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Objective:To analyze the risk factors for postoperative delirium in patients with glioma, and construct and validate a nomogram prediction model.Methods:A total of 304 glioma surgery patients admitted to the Department of Neurosurgery of Shandong Provincial Hospital from January 2021 to January 2022 were involved in this research. The training set (234 patients) and the validation set (70 patients) were divided according to the leave-out method. Patients in the training set and validation set were divided into delirium and non-delirium groups using the confusion assessment method (CAM) as the criteria.Clinical data of patients in the two study groups in the training set were analyzed.The risk factors for postoperative delirium were clarified by Logistic regression analysis, and an early warning model for postoperative delirium in glioma was established. The calibration curve and ROC curve were used for internal and external validation in the training set and validation set to evaluate the accuracy and discrimination of the prediction model.Results:Multivariate Logistic regression analysis showed that age>60 ( OR=4.089, 95% CI=1.898-9.103, P<0.001), diabetes ( OR=2.825, 95% CI=1.316-6.186, P=0.008), hypertension ( OR=2.176, 95% CI=1.041-4.587, P=0.008), smoking ( OR=2.432, 95% CI=1.063-5.648, P=0.036), history of epileptic seizures ( OR=4.457, 95% CI=1.924-10.689, P=0.001), poor lung function ( OR=2.452, 95% CI=1.132-5.374, P=0.023), visual analog scale (VAS)>7 points ( OR=3.394, 95% CI=1.591-7.456, P=0.002), anxiety or depression ( OR=2.746, 95% CI=1.285-5.976, P=0.010) and operation duration>4 h ( OR=2.731, 95% CI=1.255-6.062, P=0.012) were the independent risk factors of brain glial postoperative delirium.Based on the above risk factors a nomogram nursing early warning model was established.The area under the ROC curve (AUC) of internal verification was 0.852, and AUC of external verification was 0.914. Conclusion:The early-warning model for postoperative delirium in glioma patients can effectively predict the risk of delirium after glioma surgery, and it has certain clinical promotion value.
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Objective:To explore the effect of subclinical hypothyroidism(SCH) on complications after coronary artery bypass grafting(CABG).Methods:The data of CABG patients hospitalized in TEDA International Cardiovascular Disease Hospital from January 2016 to December 2017 were retrospectively analyzed. According to the thyroid function after admission, the patients were divided into normal thyroid function group(NC group, 814 cases, 0.27 mIU/L≤TSH≤4.2 mIU/L) and subclinical hypothyroidism group(SCH group, 106 cases, TSH>4.2 mIU/L). The preoperative clinical data, surgical conditions, recent complications and one-year bridge stenosis rate were compared between the two groups in male or female.Results:Compared with NC group, SCH group had more female patients(53.8% vs 24.4%, P=0.000), lower smoking rate (38.7% vs 58.0%, P=0.000). There was no statistical difference in other baseline data and postoperative complications( P>0.05). Subgroup analysis depending on gender showed that the incidence of respiratory tract infection increased in female patients with SCH(10.5% vs 3.5%, P=0.034) compared with those in NC group, there was no significant difference in male. The TSH level was an independent risk factor for respiratory tract infection in female patients( OR=1.307, 95% CI=1.110-1.539, P=0.001). Compared with the male patients, the prevalence of hypertension(84.2% vs. 67.3%, P=0.041), diabetes mellitus(45.6% vs 16.3%, P=0.001), hospitalization time in ICU(44 h vs. 42 h, P=0.003), acute renal failure(10.5% vs 0, P=0.019) and massive blood transfusion(8.8% vs 0, P=0.034)increased. Conclusion:SCH appears to influence the postoperative outcome for female patients by increasing the development of postoperative respiratory tract infection.
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Objective To analyze the practical value of D-dimer in diseases condition judgment and prognosis evaluation of childhood Mycoplasma pneumoniae pneumonia (MPP).Methods Retrospective analysis was performed on clinical data of 606 MPP at Department of Respiratory,Beijing Children's Hospital,Capital Medical University from January 2009 to July 2017,and the subjects were divided a severe group (298 cases) and a moderate group (308 cases) according to severity.By comparing clinical characteristics,laboratory tests and imaging findings,multivariate Logistic regression analysis for significant single factors was accomplished,which was to find out the independent factors affecting the severity of childhood MPP in acute phase.Receiver operating characteristic (ROC) curves were drawn in the area under the curve (AUC) and the diagnosis threshold value was calculated,which could be used to judge the predicators affecting the severity judgment of childhood MPP in acute phase.And the prognosis was judged according to the convalescent fiberoptic bronchoscopic indicators in recovery phase.Results The levels of white blood cells (WBC) [(10.25 ± 3.76) × 109/L],neutrophil (Neu) [(7.31 ± 3.76) × 109/L],platelet (PLT) [(334.66 ± 143.80) × 109/L],C-reactive protein (CRP) [(69.00 ± 80.50) mg/L],erythrocyte sedimentation (ESR) [(39.38 ± 26.29) mm/1 h],lactate dehydrogenase (LDH) [(436.61 ± 248.96) IU/L],fibrinogen (Fib) [(4.61 ± 1.36) g/L] and D-dimer [(2.09 ± 1.66) mg/L] in the severe group were higher than those in the moderate group [(7.55 ±3.14) × 109/L,(4.77 ±2.54) × 109/L,(291.60 ± 109.19) × 109/L,(23.40 ±42.50) mg/L,(30.25 ± 16.18) mm/1 h,(318.05 ± 116.97) IU/L,(4.18 ±0.88) g,(0.58 ±0.72) mg/L],and the differences were statistically significant (all P ＜ 0.01).The levels of Neu,PLT,CRP,LDH and D-dimer were independent and relevant factors for the severity of acute MPP.The area under each ROC curve was Neu 0.719,PLT 0.592,LDH 0.675,CRP 0.749,D-dimer 0.848,and each diagnostic threshold was 6.5 × 109/L,265.5 × 109/L,417.5 IU/L,28.9 mg/L,0.73 mg/L,respectively.Obviously,D-dimer had the highest sensitivity and specificity for the severe MPP.There was a significant difference in D-dimer level between the endobronchial inflammation group and the subbronchial stenosis,poor ventilation and occlusion group of fiberoptic bronchoscopy [(1.11 ± 0.26) mg/L vs.(2.14 ± 1.84) mg/L,t =-5.870,P ＜ 0.05].Conclusion D-dimer levels can be used as one of the most sensitive indicator for determining the severity and prognosis of MPP.
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Objective@#To analyze the practical value of D-dimer in diseases condition judgment and prognosis evaluation of childhood Mycoplasma pneumoniae pneumonia (MPP).@*Methods@#Retrospective analysis was performed on clinical data of 606 MPP at Department of Respiratory, Beijing Children′s Hospital, Capital Medical University from January 2009 to July 2017, and the subjects were divided a severe group (298 cases) and a moderate group (308 cases) according to severity.By comparing clinical characteristics, laboratory tests and imaging findings, multivariate Logistic regression analysis for significant single factors was accomplished, which was to find out the independent factors affecting the severity of childhood MPP in acute phase.Receiver operating characteristic (ROC) curves were drawn in the area under the curve (AUC) and the diagnosis threshold value was calculated, which could be used to judge the predicators affecting the severity judgment of childhood MPP in acute phase.And the prognosis was judged according to the convalescent fiberoptic bronchoscopic indicators in recovery phase.@*Results@#The levels of white blood cells (WBC)[(10.25±3.76)×109/L], neutrophil(Neu)[(7.31±3.76)×109/L], platelet (PLT)[(334.66±143.80)×109/L], C-reactive protein(CRP)[(69.00±80.50) mg/L], erythrocyte sedimentation (ESR)[(39.38±26.29) mm/1h], lactate dehydrogenase (LDH)[(436.61±248.96) IU/L], fibrinogen(Fib)[(4.61±1.36) g/L] and D-dimer [(2.09±1.66) mg/L]in the severe group were higher than those in the moderate group[(7.55±3.14)×109/L, (4.77±2.54)×109/L, (291.60±109.19)×109/L, (23.40±42.50) mg/L, (30.25±16.18) mm/1 h, (318.05±116.97) IU/L, (4.18±0.88) g, (0.58±0.72) mg/L], and the differences were statistically significant (all P<0.01). The levels of Neu, PLT, CRP, LDH and D-dimer were independent and relevant factors for the severity of acute MPP.The area under each ROC curve was Neu 0.719, PLT 0.592, LDH 0.675, CRP 0.749, D-dimer 0.848, and each diagnostic threshold was 6.5× 109/L, 265.5×109/L, 417.5 IU/L, 28.9 mg/L, 0.73 mg/L, respectively.Obviously, D-dimer had the highest sensitivity and specificity for the severe MPP.There was a significant difference in D-dimer level between the endobronchial inflammation group and the subbronchial stenosis, poor ventilation and occlusion group of fiberoptic bronchoscopy [(1.11±0.26) mg/L vs.(2.14±1.84) mg/L, t=-5.870, P<0.05].@*Conclusion@#D-dimer levels can be used as one of the most sensitive indicator for determining the severity and prognosis of MPP.
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Objective To OxplorO thO OffOct of lactobacillus vaginal capsulO in thO trOatmOnt of sOnilO vaginitis.Methods From January 2017 to FObruary 2018, 100 OldOrly patiOnts with vaginitis in thO SOcond POoplO＇s Hospital of Haining wOrO sOlOctOd in thO study. ThOy wOrO randomly dividOd into obsOrvation group and control group according to thO digital tablO, with 50 casOs in Oach group. ThO obsOrvation group was trOatOd by lactobacillus vagina capsulO, and thO control group was trOatOd by compound mOtronidazolO suppository. ThO clinical OffOcts of thO two groups wOrO comparOd.Results ThO total OffOctivO ratO of thO obsOrvation group (96.00% ) was significantly highOr than that of thO control group(76.00% ),thO diffOrOncO was statistically significant(χ2 =12.547,P<0.05).ThOrO was no statistically significant diffOrOncO in vaginal pH bOforO trOatmOnt bOtwOOn thO two groups[(6.89 ± 1.32) vs. (6.91 ± 1.26),t=0.102,P>0.05],and thOrO wOrO statistically significant diffOrOncOs in vaginal pH of thO two groups bOforO and aftOr trOatmOnt(t=8.204,5.112,all P<0.05),thO vaginal pH of thO obsOrvation group aftOr trOat-mOnt was significantly lowOr than that of thO control group, thO diffOrOncO was statistically significant[(4.49 ± 0.11) vs.(5.76 ± 0.37),t=5.024,P<0.05].In thO obsOrvation group, only 1 casO had rOcurrOncO at 2 months aftOr trOatmOnt, and no rOcurrOncO was obsOrvOd at 3 months and 6 months aftOr trOatmOnt, thO rOcurrOncO ratO was 2.00%. In thO control group, thOrO wOrO 2 casOs,4 casOs,6 casOs had rOcurrOncO at 2 months,3 months and 6 months aftOr trOatmOnt, and thO rOcurrOncO ratO was 24.00%. ThO rOcurrOncO ratO of thO obsOrvation group was significantly lowOr than that of thO control group (χ2 =25.634,P <0.05).Conclusion Lactobacillus vaginal capsulO in thO trOatmOnt of sOnilO vaginitis has curativO OffOct is distinct, thO rOcurrOncO ratO is low, also thO usO procOss is vOry simplO, has high clinical application valuO.
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OBJECTIVES: Cognition and speech disorders are the most common symptoms of dementia in neurodegenerative disease. Here, we present a detailed clinical evaluation of a case of logopenic variant of primary progressive aphasia (lv-PPA), an atypical form of Alzheimer disease (AD), including cognitive testing over time, brain imaging, electrophysiology, and tests of olfactory function. CASE REPORT: We present the case of a 58-year-old man suffering from progressive language difficulties who was finally diagnosed with lv-PPA. Clinical data included neuropsychological examinations, electrophysiology tests, neuroimaging, biomarkers, olfactory tests, and olfactory functional magnetic resonance imaging (fMRI). RESULTS AND DISCUSSION: The patient suffered from language disorders, including stumbling speech and forgetting appropriate words and how to pronounce some words. This had started 2 years earlier, and he had begun to deteriorate in recent months. In addition to his speech disorder, scores on the Mini Mental State Examination and Montreal cognitive assessment indicated that his cognition was affected. Structural imaging revealed no obvious hippocampal atrophy (score of 1), and molecular imaging showed hypometabolism and amyloid deposits in the temporal parietal region. The patient also presented with olfactory impairment. Although his odour detection threshold was normal, his cognitive threshold for scent recognition was significantly increased. Olfactory fMRI showed that activation of the whole brain and primary olfactory cortex was rare. CONCLUSION: This case provides evidence suggesting that lv-PPA is an atypical form of AD, with symptoms including speech disorders and impaired cognition. This patient with lv-PPA presented with olfactory impairment.
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Objective To investigate the accuracy of real-time continuous glucose monitoring(RT-CGM)system in the type 2 diabetes mellitus(T2DM). Methods A total of 318 subjects hospitalized between 2013 May to 2014 August were recruited. Each subject received a RT-CGM system. In order to calibrate the interstitial glucose level, finger-stick blood glucose were measured at least four times every day. Patients were divided into three groups according to their finger-stick blood glucose level:≤6.99 mmol/L, 7.0-10.0 mmol/L and≥10.01 mmol/L. Pearson correlation was used to analyze the relationship between the finger-stick glucose and interstitial glucose gained from RT-CGM. Clarke error grid analysis was used to analyze the accuracy of RT-CGM. Results (1)A total of 2, 815 glucose meter values from finger-stick were com?paired with glucose from RT-CGM. A positive relationship(r=0.847)were found between CGM and finger-stick blood glu?cose. The correlation was closer with higher finger-stick blood glucose levels(r=0.457, 0.648 and 0.852 respectively in≤6.99 mmol/L group, 7.0-10.0 mmol/L group and≥10.01 mmol/L group. P0.05). Conclusion RT-CGM provides accu?rate blood glucose values to guide the treatment of diabetes, and the accuracy is more reliable in high glucose environment.
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Objective To explore ultrasonographic diagnosis of severe fetal limb deformity in early pregnancy.Methods A total of 5 843 cases of pregnant women were screened and 147 cases of suspected fetal malformation were sellected.The routine ul-trasound examination results were recorded as control group,and continuous order tracking ultrasonic method inspection results were recorded as observation group.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value was compared.Results The clinical results obtained in multiparous or limb malformation fetus were 40 cases,accounting for 27.21%. In the observation group on limb loss and other detection rate of 100% (14/14)and 65.00% (13/20),significantly higher than those in control group 50.00% (7/14)and 5.00% (1/20).But in the observation group on finger deformity examination showed no advantage.Observation accuracy,sensitivity and negative predictive value was 91.84%,70.00%,89.92%,which were higher than those in the control group(78.91%,22.50%,77.54%).The differences were statistically significant (P <0.05).Conclusion The application of continuous order tracking ultrasonic method to check the first trimester fetal limb deformity with high accuracy,pro-vided sufficient time for prenatal diagnosis of fetal treatment and late.
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Objective To compare the vascularization of collagen scaffolds with or without growth factors and their efficacy on cardiac function in postinfarcted rats underwent surgical ventricular restoration.Methods Collagen scaffolds were activated with 1-ethyl-3-[3-dimethylaminopropyl]carbodiimide hydrochloride chemistry (EDC) as control or continually covalently immobilized with vascular endothelial growth factor (VEGF) and VEGF + basic fibrohlast growth factor (bFGF) as experimental groups.Adult SD male rats underwent left anterior descending artery (LAD) ligation to generate transmural myocardial infarction(MI).Four weeks later,by echocardiography,rats with moderate scar size(25％-35％ akinetic area of freedom wall of left ventricle) were screened out,assigned into 3 groups randomly and received the surgical ventricular restocation (SVR).Then,cardiac function was measured by echocardiography at 1w,2w and 4w after patch implantation.At endpoint of study (4w after patch implantation),the rats were sacrificed and the hearts were harvested.Vascularization of patch were determined by capillary density (evidenced by vWFⅧ staining) or mature vessel density (evidenced by SMA staining) respectively.Results The general mortality of the animal model is 15％ (6/40).A significant improvement of cardiac function was observed in all animals at 1 w after patch implantation but that was better preserved in both cytokine-conjugated groups 4w later (control group vs.VEGF group,P ＜ 0.05,control group vs.VEGF + bFGF group,P ＜ 0.01).More capillaries were present in patch with growth factors (P ＜0.05),while significant functional vessel formation was observed only in VEGF + bFGF group (P ＜0.01 vs.control or VEGF group).Additionally,we identified a positive correlation between heart function and mature vessel density (P =0.0297,r2 =0.998).Conclusion The mechanical property of collagen scaffold can be effectively improved by EDC,the growth factors immobilized in scaffold were in favor of vascularization of patch,which may facilitate the preservation of cardiac function posterior to SVR.
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AIM: To compare the dissolution of asperosaponin Ⅵ between the ultra-micro powder and the fine powder of Radix Dipsaci.METHODS : The real contents,in vitro release and releasing rate of asperosaponin Ⅵ were determined by HPLC for the ultra-micro powder and the fine powder.RESULTS: In the ultra- micro powder and the ordinary powder,the real content of asperosaponin Ⅵ were 4.87%,4.74%,respectively; in vitro release in 1 h were 48.2 mg/g,47.5 mg/g,respectively; releasing rate parameter T_(0.9) were 0.23 min,10.41 min,respectively.CONCLUSION: The ultra- micro porphyrization could not influent the real content and in vitro release of asperosaponin Ⅵ in Radix Dipsaci.But it could improve the releasing rate of asperosaponin Ⅵ.
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The purpose of this study is to investigate the impacts of bicyclo-monoterpene promoters (i.e., borneol and camphor) on the in vitro permeation of ligustrazine (LGT) through the hairless porcine dorsal skin. Fourier transform-infrared (FT-IR), scanning electron microscope (SEM) and transdermal delivery kinetics in vitro were performed to investigate the effect of the promoters on the biophysical changes to the stratum corneum (SC), the surface changes to porcine skin and the in vitro percutaneous fluxes of ligustrazine through procine skin. FT-IR results revealed that the peak shift and the decrease in the peak area with borneol were higher than those with camphor. SEM studies demonstrated that the morphological change to SC was related to the chosen enhancer. It was observed that the SC lipid extraction with borneol and camphor led to disruption of the SC and the scutella desquamation. Apparent density (AD) was utilized to describe the desquamation extent of the scutella. Percutaneous fluxes of ligustrazine through porcine skin were evaluated in vitro by the Franz-type diffusion cells. Use of borneol led to greater penetration of ligustrazine across porcine skin. It was shown that the permeation enhancement mechanism of bicyclo-monoterpenes to ligustrazine included extracting and disordering lipids which involved the shift changes in C-H stretching and H-bonding action between enhancers and cermaide. The penetration capability of the hydroxy groups in bicyclo-monoterpenes was better than that of the ketone groups.
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373 adult cases with type Ⅱ diabetes mellitus were treated with, Shenqi Jiung Tang (SJT) Tablet and 108 cases with phenformin as control. The result showed that the symptoms were remarkably alleviated after treatment with SJT tablet. Blood glucose was decreased by 94.36％; 24-hour urine sugar was decreased by 85.79％ the total effective rate was 83.16％. The effect was significantly better than that of control group (p
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AIM:To compare the dissolution of asperosaponin Ⅵ between the ultra-micro powder and the fine powder of Radix Dipsaci.METHODS:The real contents,in vitro release and releasing rate of asperosaponin Ⅵwere determined by HPLC for the ultra-micro powder and the fine powder.RESULTS:In the ultra-micro powder and the ordinary powder,the real content of asperosaponin Ⅵ were 4.87%,4.74%,respectively;in vitro release in 1 h were 48.2 mg/g,47.5 mg/g,respectively;releasing rate parameter T_ 0.9 were 0.23 min,10.41 min,respectively.CONCLUSION:The ultra-micro porphyrization could not influent the real content and in vitro release of asperosaponin Ⅵ in Radix Dipsaci.But it could improve the releasing rate of asperosaponin Ⅵ.
