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ObjectiveTo prepare oral nanoemulsions encapsulating essential oil from Alpinia zerumbet fructus（EOFAZ） and to investigate its pro-absorption effect in vitro and distribution in vivo. MethodThe proteoglycan conjugate polysaccharides of vinegar-processed Bupleuri Radix-bovine serum albumin（VBCP-BSA） was prepared by Maillard reaction of VBCP and BSA. Taking VBCP-BSA as emulsifier， vitamin B12（VB12） as absorption enhancer， and medium chain triglycerides mixed with EOFAZ as oil phase， the nanoemulsions loaded with EOFAZ was prepared by high energy emulsification method. The particle size， particle size distribution， surface Zeta potential， EOFAZ content and appearance and morphology of the nanoemulsions were characterized， and fluorescein tracer method was used to investigate the absorption effect of fluorescein-labeled EOFAZ nanoemulsions in vitro and their distribution in vivo. ResultVBCP-BSA was formed by Maillard reaction for 48 h with high grafting rate. Using VBCP-BSA as emulsifier， the homogeneous pink nanoemulsions was prepared and denoted as EOFAZ@VBCP-BSA/VB12. The particle size of the nanoemulsions was less than 100 nm and the particle size distribution was uniform. The surface of the nanoemulsions was a weak negative charge， and the shape was spherical. The encapsulation rate of the nanoemulsions for EOFAZ was greater than 80%， which had a good absorption effect in vitro and could enhance liver accumulation after oral administration. ConclusionThe designed proteoglycan nanoemulsions can effectively load EOFAZ， promote oral absorption and enhance liver distribution， which can provide experimental basis for the development of oral EOFAZ liver protection preparations.
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Objective:To explore the risk factors of hospital death in patients with acute Upper gastrointestinal bleeding, analyze the role of emergency endoscopy, and provide reference for grass-roots hospitals to carry out related work.Methods:A total of 370 patients with acute Upper gastrointestinal bleeding hospitalized in the Xinghua People′s Hospital from January to December 2022 were included, 278 of whom underwent emergency gastroscopy. The common causes and locations of acute Upper gastrointestinal bleeding were analyzed, and the influencing factors of death from acute upper gastrointestinal bleeding were analyzed by logistic regression.Results:Among 370 patients with acute Upper gastrointestinal bleeding, the majority were male [67.3%(249/370)], the median age was 70(57-78)years old, and the median hemoglobin level at admission was 72(57-96)g/L. Among them, 278 patients underwent gastroscopy, and 130 patients received blood transfusion treatment of 2(1.5-3.5)units of red blood cells transfusion. The median length of stay was 5(4-7)days. The age of the endoscopic group was younger than that of the non endoscopic group ( P<0.001), and the hemoglobin level was higher than that of the non endoscopic group ( P<0.001). The proportion of hemostatic drug use and blood transfusion was lower than that of the non endoscopic group ( P=0.027, P<0.001). In patients undergoing gastroscopy, the causes of upper gastrointestinal bleeding included 144 cases (51.8%) of ulcer related bleeding, 61 cases (22.0%) of bleeding caused by acute mucosal lesions, 27 cases (9.7%) of bleeding caused by tumors, 12 cases (4.3%) of bleeding caused by cardiac tears, 5 cases (1.8%) of bleeding caused by vascular malformations, and 29 cases (10.4%) of bleeding caused by varices. The bleeding sites included: 170 cases (61.1%) had bleeding from the stomach, 53 cases (19.1%) from the esophagus, 54 cases (19.4%) from the duodenum, and 1 case (0.4%) from gastroduodenal compound ulcer bleeding. Among all patients, 19 died in the hospital, and among 92 patients who did not undergo emergency gastroscopy, 16 died, with a mortality rate of 17.4%; Among 278 patients who underwent emergency gastroscopy, 3 died, with a mortality rate of 1.08%. Logistic single factor regression analysis found that the elderly (>70 years old), low hemoglobin (<70 g/L), blood transfusion and emergency gastroscopy were the influencing factors of hospital death in patients with acute upper gastrointestinal bleeding. Multivariate regression analysis showed that emergency gastroscopy ( OR=0.043, 95% CI: 0.010-0.198, P<0.001) could reduce the hospital death of patients with acute upper gastrointestinal bleeding. Conclusions:Acute upper gastrointestinal bleeding is common in elderly patients. On the basis of stable hemodynamics and early endoscopic examination, identifying the cause and combining traditional drugs for endoscopic hemostasis can improve the prognosis of patients and reduce the mortality of acute upper gastrointestinal bleeding.
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【Objective】 To understand the epidemiological characteristics of COVID-19 in Shaanxi Province from December 9, 2021 to January 20, 2022, and analyze the factors influencing the interval from isolation to diagnosis. 【Methods】 We collected the data of local COVID-19 cases from December 9, 2021 to January 20, 2022 published on the official website of Health Commission of Shaanxi Province. Descriptive statistical method was used to analyze the epidemiological characteristics of COVID-19 in Shaanxi Province. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the differences between groups. The unconditional Logistic regression model was applied to analyze the factors influencing the interval between isolation and diagnosis. 【Results】 The outbreak of COVID-19 in Shaanxi Province started on December 9, 2021 and ended on January 20, 2022. The overall change trend of the outbreak showed an "inverted V" shape. A total of 2,080 confirmed local cases were reported, and the main type of disease was mild, with an incidence rate of 5.26/100,000. Xi’an had the most cases, accounting for 98.69% of the total. The reported cases were mainly concentrated in people aged 21 to 55 years old, with a male-to-female sex ratio of 1.19∶1. The median interval from isolation to diagnosis was 3 days, the shortest interval being 0 day and the longest interval being 21 days. Unconditional Logistic regression model analysis showed that the way of finding cases was the factor influencing the interval from isolation to diagnosis. Compared with the way of isolation of the key population, the way of the nucleic acid screening could reduce the risk of late detection of confirmed cases by 89% (OR=0.11, 95% CI: 0.07-0.16). 【Conclusion】 The way of finding cases is the factor influencing the interval from isolation to diagnosis. In the face of the recent intensification of the spread of Omicron variant in mainland China, accurate and rapid identification and detection of confirmed cases can not only reduce the risk of the spread of the epidemic, but also endeavor more time and initiative for the treatment of patients, which is the key to curbing the spread of the epidemic.
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ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome types and influencing factors of protein-energy wasting （PEW） in chronic kidney disease （CKD） undergoing maintenance hemodialysis （MHD）. MethodsAccording to diagnostic criteria， 164 patients with MHD were divided into PEW group and non-PEW group. The clinical data of all patients were collected， including general information such as gender， age， height and weight， disease characteristics such as course， cormobidity， and haemodialysis duration， laboratory indicators such as blood routine， liver function， renal function， electrolyte， blood lipid， grip strength， and the four examinations. Logistic regression analysis was used to find the influencing factors of PEW by taking the clinical indicators with significant differences between the two groups （P＜0.05） as the independent variables， diagnosis of PEW as the dependent variable， and normal values as the reference. ResultsOut of 164 patients with MHD， there were 96 （58.5%） cases in PEW group and 68 cases （41.5%） in non-PEW group. Compared to the non-PEW group，PEW group had increased age， ratios of bedrest， deep vein preservation， edema， and low grip strength， percentages of comorbidities type 2 diabetes， cardiovascular and cerebrovascular diseases，infections and anemia， and levels of alanine aminotransferase and permine amin aminotransferase， as well as decreased body mass index， self-care ratio，internal arteriovenous fistula， red blood cell count， hemoglobin， serum total protein， serum albumin levels （P＜0.05）. The PEW group had significantly higher frequency of poor appetite and digestion， abdominal distension， fear of cold and preference of warmth， weak breathing and fatigue， poor appetite， oliguria， nausea and vomiting than non-PEW group （P＜0.05）. The incidence of both yin and yang deficiency syndrome and damp-turbidity syndrome were significantly higher in the PEW group than the non-PEW group， while that of liver-kidney yin deficiency syndrome and stirring of wind syndrome were lower （P＜0.05）. Logistic regression analysis showed that low BMI （＜22 kg/m2）， inability to take care of oneself， low grip strength，low serum albumin （＜38 g/L）， infection， older age， fear of cold and cold limbs，and poor appetite were the risk factors of PEW in patients undergoing MHD （P＜0.05）. ConclusionThe root syndrome of MHD-PEW patients is both yin and yang deficiency， concurrent with damp-turbidity syndrome. Low BMI， low serum albumin， infection and older age may be the influencing factors of PEW in patients undergoing MHD.
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It is the current confusion encountered by integrated Chinese and Western medicine that how to find the breakthrough direction of integrating Chinese and Western medicine， from crossover to integration to innovation， and open up a new horizon of integrated Chinese and Western medicine. The progress of Chinese medicine lay in expanding the scope of diagnosis and treatment with the help of modern diagnostic and therapeutic equipments and developing “micro” identification， while the progress of Western medicine lay in looking at “macro” and developing systemic medicine and integrated medicine， both of which are in the direction of each other. The “state-target identification and treatment” may become an important way to build a modern diagnosis and treatment system of integrated Chinese and Western medicine， and the thinking mode of “from target to state” is a further refinement and development on the basis of the theoretical system of “state-target identification and treatment”， which provided a clearer solution for the current stage of the integrated Chinese and Western medicine model， and pointed out the important development direction for the future integrated Chinese and Western medicine. From the perspective of strategic level and diagnosis and treatment practice， it integrated the “target-state” thinking mode into the modern diagnosis and treatment model of the integrated Chinese and Western medicine， i.e.， “Western medicine as the basis and treating with Chinese medicine； Chinese medicine as the basis and treating with Western medicine”. On the one hand， Western medicine should strengthen the reference to the traditional theories and holism of Chinese medicine， and advocate a higher level of education on the integrated Chinese and Western medicine under the guidance of the traditional theories of Chinese medicine. On the other hand， the “from target to state” mode of thinking should be applied to guide the establishment of diagnostic and treatment strategies and clinical selection of medicines in clinical practice， so as to locate the target and adjust the body state in a gradual and orderly manner， and to provide practical methods for the modern clinical work of the integrated Chinese and Western medicines. Chinese and Western medicine systems can learn from each other， combine organically， give full play to their respective strengths， and form an internal law， so as to make breakthroughs and innovations in the integrated Chinese and Western medicine model.
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Objective To evaluate the effect of clinical pharmacists participating in the treatment of hospitalized patients with diabetic foot by antibiotics management index and health economics index. Methods 40 hospitalized patients with diabetic foot of Wagner Grade 4 in the Endocrine Department of Air Force Medical Center from April to September 2017 were selected as control group, and 40 hospitalized patients with diabetic foot of Wagner Grade 4 in the Endocrine Department from April to September 2019 were selected as interventional group. No clinical pharmacists were involved in drug treatment of patients in the control group, while the clinical pharmacists in the interventional group participated in drug treatment, and implemented antimicrobial stewardship, medication reconciliation, pharmaceutical care and medication education. Antibiotics management indexes (use intensity of antibiotics, use rate of special class antibiotics) and health economics indexes (medicine expenses, hospitalization expenses) of the two groups were compared. Results The efficacy of the two groups was similar. The use intensity of antibiotics and use rate of special class antibiotics of the interventional group in which clinical pharmacists participated were significantly lower than the control group (P<0.01), so were the medicine expenses and hospitalization expenses (P<0.01). Conclusion Clinical pharmacists participating in the treatment of hospitalized patients with diabetic foot could reduce antibiotics administration index and health economics index, promote rational medicine use and save medical expenses.
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Combined central and peripheral demyelination (CCPD) is a rare autoimmune disease and its action mechanism remains unknown. This article described a case of CCPD with anti-neurofascin 155 IgG4 antibodies after varicella-zoster virus (VZV) infection who was recovered after steroids and intravenous immunoglobulin treatments. The clinical characteristics of this patient were summarized and the possible pathogenesis was discussed, so as to provide information of CCPD after VZV infection for clinicians.
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Objective:To explore the causal relationship between body mass index (BMI) and hypothyroidism using the two-sample Mendelian randomization model.Methods:A large-scale anthropometric genome-wide association study published in the GIANT database was used to select single nucleotide polymorphisms (SNPs) which were statistically significantly associated with BMI as an instrumental variable ( P<5×10 -8, linkage disequilibrium r 2<0.1). The causal relationship between BMI and hypothyroidism was determined by the inverse variance weighted (IVW), weighted median method and the MR-Egger method, respectively. A heterogeneity test, gene pleiotropy test, and sensitivity analysis were performed to evaluate the stability and reliability of the results. Results:A total of 89 SNPs related to BMI were screened out as instrumental variables. IVW analysis suggested that for every standard deviation increase in BMI, the risk of hypothyroidism increased by 0.9% (odd ratio ( OR)=1.009, 95% confidence interval ( CI): 1.006-1.012, P<0.001). Similar results were obtained with the weighted median method ( OR=1.007, 95% CI: 1.002-1.011, P=0.003) and the MR-Egger method ( OR=1.008, 95% CI: 1.001-1.015, P=0.006). The MR-Egger analysis showed that genetic pleiotropy did not bias the results (intercept=0.000 1, P=0.776), the one-by-one exclusion method did not show that a single instrumental variable SNP had a significant impact on the results, and the difference was not statistically significant ( P>0.05). Conclusion:Mendelian randomized analysis showed a positive causal relationship between BMI and hypothyroidism.
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ObjectiveTo establish the specific chromatogram and thin layer chromatography（TLC） identification method of Kaixinsan（KXS） samples， in order to clarify the key quality attributes and provide reference for the quality evaluation of KXS. MethodHigh performance liquid chromatography（HPLC） specific chromatogram of KXS was developed with YMC Hydrosphere C18 column（4.6 mm×250 mm， 5 μm）， the mobile phase was acetonitrile（A）-0.2% formic acid aqueous solution（B） for gradient elution（0-15 min， 2%-20%A； 15-25 min， 20%-25%A； 25-30 min， 25%-30%A； 30-45 min， 30%-31%A； 45-50 min， 31%-44%A； 50-65 min， 44%-45%A； 65-73 min， 45%-75%A； 73-95 min， 75%-100%A； 95-105 min， 100%A； 105-105.1 min， 100%-2%A； 105.1-120 min， 2%A）， the detection wavelength was 320 nm. Ultra high performance liquid chromatography-linear ion trap-electrostatic field orbitrap mass spectrometry（UHPLC-LTQ-Orbitrap MS） was used to identify the chemical components of KXS with electrospray ionization（ESI）， negative ion mode and scanning range of m/z 50-2 000. TLC identification methods for Poria and Ginseng Radix et Rhizoma in KXS were established. ResultThere were 11 common peaks in the specific chromatogram of KXS， attributed to Polygalae Radix， Poria and Acori Tatarinowii Rhizoma. Taking peak 9（α-asarone） as the reference peak， the relative standard deviations of the retention times of 15 batches of KXS samples were<0.2%. A total of 34 compounds were identified by UHPLC-LTQ-Orbitrap MS， including terpenoids， phenylpropanoids， oligosaccharides and ketones. The established TLC had good separation and was rapid， reliable， simple， feasible， suitable for the identification of Poria and Ginseng Radix et Rhizoma in KXS. ConclusionThe specific chromatogram and TLC of KXS are stable and reproducible. The material basis of KXS is basically clarified by MS， which can provide a reference for the development and quality control of KXS.
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Objective:To understand the epidemiology, clinical characteristics and associated risk factors of severe adenovirus(ADV)pneumonia in children, providing the basis for targeted prevention and treatment.Methods:Clinical features of children with ADV pneumonia at Children′s Hospital of Soochow University from January 2011 to December 2020 were retrospectively analyzed.According to the severity of the disease, cases were divided into severe ADV pneumonia group and common ADV pneumonia group.The epidemiological and clinical characteristics of two groups were compared, and risk factors for the occurrence of severe ADV pneumonia were analyzed.Results:A total of 1 158 patients with ADV pneumonia were enrolled, including severe ADV pneumonia 104 cases(8.98%) and ordinary ADV pneumonia 1 054 cases(91.02%).The median age of severe ADV pneumonia group was 1.17 (0.83, 2.73) years, which was significantly younger than that of common ADV pneumonia group 3.16 (1.50, 4.50) years( P<0.05), and 77.89% (81/104) of them were younger than 3 years old.The occurrence of severe ADV pneumonia was predominant in winter and spring, accounting for 71.15% (74/104).Cough was present in 89.42% (93/104) and fever in 99.01% (103/104) of the severe ADV pneumonia group.Compared with the common ADV pneumonia group, the severe ADV pneumonia group had a significantly longer febrile time[10(6, 14)d vs. 5(4, 7)d, P<0.05], significantly higher incidence of shortness of breath, wheezing, convulsions/coma[100% vs. 2.09%, 45.19% vs. 13.57%, 10.57% vs. 1.99%, P<0.05], and significantly higher incidences of emphysema, pleural effusion, bronchial signs, pulmonary solids, and atelectasis [21.15% vs. 2.09%, 5.77% vs. 0.19%, 4.81% vs. 0, 3.85% vs. 0.09%, P<0.05].Multivariable Logistic regression showed that age younger than 1.71 years old, wheezing, and the presence of underlying diseases (moderate to severe anaemia, congenital heart disease, neurological disease) were risk factors for the development of severe ADV pneumonia ( P<0.05).Receiver operating characteristic curve analysis showed that the sensitivity and specificity of age<1.71 years old(20 months old) for predicting the occurrence of severe ADV pneumonia were 65.4% and 71.5%, respectively. Conclusion:The age of most severe ADV pneumonia is less 3 years in Suzhou.It usually occurres in winter and spring, with fever, cough, shortness of breath, and wheezing as the main symptoms.Pulmonary manifestations such as pleural effusion, emphysema, pulmonary consolidation, and atelectasis may occur.The underlying disease, wheezing, and age of onset less than 1.71 years (20 months) old are independent risk factors for severe ADV pneumonia.
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Cerebral amyloid angiopathy (CAA) is a common cerebral small vessel disease, mainly caused by β-amyloid deposition on the small vessels less than 200 μm in diameter in cortex and leptomeninges. CAA is a major cause of spontaneous intracerebral hemorrhage in the elderly, especially lobar location. Early symptoms are insidious, and as the disease progress, they manifest as cerebral hemorrhage, cognitive decline, transient focal neurological episodes, cerebral infarction, epilepsy, headache, etc. MRI revealed that CAA is a disease in which bleeding and ischemia coexist, and even inflammation and immune responses are involved. MRI findings of CAA include cerebral hemorrhage, cerebral microbleeds, convexity subarachnoid hemorrhage and cortical superficial siderosis, cortical microinfarcts, CAA-associated inflammation, white matter hyperintensities, enlarged perivascular spaces, cerebral atrophy and lacune, etc. The same patient often has several of the above manifestations, and each manifestation has different specificity for the diagnosis of CAA. The rapid development of MRI technology has led to the improvement of the diagnostic level of CAA, and it is of great clinical significance to understand these imaging findings. This article reviews the MRI findings of sporadic CAA.
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Background A rational diet is the foundation of health. Dietary guidelines for Chinese residents and Chinese Food Guild Pagoda aim to provide healthy eating guidance for Chinese residents. Objective To evaluate the rationality and applicability of the "Chinese Food Guild Pagoda" (2022). Methods The energy and nutrient supplies of foods recommended by the Food Pagoda-were calculated based on the chinese food composition Table. The degree of requirement satisfaction for energy or nutrients was calculated by comparing with the recommended nutrient intake (RNI) or adequate intake (AI) for adults (≥ 18 years) with light physical activity according to the Chinese dietary reference intakes. Results The estimated energy intake was 46662.79-10062.28 kJ, which met the 6697.36-10046.04 kJ set by the Food Pagoda. We estimated that 65.74-102.78 g of protein, 59.67-82.71 g of fat, and 211.27-333.19 g of carbohydrate were provided by following the Food Pagoda. Adequate vitamins and minerals were also provided by following the Food Pagoda. However, the amounts of vitamin E was estimated to be 2.40-3.28 times and sodium was 1.59-1.75 times of AI, while selenium was 63.40%-98.15% of RNI. Conclusion The amounts of vitamin E and sodium by following the Food Pagoda may be higher and selenium may be lower than recommended intakes. Energy and other nutrients in the Food Pagoda are suitable for general adults in China.
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【Objective】 To identify the key factors that regulate the physical vacuum stirring deoxygenation process of bovine hemoglobin and evaluate the stabilities of polyHb solution with different oxygenation degree. 【Methods】 The effects of several factors including gas liquid specific phase boundary area, pH values and polyHb concentrations on deoxygenation process were investigated through monitoring the oxygen saturation of polyHb solution. Furthermore, the MetHb contents of the studied polyHb solutions were measured at regular intervals during the experiments to evaluate the molecular stability of the polyHb through monitoring the oxidation degrees of the experimental Hb solutions under the mimic pasteurevirus inactivation conditions. 【Results】 The results showed that the more gas liquid specific phase boundary area could accelerate deoxygenation rate, the better deoxygenation results could be yielded. On the other hand, lower pH value could promote the deoxygenation process of the polyHb solution due to the decreasing of oxygen affinity of the polyhemoglobin molecules. Furthermore, results of investigation about the Hb concentration presented that Hb concentration had no remarkable effects on the deoxygenation of polyHb. In addition, the results from the stability experiments presented that higher degree of deoxygenation could decrease the oxidation process and thus increase the heat tolerance of the polyhemoglobin. 【Conclusion】 The deoxygenation of polyhemglonbin could improve the stability of the polyhemoglobin and the deoxygenation process could be regulated by changing the gas liquid specific phase boundary area and oxygen affinity. This study could provide reference and preliminary basis for the industrialization and development of HBOCs in the future.
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Objective:To investigate the expression of CXC chemokine ligand 11 (CXCL11) in gallbladder cancer (GBC) and its effect on cell proliferation and invasion.Methods:The surgically resected specimens of 47 GBC patients were collected in Lihuili Hospital Affiliated to Ningbo University from January 2017 to December 2020. There were 26 females and 21 males, with the age (62.0±8.2) years. The expression of CXCL11 protein in GBC tissues and corresponding paracancer tissues was detected by immunohistochemistry. Associations between CXCL11 expression and clinicopathological features were analyzed. After co-culturing of GBC-SD cells with exogenous CXCL11, cell counting kit-8 (CCK-8) and Transwell assays were performed to detect cell proliferation and invasion ability. The expression and phosphorylation level of phosphatidylinositol 3 kinase (PI3K) and protein kinase B (Akt) were also detected by Western blot.Results:The positive expression rate of CXCL11 in GBC tissues was significantly higher than that in adjacent paracancerous tissues [63.8% (30/47) vs 31.9% (15/47), χ 2=9.59, P=0.002]. Furthermore, CXCL11 expression was significantly associated with tumor stage (χ 2=6.64, P=0.010) and lymph nodal metastasis (χ 2=7.86, P=0.005). CCK-8 assay revealed that the proliferation ability of GBC-SD cells in CXCL11-treated group significantly increased than that in the control group (absorbance value: 0.59±0.06 vs 0.32±0.04, t=9.64, P<0.001). Transwell assay showed that the cell invasion ability in CXCL11-treated group significantly increased than that in the control group [number of transmembrane cells: (133.4±12.3) cells vs (38.6±4.4) cells, t=16.21, P<0.001]. Western blot analysis showed that the relative expression levels of phosphorylated PI3K (p-PI3K) and phosphorylated Akt (p-Akt) in CXCL11-treated group (0.88±0.06 and 0.83±0.04) were significantly higher than those in the control group (0.17±0.04 and 0.23±0.06), and the differences were statistically significant ( t=18.54, P<0.001 and t=15.21, P<0.001). Conclusion:CXCL11 is highly expressed in GBC and closely related to tumor progression. CXCL11 can promote the proliferation and invasion of GBC cells via PI3K/Akt signaling pathway.
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Objective:To explore the pathogenesis of major depressive disorder(MDD) by comparing the serum glucose and lipid metabolism indicators, levels of glucagon-like peptide-1(GLP-1) in plasma and feces, and the content of specific intestinal flora ( Lactobacillus, Bifidobacterium) between patients with MDD who were diagnosed for the first time and healthy controls. Methods:Totally 80 MDD patients hospitalized from January 1, 2020 to March 30, 2021 and 80 healthy volunteers with normal physical examination in the same period were selected. Blood and fecal samples of patients with MDD and healthy controls were collected respectively. The indicators of serum glucose and lipid metabolism were detected by automatic biochemical analyzer, the concentrations of GLP-1 in plasma and feces were detected by ELISA, and the relative contents of Lactobacillus and Bifidobacterium in feces were detected by real-time PCR. The differences between two groups of glucose and lipid metabolism indicators, GLP-1 levels and the relative contents of Lactobacillus and Bifidobacterium in feces were analyzed. SPSS 22.0 software was used for statistical analysis. Independent sample t-test and analysis of variance were used for inter group comparison, and Pearson correlation analysis was used for correlation analysis. Results:Compared with the control group, the levels of serum TC, HDL, and LDL in the MDD group decreased ((3.99±0.85)mmol/L , (4.78±0.86)mmol/L; (1.18±0.29)mmol/L, (1.30±0.28)mmol/L; (2.64±0.70)mmol/L, (3.19±0.69)mmol/L; t=5.559, 2.371, 4.695, all P<0.05). The plasma and fecal GLP-1 levels of the MDD group were lower than those of the control group (plasma: (0.81±0.22)pmol/mL, (1.05±0.26)pmol/mL , t=4.509, P<0.01; feces: (2.23±0.46)pmol/mL , (2.47±0.37)pmol/mL, t=2.533, P<0.05). Compared with the control group, the relative contents of Lactobacillus(2.56±1.59, 3.51±2.21) and Bifidobacterium(2.24±1.89 , 3.17±2.08) in the MDD group decreased ( t=2.218, 2.082, both P<0.05). The level of plasma GLP-1 in the MDD group was negatively correlated with FPG, TG, and disease severity ( r=-0.281, -0.221, -0.437, P<0.05). The level of plasma GLP-1 in the control group was negatively correlated with FPG ( r=-0.580, P<0.01). The fecal GLP-1 level of the MDD group was negatively correlated with the severity of the disease ( r=-0.298, P<0.01), and the fecal GLP-1 level of the control group was positively correlated with fecal Lactobacillus and Bifidobacterium ( r=0.685, 0.428, P<0.01). Conclusion:MDD patients have abnormal glucose and lipid metabolism, decreased GLP-1 level and decreased relative content of intestinal Lactobacillus and Bifidobacterium. Changes in intestinal flora affect GLP-1 levels. GLP-1 can affect glucose and lipid metabolism and depressive symptoms in patients with MDD by binding to specific receptors in intestinal tract and central nervous system.
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Objective:To study the correlation between umbilical artery blood gas (UABG) and Apgar score of neonates and the risk factors of low base excess (BE) in UABG.Methods:From March 2017 to September 2020, newborns without congenital malformation born in three hospitals were prospectively enrolled and received UABG analysis. According to their Apgar score, the infants were assigned into low Apgar score group and normal Apgar score group. According to BE of UABG, they were assigned into BE<-12 mmol/L group and BE≥-12 mmol/L group. The UABG indexes including abnormal pH and BE between the low Apgar score group and the normal Apgar score group were compared. The risk factors of low BE in UABG were analyzed.Results:A total of 1 351 qualified samples were included including 208 cases in low Apgar score group and 1 143 cases in normal Apgar score group. 115 cases were in BE <-12 mmol/L group and 1 236 cases in BE ≥-12 mmol/L group. The incidences of abnormal pH and BE values in the low Apgar score group were higher than the normal Apgar score group [50.0% (104/208) vs. 13.8% (158/1 143), 34.6% (72/208) vs. 3.8% (43/1 143)]. The pH and BE values of UABG were positively correlated with 1 min Apgar score ( r=0.402, 0.398, P<0.001). Multivariate logistic regression analysis indicated that the risk factors for BE<-12 mmol/L were Ⅲ° contaminated amniotic fluid ( OR= 3.155, 95% CI 1.972~5.025, P<0.001) and placental abruption ( OR = 3.968, 95% CI 1.992~7.874, P <0.001). Conclusions:The pH and BE values of neonatal UABG are positively correlated with 1 min Apgar score. Ⅲ° contaminated amniotic fluid and placental abruption are risk factors of low BE in UABG.
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Objective:To explore the nursing effect of enhanced recovery after surgery in total knee arthroplasty under multidisciplinary cooperation.Methods:From January 2017 to May 2020, the clinical data of 102 patients with total knee arthroplasty in First Hospital of Zibo were selected for retrospective analysis. According to the different nursing methods, they were divided into observation group and control group with 51 cases in each group, observation group was given enhanced recovery after surgery under multidisciplinary collaboration, and the control group was given routine nursing care. The length of hospitalization, hospitalization costs, intraoperative blood loss, 24 h postoperative hemoglobin, Visual Analogue Scale (VAS), knee range of motion (ROM), New York Hospital for Special Surgery (HSS) Knee Joint Score and complications were compared between the two groups of patients.Results:In the observation group the length of hospitalization was (7.65 ± 1.21) d, the cost of hospitalization was (92 355.21 ± 352.52) yuan, intraoperative blood loss (224.12 ± 25.32) ml, and 24 h postoperative hemoglobin was (115.12 ± 12.05) g/L,while those were (9.68 ± 2.15) d, (105 423.45 ± 544.25) yuan, (362.12 ± 38.78) ml, (102.32 ± 7.52) g/L in the control group, the difference between the two groups was statistically significant ( t values were 5.88-143.92, all P<0.05). Repeated measures analysis of variance showed that time point, between groups, interactive comparisons of VAS scores, ROM, HSS scores were significantly different between the two groups ( P<0.05). And 12, 48, 72 h after the operation, the VAS scores of the observation group were 4.12 ± 0.35, 2.62 ± 0.21, 1.65 ± 0.12, and 5.62 ± 0.58, 3.85 ± 0.41, 2.85 ± 0.24 in the control group, the difference between the two groups was statistically significant ( t=15.81, 19.07, 31.94, all P<0.05). 1 and 3 months after the operation, the ROM of the observation group were (99.78 ± 12.14)° and (108.95 ± 15.25)°, and the ROM of the control group were (81.65 ± 10.02)° and (98.77 ± 11.08)°, respectively. The difference between the two groups was statistically significant ( t=9.00, 4.22, both P<0.05). Conclusions:To give fast track surgery under multidisciplinary cooperation is beneficial to reduce the amount of bleeding in patients undergoing total knee arthroplasty, shorten the length of hospital stay, and reduce the incidence of complications.
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Hepatolenticular degeneration (HLD) is Wilson's disease, which is an autosomal recessive inherited disease caused by gene abnormality and copper transport disorder in liver cells. The pregnancy of HLD patients is safe. During pregnancy, the treatment of eliminating copper should be continued, the dosage of drugs should be reduced according to the condition, and regular monitoring should be done. HLD patients with satisfactory copper control had better pregnancy outcomes than untreated HLD patients. The treatment during pregnancy should be individualized, and perinatal care should be coordinated by obstetrics, hepatology, liver transplantation, genetic counseling, pharmacy, anesthesiology, pediatrics and other disciplines.
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Objective:To explore the efficacy and compliance of e-aid cognitive behavioral therapy (eCBTI) in patients with situational insomnia among different age groups.Methods:A total of 194 patients with situational insomnia were recruited via a campaign of the " Prevention and Protection Handbook Against Epidemic" from March to April 2020 in Guangzhou, China.Participants were divided into two groups according to age: under 35 years old ( n=87) and 35 years old and above ( n=107). They all received one-week eCBTI intervention.Insomnia severity index (ISI), Pre-sleep arousal scale (PSAS) and Hospital anxiety and depression scale (HADS) were used to evaluate the severity of insomnia for all participants pre- and post-intervention.The change of each scale within the group and the reduction rate of each scale between groups were compared using t test and one-way ANOVA. Results:(1) Intervention efficacy: in the <35-year-old group, compared with baseline, the scores of ISI scale ((9.2±4.1), (14.8±5.1)), PSAS cognitive arousal subscale ((18.5±8.4), (23.5±6.6)), PSAS((34.3±15.8), (40.3±10.7)), HADS depression subscale ((5.8±3.6), (8.5±4.6)) and HADS anxiety subscale((7.1±3.9), (9.5±4.5) )were statistically significant after eCBTI intervention ( t= 2.88-8.80, all P<0.01), but there was no significant difference in score of PSAS body subscale ((15.8±7.8), (16.8±5.7)). In ≥35-year-old group, compared with baseline, the scores of ISI scale ((9.7±4.2), (14.4±4.3)), HADS depression subscale ((4.6±2.2), (6.6±3.5))and PSAS cognitive arousal subscale ((16.9 ±8.5), (20.0±5.8))were significantly different after intervention ( t= 2.90-6.86, all P<0.01), meanwhile the scores of PSAS body subscale ((14.3±8.0), (13.9±5.2)), PSAS((32.2±16.5), (33.9±9.2)), HADS anxiety subscale((6.1±3.2), (7.0±3.5)) were not statistically significant (all P>0.05). There was no significant difference in the score reduction rate between the two groups before and after intervention (all P>0.05). (2) Compliance: 86 cases dropped out, and the dropout rate was 61.3%.Totally 75 cases (38.7%) completed the 7-day treatment, and 119 cases (61.3%) completed the treatment within 1-6 days.Further study found that there was statistically significant difference in the reduction rate of ISI total score among the three groups with excellent, good and poor compliance ( F=5.655, P=0.004). Conclusion:eCBTI has a good effect on situational insomnia in different age groups, and there is no difference in treatment compliance.
ABSTRACT
Objective:To explore the characteristics and differences of oxygenated hemoglobin responses in different brain regions in adolescent depressive disorder patients and healthy adolescents during speech fluency task based on functional near-infrared spectroscopy imaging.Methods:From March 2021 to June 2021, twenty-nine adolescents with depression(depressed group) and 26 healthy adolescents(normal group) were enrolled. The severity of depression was assessed by Hamilton depression scale, and the speech fluency task was performed by functional near-infrared spectroscopy brain imaging, and the relative concentrations of oxyhemoglobin in the prefrontal and bilateral temporal lobes were measured.SPSS 26.0 statistical software was used for data analysis, chi-square test was used for gender count data. The t-test was used for comparison of two groups. The measurement data that did not conform to normal distribution were compared between the two groups by Mann-Whitney U test. Results:In the speech fluency task, there was no significant difference in the concentration of oxygenated hemoglobin in prefrontal and left temporal between the depressed group and the normal group (both P>0.05); the oxygenated hemoglobin concentration in the right temporal lobe(-9.179(-22.231, 4.789)) of depressed group was significantly lower than that of the normal group (12.754(-9.438, 35.008)), and the difference was statistically significant ( U=538.00, P<0.05). The oxygenated hemoglobin concentration in right temporal lobe of depressed group had no correlation with the score of Hamilton depression rating scale ( r=0.092, P>0.05). Conclusion:The right temporal lobe function of adolescent depression patients is lower than that of healthy controls during speech fluency tasks, which provides a basis for study of the relationship between depression and some cognitive sensitivity impairment and the function of right temporal lobe.