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Glycyrrhizae Radix et Rhizoma,a traditional Chinese medicine also known as Gan Cao(GC),is frequently included in clinical prescriptions for the treatment of pneumonia.However,the pharmacological com-ponents of GC for pneumonia treatment are rarely explored.Gan An He Ji oral liquid(GAHJ)has a simple composition and contains GC liquid extracts and paregoric,and has been used clinically for many years.Therefore,GAHJ was selected as a compound preparation for the study of GC in the treatment of pneumonia.We conducted an in vivo study of patients with pneumonia undergoing GAHJ treatments for three days.Using the intelligent mass spectrometry data-processing technologies to analyze the meta-bolism of GC in vivo,we obtained 168 related components of GC in humans,consisting of 24 prototype components and 144 metabolites,with 135 compounds screened in plasma and 82 in urine.After analysis of the metabolic transformation relationship and relative exposure,six components(liquiritin,liquiritigenin,glycyrrhizin,glycyrrhetinic acid,daidzin,and formononetin)were selected as potential effective components.The experimental results based on two animal pneumonia models and the in-flammatory cell model showed that the mixture of these six components was effective in the treatment of pneumonia and lung injury and could effectively downregulate the level of inducible nitric oxide synthase(iNOS).Interestingly,glycyrrhetinic acid exhibited the strongest inhibition on iNOS and the highest exposure in vivo.The following molecular dynamic simulations indicated a strong bond between glycyrrhetinic acid and iNOS.Thus,the current study provides a pharmaceutical basis for GC and reveals the possible corresponding mechanisms in pneumonia treatment.
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Objective:To verify the validity of the clinical dementia rating(CDR) for early screening of Alzheimer's disease in the community.Methods:One thousand two hundred and eighty-one community volunteers (580 males and 701 females) came to hospital for clinical interviews, laboratory tests and a series of psychological assessment, including CDR, brief elderly cognitive screening inventory (BECSI), quickly cognitive screening scale for elderly (QCSS-E), mini-mental state examination (MMSE) and core neurocognitive test (CNT). According to clinical interview, assessment and DSM-5 criteria, 623 normal cognition, 570 mild cognitive impairment (MCI) and 88 dementia with Alzheimer's type (DAT) were screened.Results:(1) The results of CDR-global scores (CDR-GS)in the community volunteers showed that 506 (39.5%) scored 0, 688 (53.7%) scored 0.5, 72 (5.6%) scored 1, and 15 (1.2%) scored 2 or more.(2) There were significantly differences on the BECSI score, QCSS-E score, MMSE score and CNT score among people with different CDR-GS ( P<0.01). In the total or dementia sample, CDR-sum of box score (CDR-SB) and CDR-GS were significantly correlated with BECSI score ( r=0.577-0.639), QCSS-E score ( r=-0.586--0.680), MMSE score ( r=-0.570--0.764) and CNT score ( r=-0.244--0.357)( P<0.01). (3) The accuracy (95.8%) and specificity (99.8%) of the CDR-GS screening DAT were slightly higher than those of the CDR-SB(91.1%, 92.0%), and its sensitivity (65.9%) was lower than that of CDR-SB(82.5%). The accuracy (72.6%), sensitivity (81.9%) and specificity (64.0%)of the CDR-GS were close to those of CDR-SB(72.1%, 83.3%, and 61.8% respectively) in screening MCI. Conclusion:The CDR can be used for screening of AD in community populations.CDR-GS and CDR-SB have their own advantages, and combination of both advantages can improve the screening efficiency.
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Objective To evaluate whether sofosbuvir (SOF)-based direct-acting antiviral agents (DAAs) combined with ribavirin (RBV) (combined RBV) can yield benefits to the recipients infected with hepatitis C virus (HCV) genotype 1 (GT1) after liver transplantation through systematic evaluation and Meta-analysis. Methods Multiple databases at home and abroad were systematically searched, the literature screening was conducted according to relevant standards, the quality of literatures was evaluated and data extraction was performed. The literature was divided into two groups according to the recipients with HCV-GT1 hepatitis after liver transplantation who received the treatment combined RBV or SOF-based DAAs alone without RBV (not combined RBV). Meta-analysis of the data was carried out using Rev Man 5.3 and R3.4.3 software. The incidence of sustained virological response 12 weeks (SVR12) after therapy was evaluated. Results A total of 2 195 articles were retrieved, and 6 articles published in English were eventually included according to the inclusion criteria. The Meta-analysis results demonstrated that the incidence of SVR12 did not significantly differ between the combined RBV and not combined RBV groups (P=0.28). However, the incidence of anemia in the combined RBV group was significantly higher than that in the other group (P < 0.01). Both combined RBV and not combined RBV therapies were efficacious in treating HCV-GT1a and HCV-GT1b subtypes after liver transplantation with similar clinical efficacy (P=0.33). The incidence of SVR in HCV-GT1 recipients did not significantly differ after receiving 12- and 24-weeks therapy after liver transplantation (P=0.95). Conclusions When SOF-based DAAs regimen is adopted to treat HCV-GT1 in recipients after liver transplantation, combination with RBV not only fails to improve the virus clearance rate and bring clinical benefits, but also increases the risk of anemia in the recipients.
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Objective@#To investigate the neurocognitive characteristics and related factors in the elderly with subjective cognitive decline.@*Methods@#Among the 1 850 elderly volunteers aged over 50, 377 cognitive normal elderly (NC group), 234 subjective cognitive decline (SCD Group) and 291 patients with mild cognitive impairment (aMCI Group) were screened with the brief elderly cognitive screening questionnaire and the elderly rapid cognitive screening scale.They were all received clinical interview and examination and core neurocognitive test.@*Results@#(1) There were statistically significant differences in the three groups on the age, education, occupation, HAMD, low density lipoprotein and blood pressure (P<0.01). (2) The score of the picture-symbol association in SCD group(8.94±4.05)was lower than that in NC group(9.83±4.18)and higher than that in aMCI group (7.12±4.17)(all P<0.05), while the scores of the other neuropsychological tests were higher than those in aMCI group.There were no statistically significant difference between SCD group and NC group on the other neuropsychological tests(P>0.05). (3)The SCD was mainly influenced by age(β=0.063, OR=1.065, 95%CI=1.033-1.099), depression(β=0.182, OR=1.199, 95%CI=1.084-1.327)and hypertension(β=0.473, OR=1.604, 95%CI=1.185-2.171)(all P<0.01). And the aMCI was mainly influenced by age(β=0.078, OR=1.081, 95%CI=1.048-1.115), education(β=-0.174, OR=0.840, 95%CI=0.778-0.907), occupation(β=-0.406, OR=0.666, 95%CI=0.535-0.830)and low density lipoprotein(β=-0.451, OR=0.637, 95%CI=0.497-0.816)(all P<0.01 ).@*Conclusion@#Objective neurocognitive function of the elderly with subjective cognitive decline is basically normal.Age, depression and hypertension are risk factors of subjective cognitive decline.
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Objective To investigate the neurocognitive characteristics and related factors in the elderly with subjective cognitive decline. Methods Among the 1 850 elderly volunteers aged over 50,377 cognitive normal elderly (NC group),234 subjective cognitive decline ( SCD Group) and 291 patients with mild cognitive impairment (aMCI Group) were screened with the brief elderly cognitive screening question-naire and the elderly rapid cognitive screening scale. They were all received clinical interview and examina-tion and core neurocognitive test. Results ( 1) There were statistically significant differences in the three groups on the age,education,occupation,HAMD,low density lipoprotein and blood pressure (P<0. 01). (2) The score of the picture-symbol association in SCD group( 8. 94 ± 4. 05) was lower than that in NC group (9. 83±4. 18)and higher than that in aMCI group (7. 12±4. 17)(all P<0. 05),while the scores of the other neuropsychological tests were higher than those in aMCI group. There were no statistically significant differ-ence between SCD group and NC group on the other neuropsychological tests(P>0. 05). (3) The SCD was mainly influenced by age( β=0. 063, OR=1. 065,95% CI=1. 033-1. 099), depression ( β=0. 182,OR=1. 199,95%CI=1. 084-1. 327) and hypertension(β=0. 473,OR=1. 604,95% CI=1. 185-2. 171) ( all P<0. 01). And the aMCI was mainly influenced by age(β=0. 078,OR=1. 081,95%CI=1. 048-1. 115),educa-tion(β=-0. 174,OR=0. 840,95%CI=0. 778-0. 907),occupation( β=-0. 406,OR=0. 666,95%CI=0. 535-0. 830)and low density lipoprotein(β=-0. 451,OR=0. 637,95%CI=0. 497-0. 816)(all P<0. 01 ). Conclu-sion Objective neurocognitive function of the elderly with subjective cognitive decline is basically normal. Age,depression and hypertension are risk factors of subjective cognitive decline.
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Objective@#To analyze the epidemiological and spatial-temporal distribution of Brucellosis, epidemic encephalitis B and hemorrhagic fever with renal syndrome (HFRS) in Gansu province during 2014-2018 so as to provide evidence for the prevention and control of those diseases.@*Methods@#A database was established in Gansu province from 2014 to 2018, using the geographical information system. A spatial distribution map was drawn, with trend analysis and space-time clustering used to study the 3-dimention of the diseases, by using both ArcGIS 10.5 and SaTScan 9.6 softwares.@*Results@#Results from the trend surface analysis showed that the incidence of Brucellosis decreased gradually from north to south parts while the U type curve could reflect the distribution from the east to the west areas. Incidence of epidemic encephalitis B decreased significantly from south to north areas in the province, with incidence higher in the eastern than in the mid-west region. Difference on the incidence of HFRS was not significantly visible in the eastern and western regions, while the incidence was slightly higher in the southern than the northern parts of the province. Spatial and space-time clustering did exist among the 3 diseases in Gansu from 2014 to 2018. The areas with clusters of Brucellosis appeared in the eastern parts during 2014-2015, including 19 counties. The areas with secondary clusters of Brucellosis were seen in the Hexi district, including 4 counties, during 2017-2018. The areas with high incidence of epidemic encephalitis B were clustered in the middle and southeast areas, including 32 counties, during 2017-2018. Areas with most clusters of HFRS appeared in Min county of Dingxi city in 2018, with the areas of secondary clusters in 8 counties of the eastern areas in 2018.@*Conclusions@#The overall incidence rates of the 3 natural focus diseases were in a upward trend and showing obvious characteristics on spatial clustering. According to the distributive characteristics, effective measures should be developed accordingly.
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Postoperative complications of ERCP include pancreatitis,cholangitis,hemorrhage,mechanical damage (such as perforation) of the digestive tract and drug reaction.Since the the complications definition,surgical indications,operation technique,data collection and processing method were inconsistent,there were controversies for the incidences of complications after ERCP and its risk factors for different institutions.This paper discussed the evolution of ERCP risk factors,current situation and prophylaxis of major complications after ERCP and summarized the current research progress in order to provide theoretical help for prevention and prophylaxis of postoperative complications of ERCP.
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Objective To optimize the warning threshold values of common communicable diseases in Gansu province,and improve the early warning effect.Method An early warning model was set up for influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method.By calculating the sensitivity,specificity,predictive value of positive test,predictive value of negative test,Youden'index and receiver-operating characteristic curve,the optimum early warning threshold values for communicable diseases in Gansu were selected.Results The optimum early warning boundary values of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,and viral hepatitis type E were P90,P80,P95,P90,P80 and P90 respectively.The optimum early warning parameters of HFMD were k =1.2,H=5σ.Under the optimum early warning boundary values/parameters,the early warning sensitivities of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and HFMD were 86.67％,100.00％,91.67％,100.00％,100.00％,100.00％ and 100.00％,the specificities were 86.49％,62.22％,75.00％,100.00％,97.92％,89.13％ and 74.47％.The predictive values of positive test were 72.22％,29.17％,52.38％,100.00％,80.00％,54.55％ and 29.41％,and the predictive values of negative test were 94.12％,100.00％,96.77％,100.00％,100.00％,100.00％ and 100.00％,and the Youden'indexes were 0.73,0.62,0.67,1.00,0.98,0.89 and 0.74.Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram.Conclusion The early warning thresholds of influenza,other infectious diarrheal diseases,dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.
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Objective To optimize the warning threshold values of common communicable diseases in Gansu province,and improve the early warning effect.Method An early warning model was set up for influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method.By calculating the sensitivity,specificity,predictive value of positive test,predictive value of negative test,Youden'index and receiver-operating characteristic curve,the optimum early warning threshold values for communicable diseases in Gansu were selected.Results The optimum early warning boundary values of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,and viral hepatitis type E were P90,P80,P95,P90,P80 and P90 respectively.The optimum early warning parameters of HFMD were k =1.2,H=5σ.Under the optimum early warning boundary values/parameters,the early warning sensitivities of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and HFMD were 86.67％,100.00％,91.67％,100.00％,100.00％,100.00％ and 100.00％,the specificities were 86.49％,62.22％,75.00％,100.00％,97.92％,89.13％ and 74.47％.The predictive values of positive test were 72.22％,29.17％,52.38％,100.00％,80.00％,54.55％ and 29.41％,and the predictive values of negative test were 94.12％,100.00％,96.77％,100.00％,100.00％,100.00％ and 100.00％,and the Youden'indexes were 0.73,0.62,0.67,1.00,0.98,0.89 and 0.74.Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram.Conclusion The early warning thresholds of influenza,other infectious diarrheal diseases,dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.
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Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.
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Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.
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<p><b>OBJECTIVE</b>To study the time-space distribution of viral hepatitis C in Gansu province during 2009-2013, using the time-space statistics.</p><p><b>METHODS</b>Using Geoda to analysis the univariate Moran's I and univariate local Moran's I while using SaTScan to detect the time-space gathering areas.</p><p><b>RESULTS</b>There was spatial autocorrelation on incidence of hepatitis C noticed in Gansu during 2009-2013. The hot spots areas were counties as Jinchang, Wuwei, Zhangye and Lanzhou. Cold spot areas would include counties as Dingxi, Longnan, Pingliang, Gannan, Jiuquan, Qingyang, Baiyin and Tianshui. There were time-space gathering areas nitoced, during 2009-2010. Qinzhou and Maiji counties belonged to high incidence gathering areas. Lintao and Linxia were of low incidence gathering areas. In 2011-2013, high incidence gathering area would include counties as Zhangye, Jinchang, Wuwei Lanzhou and Baiyin while low incidence gathering areas would include counties as Dingxi, Tianshui, Pingliang, Longnan and Qingyang.</p><p><b>CONCLUSION</b>There appeared time-space gathering of hepatitis C in Gansu province during 2009-2013. High and low gathering areas varied with time and high incidence gathering area mainly distributed in the western and central areas of Gansu province.</p>
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Humanos , China , Epidemiologia , Hepatite C , Epidemiologia , Incidência , Análise Espaço-TemporalRESUMO
The paper conducts a case study of Yangzhou No.1 People′s Hospital, introduces the practice of outpatient process opti-mization based on informatization support platform, analyzes the operation status of self-service outpatient service platform and existing problems.Based on the M/M/s model in queuing theory, the queuing model of payment for outpatient service in the hospital is construc-ted, the characteristics of queuing payment problems for outpatient service are revealed, the relationship between the sharing rate of self-service terminals and the average length of the queue in service windows, the average waiting time of patients.