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Alzheimer's disease(AD)is a common degenerative disease of the central nervous system in which neuropathological changes precede cognitive dysfunction and behavioral impairment. Currently, early diagnosis of AD is based on invasive and expensive testing techniques that are difficult to use widely in the clinical setting. Therefore, there is an urgent need for new markers to detect AD at an early stage. The eye, as an extension of the brain, has been found to show earlier onset of ocular pathologic changes in patients with AD compared to brain pathologic changes, such as retinal structural abnormalities, visual dysfunction, retinal abnormal protein accumulation, choroidal thickness changes, decreased corneal nerve fiber density, deposition of abnormal Aβ proteins in the lens, and pupillary light decreased sensitivity of response, etc. This article reviews the ocular pathologic changes in AD patients in recent years to provide new ideas for the early clinical diagnosis of AD.
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Autism spectrum disorder (ASD) is a neurodevelopmental disorder.Its typical symptoms include social disorder, stereotyped behavior and restrictive interest.In addition, sensory abnormality is also a common symptom of ASD individuals.Pre-attentive processing is an automatic cognitive process that takes place before attention and is independent of consciousness, which reflects the ability to automatically detect changes in the environment of brain.Many researches show that the sensory abnormality and social ability disorder in ASD patients may be related to the defects in the pre-attentive processing stage.Mismatch negativity (MMN) is the most commonly used indicator of pre-attentive processing.ASD individuals show abnormal MMN in response to both social and non-social stimulus.Among them, the pre-attentive processing defect of non-social stimuli in ASD individuals is manifested as the amplitude or latency of MMN induced by single tones, voice or visual stimuli, which is different from that of normal people.The pre-attentive processing defect of social stimuli in ASD individuals is manifested as the amplitude or latency of MMN induced by emotional voice and emotional face, which is different from that of normal people.This result not only helps to find the physiological mechanism of sensory and social disorders in ASD individuals, but also provides theoretical support for MMN as an auxiliary diagnostic index of ASD.Future research on the pre-attentive processing of ASD individuals should pay more attention to enriching the research paradigms of MMN and adopting more kinds of social stimuli.At the same time, the influence of ASD genetic factors on MMN can also be one of the concerns of future research.
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Objective:To observe the characteristics of macular telangiectasia (MacTel) in multi-color and multi-mode fundus images.Methods:An abservational case series study was conducted.Sixteen eyes of 12 patients diagnosed with MacTel by fluorescein fundus angiography (FFA) from January to November 2019 in Shandong Eye Hospital were analyzed.There were 8 cases (8 eyes) with MacTel type Ⅰ, among which 4 cases were male and 4 cases were female, with an average age of (62.3±12.5) years.The other 4 cases (8 eyes) had MacTel type Ⅱ, all of which were female, with an average age of (58.7±10.5) years.Best corrected visual acuity, slit lamp microscopy, color fundus photography, multicolor scanning laser imaging, FFA, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were carried out in all the patients.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shandong Eye Institute (No.2019S003).Results:In color fundus images of MacTel type Ⅰ eyes, annular macular exudation with macular edema occurred in 6 eyes, macular edema without hard exudates in 1 eye, and hard macular exudates without macular edema in 1 eye.However, the transparency of retina in temporal fovea in MacTel type Ⅱ eyes decreased, showing a gray color.In multi-color fundus images of MacTel type Ⅰ eyes, punctate granular yellow macular exudation and yellow-green macular edema were observed, which were clearer than those in color fundus images.Punctate exudation was seen in both the blue and green reflectance images, which was clearest in green reflectance image, followed by blue reflectance image and then the infrared reflectance image.In OCT images of MacTel type Ⅰ eyes, cystoid edema of inner retina or uneven reflection signal of outer plexiform retina were observed.Loss of inner and outer retinal structures and cavities were observable in MacTel type Ⅱ eyes, and outer retinal atrophy appeared in 2 eyes.In OCTA images, the destruction of superficial and deep capillary plexus in macular area were observed in both MacTel typeⅠand type Ⅱ eyes, and the destruction of deep capillary plexus was more obvious.In addition, more obviously increased vascular space, decreased vessel density, and increased foveal avascular zone were found in MacTel type Ⅱ eyes.In early stage of FFA, delayed capillary filling near fovea was seen in MacTel typeⅠeyes, and dilated temporal vessels in fovea, some of which showed tumor-like dilation, and the limited tumor-like dilation was enhanced in the later stage.Different degrees of dilated parafoveal blood vessels in the early stage, and the capillary in the temporal side of the macula showing diffuse strong fluorescence in the late stage of FFA was observed in MacTel type Ⅱ eyes.Conclusions:Multi-color scanning laser imaging can be used to observe the morphological characteristics of MacTel, and the imaging features of different types of MacTel are significantly different.
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Objective:To explore the expression of caveolin-1 (Cav-1) and Chitinase-40 (YKL-40) in acute cerebral infarction and the value of combined detection in prognosis evaluation.Methods:118 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Hebei Northern University from January 2016 to June 2019 were selected as the research objects. According to the cerebral infarction volume, the patients were divided into small infarction group (<5 cm 3), middle infarction group (5-10 cm 3) and large infarction group (>10 cm 3). 108 healthy people were selected as the healthy control group. The serum levels of Cav-1 and YKL-40 were compared in the 3 groups, and the correlation between the degree of cerebral infarction and serum levels of Cav-1 and YKL-40 was analyzed. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of the expression levels of Cav-1 and YKL-40 in patients with acute cerebral infarction; the patients were followed up for one year and the prognosis was evaluated by modified Rankin Scale (mRS); the correlation between serum Cav-1 and YKL-40 and prognosis was analyzed. Results:The expression levels of serum Cav-1 and YKL-40 in patients with acute cerebral infarction were significantly higher than those in healthy group ( P<0.001). The serum levels of Cav-1 and YKL-40 were positively correlated with the infarct volume of acute cerebral infarction ( r=0.854, P=0.004; r=0.867, P=0.002). ROC curve analysis showed that the sensitivity, Youden index and area under ROC curve of Cav-1 (21.78 μg/L) combined with YKL-40 (158.69 ng/ml) in the diagnosis of acute cerebral infarction were 85.59%, 0.532 and 0.896 (95% CI: 0.741-0.932), respectively, which were significantly higher than those of single index ( P<0.05). At 8 and 12 months of follow-up, the proportion of death and mRS score in the positive group were significantly higher than those in the negative group ( P<0.05). Conclusions:The serum Cav-1 and YKL-40 levels are significantly higher in patients with acute cerebral infarction. The combined examination of Cav-1 and YKL-40 can improve the diagnostic efficiency and has potential application value for early diagnosis and prognosis prediction of patients.
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Objective:To determine mutations in the PTPN11 gene in a family with LEOPARD syndrome.Methods:Clinical evaluation was carried out in a large pedigree with confirmed LEOPARD syndrome diagnosed in Hwa Mei Hospital, University of Chinese Academy of Sciences. Peripheral blood samples were obtained from 4 patients and 2 unaffected healthy members in the family, as well as 100 unrelated healthy controls. DNA was extracted from the blood samples, and PCR was performed to amplify all exons of the PTPN11 genes, followed by Sanger sequencing.Results:There were 14 members in 3 generations of the family, 6 of whom were affected (3 males and 3 females) , demonstrating an autosomal dominant inheritance pattern. Skin lesions were mainly distributed on the face, trunk and limbs, accompanied by special facial features and cardiovascular system abnormalities. A missense mutation c.1632G>T (p.R558L) in the PTPN11 gene was identified in the 4 patients, which resulted in the substitution of arginine by leucine at amino acid position 558. This mutation had not yet been reported previously. No mutation was detected in the PTPN11 gene in the 2 unaffected family members or 100 healthy controls.Conclusion:The missense mutation c.1632G>T in exon 13 of the PTPN11 gene may be the molecular basis for LEOPARD syndrome in this family.
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Psychological pain is a subjective experience, mainly from the psychological needs of frustration. It is characterized by the perception of negative changes in self and its functions, accompanied by strong negative emotions. Psychological pain is often associated with the decline of mental health, which is considered to be the core of the suicide process. A higher level of psychological pain is closely related to suicidal ideation and suicidal behavior. Therefore, the measurement and evaluation of psychological pain plays an important role in outpatient screening, clinical treatment and crisis intervention. In order to improve the recognition of psychological pain and the accuracy of suicide risk prediction, after more than 20 years of application and development, more than 10 methods of measuring psychological pain can be included in clinical risk assessment. The traditional assessment methods are mostly based on Shneidman ’s definition of psychological pain and suicide theory, which are used to measure the intensity and frequency of psychological pain. In recent years, the development of suicide model and theory provides a new perspective and theoretical basis for the assessment of psychological pain. The latest assessment methods tend to be shorter and more convenient, or present the specific clinical characteristics of psychological pain. In addition, thematic apperception test, visual analogue scale, pictorial representation of illness and self measure and structured interview make up for the limitations of self-report. In the future, the assessment can be further combined with neurobiology, mobile internet and other means, while considering the application in diverse environments such as special populations and cross-cultural groups.
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Excessive theta (θ) frequency oscillation and synchronization in the basal ganglia (BG) has been reported in elderly parkinsonian patients and animal models of levodopa (L-dopa)-induced dyskinesia (LID), particularly the θ oscillation recorded during periods when L-dopa is withdrawn (the off L-dopa state). To gain insight into processes underlying this activity, we explored the relationship between primary motor cortex (M1) oscillatory activity and BG output in LID. We recorded local field potentials in the substantia nigra pars reticulata (SNr) and M1 of awake, inattentive resting rats before and after L-dopa priming in Sham control, Parkinson disease model, and LID model groups. We found that chronic L-dopa increased θ synchronization and information flow between the SNr and M1 in off L-dopa state LID rats, with a SNr-to-M1 flow directionality. Compared with the on state, θ oscillational activity (θ synchronization and information flow) during the off state were more closely associated with abnormal involuntary movements. Our findings indicate that θ oscillation in M1 may be consequent to abnormal synchronous discharges in the BG and support the notion that M1 θ oscillation may participate in the induction of dyskinesia.
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Objective:To explore the effect of kangaroo care on the neurological behavior of neonatal intensive care unit (NICU) neonates with asphyxia.Methods:Totally 76 cases of neonatal asphyxia admitted to NICU from January 2018 to December 2018 were randomly divided into observation group (40 cases) and observation group (36 cases). The control group was given routine nursing care, while the observation group was given kangaroo nursing intervention on the basis of the control group. The neurobehavioral changes, the occurrence of nervous system damage and the physical development after 42 days of birth were compared between the two groups.Results:The scores of behavior ability (11.64 ± 0.26), original reflex (5.89 ± 0.32), passive muscle tension (7.64 ± 0.46), active muscle tension (7.83 ± 0.55), general reaction (6.17 ± 0.46) in the intervention observation group were significantly higher than those in the control group (11.02 ± 0.39), original reflex (5.53 ± 0.31), passive muscle tension (7.21 ± 0.47), active muscle tension (6.17 ± 0.46) Tension (7.41 ± 0.41), general reaction (5.88 ± 0.41) ( t values were 8.227, 4.970, 4.027, 3.740, 2.888, P<0.05). The incidence of neurological damage in the observation group was 2.50% (1/40) which was significantly lower than 16.67% (6/36) in the control group ( χ 2=4.117, P < 0.05). The growth of body weight (2.17 ± 0.42) kg, length (7.15 ± 1.74) cm and head circumference (4.38 ± 0.93) cm in the observation group were significantly higher than those in the control group (1.68 ± 0.39) kg, (5.89 ± 1.81) cm, (3.81 ± 0.79) cm ( t values were 5.252, 3.093, 2.863, P<0.05). Conclusion:Kangaroo nursing can effectively promote the neurological development and physical development of neonatal asphyxia, and reduce the nervous system damage of asphyxiated neonates, and the operation is simple and easy, which is worthy of clinical application.
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OBJECTIVE@#To investigate the effect of miR-4443 expression on migration and invasion of breast cancer.@*METHODS@#We examined the expression of miR-4443 in breast carcinoma in situ and paired adjacent tissues from 3 breast cancer patients with high-throughput sequencing and verified the results using TCGA database. We also detected miR-4443 expressions using real-time quantitative PCR (RT-qPCR) in low invasive and highly invasive breast cancer cells (MCF-7 and MDA-MB-231 cells, respectively). The changes in apoptosis, migration and invasion of MCF-7 and MDA-MB-231 cells after transfection with miR-4443 mimics, mimics-NC, miR-4443 inhibitor or inhibitor-NC were analyzed using flow cytometry, wound healing assay and Transwell invasion assay. The target gene of miR-4443 was predicted by bioinformatics software and validated by a dual luciferase reporter gene system. RT-qPCR and Western blotting were performed to detect the expression of recombinant human phosphatidyl ethanolamine binding protein 1 (PEBP1) in the transfected cells.@*RESULTS@#The expression of miR-4443 was significantly higher in the breast cancer tissues than in the adjacent tissues (@*CONCLUSIONS@#MiR-4443 promotes the migration and invasion of breast cancer cells by inhibiting the expression of PEBP1, suggesting the possibility of suppressing miR-4443 expression as a potential therapeutic strategy for breast cancer.
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Humans , Breast Neoplasms/genetics , Cell Line, Tumor , Cell Movement , Cell Proliferation , Gene Expression Regulation, Neoplastic , MCF-7 Cells , MicroRNAs/genetics , Neoplasm Invasiveness/genetics , Phosphatidylethanolamine Binding ProteinABSTRACT
Objective@#To discuss the effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Mode.@*Methods@#From January to April in 2018, 106 patients (51 males and 55 females) with coronary heart disease hospitalized in general practice of hospital were selected as subjects of study. Random number table method was used to divide the patients into control group and intervention group, 53 cases in each group. The intervention group adopted the hospital-community-patient integrated nursing model, while the control group adopted the traditional health education mode after discharge. Self-efficacy evaluation was conducted before intervention, 3 months after intervention and 6 months after intervention.@*Results@#The total score of self-efficacy in the two groups was higher than that before intervention, but the increase in the intervention group was significantly better than that in the control group, the difference was statistically significant (F=34.681, P < 0.01). The total scores of self-efficacy in intervention group were(30.35±2.58), (33.59±2.68) points respectively 3 months and 6 months after intervention, which were higher than (28.95±2.42), (29.10±2.12) points in control group. The difference was significant (t = 3.702, 13.494, P < 0.01).@*Conclusion@#Hospital-community-patient integrated nursing model is superior to traditional health education model after discharge, which can significantly improve the self-efficacy of patients with coronary heart disease discharged from general practice department.
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Objective@#To survey the resident participation in community health management service and its influencing factors.@*Methods@#A survey on the resident participation in community health management service with self-designed questionnaire was conducted during January to March 2018 among residents in one of the subdistricts in Nanjing Gulou district. The questionnaire includes basic information of residents, understanding health management service, and the participation in the health management.@*Results@#Total 500 questionnaire were distributed, 449 copies were retrieved and 402 were valid. The rates of engagement in health archives, management of blood pressure, blood glucose and blood lipids, attending health education, regular health check-up, health follow-ups, and equipping family medicine kits were 62.2% (250/402), 71.0% (286/402), 49.5% (199/402), 59.9% (241/402), 72.6% (292/402), 66.9% (269/402), respectively. The rates of engagement of health archives, attending health education, regular health check-up and equipping family medicine kits for healthy residents were higher than those with chronic diseases (χ2=6.31, 4.09, 10.83, 10.83; P<0.05). The logistic regression analysis suggested that age, income, and understanding health management services were independent influence factors for resident active participation in health management.@*Conclusion@#The survey indicates that the young, high-income and healthy residents are more likely to participate in health management service, and the overall resident participation needs to be further improved.
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Objective To survey the resident participation in community health management service and its influencing factors.Methods A survey on the resident participation in community health management service with self-designed questionnaire was conducted during January to March 2018 among residents in one of the subdistricts in Nanjing Gulou district.The questionnaire includes basic information of residents,understanding health management service,and the participation in the health management.Results Total 500 questionnaire were distributed,449 copies were retrieved and 402 were valid.The rates of engagement in health archives,management of blood pressure,blood glucose and blood lipids,attending health education,regular health check-up,health follow-ups,and equipping family medicine kits were 62.2％ (250/402),71.0％ (286/402),49.5％ (199/402),59.9％ (241/402),72.6％ (292/402),66.9％ (269/402),respectively.The rates of engagement of health archives,attending health education,regular health check-up and equipping family medicine kits for healthy residents were higher than those with chronic diseases (x2=6.31,4.09,10.83,10.83;P＜0.05).The logistic regression analysis suggested that age,income,and understanding health management services were independent influence factors for resident active participation in health management.Conclusion The survey indicates that the young,high-income and healthy residents are more likely to participate in health management service,and the overall resident participation needs to be further improved.
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Objective To discuss the effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Mode. Methods From January to April in 2018, 106 patients (51 males and 55 females) with coronary heart disease hospitalized in general practice of hospital were selected as subjects of study. Random number table method was used to divide the patients into control group and intervention group, 53 cases in each group. The intervention group adopted the hospital-community-patient integrated nursing model, while the control group adopted the traditional health education mode after discharge. Self-efficacy evaluation was conducted before intervention, 3 months after intervention and 6 months after intervention. Results The total score of self-efficacy in the two groups was higher than that before intervention, but the increase in the intervention group was significantly better than that in the control group, the difference was statistically significant (F=34.681, P < 0.01). The total scores of self-efficacy in intervention group were (30.35 ± 2.58), (33.59 ± 2.68) points respectively 3 months and 6 months after intervention, which were higher than (28.95 ± 2.42), (29.10 ± 2.12) points in control group. The difference was significant (t =3.702, 13.494, P<0.01). Conclusion Hospital-community-patient integrated nursing model is superior to traditional health education model after discharge, which can significantly improve the self-efficacy of patients with coronary heart disease discharged from general practice department.
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Hepatic encephalopathy (HE) is caused by severe liver disease or portal shunt. Metabolic disorders and central nervous system dysfunctions are the main symptoms of this syndrome. Ammonia is considered to play a central role in the pathogenesis of HE. Helicobacter pylori (H. pylori) have been suggested as a possible source of ammonia production because of its high urease content. However, the relationship between H.pylori and blood ammonia and HE, as well as the therapeutic effect of H.pylori eradication on HE, is inconclusive, and the results are full of contradictions. The aim of this review is to summarize current knowledge on the association of H. pylori with HE and to address the question of whether H. pylori eradication may be beneficial in the management of HE.
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Objective To investigate the influence of WeChat + family centered health intervention on the self-efficacy of elderly hypertensive patients in General clinic. Methods A total of 102 elderly hypertensive patients aged≥60 years in General clinic from February 2017 to July 2017 were enrolled.They were divided into experimental group and control group with the table of random number, with 51 cases in each group. The experimental group used the WeChat+ family centered health intervention model,while the control group adopted the traditional health education model.The changes of blood pressure and self-efficacy were evaluated before intervention, 3 months and 6 months after intervention respectively. Results There were no statistic significant difference in blood pressure and self-efficacy total score between the two groups before intervention(P>0.05). At 3 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(144.20±4.60), (80.00±5.00)mmHg(1 mmHg=0.133 kPa)in the experimental group,those of which were(154.20±7.16), (87.00±3.81)mmHg in the control group,the differences were statistically significant (t=-2.628,-2.490,P<0.05).At 6 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(141.60±6.43),(76.00±4.85)mmHg in the experimental group,those of which were(151.60± 5.94),(85.40±4.56)mmHg in the control group,the differences were statistically significant (t=-2.555,-3.158,P<0.05).There were differences in systolic and diastolic pressure in patients with different groups at different time,and the differences were statistically significant(F=18.668,18.174,P<0.01).The total score of self-efficacy at 3 months and 6 months after intervention was(30.14±0.43),(32.56±0.23)points in the experimental group and (28.14 ± 0.15), (29.40 ± 0.19) points in the control group, the difference was statistically significant(t=9.736, 23.819, P<0.05). The differences in the total score of patients′self-efficacy in different groups at different time had statistically significance (F=2 631.551, P<0.01). Conclusions The WeChat+family centered health intervention model can significantly improve the self-efficacy of the elderly patients with high blood pressure in the General clinic.
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Objective To investigate the demands and needs of patients contracting for family doctor service in Nanjing Gulou district. Methods A questionnaire survey was conducted between July and December 2017 among residents in Nanjing Gulou district. The questionnaire included basic information of residents, willingness to sign service contract with family doctors, annual outpatient needs, demands of service mode, expectation for family doctor service, and willingness to pay. Results A total of 420 questionnaires were distributed and 415 questionnaires were valid. Multivariate analysis of variance suggested that age, income, and understanding of signing family doctor service were independent factors influencing signing intention (P<0.05).The variance analysis trend test indicated that the healthy people had highest willingness of signing, followed by the patients and the pregnant women (F=6.82, P<0.01). The number of annual outpatient service needs for healthy population, hypertensive patients, diabetic patients and pregnant women was(2.64±3.48),(7.02±4.80),(9.98±5.37)and(11.20±4.33)respectively (F=77.94, P<0.01). The average need of outpatient visit for health males was higher than that for females (P<0.01). There were significant differences in outpatient needs between patients with non-complicated hypertensionand complicated hypertension (P<0.01). The most anticipated services for healthy people were health records (74.26％,101/136), medical appointments (56.62％,77/136), and physical check-up (56.62％,77/136);those were management of blood glucose, blood pressure and body weight (70.13％, 108/154), regular testing (66.88％,103/154), follow-up supervision (66.23％,102/154) for chronic patients;those were regular physical examination (80.26％, 61/76), follow-up supervision (50.00％, 38/76) and health records (46.05％, 35/76) for pregnant women. The most popular health communication channel is WeChat, accounting for 44.10％(183/415), followed by outpatient clinic, telephone and internet services, accounting for 37.11％(154/415), 31.57％(131/415)and 11.08％(46/415)respectively. Among those who chose WeChat, 81.4％(149/183) were under 45 years old. And 86.27％(358/415)of people were willing to pay for corresponding signing fees. Conclusion Age, income, and understanding of general practice will affect residents′ willingness to sign the service contract with family doctors. Gender, disease spectrum and number of illnesses affect residents′outpatient service needs. Individualized family doctor service should be provided for people with different health needs.
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Objective To survey on training for general practice backbone mentors in tertiary hospitals of Hebei province.Methods A questionnaire survey on training status was conducted among general practice backbone mentors in tertiary hospitals of Hebei Province.The survey items included the basic information,knowledge of general practice and its training,suggestions for mentors training and general practice discipline construction in tertiary hospitals.Results Total 208 questionnaires were distributed and 208 were retrieved with a recovery rate of 100％.Among 208 participants,all of them were over the age of 30;202 (97.1％) had bachelor degree or above;202 (97.1％) were attending doctors or above;165 (79.3％) had worked for more than 10 years;169 (81.3％) had no or little knowledge of general practice;159 (76.4％)had not received general practice training before;124 (59.6％) thought that general practitioners were not qualified as "gatekeeper" at present;and 192 (92.3％) worked in the hospitals providing standardized residency training.The training contents in general section were prioritized as clinical skills,community health service development and policy,rules for general practice standardized training,theoretical training,the present situation and countermeasure of general teaching,the doctor-patient relationship and medical ethics.The contents in training method section were prioritized as lecture series of clinical medicine,case discussion,seminar,distance education with classroom teaching.The suggestions for mentors training included:the exploration of standardized training model,perfecting continuing education system for general practice mentors,more attention to the training at community health service centers and the consummation of general practice system.The suggestions for general practice discipline construction were that more attentions should be paid by the government and the hospitals leaders,the general practice departments in tertiary hospitals should closely cooperate with community health service centers in training ofqualified general practitioners.Conclusions The specialists in tertiary hospitals of Hebei province do not have enough knowledge about general practice and do not quite understand the necessity of establishment of general practice department,so the training for general practice mentors should be strengthened and improved.Properly policy and more social resources from the government and the hospitals leaders will be helpful for construction of general practice discipline in general hospital.
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Objective To investigate the clinical effect of restrictive episiotomy in low risk primipara.Methods 100 full-term pregnant women with low risk primipara were divided into observation group and control group according to random number table,50 cases in each group.The patients in the observation group were treated with restrictive episiotomy.The perineum,the second stage of labor,hospitalization time and cost,postpartum sexual life were compared between the two groups.Results In the observation group,the proportion of perineal incision (22.0％ vs.82.0％) was less than that in the control group,the proportion of perineal pain (4.0％ vs.26.0％) was lower than that in the control group,the incidence rate of first degree laceration(38.0％ vs.6.0％) was higher than that in the control group,the differences were statistically significant (x2 =36.058,9.490,14.918,allP ＜ 0.05).The hospitalization time of the observation group was significantly shorter than that of the control group [(3.15 ±0.78)d vs.(3.84 ± 0.98)d],the cost of hospitalization of the observation group was significantly lower than that ofthe control group[(1 814 ± 356) yuan vs.(1 999 ± 387) yuan],the differences were statistically significant (x2 =2.397,3.895,2.488,all P ＜ 0.05).The recovery time of sexual life in the observation group was significantly shorter than that in the control group[(45.6 ± 16.5)d vs.(72.5 ± 23.6)d],and the incidence rate of coital pain was lower than that of the control group (6.0％ vs.24.0％),the differences were statistically significant (x2 =6.606,6.353,all P ＜ 0.05).Conclusion Restrictive episiotomy in low risk primipara has good effect,it is conducive to postpartum recovery.
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Objective To investigate the expression of plasma microRNA-214 in patients with acute myocardial infarction (AMI) and its correlation with left ventricular remodeling (LVR). Methods A total of 158 AMI patients and 85 controls were selected from Hebei province Zhuozhou City Hospital. According to the left ventricular remodeling after PCI operation, AMI patients were divided into LVR group (n=41) and non LVR group (n=105). Real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the plasma microRNA-214 levels, and the brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels were detected by immunoassay. Pearson correlation analysis of plasma microRNA-214 levels and the correlation between CRP and BNP were analyzed in patients with LVR. The receiver operating characteristic (ROC) curve analysis of plasma microRNA-214, BNP and CRP were used to predict the efficacy of LVR in patients with AMI after PCI. Logistic regression model was used to analyze the relationship between the above indexes and LVR. Results Compared with the control group, left ventricular ejection fraction (LVEF) and left ventricular short axis shortening (FS) were significantly decreased in LVR group and non LVR group, and which were decreased more significantly in LVR group compared with those of non LVR group (P<0.05). The left ventricular end diastolic diameter (LVDD), left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) were significantly increased in LVR group and non LVR group, and which were increased more significantly in LVR group than those in non LVR group (P<0.05). The levels of plasma microRNA-214, BNP and CRP were significantly higher in LVR group than those in non LVR group and control group (P<0.05). Correlation analysis showed that microRNA-214, BNP and CRP were positively correlated in patients with LVR (r=0.684 and r=0.405, P<0.01). The area under ROC curve (AUC) and 95%CI predicted by plasma microRNA-214 and BNP were 0.824 (0.757-1.015) and 0.785 (0.721-0.864) in patients with AMI and LVR, which were higher than CRP [0.716 (0.645-0.837), P=0.0167]. The sensitivity and specificity of plasma microRNA-214 in predicting the occurrence of LVR were 72.6% and 86.2% in patients with AMI, respectively. Logistic regression model analysis showed that plasma microRNA-214 and BNP were risk factors of LVR. Conclusion High expression of plasma microRNA-214 is found in LVR patients, which is expected to be the biological indicator for predicting the occurrence of LVR after PCI in patients with AMI.
ABSTRACT
Objective To assess the characteristics and satisfaction of outpatients in walk-in clinic of a grade A tertiary hospital.Methods A total of 1 100 outpatients visiting walk-in clinic of the Second Hospital of Hebei Medical University during March 2016 and June 2016 were randomly selected for the questionnaire survey.The self-designed questionnaire included the general information of patients,the satisfaction degree to the walk-in clinic,to special clinics of the hospital or to community clinics and related reasons,and suggestions for further improvement.Results Total 947 valid questionnaires were received with a retrieval rate of 86.09％.Most of participants had one chronic disease (594,62.72％).The satisfaction degree of walk-in clinic (1.78) was higher than that of hospital special clinics (1.93) (P =0.010),in turn the latter(2.33)was higher than that of conmmnity clinics (P ＜ 0.001).The reasons for patient to choose the walk-in clinic were wide range of medications (389,41.08％),reliable quality (285,27.98％),short waiting time (249,26.29％) and so on.Suggestions for improvement of the walk-in clinic were further reducing the waiting time (428,45.20％),need specialists for chronic disease management (210,22.18％),raising reimbursement rate (172,18.16％) and so on.The reasons for patients to choose special clinic were need readjusting prescription (587,61.99％),special disease or drug (427,45.09％).The reasons of dissatisfaction with special clinic were long waiting time (476,50.26％),frequent transfer to multiple departments (221,23.34％),high registration fee (221,23.34％).The reasons for patients to choose community clinic were short distance (350,36.96％),better environment (350,36.96％),short waiting time (184,19.43％).The reason of dissatisfaction with community clinic were low qualification of medical staff (405,42.77％),insufficient medications (392,42.39％);distrusting the quality of drugs (263,27.77％).Suggestions for improvement of the community clinics were upgrading the qualification of medical staff (317,33.47％),enlarging drug variety (298,31.47％),improving medical environment (94,9.93％) and so on.Conclusion Most outpatients visiting walk-in clinic of grade A tertiary hospital are highly satisfied the clinic.To meet the patients' needs the primary medical unit should further improve their overall service.