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【Objective】 To study the genotypes of ABO ambiguous blood group samples(n=20) and identify their molecular biological characteristics. 【Methods】 The serological phenotype of the samples was analyzed by serological techniques. Seven exons of ABO gene were amplified by polymerase chain reaction (PCR) and the PCR products were directly sequenced; the genotypes and sequences of ABO subtypes were analyzed. 【Results】 The serological phenotypes of 20 samples presenting ABO ambiguous blood group were as follows: weak A antigen (n=5), weak A antigen combined with anti-A1 antibody (n=5), normal A antigen combined with anti-A1 antibody (n=2), weak B antigen (n=8). The genotypes of them were as follows: Ax02/O01 (n=3), Ael07/O01 (n=2), B313/O01 (n=2), A204/O02 (n=1), A220/O01 (n=1), Ael07/O02 (n=1), Ael02/O01 (n=1), Ael02/O02 (n=1), Ax03/O01 (n=1), Ax03/O02 (n=1), B313/O02 (n=1), B302/O01 (n=1), B302/O02 (n=1), Bw19/O02 (n=1), A102/B313 (n=1) and A101/Bw37 (n=1). 【Conclusion】 ABO genotyping technology can accurately identify the ambiguous blood group of samples, provide definite genetic information of blood group and ensure the safety of clinical transfusion.
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Aiming at the dilemma of expensive and difficult maintenance, lack of technical data and insufficient maintenance force for modern medical equipment, an intelligent fault diagnosis expert system of multi-parameter monitor based on fault tree was proposed in this study. Firstly, the fault tree of multi-parameter monitor was established and analyzed qualitatively and quantitatively, then based on the analysis results of fault tree, the expert system knowledge base and inference engine were constructed and the overall framework of the system was determined, finally the intelligent fault diagnosis expert system for multi-parameter monitor was developed by using the page hypertext preprocessor (PHP) language, with an accuracy rate of 80% in fault diagnosis. The results showed that technology fusion on the basis of fault tree and expert system can effectively realize intelligent fault diagnosis of multi-parameter monitors and provide troubleshooting suggestions, which can not only provide experience accumulation for fault diagnosis of multi-parameter monitors, but also provide a new idea and technical support for fault diagnosis of medical equipment.
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Sistemas Especialistas , Monitoreo FisiológicoRESUMEN
In order to solve the current problems in medical equipment maintenance, this study proposed an intelligent fault diagnosis method for medical equipment based on long short term memory network(LSTM). Firstly, in the case of no circuit drawings and unknown circuit board signal direction, the symptom phenomenon and port electrical signal of 7 different fault categories were collected, and the feature coding, normalization, fusion and screening were preprocessed. Then, the intelligent fault diagnosis model was built based on LSTM, and the fused and screened multi-modal features were used to carry out the fault diagnosis classification and identification experiment. The results were compared with those using port electrical signal, symptom phenomenon and the fusion of the two types. In addition, the fault diagnosis algorithm was compared with BP neural network (BPNN), recurrent neural network (RNN) and convolution neural network (CNN). The results show that based on the fused and screened multi-modal features, the average classification accuracy of LSTM algorithm model reaches 0.970 9, which is higher than that of using port electrical signal alone, symptom phenomenon alone or the fusion of the two types. It also has higher accuracy than BPNN, RNN and CNN, which provides a relatively feasible new idea for intelligent fault diagnosis of similar equipment.
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Algoritmos , Electricidad , Memoria a Corto Plazo , Redes Neurales de la ComputaciónRESUMEN
Objective:To explore the effect of prenatal and postnatal seamless personalized nursing intervention mode on breastfeeding of pregnant women and newborns.Methods:A total of 300 healthy mothers who were examined and delivered at Jinshan Branch of Shanghai Sixth People's Hospital from April 2018 to September 2018 were selected and randomly divided into observation group and control group. The control group was given routine care, and the observation group was given perinatal seamless nursing interventions. Clinical evaluations were performed on both maternal (how much lactation, maternal breastfeeding knowledge, swelling and cleft palate, and exclusive breastfeeding within 6 months after delivery) and neonatal aspects (abnormal temperature, crying before bedtime, and jaundice).Results:In the observation group, 63.33% (95/150) of maternal in the observation group were sufficient lactation which was significantly more than 51.33% (77/150) in the control group; the rate of knowledge of breastfeeding in the observation group was 64.00% (96/150), which was significantly higher than 54.67% (82/150) in the control group; the incidence of mammary tenderness and cleft palate in the observation group was 11.33% (17/150), which was significantly lower than 28.67% (43/150) in the control group; in the observation group within 6 months after delivery, the monthly exclusive breastfeeding rate was higher than in the control group; 44 cases of neonatal jaundice in the observation group were significantly less than the control group with 61 cases, the difference was statistically significant ( χ2 values were 4.23-15.01, P<0.05). Conclusion:By implementing this seamless individualized nursing intervention for healthy adult mothers, it is possible to increase maternal milk production and allow mothers to acquire knowledge about breastfeeding, while reducing the occurrence of breast tenderness and cleft palate, which has a positive effect on improving exclusive breastfeeding Promoting effect can also reduce the incidence of jaundice for newborns.
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The outbreak of viral pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China poses a major threat to public health. SARS-CoV-2 is highly homologous to severe acute respiratory syndrome-associated coronavirus and Middle East respiratory syndrome-associated coronavirus, all of which may cause severe respiratory symptoms. In addition to respiratory symptoms, a considerable proportion of patients with SARS and SARS-CoV-2 infection have varying degrees of liver injury, but their epidemiological features and pathogenesis remains unclear. This article summarizes the epidemiology of SARS-CoV-2 and elaborates on the current status of the research on SARS-CoV-2, possible mechanism of liver injury caused by SARS-CoV-2, and effective treatment regimens, so as to provide a reference and new research ideas for the prevention and treatment of liver injury in patients with SARS-CoV-2 infection.
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Objective To summarize the epidemiology and evaluate possible age-related differences in the presenting clinical features in three year-old children with Mycoplasma pneumoniae pneumonia(MPP)during 2009 to 2014.Methods The medical records of 17855 children with community-acquired pneumonia enrolled by Children′s Hospital of Soochow University during 2009 to 2014.Totally 1145 younger than three year-old children with MPP were enrolled,and they were classified into three groups of 1 month to 1 year-old group (n=512),1 to 2 year-old group (n=393) and 2 to 3 year-old group (n=240).The epidemiology and possible age-related differences in the presenting clinical features,main laboratory and imaging results in three year-old children with MPP were summarized.Results (1) The highest infection rate of different reasons in Suzhou was in autumn(10.46%),and the lowest was in spring(6.95%),The highest infection rate of different ages was 2 to 3 year-old group(11.61%),and the difference was statistically significant (P<0.05).(2) Compared with 1 month to 1 year-old group(n=512,4.31%) and 1 to 2 year-old group (n=39,10.09%),2 to 3 year-old group (n=240,11.61%) had higher infection rate,more patients with fever(53.9% vs. 77.1% vs. 85.4%) and high fever(16.8% vs. 30.5% vs. 41.4%),longer time to normalization of temperature(3d vs. 5d vs. 6d),but less patients with wheezing(61.3% vs. 52.4% vs. 42.9%) and dyspnea(7.6% vs. 4.6% vs. 3.8%).(3) The differences were statistically significant in the percentage of neutrophils,lymphocytes,CRP and platelet count between different ages(P<0.001).(4) The incidences of large area of lesions in chest X-ray examination among different ages had significant differences(P<0.001).Conclusions MP is one of the important pathogens of respiratory tract infection in younger than 3 year-old children.It can occur in every season,and the highest infection rate of MP is in autumn and spring.In younger than 3 year-old,older patients are more vulnerable to infection of MP,the number of fever and high fever are more,fever duration is longer,but younger patients are more vulnerable to virus infection and prone to dyspnea.Chest X-ray examination shows small patchy shadow in most cases,the younger children are more easily to have large area of lesions and pleural effusion.
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Objective To investigate the level of illness uncertainty and coping styles of parents of children with diabetes mellitus and their relationship, and provide theoretical basis of clinical intervention. Methods Totally 155 patients of children with diabetes mellitus were investigated with General Information Questionnaire, Parents′ Perception of Uncertainty Scale (PPUS) and Coping Health Inventory for Parents (CHIP) to analyze the correlation between illness uncertainty of parents and its influencing factors and coping styles. Results The total score of illness uncertainty was 80.15±10.38 in parents of children with diabetes mellitus. There was significant difference in total uncertainty score in parents with different number of children, parent′s age, education degree, profession, economic conditions and locations (P < 0.05). Coping style, education and Parent′s age entered into the multiple linear regression equation of illness uncertainty, predicting 23.2% of total variation in illness uncertainty. The level of illness uncertainty was negatively associated with coping styles (P < 0.01). Conclusions The illness uncertainty was at higher levels in parents of children with diabetes mellitus. Clinical nurses should measure illness uncertainty of parents of children with diabetes mellitus and improve their coping capacity to reduce illness uncertainty, so as to provide better services of family and promote the quality of life for children .
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OBJECTIVE:To systematically evaluate the efficacy of mecobalamin,ganglioside,mixture of calcium and magne-sium,reduced glutathione,mixture of calcium and magnesium combined with reduced glutathione in the prevention of chronic neu-rotoxicity induced by oxaliplatin, and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from PubMed,clinicltrials.gov and CJFD,randomized controlled trials (RCT) about efficacy of 5 interventions in the prevention of chronic neurotoxicity induced by oxaliplatin were collected,and network Meta-analysis were performed by using ADDIS 1.16.5 af-ter extracting data and evaluating quality. RESULTS:A total of 34 studies were included,involving 3 236 patients. 4 studies were three-arm studies,30 studies were two-arm studies,totally 42 arms. Compared with placebo,the incidence of CIPN by 5 interven-tions was significantly reduced. Mixture of calcium and magnesium combined with reduced glutathione was the most effective and the followed by mecobalamin,reduced glutathione,ganglioside and mixture of calcium and magnesium,however,there were no significant differences among 5 interventions(P>0.05). CONCLUSIONS:5 kinds of interventions are all effective in the preven-tion of chronic neurotoxicity induced by oxaliplatin. Mixture of calcium and magnesium combined with reduced glutathione is the most effective. Duo to the low quality of included studies,large-scale and high quality RCTs are required for further validation of the conclusions.
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ObjectiveTo analyze the genotype and variation ofMycoplasma pneumonia (MP) strains isolated from chil-dren with MP infection in Soochow area.MethodsThe nasopharyngeal secretions from hospitalized children with MP infection were collected during January 2012 and December 2013. The nested-multiplex PCR based on MPP1 gene was performed to detect the subtype ofMP gene.ResultsIn 313 samples, 304 (97.12 %) samples were classiifed as P1-I type and 8 (2.56%) sam-ples were classiifed as P1-II type and one (0.32%) was V2 variant. Gene sequencing results were consistent with nested-multiple PCR results.ConclusionsNested-multiplex PCR is a reliable method for genotyping of MPP1 gene. During the study period, P1-I type was the common genotype and only one case of V2 variant was found.
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<p><b>OBJECTIVE</b>To detect potential mutation of COL2A1 gene in two children suspected for Kniest dysplasia.</p><p><b>METHODS</b>The 54 exons and splicing regions of the COL2A1 gene were amplified with PCR and the product was subjected to direct sequencing.</p><p><b>RESULTS</b>A missense mutation (c.905C>T, p.Ala302Val) was found in the coding region of the COL2A1 gene, which has been previously reported in abroad. The patients appeared to have short trunk dwarfism, enlarged joints and midface hypoplasia.</p><p><b>CONCLUSION</b>The probands are the first cases of Kniest dysplasia described in China, and so was the p.Ala302Val mutation.</p>
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Preescolar , Humanos , Masculino , Secuencia de Bases , China , Fisura del Paladar , Genética , Enfermedades del Colágeno , Genética , Colágeno Tipo II , Genética , Enanismo , Genética , Exones , Cara , Anomalías Congénitas , Enfermedad de la Membrana Hialina , Genética , Datos de Secuencia Molecular , Mutación Missense , Sistemas de Lectura Abierta , Osteocondrodisplasias , Genética , Empalme del ARNRESUMEN
<p><b>OBJECTIVE</b>To analyze the clinical characteristics of protracted bacterial bronchitis (PBB) in children.</p><p><b>METHOD</b>The clinical data of patients seen from October, 2010 to March, 2014 in Department of Respiratory Diseases of our hospital were retrospectively analyzed. Inclusion criteria were over 4 weeks cough, receiving fiberoptic bronchoscopy, positive bacterial culture and (or) the increased percentage of neutral granulocytes in bronchoalveolar lavage fluid (BALF).</p><p><b>RESULT</b>Twenty eight patients were involved, 26 were male (93%) and two were female (7%). The median age of patients was 8.5 months. The median duration of cough was four weeks. The average length of hospital stay was (8.3 ± 3.9)days. The main clinical feature was wet cough in 28 cases, wet cough with wheezing was seen in 21 cases. The wet cough phase distribution was irregular in 21 cases. The crackles with wheeze (in 21 cases) was main signs of PBB. The percentage of CD3⁻ CD16⁺ 56⁺ cells increased in peripheral blood. The fiberoptic bronchoscopic manifestations of PBB were luminal mucosal edema. Eleven patients also had airway malacia. The neutrophil median in BALF was 0.2. The positive rate of bacterial culture of BALF was 36%. The main bacteria were Streptococcus pneumoniae (50%) and Haemophilus influenzae (30%). The main treatment for PBB patients included amoxycillin/clavulanate potassium and second-generation cephalosporins. The average duration of treatment was (17.3 ± 3.2)days, the prognosis was good.</p><p><b>CONCLUSION</b>PBB is common in male infants. Persistent wet cough with wheezing was the main characteristic of PBB. PBB is commonly accompanied by immune dysfunction and airway malacia, and the pathogens were Streptococcus pneumoniae and Haemophilus influenzae.</p>
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Femenino , Humanos , Lactante , Masculino , Infecciones Bacterianas , Quimioterapia , Patología , Bronquitis , Quimioterapia , Microbiología , Patología , Líquido del Lavado Bronquioalveolar , Broncoscopía , Tos , Haemophilus influenzae , Ruidos Respiratorios , Estudios Retrospectivos , Streptococcus pneumoniaeRESUMEN
Objective To explore the clinical characteristics of mycoplasma pneumonia with pulmonary atelectasis and lavage interventional effect through fiberoptic bronchoscopy in children.Methods During Jun 2012 to Apr 2013,fifty-three children diagnosed of mycoplasma pneumonia with pulmonary atelectasis who received fiberoptic bronchoscopy were enrolled as the experimental group.Thirty-five children diagnosed of mycoplasma pneumonia without pulmonary atelectasis were chosen as control group.According to the lavage interventional time of fiberoptic bronchoscopy,we divided the patients in the experimental group into two groups,the early group and late group.Clinical data and laboratory finds were collected and analyzed.Results The duration of fever,hospital stay and C-reactive protein (CRP) of the experimental group were significantly higher than those of the control group (P < 0.05).The location of pulmonary atelectasis in the experimental group were usually in the right middle lobe (18 cases,33.9%).Under fiberoptic bronchoscope,all patients had obviously bronchial mucosa congestive edema.Some of them had follicular hyperplasia (9 cases,17.0%),mucosal erosion (3 cases,5.7%),mucus plug formation (7 cases,13.2%) and poor ventilation of segmental bronchi (4 cases,7.5 %).Neutrophils (43 cases,81.1%) increased and phagocytic cells (31 cases,58.5%) dereased obviously in bronchoalevolar lavage fluid.After treatment in the experimental group,52 children (98.1%) got complete recruitment of atelectasis.The average duration of fever and hospital stay of the early group were significantly shoter than those of late group (P < 0.05).Conclusion Children diagnosed of mycoplasma pneumonia with pulmonary atelectasis had longer fever duration and higher CRP level.Bronchoscopic interventional therapy promoted the recovery of pulmonary atelectasis.Using bronchoscop early in shorten the duration of fever and hospitalization in children diagnosed of mycoplasm pneumonia with pulmonary atelectasis.
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<p><b>OBJECTIVE</b>To analyze the clinical characteristics and genetype of one children who had been diagnosed with pyruvate dehydrogenase complex deficiency.</p><p><b>METHOD</b>Comprehensive analyses of this case were performed, including clinical symptoms, signs, biochemical examinations and therapeutic effects. The eleven exons and splicing areas of PDHA1 were amplified with genomic DNA from whole blood. And variations were investigated by sequencing the PCR product. The patient was diagnosed with pyruvate dehydrogenase complex deficiency by sequence analysis of PDHA1 gene.</p><p><b>RESULT</b>The patient was a 2 years and 4 monthes old boy. He presented with muscle hypotonia and weakness for one year, and experienced recurrent episodes of unstable head control, unable to sit by himself or stand without support, with persistently hyperlactacidemia. Metabolic testing revealed blood lactate 5.37 mmol/L, pyruvate 0.44 mmol/L, and lactate/pyruvate ratio was 12.23. MRI of the brain showed hyperintense signals on the T2 and T2 Flair weighted images in the basal ganglia bilaterally. Sequence analysis of PDHA1 gene showed a G>A point mutation at nucleotide 778, resulting in a substitution of glutarnine for arginine at position 263 (R263Q). And the diagnosis of pyruvate dehydrogenase complex deficiency was identified. By giving the therapy with ketogenic diet, vitamin B(1), coenzyme Q(10) and L-carnitine , the boy was in a stable condition.</p><p><b>CONCLUSION</b>The severity and the clinical phenotypes of pyruvate dehydrogenase complex deficiency varied. Sequence analysis of PDHA1 gene revealed a 788G>A (R263Q) mutation. Patients who presented with unexplained muscle hypotonia, weakness and hyperlactacidemia could be diveded by gene analysis. And appropriate treatment can improve the quality of life.</p>
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Preescolar , Humanos , Masculino , Encéfalo , Carnitina , Exones , Genética , Imagen por Resonancia Magnética , Mutación , Fenotipo , Piruvato Deshidrogenasa (Lipoamida) , Genética , Enfermedad por Deficiencia del Complejo Piruvato Deshidrogenasa , Diagnóstico , Genética , Ácido PirúvicoRESUMEN
Objective To explore the characteristics of hemi-nested methylation specific polymerase chain reaction (hn-MSP) and to find out the possible relationship between patterns of methylation or deletion and the developmet of adult acute lymphoblastic leukemia(ALL).Methods hn-MSP and bisulfit-sequencing PCR (BSP) were designed and adopted to analyze p15 gene methylation or deletion patterns in 25 adult ALL patients,malignant hematopathy cell lines and normal lymphocytes. hn-MSP and BSP products were cloned and sequenced.The sensitivity and specificity of hn-MSP were also analized.Results The sequencing results of hn-MSP and BSP products were consistent, and the sensitivity of detection of p15 methylation was up to 1.0×10-5.17 adult ALL patients (68 %) were p15 gene hypermethylation and 3 patients were with deletion of p15 gene exon 1.There were no hypermethylation or deletion in the 10 controls.Conclusions The detection rate of p15 methylation in many tumors,especially in adult ALL,is frequent high.hn-MSP is highly sensitive and specific in analyzing p15 methylation.
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Objective To investigate the distribution of nail disorders in patients with a chief complaint of nail abnormalities. Methods From May 2007 to May 2010, patients who attended the dermatology outpatient clinic with a chief complaint of nail abnormalities were included in this study. Routine dermatological examination together with fungal culture, microscopic and pathological examination of affected nails was carried out to clarify the diagnosis of nail disorders. The results were statistically analyzed. Results Of the 2776 cases,onychomycosis accounted for 45.28% (1257), followed by paronychia (479, 17.26%) and psoriasis (122,4.39%). Conclusion In this region, patients with a chief complaint of nail disorders are most likely to suffer from nail infections.
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Objective To investigate the clinical value of mean channel of neutrophil volume (MNV), mean channel of neutrophil conductivity (MNC) and mean channel of neutrophil scatter (MNS) in predicting acute bacterial infection.Methods Peripheral blood samples from 112 patients with positive blood cultures for bacteria,70 healthy subjects and 45 non-infectious subjects with high white blood cell count(WBC) were studied using the Coulter LH 750 hematology analyzer.MNV, MNC, MNS and neutrophil volume distribution width (NDW) were retrospectively analyzed and compared with total WBC, percentage of neutrophils,neutrophil left-shift and CRP.112 blood bacterial infections were grouped according to WBC count (A:WBC <11.0×109 /L;B:11.0×109/L≤WBC<15.0×109 /L;C:WBC≥15.0×109 /L) and neutrophil rate (NE < 0.85 and NE ≥ 0.85 ).Results MNV and NDW increased significantly in septic patients (154.17 ± 10.08,24.36 ± 4.14 ) compared with those of healthy control group (142.09 ± 4.13,19.04 ± 1.97) and non-infectious patients with high WBC group ( 150.63 ± 8.14,20.19 ± 4.73 ).There was statistically significant difference (F value were 20.738 and 28.190 respectively,P < 0.01 ). On the contrary, MNS decreased significantly in septic patients (137.15 ± 7.61 ) compared with that of healthy group (144.51±4.36) and nonspetic patients with high WBC group (142.45±7.11) ,there was significant statistical difference (F=5.217,P<0.01).The MNV, NDW and MNS of A group were 148.09±5.76,22.39±1.97,140.07±6.11 respectively.The MNV, NDW and MNS of B group were 152.83±5.75,24.14±1.35,141.44±5.35 respectively.The MNV, NDW and MNS of C group were 164.28±6.49,29.42±5.93,134.27±9.61 respectively. There was statistically significant difference compared with healthy group (F value were 24.720,31.642,7.931, P < 0.01).The MNV, NDW and MNS in the group with NE <0.85 were 149.17±9.06,22.59±2.73,141.19±4.34 respectively.The MNV, NDW and MNS in the group with NE≥0.85 group were 159.03±10.23,27.64±4.51,135.62 ± 8.95 respectively.There was statistically significant difference compared with healthy group ( F value was 23.970,51.309,19.792,P<0.01).With a cut-off of 150 for the MNV, a specificity of 90% and sensitivity of 70% were achieved.NDW was associated with neutrophil left-shift (r=0.33,P<0.01).With a cut-off of 23 for the NDW, a specificity of 100% and a sensitivity of 72% were achieved.The sensitivity of the MNV and NDW was better than total white blood cells count (with a cut-off≥ 11.0×109 /L, the sensitivity was 57% ), percentage of neutrophils( with a cut-off≥0.85, the sensitivity was 44% ) and neutrophil shift to left ( with a cut-off >5%, the sensitivity was 66% ) and CRP (with a cut-off ≥10 mg/L, the sensitivity was 65% ).Conclusions The MNV and NDW of the neutrophil can reflect the morphologic change of neutrophil sensitively and specificialy in acute infection. As quantitative, objective and more sensitive parameters, MNV and NDW may have a potential role for predicting the acute bacterial infection.
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Objective To observe the effects of triptolide(TPL) on the anti-oncogene-APC gene of acute lymphoblastic leukemia cell line Jurkat in vitro. Methods The effects of TPL on proliferation Jurkat cells were assayed by using cell culture, MTT. The effects of TPL on APC gene of Jurkat cells were analyzed by nested methylation specific PCR and RT-PCR. The effects of TPL on the proteinum expression of APC gene were detected by Western blotting analysis. Results Following the treatment of TPL, the cell proliferation rate was degraded as the treatment concentration increased and the culture time extended. The effects were dose and time-dependent. The 48 hour IC50 was 19.7 ng/ml. TPL can reverse hypermethylation of APC gene,and induce the expression of the mRNA and the proteinum. Conclusion Low dose TPL could depress the proliferation rate of Jurkat. The possible mechanism might be its reversing the hypermethylation of APC gene and activiting the expression of APC gene.
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Objective To explore relationship between resistin'adipenectin and insulin resistance(IR) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Based on polysomnography (PSG) and disease history ,68 patients were divided into three groups: mild ( L, n = 24 ), moderate ( M, n = 13 ), severe ( S, n = 31 ) OSAHS, and normal control ( n = 20 ). Fasting serum glucose, insulin, lipoids, resistin and adipanectin were measured. HOMA-IR was calculated, the correlation between HOMA-IR and resistin, adiponectin, lipoids, body mass index, waist-to-hip ratio, apnea-hypopnea index ( AHI), the lowest saturation of blood oxygen ( LSaO2) and the per-centage of total sleep time spent with an oxygen saturation less than 90% (T90) were analysed. Results The levels of serum resistins in each OSAHS group were (8.04 ±2. 14), ( 10.85±4.89 ), ( 13.34±3.52 )mg/L, and were sig-nificantly higher than those in control group ( 9.49 ± 2.40) mg/L ( P < 0.05 ), S were significantly higher than L (P<0.05) ;The levels of serum adiponectin of OSAHS groups were(6. 21 ± 1.74), (4. 19±1.80), (2.26± 1.17 ) mg/L, and were significantly lower than those in control group(9.49±2.40) mg/L (P < 0.05 ), and the inter-group differences were statistically significant (P <0. 05). HOMA-IR of M and S were(4.07±0.97), (5.61± 2.26) significantly higher than those of L and control group( 1.57 ±0. 58 ), (2.47 ±1.52 ) ( P < 0.05 ), and inter-group differences between M and S were statistical significant( P < 0.05 ). Spearman correlation analysis showed that HOMA-IR was significantly positive correlated with resistin, total cholesterol, triglyceride, body mass index,waist-hip rafio,AHI,T90( r =0. 794,0.438,0. 430,0. 351,0. 456,0.775,0.624 ,P <0.01 ) ,negative with adiponectin, LSaO2 (r=-0.563, -0.623 ,P <0.01 ). Partial correlation analysis showed that after the effect of adiponeetin and resis-tin were controlled,HOMA-IR was significant positive correlation with T90 and AHI(r =0.231,0.358 ,P <0.05 ). Multiple stepwise regression analysis showed that, to HOMA-IR, resistin and AHI were the most significant impact factors (R2 =0.613,F=69.810,P<0.01). Conclusions HOMA-IR is significantly positively correlated with the severity of OSAHS,independent of the blood lipids, body mass index, waist-hip ratio, resistin, adiponectin and other factors;the effects of blood lipids,body mass index,waist-hip ratio and other factors on HOMA-IR probably depend on resistin and adiponectin;AHI and plasma resistin level may determine the level of insulin resistance in patients with OSAHS.
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Objective To explore the effectiveness of the fallopian tubes embolization for the hydrosalpinx before in vitro fertilization and embryo transfer(IVF-ET).Methods The fallopian tubes embolization was performed on 46 hydrosalpinx patients-Fimt the hysterosalpingography was performed to show the positions and shape of the hydrosalpinx.Then the hydrops was drawn into the celiac cavity in order to be absorbed after performing fallopian tube recanalization. Finally,transv(o)ihal therapy was performed,putting the embolization microcoils into the fallopian tube through a micro-catheter.One month after the fallopian tubes embolization,hystemsalpingography was conducted to check for the effectiveness of the embolization.After 3 months.all the 46 patients received the treatment of IVF-ET,Results The interventional treatment of 82 fallopian tubes obtained one time success among 46 cases of fallopian tubes embolization.Among them,obvious results were achieved in 72 fallopian tubes,taking up 88%0f tIle total;effective results were seen in 10 fallopian tubes.accounting for 12%0f the total.No one was invalid.In the same period,compared with the 91 cases of non-hydrosalpinx as the control group.the embolization group of patients achieved a higher fertilization rate(69%),and clinical pregnancy rate(41%),compared with the control group(63%and 39%respectively),but without a significant difference(P>0.05).However,the ectopic pregnancy rate(O)and the abortion rate(8%)were significantly lower than the control group(8%,16%respectively;P<0.05).Conclusions Fallopian tubes embolization used in hydrosalpinx treatment before IVF-ET is an innovative approach,simple,safe,economical,with no negative impact on ovarian functiorr It can significantly increase the clinical pregnancy rate and prevent the occurrence of tubal pregnancy.It is a feasible and effective method.
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Objective To investigate the feasible clinical teaching method for ICU specialty nurses to improve teaching quality.Methods Using new mode:teaching together but practicing with different teachers.Results Through clinical practice,19 specialty nurses have improved their theories,operational skills and clinical thinking abilities.Conlusions ICU specialty nurses can acquire systems training through the new teaching mode.