). The core competence scores of the 31 respondents ranged from 3.08 to 4.45 in each dimension. Conclusion:After 2 rounds of expert consultation, the expert opinions tended to be consistent and the degree of coordination was high. The constructed indicators can be used for the core competence training and teaching evaluation of in-service nurses in the imaging department.
RESUMO
OBJECTIVE：To establish the m ethod for simultaneous determination of 8 kinds of ginsenosides in Panax quinquefolium broken pieces. METHODS ：HPLC-DAD method was used to determine the contents of ginsenoside Rg 1，Re，Rb1， Rc，Ro，Rb2，Rb3，Rd in P. quinquefolium broken pieces. The determination was performed on Agilent 5 TC-C18 column with mobile phase consisted of acetonitrile- 0.2％ phosphoric acid water solution （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃. The detection wavelength was set at 203 nm，and sample size was 10 μL. Ginsenoside Re and ginsenoside Rb 2 were used as control ，liner calibration with two-reference substances correction was used to predict the retention time of other 6 components，and was compared with the relative retention time method. Using ginsenoside Re as control ， above components were quantified by the relative correction factor method ，and the results were compared with the external standard method. RESULTS ：The contents of ginsenoside Rg 1，Re，Rb1，Rc，Ro，Rb2，Rb3，Rd were 10.59-12.78，2.160-2.768， 27.492-38.880，3.154-4.018，3.368-4.080，0.343-0.755，0.961-1.415，5.857-6.923 mg/g. The accuracy of two-reference substances linear correction method to predict the retention time of components was higher ，and the absolute deviation of the predicted retention time was lower than that of the relative retention time method. There was no significant difference between the relative correction factor method and the external standard method ，and relative error was ＜3％ . CONCLUSIONS ：Established two-reference substances for determination of multiple components can be used for qualitative and quantitative analysis of 8 kinds of ginsensides in P. quinquefolium broken pieces simultaneously and accurately.
RESUMO
Objective:To observe the body fluid and cellular immune function of children with cerebral palsy (CP) in the plateau area, as well as the exchanges of these factors during the comprehensive rehabilitation treatment.Methods:A total number of 144 children admitted to Xining Hospital of Traditional Chinese Medicine from June 2018 to October 2019 were selected as the CP group for comprehensive rehabilitation treatment (consecutive courses). The peripheral blood immunoglobulin/complement (IgA, IgG, lgM, C3, C4) level, T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and neuron-specific enolase (NSE) content was examined in the clinical specimens before and after treatment by using the immunoturbidimetry, flow cytometry, electrochemiluminescence analysis according to the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Test Scale (GMFM-88). Children were divided as the different degrees to evaluate the rehabilitation efficacy. A total number of 50 healthy children taken a health check/physical examinations during the same period were considered as the control group. For statistical Analysis, the χ2 test and independent sample t test were performed. Results:The levels of humoral immune IgG, IgA, IgM, C3 and C4 in CP Group [(6.42±1.05), (0.64±0.13), (0.89±0.13), (0.80±0.08), (0.17±0.03) g/L, respectively] in CP groups′ children were lower than those in the control group [(10.25±0.62), (1.04±0.06), (1.06±0.17), (1.04±0.04), (0.27±0.04) g/L, respectively]. The humoral immune IgG and IgA levels [severe (5.40±0.69) and (0.55±0.09)g/L, moderate (6.63±0.30) and (0.66±0.14)g/L, mild (7.57±0.63) and (0.74±0.09)g/L, P<0.05] were also related to the children with CP of different GMFCS grades. Moreover, the level of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+) in the CP group were not statistically different to that in the control groups children. Receiving the rehabilitation treatment, the levels of serum humoral IgG and IgA in CP Group (7.69±1.14) and (0.79±0.17) g/L were significantly enhanced; whereas the serum NSE (12.82±2.49) μg/L was lower than that before treatment (18.57±3.08) μg/L, and the total score of GMFM-88 (121.35±26.51) was higher than that before treatment (101.04±27.62). The differences were statistically significant ( P<0.05). IgM, C3, C4 and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) had no significant difference compared with those before treatment ( P>0.05). Conclusions:Children with CP at high altitude have abnormal humoral immune function. IgG and IgA may be related to the severity of CP and neuronal damage. Comprehensive rehabilitation can not only improve the motor function of children with CP, relieve neuronal damage, but also enhance their humoral immunity status.
RESUMO
Objective To investigate the pollution status of phthalate esters in household indoor air particles in Wuhan. Methods The indoor air particulate matter PM10 and PM2.5 from residential houses in Wuhan were collected. The concentrations of 15 phthalate esters were determined by gas chromatography-mass spectrometry (GC-MS). Results A total of 5 phthalates were detected, including DMP, DEP, DiBP, DBP, and DEHP. The detection rate of DiBP, DBP and DEHP was 100%, while DMP and DEP were detected in only some of the samples. Conclusion Phthalate esters pollution was widespread in indoor air particles of residential houses in Wuhan. DiBP, DBP and DEHP were the main pollutants. Decoration materials and plastic household articles were important sources of the phthalate esters pollution, and their impact as a health hazard needs attention.
RESUMO
OBJECTIVE：To establish the content determination me thod of 3 mono/disaccharides in 3 kinds of medicinal Dendrobii Caulis. METHODS ：HPLC-CAD method was established. The determination was performed on Shodex Asahipak NH2P-50 4E column with mobile phase consisted of acetonitrile-water （75 ∶ 25，V/V）at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃，and sample size was 10 µL. CAD detection condition included that data acquisition frequency was 5 Hz，filter constant was 5 s，atomization temperature was 35 ℃ ，gas source was nitrogen with pressure of 4.012 × 105 Pa. RESULTS：The linear range of fructose ，D-anhydrous glucose and sucrose were 0.156 2-1.873 8 mg/mL（r＝0.999 5），0.012 7- 0.152 4 mg/mL（r＝0.999 7），0.277 6-3.331 2 mg/mL（r＝0.999 8），respectively. The limits of quantification were 0.002 61，0.004 24 and 0.005 12 mg/mL，and the limits of detection were 0.000 78，0.001 27 and 0.001 54 mg/mL，respectively. RSDs of precision ， stability，reproducibility and durability tests were all lower than 3％. The recoveries were 95.98％-98.15％（RSD＝0.83％，n＝6）， 95.64％-98.62％（RSD＝1.10％，n＝6）and 97.53％-98.94％（RSD＝0.53％，n＝6）. The contents of them were 0.28％-1.12％， 0.02％-0.13％，0.76％-2.67％，respectively. The total content was 1.38％～3.10％. The order of saccharide content in 3 kinds of Dendrobii Caulis was sucrose ＞fructose＞D-anhydrous glucose ；the order of sucrose content and total content were Dendrobium huoshanense＞D. moniliforme ＞D. officinale ；the order of D-anhydrous glucose content was D. huoshanense ＞D. officinale ＞D. moniliforme； the order of fructose content was D. moniliforme ＞D. officinale ＞D. huoshanense . CONCLUSIONS ：Established method is sensitive ，reproducible and simple in operation ，and can be used for content determination of 3 saccharides in 3 kinds of medicinal Dendrobii Caulis. There are differences in the contents of saccharide s among 3 kinds of Dendrobii Caulis.
RESUMO
OBJECTIVE: To evaluate the prognostic value of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment(SOFA) score and the blood lactic acid in heat stroke patients combined with multiple organ dysfunction syndrome(MODS). METHODS: A judge sampling method was used to select 42 cases of heat stroke patients combined with MODS as study subjects. They were divided into survival group(23 cases) and death group(19 cases) according to prognosis. The APACHEⅡ, SOFA score and blood lactate level after admission to intensive care unit(ICU) were detected. The prognostic value of each index was analyzed according to receiver operating characteristic curve(ROC) curve. RESULTS: At the 48 th hour after admission to ICU, the APACHEⅡ and SOFA scores of the patients in the death group were higher than those in the survival group(P<0.05). At the 6 th hour after admission to ICU, the blood lactate level in the death group increased compare with that in the survival group(P<0.05). APACHEⅡ or SOFA scores at 48 hours, and the blood lactate levels at the 1 st, 2 nd, and 6 th hours after admission to ICU were all positively correlated with prognosis(P<0.05). ROC curve analysis showed that APACHEⅡ and SOFA scores at 48 hours, and the blood lactate levels at the 1 st, 2 nd, and 3 rd hours after admission to ICU could be used to evaluate the prognosis(P<0.01). CONCLUSION: The dynamic monitoring of APACHEⅡ, SOFA score and the blood lactic acid have important clinical significance on the prognosis of heat stroke patients with MODS.
RESUMO
Objective To detect the expression of miRNA-95 in cervical cancer tissues and cell lines with different radiosensitivity and study the effect of its regulation on radiosensitivity of cervical cancer cells. Methods Real-time PCR was used to detect the expression of miRNA-95 in cervical cancer tissues of 20 patients with radiosensitivity, 20 patients with radiation tolerance, radioresistant cervical cancer cell lines (HeLa, SiHa), and radiosensitive cervical cancer cell lines (Me180). MiRNA-95 mimics (miRNA-95 mimics group ) and miRNA-95 inhibition ( miRNA-95 inhibition group ) were transfected into radioresistant HeLa and SiHa cells by liposome 2000, miRNA-NC was set as control group. CCk-8 assay was used to detect the proliferation of cervical cancer cells irradiated with 60Co γ-rays at 0,2,4,6,8, 10 Gy. After 4 Gy irradiation, cell clonal formation ability was detected by plate monoclonal assay, and cell apoptosis was detected by flow cytometry. Dual luciferase activity assay was used to detect the target gene of miRNA-95 in cervical cancer cells. Nude mice were used to detect the changes of tumor formation ability. Results The expression of miRNA-95 in cervical cancer tissues of patients with radiotherapy tolerance was significantly higher than that of patients with radiotherapy sensitivity ( t =12. 279, P <0. 05 ) . The expressions of miRNA-95 in HeLa and SiHa cells were significantly higher those that of Me180 cells (t = 5.162, 7.114, P < 0.05). When the cells were treated with miRNA-95 inhibition, the expression of miRNA-95 in HeLa and SiHa cell lines was significantly lower than that of microRNA-NC group (t =5. 162, 7. 114, P < 0. 05), the cell proliferation rate decreased significantly ( t =8. 273, 11. 354, 13. 489, 15. 396 and 6. 197, 9. 185, 10. 994, 12. 442, P<0. 05), the cell monoclonal formation rate decreased significantly (t=8. 378, 7. 931, P<0. 05), and the apoptosis rate increased significantly (t=10. 265, 8. 386, P<0. 05). The tumorigenic weight of nude mice in the miRNA95 inhibition group was significantly decreased (t=8. 881, 10. 037, P<0. 05). Conclusions The miRNA-95 had low levels in both radiosensitive cervical cancer tissues and cells. Inhibiting the expression of microRNA-95 can significantly improve the radiosensitivity of cervical cancer cells by targeting SGPP1 gene.
RESUMO
Objective:To establish an HPLC method for the simultaneous determination of liquiritin and glycyrrhizic acid in Erxieting granule.Methods:A TechMate C18-ST(250 mm×4.6 mm,5 μm) column with a DAD detector was used.The mobile phase consisted of acetonitrile (A) and 0.05% phosphoric acids in water (B) with gradient elution.The flow rate was 1.0 ml·min-1 and the detection wavelength was 237 nm.The sample size was 5 μl and the column temperation was room temperatence.Results:Linear calibration curves were obtained within the range of 10.32-51.62 mg·L-1 for liquiritin and 79.40-397.00 mg·L-1for glycyrrhizic acid.The average spiked recovery of liquiritin and glycyrrhizic acid was 98.10(RSD=1.0%,n=6)and 97.15(RSD=1.8%,n=6),respectively.Conclusion:The method is accurate,reproducible and stable,and can be used for the quality control of Erxieting granule.
RESUMO
Proinsulin is the precursor of mature insulin.Proinsulin to insulin ratio reflects the degree of pancreatic β-cell dysfunction and the progression of type 2 diabetes, and may predict the risk of diabetes development.Some variants in susceptibility genes of diabetes are associated with the elevation of proinsulin to insulin ratio.Moreover, several antidiabetic drugs are able to decrease the proinsulin to insulin ratio in patients with type 2 diabetes.Therefore, the proinsulin to insulin ratio may act as a simple and useful indicator in the etiological study, risk prediction, disease progression and therapeutical evaluation in type 2 diabetes.
RESUMO
<p><b>OBJECTIVE</b>To observe the impacts of electroacupuncture (EA) on microgliacytes and astrocytes of cervical spinal cord in rats with thyroid incisional pain and explore the mechanism of acupuncture anesthesia in thyroid surgery.</p><p><b>METHODS</b>Sixty Wistar male rats were randomized into a normal group, a model group, a Futu (LI 18) group, a Hegu (LI 4)-Neiguan (PC 6) group and a Zusanli (ST 36)-Yanglingquan (GB 34) group, 12 rats in each one. Except the normal group, a longitudinal incision, about 1.5 cm in length was done along the neck midline in the rats of the rest groups to prepare the model of thyroid incisional pain. In the Futu (LI 18) group, the Hegu (LI 4)-Neiguan (PC 6) group and the Zusanli (ST 36)-Yanglingquan (GB 34) group, after modeling for 4 h, 24 h and 48 h, EA was applied to bilateral "Futu" (LI 18), "Hegu" (LI 4) "Neiguan" (PC 6) and"Zusanli" (ST 36) "Yanglingquan" (GB 34) separately, once a day, continuously for 3 days. In the normal group and the model group, no any intervention was applied. The thermal radiant apparatus was used to detect the thermal pain threshold (PT). The fluorescence quantitative RT-PCR and the Western blotting (WB) were used to determine the expressions of protein and gene of microglia activation markers Iba1 and CD11b and the astrocyte specific protein marker, glial fibrillary acid protein (GFAP) in cervical spinal cord (Cto C) after intervention in the rats of each group.</p><p><b>RESULTS</b>After intervention, as compared with the normal group, in the model group, the neck PT was reduced apparently (<0.05), the expressions of Iba1 and CD11b and GFAP mRNA as well as the protein expressions in the spinal cord of Cto Cwere up-regulated apparently (<0.05,<0.01). As compared with the model group, in the Futu (LI 18) and the Hegu (LI 4)-Neiguan (PC 6) group, PT was increased significantly (both<0.05) and that did not change apparently in the Zusanli (ST 36)-Yanglingquan (GB 34) group (>0.05). In the Futu (LI 18) group, the protein and gene expressions of Iba1, CD11b and GFAP were lower than those in the model group (all<0.05). In the Hegu (LI 4)-Neiguan (PC 6) group, the expressions of Iba1 mRNA, CD11b protein, GFAP mRNA and protein were all lower apparently than those in the model group (all<0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1, CD11b and GFAP proteins were not different significantly as compared with the model group (all>0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1 mRNA and CD11b mRNA and protein expressions in the spinal cord of Cto Cwere higher apparently than those in the Futu (LI 18) group (<0.01,<0.05); the expressions of Iba1 mRNA and CD11b protein expressions were higher than those in the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05); GFAP mRNA and protein expressions were higher apparently than those in the Futu (LI 18) group and the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05).</p><p><b>CONCLUSIONS</b>EA at "Futu" (LI 18) or "Hegu" (LI 4), "Neiguan" (PC 6) relieves the acute neck incisional pain in the rats and its effect may be closely relevant with the down-regulation of the activities of microgliacytes and astrocytes in the spinal cords.</p>
RESUMO
Objective To study the effects of atractylenolide 3 on human platelet in vitro and explore the underlying mecha?nism. Methods The effects of atractylenolide 3 on human platelet aggregation induced by thrombus alkane analogues(U46619)was tested by turbidimetry in vitro. ATP secretion weas detected by luciferase detection,and the phosphorylation levels of Erk and Akt were detected by Western blotting. Results Atractylenolide 3 diminished U46619-induced human platelet aggregation in concentra?tion dependence. Compared with DMSO control group,the inhibitory rate were significant increased in each experiment group(P<0.01). Atractylenolide 3 inhibited adenosine triphosphate(ATP)secreted by human platclet in concentration dependence. Compared with the DMSO control group,the inhibitory rate were significant increased in each experiment group(P<0.01),and the levels of phospho-Akt(Ser473)and phospho-Erk1/2 were significant downregulated in the presence of atractylenolide 3 in each experiment group(P<0.01). Conclusion Atractylenolide 3 exhibits a concentration-dependent inhibitory effect on human platelet aggregation and secretion induced by U46619. Also,it regulated the MAPK and PI3K-Akt signaling pathways. These results show that atractyleno?lide 3 is an effective antiplatelet compound,may serve as new antithrombotic drugs.
RESUMO
ObjectiveToinvestigatethecorrelationsofmethylenetetrahydrofolatereductase(MTHFR) gene C677T polymorphism w ith ischemic stroke and hyperuricemia in Chinese Han population in Shandong, China.Methods The patients w ith acute ischemic stroke and age-and sex-matched controls in Chinese Han population in Shandong, China w ere enrol ed. Polymerase chain reaction amplification and microarray hybridization w ere used to detect the MTHFR gene C677T polymorphism, and the serum uric acid concentration w as measured. Results A total of 145 patients w ith acute ischemic stroke and 145 age-and sex-matched controls in Chinese Han population in Shandong, China were enroled. The proportion of diabetes ( 26.90%vs. 6.89%; χ2 = 20.653, P< 0.001 ) and fasting blood glucose ( 5.56 ± 1.57 mmol/L vs.5.01 ±1.11 mmol/L;t= -3.390, P=0.001), homocysteine (median, interquartile range:18.2[16.30-22.55 μmol/L] vs.15.20[12.10-17.85 μmol/L]; Z= -6.323, P<0.001), and uric acid (43.0[361.60-490.45 μmol/L] vs.285.9[267.00-346.25 μmol/L]; Z= -10.360, P<0.001) levels in the ischemia stroke group w ere significantly higher than those in the control group. The distribution frequencies of TT genotype (42.07%vs.15.17%; χ2 =25.673, P<0.001) and T alele (58.28%vs. 34.48%; χ2 =33.008, P<0.001) in the ischemia stroke group w ere significantly higher than those in the control group. Multivariate logistic regression analysis showed that the uric acid (odds ratio [OR] 1.018, 95%confidence interval [ CI] 1.013-1.024; P<0.001), TT genotype ( vs.CT genotype OR 6.774, 95%CI 1.779-25.507; P=0.005), hypertension ( OR 1.919, 95%CI 1.013-3.636; P=0.045), and homocysteine (OR 1.153, 95%CI 1.059-1.258;P=0.001) w ere the independent risk factors for ischemic stroke. The ischemic stroke group w as combined w ith the control group, a total of 101 patients had hyperuricemia, and 189 had normal uric acid. The proportion in patients w ith diabetes ( 32.67%vs. 11.64%; χ2 = 23.749, P< 0.001), as wel as total cholesterol ( 5.67 ±1.56 mmol/L vs.5.10 ± 1.33 mmol/L; t= -3.255, P< 0.001 ) and homocysteine ( 19.50[17.10-24.70 μmol/L] vs. 15.40[12.60-18.05 μmol/L ]; Z= -7.236, P< 0.001 ) levels in the hyperuricemia group w ere significantly higher than those in the normal uric acid group. The distribution frequencies of the TT genotype (55.45%vs.13.76%;χ2 =56.409, P<0.001) and T alele (71.9%vs.32.54%;χ2 =79.561, P<0.001) w ere significantly higher than those in the normal uric acid group. Multivariate logistic regression analysis show ed that the TT genotype ( vs.CC genotype, OR 6.434, 95%CI 2.334-17.736; P<0.001 ), CT genotype ( vs.CC genotype, OR 2.234, 95%CI 1.019-4.898; P= 0.045 ), homocysteine ( OR1.081, 95%CI 1.010-1.157;P=0.024), and total cholesterin ( OR 1.363, 95%CI 1.123-1.653;P=0.002) w ere the independent risk factors for high hyperuricemia. Conclusions MTHFR gene C677T TT genotype and serum uric acid level are the independent risk factors for ischemic stroke in Chinese Han population in Shandong, China. MTHFR gene C677T TT genotype is also an independent risk factor for hyperuricemia in this population. Adjusting dietary habit may have a positive significance for the prevention of ischemic stroke in Chinese Han population in Shandong, China.
RESUMO
Objective To evaluate the application effect of modular management in technique and nursing of department of radiology. Methods 7 modules were divided: administrative management, quality management, equipment management, environment and emergency management, material cost management, education management and scientific research management. Each module was responsible for specially-assigned person reporting daily circumstance. Results After more than a year, 16 technical professionals, 8 educational professionals, 10 research professionals and 7 technicians were cultivated, 12 key performance indicators (KPI value) increased steadily were set up. Conclusions Modular management provided a novel concept for technique and medical care management of radiology department. Our practice suggests that modular management is alternative for development of technique and medical care in radiology department. Further research and application are needed.
RESUMO
[Summary] Epigenetics defines heritable changes in gene expression that are not coded in the DNA sequence itself.Three systems,including DNA methylation,RNA-associated silencing and histone modification,are used to initiate and sustain epigenetic silencing.Type 2 diabetes mellitus(T2DM) is a polygenic disorder,which is caused by both genetic and environmental factors.However,pathogenesis of T2DM has not been elucidated.Recent studies have indicated that epigenetics may play an important role in the pathogenesis of T2DM,which is involved in the development and differentiation of β cell,secretion of β cell,insulin sensitivity and so on.Researches related to epigenetics may provide a new measure and target to clarify the pathogenesis of T2DM as well as prevent and treat the disease.
RESUMO
Objective To investigate and analyze the candida infection situation at the intensive care unit (ICU) in Tianjin Fourth Central Hospital from 2008 to 2012.Methods Critically ill patients admitted in ICU Department in Tianjin Fourth Central Hospital from Jan.2008 to Dem.2012 were selected,and candida in all blood,sputum and other specimens of patients,were tested.Data on the following items as:hospital sections and distribution of candida infection on the places where the fungus was identified,distribution of different species of candida,antifungal drug resistance of candidacies commonly used in ICU department in the last five years etc.,were statistically analyzed.Results Among 4 529 cases of critically ill patients stayed in the hospital ICU Department between 2008 and 2012,76 cases of candida infection were identified,with the rate as 1.68％.In the past five years,candida in hospital ICU was mainly detected in sputum samples in 52 cases which accounted for 68.4％.Another 9 cases were detected in blood,accounted for 11.8％,8 cases were detected in urine,which accounted for 10.5％,36 cases (47.4％) of candida infection detected at the hospital ICU department in the last 5 years with major species as Candida albicans infection,followed by Candida glabrata,Candida tropicalis,Candida parapsilosis and Portugal Candida.The highest rate of resistance was to itraconazole,with a resistance rate of 19.7％,followed by voriconazole,with the rate as 15.8％.Conclusion In recent years,the number of patients infected with candida at the ICU department had increased annually with most cases as respiratory infections,which were caused by Candida albicans.The rate of resistance ofcandida to itraconazole was the highest,which called for special attention.
RESUMO
Objective To study the PTV by ng 4DCT and compare target,target displacement and dose distribution of 3D and 4D planning for thoracic middle or lower esophageal cancer,evaluate the clinical value of 4DCT in esophageal cancer radiotherapy.Methods From Jan to Dec 2012patients with primary esophageal cancer underwent 3DCT simulation scans first,then followed by 4DCT simulation scan.PTV and OARs were sketched in the ordinary 3DCT and 4DCT respectively.And designing two sets of radiotherapy plan for each patient:3D and 4D plan.We compare PTV,PTV displacement and OARs dosimetry's differences in the 3D plan and 4D plan.Using the paired t-test or Wilcoxon sign-rank test to compare the difference between the two sets of plans.Results The volume of PTV4D was larger than the PTV3D (195.19 cm3 vs.175.67 cm3,P =0.001) in all patients.The center displacement had only significantly difference (displacement was 0.25 cm,P =0.014) in left-right direction for 10 patients of thoracic middle esophageal cancer.The center displacement had no significantly different in the three direction for 9 patients of thoracic under esophageal cancer (P=0.722,0.307,0.208).The dose target area of V100,V95 and V90 in Plan3DC were significantly than those in Plan-3D for 19 patients of thoracic middle-lower esophageal cancer (88.62％ vs.95.69％,P=0.000;95.17％ vs.99.79％,P=0.001;97.19％ vs.99.99％,P=0.001).In 4D plan the lung V5,V20 and Dmean of heart were higher than that in 3D plan for all patients (39.49％vs.37.44％,P=0.016;19.93％ vs.18.87％,P=0.018 and 2607.74 cGy vs.2389.16 cGy,P=0.004).Conclusions 4DCT positioning technology can accuracy determine individualized expanding boundary by target area of radiotherapy for thoracic middle or lower esophageal cancer.The enlarging target volume increase the dose of radiotherapy for lung,and in the dose range in the 4D plan,but the increased dose of heart should be noted.
RESUMO
Objective To assess the influence of cumulative energy balance on outcome in septic patients requiring mechanical ventilation. Methods The indirect calorimetry (IC) was used to obtain target energy in 60 septic patients. The cumulative energy balance between survivors and non-survivors were compared. Logistic regressions was used to analyze the risk factors of death. Results Non-survivors had higher negative energy balance than survivors (P<0.05). The logistic regression analysis demonstrated that the start time of feeding and cumulative caloric balance were risk factors of mortality. Conclusions Effective nutrition support might be a good strategy to improve outcomes.
RESUMO
Objective:To study the effect of Xiaoyao Powder on Alzheimer's disease in hippocampal CA 3βregion of rats PP-2A,GSK-3βexpression.Methods:Rats were randomly divided into four groups , including model group, western medicine group,Chi-nese medicine group were treated with intraperitoneal injection of D-gal and A-β1-42 peptide bilateral hippocampal injection mold-ing, physiological group only with equal volume of sterile saline intraperitoneal and hippocampal injection molding .The model was completed, normal group, model group were perfused with saline , western medicine group and Chinese medicine group were treated with oxiracetam solution and Xiaoyao decoction , four groups of intragastric volume was 0.5 ml/100 g, 1 time a day, continuous 28 d. After intragastric administration of isolated rat brain immediately , packet marking in 4℃4%glutaraldehyde solution of glass container , stored at 4℃.Repair piece, cut from the hippocampus, embedded in paraffin, sliced.Dilution of PP-2A for 1∶200, GSK-3βdilution of 1∶150.Images were analyzed by using Image-pro Plus 5 image analysis system, data were conducted by SPSS11.5 statistical analysis software, the comparison between 4 groups by single factor analysis of variance , between the two two groups was compared by LSD-t test, the test level of α=0.05.Results:The expression of PP-2A positive cell number and the positive area , average optical density, integral optical density index , in Xiaoyao Powder orally intervention compared with the model group increased significantly (P<0.01);GSK-3βabove indices were significantly decreased than that in model group after Xiaoyao Powder after intragastric ad -ministration (P<0.01).Conclusion:Xiaoyao Powder can up regulate the expression of PP-2A and down regulate expression of GSK-3β, may be condensed A-β1-42 peptide induced hyperphosphorylation of Tau has certain inhibition .
RESUMO
Objective To observe the impact of the diverse caloric energy intake on the outcomes and occurrence rate of complications in septic patients.Methods A prospective single-blind randomized controlled trial was conducted.158 cases of septic patients in intensive care unit (ICU) were enrolled and randomly assigned to three groups according to their different target value of nutrition:group A [measurements of resting energy expenditure (MREE)＜90％],B (MREE 90％-110％) and C (MREE ＞ 110％).The caloric intake,mechanical ventilation duration (MVD),nosocomial infection rate,28-day and 60-day mortality were analyzed.Results Daily energy intake in 7 days after ICU admission was as follows:the difference in target value of nutrition(kJ/d:7 075.0 ± 1 046.5,5 667.8 ± 1 908.8,4 428.8 ± 1 377.8),calory intake (kJ/d:4 671.6 ± 1 205.6,5 655.3 ± 1 373.0,6 053.0 ± 1 557.2),enteral nutrition value (kJ/d:2 051.1 ± 1 046.5,3 980.9 ± 1 586.5,5 337.1 ±2 921.8) and average intake rate [(66.0 ± 15.8)％,(100.0 ± 5.7)％,(134.0 ± 19.7)％],and they were statistically significant difference among A,B,C groups (all P＜0.05).The parenteral nutrition in group C were much higher than that in group A and group B (kJ/d:2 055.3 ± 273.4vs.427.0 ± 273.4,473.0 ± 332.0,both P＜0.05).The calories provided by glucose and diprivan were similar among three groups.The MVD and ICU stay were shorter in group B than that in groups A and C [MVD (days):8.4 ± 6.3 vs.11.0 ± 8.2,17.8 ± 13.0,P＞ 0.05 and P＜ 0.05 ; ICU stay (days):11.0 ± 6.4 vs.14.9 ± 9.6,17.8 ± 13.0,respectively,P＞0.05 and P＜0.05].The total hospital stay (days:32.0 ± 22.5,26.8 ± 7.0,30.4 ± 21.4) and nosocomial infection rate [91.1％ (51/56),84.0％ (42/50),90.4％ (47/52)] were similar among A,B,C groups (all P＞0.05).There was no difference in survival rate at 28 days among three groups as shown by the Kaplan-Meier survival curve (F=3.145,P=0.076).The survival rate at 60 days showed a tendency of lowering in groups A and C,especially in group C (F=9.284,P=0.010).Conclusion Both higher and lower caloric energy intake may be associated with an adverse impact,but appropriate caloric intake would improve the outcome and reduce the complication rate in septic patients.
RESUMO
Objective To explore the gram-negative bacteria distribution and drug resistance in severe infections patients in ICU in our hospital.Methods Gram-negative bacteria in 260 cases of the clinical specimens from ICU department in our hospital from Mar 2012 to Mar 2013 were isolated and cultured,and the distribution and drug resistance in main gram-negative bacteria were analyzed.Results 300 cases of gram-negative bacteria were isolated from the 260 cases of specimens,and 203 cases were isolated from sputum,accounting for 67.7％.The mainly gram-negative bacteria in 300 cases were as follows:Pseudomonas aeruginosa (53 cases),Acinetobacter baumannii (45 cases),Klebsiella pneumonia (39 cases),Escherichia coli (33 cases) and Enterobacter cloacae (29 cases).The resistance rates of Pseudomonas aeruginosa to ampicillin/sulbactam and ceftriaxone were 73.6 ％ and 66.0％,Acinetobacter baumannii to ampicillin/sulbactam and piperacillin/tazobactam were 80％ and 68.9％,Klebsiella pneumoniae to ampicillin/sulbactam and ciprofloxacin were 53.8％ and 48.7％,Escherichia coli to levofloxacin and ampicillin/sulbactam were 78.8％ and 75.8％,Enterobacter cloacae to ampicillin/sulbactam and ceftriaxone were 82.8％ and 65.5 ％,respectively.Conclusions Drug resistance in gram-negative bacteria in ICU infection is more severe,and more attention should be paid to sterilization in ICU ward and rational use of antibiotics in order to minimize the risk of infection.