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Objective Combined with domestic and foreign guidelines,to explore the individualized treatment strategy of urosepsis,and to provide reference for standardized diagnosis and treatment of urosepsis patient.Methods To analyze the diagnosis and treatment process of a patient with urogenic sepsis who was admitted to the department of critical care medicine of the First Affiliated Hospital of Xi'an Jiaotong University in April 15,2021.During the diagnosis and treatment process,we performed puncture drainage fluid and urine culture as soon as possible to confirm the diagnosis from the perspective of etiology.Considering the possible pathogenic bacteria at the infection site,the drug resistance of pathogenic bacteria in medical units,and drug safety,imipenem and cilastatin was chosen for anti-infective therapy.A two-step approach was used for drug administration based on drug pharmacokinetics/pharmacodynamic(PK/PD)characteristics,and drug concentration monitoring.The patients were followed up after discharge.Results The patient was critically ill on admission and was diagnosed with urosepsis.We optimize the empirical use of antimicrobials based on their PK/PD characteristics.Ultrasound-guided percutaneous nephrostomy of the left renal pelvis was performed to adequately drain the infection.Urine culture returned as extended-spectrum β-lactamase(ESBL)-producing Escherichia coli,confirming the etiological diagnosis.After 7 days of treatment,the patient's condition improved,the antibacterial drugs were downgraded to piperacillin-tazobactam,and the total course of anti-infection was 14 days.The patient was in good condition 2 months after discharge,and underwent left ureteral calculus and lithotripsy in the local hospital,and the left nephrostomy tube was removed.After discharge,the patient's condition was stable,no recurrence was found after 7 months of follow-up,and daily life was not affected.Conclusions Management of infection foci in urosepsis patient is critical.Diagnosis and treatment should refer to domestic and foreign guidelines,and formulate treatment strategies based on the distribution of local pathogens,drug resistance,and the actual clinical conditions of patients.Optimize the use of antibiotics based on drug PK/PD characteristics,monitor the concentration of therapeutic drugs,and realize individualized treatment.
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Objective:To investigate the changes in the nerve fiber layer of the cornea in patients with demyelinating optic neuritis (DON) and its correlation with visual acuity.Methods:A cross-sectional study. From March 2021 to July 2022, 27 cases (39 eyes) of DON patients diagnosed in the Department of Neurology and Ophthalmology of Beijing Tongren Hospital Affiliated to Capital Medical University were enrolled in this study. According to the serological test results, the patients were divided into aquaporin 4 antibody associated optic neuritis (AQP4-ON group) and myelin oligodendrocyte glycoprotein antibody associated optic neuritis (MOG-ON group), with 15 cases (19 eyes) and 12 cases (20 eyes) respectively. According to previous history of glucocorticoid treatment, the patients were divided into glucocorticoid treated group and non-glucocorticoid treated group, with 17 cases (27 eyes) and 10 cases (12 eyes) respectively. Twenty healthy volunteers (20 eyes) with age- and gender-matched were selected as the control group. All eyes underwent best corrected visual acuity (BCVA) and in vivo confocal microscopy (IVCM) examinations. BCVA was performed using Snellen's standard logarithmic visual acuity chart, which was converted into logarithmic minimum angle resolution (logMAR) visual acuity during statistics. The corneal nerve fiber length (CNFL), corneal nerve fiber density (CNFD), corneal nerve fiber branch length (CNBL), corneal nerve fiber branch density (CNBD) and the density of corneal dendritic cells (DC) were detected by IVCM examination. Parameter comparison between groups by t-test and Kruskal-Wallis rank sum test. The correlation between logMAR BCVA and pamameters of corneal nerve fibers were analyzed using Spearman analysis. Results:The CNFL, CNFD, and CNBL of the DON group and the control group were (10.67±2.55) mm/mm 2, (57.78±12.35) root/mm 2, (3.27±1.34) mm/mm 2, and (13.74±3.05) mm/mm 2, (70.95±13.14) root/mm 2, and (4.22±1.03) mm/mm 2, respectively; the difference in CNFL, CNFD, and CNBL between the two groups were statistically significant ( t=4.089, 3.795, 2.773; P<0.05). The CNFL, CNBL, and CNBD of the affected eyes in the MOG-ON group and AQP4-ON group were (12.02±2.13) mm/mm 2, (3.80±1.19) mm/mm 2, (47.97±8.86) fibers/mm 2, and (9.25±2.19) mm/mm 2, (2.72±1.19) mm/mm 2, (39.43±13.86) fibers/mm 2, respectively; the differences in CNFL, CNBL, and CNBD between the two groups were statistically significant ( t=-4.002, -2.706, -2.306; P<0.05). The corneal DC density of the patients in the hormone treated group and the non-hormone treated group was (24.43±8.32) and (41.22±9.86) cells/mm 2, respectively. The difference in corneal DC density between the two subgroups was statistically significant ( P<0.001). Correlation analysis showed that there was a significant negative correlation between logMAR BCVA and CNBL and CNFL in patients with DON ( r=-0.422, -0.456; P<0.05). Conclusions:There are different degrees of corneal nerve fiber damage in patients with different types of DON. There was a negative correlation between BCVA and the length of corneal nerve fibers.
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Objective@#To study the specific correlation between physical activity intensities and body compositions of adolescents and to provide guidance for the improvement of various body compositions of Chinese adolescents.@*Methods@#From September to December 2019, body composition measurement based on bioelectrical impedance analyzer and the physical activity measurement based on accelerometers were performed among 971 adolescents from 8 high schools, such as Tsinghua Middle School in Beijing, by random number coding sampling. Statistical analysis was conducted by using independent sample t test, Pearson correlation coefficient method and multiple linear regression method.@*Results@#Sedentary behavior(SB) of the junior and senior high school boys was significantly lower than that of girls, while the VPA(vigorous physical activity) and moderate vigorous physical activity(MVPA) were significantly higher than those of boys ( t =-1.98, -8.09; 5.20, 4.52; 3.53, 4.03, P <0.05). light physical activity(LPA) and moderate physical activity(MPA) of boys were significantly higher than those of girls in the senior high schools ( t =3.67, 5.63, P <0.01). Lean mass(LM) of the junior school boys was correlated to their MVPA( β =0.302), bone mineral content(BMC) was quantitively related to SB( β =-0.001), MVPA( β =0.002), and fat mass(FM) was related to SB( β =0.050), and MVPA( β =-0.323) ( P <0.05). LM of junior school girls was quantitively correlated to LPA ( β =0.080) and MVPA( β =0.613). And there was also correlation among BMC ,SB( β =-0.004) and MVPA( β =0.008) between FM and MVPA( β =-0.237) ( P <0.05) . There was a correlation between total body LM and MVPA ( β =0.393), total body BMC and SB ( β =-0.001), MVPA ( β =0.002), and total body FM and MVPA ( β =-0.393) in senior high school boys( P <0.05). There was a correlation between senior high school girls’ total body LM and LPA ( β =0.063), MVPA ( β =0.601), total body FM and SB ( β =0.029), and MVPA ( B =-0.529)( P <0.05).@*Conclusion@#There are gender differences and correlations between adolescent physical activity intensity and body composition. It is recommended that relevant departments provide personalized physical activity dose guidance for adolescents to improve their physical fitness.
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Objective:To evaluate the status quo of humanistic care of clinical nursing staff, and analyze its influencing factors to provide theoretical basis for improving the humanistic care ability of clinical nursing.Methods:The self-compiled questionnaire on the knowledge, attitude and practice of humanistic care of clinical nursing staff was adopted in June to July 2019 to select 2 136 nurses from five first-class tertiary general hospitals in Shandong province by random sampling method for the status survey.Results:The total score of humanistic care knowledge and practice of clinical nurses was 259.54±33.55, and the standard score was 82.39±10.65. Single factor analysis showed that the total score of humanistic care knowledge, credit and practice was statistically significant for clinical nurses with different gender, age, fertility status, relationship with parents, employment reasons, initial education background, department, working years, professional title, position, employment mode and night shift frequency ( t value was -2.604, F values were 2.667-23.692, all P < 0.01). Pearson correlation showed that in the pairwise correlation analysis of knowledge, belief/attitude and behavior dimension, there was positive correlation and the correlation coefficient ( r values were 0.638, 0.431, 0.560, all P < 0.01). Multiple stepwise regression analysis showed that: the influencing factors of knowledge, attitude and practice total score of clinical nursing staff on humanistic care were the relationship between the parents, employment way, night shift frequency, fertility status, and the employment reason, the initial degree, department, position ( β values were -0.132-0.126, all P < 0.05). Conclusions:The current situation of humanistic care knowledge and practice of clinical nursing staff is in the middle level. Relationship with parents, position, night shift frequency, fertility status, employment reasons, initial education background, department, and employment mode are the factors that affect the current situation of humanistic care, knowledge, attitude and practice of clinical nurses. Therefore, medical institutions should adopt targeted and focused training methods and intervention measures to improve the level of nursing staff′s knowledge, faith and practice from the aspects of different influencing factors of clinical nursing staff′s humanistic care.
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Objective@#To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems.@*Methods@#A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning. SPSS 23.0 software was used to analyze the data.@*Results@#Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures" , accounting for only 6.7%. The "calculation of target value" was the best for 45.1%, the best which "QCC report and evaluation" was 32.1%(72/224) in the promotion and management of hospital-level QCC, and the worst which "standardization approval" was only 4.0%(9/224). The main obstacle factors include personnel, skills and in-hospital support.@*Conclusions@#Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.
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Objective To evaluate the effect of weight managementfor the quality of life of patients with chronic heart failure. Methods The randomized controlled trials (RCT) on the effect of weight management for the quality of life of patients with chronic heart failure interventions were collected using the databases of China National Knowledge Infrastructure (CNKI), The Wan fang database, CBM, Chinese Science and Technology Periodical Databases (VIP), PubMed, Cochrane Library, Web of Science, Embase, time for the construction of the database to December 2017. Quality evaluation and data extraction of the included literature. Data were analyzed with Revman5.3 software. Results Five RCTs were included in the study, with a total of 739 people. The results of Meta-analysis showed that the total score of QOL [MD=-10.38(95%CI-19.83--0.93), Z=2.15,P=0.03], QOL emotional domain score [MD=-2.45(95%CI-4.35--0.55), Z=2.53, P=0.01] and body domain score [MD=-6.61(95%CI-12.81--0.41), Z=2.09, P=0.04] of patients with chronic heart failure in weight management group were lower and statistically significant. Conclusions Weight management improve the quality of life in patients with chronic heart failure, weight management improve the quality of life in patients with chronic heart failure and the physical and emotional areas. However, it is necessary to carry out high-quality, large sample randomized controlled trials to confirm the above results.
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Objective To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems. Methods A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning.SPSS 23.0 software was used to analyze the data. Results Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures", accounting for only 6.7% . The"calculation of target value"was the best for 45.1%, the best which"QCC report and evaluation"was 32.1%(72/224) in the promotion and management of hospital- level QCC, and the worst which"standardization approval"was only 4.0% (9/224). The main obstacle factors include personnel, skills and in- hospital support.Conclusions Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.
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This paper reviews the research progress of nurses' resilience from the definition and classification, evaluation tools, influencing factors and intervention status. In addition, the paper also explores the current situation and development trend of nurses'resilience research to point out that further research on nurses'resilience in China can deepen the research on factors of nurses'resilience.We should strengthen the intervention of nurses' resilience, develop localized measuring tools of nurses' team resilience, and strengthen the direction of qualitative research and longitudinal research.
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Objective To describe and compare the attitude and actual participation of decision-making regarding nursing care of patients with breast cancer, and to identify the related factors. Methods To investigate 480 cases of inpatients with breast cancer in 3 Grade ⅢA hospitals in Wuhan through questionnaire and self-designed general information questionnaire. Results There were significant differences (χ2=28.3, P<0.01) between the attitude and actual participation of decision making regarding of nursing care. The results of Logistic regression analysis showed that patients with higher education level (B=1.574, P=0.002), less children (B=-2.716, P<0.01) and higher income (B=0.323, P<0.01) , had a more active attitude to participate decision making; patients who were younger (B=-6.001, P=0.015), with higher education level (B=1.643, P=0.000), shorter duration of disease (B=-2.413, P=0.022), and lower degree of TNM stage (B=0.618, P=0.012), actually participated more often in decision making. Conclusions The actual participation was inconsistent with the attitude of decision-making regarding nursing care among patients with breast cancer. And patients′ demographic characters were related to their participation of decision making, which suggested that nurses should make a comprehensive assessment of willingness and capacity of patients′decision-making participation, identify the facilitators and barriers, and take measures to support patients to take an active part in the decision making to improve the quality of nursing care.
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Objective To observe the effects of penetrance,different time of onset and mutation sites on retinal nerve fiber layer (RNFL) and macular thickness in patients with Leber's hereditary optic neuropathy (LHON).Methods This was a cross-sectional observational study.A total of 88 patients with LHON and 1492 relatives of the maternal relatives (gene carriers) who received treatment in People's Liberation Army General Hospital from 2015 to 2017 were included in the study.Among the 1492 family members,there were 694 males and 798 females.Peripheral venous blood was extracted from all subjects for mitochondrial DNA testing,and penetrance was calculated.A total of 117 patients underwent BCVA and SD-OCT examinations,including 82 patients and 35 gene carriers.The BCVA examination was performed using the Snellen visual acuity chart,which was converted into logMAR visual acuity.The thickness of RNFL,ganglion cell complex (GCC) and inner limiting membrane (ILM)-RPE were measured with OCT instrument.The mean follow-up was 50.02± 86.27 months.The disease course was divided into 6 stages including ≤3 months,4-6 months,7-12 months and > 12 months.The thickness of RNFL,GCC and ILM-RPE in patients with different time of onset and mutation sites were comparatively analyzed by covariance analysis.Categorical variables were expressed as a percentage,and the x2 test was used for comparison among multiple groups.Results Among the 1492 family members,285 were diagnosed with LHON and highly suspected clinical manifestations (19.10%),including 190 males (21.98%) and 95 females (11.90%).The total penetrance rates of 11778,14484 and rare mutation sites were 19.84% (228/1149),20.50% (33/161),and 13.19% (24/182) respectively;male penetrance rates were 28.87% (153/530),27.28% (20/72),and 18.48% (17/92) and female penetrance rates were 12.12% (75/619),14.61% (13/89) and 7.78% (7/90).There was no significant difference in total (x2=4.732),male (x2=4.263) and female (x2=4.263) penetrance between different mutation sites (P=0.094,0.110,0.349).Compared with non-pathogenic carriers,the thickness of the RNFL,GCC and ILM-RPE were all different in the four stages (≤3months,4-6 months,7-12 months and >12 months).The thickness ofRNFL,GCC and ILM-RPE decreased with the time of onset (P=0.000).There were significant differences in the thickness of each of the GCC and ILM-RPE layers in the macular area of LHON patients with different mutation sites (P< 0.05).Among them,the site 11778 and 3460 had the most severe damage in all quadrants of macular GCC and ILM-RPE layer,followed by 14484 site,and the rare site had the least damage in all quadrants.Conclusions The penetrance of LHON patients is 19.10%.With the extension of the onset time (within 1 year),the RNFL layer of the optic disc and all quadrants of the macular GCC and ILM-RPE layer gradually thinned.Compared with 11778 and rare site,14484 site,and the rare site had the lighter damage on the thickness of RNFL,GCC and ILM-RPE.
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This paper reviews the research progress of nurses' resilience from the definition and classification, evaluation tools, influencing factors and intervention status. In addition, the paper also explores the current situation and development trend of nurses' resilience research to point out that further research on nurses' resilience in China can deepen the research on factors of nurses' resilience.We should strengthen the intervention of nurses' resilience, develop localized measuring tools of nurses' team resilience, and strengthen the direction of qualitative research and longitudinal research.
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Objective To analyze the clinical features and prognosis of adult optic neuritis patients with positive serum myelin oligodendrocyte glycoprotein antibody (MOG-ON) or aquaporin 4 antibody (AQP4-ON).Methods A retrospective study. From December 2015 to February 2018, in the Beijing Chaoyang Hospital of Capital Medical University and Chinese PLA General Hospital, 162 eyes of 132 patients with positive serum MOG antibody and AQP4 were included in the study. There were 42 MOG-ON patients (49 eyes, 31.8%), 90 AQP4-ON patients (113 eyes, 68.2%). The clinical features of optic neuritis (annual recurrence frequency, incidence of optic disc edema), brain and optic nerve enhanced MRI, serum autoimmune antibodies and cerebrospinal fluid test results were compared between MOG-ON and AQP4-ON patients. All patients were treated with intravenous methylprednisolone sodium succinate in the acute phase and then switched to oral prednisone acetate tablets. The average follow-up time was 15 months. The glucocorticoid dependence, visual prognosis, spinal cord symptoms, and myelitis at the last follow-up were comparatively analyzed between MOG-ON and AQP4-ON patients. The comparison of the count data was performed by χ2 test, and the measurement data were compared byt test.Results Compared with AQP4-ON patients, MOG-ON patients had higher annual recurrence frequency (t=3.760,P=0.005), higher incidence of optic disc edema (χ2=14.777,P<0.001), higher incidence of hormone dependence (χ2=25.496,P<0.001), and better visual prognosis (χ2=28.759, P<0.001). MOG-ON patients were more likely to involve the optic nerve, AQP4-ON patients were more likely to involve the optic chiasm and the optic tract. There was a significant difference in the location of lesions between MOG-ON and AQP4-ON patients (χ2= 5.447,P= 0.015). The proportion of AQP4-ON patients with autoimmune antibodies was significantly higher than that of MOG-ON patients (χ2 = 20.453,P<0.001). The results of cerebrospinal fluid test showed that the white blood cell count of patients with MOG-ON and AQP4-ON were within the normal range, but the IgG level of AQP4-ON patients was significantly higher than that of MOG-ON patients (t=8.669,P<0.001). At the last follow-up, there were 7 and 29 patients of myelitis in MOG-ON and AQP4-ON patients respectively (χ2=3.494,P=0.046).Conclusions The clinical characteristics of MOG-ON were different from AQP4-ON. The incidence of optic disc edema and recurrence rate were higher, but the proportion of autoimmune antibodies was lower. MOG-ON was more likely to show hormone dependence, but the visual prognosis was better. AQP4-ON was easily involved in optic chiasm and optic tract, and the incidence of myelitis was higher.
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Objective To examine the status of and factors influencing medical students' mental health.Methods The China undergraduates' mental health scale and an information questionnaire developed by the authors were administered on 1 205 students selected from Grade 1-3 in chnical medicine,anesthesia,and medical diagnostic programs using cluster sampling.Results The level of medical students' somatization,a~nxiety,depression,social withdrawal,irritabihty,and obsession was higher as compared to the norms for general undergraduates in China.Female medical students showed higher scores than males on 4 aspects:somatization,anxiety,depression,and obsession.Additionally,those belonging to minority nationalities showed higher scores on social withdrawal,irritability,and impulse as compared to those with the Han nationality.Further,students with low professional identity had higher scores on somatization,anxiety,depression,inferiority,irritability,and social withdrawal as compared to those with high professional identity.Conclusion Medical students' mental health is not optimal;therefore,it needs to be addressed by educational departments and educational works.Thus,mental health education,professional counseling,and appropriate interventions need to be conducted for medical students.
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Objective To investigate the clinical efficacy of polysaccharide iron combined with folic acid in treatment of anemia in gestation women and its effect on neonatal outcomes.Methods 82 cases of pregnant women with iron deficiency anemia were selected and randomly divided into two groups, each had 41 cases.All patients received discontinuation of iron supplementation two weeks pre-treatment, control group received compound ferrous sulfate and folic Acid Tablets (4 tablets, tid), the treatment group received with Iron Polysaccharide Complex Capsules (0.15 g~0.30 g, qd) and Folic Acid Tablets (0.4 m, qd) .Levels of serum Hb, SF and SI between two groups were compared, and the pregnancy outcomes, neonatal outcomes, and effect and safety were observed.Results Compared with pre-treatment, levels of RBC, HCT and Ret, levels of Hb, SF and SI in two groups were all increased (P<0.05),and those indexes in treatment group were higher than control group (P<0.05).Compared with control group, birth outcomes in cesarean section, the rate of postpartum hemorrhage and neonatal distress rate in treatment group were lower (P<0.05), scores of neonatal muscle tension, pulse, respiration, skin frowning were higher ( P <0.05 ), the total efficiency and safety were higher ( P <0.05 ). Conclusion Polysaccharide iron combined with folic acid in treatment of anemia in gestation women was accurate , it can significantly improve the neonatal outcomes.
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Acetic acid, as a main by-product generated in the pretreatment process of lignocellulose hydrolysis, significantly affects cell growth and lipid synthesis of oleaginous microorganisms. Therefore, we studied the tolerance of Rhodotorula glutinis to acetic acid and its lipid synthesis from substrate containing acetic acid. In the mixed sugar medium containing 6 g/L glucose and 44 g/L xylose, and supplemented with acetic acid, the cell growth was not:inhibited when the acetic acid concentration was below 10 g/L. Compared with the control, the biomass, lipid concentration and lipid content of R. glutinis increased 21.5%, 171% and 122% respectively when acetic acid concentration was 10 g/L. Furthermore, R. glutinis could accumulate lipid with acetate as the sole carbon source. Lipid concentration and lipid yield reached 3.20 g/L and 13% respectively with the initial acetic acid concentration of 25 g/L. The lipid composition was analyzed by gas chromatograph. The main composition of lipid produced with acetic acid was palmitic acid, stearic acid, oleic acid, linoleic acid and linolenic acid, including 40.9% saturated fatty acids and 59.1% unsaturated fatty acids. The lipid composition was similar to that of plant oil, indicating that lipid from oleaginous yeast R. glutinis had potential as the feedstock of biodiesel production. These results demonstrated that a certain concentration of acetic acid need not to be removed in the detoxification process when using lignocelluloses hydrolysate to produce microbial lipid by R. glutinis.
الموضوعات
Acetic Acid , Biofuels , Biomass , Culture Media , Fatty Acids , Hydrolysis , Industrial Microbiology , Lignin , Chemistry , Linoleic Acid , Lipids , Oleic Acid , Rhodotorula , Metabolismالملخص
Objective To explore the relationship between the types of female breast density and age and breast cancer .Methods By accepting the digital mammography X -ray examination for 5 006 women cases and according to the ACR BI -RADS standard in the fourth edition ,the breast density assessment was quantified . We analysed the relationship between the breast density and age and breast cancer .Results In 5 006 cases,the average female age was between 44.22 ±8.09 years old,median age was 43 years old.The components of the breast density were fat type , small amount type , large amount type and compact type each count were 256 (5.11%),726(14.51%),3 719(74.29%),305(6.09%)respectively.By dividing into different age -group to analyze the breast density,there was significant statistical differences of the breast density among age -groups(P<0.001).Among them the breast cancer were 184 cases.Age was between 51.26 ±10.15 years old.Breast cancer in each breast density were fat type 10.16%(26/256),small amount type 9.09%(66/726),large a-mount type 2.45%(91/3719)and compact type 0.33%(1/305).There were statistical differences among age -groups and breast densities and breast (P<0.001).Conclusion Age plays a very important effects on the fe-male breast density .The lower breast density is a high risk factor to breast cancer occurrence .
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Objective To investigate clinical efficacy of adefovir dipivoxil (ADV) combined with interferon α-2b in treatment of chronic hepatitis B.Methods During Jan 2008 to Dec 2014,ninety patients with chronic hepatitis B were divided into adefovir dipivoxil group (33 cases),interferon group (28 cases),and adefovir dipivoxil combined with interferon α-2b group (29 cases).Alanine aminotransferase (ALT) normalization rate,negative rate of HBV-DNA,and HBeAg/anti-HBe seroconversion rates were evaluated among three groups.Results After 48 weeks of treatment,HBeAg negative rate,HBV-DNA negative rate,and ALT normalization rate of combination group were significantly higher than that of interferons αt-2b group and adefovir dipivoxil group (P < 0.05).Conclusions Adefovir dipivoxil combined with interferon α-2b treatment can inhibit the hepatitis B virus,increase the negative rate of HBV-DNA and HBeAg,and reduce liver cell damage.
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Objective To evaluate the effects of problem-based learning (PBL) teaching model in medical imaging education in China. Methods Such databases as PubMed, Medline, CNKI, WanFang, VIP Data were electronically searched for literature on PBL versus lecture-based learning (LBL) applied in medical imaging education in China up to April, 2015. According to the strict quality evaluation of the in-cluded studies, meta-analysis was performed using RevMan 5.2 software. Results Fourteen studies were included totally. Studies included 1 233 students, of whom the PBL group had 608 cases, while LBL group had 625 cases. Compared with LBL, PBL was superior in medical imaging theoretical scores [WMD=5.22, 95%CI(3.06, 7.37), P=0.000], and the case analysis scores [WMD=6.45, 95%CI(4.77, 8.12), P=0.000]. PBL was also superior in the autonomous learning ability [RR=1.78, 95%CI (1.47, 2.16), P=0.000], the unity cooperation ability [RR=1.42,95%CI (1.25, 1.61), P=0.000] and analysis ability [RR=1.73,95%CI (1.42, 2.11), P=0.000]. There were significant differences between PBL group and LBL group. Conclusion PBL can improve teaching results in medical imaging education.
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Objective To understand the actual situation of community‐based diabetes management and analyze common prob‐lems in diabetes management and find the solutions to diabetes management though the objective investigation .Methods The pa‐tient′s data including gender ,age ,education ,medication ,lifestyle information were collected by household face‐to‐face survey and were performed a single factor χ2 analysis of relevant indicators .Results Relative to the patients with middle school education only and is less than 3 000 a month ,the diabetic patients who ere above the junior middle school and family income equal to or greater than 3 000 had good diabetes management on medication ,diet ,exercise ,blood glucose monitoring ,diabetes related knowledge .Con‐clusion Patient′s education and economic level could effect attitudes toward diabetes ,medication ,diet ,exercise ,blood glucose moni‐toring ,diabetes‐related knowledge .
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1,3-propanediol production with the byproduct of biodiesel production is important to increase the economic benefit of biodiesel industry. Accumulation of 3-hydroxypropionaldehyde is one of the key problems in the 1,3-propanediol fermentation process, leading to the cell death and the fermentation abnormal ceasing. Different from the traditional way of reducing the accumulation of the 3-hydroxypropionaldehyde, we introduced the polyhydroxybutyrate pathway into the Klebsiella pneumoniae for the first time to enhance the tolerance of K. pneumoniae to 3-hydroxypropionaldehyde, at the same time, to improve the 1,3-propanediol production. Plasmid pDK containing phbC, phbA, phbB gene was constructed and transformed into K. pneumoniae successfully. PHB was detected in the engineered K. pneumoniae after IPTG induction and its content enhanced with the IPTG concentration increasing. The optimized IPTG concentration was 0.5 mmol/L. The constructed K. pneumoniae could produce 1,3-propanediol normally, at the same time accumulate polyhydroxybutyrate. With the constructed strain, the fermentation proceeds normally with the initial glucose was 70 g/L which the wild type strain stopped growing and the fermentation was ceasing; 1,3-propanediol concentration and yield reached 31.3 g/L and 43.9% at 72 h. Our work is helpful for the deep understanding of 1,3-propanediol metabolic mechanism of Klebsiella pneumoniae, and also provides a new way for strain optimization of Klebsiella pneumoniae.