Value of cardiac magnetic resonance in the diagnosis of myocardial contusion / 中华创伤杂志

Objective:To evaluate the diagnostic value of cardiac magnetic resonance (CMR) in myocardial contusion.Methods:A case-control study was performed on 42 patients with blunt chest injury treated in Affiliated Hospital of Hangzhou Normal University from September 2018 to January 2021. There were 24 males and 18 females, with the age range of 23-66 years [(44.2±10.9)years]. The patients were divided into myocardial contusion group ( n=20) and non-myocardial contusion group ( n=22) according to the clinical diagnostic criteria of myocardial contusion (cardiac troponin I>0.06 ng/ml). All the patients underwent CMR examination within 7 days after hospitalization, and eletrocardiography (ECG) as well as transthoracic echocardiography (TTE) examinations with 24 hours. Abnormal findings on CMR, ECG and TTE were compared between the two groups. The receiver operating characteristic (ROC) curve was used for the comparison of the diagnostic efficacy of CMR, ECG and TTE for myocardial contusion. The area under the curve (AUC), sensitivity, specificity, positive predictive value and Youden index of CMR, ECG and TTE were calculated, respectively. Results:There were 15 patients (75%) presenting CMR abnormalities in myocardial contusion group compared to 2 patients (9%) in non-myocardial contusion group ( P<0.01). CMR abnormalities mainly included myocardial oedema, ischemia or hemorrhage, which were located in the left ventricle of 12 patients (71%), right ventricle of 3 (18%) and ventricular septal of 3 (12%). There were 12 patients (60%) showing ECG abnormalities in myocardial contusion group compared to 7 patients (32%) in non-myocardial contusion group ( P>0.05). Abnormal ECG changes included 8 patients (42%) with sinus tachycardia or bradycardia, 5 (26%) with ST-T changes, 3 (16%) with atrial premature beat, 2 (11%) with bundle branch block and 1 (5%) with frequent premature ventricular contractions. There were 10 patients (50%) showing TTE abnormalities in myocardial contusion group compared to 9 patients (41%) in non-myocardial contusion group ( P>0.05). TTE abnormalities manifested as left ventricular diastolic dysfunction in 12 patients (63%) and wall motion abnormalities in 7 (37%). The AUC of CMR, ECG and TTE for diagnosing myocardial contusion was 0.83 (95% CI 0.70-0.96), 0.64 (95% CI 0.47-0.81) and 0.55 (95% CI 0.70-0.72), respectively. For CMR, ECG and TTE, the diagnostic sensitivity was 75.0%, 60.0% and 50.0%, with the specificity of 91.0%, 68.2% and 59.1%, the positive predictive value was 88.2%, 63.2% and 52.6%, and the Youden index of 66.0, 28.2 and 9.1, respectively. Conclusion:CMR can accurately detect myocardial contusion, with better diagnostic performance than ECG and TTE as well as relatively higher sensitivity and specificity, indicating that CMR has great value for clinical diagnosis of myocardial contusion.

Research progress of ocular surface reconstruction with ex vivo cultured tissue engineered cell sheet / 中华实验眼科杂志

Limbal stem cells (LSCs),the source of corneal epithelial cells,play an important role in the ocular surface. In recent years, with the development of somatic stem cell application and tissue engineering, biomaterials and cell culture technology,progress has been made on the basic researches and clinical applications of ocular surface reconstruction with ex vivo cultured limbal epithelial and oral mucosal epithelial cell sheet transplantation. However, there are several issues, including the successful clinical outcomes for ocular surface reconstruction,and the in vivo tracking of donor stem cells,remained indefinitive. This article introduced and compared recent advancements of tissue engineering techniques ex vivo cultured autologous or allogeneic limbal,oral mucosal epithelial cells in ocular surface reconstruction,so as to provide a useful direction for the future research of ocular surface reconstruction.

Application and efficacy of solution focused brief therapy in patients with ulcerative colitis / 中国实用护理杂志

Objective To investigate the application value of solution focused brief therapy in the caring of patients with ulcerative colitis (UC). Methods A total of 180 active UC patients were assigned into control group (90 cases) and observation group (90 cases) using random number table. The two groups were given continuous nursing. For the observation group, the patients received the intervention of solution-focused brief therapy. SF-36 Health Survey (SF-36), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and treatment efficacy rate before and after the interventions were compared between the two groups. Univariate analysis was used to determine the related factors of effective treatment of UC. Results Before the intervention, there was no significant difference in the eight scales of SF-36 between the two groups (P>0.05). After the intervention, the eight scales of SF-36, ie, physical functioning, role limitations due to physical health problems, bodily pain, vitality, general health, social functioning, role limitations due to emotional health problems, and mental health were (70.0±20.9), (72.2± 16.3), (71.9 ± 21.7), (68.7 ± 18.2), (70.4 ± 19.3), (69.5 ± 20.4), (68.9 ± 19.3), (72.6 ± 19.7) points in the observation group, and (62.2 ± 18.7), (66.3 ± 18.8), (65.7 ± 15.2), (62.6 ± 17.4), (62.9 ± 14.9), (63.5 ± 14.6), (61.9±15.2), (64.1±14.5) points in the control group, and there was significant difference between the two groups (t=2.220-3.291, P<0.01). Before the intervention, there was no significant difference in SAS and SDS between the two groups(P>0.05). After the intervention, SASand SDS was (37.3±10.8), (36.8±10.6) points in the observation group and (41.0 ± 11.6), (41.3 ± 12.7) points in the control group, and there was significant difference between the two groups (t=2.215, 2.581, P<0.05) . The efficacy rate was 88.9％(80/90) in the observation group, and 73.3％(66/90) in the control group, and there was significant difference between the two groups (χ2=7.420, P=0.024). Solution focused brief therapy was the related factor of effective treatment in UC patients (χ2=7.107, P=0.008). Conclusions Solution focused brief therapy could improve the quality of life, reduce anxiety and depression, and increase the treatment efficacy in patients with UC, which was an effective intervention method with clinical application value.

The value of quantitative diagnosis and grading of steatosis of nonalcoholic fatty liver disease by hydrogen proton MR spectroscopy and multi-echo Dixon technique / 中华放射学杂志

Objective To investigate the value of hydrogen proton MR spectroscopy (1H-MRS) and Dixon sequence for the quantitative diagnosis and classification of steatosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods Sixty seven patients with NAFLD confirmed by liver biopsy were prospectively collected from October 2015 to May 2017 in Hangzhou Normal University Hospital. All patients underwent 1H-MRS and Dixon sequence scan within 7 days after liver biopsy, 1H-MRS-based hydrogen proton density fraction (MRS-PDFF) and Dixon-based hydrogen proton density fraction (MRI-PDFF) were obtained. Fat grading based on the fat percentage obtained from liver biopsy. Pearson correlation analysis was performed to analyze the correlation among pathological steatosis and MRS-PDFF, MRI-PDFF. One-way ANOVA analysis was performed to compare the difference of PDFF between patients with different degrees of severity of fatty liver. And the ROC curve analysis was performed to generate the thresholds of MRS-PDFF and MRI-PDFF for determining the presence of fatty liver. Results The steatosis grade of pathological biopsy showed grade S1 in 36 cases, grade S2 in 16 cases, grade S3 in 15 cases, the MRS-PDFF values of S1, S2 and S3 patients were (8.25 ± 4.32)％, (15.67 ± 4.54)％, (23.46 ± 5.82)％and the MRI-PDFF values were (6.31 ± 2.94)％, (15.42 ± 5.07)％, (24.47 ± 6.31)％. Statistically significant differences were observed among them (P<0.01). Both MRS-PDFF and MRI-PDFF were positively correlated with histological fat percentage (r values were 0.840 and 0.892,all P<0.01), there was also a correlation between MRS-PDFF and MRI-PDFF (r=0.930, P<0.01). Area under ROC curve of MRS-PDFF and MRI-PDFF for differential diagnosis of grade S1 steatosis were 0.955 and 0.976, and area under ROC curve for differential diagnosis of grade S3 steatosis were 0.972 and 0.978. Conclusion 1H-MRS and Dixon sequces have high value in liver fat content detection and classification of patients with NAFLD, and both have similar diagnostic efficacy.

Epidemiological analysis of mumps in Jinan city from 2011 to 2015 / 中华实验和临床病毒学杂志

Objective@#To analyze the epidemiological characteristics of mumps in Jinan city during 2011—2015, so as to provide scientific basis for working out effective prevention and control strategies.@*Methods@#The mumps surveillance data were obtained from Chinese Information System for Disease Control and Prevention. Descriptive statistics was used to analyze the epidemiological characteristics.@*Results@#A total of 16 510 cases were reported during the five years, with the average annual incidence of 48.08/105. The disease had obvious seasonality with two peak seasons: from January to February and from June to July. The incidence in the urban area was higher than that in the rural area. The incidence of mumps was high in children at the age of 5 to 9 years, accounting for 51.29%; mumps was more common in men than women (the ratio of men to women was 1.17∶1); The quantity of cases occurred in students was the highest, accounting for 66.74%.@*Conclusions@#In recent years, the mumps incidence in Jinan city decreased year by year.It is necessary to strengthen the monitoring, prevention and control of mumps, adopt reasonable immunization plan h is suggested that the enhanced immunization should be implemented among children under1 5 years of age to improve the immunity level of the susceptible population.

Clinical values of solution-focused therapy for caregivers of elderly patients with hip fractures / 中国实用护理杂志

Objective To investigate the effect of solution-focused therapy on the care burden and negative emotions of the primary caregivers with elderly patients with hip fractures. Methods One hundred and sixty-eight elderly patients with hip fractures and caregivers were divided into intervention group and control group with 84 pairs by random digits table method, and the two groups were given continual nursing care. At the same time, the primary caregivers of intervention group accepted the solution-focused therapy. Caregiver Burden Inventory (CBI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used as the evaluation indexes. Results Before intervention, the score of CBI, SAS,SDS was (42.07 ± 4.24), (50.75 ± 11.21), (51.59 ± 13.18) points in control group and (42.10 ± 3.96), (50.48 ± 12.59), (52.96 ± 13.51) points in intervention group, and there was no significant differences between two groups (P>0.05). After intervention, the score of CBI, SAS, SDS was (40.49±3.17), (50.64±11.33), (50.14±10.25) points in control group and (28.95±2.87), (36.73±9.45), (41.60±8.23) points in intervention group, and there was significant differences between two groups (t=5.42, 8.73, 7.45, all P<0.05). Conclusions Solution-focused therapy can effectively reduce the care burden of the primary caregivers of elderly patients with hip fractures and alleviate their anxiety and depression.