Analysis of hot topics and frontiers on blood pressure monitoring in research of chronic kidney disease at home and abroad,2011-2022 / 现代临床护理

Objective To analyse the hot topics(CKD)frontiers,and of blood pressure monitoring in research of chronic kidney disease(CKD)at home and abroad,and provide references for future research in this field.Methods Articles on blood pressure monitoring in published in Web of Science,China Knowledge Network Infrastructure(CNKI),Wanfang(Wanfang Data)and China Science and Technology Journal Database(VIP)from 2011 to 2022 were searched,and CiteSpace 5.8.R3 visual analysis software was employed to analyse the number of articles involved,country,institution,keyword co-occurrence.The analysis was performed on the number of published papers,countries,institutions,keyword co-occurrence atlas,high frequency subject terms,keyword emergence and emergence of literatures.Results ① A total of 504 articles in English and 72 articles in Chinese were extracted from the literature search.Annual distribution of the number of articles generally showed a continuous upward trend,in which 2 peaks of articles were formed in 2016 and 2018;the main country of issuance was the United States,and the main institution of issuance was the Aristotle University of Thessaloniki,Greece;② In the analysis of keyword co-occurrence,8 high-frequency keywords with a word frequency greater than or equal to 30 were identified.It indicated that the research hotspots mainly focused on the classification of hypertension,the characteristics of blood pressure circadian rhythm,the management of cardiovascular disease and the prediction of death and prognosis in the blood pressure monitoring of CKD;③ Further testing of the emergent terms and emergent literatures yielded 23 strongest emergent terms and 11 emergent literatures,which went through three stages of development,namely,early,intermediate and latest.It was found that the research gradually shifted from the application of blood pressure monitoring in the assessment and diagnosis of kidney disease to the treatment,management and prognostic assessment of hypertension in CKD Conclusion The importance of blood pressure monitoring in the management of hypertension in CKD has received increasing attention from researchers,and future researches should focus on using different blood pressure monitoring schemes to enhance the assessment of cardiovascular risks and the individualised management of hypertension.

Prevalence and associated factors of mortality after percutaneous coronary intervention for adult patients with ST-elevation myocardial infarction: A systematic review and meta-analysis.

Background: There is a paucity of systematic reviews on the associated factors of mortality among ST-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). This meta-analysis was designed to synthesize available evidence on the prevalence and associated factors of mortality after PCI for adult patients with STEMI. Materials and Methods: Databases including the Cochrane Library, PubMed, Web of Science, Embase, Ovid, Scopus, ProQuest, MEDLINE, and CINAHL Complete were searched systematically to identify relevant articles published from January 2008 to March 2020 on factors affecting mortality after PCI in STEMI patients. Meta-analysis was conducted using Stata 12.0 software package. Results: Our search yielded 91 cohort studies involving a total of 199, 339 participants. The pooled mortality rate for STEMI patients after PCI was 10%. After controlling for grouping criteria or follow-up time, the following 17 risk factors were significantly associated with mortality for STEMI patients after PCI: advanced age (odds ratio [OR] = 3.89), female (OR = 2.01), out-of-hospital cardiac arrest (OR = 5.55), cardiogenic shock (OR = 4.83), renal dysfunction (OR = 3.50), admission anemia (OR = 3.28), hyperuricemia (OR = 2.71), elevated blood glucose level (OR = 2.00), diabetes mellitus (OR = 1.8), chronic total occlusion (OR = 2.56), Q wave (OR = 2.18), without prodromal angina (OR = 2.12), delay in door-to-balloon time (OR = 1.72), delay in symptom onset-to-balloon time (OR = 1.43), anterior infarction (OR = 1.66), ST-segment resolution (OR = 1.40), and delay in symptom onset-to-door time (OR = 1.29). Conclusion: The pooled prevalence of mortality after PCI for STEMI patients was 10%, and 17 risk factors were significantly associated with mortality for STEMI patients after PCI.

Challenges and reflections on the final theoretical examination of Chinese undergraduate medical education in the context of organ-system based integrated curriculum / 中华医学教育探索杂志

In order to solve the problems faced by final theoretical examination in the context of organ-system based integrated curriculum, this article analyzes the challenges and demands placed on the final theoretical examination of organ-system based integrated curriculum in undergraduate medical education, and it is pointed out that traditional medical theoretical examinations cannot meet these new demands since they are mainly memorized questions with one knowledge point for each question, as well as a lack of multidisciplinary knowledge fusion. By analyzing the questions in the United States Medical Licensing Examination (USMLE) test, this article summarizes the features of final theoretical examination suitable for organ-system based integrated curriculum and proposes that the final theoretical examination of organ-system based integrated curriculum suitable for Chinese undergraduate medical education can be developed through the translation of USMLE test, item modeling technique, or writing new tests based on the classification of knowledge points. The reform of final theoretical examination in the context of organ-system based integrated curriculum may help to realize the aim and objective of integrated teaching.

Recent advance in predictive value of blood biomarkers in post-stroke cognitive impairment / 中华神经医学杂志

Post-stroke cognitive impairment (PSCI), one of the important complications of stroke, seriously affects the quality of life of these patients. PSCI is an important cause of disease burden of stroke. In recent years, more and more evidences show that blood biomarkers are of great significance in PSCI diagnosis, and the detection of blood biomarkers is relatively simple and more suitable for clinical application. Therefore, this paper sorts out the values of 5 blood biomarkers, nerve injury marker, metabolic biomarker, inflammatory biomarker, oxidative stress marker and other biomarker, in diagnosing PSCI, to provide references for early diagnosis and intervention of PSCI.

Expression profile and clinical significance of miRNA in children with autism spectrum disorder / 中国医师杂志

Objective:The purpose of this study was to analyze the expression profile of miRNAs in children with autism spectrum disorders (ASD), and to discuss the clinical significance of differentially expressed miRNAs.Methods:MiRNA microarray was used to analyze the expression of miRNA in peripheral blood of 3 pairs of ASD patients-healthy controls; 17 pairs of ASD patients-healthy controls were used to verify the differentially expressed miRNA; Receiver operating characteristic (ROC) curve was used to analyze the differential expression the value of miRNA in the diagnosis of ASD.Results:A total of 32 differentially expressed genes were screened by 3 pairs of miRNA microarray including 12 up-regulated miRNAs and 20 down-regulated miRNAs. miRNA verification of 20 differentially expressed miRNAs showed miR-15a-5p, miR-27a-3p , miR-142-3p and miR-142-5p were significantly down-regulated in children with ASD, with statistically significant difference (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the above four miRNAs diagnosing ASD were all greater than 0.70, with sensitivities 94.12%, 100%, 100%, and 82.35%, respectively. Conclusions:The expression of miR-142-3p, miR-27a-3p/miR-15a-5p, and miR-142-5p is down-regulated in the peripheral blood of ASD patients, and has the potential as biomarkers for early screening of ASD.

Recent advance in predictors and risk prediction models for conversion from mild cognitive impairment to Alzheimer's disease / 中华神经医学杂志

Alzheimer's disease (AD) is the most common form of dementia in the elderly, and there is no specific treatment to stop or reverse its progression. Mild cognitive impairment (MCI) is an important entry point for early diagnosis and prevention of AD. More and more studies have explored the risk factors and biomarkers for conversion from MCI to AD, and a series of risk prediction models have been established. This article analyzes and summarizes the different predictors and risk prediction models so as to provide basis for early identifying the high-risk group of AD, managing the controllable risk factors, and providing references for the selection and improvement of these models.

Imaging etiology of pathological myopia results in visual impairment / 中华实验眼科杂志

Objective:To analyze the imaging etiology of patients having vision loss with pathological myopia.Methods:A cross-sectional study was conducted.The clinical data of 110 cases (138 eyes) who had vision loss with pathological myopia diagnosed in Xiamen Eye Center of Xiamen University from June 1st, 2016 to May 31st, 2017 was collected and analyzed.Fundus photography was used to observe lacquer cracks; spectral domain optical coherence tomography (SD-OCT), fundus fluorescein angiography, indocyanine green angiography and optical coherence tomography angiography (OCTA) were employed to evaluate the choroidal neovascularization (CNV) and punctate inner choroidopathy (PIC). The macular retinoschisis (MRS), macular atrophy, macular hole and epiretinal membranes were assessed by SD-OCT.The proportion and age distribution of different fundus lesions of pathological myopia complicated with vision loss were analyzed.The study protocol was approved by an Ethics Committee of Xiamen Eye Center of Xiamen University (No.XMYKZX-2016-KY-010). Written informed consent was obtained from each patient before study.Results:Among the imaging causes of visual impairment caused by pathological myopia, there were 87 (63.0%) eyes of myopic CNV (MCNV) with the highest proportion, followed by 53 (38.4%) eyes of lacquer cracks, 48 (34.8%) eyes of MRS, 44 (31.9%) eyes of macular atrophy, 42 (30.4%) eyes of epiretinal membranes, 14 (10.1%) eyes of macular lamellar hole, 19 (13.8%) eyes of full-thickness macular hole (FTMH), and 3 (2.2%) eyes of PIC.The average age was (53.00±1.51) years of MCNV, (53.00±1.77) years of lacquer cracks, (58.00±1.64) years of MRS, (57.00±1.76) years of macular atrophy, (59.00±1.48) years of epiretinal membranes, (61.00±3.90) years of macular lamellar hole, (59.00±3.39) years of FTMH with retinal detachment (RD), and (67.00±0.50) years of FTMH without RD.The average age of PIC patients was (31.00±8.50) years, which was significantly smaller than that of the other groups (all at P<0.05). Conclusions:The main cause of visual impairment resulted from pathological myopia is the obvious abnormality of macular structure, and MCNV is the most common type.

The optimal ranges of serum calcium, phosphorus and intact parathyroid hormone in peritoneal dialysis patients / 中华肾脏病杂志

Objective To cxplore the optimal levels of serum calcium,phosphorus and intact parathyroid hormone (iPTH) in peritoneal dialysis (PD) patients.Methods This study is a single center,retrospective cohort study.The associations between serum calcium,phosphorus and iPTH and all-cause mortality in 217 PD patients were analyzed.All patients started PD between January 1,2008 and April 30,2016 were enrolled and followed up to December 31,2016.At baseline and every 3 months,biochemical and therapeutic information was collected.Cox proportional hazard regression models and cubic splines analysis were employed to assess the lowest mortality risk ranges in serum markers of bone metabolism.Results There was no significantly difference between patients within target ranges based on KDOQI or KDIGO guideline and those outside the target ranges by Kaplan-Meier survival analysis.The lowest mortality risk ranges were 2.17-2.40 mmol/L for serum calcium,1.20-1.67 mmol/L for serum phosphorus and 180-350 ng/L for serum iPTH by using Cox models and cubic splines analysis.Moreover,cumulate survival had significant difference between patients within the descriptive ranges and those out of the descriptive ranges at time-averaged values but not at baseline values.Conclusions The optimal time-averaged ranges of PD patients are 2.17-2.40mmol/L for serum calcium,1.20-1.67 mmol/L for serum phosphorus and 180-350 ng/L for serum iPTH.These ranges need further validation by large population studies to further conform.

Correlative study on thrombelastogram and hemorrhagic transformation after acute ischemic stroke / 国际检验医学杂志

Objective To investigate the correlation between indexes of thrombelastogram (TEG) and hemorrhagic transformation (HT) after acute ischemic stroke.Methods The cases of acute ischemic stroke but not receiving early reperfusion therapy were recruited in our hospital from January to November 2016,and were divided into HT group and non-HT group.Their general clinical characteristics and TEG indexes were retrospectively analyzed,and comparison between two groups and multivariate Logistic regression analysis were performed.Results A total of 71 cases were enrolled and 11 of them were divided into HT group.The percentages of massive cerebral infarction and cardio-embolic stroke were significantly higher in HT group than those in non-HT group (P<0.05),whereas the levels of CI in HT group were significantly lower than thoes in non-HT group(P<0.05).Multivariate Logistic regression analysis showed that massive cerebral infarction (OR=13.172,95%CI:1.414-122.671) and CI(OR=0.554,95%CI:0.321-0.956) were independently correlated with HT(P<0.05).Conclusion CI is independently correlated with HT after acute ischemic stroke,and may be a potential predictor of HT.

Relationship between sense of coherence and coping styles in patients with peritoneal dialysis / 现代临床护理

Objective To explore the relationship between sense of coherence and coping styles among patients at the stabile phase after peritoneal dialysis. Methods About 86 patients at stable phase after peritoneal dialysis were recruited in the investigation. The sense of coherence (SOC-13) and medical coping modes questionnaire (MCMQ) were used to evaluate the sense of coherence and coping styles. Results The average score of sense of coherence was (60.93±13.77), which was at a lower level. The scores of coping styles were confrontation, avoidance and resignation, ranked from high to low. Avoidance and resignation dimensions were higher than the norm in coping styles (all P<0.001) and there was no statistically significant difference between confrontation dimension and the norm (P>0.05). There was positive relationship between confrontation and the average score of sense of coherence, comprehensibility, manageability, meaningfulness (all P<0.05). There was negative relationship between resignation and the average score of sense of coherence, comprehensibility, manageability, meaningfulness (all P<0.001). Conclusions Patients at the stable phase after peritoneal dialysis have a lower sense of coherence and are inclined to confrontation and avoidance coping styles. The higher sense of coherence, the more positive coping styles PD patients use. Medical workers should provide personal interventions according to the results of the sense of coherence so that the patients take positive coping styles.

The value of retinoblastoma binding protein 4 in the diagnosis of prostate cancer / 中华泌尿外科杂志

Objective To explore the value of retinoblastoma binding protein 4 ( RBBP4 ) in diagnosing prostate cancer ( PCa).Methods From January 2015 to December 2015, the prostate tissue after prostatectomy were collected and the differentially expressed degree of RBBP4 protein was analyzed in PCa and adjacent tissues by 2D-DIGE technology.The RBBP4 score of prostate tissue chip which contains 3 normal prostate tissues, 7 cancer adjacent normal prostate tissues, 50 adenocarcinoma and 20 hyperplasia tissue was checked by immunohistochemistry( IHC).In 50 patients with PCa, 4 cases were less than 60 years old and 46 cases were more than 60 years.In those patients, the Gleason scores were less than 7 scores in 18 cases, and more than 7 scores in 30 cases.22 cases were confirmed less than Ⅱ stage, and 28 cases were confirmed more than Ⅲ stage.Finally, the RBBP4 IHC score and the clinic-pathological parameters such as age, Gleason score and clinical stage of PCa patients were analyzed together.Results We found that the protein of RBBP4 increased by 2.15 times in PCa tissues compared to adjacent tissues by using 2D-DIGE technology( P=0.008).The expression of RBBP4 was higher than that in benign tissues by IHC ( F=43.972,P=0.000).And the expression of RBBP4 was positive correlation with Gleason score( t=5.589, P=0.000) and clinical stage(t=5.620,P=0.000), but was negative correlation with age(t=1.125,P=0.266).Conclusions The detection of RBBP4 can help to separate PCa from benign tissues.The overexpression of RBBP4 might result in the rapid growth of malignant cells.It may have certain value in determine the clinical staging and pathological grading of PCa.

Effect of active cycle of breathing techniques on respiratory complications in post-operative lung cancer patients / 现代临床护理

Objective To evaluate the effects of active cycle of breathing techniques (ACBT) on respiratory complications of postoperative lung cancer patients. Methods One hundred non-small-cell lung cancer patients who underwent pulmonary lobectomy or segmentectomy in thoracic surgery department from April 2012 to January 2014 were assigned into the control group , while the experiment group were paired patients from February 2014 to December 2014. We applied ACBT to the experiment group for 5 days after surgical resection and afterward compared the two groups in view of incidence of respiratory complications . Result The incidences of pulmonary infection, atelectasis and hypoxemia in the experiment group were all significantly lower than those in control group (P<0.05). Conclusion ACBT strengthens endurance and force of patients′respiratory muscle group, and therefore reduces postoperative pulmonary complications.

The effect of butyl phthalide in the treatment of acute cerebral infarction and its influence on serum MCP-1 and vWF / 中国基层医药

Objective To study the relationship of serum monocyte chemotactic factor 1 ( MCP-1) and von willebrand factor (vWF) in patients with acute cerebral infarction and the therapeutic effect of butyl phthalide soft capsule.Methods As the research subjects,160 patients of acute cerebral infarction were randomly divided into two groups,80 cases in the observation group,80 cases in the control group.80 cases of healthy physical examination in our hospital were enrolled as the healthy group.The treatment control group was given conventional treatment,treat-ment observation group on the basis of conventional treatment combined with butyl phthalide soft capsule,0.2g orally, three times a day.They were treated for three months.Serum MCP-1 and vWF were detected.Results Before treat-ment,serum MCP-1 and vWF in the observation group and the control group were significantly higher than those in the healthy group(P<0.01).Before treatment,the serum MCP-1 was (480.2 ±34.2)pg/mL,vWF was (2.70 ± 0.45)μg/L,serum MCP-1 and vWF was positively correlated(r=0.286 2,P<0.05).The two groups after treat-ment serum MCP-1 and vWF were significantly decreased,and compared with the control group,the decrease of ser-um vWF and MCP-1 in the observation group was more obvious(P<0.05).Conclusion Serum MCP-1 and vWF has obvious relationship in acute cerebral infarction,butyl phthalide soft capsule can significantly lower the serum con-centration.

Newly interrupted techniques and procedures to prevent gastric cancer cells dissemination in the radical resection of gastric cancer / 中国癌症杂志

Background and purpose:Inadequate surgical operation of gastric cancer may cause introgenic tumor cell dissemination and peritoneal seeding.This study introduced a new technique of the interrupted procedure to prevent gastric cancer cells dissemination in the radical resection of gastric cancer.Methods:Patients received gastric interrupted procedure employing the use of gastric interrupted forceps in the carcinoma of antrum,gastric body or cardia.The interrupted effect,complicated nature of the procedure and the preliminary result of CK19 mRNA expression in the portal blood by RT-PCR techniques of the interrupted group and the routine operation group were analyzed.Results:All the patients were successfully interrupted in the gastric operation,but there were some differences in the detailed procedure between the carcinoma of antrum,gastric body and cardia.Special attention should be given to the prevention of spleen scrape via the interrupted forceps,and to the posterior gastric trauma in case there is adhesion between the stomach and pancreas.Nine patients (9/17) of the routine operation group have positive portal blood CK19 mRNA expression whereas all 17 patients have negative portal blood CK19 mRNA expression in the interrupted group.Conclusion:The interrupted procedure is an easy,useful and safe method of manipulating and to preventing a large amount of gastric cancer cells from disseminating in the portal blood during the radical operation of gastric cancer.