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Objective To understand the current practice status of central venous access device(CVAD)maintenance among intensive care unit(ICU)nurses in secondary and above medical institutions in Shandong province,and to provide a basis for further implementation of effective measures to reduce the incidence of central catheter-related bloodstream infections.Methods The CVAD maintenance practice questionnaire was compiled based on domestic and international evidence related to CVAD maintenance,and a survey was conducted in October 2022 to investigate the status of ICU nurses' CVAD maintenance practice in secondary and above medical institutions in Shandong Province.Results There were 1 492 nurses participated in the survey and 1 461 valid questionnaires were recovered,with a valid recovery rate of 97.92％.The type of CVAD used by the nurses was mainly central venous catheters[92.3％(1349/1461)],and the item with the best assessment at each operation was patency of the catheter[81.1％(1185/1461)],and the worst was the patient's feeling[40.7％(594/1 461)].When assessing catheter patency,[59.8％(873/1 461)]of nurses drew back blood into the catheter.In the use of infusion connectors,three-way connectors[76.0％(1 110/1 461)]and heparin caps[62.3％(910/1 461)]were most frequently used.When sterilizing needleless connectors,most nurses could follow the correct range of disinfection,but the time of disinfection needed to be extended,and the most used items for disinfection were povidone-iodine cotton balls/swabs[44.3％(647/1 461)].The timing of changing infusion connectors needs to be standardized.Most nurses would choose saline for catheter flushing,and the number of nurses choosing saline versus heparinized saline when locking the catheter was about 50％.Most nurses can use correct size syringes and follow standardized techniques for flushing and locking.When performing CVAD maintenance,84.7％(1 237/1 461)of nurses chose a specialized care package kit.The most used skin antiseptic was povidone-iodine[63.7％(931/1 461)].Most nurses could follow the standardized range of skin disinfection,but awareness of drying needs to be improved.Dressings covering puncture points were most frequently transparent[99.7％(1 457/1 461)]and gauze[94.7％(1 383/1 461)],and the frequency of gauze dressing changes needs to be standardized.Hand hygiene and aseptic awareness of nurses during CVAD maintenance was good,but hand hygiene and the timing of wearing sterile gloves need to be standardized.Conclusions ICU nurses' CVAD maintenance practices were generally in line with the latest evidence-based recommendations,but assessment,use of maintenance-related items,and hand hygiene and aseptic technique need to be further standardized.It is recommended that nursing administrators enhance ICU nursing human resource allocation as much as possible and form a central line associated bloodstream infection(CLABSI)prevention and control management system to gradually reduce the morbidity of CLABSI within the ICU.
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Objective To understand the current situation of practice and cognition of ICU nurses on intra-abdominal pressure monitoring in tertiary general hospitals in Shandong Province,and to analyze the factors affecting their cognition,so as to provide references for formulating intra-abdominal pressure monitoring standards and procedures,and carrying out targeted training in the future.Methods A convenience sampling method was used,and a self-designed questionnaire on practice and cognition of intra-abdominal pressure monitoring was used to survey ICU nurses from tertiary general hospitals in 16 prefecture-level cities in Shandong Province from September to November 2022.Results A total of 627 valid questionnaires were collected,involving 31 tertiary general hospitals(24 tertiary A hospitals,77.42%;7 tertiary B hospitals,22.58%).The operation rate of intra-abdominal pressure monitoring was low(73.37%),and the main reasons were that they had not received intra-abdominal pressure monitoring related training(61.08%),with only 111(24.94%)nurses choosing the intersection of the mid-axillary line and the iliac crest as the reference zero point measurement,274(61.57%)nurses not taking an reading at the end of expiration.The intra-abdominal pressure monitoring cognition score was 0～16(7.88±2.79)points,and only 5 questions had a correct answer rate of≥50%.Conclusion The standardization of intra-abdominal pressure monitoring practice by ICU nurses in tertiary general hospitals in Shandong Province needs to be strengthened,and their cognition needs further training.It is suggested to unify and implement the standards and procedures of intra-abdominal pressure monitoring,further accelerate the training of intra-abdominal pressure monitoring technology,and improve the standard execution rate and cognitive level of ICU nurses on intra-abdominal pressure monitoring.
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Objective To study the value of postmortem imaging on the diagnosis of intestinal perforation.Method Postmortem imaging(PMCT and PMCTA)data of 2 intestinal perforation deaths(and 4 controlled cases)were reviewed retrospectively.Diagnosing capacities of intestinal perforation by postmortem imaging method were further investigated.Results PMCT is sensitive in detecting the free air and liquid induced by intestinal perforation.PMCT can sometimes detect the gravity-dependent purulent secretions in the abdominopelvic cavity.PMCTA can visualize the extravasation of contrast agent from the perforation,which can be used to locate the accurate perforation region.Conclusion Postmortem imaging method(PMCT and PMCTA)is an important tool for the diagnosis of intestinal perforation,which can not only be used as a forensic diagnosis method,but is also useful to locate the perforation site before an forensic autopsy.
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Objective@#To explore trends in the asthma burden among Chinese children and adolescents 1-19 years old during 1990-2019.@*Methods@#Based on data from the 2019 Global Burden of Disease Study, joinpoint regression was used to analyze the dynamic changes in the gender and age specific asthma burden, and the asthma burden in China was compared with countries that have different socio demographic indices(SDI). In addition, trends in asthma burden attributed to different risk factors were also investigated.@*Results@#The asthma burden decreased slightly from 1990 to 1996 [annual percent change (APC)=-1.7%], then rapidly decreased from 1996 to 2005 (APC=-5.7%). The age standardized disability adjusted life years (DALYs) rate decreased from 158.55/100 000 to 88.59/100 000 in patients 1-19 years of age. From 2005 to 2017, the DALYs rate for asthma increased slowly, then rapidly. In 2017, the DALYs rate peaked at 176.18/100 000, then decreased to 126.79/100 000 in 2019. The burden of asthma in boys was higher than girls, and the DALYs rate for asthma in the group 5-9 years of age was higher than the remaining age groups. Furthermore, the age standardized DALYs rate for asthma among Chinese children and adolescents was relatively low among countries with a different SDI. In addition, the DALYs rate attributed to high body mass index increased in all age groups in China. Specifically, the average APC (AAPC) was 2.9% in group 1-4 years of age and the AAPC was 4.2% in the remaining age groups. The DALYs rate attributed to occupational asthmagens in the group 15-19 years of age decreased from 1990 to 2019 and the AAPC was -2.5%.@*Conclusion@#The asthma burden was relatively low among Chinese children and adolescents, and there were gender and age differences. The gender and age specific DALYs rate for asthma had a tendency to decrease, increase, then decrease. More attention should be paid to boys and the group 5-9 years of age, and strengthen the intervention of obesity and occupational asthmagens.
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Objective:To investigate the effect of curcumin on renal fibrosis in lipopolysaccharide (LPS) induced acute respiratory distress syndrome (ARDS) in adult SD rats.Methods:Twenty-four male SD rats were randomly (random number) divided into four groups: control group, ARDS group, low dose group, and high dose group ( n=6 per group). In the control group, the rats were given atomization intratracheal of standard saline 2 mL/kg; in the ARDS group, low-dose group, and high-dose group, the rats were given atomization intratracheal of 4 mg/kg LPS; in the low-dose group, the rats were given curcumin 100 mg/d by the oral administration, and in the high-dose group, the rats were given curcumin or 200 mg/d respectively. After seven days, the rats were sacrificed. The superoxide dismutase (SOD) activity and the content of malondialdehyde (MDA) and glutathione (GSH) in renal tissue were detected by colorimetric assay. Nuclear factor kappa-B p65 (NF-κB p65) and transforming growth factor-β1 (TGF-β1) were detected by Western blot. The expression of interleukin-6 (IL-6) mRNA, proline hydroxylase 3 (PHD3) mRNA, vascular endothelial growth factor (VEGF) mRNA and erythropoietin receptor (EPOR) mRNA were detected by quantitative real-time PCR (qRT-PCR). HE staining and Masson staining were used to assess pathological damage. One-way analysis of variance was used for comparison among multiple groups and SNK method was used for comparison between two groups. Results:Compared with the control group, the SOD activity and GSH content in the ARDS group, low-dose group, and high-dose group were significantly decreased (all P<0.05); the protein expression levels of MDA, NF-κB p65, and TGF-β1 were increased significantly, and IL-6 mRNA, PHD3 mRNA, VEGF mRNA, and EPOR mRNA were significantly upregulated (all P<0.05). HE staining showed inflammatory cell infiltration, and fibrogenesis in kidney tissue, and Masson staining showed deposition of collangen-like substance. Compared with the ARDS group, SOD activity and GSH content were increased, while the protein expression of NF-κB p65 and TGF-β1, IL-6 mRNA, PHD3 mRNA, VEGF mRNA, and EPOR mRNA were decreased significantly in the low-dose group and high-dose group (all P<0.05). Curcumin therapy reduced inflammatory cellular infiltration, and the deposition of collagen-like substance in kidney tissue. Compared with the low-dose group, SOD activity and GSH content were increased in the high-dose group (all P<0.05), and the protein expression of NF-κB p65 and TGF-β1, IL-6 mRNA, PHD3 mRNA, VEGF mRNA, and EPOR mRNA were decreased significantly in the high-dose group (all P<0.05). The high-dose group exhibited a significant reduction in edema, and a decrease of the deposition of collagen-like substance in kidney tissue. Conclusions:Curcumin can inhibit the development of renal fibrosis induced by acute respiratory distress syndrome in rats, and its mechanism may be related to inhibiting the expression of inflammatory factors and enhancing hypoxia tolerance.
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Objective:To investigate the characteristics of human papillomavirus (HPV) infection and genotype distribution among cervical cancer patients in northern Jiangsu Province and southern Anhui Province, so as to provide references for cervical cancer prevention and HPV vaccination.Methods:The clinical data of 505 cervical cancer patients who were admitted to Xuzhou Cancer Hospital of Jiangsu Province and Jiangsu Cancer Hospital from July 2016 to June 2019 were retrospectively analyzed. The patients were mainly from northern Jiangsu Province and southern Anhui Province, and among them, 347 patients (68.7%) were 41-60 years old. The patient's HPV infection and genotype distribution characteristics were analyzed.Results:The total infection rate of HPV among 505 patients was 96.6% (488/505), of which patients aged 41-60 years old accounted for 68.4% (334/488); the single infection rate was higher than the multiple infection rate [69.7% (352/505) vs. 26.9% (136/505)]. There was a statistical difference in the total HPV infection rate of patients with different clinical stage ( χ2 = 14.528, P < 0.05), but the infection rate did not increase with the increase of stage. Among 488 HPV-positive patients, single infection accounted for 72.1% (352/488), double infection accounted for 17.4% (85/488), triple infection accounted for 6.2% (30/488), and more than triple infection accounted for 4.3% (21/488). Among 352 patients with HPV single infection, low-risk type infection accounted for 8.0% (28/352), and high-risk type infection accounted for 92.1% (324/352). The top three high-risk HPV genotypes were type 16, type 52 and type 58, and there were 174 cases in total. Among 136 patients with multiple HPV infections, 115 cases (84.6%) were infected with at least one of type 16, type 52 and type 58. Among them, the infection of type 16 combined with other types accounted for 53.7% (73/136). Conclusions:The infection rates of high-risk HPV genotypes among cervical cancer patients in northern Jiangsu Province and southern Anhui Province are high, and type 16 is the most common. It is more valuable to inoculate the nine-valent vaccine to prevent cervical cancer in these areas; 41-60 years old is the age at which HPV infection and cervical cancer are highly prevalent, so the prevention and control should be strengthened.
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Objective:To explore the preliminary clinical values of colposcopy in the diagnosis of vaginal invasion in cervical cancer.Methods:A retrospective review of the clinical records of patients (31 cases) with cervical cancer treated in Xuzhou Cancer Hospital from April 2015 to August 2019. For those with early-stage cervical cancer and the vagina invasion being difficult to be determined, those with advanced cervical cancer and the scope of vaginal invasion being difficult to be judged, and those with obvious vaginal tumor and underexposed cervix or inconspicuous cervical lesion and the primary location needing to be identified, colposcopy-guided vaginal and cervix biopsy were performed before treatment.Results:(1) Image characteristics of colposcopy and pathological diagnosis: among 31 cases, 30 of them had the similar images of vagina and cervix. The images were dense acetowhite and (or) thick mosaic, coarse punctate and atypical vessels. Lugol′s staining was uniformly bright yellow or brown. Pathological biopsy of vaginal wall: 27 cases were metastatic carcinoma, 3 cases were vaginal intraepithelial neoplasia (VaIN) Ⅱ-Ⅲ. One case showed dense acetowhite epithelium and atypical vessels image in cervix and thin acetowhite epithelium in upper 1/3 vagina which disappeared in two minutes; the results of vaginal biopsy was chronic inflammation. (2) Vaginal invasion diagnosed by colposcopy: among 31 cases, 14 of them without invasion of uterine side, vaginal invasion was judged as followed by colposcopy, being consistent with biopsy: 1 case of chronic vaginitis, 2 cases VaINⅡ, 1 case VaINⅢ, 6 cases upper 1/3 vagina invasion, 4 cases lower 1/3 vagina invasion. Among 10 cases with invasion of uterine side, vaginal invasion were identified by colposcopy, being consistent with biopsy: 4 cases upper 1/3 vagina invasion and 6 cases upper 1/2 vagina invasion. Five cases who had clinical diagnosis of vaginal cancer were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with biopsy. Two cases with no obvious lesions of cervix and vagina were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with cervical and vaginal biopsy: 1 case with stage Ⅳ (transfer to the left supraclavicular lymph node) and 1 case with stage Ⅱ a1.Conclusions:Colposcopy and multi-point biopsy have complementary diagnostic value for the cervical cancer cases that the invasion and scope of vagina are difficult to be determined by physical examination and (or) imaging examination. Thus the range of vaginal resection for patients underwent operation and the lower boundary of pelvic radiation field for those underwent radiotherapy could be fixed, so as to make the treatment much more individualized and humanized; the indications need further discussion.
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Objective@#To investigate the clinical values of colposcopy and cervical biopsy and/or endocervical curettage (ECC) in the diagnosis of cervical lesion.@*Methods@#Clinical data of 128 cases of cervical lesion diagnosed by Xuzhou Cancer Hospital from January 23, 2014 to October 11, 2016 were collected and retrospectively analyzed, all patients underwent colposcopy and cervical biopsy and/or ECC.@*Results@#Among them, the age between 30 to 50 years old were 70 cases, whose transformation zone types of Ⅰ, Ⅱ and Ⅲ were 28 cases (40.0%), 23 cases (32.9%) and 19 cases (27.1%), respectively. The age older than 50 years were 45 cases, whose transformation zone types of Ⅱ and Ⅲ were 1 case (2.2%) and 44 cases (97.8%), respectively. Among the 128 cases of cervical lesions, diagnostic results of colposcopy showed that the chronic inflammation were 57 cases, cervical intraepithelial neoplasia (CIN)Ⅰwere 35 cases, CINⅡor CINⅡ~Ⅲ were 8 cases, CIN Ⅲ were 5 cases and cervical cancer were 23 cases. Alternatively, the pathological results showed that the chronic inflammation were 81 cases, CINⅠwere 17 cases, CINⅡor CINⅡ~Ⅲ were 7 cases, CIN Ⅲ were 5 cases and cervical cancer were 18 cases, respectively. Among the 81 cases of chronic inflammation diagnosed by pathology, 52 cases (64.2%) were consistent with the diagnostic results of colposcopy. Among the 17 cases of low grade squamous epithelial cell lesion (LSIL) diagnosed by pathology, 10 cases were in agree with the diagnostic results of colposcopy. Among the 12 cases of high-grade squamous epithelial cell lesion (HSIL) diagnosed by pathology, 9 cases were concordant with the diagnostic results of colposcopy. Among the 18 cases of cervical cancer diagnosed by pathology, 17 cases were consistent with the diagnostic results of colposcopy.@*Conclusions@#The type of transformation zone is positively correlated with the age, and it can help to choose biopsy and therapeutic manner. The diagnostic accuracies of HSIL and early stage of cervical cancer by multi-point biopsy of colposcopy and/or ECC are high. The cervical lesions which are difficultly found by direct visualization can be identified by colposcopy, and thus provides objective evidence to determine the therapeutic manner for patients with stage ⅡA of cervical cancer.
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Objective T o analyze the relationship am ong electrical conductivity (E C ), total volatile basic nitrogen (T V B-N ), w hich is an index of decom position rate for m eat production, and postm ortem inter-val (PM I). T o explore the feasibility of E C as an index of cadaveric skeletal m uscle decom position rate and lay the foundation for PM I estim ation. Methods H ealthy Sprague-D aw ley rats w ere sacrificed by cervical vertebrae dislocation and kept at 28℃. M uscle of rear lim bs w as rem oved at different PM I, ho-m ogenized in deionized w ater and then skeletal extraction liquid of m ass concentration 0.1 g/m L w as prepared. E C and T V B-N of extraction liquid w ere separately determ ined. T he correlation betw een E C (x1) and T V B-N (x2) w as analyzed, and their regression function w as established. T he relationship be-tw een PM I (y) and these tw o param eters w ere studied, and their regression functions w ere separately established. Results T he change trends of E C and T V B-N of skeletal extraction liquid at different PM I w ere alm ost the sam e, and there w as a linear positive correlation betw een them . T he regression equation w as x2=0.14 x1-164.91 (R2=0.982). E C and T V B-N of skeletal m uscle changed significantly w ith PM I, and the regression functions w ere y=19.38 x13-370.68 x12+2526.03 x1-717.06 (R2=0.994), and y=2.56 x23-48.39 x22+330.60 x2-255.04 (R2=0.997), respectively. Conclusion E C and T V B-N of rat postm ortem skeletal m uscle show sim ilar change trends, w hich can be used as an index for decom position rate of cadaveric skeletal m uscle and provide a m ethod for further study of late PM I estim ation.
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Objective To study the effective correction for concealed penis after being operated by circumcision.Methods A total of 16 concealed penis patients underwent circumcision were corrected by improved Brisson's operation,and the treatment effects were observed.Results Shapes of penis were recovered totally or nearly in 16 cases.Five cases appeared serious edema of the penis,but recovered from 3-6 months.The penises were all developed normal without problem of retraction or curvature in 1-2 years of follow up.Conclusion Improved Brisson's operation for concealed penis is an effective remediation for concealed penis after mistherapy by circumcision.
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Objective T o explore the relationship betw een the change rules of volatile organic com pounds (V O C s) in rat m uscle and postm ortem interval (PM I). Methods A total of 120 healthy rats w ere divided random ly into 12 groups (10 for each group). A fter the rats w ere sacrificed by cervical dislocation, the bodies w ere kept at (25±1)℃. R at m uscle sam ples w ere separately obtained at 12 PM I points, including 0, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 d. T he V O C s in rat m uscles w ere collected, detected and ana-lyzed by headspace solid-phase m icroextraction (H S-SPM E ) coupled to gas chrom atography-m ass spec-trom eter (G C-M S ). Results In total, 15 species of V O C s w ere identified, including 9 arom atic com-pounds, 3 sulfur com pounds, 2 aliphatic acids and 1 heterocyclic com pound. T he species of V O C s in-creased w ith PM I: no species w ere detected w ithin 1 day, 3 species w ere detected on day 2, 9 on day 3, 11 on day 4, 14 from day 5 to 7, and 15 from day 8 to 10. T otal peak area of 15 species of V O C s w as significantly correlated to PM I (adjusted R2=0.15-0.96): the regression function w as y=-17.05 x2+164.36 x-246.36 (adjusted R2=0.96) from day 2 to 5, and y=2.24 x+101.13 (adjusted R2=0.97) from day 6 to 10. Conclusion T he change rules of V O C s in rat m uscle are helpful for PM I estim ation.
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Objective To study the infection rate of fusobacterium nucleatum cancer re appeared in patients with colorectal cancer before and after radiotherapy,and the changes after cancer recarrence.Methods A total of 20 persons receiving physical examination were recruited in the control group and collected the stool specimens,and 40 colorectal cancer patients were selected in the study group.All of the subjects in the study group were collected stool specimens before operation 3 days and after operation 5 day,after radiation therapy 7 days and 30 days.The patients were followed-up 1 year.The bacterial fluid was collected by filtration,and real-time fluorescence quantitative PCR was used to detect the expression of fusobacterium nucleatum gene in feces.Results The positive rate of fecal fusobacterium fusiformis was 30% in the study group and 5% in the control group.The gene relative expression of 12 colorectal cancer patients before operation 3 days and after operation 5 days,after radiation therapy 7 days and 30 days were 5.20±0.34,8.50±0.45,1.20±0.22,0.20±0.15.The fusobacterium nucleatum gene expression of 12 patients with positive fusobacterium after operation 5 days was significantly increased compared with that before operation 3 days(t=10.419,P=0.001),which after radiation therapy 7 days and 30 days was significant lower than that before operation 3 days(t=12.728,P=0.001;t=25.889,P=0.001).Six patients recurred among 1 year,the fusobacterium nucleatum gene expression was 7.2±0.56,which was significant higher than that after radiation therapy 7 days.Conclusion The infection of fusobacterium nucleatum might be a risk factor for colorectal cancer,and the gene relative expression might be an early warning indicator of recurrence.
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Objective To explore the clinical safety and efficacy of self-made single-port retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria. Methods From Feb 2013 to Mar 2016, clinical data of 34 patients were collected. Of them, 16 cases underwent self-made single-port retroperitoneoscopic renal pedicle lymphatic disconnection and 18 cases underwent three port retroperitoneoscopic renal pedicle lymphatic disconnection. No significant difference was shown in age, body mass index between the two groups (P > 0.05). Mean operative time, estimated bleeding volume, drainage time, postoperative hospital stay, postoperative pain evaluation, satisfaction scores of incision were compared between the two groups. Results All procedures were successfully performed without conversion to open surgery. Compared with the three port surgery group, results in the single-port group were superior in terms of mean operative time [(102.3 ± 16.1) versus (132.4 ± 21.6) min, P < 0.05], there were no significant differences in estimated blood loss, drainage time, postoperative hospital stay, the date in postoperative pain evaluation, satisfaction scores of incision shown that single-port group was superior to three port group. Conclusion Our initial experience revealed that single-port retroperitoneoscopic renal pedicle lymphatic disconnection was a safe, effective, cost-effective and less-invasive procedure for chyluria with improved postoperative pain and cosmetic results.
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Objective:To investigate the effects of exposure to ambient particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) on systemic oxidative stress biomarkers in chronic obstructive pulmonary disease (COPD) patients.Methods: A panel of forty-five diagnosed and stable COPD patients, whose residences were within 5 kilometers from Peking University Health Science Center (PKUHSC), were recruited and followed up twice between November 2014 and May 2015.The lung function index percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), was measured to reflect the severity of COPD patients.The systemic oxidative stress biomarkers malondialdehyde (MDA) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in their urine samples were measured using high performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA), respectively.Concentrations of ambient air pollutants and levels of meteorological factors were measured continuously through the air pollution-monitoring station located in PKUHSC.PM2.5 samples, which were used for measuring the concentrations of PAHs, were collected by PM2.5 high volume air sampler.We constructed linear mixed-effects models, including single-pollutant model, 2-pollutant models and stratification analysis, to estimate the effects of air pollutants on urinary MDA and 8-OHdG after adjusting for confounding factors.Results: In our COPD-patient panel, the associations between ultrafine particles (UFP) and PAHs and urinary MDA were statistically significant at lag2 (P<0.05).For an interquartile range (IQR) increase in UFP and PAHs, respective increases of 28% (95%CI: 4%-57%) and 36% (95%CI: 4%-77%) in urinary MDA were observed, and the effects became stronger after adjusting for the concentration of black carbon (BC).The COPD patients were divided into 2 groups stratified by FEV1%pred.Most air pollutants had stronger effects of systemic oxidative stress in the COPD patients of FEV1%pred≥50%.In this group, we observed that an IQR increase in UFP was associated with a 98% (95%CI: 38%-186%) increase in urinary MDA, and an IQR increase in BC, UFP and PAHs were associated with respective increases of 87% (95%CI: 32%-166%), 69% (95%CI: 24%-130%) and 156% (95%CI: 66%-294%) in urinary 8-OHdG.We didn't find significant associations between fine particulate matter (PM2.5) and urinary oxidative stress biomarkers.Conclusion: Our results suggested that exposure to air pollutants, especially UFP and PAHs, was responsible for exacerbation of systemic oxidative stress in COPD patients.Most air pollutants had stronger effects of systemic oxidative stress in mild to moderate COPD patients.
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Objective To analyze the correlation of characteristics of carotid artery structure and the incidence of residual stenosis after carotid artery stent (CAS) placement and its influencing factors using color Doppler flow imaging (CDFI).Methods Five hundred and ninety-six cases from January 2013 to December 2015 who underwent CAS (600 pieces of stent) were included in this study.All patients were examined by CDFI within 1 month before and 1 week after carotid artery stenting.The incidence of residual stenosis was analysed.The correlation of residual stenosis and the characteristics of carotid artery lesions and atherosclerotic plaque before stenting were analyzed respectively.Results There was positive correlation between the incidence rates of residual stenosis and irregularly shaped plaque (odd ratios,9.02;95% confidence interval,5.21-15.59,P<0.05),the plaques with calcification in the surface(odd ratios,2.55;95% confidence interval,1.45-4.49,P<0.05),the residual diameter of carotid stenosis less than 1.0 mm(odd ratios,1.61;95% confidence interval,1.06-2.45,P<0.05),which were the independent risk factors for influencing residual stenosis after CAS.Conclusions Choosing a more adaptable stent based on the characteristics of carotid artery lesions and atherosclerotic plaque by CDFI before stenting may be useful for the patients to get best result of revascularization.The rate of residual stenosis may be decreased.
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Objective:To study the curative efficacy of wenxin granule combined with propafenone in the treatment of arrhythmia and its effects on the serum levels ofhs-CRP,TNF-α,IL-6 and heart function.Methods:96 patients of arrhythmia who were treated from July 2014 to October 2016 in our hospital were selected and randomly divided into the observation group (n=48) and the control group (n=48).The control group was treated with propafenone,while the observation group was treated with wenxin granuleon.Then the serum levels of hs-CRP,TNF-α and IL-6,heart function,clinical efficacy and incidence of adverse reactions were observed and compared between the two groups before and after the treatment.Results:After treatment,the total effective rate of observation group was significantly higher than that of the control group (P＜0.05).The serum levels of hs-CRP,TNF-α and IL-6 of observation group were significantly lower than those of the control group (P＜0.05);the left ventricular end diastolic dimension (LVEDD) and left ventricular end systolic diameter (LVESD) of observation group were significantly lower than those of the control group,and the left ventricular ejection fraction (LVEF) was significantly higher than that of control group(P＜0.05);the incidence of adverse reactions in the observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Wenxin granule combined with propafenone was effective for arrhythmia,it could effectively improve the heart function and high safety,which might be related to the decrease of serum hs-CRP,TNF-and IL-6 levels.
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Objective The aim of this study is to investigate whether functional intracranial collateral circulation can predict the security of carotid endarterectomy (CEA) by transcranial doppler (TCD) combined with transcranial color code duplex (TCCD) preoperatively.Methods A total of 437 patients with carotid stenosis undergone CEA surgeries from January 2013 to November 2015 were included in this study.According to the functional intracranial collateral artery via TCD and TCCD,patients were divided into four groups:(A) anterior communicative artery (ACoA) (B) posterior communicative artery (PCoA) (C) both ACoA and PCoA and (D) external-internal carotid artery (E-ICA) or no communicative artery.Velocities and the pulsatility index (PI) of the ipsilateral middle cerebral artery (MVMCA) were compared among the four groups during clamping and de-clamping period.Results After clamping,there were significant difference of decreasing scale of MVMCA and PIMCA among the four groups (F=43.737,P＜0.001;F=9.298,P ＜ 0.001),especially for the group D (t=9.330607,0.488951,t=5.534661,2.797039,t=10.0751,0.488951;all P ＜ 0.005).After de-clamping,compared with the baseline,there were also significant difference of increasing scale of MVMCA and PIM CA among the four groups (F=6.260,2.840,all P ＜ 0.05);compared with clamping,there were also significant difference of increasing scale of MVMCA among the four groups (H=62.210,P ＜ 0.001),the increasing scale of MVMCA for group D was significant higher than the other three groups (t=4.104773,2.190371,3.06337,all P ＜ 0.005).However,there was no differences of increasing scale of PIMCA among the four groups (P ＞ 0.05).The occurrence of cerebral hyperperfusion syndrome (CHS) were in significant differences (x2=13.255,P=0.004) among the four groups.Higher occurrence rate of CHS was found in group D compared with groups A and C (H=8.734,6.764,all P ＜ 0.01).Insufficient intracranial collateral circulation was an independent risk factor for CHS (OR=5.917,95％CI:1.325-26.415,P=0.02).Conclusion The evaluation of intracranial collateral circulation with TCD combined with TCCD can help to predict potential risk of CHS preoperatively,and improve the safety of CEA.
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Objective To investigate the correlation between the stroke-related risk factors and carotid stenosis lesions of ≥40 year′s old Han and minority populations in a community in Beijing as well as the clinical value of carotid ultrasound screening. Methods An investigation of risk factors for stroke and the results of carotid artery ultrasound screening in 510 cases (≥40 years old) Han population and 243 minority population in a community in Minzu University of China in Beijing in April 2014 were analyzed. Results (1)The prevalence of hypertension of the Han population was significantly higher than that of the minority population (53. 5% [n=273] vs. 44. 4% [n=108]; χ2 =5. 43,P=0. 02). (2) The detected rate of carotid intima-media thickness ( IMT ) of the Han population was higher than that of the minority population (77. 5% [n=395] vs. 69. 1% [n=168]; χ2 =6. 03,P=0. 01). There was no significantly difference in the detected rates of carotid plaques and carotid artery stenosis between the two groups (χ2 =0. 56,1. 13 respectively,all P>0. 05). (3) Hypertension and smoking were the independent risk factors for carotid-intima thickening in Han population ( hypertension:OR,1. 851;95% CI 1. 213-2. 825; smoking:OR,2. 311;95% CI 1. 065-5. 016;all P<0. 05). Hyperlipidemia was an independent risk factor for carotid artery intima-media thickening in the minority population (OR,2. 586;95% CI 0. 952-8. 694,P<0. 01). Conclusion To investigate the risk factors for stroke in minority population in China are of particular importance for the prevention of carotid atherosclerotic disease. Carotid ultrasound examination is an important diagnostic technique for early detection of carotid atherosclerotic disease.
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Objective To explore the relationship between postoperative cancer-related fatigue and nutritional risk in patients with colorectal cancer. Method Using convenience sampling method, 159 postoperative colorectal cancer patients were interviewed with cancer-related fatigue scale and PG-SGA 7 days after operation. Results The average score of CRF was (21.28 ± 6.06). The score by PG-SGA was (15.18 ± 5.55). About 94.34%patients were in need of nutritional intervention. The postoperative cancer-related fatigue was positively related to PG-SGA scores(all P<0.05). Conclusions The postoperative colorectal cancer patients are at a high risk of malnutrition, with nutrition risk positively related with somatic cancer-related fatigue. The clinical nursing staff should pay attention to the nutritional status of patients and correct their malnutrition so as to reduce the symptoms of cancer-related fatigue.
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ObjectiveTo investigate the accuracy of hemodynamic parameters of diagnostic criteria for basilar artery stenosis by transcranial Doppler (TCD) combined with transcranial color code sonography (TCCS).Methods261 cases with basilar artery stenosis detected by TCD or TCCS and confirmed by DSA were included in this study. The velocity of peak systolic (PSVBA), end diastolic (EDVBA), mean velocity (MFVBA), the depth (D) at the stenosis, the highest PSV of bilateral posterior cerebral arteries (PSVPCA) and intracranial segment of vertebral artery (PSVVA) were detected and recorded respectively. Depending on the findings of DSA, the receiver operating characteristic curve (ROC) was used to evaluated the sensitivity, specificity and accuracy for the PSVBA, EDVBA, MFVBA, PSVBA/PSVVA and PSVBA/PSVPCA. ResultsThe depth of proximal, middle and distal segment of basilar artery stenosis were detected at (90±5.4) mm, (97+3.0) mm, and (104+4.2) mm respectively. The best parameter of diagnostic criteria for the mild、middle and severe basilar artery stenosis were 110 cm/s≤PSVBA≤150 cm/s or 65 cm/s≤MFVBA≤90 cm/s, 150 cm/s≤PSVBA≤210 cm/s or 90 cm/s≤MFVBA≤135 cm/s and PSVBA≥210 cm/s or PSVBA/PSVVA≥3.5.ConclusionThe combination of TCD and TCCS, and choosing the hemodynamic parameters of PSV, MFV and PSVBA/PSVVA , can better assess the basilar artery stenosis, especially for severe basilar artery stenosis.