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During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.
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Objective:To investigate the clinical efficacy and adverse reactions of 192Ir 3-dimensional intraluminal post-loading radiotherapy in treatment of locally middle and advanced cervical cancer. Methods:The clinical data of 100 middle and advanced cervical cancer patients in Shanxi Province Cancer Hospital from February 2018 to January 2021 were retrospectively analyzed, including 50 patients undergoing 192Ir 3-dimensional intraluminal post-loading radiotherapy (the 3D group) and 50 patients undergoing 192Ir 2-dimensional intraluminal post-loading radiotherapy (the 2D group). The therapeutic efficacy and adverse reactions of both groups were compared. Results:The objective response rate of the 3D group was higher than that of the 2D group, and the difference was statistically significant [98% (49/50) vs. 84% (42/50), χ2 = 4.40, P = 0.036]. The overall incidence of acute radioactive cystitis in the 3D group was lower than that in the 2D group, and the difference was statistically significant [60% (30/50) vs. 88% (44/50), χ2 = 10.19, P = 0.003]. The incidence of grade 1 acute radiation cystitis in the 3D group was lower than that in the 2D group, and the difference was statistically significant [26% (13/50) vs. 48% (24/50), χ2 = 5.19, P = 0.038]. The overall incidence of acute radiation enteritis in the 3D group was lower than that in the 2D group, and the difference was statistically significant [68% (34/50) vs. 92% (46/50), χ2 = 9.00, P = 0.005]; the incidence of grade 2 and 3 acute radiation enteritis in the 3D group was lower than that in the 2D group, and the differences were statistically significant [28% (14/50) vs. 50% (25/50); 4% (2/50) vs. 20% (10/50), χ2 = 5.09, P = 0.040; χ2 = 6.06, P = 0.028]. The overall incidence of chronic radiation enteritis in the 3D group was lower than that in the 2D group, and the difference was statistically significant [28% (14/50) vs. 54% (27/50), χ2 = 6.99, P = 0.014]. Conclusions:Compared with 2-dimensional intraluminal post-loading radiotherapy, 3-dimensional intraluminal post-loading radiotherapy improves the efficacy of patients with intermediate and advanced cervical cancer, reduces the occurrence of acute and chronic radiation enteritis and radiation cystitis, reduces the adverse reactions of patients.
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Objective:To investigate the correlation between obstructive sleep apnea (OSA) and triglyceride-glucose (TyG) indexin patients with ischemic stroke.Methods:Patients with ischemic stroke underwent sleep breathing monitoring in Nanjing Stroke Registry Program from August 2020 to August 2021 were retrospectively enrolled. According to apnea-hypopnea index (AHI), the patients were divided into no/mild OSA group (AHI≤15 events/h) and moderate to severe OSA group (AHI>15 events/h). The TyG index was calculated according to triglycerides and fasting blood glucose, and the patients were grouped by quartile. The relationship between moderate to severe OSA and TyG index was determined by ordinal multinomial logistic regression analysis. Pearson correlation analysis was used to evaluate the correlation between TyG index and AHI. Results:A total of 155 patients with ischemic stroke were enrolled in the study, including 66 patients in the no/mild OSA group, 89 in the moderate to severe OSA group; 39 in the Q1 group (TyG index ≤8.46), 39 in the Q2 group (TyG index 8.47-8.78), 39 in the Q3 group (TyG index 8.79-9.17), and 38 in the Q4 group (TyG index >9.17). Ordinal multinomial logistic regression analysis showed that after adjusting for potential confounding factors, higher fasting blood glucose (odds ratio 2.370, 95% confidence interval 1.745-3.222; P<0.001) and moderate to severe OSA (odds ratio 2.377, 95% confidence interval 1.217-4.646; P=0.011) had significant independent positive correlation with TyG index. Pearson correlation analysis showed that AHI was positively correlated with the TyG index in patients with ischemic stroke ( r=0.209, P=0.011). Conclusion:OSA is independently correlated with TyG index in patients with ischemic stroke.
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Objective@#To understand the malnutrition status and trends among children and adolescents, and to provide evidence for improving the nutritional status of children and adolescents in 9 provinces of China.@*Methods@#A total of 5 746 children and adolescents aged 7-17 years old from the "China Health and Nutrition Survey" in 2000, 2006, 2011, 2015 and 2018 were selected as the subjects. Variance analysis and Chi square test were used to analyze the BMI of children and adolescents with different characteristics and different types of malnutrition. Linear regression model was used to analyze the trends of BMI, stunting and wasting, and overweight and obesity in children and adolescents with different characteristics.@*Results@#From 2000 to 2018, the BMI of children and adolescents aged 7-17 increased from 17.66 kg/m 2 to 19.08 kg/m 2 ( F =22.88, P <0.05). The prevalence of overweight and obesity increased in both males and females( t =16.65,11.01, P <0.05). Comparison of the rates of wasting and Growth Retardation and overweight and obesity among children and adolescents aged 7-17 years in nine provinces in 2000, 2006,2 011, 2015 and 2018, the difference was statistically significant ( χ 2 wasting and grouth retardation =85.46, 29.55, 41.09, 29.86, 45.29; χ 2 overweight and obesity = 109.12 , 52.21, 98.23, 68.27, 52.49, P <0.05).@*Conclusion@#The prevalence of stunting and wasting of children and adolescents aged 7-17 in 9 provinces of China decreased. The prevalence of overweight and obesity showed an upward trend in 9 provinces of China. There were regional differences among the prevalence of stunting and wasting, as well as overweight and obesity. Active intervention strategies and measures should be taken to improve malnutrition and focus on the prevention of obesity in children and adolescents in China.
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Objective To evaluate the scientific research efficiency of tertiary hospitals and analyze the influencing factors, providing reference for the decision-making of scientific research managers in China. Methods Evaluation indicators were collected from 100 tertiary hospitals in China, and their research efficiency was evaluated using Bootstrap data envelopment analysis (DEA) method. The influencing factors were analyzed using ordinary least square ( OLS) regression model. Results The averaged scientific research efficiency of these hospitals using Bootstrap DEA method was 0. 5224, lower than that using conventional DEA method (0. 0676), yet with a great variation (from 0. 1103 to 0. 8790) among them. Linear regression analysis showed that factors such as R&D input and output, and hospital types has statistical significance on the saentific research efficiency (P < 0. 05). Conclusions These hospitals are inefficient in scientific research with sizable room for improvement. Conventional DEA method should be used with caution, as deviations should be corrected with Bootstrap DEA method. The research development level and hospital types of their province can influence the research efficiency the hospitals significantly.
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Distant metastasis is one of the main obstacles to cancer treatment.Overexpression of S1PR1 in malignant tumors enhances cell invasion and migration activity,mediates EMT and induces lymphangiogenesis and angiogenesis via activation of its downstream signaling pathways,eventually results in the occurrence of tumor metastasis.S1PR1 is also closely related to generation of acquired radiotherapy resistance.This article discusses the roles of S1PR1 in tumor metastasis and radiotherapy resistance.
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Objective To compare the functional outcomes between emergency operation and delayed selective operation for extra-articular fractures of distal radius complicated with dorsal displacement and comminuted metaphysis in elderly females.Methods Included for this study were 60 elderly female patients who had been treated at Department of Orthopedic Trauma,The Second People's Hospital of Shenzhen from March 2016 to March 2017 for extra-articular fractures of the dorsally displaced distal radius with a volar locking plate.They were all female,aged from 65 to 80 years (average,73.8 years).Of them,30 received surgical operation on the day or the next day after injury (emergency group) and the other 30 did 5 to 15 days after surgery (mean,8 days) (selective group).Follow-ups were conducted at 4,12 and 48 weeks after surgery to assess the ranges of motion (ROMs) of the wrist and forearm,grip strength (GS),the Disability of Arm,Shoulder and Hand (DASH) scores and complications.Results The 2 groups were comparable because there were no significant differences between them in their preoperative general data (P ＞ 0.05).A 4 weeks after operation,the ROMs,GS and DASH scores were all significantly improved in both groups,but the ROM of dorsal extension (49.6° ± 4.1°),ROM of volar flexion (58.6°± 3.5°),ROM of supination (78.1° ± 7.5°),ROM of pronation (81.4°± 7.0°),GS (58.5％ ± 11.2％) and DASH scores (17.3 ± 7.9) in the emergency group were all significantly better than those in the selective group (37.0° ± 6.3°,45.1 ° ± 3.6°,70.7 ° ± 9.6°,67.1 ° ± 10.3°,37.3％ ±9.1％ and 32.5 ± 9.6,respectively) (all P ＜ 0.05).At 12 weeks after operation,the ROM of dorsal extension (64.8° ± 7.9°),ROM of volar flexion (70.5°± 9.7°),GS (80.4％ ± 9.9％) and DASH scores (7.7 ± 4.9) in the emergency group were significantly better than those in the selective group (41.2°± 7.0°,61.6°±10.9°,66.9％ ±18.2％ and 14.2±7.3,respectively) (P ＜0.05),but there were no significant differences between the 2 groups in ROM of supnition or pronation (P ＞ 0.05).At 48 weeks after operation,there were no significant differences between the 2 groups in ROMs,GS or DASH scores (P ＞ 0.05).Postoperatively,superficial infection happened in one case and the extensor pollicis longus muscle tendon was ruptured in another in the emergency group.Conclusion In the elderly women with dorsally displaced extra-articular fracture of the distal radius,emergency surgery with a volar locking plate may lead to better functional recovery within 12 weeks post-surgery than the elective or delayed surgery.
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OBJECTIVE: The most existing research has predominantly focused on city rather than township hospitals. This study aimed to explore depressive symptoms and its associated factors among general practitioners and nurses in Chinese township hospitals.METHODS: This cross-sectional study was carried out in Liaoning, China in 2016. 2,000 general practitioners and nurses in Chinese township hospitals were recruited and 1,736 of them became final subjects (effective response rate: 86.8%). Data on depressive symptoms, workplace violence (WPV), psychological capital (PsyCap), and demographic factors were collected through questionnaires. Hierarchical multiple regression was used to explore the factors related to depressive symptoms. Asymptotic and resampling strategies were applied to examine the potential mediating effect of PsyCap.RESULTS: The prevalence of depressive symptoms among the participants was 49.9%. Workplace violence was positively associated with depressive symptoms, whereas psychological capital and its components of hope, optimism and resilience were negatively associated with depressive symptoms. Psychological capital and its components of hope, optimism and resilience all played partial mediating roles between workplace violence and depressive symptoms.CONCLUSION: Nearly half of general practitioners and nurses surveyed suffered from depressive symptoms. Reduction of workplace violence and development of psychological capital can be targeted for interventions to combat depressive symptoms.
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Humanos , Povo Asiático , China , Estudos Transversais , Demografia , Depressão , Clínicos Gerais , Esperança , Negociação , Otimismo , Prevalência , Violência no TrabalhoRESUMO
Objective To analyze the influencing factors on condom use among 35-yearsor-older female sex workers (OFSWs) in Qingdao by using the three-level logistic model.Methods From March to June 2014,OFSWs were recruited in Qingdao,using respondent-driven sampling.Related information on OFSWs and their recent five sexual partners (not including husband) were obtained by conducting a questionnaire survey on OFSWs.A Three-level logistic regression model was conducted to analyze the influencing factors of condom use between OFSWs and their sexual partners.Results A total of 420 OFSWs participated the survey as well as information on 2 100 sexual partners.Results from the empty model showed that the use of condoms among OFSWs having an aggregation that related to the levels of working sites and their own behaviors.Results from the three-levels of logistic model analysis showed that,OFSWs that having had junior middle school education (OR=1.450,95％CI:1.054-1.994)/high school education or above (OR=2.264,95％ CI:1.215-4.222),knowing the function of condom use (OR=2.004,95％ CI:1.273-3.154) would have higher rates of condom use.OFSWs with higher score of attitude on condom use (OR=0.796,95％CI:0.745-0.849),having had syphilis infections in the past (OR=0.657,95％ CI:0.478-0.902) would have lower rate of condom use.For the sexual partners,the rate of condom use among OFSWs' regular partners were higher than that of OFSWs' boyfriends (OR=15.291,95％CI:8.441-27.700;OR=29.032,95％ CI:15.413-54.682).Conclusion Condom use of OFSWs was affected by behaviors of both OFSWs themselves and their sexual partners.Prevention and control programs should focus on OFSWs and their sexual partners at the same time.The key intervention contents should include target populations as:OFSWs with low level of education,having had infections of syphilis,those who do not use condoms with their trusted partners.
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Objective To analyze the influencing factors on condom use among 35-yearsor-older female sex workers (OFSWs) in Qingdao by using the three-level logistic model.Methods From March to June 2014,OFSWs were recruited in Qingdao,using respondent-driven sampling.Related information on OFSWs and their recent five sexual partners (not including husband) were obtained by conducting a questionnaire survey on OFSWs.A Three-level logistic regression model was conducted to analyze the influencing factors of condom use between OFSWs and their sexual partners.Results A total of 420 OFSWs participated the survey as well as information on 2 100 sexual partners.Results from the empty model showed that the use of condoms among OFSWs having an aggregation that related to the levels of working sites and their own behaviors.Results from the three-levels of logistic model analysis showed that,OFSWs that having had junior middle school education (OR=1.450,95％CI:1.054-1.994)/high school education or above (OR=2.264,95％ CI:1.215-4.222),knowing the function of condom use (OR=2.004,95％ CI:1.273-3.154) would have higher rates of condom use.OFSWs with higher score of attitude on condom use (OR=0.796,95％CI:0.745-0.849),having had syphilis infections in the past (OR=0.657,95％ CI:0.478-0.902) would have lower rate of condom use.For the sexual partners,the rate of condom use among OFSWs' regular partners were higher than that of OFSWs' boyfriends (OR=15.291,95％CI:8.441-27.700;OR=29.032,95％ CI:15.413-54.682).Conclusion Condom use of OFSWs was affected by behaviors of both OFSWs themselves and their sexual partners.Prevention and control programs should focus on OFSWs and their sexual partners at the same time.The key intervention contents should include target populations as:OFSWs with low level of education,having had infections of syphilis,those who do not use condoms with their trusted partners.
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Fetal atrioventricular block (AVB) is a type of fetal bradyarrhythmias. The reported incidence of fetal complete atrioventricular block (CAVB) and mortality of perinatal fetuses and neonates are signiifcantly higher in pregnancies of anti-SSA/Ro-positive mothers than that of anti-SSA/Ro-negative mothers. The auto-antibodies in maternal serum that can be transported into fetal circulation through placenta may damage fetal cardiac conductive system and eventually result in fetal AVB. There are evidences that early diagnosis and proper treatment can improve the prognosis and survival rate of affected fetuses. In this article, the pathogenesis, risk factors, prenatal diagnosis, treatment and prognosis of fetal immune mediated AVB is reviewed.
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Since the modern times, traditional Chinese medicine (TCM) has been more widely spread in the western world. However, it becomes more difficult to be accepted or even be demonized. The perspective of oreintalism can help to accurately analyze the origin of TCM acceptance in the western countries. This acceptance follows the cognitive model of orientalism. The change of orentalism discourse system directly affects the TCM communication to the West in the modern times. To conclude this period of history will provide some useful inspiration to the further TCM communication to the West.
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With the development of fetal medical imaging and minimal invasive interventional therapy,fetal cardiac intervention has taken into clinical practice in few medical centers.Fetal cardiac therapy may alter the abnormal hemodynamics of fetal circulation,which can lead to recruit hypoplastic ventricle,to create a two-ventricle circulation after birth,to remodel the fetal pulmonary vascular bed whose outlet is obstructed,and to provide a better prognosis for the suffered children.However,according to the limitations and risks of this cutting edge technique,as well as the dilemmas to balance the interests among fetus,mother/parents and doctor/medical institution,ethical challenges never fade away ever since the first beginning in this rising field.Following the encouraging research results published,the risk of the technique has been partly taken control.So in current status,how to balance the interests among three participants and to establish optimal routine clinical practice are the most challenging problems.
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Objective To study the subject domain knowledge of clinical education of pediatrics in our country with multivariate statistical analysis and social network study,research on the domain subject distribution and knowledge cluster,and then built visualized knowledge-mapping,so as to predict and guide the developmental trend in this field.Methods We searched the CNKI with MESH keywords (pediatrics OR children OR infants) AND clinical education OR bedside education OR interview of clinics in March,2013.679 articles were enrolled in and then imported into Bicomb.After core keywords had been identified by Bicomb,a word text matrix and co-occmrence matrix of words to articles were built.Systemic clustering of the co-occmrence matrix was finished by SPSS 20.0,leading the strategic plot to be built.Then draw visualized network in Ucinet 6.0.Results Totally 679 articles about pediatrics education were included.The number of core keywords was 66,and the lowest frequency of core keywords was 5.With multivariate statistical analysis and social network study,the visualized domain knowledge-mapping was successfully built,and it directly reflected the structure of subject knowledge-mapping of pediatric clinical education in our country,and then key clusters were formed,in which the clusters of participation model of clinical education and applications of clinical education had been well developed,and had been the dominant subject in pediatric clinical education.Whereas the unbalanced developed cluster of Exploration in refommtion of clinical education was now in rapid development with the introduction of new technology and innovative teaching model.At the same time,the nursing clinical education cluster has been separate cluster,but needed further and enhanced research.Conclusion The well developed subjects of participation model of clinical education applications of clinical education stood in the center of the subject do main knowledge-mapping,and with several clusters following.And the study of refomation of clinical education makes a great contribution to the progress of the subject.The nursing teaching needed balanced development.
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<p><b>OBJECTIVE</b>To investigate the expressions of midkine (MK) and Ki67 in gastric carcinoma (GC) and their relation with the clinicopathologic characteristics.</p><p><b>METHODS</b>The expressions of MK and Ki67 in 71 GC and 20 adjacent normal tissues were evaluated by immunohistochemistry.</p><p><b>RESULTS</b>The expressions of MK and Ki67 were significantly higher in GC than in adjacent normal tissues (76.1% vs 0, and 73.2% vs 5%, respectively, P<0.05). MK and Ki67 expressions were correlated with the infiltration depth, lymph node metastasis and TNM stage (P<0.05), and a significant correlation was found between MK and Ki67 expressions (P<0.05).</p><p><b>CONCLUSION</b>GC tissues have high expressions of MK and Ki67, indicating that MK and Ki67 play important roles in promoting the tumorigenesis and progression of GC.</p>
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Humanos , Citocinas , Metabolismo , Progressão da Doença , Imuno-Histoquímica , Antígeno Ki-67 , Metabolismo , Metástase Linfática , Fatores de Crescimento Neural , Neoplasias Gástricas , MetabolismoRESUMO
Objective To investigate the protective effect of dexamethasone on stress response induced by intraute-rine balloon aortic valvuloplasty (IUBAV) in a fetal lamb model. Methods Twenty-four near term twin pregnant goats were randomly assigned to control group (n=12) and dexamethasone group (intracardiac injection of dexamethasone) (n=12). Ultrasound guided IUBAV model was established. According to the combination of treatment and operation, 48 fetal lambs were divided into four groups. The following parameters were dynamically monitored by ultrasound, which were fetal and neonatal heart rate (HR), cardiac rhythm, aortic resistance index (RI) and pulsatility index (PI). On established IUBAV model, blood samples and liver tissue specimens were taken from fetal/neonatal goats for detection of blood glucose (Glu), lactate acid (LA), plasma epinephrine (E), norepinephrine (NE), cortisol (Cort), hepatic glycogen staining. Results IUBAV resulted in increased values of Glu, LA, E, NE and Cort levels, and decreased pH value, there were significant differences between pre-and 3h-post procedure (P<0.05), and significant differences were also existed in these values between pre-and 3d-post procedure (P<0.05). After administrating dexamethasone, the changes of Glu, LA, E, NE, Cort and pH levels were suppressed effectively. Fetal hepatic glycogen was consumed in large amounts due to IUBAV while recovered 3 days after IUBAV by glycogen staining. After administrating dexamethasone, hepatic glycogen consumption related to IUBAV was obviously inhibited. After IUBAV, fetal aortic RI was increased, and there was significant differences compared with pre-procedure (P<0.05). Up to 3d-post procedure, the values of RI recovered to some extent, but statistical difference was exist-ed compared with pre-procedure (P<0.05). After administrating of dexamethasone, increased aortic RI was effectively sup-pressed. Conclusions IUBAV could lead to reversible stress response and increased aortic RI in a fetal lamb model which could be alleviated by dexamethasone.
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Stratospheric ozone depletion results in an increased level of solar UV-B radiation (UV-B, 280-320 nm) reaching the earth surface. By the effect of UV-B radiation, various medicinal active ingredients changed because of the change of gene expression, enzyme activity and secondary metabolism, clinical effect is also changed. The research status of UV-B radiation and the accumulation of plant secondary metabolites in the past 10 years were summarized in this paper to supply reference for cultivation and exploitation of the medicinal plants.
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Ecossistema , Extratos Vegetais , Metabolismo , Plantas Medicinais , Metabolismo , Efeitos da Radiação , Raios UltravioletaRESUMO
Holo glutaredoxin (Grx) is a homo-dimer that bridges a [2Fe-2S] cluster with two glutathione (GSH) ligands. In this study, both monothiol and dithiol holo Grxs are found capable of transferring their iron-sulfur (FeS) cluster to an apo ferredoxin (Fdx) through direct interaction, regardless of FeS cluster stability in holo Grxs. The ligand GSH molecules in holo Grxs are unstable and can be exchanged with free GSH, which inhibits the FeS cluster transfer from holo Grxs to apo Fdx. This phenomenon suggests a novel role of GSH in FeS cluster trafficking.
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Dicroísmo Circular , Dimerização , Ferredoxinas , Química , Metabolismo , Glutarredoxinas , Química , Metabolismo , Glutationa , Metabolismo , Ferro , Química , Ligantes , Espectroscopia de Ressonância Magnética , Compostos de Sulfidrila , Química , Enxofre , Química , Tolueno , QuímicaRESUMO
Objective To treat urinary calculi with pneumatic lithotripsy under non-endoscopy.Methodes We applied the pneumatic lithotripsy machine,which made in China,to treat huge or staghom nephrolith and calculi of anterior urethra under non-endoscopy,taken out stone fragmentations after lithotripsy.There was 1 case of huge nephrolith,7cases of staghom nephrolith,3 cases of anterior urethral calculi.Results Every case of nephrolith was successfully performed by using lithotrisy and extracted stones only one case.1 case in total nephrolith cases was found residual stones and sick-side renal functions were improved than before in all casws followed up for 3 moths to 2 years.the cases of anterior urethral calculi urinated fluently and had no urethral stenoses followed up 1～2 years.Conclusion This kind of operation used pneumatic lithotripsy to treat urinary calculi under non-endoscopy is safe,slight injury and curative effect is reliable.
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Objective To explore the preoperative diagnosis and treatment of xanthogranulomatous pyelonephritis(XGP). Methods The clinical data of 16 patients with XGP from 1978 to 2003 were retrospectively reviewed, and its clinic symtoms, diagnosis and therapy were discussed in combination with literature review. Results 16 cases of patients with XGP confirmed by histopathological examination recovered well after operation, and did not relapse till now. Conclusion According to medical history, symptom, physical sign, the foam cells in urine and CT examination, XGP could be diagnosed. Sometimes, fine needle aspiration biopsy should be done in order to confirm the diagnosis of XGP. The operation was a major method for treating this disease.