Detection of serum homocysteine levels in retinal branch vein occlusion patients with hypertension or non-hypertension / 中华眼底病杂志

Objective To observe the serum homocysteine (Hcy) levels in retinal branch vein occlusion (BRVO) patients with with hypertension or non-hypertension.Methods A total of 120 patients (120 eyes) with BRVO were divided into hypertension group [72 eyes,blood pressure 140-175/90-105 mmHg (1 mmHg=0.133 kPa)] and non-hypertension group (48 eyes,blood pressure 100-139/70-88 mmHg).According to the sex and age,78 patients with hypertensive non-retinal vascular diseases and 48 patients with non-hypertensive and non-retinal vascular diseases were collected by a way of same-size ratio as hypertension control group and non-hypertension control group,respectively.Fasting venous blood was collected from all patients in the moming and serum Hcy levels were measured by rate method.The total Hcy concentration over 15.0 μ mol/L was defined as high level Hcy.Fasting serum glucose and fasting serum lipid were also measured.Measurement data among groups were compared with t test.Results The serum Hcy levels were (26.82 ± 28.0),(8.39± 3.11),(21.37 ± 4.24),(9.25 ± 3.31) μmol/L in the hypertension group,hypertension control group,non-hypertension group and non-hypertension control group,respectively.The serum Hcy levels of patients in the hypertension group was significantly higher than that in the hypertension control group (t=3.324,P=0.004).The serum Hcy levels of patients in the non-hypertension group was significantly higher than that in the non-hypertension control group (t=2.216,P=0.049).The serum Hcy levels of patients in the hypertension group was significantly higher than that in the non-hypertension group,but the difference had not statistical significance (t=0.581,P=0.566).Among 120 patients,there were 68 patients (56.67％) with high level of Hcy (40 patients in the hypertension group and 28 patients in the non-hypertension group).Among the 40 patients with high levels of Hcy in the hypertension group,36 patients were older than 50 years old (90.00％) and 4 patients were less or equal than 50 years old (10.00％).Among the 28 patients with high levels of Hcy in the non-hypertension group,16 patients were older than 50 years old (57.14％);12 patients were less or equal than 50 years old (42.86％),whose indexes of serum glucose and serum lipid were not abnormal.There was significant difference in age distribution of patients with high level of Hcy between the hypertension group and the non-hypertension group (x2=9.882,P=0.002),but there was no significant difference in sex distribution (x2=2.052,P=0.216).Conclusions The level of serum Hcy increased both in BRVO patients with hypertension and non-hypertension.The indexes of serum glucose and serum lipid were not abnormal in BRVO patients aged less or equal than 50 years old with non-hypertensive except for the increase of serum Hcy level.

Evaluation of the effects of precautionary high-flow oxygen therapy in patients undergoing tracheal intubation after Stanford type A aortic dissection / 中华护理杂志

Objective To investigate the effects of precautionary high-flow oxygen therapy on preventing hypoxemia in patients with Stanford type A aortic dissection after intubation.Methods Totally 90 hospitalized patients with Stanford type A aortic dissection in our hospital were enrolled in this study.Forty-five patients were recruited in the control group from January to April 2017,and the common mask-type nebulizer was used for oxygen inhalation.From May to October in 2017,45 patients were recruited in the experimental group.The parameters of highflow oxygen therapy in the experimental group were set as oxygen concentration (FiO2) 40％～60％,oxygen flow rate 35～60 L/min.Then after 72h's therapy,normal mask oxygen therapy was provided as replacement therapy.Results Oxygenation index and oxygen partial pressure were increased in the experimental group than those in the control group,the rate of respiration and carbon dioxide partial pressure were decreased than those in the control group,and the differences were statistically significant(P＜0.05).The scores of oral nasal dryness symptom and sore throat symptom in the experimental group were lower than those in the control group in 24 h,48 h,72 h during therapy,and the differences were statistically significant (P＜0.05).The incidence of hypoxemia and the incidence of secondary intubation were lower in the experimental group than those in the control group(P＜0.05).Conclusion Precautionary high-flow oxygen therapy for patients with Stanford type A aortic dissection can increase PaO2/FiO2,PaO2,reduce PaCO2,respiratory rate,reduce respiratory symptoms,reduce the incidence of hypoxemia,and secondary intubation.

Chronic obstructive pulmonary disease molecular subtyping and pathway deviation-based candidate gene identification

Objective: The aim of this study was to identify the molecular subtypes of chronic obstructive pulmonary disease [COPD] and to prioritize COPD candidate genes using bioinformatics methods

Materials and Methods: In this bioinformatics study, the gene expression dataset GSE76705 [including 229 COPD samples] and known COPD-related genes [candidate genes] were downloaded from the Gene Expression Omnibus [GEO] and the Online Mendelian Inheritance in Man [OMIM] databases respectively. Based on the expression values of the candidate genes, COPD samples were divided into molecular subtypes through hierarchical clustering analysis. Candidate genes were accordingly allocated into the defined molecular subtypes and functional enrichment analysis was undertaken. Pathway deviation scores were then analyzed, followed by the analysis of clinical indicators [FEV1, FEV1/FVC, age and gender] of COPD patients in each subtype, and prediction models were constructed. Furthermore, the gene expression dataset GSE71220 was used to bioinformatically validate our results

Results: A total of 213 COPD-related genes were identified, which divided samples into three subtypes based on the gene expression values. After intersection analysis, 160 common genes including transforming growth factor beta1 [TGFB1], epidermal growth factor receptor [EGFR] and interleukin 13 [IL13] were obtained. Functional enrichment analysis identified 22 pathways such as 'hsa04060: cytokine-cytokine receptor interaction pathways, 'hsa04110: cell cycle' and 'hsa05222: small cell lung cancer'. Pathways in subtype 2 had higher deviation scores. Furthermore, three receiver operating characteristic [ROC] curves [accuracies >80%] were constructed. The three subtypes in COPD samples were also identified in the validation dataset GSE71220

Conclusion: COPD may be further subdivided into several molecular subtypes, which may be useful in improving COPD therapy based on the molecular subtype of a patient

The strategies of nurse participating in informing the truth disclosure to cancer patients / 中华行为医学与脑科学杂志

Truth disclosure of cancer patients is becoming more and more recognized in the world.Truth disclosure is usually regarded as the doctor's responsibility.However,the nurse has become an active participant in the truth disclosure of cancer patients both intentionally and inadvertently.This article systematically reviewed the role of nurses at home and abroad in informing patients with cancer the truth so as to provide guidance for the clinical practice.In April 2017,we retrieved articles in Pubmed,Chinese CNKI,Wanfang database,VIP database,and retrieval time is not restricted.A total of 92 literatures were retrieved and 8 articles were retrieved by manual searching.Finally,23 articles were included.Through systematic review of the literature,nurses are found to play an important role in informing cancer patients the truth.Compared with physicians,nurses have a more positive attitude for truth disclosure.Nurses have the most contact with patients and family members,if the nurses have plans to communicate with the families on telling the truth to cancer patients,there will be a positive impact on the truth disclosure attitude of family members.It is necessary to explore the strategy of truth disclosure for cancer patients with integrated medical staff in the future.

The strategies of nurse participating in informing the truth disclosure to cancer patients / 中华行为医学与脑科学杂志

Truth disclosure of cancer patients is becoming more and more recognized in the world.Truth disclosure is usually regarded as the doctor's responsibility.However,the nurse has become an active participant in the truth disclosure of cancer patients both intentionally and inadvertently.This article systematically reviewed the role of nurses at home and abroad in informing patients with cancer the truth so as to provide guidance for the clinical practice.In April 2017,we retrieved articles in Pubmed,Chinese CNKI,Wanfang database,VIP database,and retrieval time is not restricted.A total of 92 literatures were retrieved and 8 articles were retrieved by manual searching.Finally,23 articles were included.Through systematic review of the literature,nurses are found to play an important role in informing cancer patients the truth.Compared with physicians,nurses have a more positive attitude for truth disclosure.Nurses have the most contact with patients and family members,if the nurses have plans to communicate with the families on telling the truth to cancer patients,there will be a positive impact on the truth disclosure attitude of family members.It is necessary to explore the strategy of truth disclosure for cancer patients with integrated medical staff in the future.

Clinical value of plasma D-dimer detection in acute cerebral hemorrhage / 国际检验医学杂志

Objective To investigate the change and clinical application value of plasma D‐dimer in acute cerebral hemorrhage . Methods The plasma D‐dimer level was detected in 78 individuals of healthy physical examination(healthy control group) and 82 patients with acute cerebral hemorrhage .Results The plasma D‐dimer levels at admission(0 h) had no statistical difference among various groups(P> 0 .05) ;the D‐dimer level at 24 ,48 ,72 h in the small cerebral hemorrhage group was significantly higher than that in the healthy control group(P< 0 .05) ;the D‐dimer level in the massive cerebral hemorrhage group was significantly higher than that in the small cerebral hemorrhage group(P< 0 .05) ;the D‐dimer level in the small cerebral hemorrhage group reached the peak at 24 h ,while which in the massive cerebral hemorrhage group reached the peak at 48 h and was positively correlated with the intracranial hemorrhage volume(r= 0 .914 ,P= 0 .000 < 0 .05) .Conclusion The plasma D‐dimer level in the patients with acute cer‐ebral hemorrhage is obviously increased and shows the increasing trend with the intracranial hemorrhage volume increase ;the more the intracranial hemorrhage volume ,the longer the persistence time of high D‐dimer level .Therefore detecting plasma D‐dimer level has an important significance for monitoring the condition in the patients with acute cerebral hemorrhage .

Investigation of the surgical safety checklist implementation in a tertiary hospital / 中华医院管理杂志

Objective To investigate the implementation of the surgical safety checklist in the hospital.Methods The investigation covered the participants of 560 surgical operations of a tertiary hospital,including the surgeons,surgical assistants,scrub nurses and anesthetists,to learn their compliance and awareness of the content of the surgical safety checklist.Results Poor compliance and unawareness of some items of surgical safety checklist in surgical team members were found,plus insufficient understanding of some the items on the checklist.This checklist can improve the quality and safety awareness of the team.Conclusion The implementation of the surgical safety checklist is feasible and effective for avoidance of risks in selective operations,and conducive to promoting communication among the surgical team and preventing surgical errors.

The curative effect of nasal flush combined budesonide suspension liquid atomizing inhaled treatment in infant allergic rhinitis / 中国基层医药

Objective To observe the nasal flush combined budesonide suspension liquid atomizing inhaled treatment of allergic rhinitis in infants,explore the allergic rhinitis treatments in infants. Methods 137 cases diagnosed as allergic rhinitis were collected and randomly divided into 70 cases as the treatment group and 67 patients as the control group. The patients in control group were washed the nasal cavity with 2.8% warm sodium chloride solution using 50ml and 0.5% metronidazole injection 30ml by turn. At the first week, 1 time/d, then one time every other day,while according to age,body mass the patients were given to loratadine, 1 time/d. Treatment group were used budesonide nasal inhalation of 1 ml at the base of treatment of the control group. Before and after the treatment , nasal congestion,sneezing, flow clear nose, sleep snoring and sleep quality score index were observed and compared.Results 70%of the treatment group the nasal congestion,sneezing,flow clear in 3 times after treatment with ease.The children sleep quality improved and the snoring fewer over night,only 56.7% of the control group of these symptoms improved. After the treatment the efficiency evaluation of treatment group and control group respectively was 95.1% and 77.7% ,there was statistically significant difference( x2 =9.83 ,P ＜0. 01 ). 137 cases of patients without a side effects. Conclusion curative effect of nasal flush combined budesonide suspension liquid nasal spray inhaled treatment of allergic rhinitis was distinct,infant effect-acting quickly,without side effects,easy to use.