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Objective To investigate the occurrence of multiple organ dysfunction syndrome(MODS)in patients with basal ganglia hypertensive intracerebral hemorrhage,and analyze its influencing factors.Methods A total of 100 patients with cerebral hemorrhage in our hospital were selected as the research objects.Patients were divided into MODS group and non-MODS group according to whether or not the occurrence of MODS occurred.The clinical data of the two groups were collected.Logistic regression was used to analyze related influencing factors,and ROC curve was used to evaluate the predictive value of Logistic regression model.Results The Logistic regression equation showed that age,time from onset to admission,hematoma volume,Acute Physiology and Chronic Health Status Rating System Ⅱ(APACHEⅡ)score,duration of postoperative mechanical ventilation,fasting plasma glucose(FPG)and delayed surgery were all independent risk factors for the occurrence of MODS in patients with basal ganglia hypertensive cerebral haemorrhage,and GCS score was an independent protective factor for the occurrence of MODS in patients with basal ganglia hypertensive cerebral haemorrhage(all P＜0.05).The ROC curve plotted according to predicted and true values showed that when Log(P)＞3.74,the sensitivity was 84.62%and the specificity was 90.16%;the standard regression coefficients calculated by the partial standardization method yielded that in the Logistic regression analysis.The independent influencing factors in order of importance were APACHEⅡ score,age,FPG,haematoma volume,postoperative mechanical ventilation time,GCS score,time from onset to admission,and delayed surgery.Conclusions Affected by many factors such as age,time from onset to hospital admission,hematoma volume,APACHEⅡ score,postoperative mechanical ventilation time,FPG and so on,patients with cerebral hemorrhage are at risk of MODS.In clinical work,the management of the above factors can be strengthened to reduce the incidence of MODS.
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Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.
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Objective:To evaluate the screening value of serum pepsinogen (PG) Ⅰ, pepsinogen ratio (PGR, PG Ⅰ/PG Ⅱ) and gastrin 17 (G17) levels combined with gastroscopy for early-stage gastric cancer in high incidence areas of gastric cancer in Qinghai Province.Methods:A total of 2 700 cases were identified as the appropriate age (40-69 years) target population through the questionnaire survey from 25 000 local residents in high incidence areas of gastric cancer in Qinghai Province. The serum PGⅠ, PGⅡ and G17 levels of the 2 700 target population were determined by ELISA, and PGR were calculated. And then 949 patients with abnormal levels of PG and G17 were screened out as a high-risk group of gastric cancer to receive gastroscopy and pathologic biopsy. According to the results of gastroscopy and biopsy, the patients were divided into non-atrophic gastritis group, atrophic gastritis group, peptic ulcer group, early-stage gastric cancer group, and advanced gastric cancer group. The optimal threshold and its sensitivity and specificity of serum PG Ⅰ, PGR and G17 levels for diagnosis of early-stage and advanced gastric cancer were determined based on the receiver operator characteristic curve (ROC).Results:Totally 949 cases received gastroscopy and 649 cases received pathological biopsy, including 239 cases of non-atrophic gastritis, 500 cases of atrophic gastritis, 197 cases of peptic ulcer, 5 cases of early-stage gastric cancer, and 8 cases of advanced gastric cancer. The level of serum PG Ⅰ in the early-stage gastric cancer group (70.00±12.35 μg/L) and advanced gastric cancer group (38.39±2.77 μg/L) was significant lower than that in the non-atrophic gastritis group (103.89±37.45 μg/L, both P<0.05), and the value of early-stage gastric cancer group was obviously higher than that of advanced gastric cancer group ( P<0.05). The PGR of the early-stage gastric cancer group (3.74±1.40) and the advanced gastric cancer group (2.05±0.59) was significantly lower than that in the non-atrophic gastritis group (9.18±4.10, both P<0.05), and the value of early-stage gastric cancer group was significantly higher than that of the advanced gastric cancer group ( P<0.05). The level of serum G17 in the early gastric cancer group (18.03±4.52 pmol/L) and the advanced gastric cancer group (25.15±3.76 pmol/L) was significantly higher than that in the non-atrophic gastritis group (14.99±7.12 pmol/L, both P<0.05), and the level of early-stage gastric cancer group was significantly lower than that of advanced gastric cancer group ( P<0.05). According to the analysis of ROC in the diagnosis of early-stage gastric cancer, the best threshold of PG Ⅰ, PGR and G17 was 71.85 μg/L, 5.04, and 15.65 pmol/L, respectively, and the corresponding sensitivity and specificity was 80.0% and 59.0%, 100.0% and 70.4%, and 80.0% and 69.3%, respectively, for PG Ⅰ, PGR and G17. The analysis of ROC in the diagnosis of advanced gastric cancer showd that the best critical value of PG Ⅰ, PGR and G17 was 42.55 μg/L, 2.79 and 20.55 pmol/L, respectively, and the corresponding sensitivity and specificity was 100.0% and 95.3%, 100.0% and 92.1%, and 100.0% and 89.7%, respectively. Conclusion:Using serological detection of PG and G17 to screen high-risk group of gastric cancer, and then making diagnosis by gastroscopy and biopsy is an effective, low-cost and non-invasive approach for the early-stage gastric cancer in high incidence areas of gastric cancer in Qinghai Province.
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Objective@#To explore the effect of extended nursing service on malnutrition in patients undergoing maintenance hemodialysis combined with peritoneal dialysis.@*Methods@#According to the formula, 124 patients with malnutrition in maintenance hemodialysis combined with peritoneal dialysis were divided into intervention group and control group by lottery, 62 in intervention group and 62 in control group. The control group received routine specialist nursing and health education during hospital dialysis, while the intervention group received extended nursing services for 6 months, including telephone follow-up, knowledge lectures and Wechat interaction. The nutritional status of two groups of patients was assessed by modified subjective comprehensive nutrition assessment (MQSGA) one day before the implementation of extended nursing service, three months and six months after the implementation of extended nursing service, and the body mass index(BMI), albumin, prealbumin, hemoglobin, serum calcium and serum phosphorus were measured at the same time.@*Results@#There was no significant difference in nutritional status, BMI and blood index between the two groups before intervention (P > 0.05). After 3 months and 6 months of intervention, MQSGA scores of intervention group were (13.28±3.99), (10.17±3.43) respectively, which were significantly lower than those of control group (15.32±3.52), (14.37±3.73). There were significant differences between the two groups (t=2.946, 6.336, P<0.01). After 3 months and 6 months of intervention, BMI was (18.29±2.27), (20.27±2.09) kg/m2, respectively, which were significantly higher than those of control group (16.41±2.32), (16.49±2.26) kg/m2. The difference between the two groups was significant (t=-4.430, -9.372, P <0.01). After 3 months of intervention, albumin, preaalbumin, hemoglobin, serum calcium, and serum inorganic phosphorus in intervention group were (35.63±4.24) g/L, (277.57±29.52) mg/L, (102.03±11.21) g/L,(2.01±0.19) mmol/L, (1.74±0.37) mmol/L; and the control group were (33.19±4.89) g/L, (216.81±24.06) mg/L, (92.58±13.79) g/L, (1.91±0.21) mmol/L, (2.05±0.49) mmol/L, respectively. After 6 months of intervention, the intervention groups were (41.49±6.14) g/L, (344.60±30.56) mg/L, (111.34±10.09) g/L, (2.28±0.18) mmol/L, (1.45±0.33) mmol/L, the control group were (34.16±4.71) g/L, (218.63±24.85) mg/L, (94.36±11.21) g/L, (1.99±0.24) mmol/L, (1.95±0.41) mmol/L. There were significant differences between the two groups (t=-24.484-7.220, P<0.01).@*Conclusions@#Extended nursing service can significantly improve the nutritional status of patients undergoing maintenance hemodialysis combined with peritoneal dialysis.
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Objective:To explore the effect of extended nursing service on malnutrition in patients undergoing maintenance hemodialysis combined with peritoneal dialysis.Methods:According to the formula, 124 patients with malnutrition in maintenance hemodialysis combined with peritoneal dialysis were divided into intervention group and control group by lottery, 62 in intervention group and 62 in control group. The control group received routine specialist nursing and health education during hospital dialysis, while the intervention group received extended nursing services for 6 months, including telephone follow-up, knowledge lectures and Wechat interaction. The nutritional status of two groups of patients was assessed by modified subjective comprehensive nutrition assessment (MQSGA) one day before the implementation of extended nursing service, three months and six months after the implementation of extended nursing service, and the body mass index(BMI), albumin, prealbumin, hemoglobin, serum calcium and serum phosphorus were measured at the same time.Results:There was no significant difference in nutritional status, BMI and blood index between the two groups before intervention ( P > 0.05). After 3 months and 6 months of intervention, MQSGA scores of intervention group were (13.28±3.99), (10.17±3.43) respectively, which were significantly lower than those of control group (15.32±3.52), (14.37±3.73). There were significant differences between the two groups ( t=2.946, 6.336, P<0.01). After 3 months and 6 months of intervention, BMI was (18.29±2.27), (20.27±2.09) kg/m 2, respectively, which were significantly higher than those of control group (16.41±2.32), (16.49±2.26) kg/m 2. The difference between the two groups was significant ( t=-4.430, -9.372, P <0.01). After 3 months of intervention, albumin, preaalbumin, hemoglobin, serum calcium, and serum inorganic phosphorus in intervention group were (35.63±4.24) g/L, (277.57±29.52) mg/L, (102.03±11.21) g/L,(2.01±0.19) mmol/L, (1.74±0.37) mmol/L; and the control group were (33.19±4.89) g/L, (216.81±24.06) mg/L, (92.58±13.79) g/L, (1.91±0.21) mmol/L, (2.05±0.49) mmol/L, respectively. After 6 months of intervention, the intervention groups were (41.49±6.14) g/L, (344.60±30.56) mg/L, (111.34±10.09) g/L, (2.28±0.18) mmol/L, (1.45±0.33) mmol/L, the control group were (34.16±4.71) g/L, (218.63±24.85) mg/L, (94.36±11.21) g/L, (1.99±0.24) mmol/L, (1.95±0.41) mmol/L. There were significant differences between the two groups ( t=-24.484-7.220, P<0.01). Conclusions:Extended nursing service can significantly improve the nutritional status of patients undergoing maintenance hemodialysis combined with peritoneal dialysis.
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Objective To investigate the effect of ulinastatin combined pantoprazole on inflammatory factors and gastrointestinal tract in patients undergoing cardiopulmonary bypass ( CBP) cardiac surgery. Methods A total of 200 patients who suffered rheumatic heart disease were scheduled for valve replacement surgery with CPB, were randomly divided into four groups:control group (CON),ulinastatin (UTI),pantoprazole groups (PTZ) and ulinastatin+pantoprazole groups(UTI+PTZ),50 cases in each group.Before CBP,group UTI was given ulinastatin 10 000 U·kg-1,group PTZ was given pantoprazole 40 mg,group UTI+PTZ was given ulinastatin 10 000 U·kg-1and pantoprazole 40 mg,group CON was given 0.9% sodium chloride soution.The gastric mucosa pHi and blood samples would be collected in all four groups at the preoperative (t1),CPB 30 min (t2),after CBP (t3),6 h after surgery (t4),24 h (t5) five time points.The IL-6 and TNF-α would be detected by enzyme linked immunosorbent (ELISA) method,and abdominal distension,abdominal pain,hematemesis,black and defecate occult blood test positive for digestive tract related complications would be collected after the surgery 1,2 days. Results The concentration of TNF-α and IL-6 at t2,t3, t4,t5were higher than those at t1in all four groups(P<0.05).Compared with CON group,the concentration of TNF-α and IL-6 at t2, t3,t4,t5in UTI,PTZ and UTI+PTZ group were significantly decreased (P<0.05).The concentration of TNF-α and IL-6 in UTI and UTI+PTZ group were better than in PTZ group.The pHi at t2,t3,t4was lower than that at t1in four groups(P<0.05),and pHi at t5 was obviously lower than that at t1in group CON (P<0.05).The pHi at t2,t3,t4in UTI,PTZ and UTI+PTZ group was higher than that in CON group ( P<0. 05), and pHi in UTI+PTZ group was better than that in UTI and PTZ group. The postoperative gastrointestinal complications in CON group were higher than those in UTI,PTZ and UTI+PTZ group (P<0.05). Conclusion Ulinastatin combined with pantoprazole for patients undergoing CPB heart surgery,can significantly reduce the release of TNF-α and IL-6、increase gastric pHi and reduce the incidence of gastrointestinal complications.
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ObjectiveTo investigate the ultrasonic features of phyllodes tumors of the breast (PTB) with different pathologic types.MethodsTwo-dimensional ultrasound and CDFI were performed in 16 patients with pathologically proved PTB,and the ultrasonic characteristics of different pathologic types PTB were reviewed retrospectively.ResultsAccording to WHO criteria,there were 12 benign PTB,2 borderline and 2 malignant PTB.Associated breast fibroadenoma was detected in 7 patients,including 6 benign and 1 borderline PTB.All of 16 PTB had clear boundary.Benign PTB had regular or irregular shapes,homogeneous or unhomogeneous internal echo and posterior acoustic enhancement in a few cases.Most borderline and malignant PTB showed regular or irregular shapes,mixed cystic and solid internal echo or irregular internal echo,as well as posterior acoustic enhancement.No calcification of PTB was found in all 16 patients.Conclusion The ultrasonograghic features of PTB with different pathologic types are characteristic to some extent,therefore being helpful to the differential diagnosis of PTB.
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Objective To undertake a survey on the prevalence, pathogenic factors and treatment needs of hearing impairment in children under 14 years old in Guizhou province. Methods Using the probability proportion to size (PPS) method, 2 068 children aged 0～14 years were included in the study and in 30 clusters in Guizhou province based on the WHO protocol. Results For children aged 0～14 years, the prevalence of hearing impairment was 3.48% and the prevalence of hearing disability was 1.84 %. There were statistically differences of the prevalence of hearing disability between children aged 7～ 14 years (2.66 %) and 0～ 6 years (0. 51%), and the differences also in hearing impairment between male children (4.22%) and female children (2.54%). The main causes of hearing impairment were ear diseases (50.00%), non-infective conditions (11.11%), genetic conditions (20.83 %) and unknown causes (27. 77%). 3. 58% of all subjects needed medical or surgical treatment and 2. 32% needed hearing aids. Conolusion The prevalence of hearing disability of children under 14 years old in Guizhou province was higher than that of other cities. The main cause of the hearing impairment of children was otitis media with hereditary deafness also ranked in top.
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OBJECTIVE@#To undertake a population-based survey on the prevalence, pathogenic factors and medical requirements of ear and hearing impairment.@*METHOD@#Using the probability proportion to size (PPS) method, 6626 residents were investigated in 30 clusters with the WHO protocol.@*RESULT@#The prevalence of hearing impairment was 17.1% (the standardized rate: 17.6% in the whole country). Degrees of hearing impairment were mild (11.0%), moderate (4.2%), severe (1.4%), and profound (0.5%). Among them, male were 663(20.2%) and female were 468 (14.0%). The prevalence of hearing disability was 6.1% (the standardized rate: 6.5% in the whole country). The causes of hearing impairment were ear disorders (31.4%), non-infectious (42. 5%), genetic condino (6.7%), infectious disease (0.4%) and undetermined cause (29.3%). 13.8% of person needed otology and/or audiology actions. 9.1% of person needed hearing aid.@*CONCLUSION@#The prevalence of hearing impairment and hearing disability is higher than last twenty years and it can provide scientific data for drawing up precaution and control strategies on deafness for government.
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Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Mâle , Adulte d'âge moyen , Jeune adulte , Chine , Épidémiologie , Maladies des oreilles , Épidémiologie , Troubles de l'audition , Épidémiologie , Prévalence , Facteurs de risqueRÉSUMÉ
OBJECTIVE: To explore the mechanisms of the effects of Runing Recipe in anti-invasion and anti-recurrence of breast cancer by experimental research in vitro. METHODS: SD female rats were randomly divided into Runing Recipe-treated group and its decomposed formulas Kidney-Warming Recipe and Liver-Soothing Recipe-treated groups, tamoxifen (TAM) -treated group, cyclophosphamide (CTX) -treated group, and normal control group to make medicated serums. Methods of matrigel basement membrane and real-time reverse transcription polymerase chain reaction were employed to investigate the gene expressions of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) after MDA-MB-435 cells were treated with the medicated serums. RESULTS: The gene expression of VEGF was dropped in CTX-treated, TAM-treated and Liver-Smoothing Recipe-treated groups. The gene expression of TIMP-1 was up-regulated in CTX-treated, Runing Recipe-treated and Kidney-Warming Recipe-treated groups; while MMP-9 was down-regulated in these groups. CONCLUSION: The mechanisms of Runing Recipe in inhibiting the cancer cell invasion may be related to down-regulating the gene expressions of VEGF and MMP-9, and up-regulating the gene expression of TIMP-1.