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Objective: To evaluate the efficacy of Tuina (Chinese therapeutic massage) at points on abdomen and back meridians in the treatment of infantile colic.Methods: A total of 120 infants with intestinal colic were randomly divided into a control group and an observation group, with 60 cases in each group. In the control group, the parents of the infants were given soothing and health education. In addition to the intervention used in the control group, the observation group was treated with Tuina at points on abdomen and back meridians once a day for 5 consecutive days as a course of treatment. The pain scale score and clinical symptoms of the two groups were recorded before and after treatment. Results: After treatment, the total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The pain scale score of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). In the 24 h behavior diary indicators, the daily attack duration, the daily attack times, and the weekly attack days in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion: Tuina at points on abdomen and back meridians is effective and safe in the treatment of infantile colic.
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Objective:To analyze the correlation between body mass index (BMI) and the graded expression, subcutaneous depth, and diameter of elbow veins (cephalic vein, median vein, basilic vein) in patients with metabolic syndrome, to provide a method and theoretical basis for precise puncture of peripheral veins in obese patients.Methods:From January to October 2021, a total of 767 patients with metabolic syndrome with gastric volume reduction were selected as the study subjects by retrospective cohort study from the first Affiliated Hospital of Nanjing Medical University. According to the quartile Q1, M and Q3 of BMI level, they were divided into four groups: group A, group B, group C and group D. The subcutaneous depth and diameter of the cephalic vein, median vein and basilic vein were measured by B-ultrasound, and the three veins were evaluated and graded according to the grading criteria of superficial veins.The correlation between BMI and the subcutaneous depth and diameter of the three elbow veins was analyzed, and collected data such as puncture method and puncture times. Results:There was no significant correlation between BMI and subcutaneous depth and vessel diameter of the basilic vein ( r = 0.041 and 0.046, both P>0.05), the level of BMI was positively correlated with the subcutaneous depth and diameter of cephalic vein ( r = 0.275 and 0.117, both P<0.05) and median vein ( r = 0.236 and 0.148, both P<0.05), and a linear regression relationship was found ( OR values were 1.013-1.031, all P<0.05). 187 cases had direct puncture conditions under direct vision, and the success rate of one puncture was 86.63%(162/187).Venipuncture was completed under the guidance of B-mode ultrasound for 25 cases with failure under direct vision and 580 cases without direct puncture conditions under direct vision, the success rate of one puncture was 98.51% (596/605). Conclusions:With the increase of BMI level in patients with metabolic syndrome, the depth and diameter of both cephalic vein and median vein increase, venous exposure is difficult to express. The visual vein puncture guided by B-ultrasound is more accurate and catheterization is more reliable.
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Objective:Exercise is a key way to control the blood glucose,which can improve blood lipids and blood pressure,reduce glycated hemoglobin levels,and increase insulin sensitivity.It is of great significance for maintaining blood glucose homeostasis.This study aims to explore the optimal exercise combinations suitable for diabetic patients,and to provide scientific and effective personalized exercise guidance for diabetic patients. Methods:The physical examination data and questionnaire results of were collected from the Third Xiangya Hospital of Central South University.The study was involved in 3 867 diabetes from January,2020 to December,2021.The basic information and living habits were obtained through questionnaires.The fasting blood samples were collected to measure the levels of total cholesterol(TCh),triglyceride,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and fasting blood glucose.Physical measurements included height,weight,waistline,hipline,and blood pressure.Categorical variables were tested using chi-square tests,and continuous variables were tested using non-parametric Kruskal-Wallis test.Multiple linear regression model was used to analyze the relationship between exercise behaviors(frequency,duration,and intensity),years of exercise,diet habits,medicine,and fasting blood glucose.The relationship between different exercise behaviors and various indexes(BMI,blood pressure,blood lipids,blood glucose)was analyzed by multiple rising sun rose plots.The polar thermal diagram showed the relationship of exercise behaviors with the best expected effect. Results:Non-parametric Kruskal-Wallis test showed that there were significant differences in other indexes except LDL-C(P=0.681)among groups with different exercise behaviors(all P<0.01).The multiple rising sun rose plots showed that diabetic patients who did moderate to high intensity exercise more than 5 times a week for more than 30 min each time had a healthier BMI,blood lipid levels,blood glucose levels,and blood pressure.Polar thermal diagram showed that low-intensity exercise once or twice a week requires 30 to 60 min or more of exercise to achieve the desired results.Multiple linear regression analysis showed that frequency(β=-0.208,95% CI-0.356 to-0.059,P=0.006),duration(β=-0.227,95% CI-0.387 to-0.066,P=0.006),intensity of exercise(β=-0.110,95% CI-0.218 to-0.002,P=0.046),diet habits(β=0.462,95% CI 0.295 to 0.556,P<0.001)and medicine(β=-0.520,95% CI-0.720 to-0.312,P<0.001)were correlated with fasting blood glucose. Conclusion:Moderate to high intensity exercise for more than 30 min and 5 times a week is the most beneficial combination for diabetes.Low exercise intensity should be combined with higher exercise frequency and longer exercise time to achieve the desired effect.With the increase of exercise intensity,the relationship between low exercise frequency and long exercise time is weakened.
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This study aims to investigate the therapeutic effects and potential mechanisms of resveratrol(Res) on poor ovarian response(POR) in mice. The common target genes shared by Res and POR were predicted by network pharmacology, used for Gene Ontology(GO) annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment, and then validated by animal experiments. The mice with regular estrous cycle after screening were randomized into normal, POR, and low-and high-dose(20 and 40 mg·kg~(-1), respectively) Res groups. The normal group was administrated with an equal volume of 0.9% sodium chloride solution by gavage, and the mice in other groups with tripterygium glycosides suspension(50 mg·kg~(-1)) by gavage for 2 weeks. After the modeling, the mice in low-and high-dose Res groups were treated with Res by gavage for 2 weeks, and the mice in normal and POR groups with an equal volume of 0.9% sodium chloride solution by gavage. Ovulation induction and sample collection were carried out on the day following the end of treatment. Vaginal smears were collected for observation of the changes in the estrous cycle, the counting of retrieved oocytes, and the measurement of ovarian wet weight and ovarian index. The enzyme-linked immunosorbent assay(ELISA) was employed to measure the levels of anti-mullerian hormone(AMH), follicle-stimulating hormone(FSH), estradiol(E_2), and luteinizing hormone(LH) in the serum. The ovarian tissue morphology and granulosa cell apoptosis were observed by hematoxylin-eosin(HE) staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL), respectively. Western blot was employed to determine the protein levels of phosphatidylinositol 3-kinase(PI3K), protein kinase B(AKT), forkhead box O(FOXO) 3a, hypoxia-inducible factor(HIF)-1α, B-cell lymphoma-2(Bcl-2), and Bcl-2-associated X protein(Bax). A total of 222 common targets shared by Res and POR were collected. GO annotation indicated that these targets were mainly involved in oxidative stress response. KEGG enrichment analysis revealed that Res can intervene in POR via PI3K/AKT, HIF-1, and FOXO signaling pathways. Animal experiments showed that the model group had higher rate of estrous cycle disorders, lower number and poorer morphology of normally developed follicles at all levels, more atretic follicles, higher apoptosis of ovarian granulosa cells, lower number of retrieved oocytes, lower ovarian wet weight and ovarian index, higher serum levels of FSH and LH, lower levels of AMH and E_2, higher expression levels of HIF-1α, FOXO3a and Bax, and lower expression levels of PI3K, AKT, and Bcl-2 in the ovarian tissue than the normal group. Compared with the POR group, low-and high-dose Res decreased the rate of estrous cycle disorders, improved the follicle number and morphology, reduced atretic follicles, promoted the apoptosis of ovarian granulosa cells, increased retrieved oocytes, ovarian wet weight and ovarian index, and lowered serum FSH and LH levels. Moreover, Res down-regulated the expression levels of HIF-1α, FOXO3a and Bax, and up-regulated the expression levels of PI3K, AKT and Bcl-2 in the ovarian tissue. In summary, Res can inhibit apoptosis and mitigate poor ovarian response in mice by regulating the PI3K/AKT/FOXO3a and HIF-1α pathways.
الموضوعات
Female , Mice , Animals , Proto-Oncogene Proteins c-akt/metabolism , Resveratrol/pharmacology , bcl-2-Associated X Protein , Phosphatidylinositol 3-Kinases/metabolism , Sodium Chloride , Follicle Stimulating Hormone , Proto-Oncogene Proteins c-bcl-2الملخص
Acephalic spermatozoa syndrome (ASS) is one of the most severe spermatogenic failures of all infertility in men. The cognition of ASS has experienced a tortuous process. Over the past years, with the in-depth understanding of spermatogenesis and the emergence of new genetic research technologies, the unraveling of the genetic causes of spermatogenic failure has become highly active. From these advances, we established a genetic background and made significant progress in the discovery of the genetic causes of ASS. It is important to identify pathogenic genes and mutations in ASS to determine the biological reasons for the occurrence of the disease as well as provide genetic diagnosis and treatment strategies for patients with this syndrome. In this review, we enumerate various technological developments, which have made a positive contribution to the discovery of candidate genes for ASS from the past to the present. Simultaneously, we summarize the known genetic etiology of this phenotype and the clinical outcomes of treatments in the present. Furthermore, we propose perspectives for further study and application of genetic diagnosis and assisted reproductive treatment in the future.
الموضوعات
Humans , Male , Infertility, Male/pathology , Membrane Proteins/genetics , Mutation , Spermatogenesis/genetics , Spermatozoa/pathologyالملخص
Obstructive sleep apnea hypopnea syndrome(OSAHS)is a group of diseases which occurred in the upper respiratory tract with transient, recurrent, partial or complete obstruction during night sleep. It can affect the regulation of hemodynamics, endocrine systems and autonomic nerve, and then result in the reduction of body oxygen saturation, chronic hypoxia and hypercapnia. Beside being an independent risk factor for cardiovascular and cerebrovascular diseases, many studies have shown that it is also associated with ocular surface diseases in OSAHS, such as floppy eyelid syndrome, dry eye, keratoconus, etc., but there is still a lack of perfect systematic analysis. This paper reviews the relationship between OSAHS and relevant ocular surface diseases including pathogenesis,clinical manifestations and treatment progress, in order to reduce the ophthalmic complications of OSAHS patients in clinical diagnosis and treatment,and better improve the quality of life of patients.
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OBJECTIVE@#To investigate the therapeutic effect of Epothilone D on traumatic optic neuropathy (TON) in rats.@*METHODS@#Forty-two SD rats were randomized to receive intraperitoneal injection of 1.0 mg/kg Epothilone D or DMSO (control) every 3 days until day 28, and rat models of TON were established on the second day after the first administration. On days 3, 7, and 28, examination of flash visual evoked potentials (FVEP), immunofluorescence staining and Western blotting were performed to examine the visual pathway features, number of retinal ganglion cells (RGCs), GAP43 expression level in damaged axons, and changes of Tau and pTau-396/404 in the retina and optic nerve.@*RESULTS@#In Epothilone D treatment group, RGC loss rate was significantly decreased by 19.12% (P=0.032) on day 3 and by 22.67% (P=0.042) on day 28 as compared with the rats in the control group, but FVEP examination failed to show physiological improvement in the visual pathway on day 28 in terms of the relative latency of N2 wave (P=0.236) and relative amplitude attenuation of P2-N2 wave (P=0.441). The total Tau content in the retina of the treatment group was significantly increased compared with that in the control group on day 3 (P < 0.001), showing a consistent change with ptau-396/404 level. In the optic nerve axons, the total Tau level in the treatment group was significantly lower than that in the control group on day 7 (P=0.002), but the changes of the total Tau and pTau-396/404 level did not show an obvious correlation. Epothilone D induced persistent expression of GAP43 in the damaged axons, detectable even on day 28 of the experiment.@*CONCLUSION@#Epothilone D treatment can protect against TON in rats by promoting the survival of injured RGCs, enhancing Tau content in the surviving RGCs, reducing Tau accumulation in injured axons, and stimulating sustained regeneration of axons.
الموضوعات
Animals , Rats , Disease Models, Animal , Epothilones , Evoked Potentials, Visual , Nerve Regeneration/physiology , Optic Nerve Injuries/metabolism , Rats, Sprague-Dawley , Retinal Ganglion Cells/physiologyالملخص
Here, we took base construction of neurosurgery as example to discuss and analyze according to requirements and evaluation indexes of base construction in Xinqiao Hospital, and put forward the specific objectives, measures and implementations of base construction. Foremost, we summarized experiences and overcame shortcomings through interpreting and implementing scheme of our base construction, which would help to improve the construction of standardized residency training base in China.
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@#AIM: To evaluate the effectiveness of intravitreal bevacizumab(IVB)and ranibizumab(IVR)for the treatment of type 1 retinopathy of prematurity(ROP)by Meta-analysis.<p>METHODS: The PubMed, Embase, Web of Science, the Cochrane Library, CNKI, CQVIP, CBM, OVID and Wanfang were systematically searched. All comparative studies of IVB or IVR as treatment for ROP were included. Two independent reviewers performed the date extraction and assessed study quality. Meta-analysis was performed using Review Manager 5.3 software. The retreatment rate was defined as the primary outcome. Secondary outcomes were prevalence of complete vascularization and myopic(spherical equivalent, SE).<p>RESULTS: Eight non-randomized studies, including a total of 885 eyes were included in this study. Compared with IVB-treated children, IVR-treated children have higher retreatment rate \〖<i>OR</i>=0.55, 95% <i>CI</i>:0.34-0.88, <i>P</i><0.05\〗, less spherical equivalent \〖<i>WMD</i>= -1.44, 95% <i>CI</i>: -2.28 to -0.00, <i>P</i><0.05\〗, and the same percentage of complete vascularization \〖<i>OR</i>=2.15, 95% <i>CI</i>: 0.80-0.576,<i> P</i>>0.05\〗.<p>CONCLUSION: Both IVR and IVB can complete the vasculization of the retina in the treatment of type 1 ROP, but the two treatments have their own advantages. IVR has little effect on the refractive effect in children, but its effect in reducing the retreatment rate is worse than IVB.
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OBJECTIVE@#To observe clinical effect of acupuncture combined with conventional visual stimulation on cerebral visual impairment (CVI) in children aged 3-10 years and influence on the pattern visual evoked potential (P-VEP).@*METHODS@#A total of 60 cases of children aged 3-10 years with CVI were randomly divided into an observation group and a control group, 30 cases in each group. The children in the control group received conventional visual stimulation therapy, 1 month as a course of treatment. On the basis of the control group, the children in the observation group was treated with acupuncture at Baihui (GV 20), Jingming (BL 1), Taiyang (EX-HN 5), Sibai (ST 2), etc. 3 times a week, and the treatment was given 4 weeks continuously as a course. Both groups received 3 courses of treatment. The visual acuity and P-VEP improvement were compared between the two groups before and after treatment.@*RESULTS@#After treatment, the incubation period (P100-L) of the two groups was shorter than before treatment, and the amplitude (P100-A) was higher than before treatment (@*CONCLUSION@#Acupuncture combined with conventional visual stimulation can improve the incubation period (P100-L) and amplitude (P100-A) of P-VEP in children with CVI, and improve the best corrected visual acuity in children, the clinical effect is better than the conventional visual stimulation alone.
الموضوعات
Child , Child, Preschool , Humans , Acupuncture Points , Acupuncture Therapy , Brain Diseases , Evoked Potentials, Visual , Vision Disorders/therapyالملخص
Objective:To observe the clinical efficacy of addition and subtraction therapy of Jinkui Shenqiwan combined with Buzhong Yiqitang to postmenopausal osteoporosis (PMO) with deficiency of spleen and kidney, and to investigate its regulation effect on immune inflammatory factors. Method:One hundred and sixty patients were randomly divided into observation group and control group, with 80 cases in each group. Both groups got comprehensive western medicine treatment measures. Patients in control group additionally got Zhuanggu Zhitong capsule, 4 capsules/time, 3 times/day. Patients in observation group additionally got addition and subtraction therapy of Jinkui Shenqiwan combined with Buzhong Yiqitang, 1 dose/day. The treatment was continued for 24 weeks. Before and after treatment, lumbar L2-4 bone mineral density (BMD) was detected by Dual energy X-ray absorptiometry (DXA) and lumbar BMD was detected by quantitative CT (QCT). Scores of traditional Chinese medicine(TCM) syndromes and Chinese osteoporosis-targeted quality of life questionnaire (COQOL) were graded. Levels of Estradiol (E<sub>2</sub>), type Ⅰ procollagen amino terminal pro peptide (PINP), serum osteocalcin (OC), osteoprotegerin (OPG), type Ⅰ collagen cross-linked C-terminal peptide (S-CTX), tartrate resistant acid phosphatase (TRACP) and urinary pyridinoline (PYD) were detected. Levels of CD4<sup>+</sup> T cells, CD8<sup>+</sup> T cells, interleukin-17 (IL-17), tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), <italic>γ-</italic>interferon(IFN-<italic>γ</italic>) and interleukin-4 (IL-4) were calculated. The proportion of T helper cell (Th)17 and regulatory T cell (Treg) in CD4<sup>+</sup> T cells was calculated. Besides, the safety was evaluated. Result:Bone density was detected by DXA in observation group, and its T-value and bone density detected by QCT were all higher than those in control group (<italic>P</italic><0.01). After treatment, scores of TCM syndrome and COQOL were lower than those in control group (<italic>P</italic><0.01). Levels of PINP, OC, S-CTX, TRACP and PYD/Cr were all lower than those in control group (<italic>P</italic><0.01). Levels of OPG, CD8<sup>+</sup> and Treg were higher than those in control group (<italic>P</italic><0.05), levels of Th17, Th17/Treg, CD4<sup>+</sup>/CD8<sup>+</sup>, IL-17, TNF-<italic>α</italic> and IFN-<italic>γ </italic>were lower (<italic>P</italic><0.01), and levels of IL-4 and E<sub>2</sub> were higher than those in control group (<italic>P</italic><0.01). The clinical efficacy in observation group was better than that in control group (<italic>Z</italic>=2.103, <italic>P</italic><0.05). Conclusion:On the basis of calcium and vitamin D supplementation, Jinkui Shenqiwan combined with Buzhong Yiqitang can improve levels of E<sub>2</sub> and bone density, reduce clinical symptoms, improve quality of life, regulate bone metabolism index and immune inflammation reaction, with better clinical efficacy and safety.
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Objective:To explore the influence of neonatal intensive care unit (NICU) environmental factors on physiological function of premature infants, and propose improvement plan.Methods:A total of 40 cases of low body mass premature infants from June to December in 2017 in Chongqing Center for Women and Children were selected as the research objects, and 8:00-9:00 of working day was set as the daily period, 10:00-11:00 as the quiet period. Light, sound, touch and other environmental factors in NICU were detected quantitatively, basic vital signs, activity, stress hormones and other changes were recorded, and the impact of environmental factors on the children was analyzed.Results:Touch times in daily and quiet periods were (5.02±0.54) times/h and (4.56±0.55) times/h, with no significant difference ( P>0.05). The same time as the next two days, the activity of premature infants in quiet period was (8.26±3.10), which was lower than that in daily period (17.52±5.78), and the difference was statistically significant ( t value was 8.967, P<0.01). The sleep time of premature infants during quiet period (23.24±8.38) was significantly higher than that of daily period (4.80 ±5.39), the difference was statistically significant ( t value was-11.679, P<0.01). The levels of cortisol, epinephrine and norepinephrine in premature infants were (61.53±13.47), (15.91±3.94), (49.22±15.15) μg/L in quiet period, which were significantly lower than those in daily period (74.52±20.98), (23.40±11.66), (80.32±32.43) μg/L ( t value was 3.295, 3.848, 5.502, P<0.01). The heart rate and systolic pressure of premature infants in quiet period (130.44±8.06) beats/min, (64.05±10.40) mmHg (1 mmHg=0.133 kPa) were significantly lower than those in daily period (145.21±10.52) beats/min, (72.85±13.36) mmHg, and the difference was statistically significant ( t value was 3.340, 2.166, P<0.01 or 0.05). Different time periods on the same day, the activity of premature infants in quiet period was (9.87±3.31), which was lower than that in daily period (19.82±5.57), and the difference was statistically significant ( t value was 9.761, P<0.01). The sleep time of premature infants during quiet period (25.75±9.07) was significantly higher than that of daily period (4.70±3.89), the difference was statistically significant ( t value was-13.457, P<0.01). The levels of cortisol, epinephrine and norepinephrine in premature infants were (59.42±11.95), (15.78±1.45), (50.90±14.73) μg/L in quiet period, which were significantly lower than those in daily period (71.50±20.56), (25.62±11.95), (79.87±29.91) μg/L ( t value was 3.212, 5.169, 3.585, P<0.01). The heart rate and systolic pressure of premature infants in quiet period (136.02±11.22) beats/min, (65.35±9.56) mmHg were significantly lower than those in daily period (144.10±9.18) beats/min, (73.47±12.92) mmHg, and the difference was statistically significant ( t value was 3.533, 2.008, P<0.01 or 0.05). Conclusions:Children with NICU are generally in high noise and strong light environment, these factors will cause adverse physiological reactions to a certain extent.
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Objective:To explore the application effect of disease-oriented digitalized teaching model in the undergraduate teaching of stomatology.Methods:A total of 34 undergraduate students in clinical medicine from Batch 2018 were selected as the control group 1, 24 undergraduate students in stomatology from Batch 2015 were selected as the control group 2, and 23 undergraduate students in stomatology from Batch 2018 were collected as the experimental group. The two control groups all accepted the traditional teaching mode, and the experimental group accepted the disease-oriented digitalized teaching model. Finally, the teaching effect was evaluated through questionnaire surveys and less difficult oral professional tests. The SPSS 24.0 was used to conduct t test. Results:After accepting this teaching model, students improved their understanding of the concept of "organism" and "disease" ( P<0.05), and they had a positive evaluation of this teaching model. It was found that the tests scores of the experimental group (42.17±1.21) were significantly higher than those of non-dental major students of the same Batch (24.71±1.42) ( P<0.05), with significant differences, while without significant difference between the tests scores of the senior stemmatological students (43.33±1.30) ( P>0.05). Conclusion:This teaching model enables students to establish the concept of "organism" and form a disease-oriented knowledge framework before entering the decentralized professional courses, which may further stimulates the interest of junior students in their majors, and enhances their professional awareness compared with traditional teaching model. It's also a useful exploration for teaching hospitals to conduct teaching activities of junior undergraduates outside the classroom.
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OBJECTIVES@#Sleep disorders directly affect health-related quality of life, so it is of great significance to investigate the risk factors of sleep disorders and to actively intervene. This study aims to investigate the relationship between dietary patterns and associated factors and sleep disorders among the health screening populations in Changsha.@*METHODS@#A cross-sectional study was carried out in 86 073 subjects aged 18-70 years old who underwent the health screening. The association between dietary patterns and sleep disorders was analyzed. The associated factors for sleep disorders were identified via by principal component analysis and classification tree model.@*RESULTS@#The overall prevalence of reporting sleep disorders was 18.64%. Four major dietary patterns (healthy, snacks, whole-grain, and fried food patterns) were identified. In logistic regression, snacks and fried food patterns had higher risk of sleep disorders. The whole-grain pattern was a protective factor for sleep disorders. Nine associated factors including age, susceptibility to anxiety, snacking parterns, feelings of depression, chronic pain, physical activity, educational level, gender, and weight, and 9 groups at high risk for sleep disorders were identified by classification tree model.@*CONCLUSIONS@#Sleep disorders are prevalent in the health screening population of Changsha. There is a close association between snacks dietary patterns and sleep disorders. It is necessary to promote healthy and reasonable diet, and keep good lifestyle for the prevention and control of sleep disorders. Health management after physical examination should take different health interventions for high-risk groups with different characteristics of sleep disorders.
الموضوعات
Adolescent , Adult , Aged , Humans , Middle Aged , Young Adult , Cross-Sectional Studies , Diet , Feeding Behavior , Health , Mass Screening , Quality of Life , Sleep Wake Disorders/epidemiologyالملخص
Objective@#To explore the influence of neonatal intensive care unit (NICU) environmental factors on physiological function of premature infants, and propose improvement plan.@*Methods@#A total of 40 cases of low body mass premature infants from June to December in 2017 in Chongqing Center for Women and Children were selected as the research objects, and 8:00-9:00 of working day was set as the daily period, 10:00-11:00 as the quiet period. Light, sound, touch and other environmental factors in NICU were detected quantitatively, basic vital signs, activity, stress hormones and other changes were recorded, and the impact of environmental factors on the children was analyzed.@*Results@#Touch times in daily and quiet periods were (5.02±0.54) times/h and (4.56±0.55) times/h, with no significant difference (P>0.05). The same time as the next two days, the activity of premature infants in quiet period was (8.26±3.10), which was lower than that in daily period (17.52±5.78), and the difference was statistically significant (t value was 8.967, P<0.01). The sleep time of premature infants during quiet period (23.24±8.38) was significantly higher than that of daily period (4.80 ±5.39), the difference was statistically significant (t value was-11.679, P<0.01). The levels of cortisol, epinephrine and norepinephrine in premature infants were (61.53±13.47), (15.91±3.94), (49.22±15.15) μg/L in quiet period, which were significantly lower than those in daily period (74.52±20.98), (23.40±11.66), (80.32±32.43) μg/L (t value was 3.295, 3.848, 5.502, P<0.01). The heart rate and systolic pressure of premature infants in quiet period (130.44±8.06) beats/min, (64.05±10.40) mmHg (1 mmHg=0.133 kPa) were significantly lower than those in daily period (145.21±10.52) beats/min, (72.85±13.36) mmHg, and the difference was statistically significant (t value was 3.340, 2.166, P<0.01 or 0.05). Different time periods on the same day, the activity of premature infants in quiet period was (9.87±3.31), which was lower than that in daily period (19.82±5.57), and the difference was statistically significant (t value was 9.761, P<0.01). The sleep time of premature infants during quiet period (25.75±9.07) was significantly higher than that of daily period (4.70±3.89), the difference was statistically significant (t value was-13.457, P<0.01). The levels of cortisol, epinephrine and norepinephrine in premature infants were (59.42±11.95), (15.78±1.45), (50.90±14.73) μg/L in quiet period, which were significantly lower than those in daily period (71.50±20.56), (25.62±11.95), (79.87±29.91) μg/L (t value was 3.212, 5.169, 3.585, P<0.01). The heart rate and systolic pressure of premature infants in quiet period (136.02±11.22) beats/min, (65.35±9.56) mmHg were significantly lower than those in daily period (144.10±9.18) beats/min, (73.47±12.92) mmHg, and the difference was statistically significant (t value was 3.533, 2.008, P<0.01 or 0.05).@*Conclusions@#Children with NICU are generally in high noise and strong light environment, these factors will cause adverse physiological reactions to a certain extent.
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Objective Analyzing the patent applications of top 10 hospitals in China during past 10 years,to provide reference for hospital management departments and researchers,propose possible suggestions.Methods Selecting the top 10 hospitals of China,and searching their patent application data during the period of 2008-2017 based on China Intellectual Property Right Net.Analyze the age distribution,patent type distribution,patent effective rate,IPC distribution,as well as the relationship between patents and the CSCD papers.Results The top 10 hospitals have applied 5430 patents in past 10 years,including 2188 inventions,3197 utility models and 45 design patents.Conclusions Patent applications increased year by year.The main direction of the patents is innovation and improvement to surgical instruments or technology.The level of patents is not high,utility model patent is in the majority.Hospitals need to put equal emphasis on patents and papers.Proposed suggestions including:improving the patent consciousness of medical staff;cooperating with the patent agency;improving the quality of patents on creativity;encouraging staffs to apply invention patent,and increasing the proportion of invention patents when promotion and evaluation.
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The standardized training for surgical residents is the systematic and normalized training for residents in the base with national authentication, whose goal is to promote the clinical experience and skill for treatment of the patients. The base construction is an important step to apply the resident training system according to the national policies and regulations . This study analyzed the experience of the Neurosurgical Unit of Xinqiao Hospital in standardized training for surgical residents according to the base construction requirements and evaluation index. Based on the analysis, the study proposed the concrete aims, measures and applying steps for neurosurgery base construction, especially the regulations for diagnosis and treatment of neurosurgical disease , which as a whole is beneficial for promoting the quality of the standardized training of residents in future.
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To investigate the role of cardiac magnetic resonance imaging (CMRI) in evaluating pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PAH); and the relationship between CMRI parameters and pulmonary function parameters, blood gas analysis parameters and 6-minute walk test (6MWT) parameters in patients with COPD complicated with PAH. Methods Thirty-seven patients were diagnosed with COPD in the department of respiratory and critical care discipline of Ningxia Medical University General Hospital from October 2013 to October 2016, who underwent transthoracic echocardiography (TTE) to measure pulmonary arterial systolic pressure (PASP), and were divided into COPD group and COPD+PAH group according to whether there was PAH [PASP > 40 mmHg (1 mmHg = 0.133 kPa) was defined as PAH]. All patients completed pulmonary function tests [1 second forced expiratory volume to forced vital capacity ratio (FEV1/FVC), FEV1 predicted value (FEV1pred)], blood gas analysis [arterial blood oxygen partial pressure (PaO2), arterial blood carbon dioxide partial pressure (PaCO2)], CMRI examination [relative dilatation of the main pulmonary artery (mPAD), mean pulmonary artery pressure (mPAP), left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), right ventricular end-diastolic myocardial mass (RVMED), right ventricular end-systolic myocardial mass (RVMES)], and 6MWD [6-minute walk distance (6MWD)] within 1 week. The obtained clinical parameters had been compared between the groups, and correlation was analyzed. Results Among the 37 patients with COPD, 16 patients were complicated with PAH. There were no significant differences in FEV1/FVC, FEV1pred, PaO2, PaCO2 and other baseline indicators between the two groups. In the COPD group, TTE obtained PASP of 2 patients were normal (PSAP < 40 mmHg), while CMRI measured mPAP were higher than the normal limit (> 25 mmHg). Compared with the COPD group, mPAD, RVEF and 6MWD were significantly decreased in the COPD+PAH group [mPAD: (25.64±5.01)% vs. (44.00±22.52)%, RVEF: 0.525±0.054 vs. 0.592±0.071, 6MWD (m): 319.3±116.5 vs. 408.2±38.0, all P < 0.01], mPAP, RVMED and RVMES were significantly increased [mPAP (mmHg): 28.89±3.16 vs. 20.18±2.43, RVMED (g): 57.19±15.46 vs. 40.71±15.44, RVMES (g): 45.99±11.16 vs. 33.71±13.39, all P < 0.01], and there was no significant differences in LVEF (0.663±0.082 vs. 0.699±0.075, P > 0.05). Correlation analysis showed that mPAD was positively correlated with FEV1/FVC and FEV1pred (r1 = 0.538, P1 = 0.021; r2 = 0.448, P2 = 0.049);RVMED was negatively correlated with PaO2 (r = -0.581, P = 0.015), and positively correlated with PaCO2 (r = 0.592, P = 0.014); 6MWD was positively correlated with RVEF (r = 0.485, P = 0.041), and had no correlation with LVEF (r = 0.271, P = 0.104). Conclusions Compared with COPD patients, changes in pulmonary hemodynamics and right ventricular function in COPD patients with PAH are related to the severity of airflow limitation. CMRI can early monitor pulmonary hemodynamics and right heart function changes in patients with COPD. Once PAH appears, pulmonary hemodynamics, right heart function and exercise tolerance have changed.
الملخص
Amblyopia greatly affects the physical and mental development of children. Acupuncture is effective for amblyopia, though its mechanism remains unclear. This article summarized the mechanism of acupuncture treatment of amblyopia from the perspectives of morphology of neurons in visual cortex, visual electrophysiology, and molecular biology, etc. It was found that acupuncture may treat amblyopia through repairing the morphological and ultrastructural damages of neurons in visual cortex, promoting the electrical activities in visual pathway and visual cortical neurons, and modulating the synthesis and expression levels of factors involved in visual system. Nevertheless, further studies are required to unveil the mechanism of acupuncture treatment of amblyopia.
الملخص
@#【Objective】To study the relationship between circulation tumor cell(CTC)and clinicopathological characteristics in early and middlestage colorectal cancer,and to evaluate the diagnostic and prognostic value of peripheral blood CTC through dynamically monitoring the changes of peripheral blood CTC in the patients before and after operation.【Methods】 Prospectively 67 patients with early and middle stage colorectal cancer were included,and 20 healthy volunteers served as contrast during the same period. Peripheral venous blood(7.5 mL)was collected 24 h before radical operation,3 months after radical operation and in control group. SE- iFISH technique was used to isolate and identify CTC. The cutoff value of CTC in diagnosis of colorectal cancer was determined by the receiver operating curve(ROC)and Youden index. Kaplan-Meier and log-rank methods were used for survival analysis and multivariate COX regression analysis for multivariate correction. The value of CTC in the diagnosis of early and middle stage colorectal cancer was evaluated comprehensively,and then the relationship between CTC in peripheral blood and clinicopathological characteristics and prognosis was synthetically evaluated combined with clinicopathological characteristics and postoperative follow- up data. 【Results】The positive rate of CTC in patients with early and middle stage colorectal cancer was significantly higher than that in healthy people(91.0% vs. 5.0% ,P<0.01). The CTC enumeration was significantly correlated with the depth of invasion and tumor location(P = 0.001,P = 0.044),but not with gender,age,tumor size,lymph node metastasis,TNM stage ,CEA level and CA-199 level. The preoperative CTC enumeration were not correlated with the above-mentioned clinicopathological parameters. Preoperative CTC had no predictive significance for disease free survival(DFS)and total survival(OS)(AUC = 0.359,P = 0.068;AUC = 0.428,P = 0.423),and postoperative CTC critical point of 3/7.5 mL had predictive significance for DFS and OS(AUC = 0.936 ,P < 0.001 ;AUC = 0.863 ,P < 0.001). It was found that patients with early and middle stage colorectal cancer were divided into two groups :good prognosis group(CTC < 3 after operation or the number of CTC after operation was equal or decreased with the number of CTC before operation)and bad prognosis group(CTC ≥ 3 after operation or the number of CTC after operation was higher than the number of CTC before operation). The DFS of the good prognosis group was significantly longer than that of the poor prognosis group (43.7 months vs. 20.4 months,P < 0.001;48.7 months vs. 26.8 months,P < 0.001),and the OS was also significantly longer (54.7 months vs. 43.3 months,P < 0.001;54.8 months vs. 45.1 months,P < 0.001). Multivariate analysis showed that CTC ≥ 3/7.5 mL was a bad independent factor of DFS and OS.【Conclusions】CTC has high clinical value in patients with early and middle stage colorectal cancer. Preoperative CTC values can not predict the prognosis of early and middle stage colorectal cancer ,but postoperative CTC values and dynamic detection for CTC changes before and after operation can independently predict the prognosis of early and middle stage colorectal cancer.