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Objective:To investigate the clinical and imaging differences between serum aquaporin 4 (AQP4) antibody positive and negative patients with neuromyelitis optica spectrum disorder (NMOSD).Methods:The clinical data and radiologic findings of 89 NMOSD patients diagnosed at Beijing Tiantan Hospital, Capital Medical University from January 2018 to June 2022 were retrospectively analyzed. There were 17 male cases and 72 female cases, aged 18-74 years. According to the results of serum AQP4 antibody test, the patients were divided into AQP4 antibody positive group and AQP4 antibody negative group, and the differences in clinical data, lesion distribution, lesion characteristics, and brain area volume between the 2 groups were compared using independent sample t-test and χ 2 test, and the correlation between brain area volume and expanded disability status scale (EDSS) scores was further investigated using Spearman correlation analysis. Results:There were 68 cases in the AQP4 antibody positive group and 21 cases in the AQP4 antibody negative group. Patients in both groups were predominantly female, but the percentage of females in the AQP4 antibody-positive group (86.8%, 59/68) was higher than that in the AQP4 antibody-negative group (61.9%, 13/21), with a statistically significant difference (χ 2=4.91, P=0.027). The incidence of optic neuritis in AQP4 antibody negative group (66.7%, 14/21) was higher than that in antibody positive group (41.2%, 28/68), with a statistically significant difference (χ 2=4.18, P=0.041). In the distribution of intracranial lesions on MRI, the probability of lesions involving the brain stem in AQP4 antibody negative group (47.6%, 10/21) was higher than that in AQP4 antibody positive group (23.5%, 16/68), the difference had statistically significance (χ 2=4.50, P=0.034). The volumes of whole brain white matter, right amygdala, right accumbens-area and right ventral diencephalon in AQP4 antibody positive group were lower than those in AQP4 antibody negative group ( P<0.05), and the volumes of the right accumbens-area were negatively correlated with the EDSS scores in AQP4 antibody positive group ( r=-0.628, P=0.009). Conclusion:There are differences in clinical and imaging manifestations between AQP4 antibody positive and AQP4 antibody negative patients, which provides more basis for clinical in-depth understanding of NMOSD.
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Objective:To investigate the knowledge, attitude and practice status of ophthalmic nurses on prevention and control of intraocular infection in grade Ⅲ class A hospitals.Methods:A self-made questionnaire was used to investigate the knowledge, attitude and practice of 236 nurses on prevention and control of intraocular infection in the ophthalmology department of 8 grade Ⅲ class A hospitals in Zhengzhou from January to June 2020. The correlation between the knowledge, attitude and practice were analyzed by Pearson correlation analysis and the influencing factors of each term were analyzed by multivariate Logistic regression.Results:The scores of knowledge, attitude, practice of all nurses were (26.08 ± 2.46), (67.45 ± 8.48), (50.31 ± 6.67) points, and the scoring rate were (87.0 ± 8.2)%, (84.3 ± 10.1)%, (83.9 ± 9.8)%, respectively. The scores of each dimension of knowledge, attitude and practice were significantly positively correlated ( r values were 0.26-0.42, all P<0.05), respectively. Multivariate Logistic regression analysis showed that education background, professional title and training experience of infection were the influencing factors of knowledge score ( P<0.05), education background, professional title, training experience of infection and demand were the influencing factors of attitude score ( P<0.05), and nursing age and work post were the influencing factors of practice score ( P<0.05). Conclusions:The level of knowledge, attitude and practice of ophthalmic nurses in grade Ⅲ class A hospitals on prevention and control of intraocular infection is overall good. Hospital management department still needs to make reasonable management countermeasures according to personnel characteristics to improve the knowledge, attitude and practice level of ophthalmic nurses and to reduce post-operative intraocular infection.
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Hierarchical diagnosis and treatment is an effective way to "optimize and reconstruct medical and health service system" and solve the problems of "difficulty and expensiveness of getting medical treatment". At present, the hierarchical diagnosis and treatment still exists many problems in the process of practice, and the solu-tion of these problems not only requires government departments to do the top-level supporting policies, but also needs the medical institutions at all levels to change their thinking mode and innovate the appropriate hierarchical diagnosis and treatment system. This paper analyzed the dilemma of hierarchical diagnosis and treatment in China from the aspects of medical alliance operation mechanism, medical insurance system, physician multi-point occu-pation, medical resource allocation and medical information sharing and so on, and put forward corresponding countermeasures.
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Objective@#To evaluate the prognostic significance of early phase full donor chimerism (FDC) after myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT).@*Methods@#The clinical data of 72 hematological patients received myeloablative allo-PBSCT from Feb. 2016 to Jul. 2017 were analyzed retrospectively. The median age was 36.5 years (range 4-59), 44 were males and 28 females. Of the donors, there were 35 HLA matched sibling donors, 27 haploidentical donors and 10 unrelated donors. Polymerase chain reaction amplification of short tandem repeat sequence (PCR-STR) was used to detect donor cell chimerism (DC) rate of recipient bone marrow at one, two and three months after transplantation.@*Results@#The median follow-up was 462 d (range: 47-805 d), 55 cases were still alive, and 45 cases were disease-free survival (DFS) at the end of follow-up. The 2-year overall survival (OS) and DFS were (68.9±7.7)% and (59.5±6.3)%, respectively. A number of 16 cases underwent relapses, with 2-year cumulative incidence of (24.1±5.3)%. The median time of recurrence was 157(32-374) d. Forty cases (55.6%) developed acute graft-versus-host diseases (aGVHD), with median time of 35.5 (13-90) d. Chronic GVHD (cGVHD) occurred in 23 patients (31.9%), with median time of 169 (94-475) d. Univariate analysis found the following factors were not related to OS, DFS or relapse rate (RR), including age, sex, blood type and sex of donor-recipient, occurrence of aGVHD and cGVHD. The OS and DFS in cases reached FDC and no FDC at two months after transplantation were (85.2±6.9)% vs (66.1±7.7)% (P=0.051) and (76.7±7.7)% vs (48.9±8.1)% (P=0.021), respectively. The RR rate in FDC group was lower than that in no FDC group [(16.6±6.8)% vs (30.4±7.8)%, P=0.187, respectively].@*Conclusion@#The present study confirmed the important value for predicting the prognosis with whether or not the patients reached FDC at the early phase after allo-PBSCT. The OS and DFS in cases with FDC at two months after transplantation were significantly higher than those of no FDC patients.
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Objective To improve the recognition of therapy-related acute myeloid leukemia (t-AML). Methods One patient who was diagnosed as AML with inv (16) following treatment of Hodgkin lymphoma (HL) was reported. The pathomechanism, diagnosis, treatments and prognosis of t-AML were systematically studied by reviewing a series of literature. Results A 36-year-old female with a history of HL 2 years ago was diagnosed t-AML. Karyotype analysis demonstrated inv (16) and the fusion gene of CBFβ/MYH11 was positive by polymerase chain reaction (PCR). The fusion gene of CBFβ/MYH11 was still positive after receiving 3 courses of chemotherapy. The leukemia reached completely molecular biological remission after receiving haploidentical peripheral blood stem cell transplantation. The patient has now survived 1.5 years with leukemia free and in a good performance. Conclusions The t-AML is difficult to treat, but it is heterogeneous. Cytogenetics and molecular biology have important implications for the prognosis of t-AML. Currently, allogeneic hematopoietic stem cell transplantation is the only effective way to cure t-AML.
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AIM:To observe the effects and mechanisms of hydroxyethylstarch (HES) 130/0.4 on no-reflow phenomenon after myocardial ischemia-reperfusion in rats.METHODS: SD rats were randomly divided into 4 groups:sham operation group , ischemia-reperfusion ( IR, treated with normal saline ) group, normal saline ischemia-reperfusion (NS-IR, treated with NS) group and HES ischemia-reperfusion (HES-IR, treated with HES) group.Myocardial infarct size and no-reflow range were determined by staining methods , and the activities of myocardial enzymes ( CK-MB, cTnI and MPO) were measured .Meanwhile , cardiac microvascular endothelial cells of the rat were cultured and divided into 4 groups:control group, hypoxia/reoxygenation (H/R) group, NS-H/R group and HES-H/R group.Acute ischemia reper-fusion models were simulated , and the concentration of calcium ions was measured .The relative cell activity was evaluated by CCK-8 assay, and the apoptotic rate was detected by flow cytometry .RESULTS:In HES-IR group, the myocardial in-farct size, the no-reflow zone, CK-MB, cTnI and MPO activity were all significantly lower than those in IR group ( P<0.05).In microvascular endothelial cells , the concentration of calcium ions and the apoptotic rate in HES-H/R group were significantly decreased, while the relative cell activity increased compared with H/R group (P<0.05).CONCLUSION:HES reduces no-reflow in acute myocardial ischemia-reperfusion .The mechanism may be involved in the inhibition of both the infiltration of neutrophils and the calcium overload of endothelial cells .
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@#Objective To explore the efficacy of process management on bladder function among traumatic brain injury (TBI) patients admitted to intensive rehabilitation and care unit (IRCU). Methods 33 cases were collected to control group who were cared with routing nursing during February, 2011 to December, 2012. Other 39 cases were recruited to trial group cared with process management of bladder function during January, 2013 to December, 2014. Process management of bladder function contained the establishment of process manage-ment guide, evaluation of removing catheter, nursing of bladder based on residue of urine volume and keeping a diary of urination, etc. Re-sults There were more cases with residue of urine volume less than 100 ml and less with catheter associated urinary tract infection in the tri-al group than in the control group (P<0.05). Conclusion Process management of bladder function can improve the recovery of bladder func-tion of TBI patients, shorten rehabilitation time and decrease the risk of catheter associated urinary tract infection.
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@#Objective To observe the effects of intensive lower extremity motor control training on the motor function of lower extremity, balance and walking capability of stroke patients. Methods 40 stroke patients were randomized into the intervention group (n=20) and control group (n=20). Both groups received the routine rehabilitation, while the intervention group accepted the lower extremity motor control training in addition for 6 weeks. Before and after 6 weeks of treatments, they were assessed with Fugl-Meyer Assessment of lower extremity (FMA-L), Berg Balance Scale (BBS), Holden Functional Ambulation Category (FAC); their gaits were analysesd with footprint. Results Both groups improved significantly in scores of FMA-L, BBS, FAC and average step length, stride width, walking velocity (P<0.01) after treatment, and improved more in the intervention group than in the control group (P<0.05). Conclusion Intensive motor control training of lower extremity may promote the recovery of motor function of lower extremities, balance and walking ability of stroke patients.
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Objective To observe the effects of intensive lower extremity motor control training on the motor function of lower extremi-ty, balance and walking capability of stroke patients. Methods 40 stroke patients were randomized into the intervention group (n=20) and control group (n=20). Both groups received the routine rehabilitation, while the intervention group accepted the lower extremity motor con-trol training in addition for 6 weeks. Before and after 6 weeks of treatments, they were assessed with Fugl-Meyer Assessment of lower ex-tremity (FMA-L), Berg Balance Scale (BBS), Holden Functional Ambulation Category (FAC);their gaits were analysesd with footprint. Re-sults Both groups improved significantly in scores of FMA-L, BBS, FAC and average step length, stride width, walking velocity (P<0.01) after treatment, and improved more in the intervention group than in the control group (P<0.05). Conclusion Intensive motor control train-ing of lower extremity may promote the recovery of motor function of lower extremities, balance and walking ability of stroke patients.
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@#ObjectiveTo evaluate the relationship between the level of thoracic complete spinal cord injury(SCI) and ambulatory function wearing Reciprocating Gait Orthosis(RGO) through three dimentional gait analysis, and to explore the quantitative indicators of reconstructing walking capacity of thoracic complete SCI patients.Methods10 patients with thoracic complete spinal cord injury of lesion level from T4 to T12 who had experienced RGO gait training for at least 3 months. Three dimentional gait analysis system of Vicon Nexus 1.2 was used to test and examine the gait speed, cadence, stride length, pelvic angle of rotation, hip range of motion(ROM), crutch force, angular velocity of hip flexion and extension phases, etc. Pearson's product moment correlation coefficient and Spearman rank correlation coefficient were used to examine the relationship between the level of spinal cord injury and the kinematic and kinetic values.ResultsThe mean cadence and stride length were (37.4±2.15) steps/min and (91.6±9.09) cm. The mean hip ROM, angular velocity of hip flexion and extension phases were (42.57 °±5.43 °), (20.88 °±2.18 °)/s and (124.75 °±9.31 °)/s respectively. The gait speed, stride length, peak crutch force, hip ROM, mean crutch force and angular velocity of hip extension phase all had significant pertinence with the level of spinal cord injury.ConclusionThe limitation of hip ROM and excessive load of upper limbs mainly result in ambulatory disorder in higher thoracic complete SCI patients who should be undertaken some rehabilitation training to reduce excessive physiological load in order to improve their ambulatory capacity.
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Objective To develop a new method for rapid detection of E.Coli.with a new substrate Na p nitrophenyl ? D glucuronate (PNP Glucu Na). Method The test paper was immersed with of Na p nitrophenyl ? D glucuronate which was synthesized by us and another paper with culture medium and phorphate buffer.Colour change was observed to detect the E.coli. Results An E.coli concerntration of 4?10 7 took 0.5 hour, while a concentration of 4?10 0 took 12 hours. 138 strains of E.coli and 190 strains of other bacteria were examined . The sensitivity was 94.2% and the specificity was 92.6%. Conclusion This method is rapid, accurate, simple, and economical for detecting E.coli.
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Paeoniflorin in antiaging Preparation was qualitatively identified with chemical and TLC methods and quantitatively determined with HPLC. The results showed both tne chemical and TLC method gave fast and accurate results and HPLC was an excellent for quantitative determination with an average recovery of 100.72% and coefficient of variation 1.22%, which is suitable for the quality control of the preparation.