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1.
Chinese Critical Care Medicine ; (12): 195-201, 2024.
Artículo en Chino | WPRIM | ID: wpr-1025373

RESUMEN

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

2.
Artículo en Chino | WPRIM | ID: wpr-1039114

RESUMEN

ObjectiveTo investigate the genetic polymorphism and structure of 47 autosomal microhaplotypes in the Han population in Changshu City, Jiangsu Province, and to evaluate the forensic efficiencies and forensic parameters. MethodsThe DNA library of unrelated individual samples was prepared according to MHSeqTyper47 kit manual and sequenced on the MiSeq FGx platform. Microhaplotype genotyping and sequencing depth statistics were processed using MHTyper. The genetic information of samples was then evaluated. The fixation index and genetic distance between the Jiangsu Changshu population and the reference populations in the 1000 Genomes Project phase 3 (1KG) were calculated, and forensic parameters were evaluated. ResultsThe fixation index and genetic distance between the Han population in Changshu, Jiangsu, and the CHB (Han Chinese in Beijing, China) reference population in 1KG were the lowest. The effective allele number (Ae) of each locus is also the closest between the two populations. The combined matching probability (CMP) of the Changshu Han population is close to the 5 populations of the East Asian reference super-population in 1KG, which is 1.25×10-36, and the combined probability of exclusion reached 0.999 999 999 964 1. ConclusionThis study reported the genetic polymorphism and allele frequency of 47 microhaplotypes in a Han population in Changshu City, Jiangsu Province. This information provides a data basis for 47 microhaplotypes in forensic applications. In addition, the polymorphism differences between the 1KG reference population and the Han population in Changshu, Jiangsu were compared, and the genetic structure of 47 microhaplotypes in the Han population in Changshu, Jiangsu was revealed. In general, the reference data of the East Asian super-population in 1KG is more in line with the genetic characteristics of Han population in Changshu, Jiangsu.

3.
Journal of Clinical Hepatology ; (12): 828-833, 2024.
Artículo en Chino | WPRIM | ID: wpr-1016532

RESUMEN

Acute hepatic porphyria (AHP) is a rare disease with abnormal heme metabolism, and breakthroughs have been made in the treatment of this disease in recent years. In addition to conventional treatment methods, this article reviews new therapies for AHP that are in the stage of initial clinical application or are still in the research stage, including RNAi therapy, enzyme replacement therapy, genetic supplementation of DNA or mRNA, drug molecular chaperones, and glycine transporter inhibitors for reducing heme synthesis. Moreover, this article also reviews the treatment of AHP-related comorbidities and complications, such as hyponatremia and posterior reversible encephalopathy syndrome. High glucose infusion is the main treatment method for AHP in China, and the improvement in diagnosis and increased attention to rare diseases in China has promoted the development of the diagnosis and treatment of AHP, and it is expected to explore more suitable treatment methods for AHP in the Chinese population in the future.

4.
Chinese Journal of Pediatrics ; (12): 126-130, 2023.
Artículo en Chino | WPRIM | ID: wpr-970250

RESUMEN

Objective: To explore the efficacy and safety of transcatheter pulmonary valve perforation in the treatment of neonatal pulmonary atresia with intact ventricular septum (PA-IVS). Methods: The clinical data on surgical treatment and follow-up in 16 patients with PA-IVS who underwent transcatheter pulmonary valve perforation in Women and Children's Hospital, Qingdao University from October 2018 to October 2021 were analyzed retrospectively. The right ventricular systolic pressure and percutaneous oxygen saturation (SpO2) were compared before and after operation. In addition, the SpO2 and echocardiographic data at preoperative and the last follow-up were compared. Comparisons between groups were performed using paired-samples t test. Results: Among the 16 patients (10 males and 6 females) with the age at operation of 19 (14, 26) days, 12 cases underwent transcatheter pulmonary valve perforation successfully, 2 cases were transferred to surgery department for open-heart pulmonary valvulotomy, and the remaining 2 cases were transmitted to surgery department for transthoracic pulmonary valve perforation. The age at operation of the 12 patients who underwent transcatheter pulmonary valve perforation was 18 (14, 27) days, and the weight was (3.6±0.4) kg. The immediate postoperative right ventricular systolic pressure decreased significantly ((57±16) vs. (95±19) mmHg (1 mmHg=0.133 kPa), t=7.49, P<0.001), and the postoperative SpO2 was improved effectively (0.90±0.48 vs.0.75±0.09, t=-5.61, P<0.001). The follow-up time was 22 (7, 33) months for 12 patients who underwent transcatheter pulmonary valve perforation successfully. At the last follow-up, the ratio of right to left ventricular transverse diameter was significantly higher than that before operative (0.55±0.05 vs. 0.45±0.05, t=-3.27,P=0.007). Furthermore, the Z-scores of pulmonary valvular diameter (-0.78±0.23 vs. -1.73±0.56, t=-8.52, P<0.001) and the tricuspid valvular diameter (-0.52±0.12 vs. -1.46±0.38, t=-10.40, P<0.001) were all significantly higher than preoperative data. At last, all the patients achieved biventricular circulation without death or major complications. Conclusion: Transcatheter pulmonary valve perforation is a safe and effective therapy for neonatal PA-IVS, and its curative effect has been confirmed by the medium follow-up data.


Asunto(s)
Niño , Masculino , Recién Nacido , Humanos , Femenino , Válvula Pulmonar/cirugía , Estudios Retrospectivos , Atresia Pulmonar/cirugía , Cardiopatías Congénitas
5.
Artículo en Chino | WPRIM | ID: wpr-970457

RESUMEN

Acute intermittent porphyria (AIP) has complicated clinical manifestations and is often accompanied by hypertension.AIP may cause hypertension through adrenergic effect,heme deficiency,inflammation,inappropriate secretion of antidiuretic hormone,toxicity of delta-aminolevulinic acid(ALA,aporphyrin precursor),and elevated serum glucose level.The prevention and treatment strategies for AIP accompanied with hypertension mainly include the controlling of porphyria attacks,application of antihypertensive drugs,lifestyle intervention,and management of latent AIP patients.


Asunto(s)
Humanos , Porfiria Intermitente Aguda , Glucemia , Hipertensión/etiología , Inflamación , Estilo de Vida
6.
China Pharmacy ; (12): 1252-1256, 2023.
Artículo en Chino | WPRIM | ID: wpr-973629

RESUMEN

OBJECTIVE To systematically evaluate the efficacy and safety of prophylactic use of low-dose hydrocortisone (HC) for the prevention and treatment of bronchopulmonary dysplasia (BPD), and to provide evidence-based reference for clinical treatment. METHODS PubMed, Embase, Web of Science, Cochrane Library, CJFD, VIP and Wanfang databases were searched by computer; randomized controlled trials (RCT) about prophylactic use of low-dose HC (trial group) versus placebo or dopamine (control group) in very premature infants were collected from the establishment of the database to Jun. 2022. The quality of the included literature was evaluated by using bias risk assessment tool recommended by Cochrane system evaluator’s manual (version 6.2) after screening the literature and extracting the data. Meta-analysis, sensitivity analysis and publication bias analysis were carried out with RevMan 5.3 statistical software. RESULTS A total of 1 437 very premature infants were included in 9 RCTs. Meta- analysis showed that the incidence of BPD [OR=0.75, 95%CI(0.58,0.95), P=0.02] and fatality [OR=0.72, 95%CI (0.54, 0.97), P=0.03] in trial group were significantly lower than control group; the survival rate without BPD [OR=1.36, 95%CI (1.06,1.74), P=0.02], the incidences of gastrointestinal perforation [OR=2.23, 95%CI (1.31,3.78), P=0.003] and sepsis [OR= 1.27, 95%CI (1.01,1.60), P=0.04] in trial group were all significantly higher than control group. There was no significant difference in the incidence of necrotizing enterocolitis, paraventricular leukomalacia, intraventricular hemorrhage, patent ductus arteriosus, hyperglycemia, pneumothorax, retinopathy of premature infants between the two groups (P>0.05). Results of sensitivity analysis showed that study results were robust. Results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS The early prophylactic use of low-dose HC can reduce BPD in very premature infants, reduce fatality, and improve the survival rate without BPD, but we should pay attention to gastrointestinal perforation and sepsis.

7.
Neuroscience Bulletin ; (6): 731-744, 2023.
Artículo en Inglés | WPRIM | ID: wpr-982448

RESUMEN

Acetylcholine (ACh) is an important neuromodulator in various cognitive functions. However, it is unclear how ACh influences neural circuit dynamics by altering cellular properties. Here, we investigated how ACh influences reverberatory activity in cultured neuronal networks. We found that ACh suppressed the occurrence of evoked reverberation at low to moderate doses, but to a much lesser extent at high doses. Moreover, high doses of ACh caused a longer duration of evoked reverberation, and a higher occurrence of spontaneous activity. With whole-cell recording from single neurons, we found that ACh inhibited excitatory postsynaptic currents (EPSCs) while elevating neuronal firing in a dose-dependent manner. Furthermore, all ACh-induced cellular and network changes were blocked by muscarinic, but not nicotinic receptor antagonists. With computational modeling, we found that simulated changes in EPSCs and the excitability of single cells mimicking the effects of ACh indeed modulated the evoked network reverberation similar to experimental observations. Thus, ACh modulates network dynamics in a biphasic fashion, probably by inhibiting excitatory synaptic transmission and facilitating neuronal excitability through muscarinic signaling pathways.


Asunto(s)
Colinérgicos/farmacología , Acetilcolina/metabolismo , Neuronas/metabolismo , Transmisión Sináptica/fisiología
8.
Chinese Critical Care Medicine ; (12): 404-408, 2023.
Artículo en Chino | WPRIM | ID: wpr-982602

RESUMEN

OBJECTIVE@#To compare the ability of the step-by-step approach and the lab-score method in early identification of non-bacterial infection in febrile infants with less than 90 days old.@*METHODS@#A prospective study was conducted. The febrile infants with less than 90 days old hospitalized in the department of pediatrics of Xuzhou Central Hospital from August 2019 to November 2021 were enrolled. The basic data of the infants were recorded. The infants with high risk or low risk of bacterial infection was evaluated by the step-by-step approach and the lab-score method, respectively. The step-by-step approach was based on clinical manifestations, age, blood neutrophil absolute value or C-reactive protein (CRP), urine white blood cells, blood venous blood procalcitonin (PCT) or interleukin-6 (IL-6) to gradually assess the high risk or low risk of bacterial infection in infants with fever. The lab-score method was based on the levels of laboratory indicators such as blood PCT, CRP and urine white blood cells, which were assigned different scores to evaluate the high risk or low risk of bacterial infection in febrile infants according to the total score. Using clinical bacterial culture results as the "gold standard", the negative predictive value (NPV), positive predictive value (PPV), negative likelihood ratio, positive likelihood ratio, sensitivity, specificity, and accuracy of the two methods were calculated. The consistency of the two evaluation methods was tested by Kappa.@*RESULTS@#A total of 246 patients were enrolled in the analysis, and ultimately confirmed by bacterial culture as non-bacterial infections in 173 cases (70.3%), bacterial infection in 72 cases (29.3%), and unclear in 1 case (0.4%). There were 105 cases with low risk evaluated by the step-by-step approach, and 98 cases (93.3%) were ultimately confirmed as non-bacterial infection; 181 cases with low risk evaluated by the lab-score method, and 140 cases (77.4%) were ultimately confirmed as non-bacterial infection. The consistency of the two evaluation methods was poor (Kappa value = 0.253, P < 0.001). The ability of the step-by-step approach in early identification of non-bacterial infection in febrile infants with less than 90 days old was superior to the lab-score method (NPV: 0.933 vs. 0.773, negative likelihood ratio: 5.835 vs. 1.421), but the sensitivity of the former was lower than that of the latter (0.566 vs. 0.809). The ability of the step-by-step approach in early identification of bacterial infection in febrile infants with less than 90 days old was similar to the lab-score method (PPV: 0.464 vs. 0.484, positive likelihood ratio: 0.481 vs. 0.443), but the specificity of the former was higher than that of the latter (0.903 vs. 0.431). The overall accuracy of the step-by-step approach and the lab-score method was similar (66.5% vs. 69.8%).@*CONCLUSIONS@#The ability of the step-by-step approach in early identification of non-bacterial infections in febrile infants with less than 90 days old is superior to the lab-score method.


Asunto(s)
Humanos , Lactante , Niño , Estudios Prospectivos , Infecciones Bacterianas , Proteína C-Reactiva , Hospitales , Interleucina-6 , Polipéptido alfa Relacionado con Calcitonina
9.
Artículo en Chino | WPRIM | ID: wpr-990721

RESUMEN

Objective:To study the risk factors, diagnosis and treatment of transient hyperinsulinemic hypoglycemia (HH) in newborns.Methods:From January 2016 to December 2020, newborns with transient HH (HH group) admitted to our hospital were enrolled in this retrospective nested case-control study. Newborns with similar gestational age (GA) (differences of GA<2 w) without HH were matched with 1∶2 ratio as the non-HH group. Clinical characteristics of the two groups were compared and the risk factors and therapeutic results of HH in newborns were analyzed using SPSS 20.0 statistical software.Results:A total of 39 cases were included in the HH group and 75 cases were matched in the non-HH group. The proportion of small for gestational age (SGA) [51.3%(20/39) vs. 32.0%(24/75)], the amount of amino acids (AA) in intravenous infusion[1.0(0.0,1.0) g/(kg·d) vs. 0.0(0.0,1.0) g/(kg·d)], the incidence of hypoglycemia [(4.3±1.9) times vs. (3.6±1.3) times] and the maximum glucose infusion rate (GIR)[(8.3±2.5) mg/(kg·min) vs. (7.4±1.1) mg/(kg·min)] in the HH group were higher than the non-HH group (all P<0.05). The platelet count in the HH group were lower than the non-HH group [(186.9±60.9)×10 9/L vs. (215.3±61.7)×10 9/L, P<0.05]. SGA ( OR=2.535, 95% CI 1.077~5.971), the amount of intravenous AA ( OR=2.180, 95% CI 1.029~4.619) and the maximum GIR ( OR=1.405, 95% CI 1.088~1.815) were independent risk factors for transient HH. In the HH group, 28/39 cases were treated with Diazoxide or Octreotide and the therapeutic effects were good with few adverse drug reactions (ADR). 37/39 cases were recovered within 28 d of birth and the other 2 cases were recovered at 2.5 m and 3.5 m, respectively. Conclusions:SGA, the amount of intravenous AA and higher GIR are risk factors for transient HH in newborns. Diazoxide or Octreotide are effective with few ADR in the treatment of transient HH. Most patients will recover from transient HH in 2 w to 3 m.

10.
Artículo en Chino | WPRIM | ID: wpr-991369

RESUMEN

Objective:To understand the current situation and influencing factors of depression among residents in Chongqing, and to explore the relationship between depression and administration satisfaction of the standardized residency training.Methods:Stratified random cluster sampling was used to select 372 residents currently participating the standardized residency training in Chongqing. The patient health questionnaire (PHQ-9) and administration satisfaction of residency training questionnaire were used to conduct a cross-sectional survey on the depression status and satisfaction of residents in Chongqing. SPSS 21.0 software package was used for partial correlation analysis and binary logistic regression analysis to explore the relationship between depression and administration satisfaction of the standardized residency training.Results:Among the 372 residents, 218 had mild depression and above (58.60%). There was a significant difference in the incidence of depression among residents of different ages, educational background, marital status, working hours and administration satisfaction of residency training ( χ2 = 23.02, 17.35, 12.24, 21.70, 95.20; P = 0.028, 0.027, 0.016, 0.041, <0.001 respectively). Partial correlation analysis showed that there was a negative correlation between the total score of depression and the five aspects of the administration satisfaction (total score, instructors, training base, managers and training income) ( r=-0.52, -0.45, -0.47, -0.45, -0.40, all P<0.01). In the binary logistic regression analysis of depression and satisfaction,the satisfaction had a negative impact on depression, and its B value was -1.71, and OR value was 0.18, P<0.001. Conclusion:The incidence of depression among residents in Chongqing is high. Age, educational background, marital status, working hours and administration satisfaction are related to the degree of depression. And the higher the degree of depression, the lower the administration satisfaction of residents. Relevant departments should pay attention to the mental health of residents and improve the quality of standardized residency training.

11.
Artículo en Chino | WPRIM | ID: wpr-998239

RESUMEN

ObjectiveTo observe the effect of proprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation on chronic ankle instability (CAI). MethodsFrom April, 2016 to December, 2021, 48 patients with CAI were randomly divided into control group (n = 24) and observation group (n = 24). Both groups accepted routine rehabilitation, and the observation group accepted proprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation additionally, for eight weeks. They were assessed with Visual Analogue Scale (VAS), peak torque to body weight of ankle dorsiflexors and plantarflexors (AD/W, AP/W), Y Balance Test (YBT) and Foot and Ankle Disability Index (FADI) before and after treatment. ResultsAfter treatment, VAS score, AD/W, AP/W, YBT and FADI improved in the observation group (|t| > 2.208, P < 0.05), while VAS score and AP/W improved in the control group (|t| > 2.156, P < 0.05); and all the VAS score, AD/W, AP/W, YBT and FADI were better in the observation group than in the control group (|t| > 2.067, P < 0.05). ConclusionProprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation can effectively relieve the pain of patients with CAI, and increase the muscle strength around the ankle, to improve the stability and balance.

12.
Chinese Pharmacological Bulletin ; (12): 1493-1499, 2023.
Artículo en Chino | WPRIM | ID: wpr-1013729

RESUMEN

Aim To investigate the effect of miR-124a on oxidative stress injury and β-cell function of pancreas in type 2 diabetic mice. Methods The wild-type C57BL/6 mice and the C57BIV6 mice with low expression of miR-124a were randomly divided into two groups, namely wild-type control (WT Con), miR-124a

13.
Chinese Journal of Neonatology ; (6): 615-620, 2023.
Artículo en Chino | WPRIM | ID: wpr-1022518

RESUMEN

Objective:To study the efficacy and safety of oral acetaminophen or high-dose ibuprofen as rescue treatment after failure of conservative management in very preterm infants (VPIs) with haemodynamically significant patent ductus arteriosus (hsPDA).Methods:From May 2020 to November 2022, VPIs with hsPDA (gestational age<32 weeks and age 4~6 d) admitted to NICU of our hospital were prospectively enrolled. The rescue treatment was initiated if hsPDA still exist after 3~4 d of conservative management. The infants were randomly assigned into acetaminophen group (oral acetaminophen 15 mg/kg, once every 6 h for 3 d) and high-dose ibuprofen group (oral ibuprofen 20 mg/kg for the first dose, 10 mg/kg each dose after 24 h and 48 h). Before and after rescue treatment, the following were recorded: echocardiography, complete blood count, biochemistry, B-type natriuretic peptide (BNP), fecal occult blood test (FOBT) and transcranial Doppler ultrasound. Urine output and complications were also examined. SPSS 20.0 was used for statistical analysis.Results:A total of 36 cases were in the acetaminophen group and 37 in the high-dose ibuprofen group. The two groups showed similar efficacy as rescue treatment [80.6% (29/36) vs. 78.4% (29/37), P>0.05]. No significant differences existed in the incidences of upper gastrointestinal bleeding, positive FOBT, oliguria, stage Ⅱ-Ⅲ necrotizing enterocolitis and stage Ⅲ-Ⅳ intraventricular hemorrhage between the two groups ( P>0.05). After rescue treatment, the serum cystatin C in high-dose ibuprofen group was higher [(1.72±0.29) mg/L vs. (1.58±0.26) mg/L] and 24-hours urine output was lower [(3.1±1.0) ml/(kg·h) vs. (3.7±0.7) ml/(kg·h)] than the acetaminophen group (all P<0.05). No significant differences existed in serum creatinine, platelet count, BNP, alanine aminotransferase and total serum bilirubin between the two groups ( P>0.05). Conclusions:After failure of early conservative management in VPIs with hsPDA, when initiated within 7-10 d after birth, rescue treatment with oral acetaminophen or high-dose ibuprofen has a similar efficacy of 80%, and both drugs are safe. Oral high-dose ibuprofen may have a greater effect on renal function than acetaminophen.

14.
Artículo en Chino | WPRIM | ID: wpr-953907

RESUMEN

ObjectiveTo determine the pathogen and phylogenetic characteristics of an uncommon outbreak of recombinant norovirus infection in Daishan County in February 2022. MethodsFluorescence quantitative PCR was used to detect the norovirus in the eight anal swabs collected in the outbreak. In the positive samples, reverse transcription PCR were used to amplify the norovirus. Norovirus sequences were characterized by MEGA7 and Simplot. ResultsNorovirus GⅠ was identified in all eight anal samples. It was further determined to be recombinant norovirus GⅠ.6 [P11], with the recombination site at the ORF1-ORF2 junction. The sequence had the highest nucleotide identity (98.75%) to a GⅠ.6[P11] strain collected in 2018 (GenBank accession number MT357995). ConclusionAccording to the etiological identification and phylogenetic analysis, this outbreak is confirmed to be caused by the uncommon recombinant norovirus GⅠ.6 [P11] in China.

15.
Chinese Journal of Neonatology ; (6): 488-493, 2022.
Artículo en Chino | WPRIM | ID: wpr-955278

RESUMEN

Objective:To compare left and right ventricular Tei indexes and to determine the reference range in newborns of different gestational age (GA) and birth weight (BW).Methods:From February 2019 to June 2021, newborns admitted to the Neonatal Intensive Care Unit of our hospital were enrolled. Tei indexes were measured and calculated during 24 h~7 d after birth and reexamined 1~2 weeks later in some of the newborns. The newborns were assigned into <32 w group, 32~36 w group and ≥ 37 w group according to their GA, < 1 500 g group, 1 500~2 499 g group and ≥2 500 g group according to their BW, and early newborn group (1~7 d) and late newborn group (>7 d) according to their age of evaluation. The data were analyzed using t test, one-way analysis of variance (ANOVA) and correlation analysis with SPSS 20.0 statistical software. Results:A total of 128 cases were included. 42 cases in <32 w group, 43 in 32~36 w group and 43 in ≥37 w group. 42 cases in <1 500 g group, 42 in 1 500 ~ 2 499 g group and 44 in ≥2 500 g group. Tei indexes were reexamined after 7 d of age in 63 preterm infants and in 31 full-term infants. The left and right ventricular Tei indexes of the ≥37 w group were less than the 32~36 w group and the <32 w group in early newborns (left ventricular: 0.382±0.069 vs. 0.431±0.069 and 0.439±0.060, right ventricular: 0.373±0.038 vs. 0.431±0.035 and 0.452±0.064); the right ventricular Tei index of the 32~36 w group was significantly less than the <32 w group ( P<0.05). No significant differences existed in the left ventricular Tei index between the 32 ~ 36 w group and the < 32 w group ( P>0.05). The left and right ventricular Tei indexes of the ≥2 500 g group were significantly less than the 1 500~2 499 g group and the <1 500 g group (left ventricular: 0.385±0.069 vs. 0.434±0.067 and 0.434±0.064, right ventricular: 0.376±0.039 vs. 0.431±0.043 and 0.450±0.061) ( P<0.05).No significant differences existed between the 1 500~2 499 g group and the <1 500 g group ( P>0.05). No significant differences existed in the left and right ventricular Tei indexes between the late newborn group and early newborn group ( P>0.05). For early newborns (1~7 d of age), the reference range of Tei index gradually decreased along with the increase of GA and BW. Conclusions:The left and right ventricular Tei indexes of full-term infants and infants with BW ≥2 500 g are less than preterm and low birth weight infants. The reference range of Tei index in early newborns shows negative correlation with GA and BW.

16.
Artículo en Chino | WPRIM | ID: wpr-955685

RESUMEN

Objective:To establish an assessment index system on the capacity of clinical medical postgraduate tutor.Methods:On the basis of "literature optimization method", the index system was initially constructed by 14 experts with "Delphi method". Then, through the survey of 109 people, the reliability and validity were tested by Cronbach's α coefficient and exploratory factor analysis. And analytic hierarchy process was used to calculate the weight coefficient of each index. SPSS 26.0 and AMOS 26.0 were applied for statistical analysis. Results:The assessment index system consisted of 2 first-level indexes, 5 second-level indexes and 27 third-level indexes. The Cronbach's α coefficient of the total index system, first-level indexes and second-level indexes ranged from 0.833 to 0.931. Five common factors were extracted by exploratory factor analysis, and the connotation of factors were basically consistent with the theoretical structure. A confirmatory factor model was established with 5 second-level indexes as the first-order factors, what's more, the theoretical model fitted well with the actual data. The combined weight values of "teaching attitude of the tutor", "medical ethics of the tutor", "scientific research projects of the tutor", "dissertation quality of the graduate students", "the quality of the scientific research and training of the graduate students", "the quality of the clinical training of the graduate students", and "disposable scientific research funds of the tutor" ranked in the top 7 weights of third-level indexes. Conclusion:This assessment index system has good reliability and validity with reasonable connotation, which could be used as a reference for tutor evaluation.

17.
Artículo en Chino | WPRIM | ID: wpr-957236

RESUMEN

Objective:To analyze the correlation between the body composition and cardiorespiratory fitness (CRF) decline in physical examination population of different genders.Methods:Clinical data of the cardiopulmonary exercise testing (CPET) and body composition analysis of 439 people who received physical examination in the Medical Examination Center of Peking University Third Hospital from May 2021 to September 2021 were retrospectively analyzed. The general data, physical examination, biochemical parameters, body composition and CPET results were collected. The subjects were divided into normal group and decline group according to the percentage of peak oxygen uptake (VO 2peak) levels ≥ 85% or<85%. Multivariate logistic regression was applied to investigate the influencing factors of CRF decline in subjects of different genders. Results:Among men, total cholesterol and triglyceride in the decline group were significantly higher than those in the normal group [(5.097±0.890) vs (4.865±0.856) mmol/L, (1.778±1.200) vs (1.485±0.709) mmol/L], and the blood homocysteine (Hcy) and skeletal muscle index were significantly lower than those in the normal group [13.00 (11.30, 15.90) vs 13.80 (12.05, 17.10) μmol/L, (7.89±0.65) vs (8.08±0.64) kg/m 2] (all P<0.05). Among women, skeletal muscle index in the decline group was significantly lower than that in the normal group [(6.21±0.52) vs (6.53±0.56)kg/m 2], and percent body fat was significantly higher than that in the normal group [(32.83±4.92)% vs (31.21±4.55)%] (all P<0.05). The elevation of triglyceride level ( OR=1.487, 95% CI: 1.042-2.121) and visceral fat area ( OR=1.032, 95% CI: 1.014-1.051) were positively correlated with the decline of CRF in man, the decrease of skeletal muscle index ( OR=0.215, 95% CI: 0.106-0.435) and the increase of percent body fat ( OR=1.149, 95% CI: 1.060-1.245) were positively correlated with the decrease of CRF in women (all P<0.05). Conclusions:There is a correlation between body composition and CRF decline in physical examination population of different genders. Men should control visceral fat more effectively, and women should pay attention to increase muscle mass while reducing body fat, in order to improve CRF.

18.
Artículo en Chino | WPRIM | ID: wpr-957619

RESUMEN

Hyponatremia is common in the attack of acute intermittent porphyria(AIP), which can cause epilepsy, coma and other adverse events and endanger the life of patients. Carbohydrate loading therapy is applied to control the attack of AIP in the clinic. But the application of glucose can exacerbate hyponatremia. It is difficult for clinicians to effectively correct hyponatremia while treating AIP with glucose. We reported a case of AIP whose refractory hyponatremia was corrected with short-term low-dose tolvaptan to improve knowledge in management.

19.
Artículo en Chino | WPRIM | ID: wpr-957910

RESUMEN

Objective:To investigate the effects of non-invasive positive pressure ventilation (NPPV) on plasma B-type natriuretic peptide (BNP) level and Tei index of right ventricle in preterm infants.Methods:Premature infants of gestational age<34 weeks with respiratory distress syndrome who were admitted in Neonatal Intensive Care Unit of Xuzhou Central Hospital and requiring for NPPV from December 2018 to October 2020, were enrolled in the study. Patients were randomly divided into two groups 46 patients received nasal continuous positive airway pressure ventilation (NCPAP group) and 49 patients received bi-level positive airway pressure ventilation (BiPAP group); 42 preterm infants of gestational age<34 weeks and without NPPV were selected as the control group. The plasma BNP, Tei index of right ventricle, mean airway pressure and oxygen index at 0-12 h and 48-60 h after NPPV were monitored in NCPAP group and BiPAP group. The plasma BNP and Tei index of right ventricle at 0-12 h and 48-60 h after admission were monitored in the control group. SPSS 20.0 statistical software was used for data analysis.Results:(1)The plasma BNP and Tei index of right ventricle at 48-60 h after NPPV were significantly higher than those at 0-12 h after NPPV in NCPAP group and BiPAP group [NCPAP group: (287.5±155.5) vs. (179.9±102.3) ng/L, (0.43±0.08) vs. (0.38±0.06); BiPAP group: (303.1±135.4) vs. (186.5±95.6) ng/L, (0.45±0.08) vs. (0.39±0.06); t=6.00, 3.34, 7.47, 4.48; all P<0.05]. There were no significant differences in the plasma BNP and Tei index of right ventricle at 48-60 h and 0-12 h after admission in the control group [(181.9±86.8) vs. (169.5±78.9) ng/L, (0.34±0.05) vs. (0.36±0.05); t=0.83, -1.59; all P>0.05].(2) There were no significant differences in the plasma BNP and Tei index of right ventricle at 48-60 h after NPPV between NCPAP group-and BiPAP group (all P>0.05), but they were significantly higher than those in control group at 48-60 h after admission(all P<0.05). (3)The mean airway pressure and oxygen index at 48-60 h after NPPV in NCPAP group and BiPAP group showed a decrease trend compared to those at 0-12 h after NPPV, but the differences were not significant [NCPAP group: (6.8±1.2) vs. (7.0±1.3) cmH 2O(1 cmH 2O=0.098 kPa), (5.7±2.1) vs. (6.1±2.3); BiPAP group: (7.0±1.3) vs. (7.2±1.2) cmH 2O, (5.5±2.0) vs. (5.8±2.1); t=-1.05, -0.80, -1.88, -0.67; all P>0.05]; while there were no significant differences between the two groups (all P>0.05). (4)There was a positive correlation between the plasma BNP and mean airway pressure ( r=0.48, P<0.001), but no correlation between Tei index of right ventricle and mean airway pressure ( r=0.17, P=0.119) at 48-60 h after NPPV. Conclusion:The cardiac function indexes such as plasma BNP and Tei index of right ventricle in preterm infants are increased at 48-60 h after NPPV. When mean airway pressure is the same, the effects of NCPAP and BiPAP on plasma BNP and Tei index of right ventricle in preterm infants are similar.

20.
Artículo en Chino | WPRIM | ID: wpr-957915

RESUMEN

The top-level design and training system of standardized training for residents has been basically completed in China, and now is gradually transiting to connotation construction and quality improvement, with the emphasis on post competency and quality as the core. There are discrepancies in clinical ability among general practice residents of different categories, so the step-up training mode should be adapted for set up and implement of phased training objectives to achieve the overall goal of training qualified general practitioners. The step-up training based on the framework of entrustable professional activities(EPAs)can quantitatively and qualitatively evaluate the competency of general practice residents and continuously track it, so that to ensure the competency of residents. This study has developed assessment item pools of EPAs-based step-up training for general practice residents through literature review and focus group discussion, and proposed implementation plans, and explored the application of EPAs in the step-up training of general practice residents.

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