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BACKGROUND: Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood. Little is known about how infancy growth trajectories affect adiposity in early childhood in LGA. METHODS: In the Shanghai Birth Cohort, we followed up 259 LGA (birth weight >90th percentile) and 1673 appropriate-for-gestational age (AGA, 10th-90th percentiles) children on body composition (by InBody 770) at age 4 years. Adiposity outcomes include body fat mass (BFM), percent body fat (PBF), body mass index (BMI), overweight/obesity, and high adiposity (PBF >85th percentile). RESULTS: Three weight growth trajectories (low, mid, and high) during infancy (0-2 years) were identified in AGA and LGA subjects separately. BFM, PBF and BMI were progressively higher from low- to mid-to high-growth trajectories in both AGA and LGA children. Compared to the mid-growth trajectory, the high-growth trajectory was associated with greater increases in BFM and the odds of overweight/obesity or high adiposity in LGA than in AGA children (tests for interactions, all P < 0.05). CONCLUSIONS: Weight trajectories during infancy affect adiposity in early childhood regardless of LGA or not. The study is the first to demonstrate that high-growth weight trajectory during infancy has a greater impact on adiposity in early childhood in LGA than in AGA subjects. IMPACT: Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood, but little is known about how weight trajectories during infancy affect adiposity during early childhood in LGA subjects. The study is the first to demonstrate a greater impact of high-growth weight trajectory during infancy (0-2 years) on adiposity in early childhood (at age 4 years) in subjects with fetal overgrowth (LGA) than in those with normal birth size (appropriate-for-gestational age). Weight trajectory monitoring may be a valuable tool in identifying high-risk LGA children for close follow-ups and interventions to decrease the risk of obesity.
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Objective@#To identify the functional connectivity characteristics of insula, sensory and social related brain regions in boys with autism spectrum disorder(ASD), to explore the central nervous basis of sensory abnormality affecting core symptoms in boys with ASD.@*Methods@#Resting state functional magnetic resonance imaging (rs fMRI) data were collected from 34 boys with ASD and 29 typical development boys (TD group). Based on functional connectivity analysis, the sensory related brain regions, insula, and social related brain regions were taken as regions of interest to calculate the functional connectivity (FC) level between the regions of interest, the differences between the two groups were compared and the results were corrected by FDR. The Autism Diagnostic Observation Schedule (ADOS), Childhood Autism Rating Scale (CARS) and Autism Spectrum Quotient-Children s Version (AQ-Child) were used to assess the core phenotypes of boys with ASD.@*Results@#Compared with the TD group, the levels of FC between tactile brain regions and insula, olfactory brain regions and insula, auditory brain regions and insula in boys with ASD group were significantly increased. The level of FC between the insula and bilateral amygdala，insula and the medial prefrontal cortex(mPFC) were significantly increased( P <0.05).Pearson correlation analysis showed that the level of FC between auditory brain region(BA42)and left insula in ASD group was negatively correlated with the scores of communication subscale of ADOS( r =-0.44)，social interaction subscale of ADOS( r =-0.43), communication & social interaction subscale of ADOS( r =-0.49),attention to details subscale of AQ-Child( r =-0.41). The level of FC between the right insula and right amygdala was positively correlated with the attention switch subscale of AQ-Child( r =0.38), the level of FC between right insula and mPFC was positively correlated with the scores of repetitive behavior subscale of ADOS( r =0.48), the attention switch subscale of AQ-Child( r =0.49), total scale subscale of AQ-Child( r =0.41), total scale of CARS( r =0.41)( P < 0.05 ).@*Conclusion@#The levels of FC between insula and sensory related, social related brain regions are abnormal in children with ASD, which have significant correlations with clinical symptoms. In depth studies can be conducted to explore underlying neutral mechanisms.
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BACKGROUND: The aim of this study was to explore the effect of infection prevention care on the drainage of malignant pleural effusion (MPE) by indwelling Central venous catheterization (CVC). METHODS: From January 2016 to January 2018, 128 patients at our hospital who needed indwelling CVC for drainage of MPE were randomly divided into an infection prevention group and a conventional group. The corresponding nursing plan was given to compare the 2 groups in several measures, including nursing effect and complications. RESULTS: After intervention, the total effective rate of the infection prevention group was 96.88%, while the total effective rate of the conventional group was 87.50%, which was a statistically significant difference (P<0.05). The disappearance time of pleural effusion, catheter indwelling time, and length of stay in the infection prevention group were significantly lower than those in the conventional group (P<0.05). The incidence of infection and the total incidence of all complications in the infection prevention group were significantly lower than those in the conventional group (P<0.05). The proportion of the number of cases with Karnofsky Performance Scale (KPS) ≤10 in the infection prevention group was significantly lower than that in the conventional group (P<0.05). CONCLUSIONS: As infection prevention care significantly improves clinical efficacy and reduces the occurrence of complications, it uses in clinic is warranted.
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Central Venous Catheters , Pleural Effusion, Malignant , Drainage , Humans , Pleural Effusion, Malignant/prevention & control , Pleurodesis , TalcABSTRACT
Objective:To understand the perceptions and suggestions of emergency medical staff on the evaluation of nursing quality in the resuscitation room, and to provide reference for the construction of nursing quality evaluation standards in the resuscitation room.Methods:Phenomenological research methods in qualitative research were used to conduct semi-structured personal in-depth interviews with 15 physicians and nursing staff from August to October 2020 using a purposive sampling method, and the results of the interviews were organized and themes were refined using the Colaizzi 7-step analysis.Results:Three themes related to the evaluation criteria of nursing quality in the structure category of the resuscitation room were extracted, namely, nursing management system, nursing human resources, and environment and facilities; three themes related to the evaluation criteria of nursing quality in the process category of the resuscitation room were extracted, namely, sterile isolation/nosocomial infection, quality of specialty care, and standard of nursing documentation; and three themes related to the evaluation criteria of nursing quality in the outcome category of the resuscitation room were extracted, namely, patient health outcome, satisfaction, and incidence of adverse events.Conclusions:At present, the evaluation of the quality of emergency room care needs to be further standardized, and the themes related to the evaluation of the quality of emergency room care extracted based on the perspective of medical and nursing staff can provide a reference basis for the construction of a reasonable, scientific and comprehensive evaluation standard of nursing quality of emergency room.
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Objective: To evaluate the clinical efficacy of Biqi Capsule in treating knee osteoarthritis through randomized controlled trial, and investigate its effect on radiography. Methods: One hundred eligible patients were randomly assigned at a 1:1 ratio to receive Biqi Capsule (intervention group) and Calcitriol Capsule (control group). The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and VAS for pain were assessed at week 12 and 24. MRI Osteoarthritis Knee Score (MOAKS) was assessed at week 24. The safety index and adverse event were also tested before and after the trial. Results: A total of 100 participants were enrolled in this trial, of which 16 patients were lost to follow-up, and 84 patients were included into analysis for per-protocol set. The intervention group could better improve the WOMAC than the control group after 24-week treatment (P 0.05). However, in the sub-group analysis, the intervention group had an improvement on the MOAKS score in the patients who did not take the non-steroid anti-inflammatory drugs (NSAIDs) (P 0.05). Conclusion: Biqi Capsule had a better treatment effects on the improvement of joint stiffness and function of patients with knee osteoarthritis. It also had a better effect in the patients who did not take NSAIDs on the radiographic evaluation.
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Objective:To observe the efficacy and safety of Qifu Huazhuo decoction in treating intermittent and chronic gout. Method:A total of 160 eligible patients with intermittent and chronic gout were divided into intervention group and control group according to treatment methods， 80 cases in each group. Qifu Huazhuo decoction combined with febuxostat was given in intervention group by oral administration， while the patients in control took febuxostat combined with sodium bicarbonate tablet. After twelve weeks of treatment in both groups， the onset frequency of gout， the degree of joint pain， the levels of uric acid， creatinine， alanine transaminase in the blood， number of cases to use analgesics and adverse events were recorded compared before and after treatment. Twelve weeks follow-up was also conducted after the treatment. Result:The total effective rate was 91.25% （73/80） in intervention group， higher than 83.75% （67/80） in control group， with a significant difference between two groups （χ2=0.16， P<0.05）. Intervention group was superior to control group in improvement of onset frequency of gout， joint pain （P<0.05）， and blood uric acid （P<0.05）. There was no significant difference between two groups in blood creatinine and alanine transaminase. The number of patients using analgesics was less in intervention group （P<0.05）. In terms of adverse reactions， there were two cases of fever， two cases of abnormal liver function， six cases of abnormal kidney function and three cases of gastrointestinal reaction after the treatment in intervention group. While for control group， there were one case of fever， two cases of abnormal liver function， eight cases of abnormal kidney function and five cases of gastrointestinal reaction， without significant differences between two groups. Conclusion:The Qifu Huazhuo decoction can effectively reduce the onset frequency of gout and the degree of joint pain in intermittent and chronic phases， effectively control the level of blood uric acid， and reduce the number of cases using analgesics， with less adverse reactions， so it is suitable for clinical use.
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@#AIM:To observe the different effect of controlling myopia by orthokeratopraxis with different width between defocus circle and the rim around the cornea.<p>METHODS: A retrospective case-control study. A total of 45 patients(85 eyes)who came to our hospital for orthokeratopraxis lens fitting during January 2014 to December 2015 were selected. The diameter of the orthokeratopraxis lens was 90%-95% of the diameter of the cornea. So the patients were divided into three groups according to the different diameter of the orthokeratopraxis lens. The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 12.1 to 13.00mm was 11.0-11.2mm(Group A). The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 11.1-12.00mm was 10.5-10.9mm(Group B). The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 10.0-11.00mm was 10.0-10.4mm(Group C). The change of the spherical equivalent(SE)and axial length(AL)were analyzed after wearing the lens for 1a and 2a.<p>RESULTS: Before wearing lens, the age, SE(D)and AL(mm)was not statistically significant in the three groups(<i>P</i>>0.05). After wearing lens for 1a and 2a, the change of SE(D)and AL(mm)was not statistically significant in Group A and Group B(<i>P</i>>0.05)and the change was statistically significant in Group C(<i>P</i><0.05). The change of the SE and AL was also significantly different between Group A and Group C after wearing orthokeratopraxis lens for 2a(<i>P</i><0.05). A similar result was found between Group B and Group C(<i>P</i><0.05).<p>CONCLUSION: The effect of controlling myopia by orthokeratopraxis with different position of defocus circle on cornea is different. The position of defocus circle is more close to the corneal limbus, the effect is weaker.
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Objective To investigate the status of diabetes in fasting state on different therapies.Methods 244 type 2 diabetic patients were divided into four groups according to different insulins:60 for insulin pump group(A),64 cases for insulin glargine group(B),59 cases for microinjection pump group(C),61 cases for isophane insulin suspension group.Then the time when blood glucose was up to standard,the usage of insulin and the rate of hypoglycemia were abserved.Results A group was(2.89 ± 1.32)d on the time when blood glucose was up to standard,B group was(3.14 ±1.25)d,C group was(4.91 ±2.81)d and D group was(5.62 ±2.52)d.There were significant differences between A and other groups( P ＜ 0.05 ) on time.There were significant differences between B and C group,B and D group,but there was no difference between C and D group.A group was(30.61 ±2.21) IU/don the usage of insulin,B group was ( 31.12 ± 3.38 ) IU/d,C group was ( 42.25 ± 4.01 ) IU/d and D group was (44.31 ±3.22)IU/d.There were significant differences between A and C group,A and D group,B and C group,B and D group(P ＜0.05)on usage of insulin,but there were no differences between A and B group,C and D group.A group was 3.3％ on the rate of hypoglycemia,B group was 4.7％,C group was 15.2％ and D group was 16.4％.There were significant differences between A and C group,A and D group,B and C group,B and D group ( all P ＜ 0.05 ) on usage of insulin,but there were no differences between A and B group,C and D group.Conclusion Compared to other insulin therapies,insulin pump had obviously superiority,which could be generalized to diabetics in fasting state.
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<p><b>OBJECTIVE</b>To explore the adjunctive therapeutic effects of acupuncture for leukopenia induced by chemotherapy. METHODS Eighty six cases with leukopenia after chemotherapy treatment were randomly divided into a granulocyte colony-stimulating factor (G-CSF) plus acupuncture (A) group and a G-CSF group, 43 cases in each group. After chemotherapy treatments, the patients of both groups were treated with G-CSF for 4 times, with acupuncture at Zhigou (TE 6), Quchi (LI 11), Hegu (LI 4), etc. added in the G-CSF plus A group, for an observaion cycle of 45 days. Their therapeutic effects on the 10th and 31st day and peripheral white blood cell (WBC) counts and neutrophilic granulocyte classification on the 10th, 17th, 24th, 45th day after treatment were compared.</p><p><b>RESULTS</b>After they were treated on the 10th day, the effective rates were both 100.0% (both 43/43), and on the 31st day, the effective rate of 98.9% (42/43) in the G-CSF plus A group was higher than 91.1% (35/43) in the G-CSF group (P < 0.05). The WBC counts in the G-CSF plus acupuncture group were both higher than those in the G-CSF group on the 10th, 17th and 24th day after treatment (all P < 0.05). The ratios of mature neutrophilic granulocyte in the G-CSF plus A group were all higher than those in the G-CSF group at the same time (all P < 0.01).</p><p><b>CONCLUSION</b>Acupuncture can increase the therapeutic effect of G-CSF, delay the decrease of WBC after discontinuing G-CSF, promote the neutrophilic granulocyte differentiating forward to mature and it is better for improving leukopenia induced by chemotherapy.</p>
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Adult , Female , Humans , Male , Middle Aged , Acupuncture Therapy , Blood Cell Count , Combined Modality Therapy , Drug-Related Side Effects and Adverse Reactions , Granulocyte Colony-Stimulating Factor , Therapeutic Uses , Leukopenia , Drug Therapy , Allergy and Immunology , TherapeuticsABSTRACT
The latest clinical studies show that vitamin D has many health promoting functions. However, the current dietary reference intakes (DRIs) of vitamin D is too low. In particular the maximum tolerable intake (UL) of vitamin D is too low, which hampers the clinical use of vitamin D as an nutrient and must be re-assessed. We reviewed the average requirement (EAR) and the recommended intake (RNI) of vitamin D in children, adults, elderly and pregnant and parturient women, and encouraged to increase the recommended intake of vitamin D. We also reviewed the risk of high-dose vitamin D intake and suggested to raise the maximum tolerable intake (UL) made by American CRN. Finally, we propose that Chinese Nutrition Society will consider to increase the UL of vitamin D from 20 microg to 50 microg.
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Vitamin D/administration & dosage , Adult , Aged , Child , Feeding Behavior , Female , Humans , Nutrition Policy , Nutritional Requirements , PregnancyABSTRACT
<p><b>OBJECTIVE</b>To conduct a meta-analysis of the effect of levosimendan on B-type natriuretic peptide (BNP) levels and evaluate the therapeutic effect of levosimendan on advanced heart failure.</p><p><b>METHODS</b>A meta-analysis was performed on the selected data to analyze the effect of levosimendan on BNP levels.</p><p><b>RESULTS</b>Levosimendan decreased BNP by a mean of 337.66 [95%CI (-296.30, -379.02)] pg/ml 24 h after the administration, and by 259.92 [95%CI (-195.76, -324.08)] pg/ml at 48 h, and by 123.09 [95%CI(-53.32,-195.86)] pg/ml at 1 week. Levosimendan resulted in improvements of the cardiac function by about 29%, 22%, and 10% at 24 h, 48 h and 1 week after the administration.</p><p><b>CONCLUSION</b>Levosimendan produces favorable effects on the cardiac functions and BNP levels.</p>
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Humans , Cardiotonic Agents , Therapeutic Uses , Heart Failure , Blood , Drug Therapy , Hydrazones , Therapeutic Uses , Natriuretic Peptide, Brain , Blood , Pyridazines , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To investigate the value of cardiac troponin I (cTnI) levels in assessing myocardial protection by remifentanil precondition against myocardial injury induced by off-pump coronary artery bypass (OPCAB).</p><p><b>METHODS</b>Twenty-four patients undergoing OPCAB were randomized into control and remifentanil preconditioning group (n=12). All the patients received pretreatment with oral diazepam (10 mg), intramuscular morphine (10 mg) and hyosine (0.3 mg). General anesthesia was induced with midazolam (0.08 mg/kg), etomidate (0.1-0.3 mg/kg), fentanyl (5-10 microg/kg), and rocuronium (1 mg/kg), and maintained with isoflurane inhalation and propofol infusion. Intermittent fentanyl and pipecuronium were given intravenously. In remifentanil preconditioning group, remifentanil (5 microg/kg in 50 ml normal saline) was infused in 10 min after anesthesia induction, and only NS was administered in the control group. Blood samples were obtained before and at 0, 2, 6, 24, and 48 h after the operation to determine serum cTnI levels.</p><p><b>RESULTS</b>In both of the two groups, the cTnI levels increased significantly at the postoperative time points (0, 2, 6, 24, and 48 h) as compared with those before the operation (P<0.05). The cTnI levels of remifentanil preconditioning group were markedly decreased after the operation in comparison with those of the control group (P<0.05).</p><p><b>CONCLUSION</b>Remifentanil preconditioning decreases the cTnI levels and reduces myocardial injury induced by OPCAB.</p>
Subject(s)
Aged , Female , Humans , Male , Coronary Artery Bypass, Off-Pump , Heart , Ischemic Preconditioning, Myocardial , Myocardial Reperfusion Injury , Blood , Metabolism , Myocardium , Metabolism , Piperidines , Pharmacology , Postoperative Period , Time Factors , Troponin I , Blood , MetabolismABSTRACT
Objectives To investigate the epidemiological and clinical characteristics of dyslipidemia as well as its treatment and influence on accompanying diseases in impaired glucose status among inpatients. Methods A cross-sectional survey was conducted among the inpatients registered in ten university hospitals of Guangdong, China during the week before the Diabetes Day in 2004. The fasting blood glucose (FBG), lipid profiles, BMI, waist to hip ratio (WHR) and concomitant disorders of the first screen during the hospitalization period were recorded. Those who had FBG level from 5.6 to 6. 9 mmol/L and not been previously diagnosed diabetes (PDM) underwent oral glucose tolerance test (OGTF). Results Of the 8753 inpatients investigated, 1067 eases had complete medical records(CMR case) including PDM cases and previously non-diagnosed diabetes ones with FBG ≥ 5. 6 mmol/L. Of the previously non-diagnosed diabetes cases with FBG levels from 5.6 to 6.9 mmmol/L, 65.8% accepted OGTT. Of the CMR cases, 41.9% had PDM, 21.7% was newly diagnosed diabetes mellitus (NDM), 29. 1% had impaired glucose regulation (IGR) and only 7.3% had normal glucose tolerance (NGT). The TG levels in NDM and PDM group were higher than those in IGR and NGT group (P < 0.05, respectively). The HDL-C levels in IGR, NDM and PDM group were lower than those in NGT group (P < 0.05, respectively). Sixty-nine point six percent of the diabetes mellitus (DM) inpatients was accompanied with dyslipidemia and the rate was higher than those in NGT (56.4%) and IGR inpatients (52.5%, P <0.05, respectively). Only 22. 8% of the PDM inpatients underwent treatment of dyslipidaemia and just 3.4% achieved the target suggested by the guideline of ATP-Ⅲ. BMI was higher and waistline longer in the PDM and NDM inpatients than those in the NGT cases (P <0.05, respectively). Seventy-two point eight percent of the PDM inpatients was complicated with more than one type of vascular diseases. Nine point seven percent and 0. 2% of the NDM inpatients were tormented by diabetic nephropathy and diabetic retinopathy respectively. Conclusions More inpatients with accompany DM or IGR had concomitant dyslipidemia than those with NGT, which included hypertriglyccridemia, hypo-high-density lipoproteinemia and metabolic syndrome. Concomitant vascular diseases were more frequently found in PDM inpatients than in the others. Some of the NDM and IGT inpatients were complicated with microvascular diseases.
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AIM: To learn the condition of the memory and the visual space of the patient who has suffered from the infarction in basal ganglia region, and to analyze its impact on and the characteristics of the patients' cognition. METHODS: By testing respectively on 21 subjects who were initially infarcted in basal ganglia with single focus on one side, and 21 healthy volunteers with corresponding age, gender and educational background with Rey-Osterrieth Complex Figure Scale (Rey), Clinical Memory Scale (CMS), Hospital Anxiety-Depression Scale (HAD), National Institute of Health Stroke Scale (NIHSS), Oxford Handicap Scale (OHS), Barthel Index (BI), and Aural Event Related Evoked Potential (AERP) as well. RESULTS: Compared with the control group, the patient group got higher scores of anxiety and depression in HAD), which showed absolutely statistical significance; they demonstrated longer reaction time in AERP, which also showed statistical significance; and in CMS. they displayed inferior performance in the free picture recall and the memory quotient (MQ), which again had statistical significance. However, compared with the control group, the patient group got scores with no significance in copy, immediate recall and delayed recall in Rey. CONCLUSION: The infarction in basal ganglia region with single focus on one side may impact on the patient's executive function, memory function and emotion. But no impact is showed on patient's visual space function.