Nursing Grading Evaluation System for Patients with Stroke at Home: Construction, Validity and Reliability / 中国康复理论与实践

Objective:To construct a nursing grading evaluation indicator system for patients with stroke at home to provide a basis for graded care. Methods:Based on literature analysis, qualitative interviews and panel meeting, an evaluation indicator system was preliminarily drafted. June to September, 2018, the indicator system was consulted to experts three times. It was used to evaluate 210 patients with stroke at home from September to December, 2018 to test its reliability and validity. Results:The effective recovery rates of the three times of consultation were 85.00%, 89.47% and 100%, and the authority coefficient were 0.878, 0.879 and 0.879. The indicator system included four first-level indicators, 30 second-level indicators and 120 items. The scale-level content validity index (CVI) universal agreement was 0.733, average CVI was 0.927; the item-level CVIs were 0.83 to 1.00. For the overall level, the Cronbach's α coefficient was 0.928, and the Guttman Spilt half-factor coefficient was 0.794. For the dimensions, the Cronbach's α coefficient and the Guttman Spilt half-factor coefficients were all above 0.700. The correlated coefficients inter-evaluator of each indicators were 0.492 to 0.963 (P< 0.05). Conclusion:The nursing grading evaluation indicator system for patients with stroke at home is simple and operable, with satisfactory reliability and validity to grade the level of care for patients with stroke at home.

Development and Application of Professional Care APP for Stroke Patients at Home / 中国康复理论与实践

Objective:To develop and evaluate the effect of Professional Care APP for stroke patients at home. Methods:Professional Care APP 1.0 was developed by reviewing literature, analyzing APP function and consulting expert, and combined with the findings at the early stage. And then it was upgraded to APP 2.0 after a 4-week trial in 10 stroke patients at home, which included two parts: patient-side and medical-side. The patient-side provided health education, rehabilitation guidance, medication reminder, online consultation and so on. From December, 2017 to June, 2018, 77 stroke patients in a community in Zhengzhou, China were conveniently selected and randomly divided into control group (n = 39) and intervention group (n = 38). The control group received routine community follow-up, and the intervention group received Professional Care APP 2.0, for 12 weeks. Results:After a 12-week intervention, the level of knowledge and medication compliance was significantly higher in the intervention group than in the control group (t > 4.205, P < 0.001). The score of demand for professional care was significantly lower in the intervention group than in the control group (t = -18.183, P < 0.001). The intervention group made a good evaluation for APP in usefulness, ease of learning, usability, credibility, acceptability and satisfaction. Conclusion:Professional Care APP can meet the professional care needs, and improve the level of knowledge on disease and medication compliance for stroke patients at home. The patients' evaluation for APP is ideal.

Effects of Enalapril Maleate Folic Acid Tablets on Carotid Atherosclerosis in H Type Hypertension Patients with Type 2 Diabetes Mellitus and Its Potential Mechanism / 中国药房

OBJECTIVE: To investigate the effects of Enalapril maleate folic acid tablets on carotid atherosclerosis in H type hypertension patients with type 2 diabetes mellitus (T2DM) and its potential mechanism.METHODS: In prospective control study, 182 H type hypertension patients with T2DM were selected from Chongqing People's Hospital during Jan. 2014-Jan. 2016, and then randomly divided into observation group and control group, with 91 cases in each group. All patients received basic or hypoglycemic treatment of premixed insulin; observation group was additionally given Enalapril maleate folic acid tablets (containing enalapril maleate 10 mg, folic acid 0. 8 mg in each tablet) orally, one tablet, qd; control group was additionally given Enalapril maleate tablets (containing enalapril maleate 10 mg in each tablet) orally, one tablet, qd. Treatment course lasted for 12 months. The levels of blood pressure, plasma homocysteine (Hcy), fasting blood glucose (FBG), C-reactive protein (CRP) and carotid plaque score were detected in 2 groups before treatment, 12 months after treatment. RESULTS: Compared to before treatment, SBP and DBP of 2 groups were decreased significantly in 2 groups after 12 months of treatment (P<0. 05); there was no statistical significance between 2 groups (P>0. 05). The levels of plasma Hcy, FBG and CRP, carotid intima-media thickness and carotid plaque integral in observation group were significantly lower than control group (P<0. 05). CONCLUSIONS: Enalapril maleate folic acid tablets can relieve inflammation by reducing plasma Hcy, FBG and CRP so as to treat carotid atherosclerosis in H type hypertension patients with T2DM.

A study of the efficacy and safety of antithrombotic therapy in aging patients with atrial fibrillation and coronary disease / 重庆医学

Objective To investigate the efficacy and safety of different strategy of antithrombotic therapy in elderly patients with atrial fibrillation (AF) and coronary disease.Methods 224 inpatients and outpatients with AF and coronary disease whose mean follow-up time was 2 years,were divided into warfarin group,warfarin combined with antiplatelet drug(aspirin or clopidogrel) group,antiplatelet drug(aspirin or clopidogrel) group and control group.The thromboembolic event rate and adverse events incidence were observed in different groups.Results The risk of thromboembolic events,particular emerging risk of cerebral infarction in the control group(12.50 ％) was significantly higher than other groups (P＜ 0.05).Thrombotic event rates in warfarin + single joint group(2.78％) was lower than other groups(warfarin group 4.29 ％,single joint group 5.81％),but there was no significant statistical difference.The overall risk of bleeding in the control group (3.13 ％) was significantly lower than other antithrombotic group (P＜0.05).The incidence of skin bruising in single joint group was lower than other antithrombotic groups,the overall bleeding risk,especially gasfrointestinal bleeding in warfarin+ single joint group was significantly higher than other groups (P＜ 0.05).Conclusion Elderly patients with coronary heart disease and atrial fibrillation need antithrombotic therapy to prevent thrombotic events.Using warfarin alone or warfarin combined antiplatelet drug does not lead to serious bleeding events,but generally bleeding risk should be attracted more attention.

Analysis of nursing effect of different feeding ways in children with congenital cleft lip after surgery / 口腔疾病防治

Objective@# To investigate the influence of different feeding ways on the incidence rate of complication in patients with congenital cleft lip and their family satisfaction degree.@*Methods@# A retrospective analysis were conducted from 90 cases underwent surgery of congenital cleft lip with clinical data, were randomly assigned to the control group and the observation group, 45 cases in each. The control group routinely take spoon feeding way after surgery, whereas patients in the observation group does not change the feeding way in the past, continuely taking the nipple feeding or breastfeeding. Wound infection rate, wound rupture rate, crying in the process of feeding and parents' satisfaction were compared between the two groups.@*Results@#The wound infection rate and wound rate of the observation group were 2.2% and 0 respectively, the control group were 4.4% and 0 respectively. There was no significant difference between the 2 groups in the 2 index (P > 0.05). In the observation group, the crying children were less than the control group, In the observation group, the degree of coordination, parental satisfaction and acceptance of feeding were 84.4%, 88.9%, 93.3%, respectively, the control group were 55.6%, 60.0%, 66.7%. The observation group were better than the control group. The differences between groups was statistically significant (χ2coordination degree = 8.94, χ2satisfaction degree = 9.87, χ2recognition degree = 10.00, P < 0.05).@*Conclusion@# Children under the age of 1 with congenital grade Ⅰ and Ⅱ cleft lip do not change the way of feeding after surgery , who continue to take the bottle or breastfeeding can better meet the needs of children fed liquid diet, crying reduce, get parents' recogniton and reduce the burden on parents than the control group conventionally fed with a spoon.

Autistic Traits,Empathy and Theory of Mind of College Students with Different Level of Prosocial Behaviors / 中山大学学报(医学科学版)

[Objective]To investigate autistic traits(AT)of college students with different levels of pro-social behavior,and their characteristics of empathy and theory of mind(ToM).[Methods]372 college students(91males)were recruited. The Chinese Version of Autism-Spectrum Quotient(AQ-C)and Prosocial Tendencies Measure(PTM)questionnaires were used to assess autistic traits and prosocial behaviors. 49 participants were drawn from the total sample for the next procedure. The Chinese Version of Inter?personal Reactivity Index(IRI-C)and Reading the Mind in the Eyes Test(RMET)were used to assess empathy and theory of mind.[Results]The AQ-C's total(14.8±5.3 vs 13.8±5.3,P=0.031)and Socialness subscale(29.8±6.1 vs 27.6±6.0,P=0.001)scores in the low PTM group were higher than those in high PTM group. The IRI-C's total(46.5±9.9 vs 52.8±8.6,P=0.025)and Perspective Taking subscale(10.3±3.6 vs 12.1±2.4,P=0.049)scores in the low level of prosocial behavior group were lower than those in high lev?el group. Scores of RMET showed no significant difference between the two groups.[Conclusions]Individuals with lower level of pro?social behaviors has higher AT,which may be related to deficits of cognitive empathy. No association between ToM and prosocial be?haviors has been found.

A control study on levosimendan in treatment of refractory heart failure complicating severe renal insufficiency / 重庆医学

Objective To studythe efficacy of levosimendan in treating refractory heart failure complicating severe renal in sufficiency.Methods Sixty-seven cases of refractory heart failure complicating severe renal insufficiency in the internal medicine department of our hospital were randomly divided into the levosimendan treatment group(L group,n=33)and dopamine treatment group(D group,n=34).The changes of N-terminal pro-B-type natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction (LVEF)and glomerular filtration rate(GFR)before treatment and on 1,3,7,30 d after treatment were compared between the two groups and analyzed.Results Before the treatment,there were no statistically significant differences in the baseline indicators between the two groups(P＞0.05).The group L:the NT-pro-BNP level on 1,3,7 d after treatment was decreased significantly(P＜ 0.05),LVEF on 3,7 d was significantly increased compared with th baseline(P＜0.05)and GFR on 1,3,7,30 d was significantly increased compared with the baseline(P＜0.05).The group D:the NT-pro-BNP level on 7 d of treatment was significantly decreased(P＜0.05),LVEF on 7 d of treatment was significantly increased compared with the baseline(P＜0.05),and no statistically significant changes were observed in GFR on 1,3,7,30 d(P＞0.05).After treatment,NT-pro-BNP,LVEF and GFR significant level values in the group L were better than those in the group D.Conclusion Levosimendan is superior to dopamine in improving heart and renal function for the patients with refractory heart failure complicating severe renal insufficiency.

Relationship between cardiac resynchronization therapy and change of left atrial volume index / 重庆医学

Objective To prospectively assess the association between cardiac resynchronization therapy (CRT )and left atrial volume .Methods Fourteen patients with chronic heart failure ,sinus rhythm and left bundle branch block were enrolled in this study and prepared for CRT implantation .Clinical and echocardiographic evaluations were performed before CRT implantation and 6 months later .Followings were parameters of the left atrial and left ventricular volume:left ventricular end-systolic volume index (LVESVi)and end-diastolic volume index(LVEDVi) ,maximal LAV index(iLAVmax) ,etc ,LAV index before atrial systole(iL-AVpre)and minimal LAV(iLAVmin) .CRT responders were defined as those whose reduction rates were more than 10% in iL-VESV in 6-month follow-up .Results Responders(71 .4% )and non-responders(28 .6% )had similar baseline ,clinical characteristics and pre-implantation LV volumes .However ,iLAVmax in the responders was remarkably lower than that in non-responders .CRT therapy significantly reduced LVESVi(P<0 .01) ,LVEDVi(P<0 .001) ,iLAVmax(P=0 .004) ,iLAVpre(P=0 .003)and iLAVpost (P<0 .01) ,but when compared with the non-responders ,iLAVmax was much lower in responders .Correlation analysis showed that there was a significant correlation of LVEDVi with iLAVmax ,iLAVpost(P<0 .05) .Conclusion CRT therapy can significant-ly improve iLAVpre and iLAVmax may be a predictor of LV reverse remodeling .

Application of immunohistochemistry in biopsy specimen for differential diagnosis of small cell lung carcinoma and non-small cell lung carcinoma / 中国医师杂志

Objective To investigate the role of immunohistochemistry in the differential diagnosis between small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC).Methods The protein expressions of CD56, Syn, TTF1, CK5/6, CK14, P63, CK7, and NapsinA in percutaneous lung biopsy and bronchoscopic biopsy specimens which were suspected as SCLC were examined by immunohistological streptavidin-peroxidase ( SP) method to analyze the pathological characteristics , immunological pheno-typical features , and differential diagnosis between SCLC and NSCLC .Results Among 72 cases of lung cancer patients ,there were 27 cases of SCLC,17 cases of low differentiated squamous cell carcinoma ( SCC) and 28 cases of low differentiated adenocarcinoma ( ADC) .Conclusions It is the different therapy between SCLC and NSCLC , immunohistochemistry analysis of biopsy can provide ac-curate diagnosis of SCLC and NSCLC , which will result in less misdiagnosis and provide an important valuable in the selection of clini -cal treatment protocols for lung cancer patients .

Alkaloids from bulbs of Lycoris radiata / 中国中药杂志

Ten Amaryllidaceae alkaloids were isolated from the bulbs of Lycoris radiata. Their structures were identified as oxovittatine (1), apohaemanthamine (2), 9-O-demethylhomolycorine N-oxide (3), incartine (4), ismine (5), 6-O-methylpretazettine (6), tazettine (7), ungeremine (8), homolycorine (9), and O-methyllycorenine (10) by spectroscopic data analyses. Compound 1 was a new natural product. Compounds 2 and 3 were reported form the genus Lycoris for the first time and compounds 4-6 were isolated form the title plant for the first time.

Prevalence and risk factors of atrial fibrillation in hospitalized patients with chronic kidney disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>Atrial fibrillation (AF) is the most common sustained tachyarrhythmia in the general population. AF and Chronic Kidney Disease (CKD) share several common risk factors. We investigated the association between chronic kidney disease and risk of atrial fibrillation in hospitalized patients with CKD.</p><p><b>METHODS</b>One thousand one hundred and sixty-eight patients [(63.3 ± 14.2) years, 54.5% males] hospitalized CKD patients were included. AF was determined by electrocardiogram or medical history. The prevalence of atrial fibrillation was compared in CKD patients with various age, sex and glomerular filtration rate (eGFR). Binary logistic regression analysis was used to determine the risk factors of AF.</p><p><b>RESULT</b>The mean eGFR was (22.2 ± 19.7) ml · min(-1) · 1.73 m(-2); eGFR was ≤ 45 ml · min(-1) · 1.73 m(-2) in 84.2% patients and 38.5% patients received hemodialysis. AF was present in 14.2% of the study population and 17.2% in patients ≥ 60 years old. Prevalence of AF was significantly higher in patients with eGFR ≤ 45 ml · min(-1) · 1.73 m(-2) compared patients with eGFR > 45 ml · min(-1) · 1.73 m(-2) (15.8% vs. 5.4%, P < 0.001). Binary logistic regression analysis showed that age, body mass index (BMI), heart failure (HF), left atrial diameter (LAD), eGFR and dialysis were independent risk factors for AF.</p><p><b>CONCLUSIONS</b>AF is much more frequent in CKD patients than in the general population. Age, BMI, HF, LAD, eGFR and dialysis are risk factors for AF in hospitalized patients with CKD.</p>

Study on anemia among premarital women in 6 counties from 1993 to 2003 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the prevalence of anemia and yearly trends (1993-2003) among women who came to the hospitals or maternal and child health units for premarital examinations in 6 counties of Jiangsu and Zhejiang provinces.</p><p><b>METHODS</b>Data were obtained from the records of the premarital examinations in perinatal health care surveillance system that had been established since 1992 in these areas. We reviewed hemoglobin levels of those women who were enrolled in the perinatal health care surveillance system from 1993 to 2003. Anemia was defined according to the WHO (2001) criterion. We calculated the prevalence of anemia and analyzed the yearly trends based on the data of hemoglobin concentration.</p><p><b>RESULTS</b>In the period of 1993-2003, there were 82 995 anemia cases identified among 193,434 women with an overall anemia rate as 42.9%. The rates of anemia were high (65.5%) in 1993 but low (25.8%) in 2003. 99.7% of the anemic women whose hemoglobin concentration were between 80-119.9 g/L. Time trend analysis indicated a significant decline on anemia rate while monthly analysis showed that the prevalence rates were high (48.2%) in September and low in March (39.5%). The results also showed that the prevalence rates of anemia were relatively higher in farmers and workers in rural enterprises, and lower in Han ethnicity than minorities. The higher prevalence rates of anemia were presented among the women with less education, lower body mass index, or at older age.</p><p><b>CONCLUSION</b>For those premarital women in 6 counties of Jiangsu and Zhejiang provinces, the overall anemic rate presented a significant downward trend between 1993 and 2003 while the prevalence of anemia remained high, especially for the women with less education, lower body mass index or older ages.</p>

Study on the association between transforming growth factor alpha gene TaqI variant and cleft lip with or without cleft palate / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the association between transforming growth factor alpha gene (TGFalpha) TaqI variant and nonsyndromic cleft lip with or without cleft palate (nsCL/P) in Chinese population.</p><p><b>METHODS</b>TGFalpha TaqI variant was detected using polymerase chain reaction-restriction fragment length polymorphism for DNA samples of the 149 triads with nsCL/P affected child. We performed the Transmission/disequilibrium test and the family-based association study (FBAT) to identify the associations between this variant and risk of nsCL/P.</p><p><b>RESULTS</b>Significant distortion of C2 allele at TGFalpha TaqI locus in nsCL/P groups (P > 0.05) was not found. In the family-based association test, C2 allele and offspring C2C1 genotype was not found to be significantly associated with an increase risk of nsCL/P (P > 0.05).</p><p><b>CONCLUSION</b>Our findings did not suggest an association between offspring TGFalpha TaqI variant and the increased risk of nsCL/P in Chinese population.</p>

Association between parental transforming growth factor alpha gene TaqI variant, paternal smoking and the cleft lip with or without cleft palate / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the association between transforming growth factor alpha gene (TGFalpha) TaqI variant and nonsyndromic cleft lip with or without cleft palate (nsCL/P) in Chinese population, and the interaction with parental smoking.</p><p><b>METHODS</b>TGFalpha TaqI variant was detected using RFLP-PCR for DNA samples of the 170 triads with nsCL/P affected child. We performed the transmission/disequilibrium test (TDT) and the family-based association study (FBAT) to test the associations between this variant and risk of nsCL/P.</p><p><b>RESULTS</b>It was not found significant distortion of C2 allele at TGFalpha TaqI locus in nsCL/P groups (P > 0.05), however, by stratified analysis, we found that the rate of C2 allele transmission among nuclear families whose fathers were smoking was 1/5 (0.062 - 0.711) as compared with that among nuclear families whose fathers were not smoking, and the OR of interaction between TGFalpha variant and parental smoking is 0.102 (0.017 - 0.619).</p><p><b>CONCLUSION</b>The parental smoking may interact with TGFalpha variants of Chinese populations in occurrence of nsCL/P, but it remains to have more investigations.</p>

Study on the association between reduced folate carrier gene polymorphism and congenital heart defects and cleft lip with or without cleft palate / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the association between reduced folate carrier gene (RFC1) polymorphism and congenital heart defects (CHD) as well as cleft lip with or without cleft palate (CLP) and to provide epidemiological evidence on genetic markers of CHD and CLP.</p><p><b>METHODS</b>RFC1 (A80G) genotype was detected using RFLP-PCR for blood DNA of the 67 triads with nonsyndromic CHD-affected child, the 82 triads with child-affected cleft lip with or without CLP and the 100 control families without child-affected birth defects. We performed a family-based association test and analyzed the interaction between RFC1 A80G genotype and maternal periconceptional supplementation of folic acid.</p><p><b>RESULTS</b>Offspring of mothers who did not take folic acid had an elevated risk for CHD when comparing with offspring of mothers who did (OR = 2.68, 95% CI: 1.14 - 6.41). There was a statistical association between the risk of CHD and maternal periconceptional folic acid supplementation (chi(2) = 6.213, P < 0.05). In the family-based association test, G allele was positively associated with an increased risk for children CHD (Z = 2.140, P < 0.05) while G allele of RFC1 (A80G) polymorphism might increase the risk for CHD. Elevated risks for either CLP group were not observed between RFC1 genotype using or not using folic acid.</p><p><b>CONCLUSION</b>Our findings suggested that the G allele was likely to be a genetically susceptible allele for CHD. There was possible association between offspring with GG, GA genotype and maternal periconceptional folicacid deficiency.</p>

Effects of fosinopril and metoprolol on cardiac remodeling and plasma levels of neurohormones in heart failure patients / 第三军医大学学报

Objective To explore the effects of fosinopril and metoprolol on cardiac remodeling and the plasma levels of angiotensin II(AngⅡ),endothelin-1(ET-1) and nitric oxide(NO) in patients with congestive heart failure(CHF).Methods A total of 80 patients with CHF were divided into 3 groups,fosinopril(20 mg/d),metoprolol(from 6.25 mg,twice a day to 100 mg,twice a day or the highest tolerant dose) and combination groups(as in single use),and all were treated for 12 months.Electrocardiography including ejection fraction(EF)and left ventricular end diastolic diameter(LVEDD)was carried out,and plasma levels of the 3 neurohormones were detected with conventional methods at admission and 12 months after the treatment.(Results Plasma) levels of AngⅡ,ET-1 and NO were decreased significantly in all groups.No significant difference was seen between fosinopril and metoprolol groups,but the plasma levels was decreased remarkably(P

The epidemiology of neural tube defects in high-prevalence and low-prevalence areas of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the epidemiology of neural tube defects (NTDs) in high- and low-prevalence areas of China.</p><p><b>METHODS</b>Birth defects surveillance data, collected from 1992 through 1994 was analyzed. These data were collected as part of the Sino-American cooperative project on NTDs prevention. We classified NTDs as anencephaly, encephalocele, high-level and low-level spina bifida (SB) according to location of the lesion (high vs low) and whether the defect was isolated or occurred in association with other birth defects. Rates were compared in the high-prevalence (North) region and the low-prevalence (South) region, after adjusted for classification, urban and rural, season and sex, and calculated the adjusted rate of NTDs.</p><p><b>RESULTS</b>Among seven hundred and eighty-four NTDs cases in 326 874 recorded births (include in livebirth, stillbirth and fetal death with a gestational age of at least 20 weeks), the overall NTDs prevalence in the North was 5.57/1,000 births, and in the South was 0.88/1 000. There were also significant differences in the prevalence of anencephaly, encephalocele, high-level and low-level SB between North (0.97, 0.49, 2.75 and 1.11/1,000 birth) and South (0.36, 0.15, 0.21 and 0.14/1,000 birth) (P < 0.01), with adjusted prevalences in the North 3 - 7 times higher than those in the South. There were significant difference between urban (2.04) and rural areas (6.57/1,000 birth) in the North (P < 0.01), urban (0.52) and rural areas (0.95/1,000 birth) in the South (P < 0.05). Adjusted prevalence rates in the rural were 3 - 4 times higher than those of urban in the North and 1.6 - 1.9 times higher than in the South; The seasonal rate of high-level SB increased between September and November in the North (3.44/1,000 birth), while the seasonal rate of anencephaly decreased between September and November (0.18/1,000 birth) in the South. However there were no seasonal changes in other classified NTDs both in the South and North.</p><p><b>CONCLUSIONS</b>The birth prevalence of NTDs in the North of China was the highest in the world. There were significant differences between the North and the South, urban and rural. There was seasonal change in high-level SB in the North, which was in accordance to the phenotype of NTDs. It was suggested that there might exist etiological heterogeneity among anecephalus, low- and high-level SB.</p>

Rapid Detection of Total Bacterial Number Using NADH Fluorescence Method / 微生物学通报

To set up a new method of detecting bacterial number in situ,NADH fluorescence method based on the fluorescent characteristic of NADH was used.When the concentration of NADH ranged from 10 nmol/L to 0.2 mmol/L,its concentration had a good line relationship to the fluorescence intensity(R2= 0.9905).Separating bacterial cells by centrifugation and extracting NADH with hot Tris-HCl buffer,the re-sult of bacterial count detected with NADH standard plot was 1?104 CFU/mL in an hour.In summary,NADH fluorescence method is rapid,sensitive,simple and reliable to detect total bacterial number.There-fore,the method can be widely applied in the field of food sanitation and safety,environment detection and so on.