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Objective:To construct a preoperative rehabilitation program for gastric cancer patients, aiming to provide scientific and reasonable preoperative guidance for gastric cancer patients.Methods:On the basis of literature research and expert group meeting, the first draft of the preoperative rehabilitation program for gastric cancer patients was constructed. From October 2021 to January 2022, the Delphi method was used to conduct 2 rounds of expert letter inquiries to 16 experts in related fields from 11 hospitals in Jiangsu Province, and the entries were revised according to the experts′ inquiries.Results:In the two rounds of expert correspondence, the positive coefficients of experts were 88.89% and 100.00%, and the authority coefficients of experts were both 0.88. The coordination coefficients of the items in the two rounds of inquiry were 0.279 and 0.290, respectively. The final program consisted of 3 first-level entries, 11 second-level entries and 32 third-level entries.Conclusions:The scheme constructed in this study is scientific, reliable and applicable, and is worth being promoted further in clinical practice.
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Covid-19 is a contagious disease caused by SARS-CoV-2, a novel severe acute respiratory syndrome coronavirus. Common variants and networks underlying host genetic mechanisms have been extensively studied to identify disease-associated genetic factors. However, there are few studies about the rare variants, typically inborn errors of immunity, in understanding the host genetics behind Covid-19 infection, especially in the Chinese population. To fill this gap, we investigate likely-deleterious missense and high-confidence predicted loss-of-function variants by (a) performing gene- and pathway-level association analyses, (b) examining known genes involved in type I interferon signaling and others previously reported in Covid-19 disease, and (c) identifying candidate genes with accumulating mutations and their potential protein-protein interactions with known genes. Based on our analyses, several putative genes and pathways are uncovered and worth further investigation, for example, genes IL12RB1, TBK1, and TLR3, and pathways Tuberculosis (hsa:05152), Primary Immunodeficiency (hsa:05340), and Influenza A (hsa:05164). These regions generally play an essential role in regulating antiviral innate immunity responses to foreign pathogens and in responding to many inflammatory diseases. We believe that to some extent, as an acute inflammatory disease, Covid-19 is also affected by these inborn errors of immunity. We hope that the identification of these rare genetic factors will provide new insights into the genetic architecture of Covid-19.
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Objective:To evaluate the construction effect of famous doctor studio and the correlation among the acceptance indexes by analyzing the achievements of famous doctor studio in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine.Methods:R software was used to count the relevant data of national famous medical studios approved from 2010 to 2018, and the advantages were analyzed by radar chart; Spearman correlation coefficient was calculated, and R software was used to draw the correlation heat map between the evaluation indexes; papers published by studio members during the construction period were retrieved, which were transformed into refworks format, imported into CiteSpace software to draw a visual knowledge map.Results:A total number of 506 articles were included in this study, involving 25 evaluation indexes and 22 national famous doctors' studios. The statistical analysis results showed that there was a significant positive correlation between the number of academic experience papers of famous and senior TCM experts published in core journals (V3) and the number of diagnosis and treatment schemes of dominant diseases (V1), and there was a significant negative correlation between 8 groups of indexes; Tinnitus, insomnia, premature ovarian failure, acupuncture and acupuncture therapy are research hotspots.Conclusions:When evaluating the construction effect of famous doctor studio, various indicators should be considered comprehensively, appropriately control of the number of members is helpful to improve the quality of talent training, and pay attention should be paid to experience exchange and thought collision during the training process.
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As of early May 2021, the ongoing pandemic COVID-19 has caused over 160 million of infections and over 3 million deaths worldwide. Many risk factors, such as age, gender, and comorbidities, have been studied to explain the variable symptoms of infected patients. However, these effects may not fully account for the diversity in disease severity. Here, we present a comprehensive analysis of a broad range of patients laboratory and clinical assessments to investigate the genetic contributions to COVID-19 severity. By performing GWAS analysis, we discovered several concrete associations for laboratory features. Based on these findings, we performed Mendelian randomization (MR) analysis to investigate the causality of laboratory traits on disease severity. From the MR study, we identified two causal traits, cholesterol levels and WBC counts. The functional gene related to cholesterol levels is ApoE and people with particular ApoE genotype are more likely to have higher cholesterol levels, facilitating the process that SARS-CoV-2 binds on its receptor ACE2 and aggravating COVID-19 disease. The functional gene related to WBC counts is MHC system that plays a central role in the immune system. The host immune response to the SARS-CoV-2 infection greatly affects the patients severity status and clinical outcome. Additionally, our gene-based and GSEA analysis revealed interferon pathways, including type I interferon receptor binding, regulation of IFNA signaling, and SARS coronavirus and innate immunity. We hope that our work will make a contribution in studying the genetic mechanisms of disease illness and serve as useful reference for the clinical diagnosis and treatment of COVID-19.
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Objective:To understand the current status of nurses' awareness and needs for the Employee Assistance Program (EAP), as to provide basis for the hospital to formulate EAP.Methods:Using the purpose sampling method, 352 ICU nurses from the Nanjing Drum Tower Hospital Affiliated of Nanjing University Medical School were selected as the research subjects from December 2019 to January 2020. Finally, 350 valid questionnaires were obtained. Use the EAP demand questionnaire to investigate the ICU nurses' awareness and demand for EAP.Results:Among the 350 nurses in the intensive unit, 214 cases (61.14%) had never understood EAP, only 8 (2.29%) had understood and experienced the EAP, and 332 cases (94.86%) believed that the hospital′s implementation of EAP was a benefit provided to nurses. The top two service requirements were: "Relief of work pressure" and "mental health consultation", and hope to receive mixed-mode EAP services; in ICU and CCU, nurses hope EAP can help resolve work-family conflicts; in EICU, they need to provide Specific job skills training services.Conclusions:ICU nurses have insufficient cognition of EAP and urgently need to obtain EAP implementation knowledge; at the same time, it is necessary to formulate an implementation plan that meets ICU nurses′ needs for EAP, that is, to relieve work pressure and carry out psychological counseling to ensure that EAP is launch successfully in ICU nurses.
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Objective:To understand the role of operation management decision analysis system in the incidence of constipation in patients with acute myocardial infarction (AMI) and explore its operation mechanism.Methods:From January to December 2019, the operation management decision analysis system was applied to the management of constipation rate of patients with acute myocardial infarction in Gulou Hospital Affiliated to Medical College of Nanjing University. 624 patients were selected before the operation of the system (from January to December, 2018) and 643 cases after operation (from January to December, 2019). The incidence of constipation, patient satisfaction and nurse satisfaction in patients with acute myocardial infarction (AMI) were compared between before and after the operation of the system.Results:The incidence of constipation, patient satisfaction and nurse satisfaction were 5.45% (34/624), 93.59% (584/624) and 81.25% (23/32), respectively, before and after the operation of the system, which were 3.11% (20/643), 99.53% (640/643) and 100.00% (32/32), respectively. There were significant differences before and after operation ( χ2 value was 4.243, 34.122 and 10.473, all P < 0.05). Conclusions:Operational management decision analysis system can help nursing managers to dynamically monitor nursing sensitive indicators, urge nurses to carry out nursing measures, effectively improve the incidence of constipation in patients with acute myocardial infarction, it is worth popularizing in clinical application.
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Objective@#To investigate the value of Cytomegalovirus(CMV) DNA real-time quantitative-polymerase chain reaction(RT-PCR) in different body fluids for diagnosing CMV pneumonia in immunocompetent infants.@*Methods@#The clinical data of immunocompetent infants with CMV pneumonia who were treated in Pediatric Intensive Care Unit of Guangdong Women and Children′s Hospital from January 1st, 2016 to February 5th, 2018 were retrospectively analyzed.The clinical data included CMV DNA load of bronchoalveolar lavage fluid(BALF), urine, blood and cerebrospinal fluid(CSF); blood immunoglobulin(Ig)M CMV, alanine aminotransferase (ALT), X-ray and CT test of chest, combined infection, clinical manifestation and treatment.@*Results@#Nine hundred and twenty-six infants received bronchoalveolar lavage by bronchoscope, and 34 cases were diagnosed as immunocompetent with CMV pneumonia.The infants with CMV pneumonia: the positive percentage of urine CMV DNA, blood CMV DNA, blood IgM CMV and ALT elevation were 100.0%(34/34 cases), 61.8%(21/34 cases), 52.9%(18/34 cases) and 20.6%(7/34 cases), respectively.There was no difference in positive percentage between blood CMV DNA and blood IgM CMV (χ2=0.5, P>0.05). Both the positive percentages of blood CMV DNA and blood IgM CMV were lower than those in the urine CMV DNA, and the differences were statistically significant (χ2=16.1, 20.9, all P<0.05). The positive percentages of ALT elevation were lower than those in the positive percentage of urine CMV DNA, blood CMV DNA and blood IgM CMV, and the differences were statistically significant (χ2=44.8, 11.9, 7.7, all P<0.05). Ten patients′ CSF CMV DNA were tested, and they were all negative.The median load of CMV DNA in BALF, urine and blood was 170.0×105 copies/L, 130.0×105 copies/L and 6.0×105 copies/L.There was no difference in median load between BALF and urine (U=561, P>0.05). BALF CMV DNA load and blood CMV DNA load had a weak positive correlation (r=0.35, P<0.05), BALF CMV DNA load and age had a negative correlation (r=-0.42, P<0.05), and urine CMV DNA load and blood CMV DNA load had a positive correlation (r=0.52, P<0.05). No matter whether blood IgM CMV was positive, BALF CMV DNA load had no differences (U=92, P>0.05). The main radiographic signs were pulmonary interstitial lesions.Thirty-four immunocompetent infants with CMV pneumonia, 18 patients (52.9%) with symptoms lasted for over 2 weeks, 20 patients (58.8%) had complicated infections.They all received inductive treatment of Ganciclovir, 55.9%(19/34 cases) patients′ urine CMV DNA turned to be negative.When patients got combined infections by bacteria or mycoplasma, antibiotics were used.All discharged patients had symptoms relieved and signs improved.@*Conclusions@#BALF RT-PCR is instant, sensitive and distinctive method to diagnose CMV pneumonia.Urine RT-PCR gets specimens conveniently and safely, its positive percentage and DNA load are present well according to BALF, and is suitable for screening and monitoring CMV infection.Blood CMV DNA load and blood IgM CMV indicate viral dissemination and immunocompetence, but it is not recommended for diagnosing CMV pneumonia solely.
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Objective To investigate the value of Cytomegalovirus(CMV) DNA real-time quantitative-polymerase chain reaction(RT-PCR) in different body fluids for diagnosing CMV pneumonia in immunocompetent infants.Methods The clinical data of immunocompetent infants with CMV pneumonia who were treated in Pediatric Intensive Care Unit of Guangdong Women and Children's Hospital from January 1st,2016 to February 5th,2018 were retrospectively analyzed.The clinical data included CMV DNA load of bronchoalveolar lavage fluid (BALF),urine,blood and cerebrospinal fluid(CSF);blood immunoglobulin(Ig) M CMV,alanine aminotransferase (ALT),X-ray and CT test of chest,combined infection,clinical manifestation and treatment.Results Nine hundred and twenty-six infants received bronchoalveolar lavage by bronchoscope,and 34 cases were diagnosed as immunocompetent with CMV pneumonia.The infants with CMV pneumonia:the positive percentage of urine CMV DNA,blood CMV DNA,blood IgM CMV and ALT elevation were 100.0％ (34/34 cases),61.8％ (21/34 cases),52.9％ (18/34 cases) and 20.6％ (7/34 cases),respectively.There was no difference in positive percentage between blood CMV DNA and blood IgM CMV (x2 =0.5,P ＞ 0.05).Both the positive percentages of blood CMV DNA and blood IgM CMV were lower than those in the urine CMV DNA,and the differences were statistically significant (x2 =16.1,20.9,all P ＜0.05).The positive percentages of ALT elevation were lower than those in the positive percentage of urine CMV DNA,blood CMV DNA and blood IgM CMV,and the differences were statistically significant (x2 =44.8,11.9,7.7,all P ＜ 0.05).Ten patients' CSF CMV DNA were tested,and they were all negative.The median load of CMV DNA in BALF,urine and blood was 170.0 × 105 copies/L,130.0 x 105 copies/L and 6.0 x 105 copies/L.There was no difference in median load between BALF and urine (U =561,P ＞ 0.05).BALF CMV DNA load and blood CMV DNA load had a weak positive correlation (r =0.35,P ＜ 0.05),BALF CMV DNA load and age had a negative correlation (r =-0.42,P ＜ 0.05),and urine CMV DNA load and blood CMV DNA load had a positive correlation (r =0.52,P ＜ 0.05).No matter whether blood IgM CMV was positive,BALF CMV DNA load had no differences (U =92,P ＞ 0.05).The main radiographic signs were pulmonary interstitial lesions.Thirty-four immunocompetent infants with CMV pneumonia,18 patients (52.9％) with symptoms lasted for over 2 weeks,20 patients (58.8％) had complicated infections.They all received inductive treatment of Ganciclovir,55.9％ (19/34 cases) patients' urine CMV DNA turned to be negative.When patients got combined infections by bacteria or mycoplasma,antibiotics were used.All discharged patients had symptoms relieved and signs improved.Conclusions BALF RT-PCR is instant,sensitive and distinctive method to diagnose CMV pneumonia.Urine RT-PCR gets specimens conveniently and safely,its positive percentage and DNA load are present well according to BALF,and is suitable for screening and monitoring CMV infection.Blood CMV DNA load and blood IgM CMV indicate viral dissemination and immunocompetence,but it is not recommended for diagnosing CMV pneumonia solely.
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Objective To study the levels of coagulation factors in cord blood from normal newborns.Methods The study was clinical experimental study.One hundred and thirty-six cord blood samples collected from newborns who were born in Guangzhou Women and Children's Medical Center from November 2011 to January 2012.The levels of eight coagulation factors FⅡ,FV,FVⅡ,FVⅢ,FⅨ,FⅩ,FⅪ and FⅫ in cord blood were detected using CA-1500 Automatic Blood Coagulation Analyzer.Results The levels of eight coagulation factors in cord blood:the 95％ reference ranges were 27.04％-49.02％,53.30％-116.40％,27.80％-56.70％,19.16％-113.06％,19.85％-35.65％,24.20％-48.00％,24.40％-42.20％ and 9.20％-54.60％ respectively.The 99％ reference ranges were 23.56％-52.50％,53.30％-116.40％,27.80％-56.70％,4.31％-127.91％,17.35％-38.15％,24.20％-48.00％,24.40％-42.20％ and 9.20％-54.60％ respectively.Conclusion The study establishes the reference ranges for levels of coagulation factors in cord blood,it will provide experimental basis for diagnosis and differential diagnosis for neonatal congenital or hereditary coagulation factor deficiency.
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Objective To investigate the influence on levels of coagulation factors in cord blood,included the physiological and pathological status of mater and the newborn.Methods We Detected the levels of F Ⅱ 、FⅤ 、FⅦ 、FⅧ 、FⅨ 、FⅩ 、FⅪ and FⅫ in cord blood by CA-1500 Automatic blood coagulation analyzer and related reagents,group results by impact factors and compared them statistically.Results (1) Factors of newborn:every coagulation factor between the male group and the female group was no statistical difference(P ＞0.05) ;F Ⅱ,F Ⅴ,FⅨ and FⅪ in the group of premature infant were less active than the normal (P =0.031,0.037,0.000,0.002) ;FⅡ and FⅦ in the group of birth weight ＞4.0 kg were more active than the normal (P =0.043,0.043) ; FⅧ in the group of cesarean section was less active than the normal (P =0.004) ; FⅧ,FⅨ and FⅪ in the group of twin pregnancy were less active than the normal (P =0.002,0.000,0.028) ;F Ⅱ and F Ⅷ in the group of intrauterine hypoxia were less active than the normal (P =0.032,0.012).(2) Factors of mater:F Ⅱ and FⅨ in the group of≥35-year-old mothers with first delivery were more active than the normal (P =0.009,0.028).Every coagulation factor between the gestational diabetes mellitus (GDM) group and the not GDM group was no statistical difference(P ＞0.05) ;FⅧ in the group of pregnancy associated with gynecologic diseases was less active than the normal (P =0.043),F Ⅱ,Ⅶ and F Ⅹ were more active than the normal (P =0.032,0.024,0.022).Conclusion Premature birth,cesarean,twins,intrauterine hypoxia,perinatal infection and other factors have greater impact on the levels of FⅡ,FⅧ,FⅨ and FⅪ in cord blood.To prevent hemorrhagic disease of the newborn,we should avoid the factors mentioned above.
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Objective To study the role of gene Scanning in the clonality analysis of Ig/TCR gene remrangement in children with newly diagnosed acute lymphoblastic leukemia (ALL),and the relationship between the clinical characteristics of ALL and the type of Ig/TCR gene rearrangement.Methods The research was the clinical experimental study.Selected 86 cases of children with ALL who were diagnosed and treated in Department of Hematology-oncology of Guangzhou Women and Children's Medical Center,and All cases were confirmed by bone marrow cell morphology and flow cytometric immunophenotyping.Used multiplex PCR to detecte Ig/TCR gene rearrangements in children with newly diagnosed ALL.Applied gene scanning to analyze the clonality of Ig/TCR gene rearrangement.Results There were 83 cases detected 1 or more than 1 types of Ig/TCR gene rearrangements in 86 cases (96.5％),with 2.52 types each case.There were 56 cases detected at least one monoclonal Ig/TCR gene rearrangement in 61 cases analyzed by gene scanning (91.8％).The detectable rate for lgH,Igκ,TCRγ and TCRδ were 27.91％,27.91％,19.77％ and 24.42％ respectively in 172 of Ig/TCR gene rearrangement.Monoclonal,oligoclonal and polyclonal composition was 58.1％,30.8％ and 11.1％ respectively,the monoclonal as the main component.There was no significant difference between the types and clonality of Ig/TCR gene rearrangement and the clinical characteristics of children with newly diagnosed ALL (P ＞ 0.05).Conclusions Gene scanning can analyze clonality of the Ig/TCR gene rearrangement conveniently and rapidly,thus,it can be possible to select the stable targets for quantitative detection of minimal residual disease minimal residual disease.There is no significant difference between the types and clonality of Ig/TCR gene rearrangement and clinical characteristics of children with newly diagnosed.
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<p><b>OBJECTIVE</b>To investigate the vasodilating effect of capsaicin (CAP) on rat mesenteric artery and its mechanism.</p><p><b>METHODS</b>The third branch of the superior mesenteric artery in male Sprague-Dawley rat (250-350 g) was excised, the periadventitial fat and connective tissue were removed and the mesenteric artery was dissected into 2 mm rings. Each ring was placed in a 5 ml organ bath of DMT 610M system and the tension was recorded.</p><p><b>RESULTS</b>CAP (10(-9)-10(-5) mol/L) relaxed endothelium-intact and endothelium-denuded mesenteric artery pre-constricted by phenylephrine (10(-5) mol/L), and the vasodilation in endothelium-intact mesenteric artery was stronger than that in endothelium-denuded one. Pretreatment with either L-NAME (3 X10(-4) mol/L), an inhibitor of nitric oxide synthase(NOS), or CGRP8-37 (2 X 10(-6) mol/L), an antagonist of calcitonin gene-related peptide (CGRP), for 30 min significantly attenuated the relaxation of endothelium-intact mesenteric artery induced by CAP. CGRP (10(-10)-3 X10(-8) mol/L) relaxed endothelium-intact and endothelium-denuded mesenteric artery pre-constricted by phenylephrine, and the vasodilation in endothelium-intact mesenteric artery was stronger than that in endothelium-denuded one. Substance P did not relax the mesenteric artery pre-constricted by phenylephrine.</p><p><b>CONCLUSION</b>CAP has partial endothelium-dependent relaxation effect on rat mesenteric artery, which may be mediated by activating the endothelial NOS-NO pathway. The endothelium-independent relaxation in rat mesenteric artery induced by CAP may be mediated by CGRP.</p>
