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BackgroundAnxiety exists as a prevalent psychological problem among college students nowadays, which brings negative influence on their normal life. Mobile phone addiction and loneliness both have an impact on college students' anxiety. However, the acting path of loneliness between mobile phone addiction and anxiety requires further exploration. ObjectiveTo analyze the relationships among mobile phone addiction, loneliness and anxiety in college students, and to explore the acting path of loneliness between mobile phone addiction and anxiety. MethodsOn December 21, 2023, 1 400 college students from a university in Henan Province were selected, in accordance with the simple random sampling method, for investigation of this study. Questionnaire survey was conducted by using several scales including Mobile Phone Addiction Tendency Scale (MPATS), Self-rating Anxiety Scale (SAS) and University of California Los Angeles-Loneliness Scale (UCLA-LS). Pearson correlation analysis was used to examine the correlation between the scores of each scale above, and SPSS macro program Process 3.3 was used to test the mediation effect. ResultsA total of 1 239 valid questionnaires were collected, with an effective recovery rate of 88.50%. The MPATS score of college students was positively correlated with both SAS and UCLA-LS scores (r=0.474, 0.387, P<0.01), and UCLA-LS score was positively correlated with SAS score (r=0.541, P<0.01). The indirect effect of loneliness between mobile phone addiction and anxiety was 0.160 (95% CI: 0.118~0.173), accounting for 33.97% of the total effect. ConclusionMobile phone addiction can positively predict anxiety among college students, and loneliness may act as the mediation path between mobile phone addiction and anxiety among college students.
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Objective:To investigate the effect of mindfulness-based cognitive therapy (MBCT) on mindfulness attention awareness, experiential avoidance, and cognitive fusion in individuals with general anxiety disorder(GAD).Methods:A total of 53 patients aged 18-60 years who met the GAD diagnostic criteria of DSM-5 were selected from the Seventh People's Hospital of Hangzhou from May 2021 to September 2022.After receiving routine treatment, patients were randomly assigned to two groups: MBCT group( n=26) for an 8-week mindfulness cognitive therapy and health education group( n=27) for an 8-week health education program. Participants were evaluated using the generalized anxiety disorder scale(GAD-7), acceptance and action questionnaire-2nd edition(AAQ-Ⅱ), cognitive fusion questionnaire(CFQ), and mindful attention awareness scale (MAAS) before and after the intervention.Data were analyzed using SPSS 26.0 software, with the chi-square test, independent sample t-test, and paired sample t-test. Results:(1)There was no significant difference in MAAS score between the two groups before the intervention (42.63±10.18, 47.67±9.52, t=-1.55, P=0.13). However, after the intervention, the MAAS score in MBCT group was significantly higher than that in the health education group(54.42±9.87, 47.83±7.59, t=-2.27, P=0.03). (2) No significant difference was observed in CFQ score between the two groups before the intervention (57.11±15.97, 53.50±12.01, t=-0.77, P=0.45). However, after the intervention, the CFQ score in the MBCT group was significantly lower than that in the health education group(38.32±10.31, 47.11±10.66, t=-2.51, P<0.01). (3) There was no significant difference in AAQ-Ⅱ scores between the two groups before the intervention(33.79±7.90, 30.00±7.23, t=1.52, P=0.14). After the intervention, the AAQ-Ⅱ score in the MBCT group was significantly lower than that in the health education group(21.89±8.69, 30.22±8.68, t=-3.51, P<0.01) . Conclusion:MBCT has a positive effect on enhancing mindfulness attention awareness, reducing cognitive fusion, and mitigating experiential avoidance in GAD patients.
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Objective:To explore and analyze the influence of amyloid precursor protein (APP) protein high expression in brain glioma tissue on postoperative radiotherapy.Methods:Retrospective analysis was performed on 96 patients with surgically resected glioma admitted to the Department of Oncology, Affiliated Hospital of Jining Medical College from Feb. 2020 to Feb. 2022. Clinicopathologic data such as gender, age, tumor location, number of lesions, surgical resection, overall tumor burden reduction rate, radiotherapy dose, maximum lesion diameter of preoperative KPS score and Ki-67 proliferation index were collected, and 96 brain glioma tissue samples were collected.According to the effect of postoperative radiotherapy, the patients were divided into a good radiotherapy effect group (54 cases) and a poor radiotherapy effect group (42 cases), and the number, location, size, pathological grade and other clinical data of the two groups were compared. The expression level of APP in low-grade glioma (52 cases) and high-grade glioma tissue (44 cases) was detected by Western blot method. The clinicopathologic data of patients in the group with good radiotherapy effect and the group with poor radiotherapy effect were analyzed by single factor to find out the influencing factors of postoperative radiotherapy for patients with glioma. Multivariate Logistic analysis was used to analyze the relationship between APP protein expression and postoperative radiotherapy for glioma.Results:Among the 96 brain glioma patients, 56 cases had high expression of APP protein, with high expression rate of 58.33%. The high expression rate of APP protein in high grade gliomas was higher than that in low grade gliomas ( χ2=6.924, P < 0.05). Evaluation results of postoperative radiotherapy for 96 glioma patients showed complete remission was in 21 cases (21.88%), partial remission in 33 cases (34.38%), stable in 26 cases (27.08%) and progressive in 16 cases (16.67%), with an objective remission rate of 56.25% (54/96). Univariate analysis showed that the proportion of high grade glioma, maximum lesion diameter ≥6 cm, Ki67 proliferation index ≥10% and high expression of APP protein in the poor radiotherapy effect group was higher than that in the good radiotherapy effect group ( χ2=6.959, 9.423, 24.282, 37.481, P < 0.05). Multivariate Logistic regression analysis showed that the pathological grade of high-grade glioma ( OR=2.838, 95% CI: 1.501-5.366) and high expression of APP protein ( OR=3.089, 95% CI: 1.364-6.996) were independent risk factors for the effect of postoperative radiotherapy in patients with glioma ( P < 0.05) . Conclusions:APP protein is highly expressed in glioma tissues, and its expression increases with the increase of the pathological grade of glioma. APP protein high expression is an independent risk factor affecting the adverse effect of postoperative radiotherapy in glioma patients.
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Objective:To investigate the influencing factors of non-remission of proteinuria in patients with nephrotic syndrome (NS) and idiopathic membranous nephropathy (IMN).Methods:The study was a retrospective observational study. The clinical data of patients with NS who were diagnosed as IMN by renal biopsy and serum albumin recovered normal after six months of treatment were collected from Beijing Anzhen Hospital, Capital Medical University from June 1, 2010 to January 31, 2022. Patients were divided into proteinuria remission group and non-proteinuria remission group according to whether urinary protein < 3.5 g/24 h and decreased 50% from the onset. The differences of clinical and pathological characteristics between the two groups at baseline were compared. The logistic regression model was used to analyze the influencing factors of non-remission of proteinuria.Results:Ninety-five NS patients with renal pathology of IMN were included in this study, with age of 57(43, 65) years old and 50 males (52.6%). There were 75 patients in the proteinuria remission group and 20 patients in the non-proteinuria remission group. Compared with the proteinuria remission group, the non-proteinuria remission group had higher baseline body mass index [(26.83±4.03) kg/m 2vs. (24.68±3.97) m 2, t=-2.149, P=0.034] and proportion of overweight (85.0% vs. 58.7%, χ2=4.765, P=0.029), and larger waist circumference [88.5(85.3, 101.5) cm vs. 87.0(77.5, 92.0) cm, Z=2.362, P=0.018]. Renal pathological results showed that the proportions of diabetes nephropathy (10.0% vs. 0, P=0.043) and glomerular hypertrophy (45.0% vs. 20.0%, χ2=5.227, P=0.022) were higher, and the average diameter of hypertrophic glomeruli was longer [(197.96±6.37) μm vs. (193.51±8.50) μm, t=2.029, P=0.041] in the proteinuria remission group than those in the non-proteinuria remission group. Multivariate logistic regression analysis results showed that waist circumference was an independent influencing factor of non-proteinuria remission in patients with IMN under waist circumference > 90 cm in men and >85 cm in women ( OR=1.083, 95% CI 1.005-1.168, P=0.037). Conclusion:Abdominal obesity is an independent risk factor of non-remission of proteinuria in NS patients with IMN after early treatment.
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The study was a retrospective study. The clinical data of 866 patients with IgA nephropathy (IgAN) in Beijing Anzhen Hospital, Capital Medical University from March 2010 to March 2021 were analyzed, to investigate the clinical pathology and renal prognosis of IgAN patients with intrarenal arteriolosclerosis, and to preliminarily explore whether abnormal activation of complement system is involved in the injury of arteriolosclerosis. The patients were divided into renal arteriolar lesions group and non-renal arteriolar lesions group according to the renal histopathology, and the differences of clinical pathological manifestations, prognosis between the two groups were compared. The results showed that, compared with the non-renal arteriolar lesions group ( n=236), IgAN patients in the renal arteriolar lesions group ( n=630) had higher proportions of hypertension and malignant hypertension, higher levels of urinary albumin-creatinine ratio, 24-hour urine protein quantification and serum uric acid, lower estimated glomerular filtration rate, and more severe MEST-C lesions of the Oxford classification (all P < 0.05). Cox regression analysis results showed that intrarenal arteriolosclerosis was the independent risk factor affecting the progression of IgAN to ESRD ( HR=6.437, 95% CI 2.013-20.585, P=0.002). Renal histopathology showed that the deposition of complement C3c on the wall of intrarenal arterioles in the renal arteriolar lesions group ( n=98) was stronger than that in non-renal arteriolar lesions group ( n=18, P < 0.05). IgAN patients with renal arteriolosclerosis present with serious clinical and pathological manifestations, and renal prognosis. Abnormal activation of complement system may be involved in the pathogenesis of intrarenal arteriolosclerosis.
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OBJECTIVE To establish the methods to identify the chemical components of Ixeris chinensis, and determine the contents of 7 components (chlorogenic acid, luteolin, quercetin, rutin, protocatechuic acid, isochlorogenic acid A, luteoloside). METHODS HPLC-Q-Exactive-MS was used to identify the chemical components of I. chinensis. The contents of 7 components in I. chinensis, including chlorogenic acid, were determined by HPLC-MS/MS. RESULTS A total of 45 components were identified in I. chinensis, including 20 organic acids, 13 flavonoids, 4 fatty acids, 4 amino acids, 3 nucleosides, and 1 coumarin. The linear range of chlorogenic acid, luteolin, quercetin, rutin, protocatechuic acid, isochlorogenic acid A and luteoloside were 503.00- 25 150.00, 42.00-2 100.00, 5.05-252.50, 20.05-1 002.50, 25.10-1 255.00, 750.00-37 500.00, 196.00-9 800.00 ng/mL (r≥0.999 2), respectively. RSDs of precision, stability and reproducibility tests were all less than 3.00% (n=6), and average recovery ranged from 96.72% to 105.84% (all RSD<4.00%, n=6). The contents of 7 components in 3 batches of I. chinensis were 1 145.77- 3 261.25, 23.75-97.90, 0.92-2.12, 1.06-23.18, 9.35-21.85, 833.25-1 045.58, 199.56-1 869.78 μg/g, respectively. CONCLUSIONS The established methods for identification and content determination are rapid and simple, and can be used for the identification of chemical components and the content determination of 7 components in I. chinensis.
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OBJECTIVES: To further investigate the clinical characteristics and circulating lymphocyte profiles of patients with early-onset primary Sjögren's syndrome (pSS). METHOD: Data of 333 patients with pSS were analysed retrospectively. Early onset was defined as a pSS diagnosis at an age of 35 years or younger. The clinical, laboratory and immunophenotypic profiles of peripheral blood lymphocyte subsets were compared between early- and later-onset pSS. RESULTS: Thirty-six (10.81%) patients matched the definition of early-onset pSS, with age at disease onset being 28.97 (5.53) years. Elevated serum IgG level (77.14% vs 31.16%, P <0.001), low C3 (41.67% vs 20.20%, P =0.004) and C4 levels (27.78% vs 6.40%, P <0.001), anti-SSA positivity (91.67% vs 51.85%, P <0.001) and anti-SSB positivity (50% vs 20.54%, P <0.001) were more frequent in early-onset patients. The frequencies of hematological (80.56% vs 52.53%, P =0.001), renal (19.44% vs 5.05%, P =0.005) and mucocutaneous involvement (50% vs 22.56%, P <0.001) were significantly higher in the early-onset pSS group, which showed a higher 2010 EULAR SS Disease Activity Index (ESSDAI) [11(6.25-17) vs 7(3-12); P =0.003], compared with the later-onset group. In addition, profound CD4+ T-cell lymphopenia was found in patients with early-onset. CONCLUSIONS: Patients with early-onset pSS have distinctive clinical manifestations and greater activation of the cellular immune system, present with more severe clinical symptoms and immunological features, have increased activation of circulating T cells and have an unfavourable prognosis. Thus, they require more positive treatment with glucocorticoids and/or immunosuppressants and merit closer follow-up and regular monitoring.
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Linfocitos/inmunología , Síndrome de Sjögren/inmunología , Adulto , Factores de Edad , Anciano , Biomarcadores/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Objective:To evaluate the efficacy and tolerability of the dual therapy of dolutegravir (DTG) plus lamivudine (3TC) as a switch simplified strategy in treatment-experienced human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients.Methods:Treatment-experienced HIV/AIDS patients who switched to a dual therapy containing DTG (50 mg, once daily) plus 3TC (300 mg, once daily) were included in Beijing You′an Hospital, Capital Medical University from September 2016 to May 2019. HIV RNA, CD4 + T lymphocyte count, blood lipid indexes, renal function indexes were collected when patients changed the treatment regimen (baseline) and after 48 weeks of treatment. Efficacy (HIV RNA<50 copies/mL) and safety of the dual therapy were analyzed. Statistical comparisons were performed using the Wilcoxon matched-pairs signed rank test. Results:The reasons for 33 patients switching the treatment regimen were virologic failure (four cases, 12.1%), simplification of regimen (11 cases, 33.3%), and drug toxicity (18 cases, 54.5%). The patients were treated with anti-retroviral therapy (ART) for 2.13 (1.05, 4.23) years before regimens switching. Twenty-nine (87.9%) patients were virologically suppressed at baseline, and four (12.1%) patients were virological failure. After switching to DTG plus 3TC, all 33 patients showed HIV RNA<50 copies/mL after 48 weeks of treatment. The baseline CD4 + T lymphocyte count was 543 (363, 595)/μL. After switching the treatment regimens for 48 weeks, CD4 + T lymphocyte count was significantly increased to 625 (455, 651)/μL, and the difference was statistically significant ( Z=3.14, P=0.002). Compared with baseline, low-density lipoprotein-cholesterol was increased after 48 weeks of treatment (2.35(1.80, 3.08) mmol/L vs 3.12(2.74, 3.87) mmol/L), while triglyceride (2.21(1.27, 4.37) mmol/L vs 1.61(1.20, 2.22) mmol/L), the ratio of total cholesterol to high-density lipoprotein-cholesterol (5.02 (4.13, 6.40) vs 4.70 (3.55, 5.35)) and estimated glomerular filtration rate (106.4(78.2, 118.2) mL/(min·1.73 m 2) vs 88.6 (75.7, 107.9) mL/(min·1.73 m 2)) were decreased. The differences were all statistically significant ( Z=4.89, 2.37, 2.09 and 2.83, respectively, all P<0.050). No patient discontinued due to adverse events. Conclusions:The use of dual therapy containing DTG and 3TC is effective and well-tolerated in treatment-experienced HIV/AIDS patients under any prior ART without significant adverse events.
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Objective:To investigate the intention to obtain disease related information and its influencing factors among the elderly at their end-of-life stage.Methods:A cross-sectional survey was conducted among 414 elderly people aged ≥60 in 7 long-term residential care facilities and 15 communities in the central urban area of Fuzhou using the late-life care preference questionnaire from October 2016 to June 2017. Univariate analysis, multiple linear regression analysis and ordered multi-classification logistic regression analysis were used to identify information preference of the disease-related information and influencing factors among the elderly.Results:The level of disease-related information needs of the elderly was scored (17.1±4.9); 48.8% (202/414) preferred detailed or maximum information; 30.7% (127/414) wanted selective and partial information; 20.5% (85/414) did not want to know any information. Multiple linear regression analysis showed that age, education, and whether or not they had received or seen other life-sustaining treatments were the main factors affecting the level of disease-related information needs (standardized regression coefficients were -0.141, 0.116, 0.115, all P<0.05); ordered multi-classification logistic regression analysis showed that age (compared with 60-69 years old, 70-79 years old: OR=0.544, 95% CI: 0.310-0.957; 80-89 years old: OR=0.526, 95% CI: 0.289-0.956), education level (compared with primary school and below, college or above: OR=2.166, 95% CI: 1.093-4.290), main sources of living expenses (compared with other allowance, family support: OR=7.303, 95% CI: 1.157-46.108, pension: OR=9.288, 95% CI: 1.502-57.415; provident fund scheme/saving: OR=15.676, 95% CI: 2.122-115.793), whether or not they had received or seen other life-sustaining treatments (compared with yes, OR=1.985, 95% CI: 1.150-3.425) were the main factors affecting the level of disease-related information needs. Conclusions:Most of the elderly prefer to know disease-related information. Age, educational level, main sources of living expenses and whether or not they had received or seen other life-sustaining treatments are the main influencing factors.
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Objective:To investigate the role of complement activation in the pathogenesis of primary malignant hypertension (MHT) with nephrosclerosis complicated with severe cardiorenal injury.Methods:Data of MHT patients with nephrosclerosis proven by biopsy from January 2010 to December 2020 in the Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. The expressions of complement-related component C4d, C1q, complement factor H-related protein 5, C3c and C5b-9 were detected by immunohistochemical staining. According to whether the patients were complicated with acute heart failure (AHF) and/or acute kidney injury (AKI), they were divided into severe cardiorenal injury group and non-severe cardiorenal injury group. The differences of clinicopathological data between the two groups were compared. According to the degree of C4d deposition in renal tissues, patients were divided into C4d diffused deposition group and non-C4d diffused deposition group. The severity of cardiorenal injury and the pathological characteristics of thrombotic microangiopathy in renal tissues were compared between the two groups.Results:A total of 33 patients were enrolled in this study, of which 17 cases (51.5%) were complicated with severe cardiorenal injury; AHF occurred in 16 patients (48.5%), AKI occurred in 8 patients (26.7%), and AHF and AKI were combined in 7 patients (21.2%). Compared with non-severe cardiorenal injury group, patients in severe cardiorenal injury group had higher levels of baseline lactate dehydrogenase [326.0 (217.0, 366.0) IU/L vs 197.0 (165.0, 220.0) IU/L, Z=37.000, P=0.002] and hemoglobin [(143.6±24.0) g/L vs (106.4±24.7) g/L, t=38.500, P<0.001], lower levels of 12 h urinary incontinence osmolality [400.0 (342.5, 504.0) mmol/L vs 476.0 (432.3, 616.5) mmol/L, Z=72.000, P=0.021] and serum albumin [(36.2±9.4) g/L vs (43.2±6.2) g/L, t=6.423, P=0.017], and thicker left ventricular posterior wall [(14.0±2.1) mm vs (12.1±1.1) mm, t=6.552, P=0.018]. The immunohistochemical results of kidney tissue showed that the proportions of C4d and C5b-9 diffused deposition in severe cardiorenal injury group were significantly higher than those in non-severe cardiorenal injury group (5/16 vs 0/15, P=0.043; 12/16 vs 5/15, P=0.032). Compared with non-C4d diffused deposition group, C4d diffused deposition group had higher incidence of AHF (5/5 vs 10/26, P=0.018), poorer heart function, more severe ventricular remodeling, and shorter history of hypertension [2.0 (0, 12.0) months vs 48.0 (9.5, 84.0) months, Z=22.500, P=0.022]. Conclusions:The incidence of severe cardiorenal injury in MHT patients with nephrosclerosis is about 51.5%. The proportion of diffuse deposition of complement activated components in renal tissues in patients with severe cardiorenal injury is higher than that in patients with non-severe cardiorenal injury. Overactivation of complement may be involved in the pathogenic process of severe heart and kidney injury caused by MHT.
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OBJECTIVE: To screen the hepatoprotective active fractions from Ixeris chinensis and study its chemical constituents. METHODS:The petroleum ether,ethyl acetate,n-butanol and residual water fractions from 70% ethanol extract of I.chinensis were extracted by systematic solvent method. Human hepatocytes HL-7702 were induced by acetaminophen to induce liver injury model. MTT method was used to detect the protective effect of the above fractions(40 μg/mL,by the dosage of crude drug)on injured cells,and the active fractions were screened. The active fractions were separated and purified by silica gel column and Sephadex column chromatography. The structure of the compounds were identified by physical and chemical properties and spectral data (hydrogen spectrum,carbon spectrum). RESULTS:After treated with different fractions of I. chinensis,the cell survival rate of each administration group was increased significantly,compared with model group(P<0.01),and the n-butanol and water fractions had the strongest activity (the cell survival rates were 49.3% and 52.2% ,respectively). Six compoundswere isolated from n-butanol fraction and identified as sonchifolignan A(Ⅰ),apigenin-7-O-β-D-glucopyranoside methyl ester(Ⅱ),luteolin-7-O-β-D-glucuronopyranoside methyl ester (Ⅲ),luteolin-7-O-β-D-glucopyranoside (Ⅳ),apigenin-7-O-β-Dglucopyranoside(Ⅴ)and luteolin(Ⅵ). CONCLUSIONS:The n-butanol fraction is regarded as an effective position for protecting liver,and flavonoids are the main active omponents.KEYWORDS Ixeris chinensis;Hepatoprotective activi
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IntroductionThe purpose of the study was to summarize the clinical and laboratory characteristics of the coronavirus disease 2019 patients admitted to intensive care unit. MethodsWe tracked the data until March 5, 2020. The cases in our cohort were divided into cases only received noninvasive ventilation (NIV) and cases required invasive mechanical ventilation (IMV). The characteristics between the two groups were compared. Results34 cases were included in the study. The complications rate (including, acute liver injury, acute cardiac injury and acute kidney injury) were higher in IMV cases. Lymphocytopenia and neutrophilia occurred in most cases in both groups on the admission day, however, lymphocyte levels dropped progressively and more severe lymphopenia occurred in IMV group. Increased amounts of plasma IL-6 and IL-10 were found in both groups on the admission day, the progressive decrease of which occurred in NIV cases rather than IMV cases, and the levels were higher in IMV cases during hospitalization. ConclusionsLymphocytopenia, neutrophilia, and increase of IL-6 and IL-10 occurred in SARS-CoV-2 infected patients in ICU, however, the dynamics of those were significantly different in IMV cases and NIV cases during hospitalization.
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Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19). Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical ill COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial ow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
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Anciano , Humanos , Betacoronavirus , Cánula , Infecciones por Coronavirus , Terapéutica , Oxígeno , Pandemias , Neumonía Viral , TerapéuticaRESUMEN
Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19) induced by severe acute respiratory syndrome coronavirus 2 infection. Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial flow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
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Anciano , Humanos , Betacoronavirus , Cánula , Infecciones por Coronavirus , Terapéutica , Hipoxia , Terapéutica , Máscaras , Oxígeno , Terapia por Inhalación de Oxígeno , Estándares de Referencia , Pandemias , Neumonía Viral , TerapéuticaRESUMEN
Objective To investigate the current state of psychological distress of lymphoma patients'caregivers, and analyze its influencing factors. Methods From October 2017 to February 2018, 96 pairs (patients and their caregivers) from the department of lymphoma were enrolled. Distress Thermometer and self-designed general scale were adopted to conduct survey. Results The psychological distress score of lymphoma caregivers was as high as (4.76 ± 2.28) points, which was significantly higher than the patient's score (3.81±2.33) points, the difference was statistically significant (t=4.070,P<0.05 ). Different ages, economic status, and patient's disease of caregivers had different psychological distress, and the difference was statistically significant (P<0.05). Meta-linear regression analysis showed that age and patient psychological distress were the main influencing factors of psychological distress of lymphoma patients'caregivers, which could explain the variability of 32.7%(P<0.05). Conclusions The psychological distress of lymphoma patients'caregiver is at a moderate level, which is affected by their age and psychological distress of the patients. It suggests that clinical medical staff should pay attention to the psychological distress of patients and strengthen the psychological support of caregivers to better promote patient care.
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Objective To observe the long-term effect,adverse reaction and cosmetic outcome of early-stage breast cancer with hypofractionated whole-breast irradiation (HF-WBI) after breast-conserving surgery.Methods A total of 206 patients with stage 0-Ⅱ breast cancer after breast-conserving surgery were included in Shandong Cancer Hospital Affiliated to Shandong University from May 2014 to August 2017.According to radiotherapy fraction,patients were divided into HF-WBI group and conventional whole-breast irradiation (CF-WBI) group.In HF-WBI group,116 patients received whole-breast radiation to 42.56 Gy in 16 fractions followed by tumor bed boost of 9 Gy in 3 fractions or 10 Gy in 5 fractions.In CF-WBI group,90 patients received whole breast radiation to 50 Gy in 25 fractions followed by tumor bed boost of 10 Gy in 5 fractions.The 2-year local recurrence rate,2-year mortality rate,acute adverse reaction,late adverse reaction and cosmetic outcome of the two groups were analyzed.Results The 2-year local recurrence rates of HF-WBI group and CF-WBI group were 0.86% (1/116) and 2.22% (2/90) respectively,and there was no significant difference between the two groups (x2 =0.049,P =0.824).The 2-year mortality rates of the two groups were 0.86% (1/116) and 0 (0/90) respectively,and there was no significant difference (P > 0.999).There were 108 cases (93.1%) in HF-WBI group and 84 cases (93.3%) in CF-WBI group with grade 0-1 acute dermatitis,and 8 cases (6.9%) and 6 cases (6.7%) with grade 2-3 respectively,with no statistically significant difference (x2 =0.004,P =0.948).There were 97 cases (83.6%) in HF-WBI group and 79 cases (87.8%) in CF-WBI group with grade 0-1 bone marrow suppression,and 19 cases (16.4%)and 11 cases (12.2%) with grade 2-4 respectively,with no statistically significant difference (x2 =0.704,P =0.401).In the two groups,there were 1 case (0.9%) and 3 cases (3.3%) with grade 1-2 radiation pneumonitis,and 115 cases (99.1%) and 87 cases (96.7%) with no radiation pneumonitis respectively,and the difference was not statistically significant (x2 =1.626,P =0.202).There was 1 case (0.9%,1.1%) with grade 1 breast edema in each group,and 115 cases (99.1%) and 89 cases (98.9%) did not occur breast edema,with no statistically significant difference (x2 =0.033,P =0.857).In the late adverse reactions,there were 5 cases (4.3%) and 3 cases (3.3%) with skin pigmentation in HF-WBI group and CF-WBI group respectively.There were 2 cases (1.7%,2.2%) with grade 1 subcutaneous tissue fibrosis in each group,and there were 1 case (0.8%) and 2 cases (2.2%) with grade 1 pulmonary fibrosis respectively.The differences between the two groups were not statistically significant (x2 =0.000,P > 0.999;x2 =0.000,P > 0.999;x2 =0.049,P =0.824).The 6-month,1-year and 2-year cosmetic outcome good rates in HF-WBI and CF-WBI group were 96.5% (111/115) and 93.3% (84/90),92.1% (105/114) and 90.0% (81/90),91.4% (53/58) and 87.2% (41/47) respectively.The differences between the two groups were not statistically significant (x2 =0.526,P =0.468;x2 =0.277,P =0.599;x2 =0.476,P =0.490).The whole course of radiotherapy time in HF-WBI group was 25 days or 29 days,which was significantly shorter than the 40 days of CF-WBI group.Conclusion HF-WBI after breast-conserving surgery has the similar long-term effect,acute and late adverse reaction and cosmetic outcome compared with CF-WBI,and the treatment time is significantly shorter.It can be further promoted as the optimal adjuvant radiotherapy for early-stage breast cancer after breast-conserving surgery.
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s] Objective To analyze the diagnostic value of combined detection of sFIt-1, PLGF and Survivin in early onset preeclampsia. Methods From January 2017 to January 2018, 100 patients with early-onset PE were selected as observation group and 100 healthy pregnant women as control group in Tangshan Maternal and Child health Hospital Gynecology and Obstetrics. The expression levels of sFIt-1, PLGF and Survivin in serum were detected by enzyme-linked immunosorbent assay (ELISA), and the diagnostic value of each index was analyzed separately and jointly. Results The levels of sFIt-1 in the observation group were significantly higher than those in the control group: (36.58 ± 18.34) μg/L vs. (28.43 ± 3.28) μg/L (P<0.05), and the levels of PLGF and Survivin in the observation group were significantly lower than those in the control group: (213.18 ± 48.23) ng/L vs. (398.17 ± 41.19) ng/L, (0.72 ± 0.29) μg/L vs. (1.43 ± 0.32) μg/L (P<0.05); 103 cases of positive sFIt-1, 108 cases of positive PLGF, 107 cases of positive Survivin, 121 cases of positive parallel combined diagnosis and 121 cases of positive series combined diagnosis were found. The sensitivity and negative predictive value of parallel combined diagnosis were significantly higher than those of individualized diagnosis (P<0.05), and the specificity and positive predictive value of series combined diagnosis were significantly higher than those of individualized diagnosis (P < 0.05). Conclusions The combined detection of sFIt-1, PLGF and Survivin in serum can effectively improve the diagnostic accuracy of early-onset preeclampsia and has high clinical value.
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Objective To evaluate the diagnostic value of pathological features of atypical membranous nephropathy (AMN). Methods Ninety - one patients with AMN diagnosed by renal biopsy during 2011 and 2017 were enrolled in this study. On the basis of M - type phospholipase A2 receptor (PLA2R) and thrombospondin type - 1 domain - containing 7A protein (THSD7A) by immunohistochemistry, patients were divided into AMN group (25 cases without PLA2R and THSD7A) and idiopathic membranous nephropathy (IMN) group (66 cases with positive PLA2R or THSD7A). The results of immunofluorescence (IF), light microscopy (LM) and electron microscopy (EM) of these two groups were compared, and the parameters with statistical difference were screened out in order to assess their value in the diagnosis of AMN in fourfold table. Results IF results showed that in AMN group the proportions of IgG deposition on capillary wall and mesangial area as well as positive otherIgG subclasses and complement C1q but negative IgG4 were significantly higher than those in IMN group (respectively, 56.0% vs 12.1% , 44.0% vs 0, both P<0.05). Their diagnostic specificities for AMN were 87.9% and 100.0%, respectively. However, the positive rates of IgG accompanied with IgA and/or IgM, predominant IgG4 with other IgG subclasses and complement C1q in two groups were not significantly different (all P>0.05). LM results showed that the proportions of false double track sign on basement membrane and fuchsinophilic proteins under epithelium, endothelium, basement membrane and mesangial region in AMN group were significantly higher than those in IMN group (respectively, 36.0% vs 0, 44.0% vs 1.5%, both P<0.05). Their diagnostic specificities for AMN were 100.0% and 98.5% , respectively. However, the scores of mesangial cell proliferation of these two groups showed no significantly difference (P>0.05). EM results showed that the rate of endothelial electron dense deposits in AMN group was significantly higher than that in IMN group (36.0% vs 1.5%, P<0.05), and its diagnostic specificity for AMN was 98.5%. Conclusions IgG deposition on both capillary wall and mesangial area, positive other IgG subclasses and C1q with negative IgG4, false -double contour sign, multi - site fuchsinophilic deposits and endothelial electron dense deposits may help for the AMN diagnosis in the absence of PLA2R and THSD7A related data.
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The school-age boy was admitted to Tianjin Children's Hospital for "fever and cough for 6 days".After detail examinations,the diagnosis of severe Mycoplasma pneumoniae pneumonia was proved.Treatments:anti-infection with Azithromycin and Meropenem;the obstruction of air way was relieved;assisted with symptomatic and supportive treatment.During the treatment,disorder of consciousness and hemiplegia of right limbs occurred,cerebral infarction was proved later by magnetic resonance angiography(MRA).Severe Mycoplasma pneumoniae pneumonia complicated with cerebral infarction is clinically rare with a high morbidity and mortality.Attention should be paid to body examination and Laboratory test.Multi-disciplinary cooperation is helpful.
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Objective To explore the effects of high-frequency electromagnetic radiation exposure on the mood-cognitive behaviors of mice, and to provide an experimental basis for the study on radiation damage mechanism and protection. Methods The electromagnetic reverberation chamber can produce continuous and uniform high-frequency electromagnetic waves. Different groups of ICR mice were exposed to high-frequency electromagnetic radiation in this chamber for 1 d, 3 d and 7 d, and then series of behavioral tests were conducted to observe the changes in locomotor activities,depressive-like and anxiety-like behaviors, and cognitive function of the mice. Results After exposed to the high-frequency electromagnetic radiation(3 GHz,SAR 4 W/kg)4 h/d for 7 d,there was no obvious change in locomotor activity(times of grid crossing and standing up in the open field test)of the mice,while the times of entering the central region(P< 0.05)and the time duration(P< 0.05)were significantly decreased. Compared with the unexposed group, the percentage of the times of entering the open arm in the elevated-plus maze(P< 0.05)and the time duration in the open arm(P< 0.01)of the mice in the radiation group were significantly decreased. Meanwhile, the immobility time in the forced-swimming test(P< 0.01)and the tail suspension test(P < 0.05)of the mice exposed to electromagnetic radiation was significantly increased, and the discrimination index of new objects in the new object recognition test was significantly reduced(P < 0.001). Conclusions Continual exposure to high-frequency electromagnetic radiation(3 GHz,SAR 4 W/kg)can lead to anxious-depression behaviors and cognitive impairment of mice in a time-dependent manner,which provides an experimental basis for the relevant study of prevention and therapy techniques.