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Background The influencing factors of noise hazards in the automotive manufacturing industry are complex, diverse, and mutually correlated, resulting in significant health impacts on workers. Objective To explore the application of generalized estimating equations (GEE) to analyze the factors affecting high-frequency hearing loss among noise-exposed workers in an automotive manufacturing company, guiding enterprises to scientifically carry out employee hearing protection programs. Methods The data of occupational health field evaluation and occupational health surveillance of an automobile manufacturing company for five consecutive years from 2018 to 2022 were collected, and 806 noise-exposed workers with pure tone hearing test results for all five consecutive years were selected as study participants. The retrieved indicators were gender, physical examination year, noise intensity, blood pressure, white blood cell counts, red blood cell counts, platelet counts, concentrations of hemoglobin, alanine transaminase, aspartate aminotransferase, smoking, drinking, etc. Gender, noise intensity, blood pressure, white blood cell counts, red blood cell counts, concentrations of hemoglobin, platelet counts, glutamate aminotransferase, glutamate aminotransferase, smoking, and drinking were set as independent variables, and occurrence of high-frequency hearing loss was set as a dependent variable, and GEE were constructed by using the statistical software of SPSS 20.0 to analyze the influencing factors of high-frequency hearing loss. Results Of the 806 workers, 698 were male (86.6%) and 108 were female (13.4%). The detection rates of high-frequency hearing loss in each year from 2018 to 2022 were 66.4% (535/806), 69.8% (563/806), 70.0% (564/806), 68.9% (555/806), and 68.2% (550/806), respectively. The detection rate of high-frequency hearing loss in the company was varied significantly by gender, lowered white blood cell counts, lowered red blood cell counts, lowered platelet counts, smoking, and drinking (P<0.05). The results of GEE analysis showed that after adjusting for selected confounding factors and excluding interaction effects, the risk of high-frequency hearing loss was higher in men than in women (P=0.001; OR=1.907, 95%CI: 1.286, 2.829); it was higher in workplace with disqualified noise intensity than in those without (P=0.043; OR=1.289, 95%CI: 1.009, 1.648); it was also higher in smokers than in non-smokers (P=0.004; OR=1.507, 95%CI: 1.137, 1.999). Conclusion Gender, noise intensity, and smoking are the main influencing factors of high-frequency hearing loss in noise-exposed workers in this automobile manufacturing company. Controlling smoking and reducing noise exposure intensity may reduce the occurrence of high-frequency hearing loss in workers.
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Objective:To investigate the clinical situation of 201 emergency adult sudden death patients, and analyze the influence of white blood cell count and arterial blood lactate level on prognosis.Methods:The clinical data of 201 patients diagnosed with sudden death in the emergency department of Medical College of Cangzhou people's Hospital from January 2017 to January 2021 were retrospectively analyzed. The gender, age, disease composition and etiology of the patients were statistically analyzed. The independent sample t-test was used to compare the measurement data with normal distribution, the χ 2 test or Fisher exact probability method was used to compare the counting data between groups, and the logistic regression model was used to screen the risk factors of emergency death, and the impact of white blood cell count and arterial blood lactate level on the prognosis was analyzed. Results:After active rescue, 11.44% (23/201) of the patients were successfully rescued, and 88.56% (178/201) of the patients were ineffective; ≥46-≤65 years old was the age group with high incidence of sudden death (55.22%(111/201)). The proportion of male (43.28% (87/201), 23.38% (42/201)) in the age group of ≥46-≤65 years old and the age group over 65 years old were higher than that of female (11.94% (24/201), 14.43% (29/201)), with a statistically significant difference (χ 2=4.801, 9.209; P=0.028, 0.002). In the past history of sudden death patients, the proportion of cardiovascular disease (53.23% (107/201)) was the highest; the proportion of patients may have inducements before sudden death was 74.13% (149/201), the proportion of patients have premonitory symptoms before sudden death was 67.66% (136/201), and sudden cardiac death was the first cause. Logistic regression analysis showed that white blood cell count ( OR=4.442,95% CI: 1.898-10.395), arterial blood lactic acid concentration ( OR=4.272,95% CI: 2.024-9.016), and albumin concentration ( OR=2.657,95% CI: 1.302-5.422) were independent risk factors affecting emergency sudden death patients ( P values were 0.001, <0.001, 0.007, respectively). Conclusions:There are some differences in gender, age and past history of adult sudden death patients. Most of them have premonitory symptoms and inducements. Sudden cardiac death is the primary cause. The increases of white blood cell count and lactic acid level, the decrease of albumin level are the risk factors of sudden death.
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【Objective】 To explore the recruitment and retention strategy of blood donors by investigating the age composition of blood donors in some areas of China, so as to promote blood donation and enhance clinical blood supply. 【Methods】 Through the working platform of Practice Comparison Working Group of China’s Mainland Blood Collection and Supply Institutions, the average age and age composition of blood donors from 22 blood centers were collected, and statistical analysis was conducted after eliminating invalid data. 【Results】 The median average age of blood donors during the survey year was 30.02.The median age in 2.89% of the blood centers was lower than 25. The average age of different genders was statistically significant only in 2018(P<0.05). Fot first-time blood donors, the median constituent ratio of donors <25 and ≥25 years old was 54.53% and 44.28%, with median retention rate at 10.30% and 9.61%, respectively. The median overall participation rate of blood donors was 2.7%, with median participation rate of blood donors <25 years old at 5.1%. 【Conclusion】 The recruitment and retention of blood donor is crucial to enhance clinical blood supply. Blood donors <25 years old, with a longer period for future donation, should be the main target of blood donation recruitment. Meanwhile, the revision of upper age limit for blood donation is another important initiative to grow the blood donor pool.
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Objective:To investigate the expression of MST1 in ovarian cancer (OV) , its relationship with the clinicopathological characteristics, and the potential molecular mechanism.Methods:62 OV patients admitted to Chongqing Emergency Medical Center and the Fifth People’s Hospital of Chongqing from Mar. 2016 to Feb. 2020 were selected. The expression levels of mRNA were detected by quantitative real-time polymerase chain reaction. [MST1 over-expression group: 24 h: (0.31±0.02) , 48 h: (0.44±0.03) , 72 h: (0.62±0.02) ; Blank group:24 h: (0.32±0.02) , (0.55±0.02) , (0.74±0.02) ;MST1 empty vector group:24 h: (0.32±0.03) , 48 h: (0.56±0.02) , 72 h: (0.77±0.02) ]Results:The expression of MST1 was lower in OV than in adjacent tissues[ (0.52±0.12) vs (1.18±0.21) ]. MST1 expression level was not related to age, but significantly correlated with the size of the tumors[ (0.46±0.12) vs (0.58±0.10) , P=0.00], TNM[ (0.57±0.10) vs (0.43±0.12) , P=0.00], TNM stage 9 (0.57±0.10) vs (0.43±0.12) , P=0.00] and lymph node metastasis[ (0.47±0.14) vs (0.56±0.09) , P=0.003]. Over-expression of MST1 obviously inhibited cellular proliferation in OV (MST1 over-expression group: 24 h: 0.31±0.02, 48 h: 0.44±0.03, 72 h: 0.62±0.02; blank group: 24 h: 0.32±0.02, 0.55±0.02, 0.74±0.02; empty vector group: 24 h: 0.32±0.03, 48 h: 0.56±0.02, 72 h: 0.77±0.02) . MST1 over-expression could promote FOXO3 expression, ,the expression level of FOXO3 in Mst1 overexpression group and control group were[ (0.61±0.04) vs (0.41±0.03) ]. MST1 inhibited proliferation of OV cells through upregulating the expression of FOXO3. Conclusions:The expression of MST1 is closely related to the clinicopathological features of OV patients, and MST1 may restrain OV by positively regulating FOXO3 expression.
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To evaluate right atrial ( RA ) structure and function of different left ventricular geometry in patients with obstructive sleep apnea syndrome ( OSAS ) by real‐time three‐dimensional echocardiography ( RT‐3DE) . Methods One hundred and ninety‐nine patients with habitual snoring were diagnosed as OSAS by polysomnography with apnea hypopnea index ≥ 5/h . Fifty gender ,age matching healthy people were selected as control group . Blood pressure and general clinical characteristics were collected and echocardiography was performed next morning . On the basis of left ventricular mass index , relative wall thickness ,left ventricular end‐diastolic diameter ,patients were divided into 6 groups :normal geometry ( NG) ,concentric remodeling ( CR) ,eccentric non dilated hypertrophy ( ND‐EH ) ,concentric non dilated hypertrophy ( ND‐CH ) ,eccentric dilated hypertrophy ( D‐EH ) ,and concentric dilated hypertrophy ( D‐CH) .Full volume images at apical four‐chamber view were collected . Right atrial volume‐time curve , RA maximum volume ( RAVmax ) , RA minimum volume ( RAVmin ) , RA pre‐contraction volume ( RAVpre‐a) were analyzed with QLab workstation . Following parameters including RA total emptying volume ( RA TotEV ) , RA total emptying fraction ( RA TotEF ) , RA passive emptying volume ( RA PassEV ) ,RA passive emptying fraction ( RA PassEF) ,RA active emptying volume ( RA ActEV ) ,RA active emptying fraction ( RA ActEF) were calculated . All structural parameters were corrected by BSA . Results①RA structural parameters :compared with control and NG groups ,RAVmax ,RAVmin ,RAVmin/BSA , RAVpre‐a and RAVpre‐a/BSA were increased in ND‐EH ,ND‐CH and D‐( CH+ EH) groups ( P ＜0 .05) . Compared with control ,NG and CR groups ,RAVpre‐a and RAVpre‐a/BSA were increased in ND‐EH ,ND‐CH and D‐( CH + EH ) groups , RAVmax , RAVmax/BSA , RAVmin , RAVmin/BSA , RAVpre‐a and RAVpre‐a/BSA were increased in ND‐CH and D‐( CH+EH ) groups( P ＜0 .05) . Compared with control , NG ,CR and ND‐EH groups ,RAVmax ,RAVmax/BSA ,RAVpre‐a and RAVpre‐a/BSA were increased in ND‐CH ,D‐( CH+EH) groups ,RAVmin and RAVmin/BSA were increased in D‐( CH+ EH ) group ( P ＜0 .05) . Compared with control ,NG ,CR ,ND‐EH and ND‐CH groups ,RAVpre‐a and RAVpre‐a/BSA were increased in D‐( CH + EH ) group ( P ＜ 0 .05 ) . ② RA reservoir function parameters :compared with control ,NG and CR groups ,RA TotEV was increased in ND‐CH and D‐( CH+ EH ) groups ( P ＜0 .05 ) . Compared with control ,NG ,CR and ND‐EH groups ,RA TotEV was increased in D‐( CH + EH ) group ( P＜0 .05) . ③ RA conduit function parameters :compared with control ,NG and CR groups ,RA PassEF was decreased in ND‐EH ,ND‐CH and D‐( CH + EH ) groups ,RA PassEV was decreased in ND‐CH and D‐( CH+EH) groups( P ＜0 .05) . Compared with control ,NG ,CR and ND‐EH groups ,RA PassEV was decreased in D‐( CH+EH) group ,RA PassEF was decreased in ND‐CH and D‐( CH+ EH ) groups ( P ＜0 .05) . ④ RA pump function parameters :compared with control ,NG and CR groups ,RA ActEF were increased in ND‐CH and D‐( CH+EH) groups ( P ＜0 .05 ) ; Compared with control ,NG ,CR and ND‐EH groups ,RA ActEV was increased in ND‐CH and D‐( CH+EH) groups ( P ＜0 .05) . Conclusions Different left ventricular geometric patterns have different RA structure and function in OSAS ,patients with ND‐CH and D‐( CH + EH ) have worse RA structure and function . T he results of this study suggested that the clinical need to pay attention to the RA structure and function of OSAS patients with dilated LV H .
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Objective To retrospectively analyze the differential diagnosis and treatment strategy of neonatal intestinal perforation caused by neonatal necrotizing enterocolitis (NEC) and Hirschsprung's disease (HD).Methods The clinical data of 42 cases with NEC and 22 cases with HD combined with intestinal perforation from January 2012 to January 2017 admitted at Fujian Provincial Maternity and Children's Hospital were collected,the proportion of premature infants,and the proportion of low birth weight infants,age of onset,preoperative clinical symptoms and surgical treatment was compared between the two groups.Results The proportion of premature infants[95.23％ (40/ 42 cases) vs.27.27％ (6/22 cases)],the proportion of low birth weight infant [90.48％ (38/42 cases) vs.45.45％ (10/22 cases)] and the age of onset [(14.48 ± 10.51) d vs.(3.18 ± 3.43) d] were statistically different between the NEC group and the HD group,and the differences were statistically significant(all P ＜ 0.05).There were significant differences in the presence of normal defecation before the operation [71.4％ (30/42 cases) vs.27.3％ (6/22 cases)],and in the the defecation characteristics at the onset[95.2％ (40/42 cases)vs.9.1％ (2/22 cases)] between the NEC group and HD group(all P ＜ 0.05).Among 42 cases of NEC patients,8 cases underwent intestinal anastomosis,and 34 cases underwent enterostomy because of the high risk of anastomosis.All of 22 patients with HD underwent double-lumen enterostomy.Conclusions The general conditions,preoperative manifestations and intraoperative findings of the children should be comprehensively analyzed for identification.Enterostomy is recommended for NEC intestinal perforation,but if the risk of anastomosis is high,then fistula should be performed.Double-lumen fistula should be recommended for HD intestinal perforation,and enterostomy should be recommended if the two cannot be clearly distinguished.
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Objective@#To explore the incidence regularity and characteristics of pneumoconiosis among migrant workers in Shiyan city, and to provide a basis for making policies about pneumoconiosis prevention and treatment among migrant workers.@*Methods@#In September 2018, 338 cases of pneumoconiosis among migrant workers and 354 cases of pneumoconiosis among non-migrant workers were collected between 2013 and 2017. The proportions of pneumoconiosis types, the age and seniority of onset workers, the severity grade of pneumoconiosis, the type of pneumoconiosis, the type of work and regional distribution, etc. were analyzed.@*Results@#The age at onset of pneumoconiosisand the length of service of migrant workers and non-migrant workers in Shiyan city were significantly different (t=2.237, 3.208, P<0.05) . The proportion of pneumoconiosis stage was significantly different from that of non-migrant workers (χ2=47.897, P<0.05) , among migrant workers, the types of pneumoconiosis were mainly silicosis (308 cases, 91.1%) , coal worker's pneumoconiosis (29 cases, 8.6%) . The leading work types are rock drilling (115 cases, 34.0%) and blasting (105 cases, 31.1%) . The industry was mainly engaged in non-ferrous metal mining (205 cases, 60.7%) and coal (105 cases, 31.1%) . The area distribution involved each counties of Shiyan city, with Zhushan county (175 cases, 51.8%) and Yunxi county (125 cases, 37.0%) as the top two districts in number of cases. Of the cases of migrant workers, 89 cases (26.3%) had blood relationship with any others. There was no work-related injury insurance for migrant workers with pneumoconiosis.@*Conclusion@#There is a high incidence of pneumoconiosis among migrant workers in Shiyan city, featured with the phenomenon of "late occurrence" and "family clustering", so it is urgent to strengthen the prevention and treatment of pneumoconiosis of migrant workers.
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Objective@#To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu.@*Methods@#One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People′s Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method.@*Results@#The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction.@*Conclusion@#AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.
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Objective@#To retrospectively analyze the differential diagnosis and treatment strategy of neonatal intestinal perforation caused by neonatal necrotizing enterocolitis (NEC) and Hirschsprung′s disease (HD).@*Methods@#The clinical data of 42 cases with NEC and 22 cases with HD combined with intestinal perforation from Ja-nuary 2012 to January 2017 admitted at Fujian Provincial Maternity and Children′s Hospital were collected, the proportion of premature infants, and the proportion of low birth weight infants, age of onset, preoperative clinical symptoms and surgical treatment was compared between the two groups.@*Results@#The proportion of premature infants[95.23%(40/42 cases) vs.27.27%(6/22 cases)], the proportion of low birth weight infant[90.48%(38/42 cases) vs.45.45%(10/22 cases)]and the age of onset [(14.48± 10.51) d vs.(3.18±3.43) d]were statistically different between the NEC group and the HD group, and the differences were statistically significant(all P<0.05). There were significant differences in the presence of normal defecation before the operation[71.4% (30/42 cases)vs.27.3%(6/22 cases)], and in the the defecation characteristics at the onset[95.2% (40/42 cases)vs.9.1%(2/22 cases)]between the NEC group and HD group(all P<0.05). Among 42 cases of NEC patients, 8 cases underwent intestinal anastomosis, and 34 cases underwent enterostomy because of the high risk of anastomosis.All of 22 patients with HD underwent double-lumen enterostomy.@*Conclusions@#The general conditions, preoperative manifestations and intraoperative fin-dings of the children should be comprehensively analyzed for identification.Enterostomy is recommended for NEC intestinal perforation, but if the risk of anastomosis is high, then fistula should be performed.Double-lumen fistula should be recommended for HD intestinal perforation, and enterostomy should be recommended if the two cannot be clearly distinguished.
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Objective To explore the relationship between different airway pressure and expression of related cytokines to airway remodeling.Methods Fourty-two chronic obstructive pulmonary disease cases (COPD group) and thirty-three control cases were collected.The above cases underwent mechanical ventilation in the period of general anesthesia.According to different levels of peak inspiratory pressure(PIP), above two groups, randomly and respectively, were divided into high PIP (HPIP, 24 cmH2O) group, moderate PIP (MPIP, 22 cmH2O) group, low PIP (LPIP, 20 cmH2O) group.All positive end expiratory pressure (PEEP) was set to 5 cmH2O.Then the collection of BALF was performed before and 3 hours after applying ventilator.The related factors to airway remodeling, such as fibroblast growth factor 2 (FGF-2), transforming growth factor β1 (TGF-β1) and matrix metalloproteinase-9 (MMP-9), were measured by enzyme-linked immunosorbent assay (ELISA) and Western blot.Results 1)Beforemechanical ventilation, the levels of FGF-2, TGF-β1 and MMP-9 in COPD group were higher than control group (P<0.01).2)3 hours after mechanical ventilation, we saw significant upregulated expression of FGF-2, TGF-β1, MMP-9 in HPIP subgroup in control group (P<0.05) and the 3 factors levels of COPD group were all increased (P<0.05).Moreover, HPIP subgroup was significantly higher than MPIP and LPIP subgroup in COPD group (P<0.05).3)The expression of FGF-2, TGF-β1, MMP-9 in BALF had a positive correlation with the airway pressure levels in COPD group(P<0.01).Conclusions Under mechanical ventilation, sustained high airway pressure may enhance the expression of FGF-2, TGF-β1 and MMP-9 which may result in airway remodeling by mechanosensitive cation channel in bronchial epithelial cells, especially in COPD patients.
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OBJECTIVE:To observe the efficacy and safety of carboprost and Foley catheter for the expand cervix before hys-teroscopic electric resection. METHODS:80 patients with hysteroscopic operation were randomly divided into research group and control group. Research group was placed inside the vagina carboprost 1 mg 30 minutes before operation;control group was placed inside the Foley catheter 12 hour before operation. The relaxation degree of the cervix,average operative time,preoperative pain, postoperative morbidity and incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differ-ences in the relaxation degree of the cervix,postoperative morbidity and incidence of adverse reactions between 2 groups(P>0.05). The average operative time and preoperative pain in research group were significantly better than control group,the differ-ence was statistically significant(P<0.05). CONCLUSIONS:Carboprost and Foley catheter have good efficacy and safety for ex-pand cervix before hysteroscopic electric resection,however,carboprost is better than Foley catheter in terms of average operative time and preoperative pain.
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OBJECTIVE@#To investigate the characteristics of psychiatric comorbidity in pharyngitis patients.@*METHOD@#The psychological investigation and evaluation were done in 100 pharyngitis patients by using self-reporting inventory 90 (SCL-90). All the results were compared with healthy Chinese population, including factors of gender, age, course of disease and education level, using rank-sum test analysis, SPSS 19.0.@*RESULT@#Mild and moderate levels of psychosis were respectively noted in 65% and 14%, with high score of somatization (P < 0.05), obsession (P < 0.05), interpersonal sensitivity (P < 0.05), anxiety (P < 0.05) and other (sleep, diet, P < 0.05) compared with control group. The factor scores of obsession (P < 0.05), anxiety (P < 0.05) in male group were higher than female group. The factor scores of somatization (P < 0.05) and obsession (P < 0.05) in junior group were higher than senior group. The factor scores of somatization (P < 0.05), interpersonal sensitivity (P < 0.05) and anxiety (P < 0.05) in long course group were higher than short course group. The factor score of interpersonal sensitivity (P < 0.05) in low educated group was higher than highly educated group.@*CONCLUSION@#Psychiatric disorders are prevalent in pharyngitis patients, especially upon the factors of somatization, obsession, interpersonal sensitivity, anxiety and other (sleep, diet). Male, junior, long course patients and low educated are in high risk group.
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Feminino , Humanos , Masculino , Ansiedade , Povo Asiático , Análise Fatorial , Transtornos Mentais , Inventário de Personalidade , Faringite , Psicologia , PrevalênciaRESUMO
Objective To analyze the clinical distribution and drug resistance of clinically isolated strains of Acinetobacter Bau-mannii(ABA)in our hospital from January 2007 to December 2012 so as to provide the basis for the rational use of antibacterial drugs in clinic.Methods The API microbiological culture and identification system was adopted to conduct the ABA culture,identi-fication and drug susceptibility analysis on the clinical specimens submitted by various clinical department and the drug resistance of the strains was analyzed by using WHONET5.6 software.Results 791 strains of ABA were isolated in the recent 6 years,and the isolating rate of ABA in the pathogenic bacteria was 7.8%;The ABA detection was dominated by the sputum (80.4%)and the throat swab(10.9%)specimens;the distribution of isolated ABA strains were relatively widespread;the infection rates of the pa-tients were higher in ICU (18.8%),cadre wards(17.6%),respiratory medicine department(13.3%)and neurosurgery department (12.3%).During these 6 years,the drug resistance rate of less than 50% included imipenem(IPM)and cefoperazone sodium/sul-bactam,and the resistance rate in most of commonly used antibacterial drugs showed an increasing trend,especially IPM.Conclusion The drug resistance of ABA is more serious and the resistance rate of clinically isolated strains to most of antibacterial drugs in our hospital during 2007- 2012 showed an increasing trend.Dynamically monitoring the ABA distribution and the drug resistance changes conduces to guide the rational use of antibacterial drugs in clinic,prevent the nosocomial infection and reduce the generation of pan-drug resistant strains.
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Objective To establish a standardized management system and process for teaching ward rounds of clinical practice,so as to improve the quality of clinical practice. Methods (1) We established the system and process for teaching ward rounds. (2) The students of 2008 grade were divided into two groups. The new system and process for teaching ward rounds was used in 71 students in the experimental group,and the primary teaching ward rounds system was used in 72 students in control group. (3) A survey concerned about students' abilities of grasping theoretical knowledge, clinical thinking, self-study, clinical operation and doctor-patient communication were investigated in both students and their tutors. Result The result showed that the abilities of grasping theoretical knowledge,clinical thinking,self-study,clinical operation and doctor-patient communication in the experimental group were enhanced much more than the control group ( <0.01) . Conclusion The standardized management system and process for teaching ward rounds of clinical practice can improve the students, comprehensive abilities and the quality of clinical practice.
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Objective To determine the nursing measures of patients with primary open angle glaucoma undergoing implantation of EX-PRESS device.Methods 12 glaucomatous patients with EX-PRESS miniature glaucoma device received appropriate hygienic-education preoperatively,intensive nursing services during and after surgery,as well as health instructions in the follow-up period.Results 12 patients finally recovered from the surgery.The main post-operative complications were low tension and shallow anterior chamber(2 eyes),obstruction of the device by iris (1 eye).The intraocular pressures of all these patients remained normal levels before discharge and the visual acuity were the same as those pre-operation.Conclusions The effective nursing services for patients with EX-PRESS implantation is beneficial to the rehabilitation by increasing the adherence to the follow-up schedule,contributing to better understanding the common sense of the disease and the choice of the surgery.
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Objective To investigate the current situation and influencing factors of self-transcendence among the elderly people and provide the theoretical basis to improve the elderly people's self-transcendence level.Methods Totally 300 elderly people were recruited by convenience sampling from two communities in Taiyuan.They were investigated by questionnaires.Results The total score of self-transcendence was (43.83±7.29).Single factor analysis of variance and nonparametric test showed that the influencing factors of elderly people's self-transcendence level were education background,occupation before retirement,economic status,characteristics,the frequency of group activity,and the experience of significant events.Multiple linear stepwise regression analysis showed that the education background and personality characteristics were the main influencing factors on the elderly people's self-transcendence.Conclusions Elderly people's family members,health care workers,and other social workers should pay high attention to the elderly people's self-transcendence level,take measures to increase their self-transcendence level and stimulate the elderly people's enthusiasm of self-management according to the influencing factors,so as to improve the elderly people's life quality,extend the healthy life expectancy,and finally achieve the whole healthy aging.
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Bone marrow mesenchymal stem cells (BMSCs) have been shown to be multipotent cells that possess high self-replicating capacity. The purpose of our study was to investigate the feasibility of using enteric neuron-like cells obtained by in vitro induction and differentiated from rat BMSCs for the treatment of Hirschsprung's disease (HD). Glial cell-derived neurotrophic factor (GDNF) and neurotrophin-3 (NT-3) are neurotrophic factors that play important roles in neuronal development, differentiation, survival and function. Meanwhile, GDNF mutations are a major cause of HD. In this study, BMSCs were transfected with eukaryotic expression plasmids co-expressing GDNF and NT-3, and the transfected cells displayed neuron-like changes after differentiation induced by fetal gut culture medium (FGCM). Immunofluorescence assay showed positive expression of the neuronal marker NSE and the enteric neuronal markers PGP9.5, VIP and nNOS. Reverse transcription-polymerase chain reaction (RT-PCR) revealed the expression of GDNF and NT-3 in transfected BMSCs. The present study indicates that genetically modified BMSCs co-expressing GDNF and NT-3 are able to differentiate into enteric neuronal cells and express enteric nerve markers when induced by FGCM. This study provides an experimental basis for gene therapy to treat enteric nervous system-related disorders, such as HD.
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ObjectiveTo evaluate the efficacy and safety of the angiotensin Ⅱ receptor blockers (ARB) in reducing portal hypertension ( PHT) in patients with cirrhosis.Methods PubMed,EMBASE,Web of Science,The Cochrane Central Register of Controlled Trials,Chinese BiomedicalDatabase,ChineseJournals Full-text Database and WanFang Digital Journal Full-text database were searched.Statistical analysis was performed by meta-analysis using RevMan4.2 software.ResultsAmong 8 randomized controlled trials ( RCT) including 282 patients met the inclusion criteria,4 trials were analyzed to compare the ARB with the placebo or no treatment and the other 4 trials were analyzed to compare the ARB with propranolol.Meta-analysis results were as follows.(1) The ARB resulted in more significant hepatic venous pressure gradient ( HVPG) reduction as compared with the placebo or no treatment [ WMD =1.87 mm Hg (1 mm Hg =0.133 kPa),95％CI ( 0.86-2.87 )mmHg,P =0.00003 ].Andthe ARB were similar to propranolol in reducing HVPG [ WMD =0.92 mm Hg,95％ CI ( - 0.41-2.26)mm Hg,P =0.17 ].(2)The ARB led to more significant reduction in mean arterial pressure than the placebo or no treatment [ WMD =8.89 mm Hg,95％ CI( 7.16-10.62)mm Hg,P ＜ 0.00001 ],but they were similar to propranolol had no significant difference.And the ARB had no significant effect on the heart rate of the patients,which was similar to no treatment group ( P ＞ 0.05 ).Whereas,propranolol could greatly decrease heart rate of the patients ( WMD =- 21.25,95％ CI - 25.83-16.68,P ＜ 0.000 01 ).( 3 ) No significant differences were found in serum bilirubin and creatinine levels between the ARB and the placebo or no treatment groups ( P ＞0.05).The rate of nonspecific adverse events was higher in the ARB groups than in the placebo or no treatment groups ( P =0.03 ),but it showed there was no difference between the ARB and propranolol groups (P =0.72).ConclusionThe ARB is effective in reducing portal hypertension in patients with cirrhosis,which is similar to propranolol.Their effects on mean arterial pressure is similar to propranolol without significant effects on hear rate,liver functionand kidney function,and with less nonspecific adverse events.The ARB could become a new choice for the treatment of portal hypertension.
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Robot assisted surgery is becoming a widely popular technology and is now entering the total knee replacement. The development of total knee replacement and the operation system structure are introduced in this paper. The vision position technology and the related calibration technology, which are very important, are also analyzed. The experiments of error analysis in our WATO system demonstrate that the position and related calibration technologies have a high precision and can satisfy surgical requirement.
Assuntos
Humanos , Artroplastia do Joelho , Métodos , Reconhecimento Automatizado de Padrão , Métodos , Robótica , Cirurgia Assistida por Computador , MétodosRESUMO
Driver fatigue/drowsiness is one of the important causes of serious traffic accidents and results in so many people deaths or injuries, but also substantial directly and indirectly economic expenses. Therefore, many countries make great effort on how to detect drowsiness during driving. In this paper, we introduce the recent developments of driver fatigue/drowsiness detection technology of world wide and try to classify the existing methods into several kinds according to different features measured, and analyzed. Finally, the challenges faced to fatigue/drowsiness detection technology and the development trend are presented.