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The decreasing reliability of forensic medical reports led to the inadequate credibility of forensic science.Therefore,we can improve the credibility of forensic science by improving the reliability of forensic medical reports.The reliability assessment of the forensic medical examination is presented by the final reports.Standardized production of forensic medical reports can not only reflect the reliability of the related forensic service,but also improve such forensic activities by reversing supervision.The standardized preparation of forensic medical reports is the final positive step when improving the reliability of justice.Therefore,it is necessary to improve the standardization of forensic medical reports from the micro perspective,in order to help enhance the credibility of forensic science,which will finally lead to the enhancement of the credibility of the judicial activities.
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AIM:To explore the molecular mechanism of Tiaopi Chengqi decoction (TpCqD) improving hyperthermia and high-protein food-induced hyperphagia mice based on transcriptomics. METHODS:C57 mice were randomly divided into a control group, model group, low-dose TpCqD group, high-dose TpCqD group, and domperidone group. The general condition of the experimental mice was observed and the average food intake was counted, and the rate of gastric emptying and intestinal propulsion was determined for each group of mice. H&E staining was used to observe pathological changes in gastric tissue. PAS staining was used to observe glycogen changes in gastric tissue. Pepsin activity was determined by colorimetry. pH value of gastric contents was measured by acid-base titration. Transcriptome sequencing was used to analyze the differential genes in gastric tissue, a volcano map and a cluster heat map were made for the differential genes, and KEGG was used to analyze the signal pathway enrichment of the differential genes. RT-qPCR verified the differential genes obtained by screening. RESULTS:After treatment with TpCqD, the body weight and average food intake of mice with food accumulation increased (P<0.05), and the intestinal propulsion rate and gastric emptying speed of mice with food accumulation accelerated (P<0.05). TpCqD could protect gastric tissue structure and glycogen degradation, increase pepsin activity (P<0.05), and reduce gastric content pH (P<0.05). Transcriptome results showed that TpCqD could regulate the expression of Acox2 and cilp2, regulate fat digestion and absorption, protein digestion and absorption, and pancreatic secretion signals. RT-qPCR showed that compare with model group, TpCqD up-regulated Acox2 (P<0.05) and down-regulated the mRNA level of cilp2 (P<0.05). CONCLUSION:TpCqD ameliorated digestive dysfunction in mice with high-calorie and high-protein diets leading to food accumulation involving the regulation of the fat and sugar metabolism genes Acox2 and cilp2, and pancreatic secretory signaling.
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Objective:To investigate the relationship between NUDT15 gene polymorphism and tolerance to treatment with 6-mercaptopurine (6-MP) in children with acute lymphoblastic leukemia (ALL).Methods:Fifty-eight children diagnosed with ALL in Shanxi Children's Hospital from January 2019 to December 2020 were recruited. All of them were treated with CCLG-ALL2018 chemotherapy regimen and the bone marrow showed complete remission. They received 6-MP oral treatment during maintenance treatment. Single nucleotide polymorphism of NUDT15 gene was detected by real-time fluorescence quantitative polymerase chain reaction. The bone marrow suppression after 6-MP treatment and 6-MP tolerance dose in patients with different NUDT15 genotypes were analyzed.Results:Among 58 patients, 3 patients had NUDT15 TT genotype, 46 patients had CC genotype and 9 patients had TC genotype. During maintenance treatment with 6-MP, the differences in leukocyte count, hemoglobin and platelet count among the three groups of patients with different NUDT15 genotypes were statistically significant (all P < 0.05). Among 58 patients, 23 (39.66%) patients had varying degrees of neutropenia after medication, including 16 cases of NUDT15 CC genotype, 5 cases of TC genotype and 2 cases of TT genotype. There was a statistically significant difference in bone marrow suppression among the three groups ( H = 29.10, P < 0.05). The dosages of 6-MP used in patients with TT, CC and TC genotypes were (10.4±8.8) mg·m -2·d -1, (41.5±1.3) mg·m -2·d -1 and (36.7±2.4) mg·m -2·d -1, respectively, and the difference was statistically significant ( F = 16.95, P < 0.05). Conclusions:Children with different NUDT15 genotypes have different tolerance to 6-MP, and NUDT15 gene polymorphism is associated with 6-MP intolerance during maintenance treatment in children with ALL, which may affect the treatment of the disease.
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Objective:To evaluate the short-term efficacy and the improvement of quality of life of enzyme replacement therapy (ERT) with Imiglucerase on children with Gaucher disease(GD) through the same time monitoring.Methods:Six children diagnosed as GD who were treated by ERT with Imiglucerase in the Department of Hematology of the Children′s Hospital of Shanxi Province from May 2019 to May 2020 were recruited.Every 3 months, the sizes of the liver and spleen was palpated, the change of bone pain was recorded, and the haematological index was examed.The volumes of the liver and spleen at 1-year treatment were measured by CT.Bone involvement was examined by magnetic resonance imaging (MRI). In addition, the body weight, height, and the 36-Item Short Form Survey (SF-36) were measured and compared with pre-treatment levels.These data were analyzed statistically by SPSS 25.0 and the difference between pretherapy and post-treatment was compared by paired t test. Results:Six children diagnosed as GD received ERT with Imiglucerase.No adverse events were reported.Decreased volumes of the liver and spleen, and increased hemoglobin level and platelet count were detected after 3-6 months of ERT.After 1 year of ERT, hemoglobin level significantly increased compared with pre-treatment level ( t=4.200, P=0.008). Although the platelet count increased at 1-year ERT, it was comparable with pre-treatment level ( t=2.260, P=0.073). The volumes of liver and spleen decreased by (22.10±15.28)% ( t=2.725, P=0.042) and (47.10±18.42)% ( t=3.162, P=0.034) after 1 year of ERT, respectively.During the first year of ERT, the height and weight increased (6.17±2.86) cm ( t=5.286, P=0.003) and (4.08±2.01) kg ( t=4.975, P=0.004), respectively.SF-36 score increased significantly from (489.35±103.99) points to (632.75±73.34) points ( t=5.740, P=0.002). After 1 year of ERT, 1 patient still had bone pain, and 2 cases were worse in bone MRI, which may be attributed to the short period of follow-up and insufficient dose, and another 3 had no change in bone MRI. Conclusions:ERT ameliorates GD-associated anemia, organomegaly and growth retardation, and improves the growth rate of body mass and height and the quality of life in the short period.However, short-term ERT does not improve the bone disease.
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Objective:To explore the application and effect of multi-level quality control system (referred to as “quality control”) in health management center setting.Methods:The health management center of Hanzhong Central Hospital constructed a multi-level quality control system of “hospital-department-unit” and “department-unit-quality-controller” in August 2019. A total of 83 619 people who underwent physical examination in the Health Management Center of Hanzhong Central Hospital from August 2018 to July 2020 were selected as the subjects. 32 009 people who underwent physical examination from August 2018 to July 2019 were selected as the control group, and 51 610 people who underwent physical examination from August 2019 to July 2020 were selected as the experimental group. The timely notification of important abnormal results and the follow-up of the “four-high” population (hypertension, hyperglycemia, hyperlipidemia, and hyperuricemia) were observed. Two thousand satisfaction questionnaires and two thousand physical examination reports were collected from the institutions who had received both physical examination in the Health Management Center of Hanzhong Central Hospital for two consecutive years. The physical examination items of the above clients were basically the same. The satisfaction rate of the two groups of physical examination and the qualification rate of the physical examination reports were measured respectively.Results:The results showed that the timely notification rate of important abnormal results (99.4% vs 96.6%), follow-up rate of “four-high” population (hypertension 95.1% vs 91.2%, hyperglycemia 95.3% vs 91.6%, hyperlipidemia 94.6% vs 92.3%, hyperuricemia 92.7% vs 86.4%), satisfaction rate of physical examination (physical examination environment 94.0% vs 91.3%, service attitude 96.4% vs 91.9%, waiting time 97.6% vs 95.4%, physical examination process 98.3% vs 96.8%, professional level of medical staff 97.2% vs 95.1%), and qualified rate of physical examination report (accuracy of input information 99.5% vs 98.1%, accuracy of main examination conclusion 99.4% vs 97.3%, normative sorting 99.8% vs 98.8%, rationality of health advice 99.2% vs 96.8%) in the experimental group were significantly higher than those in the control group (all P<0.05). Conclusion:The establishment of a multi-level quality control system in health examination service can improve the timely notification rate of important abnormal results, the follow-up rate of the “four-high” population, the satisfaction of physical examinees, and the qualified rate of physical examination reports.
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Objective To evaluate the influence of stress distributions on bone-anchored maxillary protraction at different protraction sites, so as to guide patients to choose an optimal protraction site in clinic. Methods A three-dimensional (3D) finite element model of child head with implant anchorages was establised. Four protraction sites were set according to the position of implant installation. Working condition 1: the alveolar bone at the intersection of distal 2 mm of primary lateral incisor crown distal surface and gingival cervical margin to 5 mm. Working condition 2: the alveolar bone at the intersection of mesial 2 mm of maxillary first primary molar crown mesial surface and gingival cervical margin to 5 mm. Working condition 3: the alveolar bone at the intersection of mesial 2 mm of maxillary first molar crown mesial surface and gingival cervical margin to 5 mm. Working condition 4: the alveolar bone at the intersection of distal 2 mm of maxillary first molar crown distal surface and gingival cervical margin to 5 mm. The finite element models were loaded with 500 g protraction force at each side with 30° forward direction to the occlusal plane. Stress distributions on each suture were analysed. Results The maximum stress of frontomaxillary suture was in working condition 2 (1 477-28 190 Pa). The maximum stress of nasomaxillary suture was in working condition 1 (5.296-924 Pa). The maximum stress of zygomaticomaxillary suture was in working condition 4(394.7-13 130 Pa). The maximum stress of zygomaticofrontalis suture was in working condition 4 (495.2-31 690 Pa). The maximum stress of zygomaticotemporal suture was in working condition 3 (1 148-15 870 Pa). The maximum stress of medianpalatine suture was in working condition I (6.479-730 Pa). Conclusions When the protraction sites are set in distal maxillary primary lateral incisor and mesial maxillary first primary molar, it is of positive significance to improve the concave profile, especially in nose root. When the protraction sites are set in mesial or distal maxillary first molar, it is of positive significance to improve the concave profile, especially in maxillary basal bone of the midface.
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Leptin, an adipocyte-derived peptide hormone, has been shown to facilitate breathing. However, the central sites and circuit mechanisms underlying the respiratory effects of leptin remain incompletely understood. The present study aimed to address whether neurons expressing leptin receptor b (LepRb) in the nucleus tractus solitarii (NTS) contribute to respiratory control. Both chemogenetic and optogenetic stimulation of LepRb-expressing NTS (NTSLepRb) neurons notably activated breathing. Moreover, stimulation of NTSLepRb neurons projecting to the lateral parabrachial nucleus (LPBN) not only remarkably increased basal ventilation to a level similar to that of the stimulation of all NTSLepRb neurons, but also activated LPBN neurons projecting to the preBötzinger complex (preBötC). By contrast, ablation of NTSLepRb neurons projecting to the LPBN notably eliminated the enhanced respiratory effect induced by NTSLepRb neuron stimulation. In brainstem slices, bath application of leptin rapidly depolarized the membrane potential, increased the spontaneous firing rate, and accelerated the Ca2+ transients in most NTSLepRb neurons. Therefore, leptin potentiates breathing in the NTS most likely via an NTS-LPBN-preBötC circuit.
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Leptina/farmacologia , Potenciais da Membrana , Neurônios/metabolismo , Núcleo Solitário/metabolismoRESUMO
Objective:To promote evidence-based practice in the pre-chemotherapy nursing assessment among adult cancer patients.Methods:The Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tools were used. The project was conducted in Shanghai Cancer Center of Fudan University from May to October 2018, 12 audit criteria were developed in the program including nursing training, patient medical and allergic history, medical diagnosis, lab data and so on.Results:A baseline audit of pre-chemotherapy nursing assessment among adult cancer patients was conducted, with a sample size of 68 patients and 36 nursing staff, during this stage, the compliance of audit 11 and 12 were 100%. After the implementation of systematic strategies, a follow-up audit involving similar sample as first audit was conducted using the same audit criteria. In the follow-up audit, except criterion 4 and 10, the compliance of the remaining 8 criteria had significantly improved, and χ2 value was 10.29-132.06, P<0.01. The result of history adverse reaction in the follow-up audit showed that among 68 patients, 3 had experienced chemotherapy infusion reactions in the past (The drugs were oxaliplatin, gemcitabine and paclitaxel), 39 had chemotherapy-related symptoms before admission (most of them were relieved at admission), of which the top five were loss of appetite, fatigue, nausea, neurotoxicity and vomiting. Conclusions:The aims of the project were fulfilled. We achieved increased compliance with evidence-based best practice recommended by JBI in most of audit criteria. Further audit will need to be carried out to improve the validity and quality of nursing assessment.
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The electronic nursing clinical pathway was fully applied, and the evidence-based practice achievements of cancer patient symptom management was integrated into the electronic nursing clinical pathway in Fudan University Shanghai Cancer Center. Taking " comprehensive evaluation before chemotherapy" , " chemotherapy-related nausea and vomiting" , " chemotherapy-related diarrhea" as examples, the authors introduced the application of evidence-based practice project in nursing clinical pathway. Through the implementation of the project, a standardized operation flow of electronic nursing clinical pathway was formed; The nurses introduced new nursing tools, new processes and new technologies in the process of project implementation; Meanwhile, the project reduced the incidence of adverse symptoms and shortened the hospitalization time of patients. The project achieved the goal of " win-win" to reduce the burden of patients′ disease and improve the efficiency of tumor care.
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Objective:To explore the clinical characteristics and prognostic factors of children with relapsed acute lymphoblastic leukemia (ALL).Methods:The clinical data of 52 children with relapsed ALL in Children's Hospital of Shanxi Province from January 2010 to April 2019 were retrospectively analyzed. The clinical characteristics of the children were summarized and the prognostic factors after recurrence were analyzed.Results:Till May 1, 2019, 5 out of 52 children gave up treatment after diagnosis and were lost to follow-up. For the remaining 47 children with successful follow-up, the median age at initial diagnosis was 60 months (11-168 months), the median time from initial diagnosis to relapse was 21 months (2-112 months), the median follow-up time was 5.5 months (1.0-69.0 months), and the 2-year overall survival (OS) rate after relapse was 31%. Nine patients accepted allogeneic hematopoietic stem cell transplantation after the second time complete remission, the median time from diagnosis to transplantation was 4.5 months (3.0-7.0 months), and the median follow-up time was 22 months (4-69 months). The 2-year OS rates in relapsed children with white blood cell count < 50×10 9/L and ≥ 50×10 9/L at initial diagnosis were 39% and 13%, respectively (χ 2=5.623, P=0.018). The 2-year OS rate after relapse in standard-risk, intermediate-risk and high-risk groups were 72%, 31% and 8%, respectively (χ 2=10.068, P=0.007). The 2-year OS rate after relapse in very early relapse, early relapse and late relapse groups were 0, 33% and 79%, respectively (χ 2=30.066, P < 0.01). The 2-year OS rate after relapse in chemotherapy with or without radiotherapy group, transplantation group and irregular treatment group were 57%, 89% and 0, respectively (χ 2=26.885, P < 0.01). Cox multivariate analysis showed that relapse time was the independent risk factor affecting the prognosis of children with relapsed ALL ( HR=0.340, 95% CI 0.146-0.789, P=0.012). Compared with the transplantation group, the risk of death in the chemotherapy with or without radiotherapy group and the irregular treatment group was significantly higher ( HR=12.313, 95% CI 1.266-119.758, P=0.031; HR=20.699, 95% CI 2.230-192.129, P=0.008), suggesting that hematopoietic stem cell transplantation is a protective factor for the prognosis of children with relapsed ALL. Conclusions:The relapse of ALL in children mainly happens in very early and early time. The main part of relapse is bone marrow, and there are many high-risk patients at initial diagnosis. The risk group at initial diagnosis, white blood cell count at initial diagnosis, relapse time, and treatment after relapse are the risk factors affecting the prognosis, and the relapse time and hematopoietic stem cell transplantation are the independent prognostic factors.
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Objective@#To analyze the level of sex-related knowledge and behavior and related factors among children in senior grade of kindergarten in rural areas, and to provide the evidence for early childhood sexuality education.@*Methods@#Multi-state stratified sampling method was adopted. From March to May 2019,a total of 324 students and their parents from 16 kindergartens of rural areas in Sichuan Province were enrolled, self-developed questionnaire was used to collect the basic demographic characteristics, information of sexuality education knowledge and sex-related behavior.@*Results@#The average score of sexuality education knowledge was 5(4,6) point, and the awareness rate was 33.6%(109). The qualified sex-related behavior was observed in 75.0%(243 of all the children), while 25.0%(81) needed to be improved. Multivariate analysis showed that,compared with children were aware of the sexuality education knowledge, children who were unaware of the sexuality education knowledge were more likely to have good sex-related behavior, with the OR(95%CI) value was 2.06(1.14-3.72). The possibility of having good sex-related behavior among those children with more than 2 members in the family parents carring out sexuality education was higher than children without sexuality education in the family, with the OR(95%CI) value being 2.40(1.17-4.89).@*Conclusion@#The level of sexuality education knowledge among children in senior grade of kindergarten of rural areas in Sichuan is low, and most children s behavior needs to be improved. Children s awareness of sexuality education knowledge and the number of family members who have carried out sexuality education are related to the occurrence of children s sex-related behavior.
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Objective: To observe the effect of ultrasound combined with neurostimulator in guiding saphenous nerve block (SNB) on elderly knee osteoarthritis (OA) patients after total knee arthroplasty (TKA). Methods: A total of 50 elderly OA patients who would undergo unilateral TKA were randomly divided into group A and group B (each n=25). Patients in Group A underwent ultrasound and nerve stimulator guided femoral nerve block (FNB), while in group B underwent ultrasound and nerve stimulator guided SNB. Visual analogue score (VAS), maximum knee flexion and quadriceps strength, the time of postoperative motor recovery and sensory recovery, as well as the complications before operation and 24 h, 48 h, 72 h, 1 week and 2 weeks after operation were recorded and compared. Results: There was no significant difference of VAS between groups at any time point (all P>0.05). The maximum knee flexion 48 h, 72 h, 1 week and 2 weeks after surgery in group A were all less than in group B (all P<0.05). Quadriceps muscle strength 24 h, 48 h and 72 h of post operation in group A were lower than in group B (all P<0.05). In group A, motor recovery time was (25.28±4.55)h, and sensory recovery time was (33.20±2.92)h, which in group B was (14.64±2.16)h and (28.84±3.27)h, respectively (both P<0.001). Within 2 weeks after operation, vomiting was observed in 2 cases of group A and 1 case of group B, while dizziness was noticed 1 case of group B. No adverse reaction such as hypotension occurred. Conclusion: Ultrasound combined with neurostimulator-guided SNB is safe and effective for managing OA patients after TKA, which is superior to FNB in promoting sensory and motor function recovery.
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Objective To explore the feasibility of applying fractional flow reserve (FFR) into the assessment of carotid stenosis, and analyze the effects from elastic modulus of vessel wall on hemodynamic parameters of carotid artery stenosis model and FFR calculation results. Methods The standard models of carotid bifurcation and stenosis models with different stenosis rates were established by computer-aided design software. Assuming that the vessel wall was linear elastic material and the blood was incompressible Newtonian fluid, the fluid-structure coupling simulation of blood flow in carotid artery stenosis model under the pulsating flow was carried out by finite element analysis, and the relevant hemodynamic parameters were obtained, and the corresponding FFR was calculated. Results When the elastic modulus was fixed, the FFR for narrow part of the model decreased gradually with the increase of the stenosis rate, and the relative difference between the FFR of elastic wall and rigid wall increased with the increase of the stenosis rate; when the stenosis rate was fixed at 70%, the FFR decreased gradually with the increase of elastic modulus. Conclusions The effect of vascular wall elasticity should be considered in the process of functional assessment on carotid stenosis with FFR; the larger stenosis rate will lead to the greater influence from elastic modulus of vessel wall on FFR.
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OBJECTIVE@#To design a new modified sick clothes for electrocardiogram (ECG) monitoring, and to observe its clinical application effect.@*METHODS@#In order to overcome the shortcomings of the existing modified ECG monitoring clothes, a new type of modified sick clothes was designed on the basis of the traditional sick clothes, and a national utility model patent was obtained. 408 conscious patients with ECG monitoring admitted to department of neurology of the First Affiliated Hospital of Fujian Medical University from January 2015 to June 2018 were enrolled, and they were randomly divided into three groups according to the order of admission for comparing the wearing effect of three kinds of sick clothes. 133 patients dressed traditional clothes, while 139 patients dressed modified ECG monitoring clothes. According to the method reported in the literature, the pockets were removed on the basis of the traditional patient clothes, and a circular hole 5 cm in diameter was made at the position of the electrodes for ECG monitoring, which was used to pass through the lead wire and the electrodes. 136 patients dressed the new modified sick clothes. In view of the inconvenience of ECG monitoring and stimulation of patients' thoracic and abdominal skin by traditional sick clothes, the existing modified ECG monitoring clothes were not easy to operate, the location of electrodes sticking was not easy to judge and the lead line was messy, the new modified sick clothes were still based on the traditional ones. The three circular holes of the existing modified ECG monitoring clothes were made into incisions about 12 cm in length to facilitate the ECG monitoring lead line and electrodes sticking. A compression band or a simple patch was added to each side near the shoulder for tidying up the fixed lead. The self-evaluation of patient's comfort, the operation time of ECG monitoring by nurses, skin allergy rate and lead damage rate were recorded and compared among the three groups.@*RESULTS@#Compared with the traditional sick clothes and the modified ECG monitoring clothes groups, the patients in the new modified sick clothes group had higher comfort [the proportion of no discomfort: 11.0% (15/136) vs. 0% (0/133), 5.8% (8/139); the proportion of severe discomfort: 0% (0/136) vs. 4.5% (6/133), 0.7% (1/139), all P < 0.05], the installation and disassembly time of ECG monitoring by nurses was significantly shortened [installation time (s): 69.12±16.47 vs. 96.74±3.89, 88.24±9.83; disassembly time (s): 50.24±4.54 vs. 75.76±4.98, 66.54±7.86, all P < 0.01], and the skin allergies rate [3.7% (5/136) vs. 15.8% (21/133), 8.6% (12/139)] and the insulation loss rate of the lead wires [2.9% (4/136) vs. 15.8% (21/133), 7.9% (11/139)] were significantly lowered (all P < 0.05).@*CONCLUSIONS@#The ECG monitoring patients using new modified sick clothes could increase their comfort, reduce the workload of nurses, save medical consumables, and have beautiful appearance and high practicability, which was worthy of clinical application.
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Humanos , Vestuário , Eletrocardiografia , Eletrodos , Monitorização FisiológicaRESUMO
Objective@#To investigate the current status of family hardiness and its influencing factors in children with leukemia.@*Methods@#The children with leukemia and their caregivers in the Children's Hospital of Shanxi from August to November 2017 were enrolled. A questionnaire survey was conducted using a convenient sampling method, and 100 questionnaires were distributed. The questionnaire included the General Status Questionnaire, the Family Hardiness Index (FHI), the Coping Health Inventory for Parents (CHIP) and the Positive and Negative Affect Scale (PANAS).@*Results@#A total of 92 valid questionnaires were collected. Among the scores of family hardiness in children with leukemia [(3.29±0.43) points], the responsibility score [(3.32±0.45) points] was higher than the control score [(3.31±0.46) points] and the challenge score [(3.23±0.53) points], and the challenge score was the lowest. The score of frequency of coping styles used by the caregiver of the child with leukemia was (3.64±0.70) points, the most frequent coping style used by the caregiver was "family unity, optimism, cooperative attitude" [(3.73±0.89) points], and the positive [(3.28±0.84) points] and negative [(2.51±0.80) points] emotions were in a moderate state. The child's sex, age, stage of chemotherapy and medical insurance status, the caregiver of the child, the age of the caregiver, the family's place of residence, and the education level were the related factors affecting the family hardiness score (all P < 0.01). The age of child, CHIP-1, CHIP-2, positive emotion and negative emotion were independent factors affecting the family hardiness (all P < 0.05). The CHIP, CHIP-1, CHIP-2 and positive emotion were positively correlated with the family hardiness (r values were 0.827, 0.883, 0.707 and 0.846, all P < 0.01); the negative emotion was negatively correlated with the family hardiness (r=-0.832, P < 0.01).@*Conclusion@#The family hardiness of children with leukemia is in the middle and upper level, the children's age, caregiver's coping style, positive emotion and negative emotion are factors affecting the family hardiness.
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Objective To design a new modified sick clothes for electrocardiogram (ECG) monitoring, and to observe its clinical application effect. Methods In order to overcome the shortcomings of the existing modified ECG monitoring clothes, a new type of modified sick clothes was designed on the basis of the traditional sick clothes, and a national utility model patent was obtained. 408 conscious patients with ECG monitoring admitted to department of neurology of the First Affiliated Hospital of Fujian Medical University from January 2015 to June 2018 were enrolled, and they were randomly divided into three groups according to the order of admission for comparing the wearing effect of three kinds of sick clothes. 133 patients dressed traditional clothes, while 139 patients dressed modified ECG monitoring clothes. According to the method reported in the literature, the pockets were removed on the basis of the traditional patient clothes, and a circular hole 5 cm in diameter was made at the position of the electrodes for ECG monitoring, which was used to pass through the lead wire and the electrodes. 136 patients dressed the new modified sick clothes. In view of the inconvenience of ECG monitoring and stimulation of patients' thoracic and abdominal skin by traditional sick clothes, the existing modified ECG monitoring clothes were not easy to operate, the location of electrodes sticking was not easy to judge and the lead line was messy, the new modified sick clothes were still based on the traditional ones. The three circular holes of the existing modified ECG monitoring clothes were made into incisions about 12 cm in length to facilitate the ECG monitoring lead line and electrodes sticking. A compression band or a simple patch was added to each side near the shoulder for tidying up the fixed lead. The self-evaluation of patient's comfort, the operation time of ECG monitoring by nurses, skin allergy rate and lead damage rate were recorded and compared among the three groups. Results Compared with the traditional sick clothes and the modified ECG monitoring clothes groups, the patients in the new modified sick clothes group had higher comfort [the proportion of no discomfort: 11.0% (15/136) vs. 0% (0/133), 5.8% (8/139); the proportion of severe discomfort: 0% (0/136) vs. 4.5% (6/133), 0.7% (1/139), all P < 0.05], the installation and disassembly time of ECG monitoring by nurses was significantly shortened [installation time (s): 69.12±16.47 vs. 96.74±3.89, 88.24±9.83; disassembly time (s): 50.24±4.54 vs. 75.76±4.98, 66.54±7.86, all P < 0.01], and the skin allergies rate [3.7% (5/136) vs. 15.8% (21/133), 8.6% (12/139)] and the insulation loss rate of the lead wires [2.9% (4/136) vs. 15.8% (21/133), 7.9% (11/139)] were significantly lowered (all P < 0.05). Conclusion The ECG monitoring patients using new modified sick clothes could increase their comfort, reduce the workload of nurses, save medical consumables, and have beautiful appearance and high practicability, which was worthy of clinical application.
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Purpose To explore the difference of prenatal ultrasound in the diagnosis of absence of nasal bone and short nasal bone in fetuses.Materials and Methods The clinical data of 23 131 pregnant women who received prenatal ultrasound system screening in the second trimester in the Third Affiliated Hospital of Zhengzhou University from August 2015 to July 2016 were analyzed retrospectively.The fetuses with absence of nasal bone and short nasal bone as well as the types of complicated malformation were recorded respectively,among whom those with chromosomal examination had their chromosomal results recorded.The fetuses were grouped for analysis based on absence of nasal bone,short nasal bone and whether they were complicated with malformation.Results Sixtynine fetuses had abnormal development of nasal bone,among whom 24 cases had absence of nasal bone (7 cases were complicated with malformation) and 45 cases had short nasal bone (13 cases were complicated with malformation),but there was no significant difference in the ratio of complicated malformation between fetuses with absence of nasal bone and those with short nasal bone (P>0.05).Of the 41 cases with analysis of chromosomal karyotypes,32 cases had single abnormal development of nasal bone (4 cases had chromosomal abnormality) and 9 cases had abnormal development complicated malformation of nasal bone (7 cases had chromosomal abnormality),and the occurrence rate of chromosomal abnormality in abnormal development complicated malformation of nasal bone was notably higher than that in single abnormal development of nasal bone (P<0.05).A total of 32 fetuses with single abnormal development of nasal bone received chromosomal examination,among whom 4 cases had chromosomal abnormality.Of the 32 fetuses,9 cases had single absence of nasal bone (one had chromosomal abnormality) and 23 cases had single short nasal bone (3 cases had chromosomal abnormality).However,there was no significant difference in the ratio of chromosomal abnormality between fetuses with single absence of nasal bone and those with single short nasal bone (P>0.05).Conclusion Abnormal development complicated with malformation of nasal bone is of great significance in the evaluation of chromosomes.And there is no significant difference in the ratios of complicated malformation and chromosomal abnormality between fetuses with absence of nasal bone and those with short nasal bone.
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Objective:To investigate the effects of ligamen remnant preservation on knee joint function and proprioception recovery in patients with anterior cruciate ligament (ACL) injuries during ACL reconstruction under arthroscope.Methods:The clinical data of 266 patients with ACL injuries,who were treated in the 174th hospital of PLA from January 2010 to March 2016,were retrospectively analyzed.All the patients underwent ACL reconstruction under arthroscopy,among them,163 patients with remnant preservation were chosen as remnant preservation group;103 patients with completely clearing remnant preservation in the operation,as non remnant preservation group.All the patients were followed up for more than 12 months,and the knee function and proprioception recovery of the two groups were evaluated.Results:There were no significant differences in the knee ipsilateral Lysholm score,international knee documentation committee knee assessment scale (IKDC) score,passive activity detection threshold,passive angle regeneration test results between the two groups before operation,9 and 12 months after operation (P>0.05).The Lysholm scores and IKDC scores of the two groups at each time point were significantly higher than those before operation,the passive activity detection threshold and passive angle regeneration test results were significantly lower than those before operation (P<0.05).The Lysholm scores and IKDC scores in the remnant preservation group 3 and 6 months after operation were higher than those in the non remnant preservation group,the passive activity detection threshold and the passive angle regenerated test results were lower than the non remnant preservation group,the difference was statistically significant (P<0.05).Conclusion:Remnant preservation in the ACL reconstruction under arthroscopy can accelerate the recovery of knee joint function and proprioception,and satisfactory clinical results are achieved,which is worth popularizing.
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Objective@#To investigate the effects of mandibular advancement device (MAD) upon nuclear factor κB (NF-κB), tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in the genioglossus.@*Methods@#Eighteen New Zealand white rabbits (male, six months old), in accordance with the random number table, were equally divided into three groups, the control group, obstructive sleep apnea hypopnea syndrome (OSAHS) group and MAD group. All animals were induced to sleep in supine position for 2 hours every morning in the next 8 weeks. The specimens of genioglossus were prepared. The relative expression of NF-κB p65 was measured with Western blotting and the mass concentration of TNF-α and IL-6 was determined with enzyme-linked immunosorbent assay.@*Results@#The relative expressions of NF-κB p65 protein in genioglossus in the control group, OSAHS group and MAD group were 0.24±0.07, 0.44±0.08 and 0.30±0.09, respectively. The mass concentrations of TNF-α in genioglossus in the control group, OSAHS group and MAD group were (0.065±0.020), (0.097±0.018) and (0.071±0.020) μg/L, respectively. The mass concentrations of IL-6 in genioglossus in the control group, OSAHS group and MAD group were (0.063±0.013), (0.093±0.017), and (0.069±0.014) μg/L, respectively. For the above indicators, the data in OSAHS group were all significantly higher than that in MAD group and the control group (P<0.05). No significant difference was found between MAD group and the control group (P>0.05).@*Conclusions@#Treatment of OSAHS with MAD decreased the mass concentration of TNF-α and IL-6 leading to fatigue of genioglossus, reduced the activation of NF-κB and played a significant role in protecting genioglossus.
RESUMO
ObjectiveTo observe the clinical efficacy of qi-blood-supplementing needling in treating the incipient leukopenia after chemotherapy for breast cancer.MethodSeventy-eight patients with incipient leukopenia after chemotherapy for breast cancer were recruited and randomized into a control group (38 cases) and a treatment group (40 cases). The control group was intervened by medications for increasing white blood cell (WBC) count, while the treatment group was by qi-blood-supplementing needling plus the medication. The therapeutic efficacies were evaluated at the end of the intervention.ResultThe WBC counts increased significantly in both groups after treatment (P<0.01), and the count in the treatment group was significantly higher than that in the control group (P<0.05). The total effective rate was 95.0% in the treatment group versus 89.5% in the control group, and the therapeutic efficacy of the treatment group was superior to that of the control group (P<0.05). The treatment group was also better than the control group in improving symptoms including poor appetite, fatigue, pale complexion, and lassitude (P<0.05,P<0.01).ConclusionFor patients with incipient leukopenia after chemotherapy for breast cancer, qi-blood-supplementing needling plus medication for increasing WBC count can up-regulate the WBC count and improve the symptoms due to qi-blood deficiency.