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1.
Article in Chinese | WPRIM | ID: wpr-847223

ABSTRACT

BACKGROUND: Stem cell therapy has emerged as a novel treatment for chronic temporal lobe epilepsy that has been widely used in various animal models of epilepsy. However, there is yet no consensus in the therapeutic effect in existing experimental studies. OBJECTIVE: To systemically evaluate the therapeutic efficacy of stem cell therapy in animal models of chronic temporal lobe epilepsy, providing experimental evidence and new ideas for further clinical trials. METHODS: A systematic search of CNKI, WanFang, PubMed, Embase and Web of Science was performed for animal studies related to stem cell therapy for chronic temporal lobe epilepsy published from inception to May 2018. Two reviewers independently extracted data, assessed methodological quality and evaluated evidence quality by using CERQual tool. RESULTS AND CONCLUSION: Eight animal studies were eligible for inclusion, including 284 animals suffering chronic temporal lobe epilepsy. Between-study heterogeneity was substantial, so a qualitative description was performed. Stem cell therapy has some improvement in the seizure frequency and duration of chronic temporal lobe epilepsy in animals, which can promote the recovery from epilepsy in most animals. Other outcomes include memory and learning, stem cell migration, differentiation and integration. The exact efficacy of stem cells cannot be determined due to the lack of rigor, characterization, and evidence quality. We therefore do not have absolute confidence to recommend the clinical use of stem cell therapy for chronic temporal lobe epilepsy. Thus, it is necessary to conduct high-quality preclinical studies to further evaluate the efficacy of stem cell transplantation for chronic temporal lobe epilepsy and its clinical conversion risk before implementation of clinical trials.

2.
Article in Chinese | WPRIM | ID: wpr-884177

ABSTRACT

Objective:To investigate the diagnostic performance of Xpert Mycobacterium tuberculosis/rifampin (Xpert MTB/RIF) assay for pulmonary tuberculosis (TB) in patients with acquired immunodeficiency syndrome (AIDS). Methods:Clinical data of 226 patients with AIDS and suspected pulmonary TB in Shanghai Public Health Clinical Center, Fudan University from July 2017 to November 2019 were retrospectively analyzed. Fluorescence staining microscopy of sputum smear, BACTEC MGIT 960 liquid culture (or Roche solid culture) and Xpert MTB/RIF assay were implemented respectively. The sensitivity and specificity of Xpert MTB/RIF in the diagnosis of Mycobacterium tuberculosis (MTB) infection and rifampin resistance were analyzed. Results:Totally 226 patients of suspected pulmonary TB were enrolled. There were 94(41.6%) patients had positive mycobacterium culture, in which 51 (54.3%) were MTB and 43 (45.7%) were nontuberculous mycobacteria (NTM). Using the positive MTB culture of sputum and mycobacterial protein from BCG of Rm 0.64 in electrophoresis (MPB64) as reference standard, the sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis were 72.6%(95% confidence interval ( CI) 66.7%-78.4%) and 97.1% (95% CI 95.0%-99.3%), respectively. The sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis in patients with positive sputum smear were 76.7%(95% CI 67.7%-85.8%) and 90.0(95% CI 83.6%-96.5%), respectively. The sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis in patients with negative sputum smear were 50.0%(95% CI 41.8%-58.2%)and 99.3%(95% CI 97.9%-100.0%), respectively. With phenotypic resistance as reference standard, the sensitivity and specificity of Xpert MTB/RIF assay for rifampicin resistance were 75.0% and 100.0%, respectively. Conclusion:Among AIDS patients, the performance of Xpert MTB/RIF assay for pulmonary TB diagnosis is pretty good and could differentiate MTB from NTM rapidly, which has good application value.

3.
Journal of Chinese Physician ; (12): 198-202, 2021.
Article in Chinese | WPRIM | ID: wpr-884031

ABSTRACT

Objective:To investigate the mechanism of sinomenine (SIN) in inducing the immunosuppressive effects of rat-derived dendritic cells (DCs).Methods:The bone marrow-derived precursor cells from Wistar rats were cultured in vitro. The morphological differences between sinomenine treated DCs (sinomenine modified group, SIN group) and conventional induced DCs (conventional induced group, control group) were observed under microscope. The CD phenotype of DCs was detected by flow cytometry. DCs were induced maturation by lipopolysaccharides (LPS) stimulation. The impact of SIN on the expressions of Toll-like receptor (TLR)2, TLR3 and TLR4 on the DCs surface were detected by flow cytometry. Results:In the conventional induction group, the cells showed clusters or suspension growth, with obvious granular sense on the cell surface; while in the sinomenine induction group, the cells were clustered together, with no significant change in cell volume and morphology. The relative expressions of CD80 and CD86 were 70.7% and 71.3% in the conventional induction group, while 51.7% and 49.4% in the SIN group. The relative expression of TLRs on DCs in SIN + LPS group was TLR2 (51.2±0.34)%, TLR3 (50.3±0.14)%, TLR4 (52.1±0.16)%, which were significantly lower than those in LPS group [(94.35±0.16)%, (97.55±0.16)%, (94.6±0.12)%].Conclusions:SIN may induce immune tolerance by inhibiting the maturation of DCs via inhibiting the TLRs signaling pathways.

4.
Article in Chinese | WPRIM | ID: wpr-883943

ABSTRACT

Objective:To explore the semantic priming processing characteristics of children with Chinese developmental dyslexia(DD).Methods:According to scores of the dyslexia checklist for Chinese children, character recognition test and Raven's standard progressive matrices (RSPM), 19 primary school students from a school in Wuqia County of Xinjiang were selected as DD group.Meanwhile, 19 children were selected as chronological-age control(CA) group matching in age and RSPM scores, and 20 children were selected as reading-level control(RL) group according to the character recognition test and RSPM scores.The amplitude of N400 of children in three groups were tested by semantic priming paradigm under the conditions of semantic related, unrelated and pseudo words.Results:The accuracy of the DD group under the conditions of irrelevant semantics((0.55±0.25) vs (0.81±0.16), P<0.05), and pseudo characters((0.43±0.27) vs (0.68±0.26), P<0.05) were significantly lower than those of CA group.There was no difference between DD group and RL group, as well as between RL group and CA group(both P>0.05). There was no significant difference in the response time among the three groups of children under semantic related and unrelated conditions( F=1.23, 2.03, both P>0.05). In terms of ERP data, in semantic related condition, there was no significant difference in N400 amplitude among the three groups ( F=0.55, P>0.05). In semantic unrelated condition, the amplitude of N400 in DD group was smaller than that in CA Group((-5.92±3.70)μV vs (-9.76±3.45)μV, P<0.05), and there was no statistically significant difference between DD group and RL Group((-5.92±3.70)μV vs (-7.41±4.02)μV, P>0.05), as well as between CA gorup and RL group.As to pseudo words condition, children in DD group had a lower amplitude of N400 than those in CA and RL groups ((-6.03±2.92)μV vs (-9.98±3.40)μV, (-8.91±3.40)μV, both P<0.05). While no significant differences were found between CA group and RL group. Conclusion:Children with Chinese DD have cognitive defects in semantic and orthographic processing.The semantic cognitive defects may caused by their low reading level, rather than their inherent defect, while the defect in orthographic processing may be their inherent defect.

5.
Chinese Journal of Endemiology ; (12): 385-389, 2021.
Article in Chinese | WPRIM | ID: wpr-883731

ABSTRACT

Objective:To understand the surveillance of iodine deficiency disorders (IDD) in Zhongwei City of Ningxia Hui Autonomous Region after marketization reform of salt industry (2017).Methods:In 2018, Shapotou District, Zhongning County and Haiyuan County of Zhongwei City were divided into five sampling areas according to the location of east, west, south, north and middle. In each area, one township was selected, and three salt sales outlets were selected from each township; at the same time, three supermarkets were selected from the cities and towns of each county (district), and different kinds of salt samples in all sales outlets and supermarkets were tested semi-quantitatively. From 2016 to 2020, Shapotou District, Zhongning County and Haiyuan County of Zhongwei City were divided into five sampling areas according to the location of east, west, south, north and middle. One township was selected from each area, and one primary school was selected from each township, 40 non-boarding students aged 8 - 10 years old (age balanced, half males and half females) were selected from each primary school; at the same time, 20 pregnant women were selected from each township, and salt samples were collected from houses of children and pregnant women to test salt iodine content. From 2018 to 2020, according to the "Ningxia Iodine Deficiency Disorders Surveillance Program (2016 Edition)", random urine samples of children and pregnant women were collected to detect urinary iodine content. In 2018 and 2019, the thyroid volume of children was measured by B-mode ultrasound, and the goiter rate was calculated.Results:In 2018, 13 kinds of salt were supplied in the market of Zhongwei City, a total of 130 salt samples were tested, and 11 samples of non-iodized salt were detected, with a rate of 8.46%. From 2016 to 2020, the consumption rates of qualified iodized salt in Zhongwei City were 90.33% (813/900), 67.89% (611/900), 78.67% (708/900), 91.56% (825/901) and 94.44% (850/900), respectively. From 2018 to 2020, the medians urinary iodine of children aged 8 - 10 years old were 189.33, 195.64, and 222.10 μg/L, and the medians urinary iodine of pregnant women were 158.21, 158.01, and 171.84 μg/L, respectively. In 2018 and 2019, the goiter rates of children aged 8 - 10 years old were 1.75% (7/400) and 0.67% (4/600), respectively.Conclusion:After marketization reform of salt industry, the consumption rates of qualified iodized salt in Zhongwei City decrease in 2017 and 2018, however, children and pregnant women have sufficient iodine nutrition, and the goiter rate of children is controlled at a low level.

6.
Chinese Journal of Endemiology ; (12): 173-178, 2021.
Article in Chinese | WPRIM | ID: wpr-883688

ABSTRACT

Objective:To explore if there is premature senescence of chondrocytes in patients with Kashin-Beck disease (KBD) and osteoarthritis.Methods:Five knee cartilage samples of KBD, osteoarthritis and control groups were collected, respectively, from the Second Affiliated Hospital of Xi'an Jiaotong University. DNA was then extracted from cartilage samples and DNA methylation was analyzed by Illumina Infinium HumanMethylation450 BeadChip. At the same time, based on genome-wide methylation data, the online DNA methylation aging clock calculator (https://dnamage.genetics.ucla.edu/home) was used to calculate the DNA methylation age (DNAm age) of samples, and the results were compared with their actual ages.Results:In the comparison between KBD group and control group, 1 212 differentially methylated CpG sites were found, including 497 hypermethylated CpG sites and 715 hypomethylated CpG sites, corresponding to 264 hypermethylated genes and 368 hypomethylated genes, respectively. In the comparison between osteoarthritis group and control group, 656 differentially methylated CpG sites were found, including 343 hypermethylated CpG sites and 313 hypomethylated CpG sites, corresponding to 177 hypermethylated genes and 174 hypomethylated genes, respectively. In the above comparison, 367 overlapped CpG sites (corresponding to 182 genes) were found, which were differentially methylated in both KBD and control groups and osteoarthritis and control groups. The results of DNA methylation aging clock showed that the average age acceleration differences between DNAm age and actual age of KBD, osteoarthritis and control groups were 2.549, 0.017, and - 5.364 years, respectively, the DNAm ages of KBD and osteoarthritis groups were greater than the actual ages.Conclusion:The chondrocytes show premature senescence in both KBD and osteoarthritis.

7.
Article in Chinese | WPRIM | ID: wpr-883567

ABSTRACT

The implementation of artificial intelligence courses in medical colleges is of great significance to the cross-integration of artificial intelligence and medical fields. However, there are problems such as the lack of basic knowledge of artificial intelligence, the lack of closely related teaching materials, and the difficulty in copying the teaching mode of medical courses. Based on the above problems, through the establishment of artificial intelligence course in our school, the teaching implementation process and teaching effects have been summarized and analyzed, aiming at exploring the artificial intelligence curriculum system which is suitable for medical undergraduate students, so as to improve the students' ability of using artificial intelligence technology for medical project practice, promote the combination of medical and engineering, and provide reference for the teaching reform of undergraduate artificial intelligence courses in medical colleges at home and abroad.

8.
Article in Chinese | WPRIM | ID: wpr-883213

ABSTRACT

Objective:To analyze the causes, influencing factors and trends of dead on arrival cases in children′s Hospital in the past 5 years, aiming to provide direction and basis for reducing the dead on arrival cases of children.Methods:We collected the dead on arrival cases in the department of emergency at Shanghai Children′s Hospital from January 2015 to December 2019, classifed and analysed the gender, age, native place, death season, time of death, and possible causes of death, and then studied the correlation between above factors and the cases.Results:A total of 151 dead on arrival cases were collected.The annual number decreased year by year, and boys were more than girls in gender.Most of them were infants under 1 year old, and nonlocal children were more than Shanghai native.The above differences were statistically significant, but there was no significant difference in the distribution of death season and death time.In terms of the cause of death, perinatal diseases accounting for 33.8%(51/151), those accompanied with severe underlying diseases accounting for 39.1%(59/151), accidental death accounting for 14.6%(22/151), unexplained deaths accounting for 12.6%(19/151). Those distribution differences were statistically significant( χ2=32.497, P<0.001). Meanwhile, there were statistic differences in gender and age of the cases with severe underlying diseases( χ2=4.898, P=0.027; χ2=32.169, P<0.001), and the year and age distributions of the accidental death cases also had significant differences( χ2=16.636, P=0.002; χ2=14.727, P=0.002). Conclusion:To reduce dead on arrival cases of children, we should do a good job in perinatal health care and screening, reduce premature birth and birth defects, actively conduct propaganda to prevent children′s accidental injuries, popularize medical first aid knowledge, and strengthen children′s transport system.

9.
Article in Chinese | WPRIM | ID: wpr-883133

ABSTRACT

Objective:To construct a esophageal cancer module with Chinese characteristics based on MD Anderson Symptom Inventory (MDASI) public scale, develop the Perioperative Esophageal Cancer Symptoms Assessment Scale combining above two parts.Methods:The original item pool was formulated through literature review, clinical interviews, and reference of existing symptoms assessment tools. After two rounds of expert evaluation and pilot survey, the preliminary Perioperative Esophageal Cancer Symptoms Assessmment Scale was developed combining Chinese MDASI (MDASI-C). A total of 150 perioperative esophageal cancer patients was assessed using the new scale, the included items were analyzed one by one, the reliability, validity and sensitivity of scale were checked.Results:Feasibility: the scale recovery was 100%, the completion rate of scale was 93.75%, the average completion time was 10 min. Reliability: the value of Cronbach α of the esophageal cancer module, MDASI-C, the combined scale were 0.747, 0.894, 0.883, respectively. Validity: the range of content validity index of items was 0.83-1.00, the scale-level content validity index average value was 0.93. Two common factors, which explained for 67.994% of variance, were extracted by exploratory factor analysis, the validity of criterion had statistical significance ( P<0.05). Sensitivity: the scores of the esophageal cancer module were significantly different among perioperative esophageal cancer patients with different Eastern Cooperative Oncology Group performance status ( H value was 9.264, P<0.05). Conclusions:The Perioperative Esophageal Cancer Symptoms Assessment Scale has good feasibility, reliability, validity and sensitivity, it is suitable for symptoms assessment of Chinese perioperative esophageal cancer patients.

10.
Article in Chinese | WPRIM | ID: wpr-882337

ABSTRACT

Chronic cough can occur in children of all ages, and the incidence rate and consultation rate increase each year.Clarifying the cause of chronic cough is the key to treatment.At present, there are no convenient, operable and unified standards for etiological analysis of chronic cough in the world.Therefore, the etiological analysis of chronic cough has always been a hot topic in clinical research.With the development of diagnosis and treatment technology, the role of pulmonary function and exhaled nitric oxide in the diagnosis of chronic cough has attracted attention.This article reviews the application value of pulmonary function combined with exhaled nitric oxide in etiology analysis of chronic cough in children, to provide reference for etiology analysis of chronic cough in children.

11.
Article in Chinese | WPRIM | ID: wpr-882219

ABSTRACT

Objective:To establish a comet test method for detection of genotoxicity of three reference chemicals in rat liver cells. Methods:6-10 week old Sprague Dawley rats were randomly divided into 4 groups, with normal saline (0.9% NaCl solution) as negative control group. Animals in three test groups were treated, respectively, with ethyl methanesulfonate (EMS) 200 mg/kg, N-methyl-N-nitrosourea (MNU) 50 mg/kg, and D-mannitol 2 000 mg/kg. There were 10 animals in each group, 5 males and 5 females. The animals received two times (21 h interval) of test compounds through intragastric administration, and their clinical symptoms and body weight changes were recorded during the experiment. The rats were sacrificed 3 h after the last exposure. The liver was weighed, then used to prepare single-cell suspensions for the alkaline comet test which determines the average tail DNA content percentage (DNA%) of hepatocytes and other comet indicators. Results:(1) D-mannitol, EMS and MNU did not show significant toxicity in the whole animal. (2) The mean values of tail DNA content percentage (DNA%) of rat hepatocytes in EMS [(60.07±24.69)%] and MNU [(41.66±22.35)%] groups were higher than that in the negative control group [(2.32±1.39)%] and the difference was statistically significant (P<0.05). The difference between D-mannitol group [(3.06±3.30)%] and the negative control group was not significant (P>0.05). Conclusion:This laboratory has established a comet test method using hepatocytes from treated rats. Among three testing chemicals, EMS and MNU have displayed genotoxicity by this assay, but no genotoxicity was observed in D-mannitol treated animals.

12.
Article in English | WPRIM | ID: wpr-881062

ABSTRACT

Triptolide (TP), an active component of Tripterygium wilfordiiHook. f. (TWHF), has been widely used for centuries as a traditional Chinese medicine. However, the clinical application of TP has been restricted due to multitarget toxicity, such as hepatotoxicity. In this study, 28 days of oral TP administration (100, 200, or 400 μg·kg

13.
Article in Chinese | WPRIM | ID: wpr-880158

ABSTRACT

OBJECTIVE@#To observe and compare the therapeutic effects of hydroxypropyl chitosan ferrous ion complex solution and ferrous sulfate solution in iron deficiency anemia rats and their effects on gastric mucosa.@*METHODS@#Seven rats were randomly selected from thirty five SPF grade SD rats as control group, and were fed with normal diet, distilled water (E). The rest of SD rats were fed with low iron feed and distilled water plus continuous tail vein bloodletting to establish the iron deficiency anemia model. After the model was established successfully, the rats were randomly divided into four groups: blank control group (A), iron deficiency anemia control group (B), ferrous sulfate group (C), hydroxypropyl chitosan ferrous ion complex (HPCTS-Fe@*RESULTS@#After modeling, except the normal control group, the hair color of the rats in the four groups showed dark yellow and the belly of the toes became white gradually. HGB, HCT, Ret%, MCV, MCH, MCHC and SF decreased significantly (P < 0.05). After treatment, the rats with dark yellow hair in group C and D were improved, and the toe abdomen turned pink gradually. RBC, HGB, HCT, Ret%, MCV, MCH, MCHC and SF in rats in group C and D increased, which were higher than those in group B (P < 0.05). The HGB of the rats in group D was higher than that of group C in day 28th during treatment and the Ret% was higher than that in group C at day 10th (P<0.05).After treatment, the liver and spleen of the rats in group C and D were lighter than those in group B (P<0.05).The gastric mucosa in group A, B, D and E was not damaged obviously, while it was slightly irritated and damaged in group C.@*CONCLUSION@#Hydroxypropyl chitosan ferrous complex solution can improve the hemoglobin level of SD rats with iron deficiency anemia, which is stronger than ferrous sulfate solution and shows no damage to gastric mucosa.


Subject(s)
Anemia, Iron-Deficiency/drug therapy , Animals , Chitosan , Ferrous Compounds , Hemoglobins , Iron , Rats , Rats, Sprague-Dawley
14.
Article in Chinese | WPRIM | ID: wpr-879894

ABSTRACT

OBJECTIVE@#To study the association of neonatal blood calcium levels with perinatal factors and neonatal urinary calcium levels measured by an intelligent urine test system.@*METHODS@#The medical data of 96 full-term singleton neonates with mild diseases were collected by a cross-sectional survey, who were hospitalized in the Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, from June to August 2018. Urinary calcium levels measured by an intelligent urine test system, total blood calcium levels, ionized calcium levels, and the mother's calcium and vitamin D supplementation during pregnancy were recorded.@*RESULTS@#Compared with the group without vitamin D supplementation for the mother (17 neonates), the group with vitamin D supplementation for the mother (79 neonates) had significantly higher levels of total blood calcium and ionized calcium (@*CONCLUSIONS@#Vitamin D supplementation during pregnancy can increase the blood levels of total calcium and ionized calcium in neonates, and calcium supplementation alone cannot increase the blood levels of total calcium or ionized calcium in neonates. Hypothermia in neonates might cause the reduction in blood calcium levels. The urinary calcium level measured by the intelligent urine test system is positively correlated with the blood level of ionized calcium.


Subject(s)
Calcium , Calcium, Dietary , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Pregnancy , Vitamin D , Vitamin D Deficiency
15.
Article in Chinese | WPRIM | ID: wpr-879549

ABSTRACT

OBJECTIVE@#To explore the genetic basis for a Chinese pedigree affected with autosomal dominant late-onset non-syndromic hearing loss (NSHL).@*METHODS@#Clinical data of the pedigree were collected. Genomic DNA was extracted from peripheral blood samples of the proband and other family members. Trio whole exome sequencing was carried out for 19 396 genes to identify potential pathogenic variants. Sanger sequencing was carried out to verify the candidate variant in the pedigree.@*RESULTS@#The proband and his father were found to carry a c.1183+1delG p.? variant of the DFNA5 gene. The variant was confirmed to be co-segregating with the disease phenotype in the pedigree.@*CONCLUSION@#The c.1183+1delG p.? variant of the DFNA5 gene probably underlay the late onset NSHL in this pedigree. Above finding has enabled accurate genetic counseling for this pedigree.


Subject(s)
Age of Onset , China , Hearing Loss, Sensorineural/genetics , Humans , Male , Mutation , Pedigree , Receptors, Estrogen/genetics
16.
Article in Chinese | WPRIM | ID: wpr-878711

ABSTRACT

Peripheral artery aneurysms,with low incidence and complex anatomic structure,often involve important branches.This paper introduces a new surgical technique-sleeve shaping on the basis of two cases.The basic data,including characteristics,imaging,operation and follow-up data of the cases,were collected.The data were then combined with the previous literature for explaining in detail that this technique can be used as a supplementary method of reconstruction following resection or endovascular repair.


Subject(s)
Aneurysm/surgery , Arteries , Humans , Treatment Outcome
17.
Article in Chinese | WPRIM | ID: wpr-879000

ABSTRACT

Due to worldwide abuse of chemical antibiotics and continuous emergence of "superbugs", the harm of bacterial drug resistance to human beings has become more and more serious. Therefore, it is of great significance to look for green antibiotics with a wide range of sources, broad antibacterial spectrum, non-toxicity or low toxicity, environmentally friendliness, diverse active components and low drug resistance. The volatile oil of traditional Chinese medicine is a kind of volatile oily liquid that exists in plants and can be distilled with steam and immiscible with water. Because of its good potential to resist drug-resistant pathogens, it is widely used in food, medicine and other fields. This paper summarized the antibacterial advantages and characteristics of volatile oil of traditional Chinese medicine, and the antibacterial effect and antibacterial mechanism of combined application of volatile oil of traditional Chinese medicine, in order to provide some theoretical basis and study ideas for solving the problem of bacterial drug resistance and developing natural and green antibiotics.


Subject(s)
Anti-Bacterial Agents/pharmacology , Anti-Infective Agents , Drugs, Chinese Herbal/pharmacology , Humans , Medicine, Chinese Traditional , Oils, Volatile/pharmacology
18.
Article in Chinese | WPRIM | ID: wpr-869874

ABSTRACT

Twenty-three secondary and higher level hospitals in Nantong City were selected from June 3 to June 19, 2019, and the anesthesia safety and quality control surveys were conducted by using "Supervision and Evaluation Scale of Medical Quality Control Index System in a Department of Anesthesiology in Nantong City (2019 edition)" and "Special Supervision and Evaluation Scale of Perioperative Management and Information Construction in a Department of Anesthesiology in Nantong City (2019 edition)" . The results showed that the total score for medical quality control was 90.2±1.3, and the rate of reaching the standard was 87%.The department configuration score was (12.4±0.7), with the rate of reaching the standard 100%, 87% hospitals had anesthesia recovery rooms, but only 2 hospitals had anesthesia clinics.The staffing score was (15.50±0.23), with the rate of reaching the standard 74%, Nantong City had 0.67 anesthesiologists per 10 000 population, the ratio between the number of anesthesiologists and the number of operating rooms was (1.55±0.10), the ratio between the number of nurse anesthetists and the number of operating room was (0.30±0.04), and three hospitals even had no nurses in the department of anesthesiology.The department management and system score was (28.6±0.5), the rate of reaching the standard was 91%, and the operation safety verification system was not implemented in place in 87% hospitals.The medical technique score was (33.6±0.7), the rate of reaching the standard was 83%, and anesthesiology department was not equipped with anesthesia depth monitor, muscle relaxation monitor, body temperature monitor and other equipment in 35% hospitals.The perioperative management and information construction score was (40.2±1.7), the rate of reaching the standard was 48%, standardized post-operative ward round system was not carried out in 43% hospitals, and the surgical anesthesia information system was not used in 65% hospitals.In conclusion, the current status of anesthesia safety and quality control in secondary and higher level hospitals in Nantong City mainly manifests in the urgent need to improve the awareness of anesthesia safety and quality control, lack of doctors and nurses in a department of anesthesiology and lag of anesthesia information construction.

19.
Article in Chinese | WPRIM | ID: wpr-868871

ABSTRACT

Objective:To find out whether surgeon's proficiency in laparoscopic gastrectomy helps to get over the learning curve of laparoscopic pancreaticoduodenectomy (LPD) more quickly.Methods:From January 2015 to October 2016, the clinical and perioperative data of 41 consecutive patients who underwent LPD at the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The learning curves were evaluated using the CUSUMOT method and RA-CUSUM method.Results:Of 41 patients, 25 were males and 16 were females, with age ranging from 25.0 to 83.0 (60.6±13.7) years. These patients all successfully underwent LPD, with operation time Mean±SD being (456.3±85.9) min. There were 4 patients (9.8%) who developed biochemical fistula and 4 patients (9.8%) grade B pancreatic fistula. There was no grade C pancreatic fistula after operation. There were 10 patients who developed postoperative complications ≥ Clavien-Dindo grade III (24.39%) and 1 died. The data of the CUSUMOT method showed the learning curve to be over after the 33rd patient and the data of the RA-CUSUM method showed the learning curve to be over after the 31st patient.Conclusions:Laparoscopic gastrectomy helped surgeons to master the key techniques in LPD faster, and to get over the learning curve more safely and quickly.

20.
Article in Chinese | WPRIM | ID: wpr-867659

ABSTRACT

Objective:To investigate the clinical manifestations, imaging findings, characteristics of cerebrospinal fluid, treatment and prognosis in patients with acquired immune deficiency syndrome (AIDS)-related progressive multifocal leukoencephalopathy (PML) diagnosed by second generation sequencing techniques with cerebrospinal fluid.Methods:From October, 2017 to January, 2019, ten patients with AIDS-related PML were diagnosed by second generation sequencing techniques with cerebrospinal fluid, and their clinical data were retrospectively reviewed. Descriptive analysis was used.Results:Among the ten patients with AIDS-related PML, eight were males and two were females. The age was (38.7±8.2) years. The median CD4 + T lymphocyte count was 46/μL. The median human immunodeficiency virus (HIV) RNA was 5.99×10 4copies/mL. The main clinical manifestations included dyskinesia in four patients, dizziness in three patients, cognitive decline in two patients, and speech disorder in one patient. Three patients developed convulsion throughout the course of the disease. Image findings indicated that lesions could appear in any part, including lesions located under the tentorium of cerebellum in three cases, and above the cerebellum in seven cases. Mild increase of total protein was observed in the cerebrospinal fluid of four cases, while white blood cell count ((0-10)×10 6/L), sugar and chloride were normal in all cases. The reads of JC virus sequence in the cerebrospinal fluid ranged from 3-12 531 reads (median 67 reads). All the patients received antiviral therapy containing integrase inhibitors. Among the 10 patients, two died in hospital and eight survived, and two of them had survived for more than one year. The symptoms were improved in five patients and unchanged in three patients. Conclusions:PML is less common in patients with HIV/AIDS. The second generation sequencing techniques with cerebrospinal fluid can help to diagnose the disease together with clinical manifestations, routine detection of cerebrospinal fluid and imaging. Potent antiretroviral treatment may improve the prognosis of the patients.

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