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Objective:To determine the epidemiology of hyperkalemia and influencing factors in a general population in Pinggu district of Beijing city.Methods:This study was a cross-sectional survey. The subjects were from the epidemiological survey population of chronic diseases in Pinggu district of Beijing city from March to May 2014. All participants completed a questionnaire, anthropological measurement, and venous blood samples collection to detect serum creatinine and potassium and so on. First void morning urine was collected to detect the albumin-creatinine ratio. Hyperkalemia and hypokalemia were defined as serum potassium level>5.0 mmol/L and≤3.5 mmol/L, respectively. Logistic regression analysis method was used to analyze the influencing factors of hyperkalemia.Results:Of the 10 252 people in this study, the prevalence of hyperkalemia was 6.17%(95% CI 5.70%-6.67%), the prevalence of hypokalemia was 0.61%(95% CI 0.47%-0.79%), and the prevalence of participants with serum potassium>5.5 mmol/L was 0.53%(95% CI 0.40%-0.69%). Multivariate logistic regression analysis results showed that males ( OR=1.269, 95% CI 1.074-1.498, P=0.005), diabetes ( OR=1.226, 95% CI 1.008-1.490, P=0.041), increased total cholesterol ( OR=1.219, 95% CI 1.119-1.329, P<0.001), and decreased estimated glomerular filtration rate ( OR=0.971, 95% CI 0.965-0.977, P<0.001) were significantly correlated with the increased risk of hyperkalemia. Usage of renin-angiotensin-aldosterone system inhibitors and diuretics were not found to be significantly associated with the risk of hyperkalemia ( OR=1.018, 95% CI 0.751-1.380, P=0.908; OR=0.638, 95% CI 0.229-1.781, P=0.391). Conclusions:The prevalence of HK in the general population is 6.17%. The male, decreased estimated glomerular filtration rate, diabetes, and increased total cholesterol are influencing factors of hyperkalemia.
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Objective:To analyze the clinical and pathological characteristics, treatment and prognosis of renal changes in patients with Kimura disease and improve the clinicians′ understanding on renal manifestations of Kimura disease.Methods:The clinical data of Kimura disease patients with definite diagnosis and detailed data in Peking Union Medical College Hospital from January 1980 to August 2020 were retrospectively analyzed. The patients were divided into renal impairment group and non-renal impairment group according to whether the kidney was involved or not and the related clinical data between the two groups were compared. The patients presenting with nephrotic syndrome were followed up.Results:There were 60 patients with Kimura disease confirmed by pathological diagnosis with 48 males. The median age was 33(3, 62) years old, and the median duration was 36(12, 111) months. There were 18 cases complicated with renal injury in 49 patients with complete routine urine and renal function examination and the main manifestations of renal injury were proteinuria and/or microscopic hematuria. There was no significant difference at age, sex and absolute value of eosinophils between the two groups (all P>0.05). Compared with the renal inpairment group, patients in non-renal inpairment group had longer course of disease, higher levels of hypersensitive C-reactive protein and erythrocyte sedimentation rate, and lower median values of total eosinophils and total IgE, but there was no statistically significant difference (all P>0.05). Among the patients with renal involvement, 6 patients met the diagnostic criteria for nephrotic syndrome, and 5 of them completed renal biopsies. The renal pathological diagnosis was membranous nephropathy in 2 cases and minimal change disease in 3 cases, and no interstitial eosinophil infiltration was found in renal biopsy tissues. These patients had a good response to glucocorticoids and/or immunosuppressive therapy, and achieved complete remission of nephrotic syndrome; at the same time, lymphadenopathy caused by Kimura disease could be well controlled. Conclusions:Kimura disease can combine with various renal lesions, and the pathology of nephrotic syndrome can be membranous nephropathy or minimal change nephropathy. After energetic treatment of glucocorticoids and/or immunosuppressive therapy, nephrotic syndrome can be completely relieved, and lymphadenopathy can be well controlled. The relationship between Kimura disease and renal disease needs further study.
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OBJECTIVE To study the triterpenoid saponins from Anemone rivularis var. flore-minore and their antitumor activities. METHODS The n-butanol extract of 70％ ethanol extract from rhizome of the plant was separated. The triterpenoid saponins were separated and purified by normal silica gel column chromatography ，reversed phase ODS column chromatography ， Sephadex LH- 20 gel column chromatography and semi-preparation high performance liquid chromatography. The structures of these saponins were identified by spectral analysis （NMR and MS ）and physical and chemical properties. MTT assay was used to test the proliferation inhibitory activity of the compounds against five kinds of human tumor cells （HL-60 cells，A549 cells，HepG2 cells，HeLa cells and U 87MG cells ）. The apoptosis inducing effect of compound 7 on U 87MG cells was evaluated by flow cytometric Annexin V-FITC/PI staining test. RESULTS：Sixteen triterpenoid saponins were obtained and identified as 3 β-O-β-D-xylopyranosyl-（1→2）-α-L-arabinopyranosyl-oleanolic acid-28-O-α-L-rhamnopyranosyl- （1→4） -β-D-glucopyranosyl-（1→6）-β-D-glucopyranoside（1），3β-O-L-arabinopyranosyl oleanolic acid- 28-O-β-D-glucopyranoside（2），saponin B （3）， 163.com oleanolic acid- 3β-O-β-D-glucopyranosyl-（1→2）-α-L-arabino- pyranoside（4），HN-saponin F （5），clematoside S （6），prosapogenin CP 4（7），cussonside B （8），pulsatilla saponin C （9）， clemastanoside D （10），3 β-O-β-D-glucopyranosyl-（1→2）-β-L-arabinopyranosyl-hederagenin-28-O-β-D-glucopyranoside（11）， ciwujianoside C 3（12），ciwujianoside A 1（13），huzhangoside D （14），kalopanaxsaponin B （15）and hederacolchiside E （16）. Compounds 3，4，6-9 displayed inhibitory activities on the proliferation of tumor cells to different extent ，and compound 7 had the strongest activity ；compound 7 induced the apoptosis of U 87MG cell so as to inhibit the proliferation of cancer cells in a time-dependent manner. CONCLUSIONS The obtained 16 saponins are all identified as oleanolane-type ，among which compound 1 is a new compound. The monodesmosidic saponins ，the sugar chain of which attached at C- 3 and a free carboxyl at C- 28， possess stronger antitumor activity than others.
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Objective@#To explore the prevalence of health risk behaviors and the association between locus of control and health risk behaviors among college students, and to provide reference for the formulation of health risk behavior intervention for college students.@*Methods@#A multi stage cluster random sampling method was used to select 2 provinces from the east, central and west regions of China, respectively. Two universities were then randomly selected from each selected province. A total of 3 951 college students from 12 universities completed the electronic and anonymous questionnaires, which included demographic characteristics, Multidimensional Health Locus of Control Questionnaire (MHLC) and Health Risk Behaviors Questionnaire. Chi square test and binary Logistic regression were applied to analyze data.@*Results@#Totally 2 287(57.88%) students reported having three or more kinds of health risk behaviors. The prevalence of excessive screen time, insufficient physical exercise, poor eating behaviors, drinking and smoking were 97.34%(3 846), 74.72%(2 952), 72.21%(2 853), 13.62%(538) and 5.57%(220). Internal locus of control was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98) and inadequate physical activity ( OR =0.93) and associated with higher risk of smoking ( OR =1.07). The powerful others was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98), drinking ( OR =0.95) and unhealthy eating behavior ( OR =0.97). And the chance was associated with higher risk of three or more kinds of health risk behavior ( OR = 1.04 ), drinking ( OR =1.04) and inadequate physical activity ( OR =1.03)( P <0.01).@*Conclusion@#College students have serious health risk behavior problems, the locus of control is associated with health risk behaviors among college students. Which might be helpful to prevent the occurrence of health risk behaviors, and improve overall health of college students.
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A 43-year-old male patient with onset of edema caused by nephrotic proteinuria and low titer of anti-M type phospholipase-A 2-receptor (PLA 2R) antibody was diagnosed as idiopathic membranous nephropathy by renal biopsy. Administrated with prednisone 40 mg once a day and cyclosporine 100 mg twice a day as front-line regimen, the patient relapsed after transient partial remission. When treatment was combined with cyclophosphamide 100 mg once a day, the 24-hour total urine protein and titer of anti-PLA 2R antibody were even elevated. Therefore, the patient received rituximab 1 g intravenously in April 2019, October 2019 and October 2020 respectively. CD19 positive B lymphocytes in peripheral blood were eliminated from 71/μl to zero. Immunosuppressants and corticosteroids were withdrawn successively. On the last follow-up in November 2020, the anti-PLA 2R antibody was negative, and the 24-hour total urine protein and serum albumin was 4.4 g and 34 g/L, respectively. This case suggested the potential efficacy of rituximab for refractory membranous nephropathy. Further studies should explore whether the titer of anti-PLA 2R antibody indicates the dose of rituximab.
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Objective To evaluate the construction effect of a national comprehensive prevention and control demonstration area for chronic diseases in a banner county in Inner Mongolia, and to provide a scientific basis for deepening the construction of the demonstration area and improving the formulation of chronic disease prevention and control strategies and measures. Methods Using the chronic disease nutrition monitoring data of residents aged 18 and over in a banner county in Inner Mongolia in 2015 and 2018, the prevalence, awareness, and management and treatment rates of the main chronic diseases of residents with different characteristics, as well as the changes in healthy behaviors and lifestyles were compared and analyzed. SPSS25.0 software was used for data analysis. The classification variables were mainly described by rate and composition ratio. The comparison of rates of various indicators between the two years was performed using 2 test. Multivariate logistic regression analysis was used to analyze statistical correlation between the continuous construction of the demonstration area from 2015 to 2018 and the various indicators. The test level was α=0.05. Results In 2015 and 2018, 621 and 600 residents aged 18 and above were investigated respectively. The prevalence of diabetes (8.17%) and the prevalence of dyslipidemia (28.13%) of residents in the demonstration area in 2018 were lower than those in the demonstration area in 2015 (12.08% and54.91%, respectively), and the differences were statistically significant (P<0.05). In 2018, the diabetes awareness rate (71.43%), diabetes treatment rate (71.43%), diabetes management rate (38.78%), and dyslipidemia awareness rate (51.50%) of residents in the demonstration area were higher than those in the demonstration area in 2015 (42.67%, 42.67%, 13.33%, and 31.09%, respectively), and the differences were statistically significant (P<0.05). In 2018, the current smoking rate (20.83%) of residents in the demonstration area, the drinking rate within one year (31.67%), insufficient intake of fresh vegetables (51.00%), and excessive intake of edible salt (47.83%) were all lower than those of residents in the demonstration area in 2015 (30.43%, 45.57%, 71.18%, and 78.42%, respectively), and the differences were statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that the continuous construction of the demonstration area was statistically correlated with dyslipidemia (OR=0.31, 95%CI: 0.24-0.39), diabetes awareness (OR=3.92, 95%CI: 1.68-9.12), diabetes treatment (OR=4.53, 95%CI:1.75-11.70), diabetes management (OR=5.82, 95%CI: 1.94-17.52), awareness of dyslipidemia (OR=1.57, 95%CI: 1.04-2.38), current smoking (OR=0.60, 95%CI:0.44-0.82), drinking within one year (OR=0.46, 95%CI: 0.35-0.61), and insufficient intake of fresh vegetables (OR=0.45, 95%CI: 0.35-0.58). Conclusion The construction of a national demonstration zone for comprehensive prevention and control of chronic diseases can significantly reduce the prevalence of major chronic diseases among residents in a banner county in Inner Mongolia, improve the self-management level of patients with chronic diseases, and promote the development of healthy behaviors and lifestyles.
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Onset with fever and back pain, an 81-year-old man had sudden oliguria and progressively elevated serum creatine from normal range to 660 μmol/L within 1 week after receiving contrast agents, various antibiotics, and several nonsteroidal anti-inflammation drugs. Urine output recovered after supportive treatment. However, his serum creatinine level rose again soon after a temporary decline accompanied by gross hematuria with almost normal morphology, nephrotic proteinuria, and hypoalbuminemia. Renal biopsy revealed necrotizing glomerulonephritis. Methylprednisolone was intravenously administrated 500 mg per day for 3 days, followed by oral glucocorticoids and cyclophosphamide. Gradually the patient′s serum creatinine descended to 144 μmol/L.
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A 65-year-old woman presented with intermittent right hand numbness and elevated serum creatinine for more than 2 months. The histological examination of kidney biopsy showed renal arterioles occlusion and interstitial fibrosis. Pathological abnormality was originally considered as a part of systemic atherosclerosis. Thus, rosuvastatin 20 mg/d, fosinopril 10 mg/d, metoprolol 47.5 mg/d and aspirin 0.1g/d were administrated. No improvement of renal function was seen. Further Congo red staining was applied. Diffuse amorphous eosinophilic substance was deposited in interlobular artery and small arteriolar artery. Combined with the abnormal free light chain (FLC) level and ratio (serum κ 340 mg/L, κ/λ 10.932), the diagnosis of systematic light-chain amyloidosis was confirmed. The patient received 3 courses of chemotherapy regimen as BCD (bortezomib 2 mg d1, 8, 15, 22, cyclophosphamide 0.3 g d1, 8, 15, 22 and dexamethasone 40 mg d1, 8, 15, 22). A hematologic partial response was achieved and serum creatinine decreased to 180 μmol/L.
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Objective:To understand the current situation of clinical application and management of food for special medical purpose (FSMP) in China's medical institutions.Methods:A questionnaire was developed based on literature review, consultation with experts and multiple discussions to investigate the application and management of FSMP in hospitals. The survey was conducted in secondary and tertiary general or specialized hospitals in China. The accountable person of Clinical Nutrition Department in each hospital filled in the questionnaire with the guidance from provincial quality control center.Results:A total of 592 hospitals across 30 provinces/municipalities participated in the survey. The majority (40.5%) of prescription for FSMP with approved batch number was given by clinical nutrition departments, nutritional risk screening was conducted before using FSMP as enteral nutrition in 64.0% of the hospitals, consent from patients or their families prior to initial FSMP use was required in 94.8% of the hospitals, follow-up after FSMP use was carried out in 86.5% of the hospitals, 79.2% of the hospitals maintained electronic or paper documentation of the clinical application of enteral nutrition preparations, 41.6% of the hospitals had no organization or institution to supervise the standardized application of FSMP.Conclusion:In the future, we should strengthen the construction of FSMP professional team, establish convenient and efficient nutrition diagnosis and treatment information module, and set up special institutions to implement FSMP standardized management.
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Objective:To explore the role of clinical pathway teaching in the practice teaching of respiratory medicine.Methods:A total of 51 intern students in the Department of Respiratory Medicine from January 2019 to June 2020 were selected as the research objects, and they were divided into a control group (25 cases) and a study group (26 cases). The control group adopted traditional clinical teaching, and the research group adopted clinical path teaching; the two groups' assessment results, comprehensive quality scores and satisfaction evaluations were compared respectively. SPSS 22.0 was used for t test and chi-square test. Results:In terms of evaluation results: including theoretical knowledge, case analysis, practical ability, and coping ability, the study group was higher than the control group, with significant differences ( P<0.05); in comprehensive quality: including the improvement of learning interest, the scores in 6 aspects, including expanded knowledge, professional diagnosis and treatment level, self-study ability, clinical thinking ability, teamwork ability, etc., were higher in the study group than in the control group, and the difference was statistically significant ( P<0.05); the number of people satisfied with the teaching in the study group was more than the control group. Conclusion:The role of clinical pathway teaching in the practice teaching of respiratory medicine is better than that of traditional teaching. By clarifying the teaching objectives and standardizing the teaching process, it can effectively improve students' assessment scores, overall quality and teaching satisfaction, which is worthy of further promotion.
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Objective:To investigate the predictive value of fasting blood glucose on clinical outcome after intravenous thrombolysis in patients with severe acute ischemic stroke (AIS).Methods:From January 2016 to November 2020, consecutive patients with severe AIS receiving intravenous thrombolysis in the Department of Neurology, Shengli Oilfield Central Hospital were enrolled retrospectively. Severe AIS was defined as the baseline National Institutes of Health Stroke Scale (NIHSS) score ≥15. The primary endpoint was the clinical outcome evaluated according to the modified Rankin Scale at 90 d after onset. 0-2 was defined as a good outcome and a score of >2 were defined as a poor outcome. The secondary endpoint events were any intracranial hemorrhage and symptomatic intracranial hemorrhage (sICH). Intracranial hemorrhage was defined as any local or distant parenchymal hemorrhage shown by craniocerebral imaging during the hospitalization. sICH was defined as any intracranial hemorrhage and the NIHSS score increased by ≥4 within 7 d after treatment. Univariate and multivariate logistic regression analysis were used to determine the independent influencing factors of various endpoint events. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of fasting blood glucose levels for endpoint events. Results:A total of 113 patients with severe AIS treated with intravenous thrombolysis were included, and 73 (64.6%) had a poor outcome; 29 (25.7%) had intracranial hemorrhage, of which 10 (8.8%) were sICH. Multivariate analysis showed that fasting blood glucose was the independent risk factors for poor outcome (odds ratio [ OR] 1.451, 95% confidence interval [ CI] 1.053-2.000; P=0.023) and sICH ( OR 1.235, 95% CI 1.013-1.504; P=0.036). The ROC curve analysis showed that the area under the curve of fasting blood glucose predicting poor clinical outcome at 90 d after onset was 0.731 (95% CI 0.637-0.824), the optimal cut-off value was 6.25 mmol/L, and the corresponding sensitivity and specificity were 63.0% and 82.5% respectively. The area under the curve of fasting blood glucose predicting sICH was 0.728 (95% CI 0.577-0.878), the optimal cut-off value was 7.98 mmol/L, and the corresponding sensitivity and specificity were 70.0% and 77.7% respectively. Conclusion:Fasting blood glucose is an independent predictor of sICH and poor outcome at 90 d after onset in patients with severe AIS receiving intravenous thrombolysis.
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Objective:To explore the influence of elastic band aerobics training on cardiovascular risk factors in adults.Methods:Twenty-four health management centers participated in the competition. Each individual participant learned elastic band aerobics through video and tested their own indexes before and after intervention. Height, body weight (BW), muscle content (MC), fat content (FC), waist circumference (WC), hip circumference (HC), body fat rate (BFR), resting systolic and diastolic blood pressure (SBP and DBP) were measured. A paired samples t-test was used to analyze pre-and post-test results.Results:After 8 weeks of elastic band aerobics training, there were significant differences in body weight, body mass index (BMI), waist circumference, body fat content, systolic and diastolic blood pressure for male contestants before and after training ( P<0.01). These decreased by 1.39%, 1.45%, 0.98%, 3.61%, 2.28%, 2.34%, and 3.05% respectively. Weight, waist circumference, hip circumference, waist hip ratio, body fat content and rate of female contestants decreased by 1.25%, 1.59%, 0.65%, 0.99%, 4.22%, and 2.38% respectively ( P<0.01). There were significant differences in absenteeism between the top 10 and bottom 14 teams ( P<0.05). Average absenteeism rates were 2.8% and 10.7% respectively. Overall attendance rate of participants was 92.6%, higher than the clinical standard of an 80% level of compliance. Conclusions:Eight-week elastic band aerobics training can significantly improve body composition of adults, reducing body fat rate and waist circumference. Using competition as an opportunity to exercise promotes implementation and persistence of sports training programs.
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Objective To describe the development status of the prevention and control of chronic non-communicable diseases (hereinafter referred to as "chronic diseases") at home and abroad, and to explore coping strategies suitable for the prevention and control of chronic diseases in China. Methods Through literature review relevant data on chronic diseases as well as the prevention and control strategies and measures were collected. A comprehensive analysis on the data was conducted. Results The epidemic trend of chronic diseases is relatively serious both in China and in the world. To cope with the rapid development and epidemic of chronic diseases, China and many other countries have implemented relevant policies to curb the growth and development of chronic diseases and have achieved different results to a certain extent. Conclusion Chronic diseases have become the main cause of death and health threats in human society. The implementation and practice of chronic disease prevention and control strategies should be strengthened, in combination with successful experience at home and abroad, to rapidly develop the strategies for the prevention and control of chronic diseases in line with national conditions in China.
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A 43-year-old male presented with elevated serum creatinine for 4 years and developed abdominal pain for 3 days. He started peritoneal dialysis 2 months ago. Dialysis-related peritonitis was ruled out and acute gastroenteritis was diagnosed. The patient was administrated with ertapenem 500 mg/d. An acute mental abnormality developed 3 days later. After excluded organic encephalopathy, ertapenem was discontinued for the suspicion of antibiotic-related encephalopathy. The frequency of peritoneal dialysis was increased to accelerate the clearance of antibiotics. However, the metal abnormality became even more severe. Then a diagnosis of Wernick-Korsakoff syndrome was considered. After the administration of high dose vitamin B1, the mental disorder dramatically relieved. Vitamin B1 30 mg/d is maintained during peritoneal dialysis and the mental disorder does not relapse.
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With the increasing global burden of various cancer, an abundance of papers emerged every year in the research hotspots of oncology, covering a wide range of research types and topics. In order to facilitate interested readers to quickly grasp the frontier and hotspots of cancer research, it would be helpful to sort out and summarize the research topic in a timely manner. According to the classification of disciplines, we screened the Essential Science Indicators (ESI) hot papers released in 2019 for the ones in the oncology field, utilized methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation to further reveal the context and characteristics of research in the field of oncology, summarized the latest progresses and future directions in the field, and provided information and hints for the trajectory of future research. A total of 549 papers were included, which were mainly from the field of clinical medicine; the country with the most publications was the United States, while China ranked the fourth in terms of contribution; the research institution with the highest number of published papers was University of Texas system;
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Bibliometrics , Biomedical Research , China , Humans , Neoplasms , Publications , United StatesABSTRACT
A 66-year-old male presented with edema for 10 months and high fever for half a month. The patient was diagnosed with type 2 diabetes for 10 years. Renal biopsy revealed membrane nephropathy combined with diabetic nephropathy. A combination regimen with rituximab (1 g, day 1 and day 20), cyclophosphamide (100 mg/d) and prednisone (60 mg/d) was initiated. The dose of prednisone was gradually reduced to 17.5 mg/d within 1.5 months after partial remission of nephrotic syndrome. However, the patient was re-admitted due to high fever, productive cough and mild hand tremor. The lung imaging suggested the diagnosis of community-acquired pneumonia. Ertapenem (1 g/d) was empirically administrated and adjusted to moxifloxacin (0.4 g/d) plus ceftazidime (2 g, 2 times/d) for two weeks. The patient responded and temperature came back to normal. But the fever relapsed after the withdrawal of antibiotics. Mixed infections were suspected, but blood and sputum samples were negative for pathogens. Antibiotics were not effective. The patient recalled a history of pigeon exposure. Positive cryptococcus antigen in blood culture and cerebrospinal fluid unmasked the diagnosis of pulmonary cryptococcosis and cryptococcal meningitis. Fluconazole (200 mg, 2 times/d) and oral flucytosine (1 g, 3 times/d) were given and effective.
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A 43-year-old male presented with elevated serum creatinine for 4 years and developed abdominal pain for 3 days. He started peritoneal dialysis 2 months ago. Dialysis-related peritonitis was ruled out and acute gastroenteritis was diagnosed. The patient was administrated with ertapenem 500 mg/d. An acute mental abnormality developed 3 days later. After excluded organic encephalopathy, ertapenem was discontinued for the suspicion of antibiotic-related encephalopathy. The frequency of peritoneal dialysis was increased to accelerate the clearance of antibiotics. However, the metal abnormality became even more severe. Then a diagnosis of Wernick-Korsakoff syndrome was considered. After the administration of high dose vitamin B 1, the mental disorder dramatically relieved. Vitamin B 1 30 mg/d is maintained during peritoneal dialysis and the mental disorder does not relapse.
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Objective:To evaluate the diagnostic value of the Caprini risk assessment model combined with D-dimer in perioperative venous thromboembolic (VTE) of hysterectomy.Methods:The clinical data of 160 patients who had underwent hysterectomy in Lianjiang City Maternal and Child Health Hospital from February 2017 to February 2019 were retrospectively analyzed. During perioperative period, VTE occurred in 80 patients (VTE group), and 80 patients had no VTE (control group). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and Youden index of Caprini risk assessment model, D-dimer level detection and Caprini risk assessment model combined with D-dimer in the diagnosis of VTE were analyzed and compared, and the diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve.Results:The positive rates of Caprini risk assessment model and D-dimer in VTE group were significantly higher than those in control group: 87.50% (70/80) vs. 17.50% (14/80) and 90.00% (72/80) vs. 41.25% (33/80), and there was statistical difference ( P<0.05). The sensitivity, specificity, negative predictive value, positive predictive value, negative likelihood ratio, positive likelihood ratio and Youden index of the Caprini risk assessment model were 87.50% (70/80), 82.50% (66/80), 86.84% (66/76), 83.33% (70/84), 0.15, 0.50 and 0.70, respectively; the indexes of D-dimer were 90.00% (72/80), 58.75% (47/80), 85.45% (47/55), 68.57% (72/105), 0.17, 2.18 and 0.49, respectively; the indexes of Caprini risk assessment model combined with D-dimer were 97.50% (78/80), 52.50% (42/80), 95.45% (42/44), 67.24% (78/116), 0.05, 2.05 and 0.50, respectively. The areas under curve of Caprini risk assessment model, D-dimer and Caprini risk assessment model combined with D-dimer were 0.888, 0.877 and 0.945 (95% CI 0.833 to 0.943, 0.820 to 0.933 and 0.908 to 0.983, P < 0.01). Conclusions:Caprini risk assessment model and D-dimer have good results in the diagnosis of perioperative VTE of hysterectomy, and Caprini risk assessment model combined with D-dimer has the highest diagnostic value.
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Objective:To investigate the current management of nosocomial infection at medical institutions of all levels in Changzhou, so as to provide basis for standardizing nosocomial infections control of hospitals within a medical alliance.Methods:An electronic questionnaire was customized for online survey of 91 hospitals affiliated to eight regional medical alliances in Changzhou city in March 2019. The survey covered such aspects as general conditions of the hospital, profile of nosocomial infection control administrators and other staffing, supervision of hospital nosocomial infection programs, and training needs, as well as outstanding problems and suggestions.Frequency number and percentage represent enumeration data, and χ2 test was used to analyze the in-group differences of medical institutions of three levels. Results:Tertiary public hospitals were superior to the secondary and primary hospitals in organizational structure, professional staffing and target monitoring, with the differences of statistical significance( P<0.05). The most urgent training needs of medical institutions at all levels were knowledge in determination and reporting of infectious diseases/nosocomial infection/infection outbreaks; top imperatives and recommendations were development of operation rules for primary medical institutions and standardization of workflows. Conclusions:Staff of primary medical institutions need capacity building in nosocomial infection control; primary hospitals are equipped with incomplete nosocomial infection control information platform; key departments in general lack homogenous management. Tertiary hospitals are encouraged to play leadership in medical alliances in achieving standardized, homogenous and informationized nosocomial infection control within the medical alliances.
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Objective:To evaluate whether dialysis modality will affect cognitive function in dialysis population.Methods:This was a cross-sectional study. Chronic dialysis patients in our center was screened from July 2013 to July 2014. All of the subjects received brain magnetic resonance imaging (MRI) examination and comprehensive cognitive function evaluation.Results:A total of 189 chronic dialysis patients were enrolled in this study, 122 cases on hemodialysis (HD) and 67 cases on peritoneal dialysis (PD). There was no significant difference in age between HD and PD groups [(56.4±13.2) years vs (56.4±16.1) years, t=0.004, P=0.997]. The dialysis vintage and serum albumin of HD patients was higher than those of PD patients[58.0(16.8, 107.5) months vs 31.0(7.0, 67.0) months, Z=-3.490, P<0.001; (39.6±3.9) g/L vs (35.3±3.8) g/L, t=7.328, P<0.001, respectively]. The prevalence of cerebral small vessel diseases (CSVDs) was comparable between HD and PD groups (all P>0.05). Compared with HD patients, PD patients presented a 11.90-fold risk of immediate memory impairment (95% CI 1.40-101.08, P=0.023) and a 6.18-fold risk of long-delayed memory impairment (95% CI 2.12-18.05, P=0.001). After adjusting for age, educational lever, dialysis vintage, serum creatinine, and CSVDs, the influence of dialysis modality on memory still worked. PD patients presented a 43% risk of executive function impairment of HD patients ( OR=0.43, 95% CI 0.17-1.04, P=0.061). Conclusions:HD patients manifested better memory than PD patients, while PD probably performed better in executive function than HD patients. There was no significant difference in language function between the two groups. The difference in cognitive function may not be related to CSVDs.