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@#Objective To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. Conclusion Lung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.
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The standardized training of medical specialists in China is far from perfect. The training contents, training system, training methods, supervision and assessment methods need to be improved. The First Clinical College of The First Hospital of China Medical University have guided the trainees to strengthen the study of guidelines and consensus by emphasizing the concept of evidence-based medicine (EBM) of training teachers by means of Sino-U.S. exchanges, case discussions and other ways. At the same time, with the help of the modern network education platform and the problem-based learning teaching mode, the concept of EBM education has been further developed, which greatly enhances the ability of specialists to analyze and solve problems, and improves the training effect.
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Objective:To investigate the efficacy of personalized family doctor contract services on risk factors of atherosclerotic cardiovascular disease (ASCVD) in high-risk population.Methods:Ten matched-community health centers of Shenzhen Luohu district were divided into intervention group and control group by cluster randomiztion. Subjects with high risks of ASCVD were screened out as intervention group from contracted residents who visited these centers and had complete data of the China-PAR model from August 2018 to April 2019. The control group received conventional general family doctor contract services. The individualized management were given to the intervention group after fully understanding patients′ ideas, concerns, and expectations (ICE). After 2-year intervention, score changes of ASCVD risk factors within and between groups were compared.Results:A total of 571 patients were enrolled, including 288 in the intervention group and 283 in the control group. After 2 years of intervention, 7 and 18 were lost to follow-up in two groups, respectively. Finally, 281 in the intervention group and 265 in the control group were included in the study. At baseline, there was no significant difference in ASCVD scores between the intervention group and the control group [(13.33±3.54) vs. (13.09±3.54) points; t=0.84, P=0.403], and the scores in both groups decreased significantly after the intervention [(10.89±4.01), (11.62±4.11) points], while the intervention group decreased more significantly (both P<0.05). Among the risk factors at baseline, HDL-C and diastolic blood pressure in the intervention group were lower than those in the control group, and there were no significant differences in other factors between the two groups. After the intervention, the levels of total cholesterol, systolic blood pressure and diastolic blood pressure in the two groups decreased significantly, and the number of people taking antihypertensive drugs increased significantly ( P<0.001 and P<0.05); HDL-C decreased in the control group ( P=0.023). After the intervention, compared to control group the intervention group had a higher proportion of patients taking antihypertensive drugs, with lower systolic and diastolic blood pressure ( P<0.05). After the intervention, the increase rate of HDL-C in the intervention group was more than that in the control group, and the decrease rate was less than that in the control group (χ 2=6.65, P=0.036). Conclusion:Family doctor contract services can reduce the risk factors of ASCVD, and personalized family doctor contract services can further improve the effects in the prevention and control of ASCVD. However, the effects might be insignificant and inconsistent for the ASCVD risk factors with deeper management requirements or no specific management measures, which highlights the complexity and diversity of ASCVD prevention and control, calling for multi-level and multi-faceted thinking and exploration.
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Objective:To investigate the germline mutation status in multi-pathway in Chinese female breast cancer patients and explore their correlation with clinicopathological characteristics. Aim to enrich the database of breast cancer germline gene mutations in Chinese population and provide laboratory evidence for the application of breast cancer targeted drugs.Methods:From January 2017 to July 2019, whole blood samples were collected from 148 women (age of onset concentrated in the 24~80 years old) diagnosed pathologically with breast cancer in the Department of breast surgery, Peking University People′s Hospital. Germline mutations in HR, MMR, BER, and KDR pathway related genes were detected by next-generation sequencing. The pathogenicity interpretation was performed, and pathogenic, likely pathogenic, and mutations of uncertain significance were screened. The clinicopathological characteristics including age at the onset, luminal typing, tumor size, metastasis, and family history were analyzed, and the correlation between mutations in different pathway genes and clinicopathological characteristics was analyzed by the Chi-squared test and Fisher′s exact probability test.Results:Among the 148 patients, there were 69 cases of HR mutations (including three types of mutations, including pathogenic, likely pathogenic and uncertain significance), 16 cases of MMR mutations, 6 cases of BER mutations and 8 cases of KDR mutation. ATM mutations in the HR pathway were associated with luminal typing ( P=0.054), and patients with HER2+breast cancer were more likely to carry ATM mutations. PMS2 mutations in the MMR pathway were correlated with tumor size ( P=0.060), and patients with tumor size>50 mm were more likely to carry PMS2 mutations. KDR mutations was significantly correlated with luminal typing and family history. ( P=0.021, P=0.024). Conclusion:The mutation frequency in BER, KDR, MMR and HR pathways in Chinese breast cancer patients increased successively. Germline mutations in ATM, PMS2 and KDR genes may be involved in the development of breast cancer in the Chinese population. Multi-pathway gene detection of breast cancer can provide laboratory evidence for the use of PARP inhibitors, trastuzumab and other targeted drugs.
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The mechanism of interactions between natural killer (NK) cells and dendritic cells (DCs) in regulating the early stage of innate immune response and the subsequent adaptive immune response has been elucidated in recent years. NK-DC interactions result in the activation of NK cells and the maturation and/or apoptosis of DCs through direct cell-to-cell contact and releasing cytokines. NK cells can control and enhance DC-mediated antiviral immune response by inducing DCs to mature in favor of Th1 immune response and providing antigens to DCs and killing immature DCs (iDCs). DCs stimulate NK cells through soluble and cell-contact activators, thereby increasing their proliferation, survival and cytotoxicity to shape the innate immune response. Recent studies have shown that interactions between NK cells and DCs also play a critical role in several antiviral responses. Therefore, this paper reviewed the NK-DC interactions and their relationship with antiviral responses, thus providing a theoretical basis for studying the molecular mechanism of NK-DC interactions in viral infectious diseases.
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prognosis of patients with acute upper gastrointestinal bleeding (AUGIB). Methods A total of 130 patients with AUGIB in our hospital were enrolled in this study from August 2014 to August 2016 . Three kinds of scoring systems including Rockall, Blatchford and AIMS65 were used to evaluate the risk classification of the patients. Patients were followed up for 2 months. The incidence rates of re-bleeding and death within 2 months after admission were observed. Data of prognosis in patients with AUGIB were compared between the three scoring systems in the prognosis of patients with AUGIB, including the risk classification and the prediction accuracy of re-bleeding and death. Results There were no significant differences in the re-bleeding rate and fatality rate between the groups divided by Rockall and Blatchford scoring systems ( P>0.05). According to the grouping results of AIMS65 scoring system, the re-bleeding rate of low-risk group was lower than that in high risk group (1.45%vs. 13.11%, P=0.01), but there was no significant difference in fatality rate between the two groups (P>0.05). The values of area under the curve (AUC) of predicting re-bleeding rates by using Rockall, Blatchford and AIMS65 scoring systems were 0.6258, 0.6910, and 0.7241, and the values of AUC of predicting fatality rates were 0.7031, 0.7969, and 0.7031 by using receiver operating characteristic curve (ROC) analysis. There were no significant differences between them (P>0.05). The values of AUC of predicting re-bleeding rates by using the risk grading calculation by Rockall, Blatchford and AIMS65 scoring systems were 0.6189, 0.6139 and 0.7254 (P>0.05). But the values of AUC of predicting fatality rates were 0.6211, 0.6641 and 0.7695 (P<0.01). Conclusion The operation method of AIMS65 scoring system is simple and convenient, which is applicable to a wide range of patients with AUGIB. In the prediction of re-bleeding and mortality, AIMS65 scoring system has high accuracy and stability, which is worthy of promoting in clinical application.
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The existing contents and standards for the standardized residents training are incomplete. Clinical management guidelines and expert consensus should be included in the standardized residents training, since they are very important for clinical decisions. Some guidelines and expert consensus have been included in the standardized residents training in our cardiovascular department,and with the problem-based teaching method, the quality of standardized residents training was improved in the cardiovascular department of ShengJing hospital.
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Objective To establish a set of scientific and quantifiable performance management standard system by using Balance score card rationale so as to supply effective results management base for nursing regulator. Methods Delphi method was used to screen each level of nursing evaluation of performance standard and confirmed its weight;meanwhile, the sort of nursing care unite and nursing load were counted accordance with work intensity, risk degree and technological complexity etc and initially built performance management standard system. Results Accordance with the balance score card rationale and internal process, finance, customer, learning and growth four dimensions, a set of performance management standard and was established, including 4 first class indicator, 10 second class indicator and 32 third class indicator were derivative. The internal process, finance, customer, learning and growth factors were 29.44%, 37.56%, 20.32%, and 12.68%respectively. Conclusions Performance management standard system covers objectives of nursing management of Grade three General Hospital, and which is full of an objective, scientific, operational system possibilities, and can be used to multi-angle evaluate nursing performance, dynamic implement nurses management and achieve strategic goals.
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Objective To explore the application value of Carbon Nanoparticles followed by microscale Methylthioninum Chloride in sentinel lymph node biopsy for breast cancer.Methods Two hundred and eight breast cancer patients were selected in the First Affiliated Hospital of Zhengzhou University during recent two years who performed sentinel lymph node biopsy.They were randomly divided into five groups according to different lymphatic tracer injected:Sequential group (A group,128 patients),Carbon Nanoparticles group (B group,44 patients) and Methylthioninum Chloride group (C group,36 patients).According to different Methylthioninum Chloride doses,sequential groups were randomly divided into low dose group (A1 group,48 patients),middle dose group (A2 group,42 patients),high dose group (A3 group,38 patients),If sentinel lymph nodes were negative no longer performed axillary lymph nodes dissection.Receive the five groups statistics of detection rate,the condition of lymphatic tracer,the incidence of local skin irritation and so on.Results (1) The detection rate of A,B and C three groups had no obvious difference.The incidence of lymphatic tracer dyed not ideal in B group was higher than A and B two groups,the incidence of local skin stimulation in C group was higher than A and B two groups.(2) A1,A2,A3,three groups had no difference of the detection rate and lymphatic tracer,but the incidence of local skin stimulation in A3 group is higher than A1,A2 two groups.3.5 groups of SLN detection rate had no relationship with patients' age,BMI,tumor size,tumor location,tumor molecular classification factors (P ＞ 0.05).Conclusions Carbon Nanoparticles followed by microscale Methyhhioninum Chloride detection rate was similar with two separate application,but can reduce the lymphatic vessels not developing situation when used Carbon Nanoparticles alone and reduce the local irritation caused by large dose of Methylthioninum Chloride,so it can be a good choice of SLNB in clinical.
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<p><b>OBJECTIVE</b>To explore the changes of serum 25-hydroxyvitamin D3 [25-(OH)D3] and interleukin-6 (IL-6) in children with Kawasaki disease (KD) after treatment with intravenous immunoglobulins (IVIG) and analyze their clinical implications.</p><p><b>METHODS</b>Thirty-five children with KD (26 boys and 9 girls) were examined for serum 25-(OH)D3 and IL-6 levels before and after IVIG treatment using enzyme linked immunosorbent assay (ELISA), with 25 febrile children with respiratory tract infections and 25 healthy children as controls.</p><p><b>RESULTS</b>Serum 25-(OH)D3 levels were significantly higher in healthy children than in febrile children (P=0.025), and was even higher in children with KD before IVIG treatment (P=0.023). Serum IL-6 levels were similar between healthy and febrile children (P=0.4), but significantly elevated in KD children (P=0.000). Serum 25-(OH)D3 level was positive correlated with serum IL-6 level in KD children before treatment (r=0.9, P=0.000). In KD children after IVIG treatment, serum 25-(OH)D3 level was significantly increased (P=0.012) and serum IL-6 levels slightly decreased (P=0.325) without showing any correlations (r=0.18, P=0.4).</p><p><b>CONCLUSION</b>Serum 25-(OH)D3 level is positively correlated with serum IL-6 level in KD children before IVIG treatment but not after the treatment,. 25(OH)D3 may participate in the pathogenesis of KD and potentially serves as the therapeutic target for KD.</p>
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Child , Female , Humans , Male , Calcifediol , Blood , Case-Control Studies , Immunoglobulins, Intravenous , Therapeutic Uses , Interleukin-6 , Blood , Mucocutaneous Lymph Node Syndrome , Blood , Drug TherapyABSTRACT
Objective To compare intraoperative,pathologic,postoperative outcomes and quality of life of laparoscopic radical hysterectomy and pelvic lymphadenectomy ( LRH + LPL) with abdominal radical hysterectomy and pelvic lymphadenectomy ( ARH + APL) for patients with early-stage cervical cancer.Methods The consecutive cases with International Federation of Gynecology and Obstetrics (FIGO) stages Ⅰ a2 - Ⅱ a cervical cancer who underwent surgery from Jan.1,2002 to Jan.1,2011 were documented,including 85 patients underwent LRH + LPL,and 85 patients underwent ARH + APL as control group.The clinical data of intraoperative,pathologic,postoperative outcomes and quality of life were compared between two groups.Survival data were estimated using Kaplan-Meier survival curves and compared with the log-rank test.Cox proportional hazards model was used for multivariate analysis.Results All but 2 surgical procedures were completed laparoscopically because of right common ihac vein vessel injuries.Mean operative time,it was longer for LRH + LPL than that for ARH + APL [ (242 ±74) minutes vs.( 190 ±61 ) minutes,P =0.000 ].Mean recovery time of intestines function was less for LRH + LPL than that for ARH + APL [ (45 ± 7 ) hours vs.(63 ± 1 1 ) hours,P =0.000 ].Mean estimated blood loss was less for LRH + LPL than that for ARH + APL[ (367 ±252) ml vs.(460 ±220) ml,P =0.006].Mean recovery time of urinary function was less that for LRH + LPL than that for ARH + APL [ ( 19 ±4) days vs.(21 ±4) days,P =0.000 ].There were no significant difference in numbers of the pelvic lymph nodes resected,the extent of parametrial tissue,vaginal cuff,negative margins obtained and complications.The median follow-up was 32 months (range 4 to 105 months),there was no significant difference in the recurrence rate (7％ vs.5％,P=0.540) and mortality rate (7％ vs.5％,P=0.540),5 years disease-free survival(90％ vs.94％,P =0.812),5 years over survival ( 90％ vs.95％,P =0.532 ).There were not significant difference in quality of life between ARH + APL group and LRH + LPL group( P ＞ 0.05 ).Only lympho-vascular space invasion was an independent prognostic factor by multivariate analysis (P =0.016).Conclusions For early stage cervical cancer,LRH + LPL has similar outcomes compared with ARH + APL.Laparoscopic treatment by experienced surgeons should be an ideal altemative.
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Objective To investigate the functional protective effect of lycium barbarum polysaccharide (LBP) against light-in-duced retinal degeneration. Design experimental studies. Participants sixty SD rats were divided randomly into 6 groups. Methods Sprague-Dawley rats were exposed for 24 hours to 2000-lux cool white fluorescent light after treatment with LBP. Scotopic flash elec-troretinogram (ERG) were recorded before and on day D1, D6 and D14 after light exposure. The b-wave amplitude was statistic. In addi-tion, rats from each group were killed for retinal morphometric analyses. Main outcome Measure The amplitudes of b-wave of scotopic flash ERG, the histopathological changes. Results In the untreated group, light exposure caused collapse of the b-wave sensitivity curves. Bmax was reduced by 29.97% at D1 without subsequent recovery. Histopathology of the temporal superior central retinas of rats showed outer segment disorganization and shortening, the inner segments swelled and vacuolated, the outer nuclear layer thicknesses decreased markedly with subsequent recovery. In the treated groups, light exposure had a weaker effect on sensitivity curves. The values of b-wave amplitude were significantly increased than those in the exposed-untreated group (P=0.005). Retinal morphometry was pre-served. Conclusion LBP afford functional protection against light-induced retinal damage. (Ophthalmol CHN, 2009, 18: 229-233)
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Objective To study the effect of c-myc small interference RNA(siRNA) on c-mye protein in leukemic cells, and investigate a new method of gene therapy on leukemia. Methods siRNA against c-myc mRNA were designed and synthesized. The siRNA at 100 nmol/ml density was transfected into HL-60 cells. The cells cultured at 24 h, 48 h or 72 h were collected after being transfected, and the total protein of the cells was extracted according to the instruction booklet of TRIzol reagent. The expression level of c-myc protein was examined by Western blotting. Results After being treated with siRNA of c-myc, the quantity of c-myc protein was obviously reduced. It was remarkably lower than that of the control group. Furthermore after 72 h treatment with siRNA, the expression of c-myc protein reached its lowest. Conclusion The siRNA of c-myc can suppress the expression of c-myc protein in HL-60 cells. There are sequence targeted and time-dependence effect. The siRNA of c-myc may become a new tool of gene therapy on leukemia.
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OBJECTIVE@#To study whether there are differences in the bacteria distribution from the nasal cavity of the healthy children, teenagers and adults@*METHOD@#The cotton swab specimens were taken from the nasal cavity of the healthy children, teenagers and adults for aerobic culture training.@*RESULT@#Corynebacterium, coagulase-negative staphylococci, Staphylococcus aureus, Gram-negative Neisseria, alpha-hemolytic streptococcus and gram-negative bacillus with, six species of bacteria in total, were cultivated from the nasal cavity of 40 healthy children. The positive rate of bacterial culture was 80.0%; Corynebacterium, coagulase-negative staphylococci and Staphylococcus aureus were cultivated from the nasal cavity of 40 healthy teenagers and 56 healthy adults with the positive rate of bacterial culture was 90.0% from the healthy teenagers group and was 92.9% from the healthy adults group.@*CONCLUSION@#There were obvious difference between the nasal cavity of the healthy children and adults with no obvious difference between the bacteria distribution from the nasal cavity of healthy teenagers and adults.