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Objective:To evaluate whether there are changes in cone cells in patients with pre-clinical hydroxychloroquine (HCQ) retinopathy using an adaptive optics (AO) retinal camera.Methods:A retrospective case-control study. From May 2020 to July 2020, 46 patients who were treated in Department of Rheumatism and Immunology, Hainan Hospital of PLA General Hospital with rheumatic immune diseases were included. All patients had a history of HCQ use and no obvious abnormality was found in fundus examination; 105 healthy people with similar demographic characteristics without a history of hydroxychloroquine were recruited as the control group were included. All subjects received the routine ophthalmological examination including best corrected visual auity (BCVA), spectral-domain optical coherence tomography (SD-OCT), Fundus autofluorescence (FAF), visual field, endoscopy of the cornea, and the measurement of axial length (AL). The BCVA was performed with the Snellen visual acuity chart, and the result was converted to logarithmic minimum angle of resolution (logMAR) visual acuity for statistic. Among the 46 cases, 6 cases were males and 40 cases were females. Age was (42.02±13.81) years old; logMAR BCVA was 0.063±0.015; AL was (23.95±0.726) mm. Visual field, macular SD-OCT, FAF examination showed no abnormality. The average cumulative dose of HCQ was 522.60 (6-1 728) g. rtx1 AO retinal camera was used to collect fundus images of subjects in four quadrants above the retina, nasal side, lower side and temporal side with 3°centrifugation from the fovea in both eyes. The cone density, cone spacing, cone arrangement regularity and the proportion of the nearest cones with 6 (nn=6) were measured in the four quadrants. The density of cone cells between the left and right eyes in case group and control group were compared by paired t test. The density and spacing of cone cells in each quadrant were compared by t test of two independent samples. Results:Compared with the control group, the cone cell density in the four quadrants of the left eye and the nasal, superior and inferior sides of the right eye in the case group was significantly decreased, and the difference was statistically significant ( t=4.247, 2.107, 4.884, 2.254, 2.643, 4.445, 4.116; P<0.05). The cone spacing in the nasal and temporal sides of the left eye of the patients in the case group was significantly larger than that in the control eye, with statistical significance ( t=2.750, 3.318; P<0.05). Compared with the control group, the regulatign of cone cell arrangement in the left temporal side of the right and left eye in the case group were significantly reduced, the difference was statistically significant ( P=0.002, 0.011). The proportion of nn=6 in the inferior and temporal sides of the right eye decreased significantly in the case group, and the difference was statistically significant ( P=0.006, 0.032). Conclusion:AO retinal imaging can detect the changes of cone cells in the early clinical stage of HCQ retinopathy.
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Objective:To construct the quality evaluation system for tracheal extubation in the patients undergoing general anesthesia based on zero-defect management theory.Methods:Based on the model of zero-defect theory, literature review, semi-structured interviews, expert consultation and analytic hierarchy process were used to determine the content and weight of each index of the quality evaluation system for tracheal extubation in the patients undergoing general anesthesia.Results:The effective recovery rates of the two rounds of expert consultation questionnaires were 93% and 96% respectively; the expert authority coefficients were 0.946 and 0.947 respectively; the Kendall harmony coefficients were 0.247 and 0.250 respectively ( P<0.001). The final evaluation index system included 3 first-level indicators, 11 second-level indicators and 48 third-level indicators.The consistency coefficients of indicators at all levels were <0.1. Conclusions:The quality evaluation system for endotracheal extubation constructed for patients undergoing general anesthesia is highly scientific and reliable and can provide a basis for the quality evaluation of and continuous improvement in endotracheal extubation in the patients undergoing general anesthesia.
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Objective@#To a evaluate the effectiveness of comprehensive nutrition interventions among primary school students in Yiwu City, so as to provide insights into malnutrition control among children.@*Methods@#Grade 3 to 5 students were sampled from four primary schools in Yiwu City using a random cluster sampling method and randomly assigned into the intervention group and the control group. Students in the intervention group received comprehensive interventions, including nutritional health education, promotion of physical activities, nutritional meal support and creation of a nutritional campus, while students in the control group were given no interventions. The awareness of nutritional health knowledge, dietary behaviors and nutritional status were compared in students between the two groups prior to interventions and one year following interventions, and the effectiveness of interventions was evaluated using generalized estimating equations.@*Results@#Totally 879 students were enrolled. There were 440 students in the intervention group, including 243 males and 197 females, with a male to female ratio of 1︰0.81 and a mean age of (10.47±0.99) years; and there were 439 students in the control group, including 244 males and 195 females, with a male to female ratio of 1︰0.80 and a mean age of (10.35±1.02) years. Following comprehensive interventions, the awareness of “type of food”, “seven nutriments from food”, “eating at least 12 types of food daily”, “less than 6 g of daily salt intake”, “food composition in nutritional breakfast”, “nutritional labels of pure milk”, “no less than 60 min of daily exercise duration” and “too fat or too thin may threaten health” and the increase in the proportion of 3 and more types of food in breakfast were significantly higher among students in the intervention group than in the control group (all P<0.05); however, there was no statistical difference in the proportion of normal nutrition between the two groups (P>0.05).@*Conclusion@#The comprehensive nutritional interventions may effectively increase the awareness of nutrition health knowledge and improve dietary behaviors among primary school students.
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The chemotherapy combined with photothermal therapy has been a favorable approach for the treatment of breast cancer. In present study, nanoparticles with the characteristics of photothermal/matrix metalloproteinase-2 (MMP-2) dual-responsive, tumor targeting, and size-variability were designed for enhancing the antitumor efficacy and achieving "on-demand" drug release markedly. Based on the thermal sensitivity of gelatin, we designed a size-variable gelatin nanoparticle (GNP) to encapsulate indocyanine green (ICG) and doxorubicin (DOX). Under an 808 nm laser irradiation, GNP-DOX/ICG responded photothermally and swelled in size from 71.58 ± 4.28 to 160.80 ± 9.51 nm, which was beneficial for particle retention in the tumor sites and release of the loaded therapeutics. Additionally, GNP-DOX/ICG showed a size reduction of the particles to 33.24 ± 4.11 nm and further improved drug release with the degradation of overexpressed MMP-2 in tumor. In the subsequently performed
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Medical big data is a hot research topic in China,and it is also the main research direction in the field of emergency medicine.The current situation of the construction of the first-aid big data platform and the construction of the first-aid clinical decision support system were analyzed,the problems existing in the development of the first-aid big data research field were enumerated,to explore the theoretical methods for promoting the development of domestic first-aid big data,so as to provide references for the research in related fields.
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Objective To explore the clinical efficacy of endovenous laser ablation (EVLA) of great saphenous vein combined with foam sclerotherapy in the treatment of variceal ulcer of lower extremities (VULE).Methods Data of 19 patients (20 affected limbs) with VULE were analyzed retrospectively.EVLA combined with foam sclerotherapy was performed,and the clinical effect was observed.Results The treatment was successfully performed in 19 patients (20 affected limbs).Diameters of the ulcer was (2.30 ± 1.61) cm before operation and (0.90± 0.32) cm 2 weeks after operation,respectively (t=10.53,P<0.01),and the ulcers healed from 7 days to 3 months after the surgery in 20 patients without recurrence.Conclusion EVLA of great saphenous vein combined with foam sclerotherapy has good clinical efficacy.
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Objective To evaluate the performance of Zika virus (ZIKV) disease prevention and control.Methods Descriptive epidemiological analysis was conducted on the clinical manifestations,laboratory detection results and disease progression of the third imported ZIKV disease case in the mainland of China.Results On 19 February 2016,a ZIKV disease case was confirmed in Yiwu,Zhejiang province,which was the third imported case of ZIKV disease confirmed by China CDC laboratory and expert consulting.The patient just had a travel to Fiji and Samoa and had mosquito bite history in Samoa.The patient was hospitalized on 16 February after the onset on 14 February and the eruption on 15 February.The body temperature of the patient became normal on 17 February,the rash disappeared on 19 February and the conjunctivitis resolved on 20 February.The positive detection of the viral nucleic acid in blood was only for 3 consecutive days,and the viral nucleic acid could be detected in urine even after negative detection in blood for 4 days.Conclusion The symptoms of the patient were typical.ZIKV can be detected by using blood sample in early phase,but after body temperature become normal,the virus can be detected in urine.
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Objective To evaluate the performance of Zika virus (ZIKV) disease prevention and control.Methods Descriptive epidemiological analysis was conducted on the clinical manifestations,laboratory detection results and disease progression of the third imported ZIKV disease case in the mainland of China.Results On 19 February 2016,a ZIKV disease case was confirmed in Yiwu,Zhejiang province,which was the third imported case of ZIKV disease confirmed by China CDC laboratory and expert consulting.The patient just had a travel to Fiji and Samoa and had mosquito bite history in Samoa.The patient was hospitalized on 16 February after the onset on 14 February and the eruption on 15 February.The body temperature of the patient became normal on 17 February,the rash disappeared on 19 February and the conjunctivitis resolved on 20 February.The positive detection of the viral nucleic acid in blood was only for 3 consecutive days,and the viral nucleic acid could be detected in urine even after negative detection in blood for 4 days.Conclusion The symptoms of the patient were typical.ZIKV can be detected by using blood sample in early phase,but after body temperature become normal,the virus can be detected in urine.
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The paper presented the thoughts and steps taken by the National Center for Cardiovascular Diseaes in biobank quality management system.By means ofprocess approach,the organizational structure,identification and analysis process were established,along with the management mechanism and normalized documentation.Centering onPlan,Do,Check and Act(PDCA),a complete set of quality management system was established.This system enables normalized management of biobanks in China,and provides practice guidelines for development industry standards of the country as well.
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Objective To explore the effect of multiple positioning procedure for prolapse and hemorrhoids (PPH) in treatment of connective tissue type mixed hemorrhoids,and compare the results between PPH and Milligan-Morgan surgery.Methods One hundred and sixteen patients with connective tissue type mixed hemorrhoids were divided into treatment group (62 cases) and control group (54 cases)according to random digits table method.The patients in treatment group received multiple positioning PPH,and the patients in control group received Milligan-Morgan surgery.The operative time,intraoperative blood loss,postoperative pain score,anal margin edema,wound healing time,perianal scar,anorectal stenosis,anal discharge and anorectal resting pressure were evaluated and compared between 2 groups.Results The operative time and intraoperative blood loss in treatment group were significantly lower than those in control group:(15.0 ± 2.3) min vs.(35.0 ± 3.4) min and (5.0 ± 2.1) ml vs.(15.0 ± 3.2) ml,and there were statistical differences (P < 0.05).The postoperative pain score and wound healing time in treatment group were significantly lower than those in control group:(4.83 ± 0.62) scores vs.(7.82 ± 0.37) scores and (8.2 ± 2.6) d vs.(17.4 ± 3.8) d,the rates of anal margin edema,perianal scar and anorectal stenosis in treatment group were significantly lower than those in control group:8.1% (5/62) vs.37.0% (20/54),0 vs.29.6% (16/54) and 1.6%(1/62) vs.16.7% (9/54),and there were statistical differences (P < 0.05 or < 0.01).The postoperative anorectal resting pressure was significantly lower than preoperative in control group:(13.80 ± 4.20) kPa vs.(17.20 ± 5.87) kPa,and there was statistical difference (P< 0.05).One patient (1.6%,1/62) in treatment group occurred anal discharge,and 10 patients (18.5%,10/54) occurred anal discharge in control group.The rate of anal discharge in treatment group was significantly lower than that in control group,and there was statistical difference (P < 0.01).Conclusions Multiple positioning PPH is effective for the treatment of connective tissue type mixed hemorrhoids.It improves the controllability of the amount of removal and the excision site.It decreases the incidence of anal margin edema,perianal scar and anal discharge scar,which provides an effective protection for the anal function.
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<p><b>OBJECTIVE</b>To analyze the epidemiology data on plague in five counties in Zhejiang province and to evaluate the risk of plague in theses areas.</p><p><b>METHODS</b>We selected five monitoring stations as a risk assessment (Qingyuan county, Longquan city, Yiwu city, Wencheng county, and Ruian city) in Zhejiang province where the plague epidemic more serious in the history. At least one constant site and 1-4 variable sites where plague occurred in history were selected for monitoring. We collected the five counties (cities) surveillance data of indoor rat density, indoor Rattus flavipectus density, the Xenopsylla cheopis index of rat, the Xenopsylla cheopis index of Rattus flavipectus in 1995-2014. Isolation of Yersinia pestis was conducted among 171,201 liver samples and F1 antibody were detected among 228,775 serum samples. Risk matrix, Borda count method, and Delphi approach were conducted to assess risk of the plague of five counties (cities) in Zhejiang province.</p><p><b>RESULTS</b>Indoor rat density in Qingyuan county, Longquan city, Yiwu city, Wencheng county, Ruian city was 1.58%-5.50%, 1.13%-9.76%, 0.56%-3.67%, 2.83%-16.08%, 7.16%-15.96%, respectively; Indoor Rattus flavipectus density of five counties (cities) was 0.08%-2.23%, 0-2.02%, 0-0.54%, 0.71%-5.58%, 0.55%-4.92%, respectively. The Xenopsylla cheopis index of rat in Qingyuan county and Wencheng county was 0.011-0.500 and 0.015-0.227, respectively; The Xenopsylla cheopis index of Rattus flavipectus of Qingyuan county and Wencheng county was 0.119-3.412 and 0.100-1.430, respectively; Ruian City and Yiwu city cannot collected Xenopsylla cheopis, Long quan city only collected the Xenopsylla cheopis index of rat in the five years. Yersinia pestis were not isolated in five counties (cities).There were 3 Apodemus agrarius samples positive of plague F1 antibody test, in Longquan city and Yiwu city in 2005. Borda count method to assess the Longquan city, Yiwu (Borda point were both 321) plague risk was higher than three other regions; Delphi approach to evaluation five counties (cities) belong to the plague had a lower risk areas, according to the level of risk score (Pf) Longquan city and Yiwu (Pf was 0.314, 0.292, respectively) plague risk were higher than three other regions (Pf were all 0.292).</p><p><b>CONCLUSION</b>The main host and media were lower in five key plague surveillance counties (cities) of Zhejiang province; The result of Borda count method and Delphi approach for risk assessment indicated that endogenous plague recrudescence was at lower level, but Longquan city and Yiwu city risk were higher than other counties (cities).</p>
Sujets)
Animaux , Humains , Rats , Villes , Épidémies , Surveillance épidémiologique , Murinae , Peste , Appréciation des risques , Yersinia pestisRésumé
To study the in situ intestinal absorption kinetics of flrubiprofen in rats, the absorption of flurbiprofen in small intestine (duodenum, jejunum and ileum) and colon of rats was investigated using in situ single-pass perfusion method and the drug content was measured by HPLC. The effects of drug concentration on the intestinal absorption were investigated. The K(a) and P(app) values of flurbiprofen in the small intestine and colon had no significant difference (P > 0.05). Drug concentration (4.0, 10.0 and 16.0 mg x L(-1)) had no significant influence on the K(a) values (P > 0.05). However, when concentration was 4.0 mg x L(-1) and 10.0 mg x L(-1), significant effect on the P(app) values (P 0.05). The K(a) and P(app) values of flurbiprofen on the perfusion flow rate had significant difference (P < 0.05). Flurbiprofen could be absorbed at all segments of the intestine in rats and had no special absorption window. The absorption of flurbiprofen complies with the facilitated diffusion in the general intestinal segments, and accompany with the cytopsistransport mechanism probably. The perfusion flow rate had significant effect on the K(a) and P(app).
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Objective To study the effect of Xuebijing injection on the change of intestinal tract mucosa barriers and the expression of macrophage antihody in rats with sepsis. Method Totally 150 Wistar rats were ran-domly divided into three groups: sham group, sepsis group, and Xuebijing group. Sepsis models were estabhshed in rats by cecal ligation and puncture. The success standards of sepsis included fever, the increase of respiration rate,increased heart rate and change in leukocyte count. At 12 hours before operation, and after operation the rats in the Xuebijing group were injected with 4 mL/kg Xuebijing (once every 12 hours for 3 days), and the rats in the others two groups were injected with the same volume of saline, the image analytical system were used to detect the pathological change of intestinal tract mucosa harriers and the expression of macrophage antibody in three groups. All the data were analyzed by rank-sum test and variance analysis(F test). Results Almost all the mucous mem-brahe of small intestine in sham groups were normal. The mucous membrane lesions of small intestine developed in sepsis and Xuebijing groups after 12,24,48,72 hours, and the lesion was severer in sepsis group than that in the Xuebijing group (H=19.732, P<0.01). There were no significant differences on the expression of macrophage antibody in mucous membrane of small intestine between three groups at 3 hours. But at 12, 24, 48 and 72 hours, the expression of macmphage antibody of sepsis and Xnebijing groups increased with time (F=560.13, P< 0.05). Conclusions At the early period of sepsis, intestinal tract mucosa barriers develops varying degrees of damage, and Xnebijing can partly protect intestinal tract mucosa barriers.
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BACKGROUND: Animal models of peripheral partial epiphyseal plate closure are commonly used in related trials.OBJECTIVE: To modify the original animal models of distal femoral partial epiphyseal plate closure.DESIGN, TIME AND SETTING: A self-controlled trial was performed at the Experimental Animal Center of General Hospital of Chinese PLA from March to October 2007.MATERIALS: Twenty healthy New Zealand rabbits of 4-6 weeks old weighing 1.0-1.5 kg were selected.METHODS: A straight incision about 2 cm was made in lateral knee of 20 rabbits. The subcutaneous tissues and knee capsule were cut open to expose distal femoral condyle. The condylar plate line was clear. Two holes were drilled in the fight lateral condyle, about 3.0-4.0 mm deep, and partial normal epiphyseal plate (about 33%-44% of the total growth plate) was removed. An incision deep to periosteum was created in the left side and regarded as self-control.MAIN OUTCOME MEASURES: Femoral length, valgus angle of the distal femur, and femoral deformity were detected by X-ray photograph, and gross observation. Bone bridge formation of bilateral femora was observed by histological examination.RESULTS: One rabbit died of diarrhea 31 days after surgery, and 19 were included in final analysis. ①Radiographs showed that the mean length of left femur (control side) was significantly longer but valgus angle was significantly smaller than the right side (experimental side) 4 months after surgery (P < 0.01). The left distal femur averagely grew for 2.27 cm,accounted for 57.6% of the overall femoral growth, and the right side averagely grew for 0.45 cm, accounted for 21.4% of the overall femoral growth.②Four months after surgery, femoral appearance of the control side was normal, with smooth and complete condylar and facies articularis patellae. While, the experimental side femur was significantly shortened, and severe vaigus deformity was observed in the distal femur. ③Five weeks after surgery, layer cells of the epiphyseal plate arranged regularly in the control side. Bone trabecula with many fibers was found in bone defect cavity of the experimental side, and the cell layer of the remnant epiphyseal plate was decreased. The epiphyseal plate was closed in the control side,and bone trabecula of the experimental side was thickened 10 weeks postoperatively.CONCLUSION: This modeling method is simple, efficient, and easy to manipulate; in addition, the bone bridge area is controllable. The models can meet the study demands for peripheral partial epiphyseal plate closure, and are significant for filling material selection during treatment.
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0.05). The correlation coefficients between receiving, giving intergeneration social support and SWB were 0.25 and 0.131 respectively. Both receiving economic support and receiving emotional support from adult-children were significant positive predictors of the elderly's SWB (R2=8.3%). Conclusion: The receiving economic support and receiving emotional support from adult-children significantly affected the elderly's SWB.