ABSTRACT
Objective:To simulate the biomechanical characteristics of the real human thoracic cavity with a multi-spring group variable damping structure, and to design a new cardiopulmonary resuscitation training manikin based on the simulated thoracic biomechanical characteristics combined with the original electronic feedback system, and to test its application effect in cardiopulmonary resuscitation (CPR) teaching.Methods:A total of 60 undergraduate students majoring in five-year clinical medicine of Batch 2019 in Naval Medical University were selected as the research objects and were randomly divided into the experimental group and the control group, with 30 students in each group. The control group used the traditional manikin for CPR training, and the experimental group used the new type of manikin for CPR training based on the control group. After the training, the two groups of personnel were assessed for single skill. The single skill was mainly manual CPR operations, including artificial respiration and chest compressions. The theory and skill operation assessment of CPR and satisfaction for teaching method in the two groups were compared. SPSS 23.0 was used for statistical analysis.Results:The students in the experimental group scored (54.33±3.09) points in the single skill operation assessment, which were significantly better than that of the students in the control group [(52.33±3.08) points], and the difference was statistically significant ( P<0.05). The follow-up questionnaire showed that the students in the experimental group had a better evaluation of the teaching and training effect of the new type of manikin. Conclusion:Compared with the traditional manikin, the new CPR manikin can simulate the CPR emergency scene of the real human body, which can effectively improve the CPR teaching effect of standardized training for medical students, and help the standardization, normalization, and popularization of CPR technology in China.
ABSTRACT
BackgroundSARS-CoV-2-caused coronavirus disease (COVID-19) is posing a large casualty. The features of COVID-19 patients with and without pneumonia, SARS-CoV-2 transmissibility in asymptomatic carriers, and factors predicting disease progression remain unknown. MethodsWe collected information on clinical characteristics, exposure history, and laboratory examinations of all laboratory-confirmed COVID-19 patients admitted to PLA General Hospital. Cox regression analysis was applied to identify prognostic factors. The last follow-up was February 18, 2020. ResultsWe characterized 55 consecutive COVID-19 patients. The mean incubation was 8.42 (95% confidence interval [CI], 6.55-10.29) days. The mean SARS-CoV-2-positive duration from first positive test to conversion was 9.71 (95%CI, 8.21-11.22) days. COVID-19 course was approximately 2 weeks. Asymptomatic carriers might transmit SARS-CoV-2. Compared to patients without pneumonia, those with pneumonia were 15 years older and had a higher rate of hypertension, higher frequencies of having a fever and cough, and higher levels of interleukin-6 (14.61 vs. 8.06pg/mL, P=0.040), B lymphocyte proportion (13.0% vs.10.0%, P=0.024), low account (<190/{micro}L) of CD8+ T cells (33.3% vs. 0, P=0.019). Multivariate Cox regression analysis indicated that circulating interleukin-6 and lactate independently predicted COVID-19 progression, with a hazard ratio (95%CI) of 1.052 (1.000-1.107) and 1.082 (1.013-1.155), respectively. During disease course, T lymphocytes were generally lower, neutrophils higher, in pneumonia patients than in pneumonia-free patients. CD8+ lymphocytes did not increase at the 20th days after illness onset. ConclusionThe epidemiological features are important for COVID-19 prophylaxis. Circulating interleukin-6 and lactate are independent prognostic factors. CD8+ T cell exhaustion might be critical in the development of COVID-19.
ABSTRACT
Objective To investigate the effects of hepatitis B virus (HBV) genotype and mutations on the development of hepatocellular carcinoma (HCC) and to establish a new qualified HCC risk scores.Methods A cohort study enrolling patients with chronic HBV infection was conducted.HBV genotypes were identified by nested multiplex PCR.HBV mutations in the basic core promoter region and PreS region were sequenced after PCR amplification.Scores on risk factors were set based on nomogram.Results Totally,1 525 patients were followed-up in this research.A total of 1 110 patients infected with genotype C were followed-up for 8.52 (QR:5.36-11.68) years on average,of whom the incidence of HCC was 11.93/1 000 person-years.In genotype C HBV infected patients,male gender,aged 40 years and over,and four DNA mutations (T 1674CG,A 1762T/G 1764A,A3120T,and A2962G) can increase the risk of HCC (P＜0.05);interferon therapy can reduce the risk of HCC (P＜0.05).A new HCC predicting model was established according to the results.After validation,the predicted disease-free survival rate was consistent with the real one.Conclusions Hepatitis B virus genotypes and mutations were closely associated with HCC.The new risk scoring system can well predict HCC occurrence in genotype C HBV infected patients.
ABSTRACT
Objective To investigate the effects of hepatitis B virus (HBV) genotype and mutations on the development of hepatocellular carcinoma (HCC) and to establish a new qualified HCC risk scores.Methods A cohort study enrolling patients with chronic HBV infection was conducted.HBV genotypes were identified by nested multiplex PCR.HBV mutations in the basic core promoter region and PreS region were sequenced after PCR amplification.Scores on risk factors were set based on nomogram.Results Totally,1 525 patients were followed-up in this research.A total of 1 110 patients infected with genotype C were followed-up for 8.52 (QR:5.36-11.68) years on average,of whom the incidence of HCC was 11.93/1 000 person-years.In genotype C HBV infected patients,male gender,aged 40 years and over,and four DNA mutations (T 1674CG,A 1762T/G 1764A,A3120T,and A2962G) can increase the risk of HCC (P＜0.05);interferon therapy can reduce the risk of HCC (P＜0.05).A new HCC predicting model was established according to the results.After validation,the predicted disease-free survival rate was consistent with the real one.Conclusions Hepatitis B virus genotypes and mutations were closely associated with HCC.The new risk scoring system can well predict HCC occurrence in genotype C HBV infected patients.
