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OBJECTIVE To prepare the Eriodictyol chewable tablet and to evaluate its quality. METHODS The chewable tablet was prepared by the wetting granulation method by using microcrystalline cellulose （MCC） and mannitol as fillers， polyvinylpyrrolidone （PVP） as adhesive， citric acid and sucralose as flavor correction agents， magnesium stearate as lubricant. The comprehensive evaluation was conducted on Eriodictyol chewable tablets with the dosage of each excipient as a factor using the appearance， taste， flavor and texture as indicators. The ratio of excipients was optimized by orthogonal test， and the quality of Eriodictyol chewable tablets prepared by optimized formulation was evaluated in terms of appearance， weight difference， hardness， fragility， eriodictyol content， dissolution and content uniformity. RESULTS The optimal formulation was as follows： 26.4% eriodictyol （50 mg each piece）， 45% mannitol， 25% MCC， 0.3% citric acid， 0.3% sucralose， 1% magnesium stearate， 2% PVP （preparing 5% solution using purified water）. The scores of 3 batches of Eriodictyol chewable tablets in the validation test were 8.76， 8.75 and 8.80 （RSD＝0.30%， n＝3）， respectively. The Eriodictyol chewable tablet had a complete appearance and a smooth surface； the average tablet weight was 192.57 mg， the average hardness was 57.36 N， the fragility was 0.09%， the average content of eriodictyol per tablet was 50.74 mg， the cumulative dissolution within 30 min was exceeding 80%， and the content uniformity was 5.51. CONCLUSIONS Eriodictyol chewable tablet prepared by optimal formulation conforms to the requirements of the 2020 edition of Chinese Pharmacopoeia.
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Objective:To investigate the prevalence of Mycoplasma pneumoniae ( Mp) in children undergoing physical examination. Methods:This study randomly enrolled 1 303 children at the age of 6-12 years who underwent physical examination in 2023. Their oral and pharyngeal swabs as well as venous blood samples were collected. The prevalence of Mp in these subjects was detected using isolation and culturing, nucleic acid detection and serological test. Chi-square test was used for statistical analysis. Results:Among the 1 303 children, the detection rate of Mp was 4.1% (53/1 303) by culturing, 7.3% (95/1 303) by nucleic acid detection and 13.6% (177/1 303) by serological test. Statistical analysis showed that there were significant differences in the the detection rates of Mp among children undergoing physical examination between the three methods ( P<0.05). Conclusions:The detection rate of Mp in children undergoing physical examination in 2023 was about 4.1%. Isolation and culturing was more accurate than nucleic acid detection and serological test in the detection of Mp in healthy population as the latter two methods would overestimate the rate.
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Objective:To analyze the maternal and neonatal outcomes of pregnant women with leukemia.Methods:This retrospective study analyzed the clinical data of singleton pregnant women with leukemia and their neonates at the Obstetrics Department of Peking University People's Hospital from June 2009 to May 2021. Statistical analysis was performed using a two-sample t-test, the Wilcoxon Mann-Whitney rank sum test, and the Chi-square test (or Fisher's exact test). Results:(1) Ninety-one pregnant women were enrolled in this study, accounting for 2.8‰ of all deliveries during the same period. Among them, there were 15 (16.5%) with acute lymphoblastic leukemia, 38 (41.8%) with acute myeloid leukemia, and 38 (41.8%) with chronic myelogenous leukemia. Twenty-nine of the 91 pregnancies (31.9%) were terminated in the second or third trimester, and 62 babies (68.1%) were born through spontaneous delivery or cesarean section. The 62 parturients were (30.1±5.0) years old, of whom two died of complications of leukemia within 7 d after delivery, and five were transferred to the intensive care unit after delivery. Of the 62 cases, 18 (29.0%) received a blood transfusion and 12 (19.3%) received chemotherapy during pregnancy. (2) The proportion of patients with unremitted leukemia during pregnancy or newly developed leukemia was higher in women with terminated pregnancy than in those who continued the pregnancy [96.6% (28/29) vs 54.8% (34/62), χ2=15.83, P<0.001]. (3) The gestational age of the 62 newborns was (37.7±2.7) weeks. Premature, low birth weight and small-for-gestational-age infants accounted for 29.0% (18/62), 25.8% (16/62), and 12.9% (8/62), respectively. Hyperbilirubinemia occurred in 10 neonates (16.1%) and hypoglycemia in two (3.2%). Perinatal anoxia and asphyxia were reported in 13 cases (21.0%). Appearance, organ malformations, or chromosomal abnormalities were found in four neonates (6.4%) whose mothers did not receive chemotherapy during pregnancy. Fifty-nine infants underwent routine blood tests within 3 d after birth. The results showed that the mean white blood cell count, hemoglobin concentration, and platelet count were (16.1±7.0)×10 9/L, (181.5±20.0) g/L and (266.2±63.7)×10 9/L, respectively, and no juvenile cells were detected in their peripheral blood samples. Twenty children were followed up to 4 years and 4 months (9 months to 10 years and 3 months). No abnormalities in physical or mental development, motor function, or hematological system were reported. Conclusions:Pregnancy complicated by leukemia is rare and dangerous, which requires an individualized management strategy besides therapy for leukemia. A good prognosis is still expected with appropriate treatment.
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Objective:To evaluate the effect of exosomes derived from bone mesenchymal stem cells (BMSCs-EXO) on the postoperative cognitive function and silent infomation regulator 1 (SIRT1)/ nuclear factor kappa B (NF-κB) signaling pathway in aged mice.Methods:BMSCs-EXO were isolated by differential centrifugation method and then identified. Twenty healthy male C57BL/6 aged mice, aged 18 months, weighing 35-40 g, were divided into 4 groups ( n=5 each) using a random number table method: sham operation group (Sham group), operation group (O group), BMSCs-EXO group and EX527 (SIRT1 inhibitor)group. The abdomen regions were shaved for sterilization without exploratory laparotomy in Sham group. Exploratory laparotomy was performed in O group. BMSCs-EXO 50 μg was injected through the tail vein at 1 h before surgery in BMSCs-EXO group. EX527 5 mg/kg was intraperitoneally injected daily at 1-3 days before surgery, and BMSCs-EXO 50 μg was injected through the tail vein at 1 h before surgery in EX527 group. Morris water maze test was used to evaluate the learning and memory ability for 5 consecutive days staring from the 1st day after surgery. Mice were sacrificed at 1 h after the end of Morris water maze test on day 5 after surgery, and the hippocampal tissues were collected for observation of the pathological changes of hippocampal CA1 region and for determination of the expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1β mRNA (quantitative real-time polymerase chain reaction) and SIRT1 and NF-κB p65 (by Western blot). Results:Compared with Sham group, the escape latency was significantly prolonged, the times of original platform crossing were decreased, the swimming time spent in the original platform quadrant was shortened, the expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1β mRNA was up-regulated, the SIRT1 expression was down-regulated, the NF-κB p65 expression was up-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were found in O group. Compared with O group, the escape latency was significantly shortened, the times of original platform crossing were increased, the swimming time spent in the original platform quadrant was prolonged, the expression of TNF-α, IL-6 and IL-1β mRNA was down-regulated, the expression of SIRT1 was up-regulated, the expression of NF-κB p65 was down-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were significantly attenuated in BMSCs-EXO group ( P<0.05). Compared with BMSCs-EXO group, the escape latency was significantly prolonged, the times of original platform crossing were decreased, the swimming time spent in the original platform quadrant was shortened, the expression of TNF-α, IL-6 and IL-1β mRNA was up-regulated, the SIRT1 expression was down-regulated, the NF-κB p65 expression was up-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were accentuated in EX527 group. Conclusions:BMSCs-EXO can improve the postoperative cognitive function in aged mice, and the mechanism may be associated with the activation of SIRT1/NF-κB signaling pathway.
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Objective:To analyze and summarize the clinical characteristics, endoscopic manifestations, pathology and treatment of gastric adenocarcinoma of the fundic gland(GA-FD)to promote clinicians' understanding of this disease.Methods:The clinical data of 3 patients with GA-FD admitted to Beijing Hospital from May 2020 to January 2022 were retrospectively analyzed.Among them, 2 presented with abdominal distension or abdominal pain.The other case was diagnosed during follow-up endoscopy after gastrectomy for gastric cancer.A diagnosis of GA-FD was made based on the results of white light imaging, magnifying endoscopy, pathology and immunohistochemistry.In addition, we reviewed the literature about GA-FD between January 1990 and April 2021 from both national and international reports of 195 cases.We analyzed and summarized the endoscopic and pathological characteristics of the disease and insights on its diagnosis and treatment.Results:Of all 198 cases, patients had a male/female ratio of 1.6/1.0 and an average age of 65.3 years(range: 39-87 years).79.82%(91/114)of the patients were negative for Helicobacter pylori.Gastroscopy showed that the average diameter was 8.97 mm, and 89.9%(178/198)of the patients had lesions infiltrating into the submucosa.91.98%(149/162)of the patients had gastric chief cells as the predominant cell type, 98.86%(130/140)had no lymphovascular invasion, and 97.6%(162/166)had no recurrence or metastasis.Conclusions:GA-FD is a rare gastric cancer, with low-grade atypia and highly differentiated tissues.The mechanisms of GA-FD are not clear and the disease is more commonly seen in the elderly.There is no obvious correlation between Helicobacter pylori infections and GA-FD.Gastric chief cells make up the predominant cell type.The results of endoscopy, pathology and immunohistochemistry can help confirm the diagnosis.The prognosis of most cases is good.
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Objective:To analyze the risk factors of acute kidney injury (AKI) in hip fracture patients with serious underlying diseases and establish a prediction nomogram.Methods:Clinical information of hip fracture patients admitted to the intensive care unit (ICU) of Beth Israel Deaconess Medical Center (BIDMC) was analyzed using the Medical Information Mart for Intensive Care (MIMIC)-IV. Patient comorbidities, disease scores, vital signs and laboratory tests, surgical modalities, invasive procedures, and drug use were recorded. According to the diagnostic criteria of AKI in the Kidney Disease Improving Global Outcome (KDIGO) guideline, the enrolled patients were randomly divided into training set and validation set. Based on logistic regression analysis, least absolute shrinkage and selection operator (LASSO) logistic regression algorithm was used to analyze the risk factors of AKI after admission, and the corresponding prediction model was calculated.Results:A total of 474 patients were enrolled, including 331 in the training set and 143 in the validation set. According to the diagnostic criteria of AKI of KDIGO guidelines, the patients were divided into AKI group (159 cases) and non-AKI group (172 cases). Univariate analysis showed that age ( t=2.61, P=0.009), coronary heart disease (χ 2=2.08, P=0.038), heart failure (χ 2=2.60, P=0.009), hemoglobin ( t=1.89, P=0.059), platelets ( t=1.81, P=0.070), urea nitrogen ( t=2.83, P=0.005), blood creatinine ( t=3.65, P<0.001), blood sodium ( t=2.55, P=0.011), blood glucose ( t=2.52, P=0.012), anion gap ( t=3.44, P=0.001), diastolic blood pressure ( t=2.72, P=0.007), mean arterial pressure ( t=2.16, P=0.031), SOFA score ( t=3.69, P<0.001), simplified acute physiological function score II (SAPSII) score ( t=2.95, P=0.003), as well as furosemide (χ 2=2.03, P=0.042), vancomycin (χ 2=1.70, P=0.089), vasoactive medications (χ 2=3.74, P<0.001) and use of invasive mechanical ventilation (χ 2=4.81, P<0.001) were risk factors associated with the development of AKI in hip fracture patients. Multivariate logistic regression analysis showed that age ( OR=1.03, P<0.001), coronary heart disease ( OR=2.05, P=0.069), hemoglobin ( OR=0.88, P=0.050), blood creatinine ( OR=1.37, P=0.009), blood sodium ( OR=1.07, P=0.026), anion gap ( OR=1.09, P=0.028) and vasoactive medications ( OR=3.83, P=0.018) and the use of invasive mechanical ventilation ( OR=6.56, P<0.001) were independent predictors of the development of AKI in hip fracture patients with serious underlying diseases. The area under the curve of the nomogram prediction model constructed by the above 8 predictors was 0.789, and the calibration curve of the nomogram was close to the ideal diagonal. Decision curve analysis showed that the net benefit of the model was significant. Conclusion:The incidence of AKI is high in hip fracture patients with serious underlying diseases. Age, coronary heart disease, hemoglobin, serum creatinine, serum sodium, anion gap, vasoactive drugs, and invasive mechanical ventilation can predict the occurrence of AKI to a certain extent. Combined with the risk factors, the construction of the corresponding prediction model can predict and manage the diagnosis and treatment of AKI in patients with hip fracture complicated with severe underlying diseases.
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Objective:To study the safety and feasibility of en-bloc lymph node dissection in laparoscopic radical resection for gallbladder cancer(GBC).Methods:The clinical data of 87 patients who underwent laparoscopic radical resection for GBC at Zhejiang Provincial People's Hospital from January 2014 to February 2022 were retrospectively analyzed. There were 26 males and 61 females, aged 67.0 (59.0, 72.0) years old. The patients were divided into the en-bloc dissection group ( n=29) and the non-en-bloc dissection group ( n=58) based on whether en-bloc lymph node dissection was carried out. Differences in general data, tumor characteristics, operation, recurrence and survival were compared between the two groups. Postoperative survival status of these patients was followed-up by telephone. Results:The number of lymph nodes dissected in the en-bloc dissection group was 9.0(8.0, 12.0), which was significantly higher than the 8.0(4.8, 11.0) in the non-en-bloc dissection group ( Z=-2.39, P=0.017). There were no significant differences in age, gender, preoperative blood biochemical indexes, tumor carbohydrate antigen 19-9, tumor stage, nerve and vascular invasion, operation time, intraoperative blood loss, postoperative drainage tube retention time, postoperative hospital stay, and incidences of postoperative complications (biliary fistula, abdominal hemorrhage and abdominal infection) between the two groups (all P>0.05). The median survival was longer in the en-bloc group than in the non-en-bloc group (21 vs. 15 months), and the median relapse-free survival time was 18 months in the en-bloc group compared with 10 months in the non-en-bloc group. However, there were no significant differences in postoperative cumulative survival and recurrence-free survival between the two groups (all P>0.05). Conclusion:En-bloc lymphadenectomy was safe and feasible in laparoscopic radical GBC surgery, with more lymph nodes being removed than the non-en-bloc lymphadenectomy group.
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Objective:To explore the value of the deep learning image reconstruction (DLIR) algorithm in improving the CT image quality of abdominal phantoms under different radiation doses by comparing the DLIR algorithm with the conventional Adaptive Statistical Iterative Reconstruction-V (ASIR-V) technique.Methods:Two groups with tube voltages of 100 kV and 120 kV (also referred to as the 100 kV and 120 kV groups, respectively) were involved. Each group was further divided into six subgroups based on different volumetric CT dose indices (CTDI vol: 2, 4, 6, 8, 10 and 15 mGy). Subsequently, CT images based on the filtered back projection (FBP) algorithm were obtained and were then reconstructed using the ASIR-V algorithm with different weights (ASIR-V 50%, 80%, and 100%) and the DLIR algorithm with different levels (DLIR-L, M, and -H). As a result, 84 groups of images were obtained in total. Afterward, this study compared and analyzed the variations in CT values, noise, signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), and subjective scores of various parts in various CTDI vol subgroups under different reconstruction conditions. In addition, the subjective scores of the image quality were compared using the Kruskal-Wallis H test, while objective indices and radiation doses were compared through the univariate analysis of variance (ANOVA) and the paired t test. Results:Under the same tube voltage, there were statistically significant differences in the noise, SNRs, and CNRs of various parts in various CTDI vol subgroups under different reconstruction conditions ( F = 415.39, 315.30, P < 0.001), while there was no statistically significant difference in the noise, SNRs, and CNRs of images constructed using ASIR-V 50% and DLIR-L ( P > 0.05). Under different tube voltages, the subjective scores of both groups show statistically significant differences (100 kV group: H = 13.47, P = 0.036; 120 kV group: H = 12.99, P = 0.043). Moreover, two physicians offered consistent subjective scores, with Kappa values > 0.70. Among these images, DLIR-H images showed the highest subjective scores, followed by DLIR-M and ASIR-V 50% images, which had roughly consistent subjective scores. Moreover, the subjective scores of the 100 kV group were slightly higher than those of the 120 kV group. With the ASIR-V 50% images of the subgroup with a CTDI vol of 15 mGy as references, the DLIR-L, -M, and -H reduced radiation doses by more than 30%, 70% and 85%, respectively on the premise that diagnostic requirements were met. Conclusions:The DLIR algorithm can not only significantly reduce the image noise and improve the image quality, but also effectively decrease the radiation doses on the premise of meeting the diagnostic requirements. It is recommended that 100 kV tube voltage combined with a medium- or high-level DLIR algorithm should be applied to low-dose abdominal CT scans in clinical applications.
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Objective:To investigate whether radiomics based on ultrasound images can predict lym-phatic metastasis of rectal cancer before surgery.Methods:A total of 80 patients with rectal cancer who underwent endorectal ultrasound (TRUS) and endorectal elastography were confirmed by postoperative pathology in Zhejiang Cancer Hospital from January 2016 to December 2019 were retrospectively analyzed. The general characteristics (gender, age, tumor size, depth of tumor infiltration, tumor location, carcinoembryonic antigen, glycoantigen 199) of the lymph node metastasis group ( n=27) and the non-metastasis group ( n=53) were compared, and the clinical risk factors with statistically significant differences were screened out. The tumor maximum sagittal 2D TRUS images and endorectal elastography were manually outlined, and the radiomics features were extracted using the open source software pyradiomics 3.0.1, and the filtering and embedding methods were used to reduce the dimensionality of the data to select the important features and obtain the best parameters of the model. Then all samples were randomly divided into training and validation sets in the ratio of 8∶2, the models were trained using the best model parameters, which were tested and validated in the validation set, and the predictive efficacy of different models was evaluated according to the ROC curve. Results:The depth of tumor infiltration was statistically significant in predicting whether the lymph nodes metastasized or not (χ 2=11.555, P<0.05), and its area under ROC curve(AUC) value was 0.699. A total of 1 710 features were extracted from sagittal 2D TRUS images and endorectal elastography. After pre-processing and screening, 10 features were strongly correlated with lymph node metastasis status. The 10 features were used to construct the prediction models with AUC values of 0.703, 0.726 and 0.742 for the Logistic Regression Model, Random Forest Model and Support Vector Machine Model, respectively. And the AUC value of the ensemble averaging model in the validation set was 0.734. The imaging-omics prediction model outperformed the prediction model based on statistical analysis of clinical data (AUC: 0.734 vs 0.699, Z=1.984), with a statistically significant difference ( P<0.05). Conclusions:The endorectal ultrasound and endorectal elastography-based radiomics model constructed in this study is better than the model constructed based on statistical analysis of clinical data only, and it is valuable for preoperative lymph node metastasis prediction in rectal cancer.
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The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
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Objective:The differential diagnosis of pulmonary artery sarcoma (PAS) and pulmonary embolism (PE) by double-detector spectral computerized tomography (CT) provides a new way to improve the detection rate of PAS and reduce the misdiagnosis rate.Methods:In the way of retrospective study, the Philips Nebula Workstation (ISP) was used to reconstruct electron density map, iodine density map and spectral curve in the spectral CT plain scan and enhancement of the PAS patient. In the plain scan image, the low density areas of the ascending aorta and the right pulmonary trunk were selected to measure their electronic density values. In the chest enhancement image, the iodine density of PAS area and PE area were measured respectively, and the spectral curves of PSA area and PE area were compared.Results:The electron density of the ascending aorta and the right pulmonary trunk in the low density area of the PAS patient during the plain scan of spectral CT were 104.4% EDW (relative to the percentage of the electron density of water) and 102.2% EDW, respectively, which were lower than those in the normal ascending aorta area. The fusion image of mixed energy and electron density clearly reflected the scope of the lesion. The iodine density in PAS area was 1.89 mg/ml, and the iodine density in PE area was 0.03 mg/ml during the enhancement phase. The iodine uptake in PAS area was significantly higher than that in PE area. The slope of PAS region was 2.08, and the slope of PE region was -1.86. The slopes of the two spectral curves were inconsistent.Conclusions:The electronic density, iodine density and spectral curve measured by double-detector spectral CT may provide powerful imaging basis for the diagnosis of PAS and the differentiation of PAS from PE, which is helpful for the early diagnosis of the lesions, and also provide basis for the biopsy location of the mixed lesions of PAS and PE.
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Objective:To investigate the correlation between cognitive function and addiction, impulsivity, and anhedonia in adolescent depressive disorder patients with self-injury behavior.Methods:From September 2021 to October 2022, adolescents with depressive disorders who visited the outpatient department of the Qingdao Mental Health Center were enrolled and divided into self-injury group and non self-injury group based on the presence or absence of self-injury behaviors, each with 60 participants.A self-compiled general information questionnaire, the 17 items Hamilton depression rating scale (HAMD-17), the Ottawa self-injury inventory (OSI), the Chinese version of the Barratt impulsiveness scale (BIS-11), and the temporal experience of pleasure scale(TEPS) were used to evaluate both groups.The Chinese brief cognitive test(C-BCT) was used to assess cognitive function in both groups.SPSS 26.0 software was used for statistical analysis, including t-test, χ2 test, Pearson correlation analysis, and multiple linear regression analysis. Results:The self-injury group had higher scores for OSI addiction factors (9.43±8.29) and BIS-11 (67.09±11.48) compared to the non self-injury group (OSI addiction factor scores: 0, BIS-11 scores: 53.70±7.12, t=6.22, 5.91, both P<0.05). TEPS score and C-BCT scores in various dimensions were lower in the self-injury group than those in the non self-injury group ( t=-2.93, -2.01, -2.88, -2.20, -5.35, all P<0.05). Information processing speed was negatively correlated with BIS-11 score ( r=-0.296, P<0.05), and attention score were negatively correlated with OSI addiction factor score and BIS-11 score ( r=-0.303, -0.561, both P<0.05) and positively correlated with TEPS score ( r=0.364, P<0.05), including a positive correlation with the scale of anticipatory anhedonia score ( r=0.318, P<0.05). Working memory score was negatively correlated with OSI addiction factor score and BIS-11 score ( r=-0.312, -0.416, both P<0.05). Comprehensive ability and executive function scores were negatively correlated with OSI addiction factor score and BIS-11 score ( r=-0.308, -0.679, both P<0.05), and positively correlated with TEPS score ( r=0.304, P<0.05). Multiple linear regression analysis showed that BIS-11 scores were influencing factors of C-BCT dimensions ( β=-0.260, -0.592, -0.557, -1.797, t=-2.150, -3.314, -2.285, -5.165, all P<0.05). Conclusion:In adolescent depressive patients with self-injury, cognitive function is correlated with addiction, impulsivity and anhedonia, among which impulsivity is a risk factor for cognitive function.
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Objective:To explore the influencing factors of tuberculosis related health behaviors among college freshmen with health belief model, so as to provide a scientific basis for the intervention of health behaviors among students.Methods:From January to February 2021, the questionnaire survey was conducted among 5 254 college freshmen from 11 universities.The survey included general demographic data, tuberculosis related health behaviors, and tuberculosis related knowledge, disease threat perception and disease policy cognition.The SPSS 23.0 software was used for data analysis, independent sample t-test and one-way ANOVA were used for inter group comparison, and Logistic regression analysis was used to explore the influencing factors of health behavior holding. Results:The total score of tuberculosis related health behaviors among freshmen was 3~12 (11.01±1.10), and the overall holding rate of tuberculosis related health behaviors was higher.Male( B=-0.753, OR(95% CI)=0.471(0.417-0.531)), and tuberculosis history ( B=-1.088, OR(95% CI)=0.337(0.157-0.722)) were risk factors for tuberculosis related health behaviors among freshmen.Birth in city( B=0.117, OR(95% CI)=1.124(0.944-1.338)), father's education level college /undergraduate and above ( B=0.177, OR(95% CI)=1.194(1.024-1.392)), mother's education level high school/secondary school( B=0.356, OR(95% CI)=1.428(1.126-1.810)), college/undergraduate and above( B=0.194, OR(95% CI)=1.214(1.029-1.433)), take the initiative to understand tuberculosis knowledge ( B=0.208, OR(95% CI)=1.231(1.095-1.385)), higher tuberculosis knowledge score ( B=0.088, OR(95% CI)=1.092(1.041-1.145)), higher disease threat perception score ( B=0.082, OR(95% CI)=1.086(1.031-1.144)) and higher disease policy cognition score( B=0.320, OR(95% CI)=1.378(1.265-1.500)) were protective factors for tuberculosis related health behaviors among first-year undergraduates(all P<0.05). Conclusion:The application of health belief model can analyze and explain the influencing factors of tuberculosis-related health behaviors of freshmen, which is helpful to strengthen health education and advocate tuberculosis-related health behaviors.
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Benzodiazepines(BDZs)are used in clinics for anxiolysis,anticonvulsants,sedative hypnosis,and muscle relaxation.They have high consumptions worldwide because of their easy availability and potential addiction.They are often used for suicide or criminal practices such as abduction and drug-facilitated sexual assault.The pharmacological effects of using small doses of BDZs and their detections from complex biological matrices are challenging.Efficient pretreatment methods followed by accurate and sensitive detections are necessary.Herein,pretreatment methods for the extraction,enrichment,and preconcentration of BDZs as well as the strategies for their screening,identification,and quantitation developed in the past five years have been reviewed.Moreover,recent advances in various methods are summarized.Characteristics and advantages of each method are encompassed.Future directions of the pretreatment and detection methods for BDZs are also reviewed.
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Trace amines(TAs)are metabolically related to catecholamine and associated with cancer and neuro-logical disorders.Comprehensive measurement of TAs is essential for understanding pathological pro-cesses and providing proper drug intervention.However,the trace amounts and chemical instability of TAs challenge quantification.Here,diisopropyl phosphite coupled with chip two-dimensional(2D)liquid chromatography tandem triple-quadrupole mass spectrometry(LC-QQQ/MS)was developed to simul-taneously determine TAs and associated metabolites.The results showed that the sensitivities of TAs increased up to 5520 times compared with those using nonderivatized LC-QQQ/MS.This sensitive method was utilized to investigate their alterations in hepatoma cells after treatment with sorafenib.The significantly altered TAs and associated metabolites suggested that phenylalanine and tyrosine metabolic pathways were related to sorafenib treatment in Hep3B cells.This sensitive method has great potential to elucidate the mechanism and diagnose diseases considering that an increasing number of physiological functions of TAs have been discovered in recent decades.
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Objective:To observe the effect of neuroendoscope-assisted drainage with lumbar cistern and large bone flap decompression in the treatment of craniocerebral injury complicated with temporal uncinate herniation.Methods:A total of 80 patients with craniocerebral trauma and temporal uncinate herniation hospitalized in Lanling County People′s Hospital from January 2017 to October 2020 were retrospectively included and divided into the observation group and the control group according to the surgical methods, with 40 patients in each group. Surgical procedures were performed by the same group of experienced neurosurgeons. The observation group was treated with neuroendoscope-assisted drainage with lumbar cistern and large bone flap decompression, while the control group was treated with large bone flap decompression only. Cephalic CT was reexamined before and 48 h after the surgery to compare the appearance rates of cisterna ambiens and suprasellar cistern. Intracranial pressure (ICP) was monitored at 3, 5 and 7 d after the surgery, and the scores of Glasgow coma scale(GCS) was recorded. Drainage time, postoperative cerebral edema and cerebral infarction complications were recorded and compared between the two groups. Six months after the surgery, the prognosis was assessed by the Glasgow prognostic scale (GPS).Results:The occurrence rates of cisterna ambiens and suprasellarcistern in the observation group were higher than those in the control group: 67.50%(27/40) vs. 45.00%(18/40), 65.00%(26/40) vs. 42.50%(17/40), χ2 = 4.11, 4.07, P<0.05. The ICP value in the observation group at 3, 5 and 7 d after the surgery were significantly lower than those in the control group, and the scores of GCS in the observation group were significantly higher than those in the control group, there were statistical differences( P<0.05). There was no statistically significant difference in drainage time between the two groups ( P>0.05). The incidence of postoperative cerebral edema in the observation group was lower than that in the control group:7.50%(3/40) vs. 25.00%(10/40), χ2 = 4.50, P<0.05. The incidence of postoperative cerebral infarction in the observation group was lower than that in the control group, and the volume of cerebral infarction was smaller than that in the control group: 5.00%(2/40) vs. 22.50%(9/40), (6.68 ± 1.75) cm 3 vs. (8.20 ± 2.15) cm 3, there were statistical differences ( P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group: 7.50%(7/40) vs. 40.00%(16/40), χ2 = 4.94, P<0.05. Six months after the surgery, the rate of good prognosis in the observation group was higher than that in the control group: 62.50%(25/40) vs. 35.00%(14/40), χ2 = 6.05, P<0.05. Conclusions:Neuroendoscope-assisted drainage with lumbar cistern and large bone flap decompression in the treatment of craniocerebral trauma and temporal uncinate herniation has good efficacy and safety.
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Objective:To observe the diurnal changes of serum hypoxia inducible factor-1α (HIF-1α) and its relationship with polysomnography (PSG) parameters in obese patients with obstructive sleep apnea (OSA).Methods:In this study, 64 obese subjects with OSA (experimental group) and 24 normal subjects (control group) were included. PSG monitoring was performed in all subjects, and peripheral blood samples were collected at night and next early morning to detect the expression level of HIF-1 α mRNA and protein concentration in serum. The data were analyzed by SPSS25.0 software. The counting data was represented by n(%), and t-tests were used for inter group comparisons. The measurement data of normal distribution adopted mean ± standard deviation ( ± s), and the inter group comparison adopted Chi-square. Serum HIF-1α mRNA levels and protein concentrations in the two groups were compared and analyzed by Two-way ANOVA, and Spearman rank correlation was used to analyze the correlation. Results:The ratio of male to female in the control group was 15: 9 and the average age was (39.25 ±10.58) years old, while that in the experimental group was 41∶24 with an average age of (41.31 ±15.20) years. The body mass index (BMI) of experimental group was higher, while all the relevant parameters recorded by PSG were significantly different between two groups ( P<0.001). The results showed that there was no significant difference in the expression of HIF-1α mRNA between the control group and the experimental group ( P=0.914), or between night and morning ( P=0.167). The concentration of HIF-1α protein in the control group was significantly lower than that in the experimental group ( P<0.001), but there was no significant difference in the concentration of HIF-1α protein in the same group at night and in the morning ( P=0.798). The results of correlation analysis showed that there was a significant correlation between PSG related indexes(AHI, minimum blood oxygen, mean blood oxygen and SIT90), night and morning mRNA expression and protein concentration ( P<0.05). Conclusions:Compared with normal people, the concentration of serum HIF-1 α protein in obese patients with OSA is higher, but there is no difference between night and morning. The process of HIF-1 α induced by CIH may be involved in post-translational regulation rather than transcription, and other compensatory mechanisms may also be involved.
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Objective: To analyze the base incidence, distribution characteristics, survival status and social security of occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") in Zibo City. Methods: The new pneumoconiosis patients in Zibo City from 1949 to 2021 were selected as the research subjects using a cross-sectional survey. Household survey or telephone follow-up were carried out, and the distribution characteristics, living conditions and social security situation were retrospectively analyzed. Results: A total of 8 910 patients with pneumoconiosis were investigated, and 96.0% of them were male. The stage Ⅰ pneumoconiosis patients accounted for 91.3%. From 1949 to 2021, the number of pneumoconiosis patients showed a stepwise upward trend with time. Most of the patients suffered from coal worker pneumoconiosis and silicosis, which accounted for 48.7% and 38.9%, respectively. The average age of onset was (52.7±11.4) years, and the average length of service exposed to dust was (21.1±9.4) years. The patients were concentrated in Zichuan District, Boshan District and Zhangdian District, that accounted for 87.8%. The industry distribution was mostly mining industry and manufacturing industry, accounting for 61.1% and 31.6% respectively. Among the 8 910 cases of pneumoconiosis, 543 cases were lost in follow-up. A total of 8 367 patients were followed-up, with a follow-up rate of 93.9%. The mortality rate of patients who completed follow-up was 50.5%, and the mortality rate decreased with the increase of the stage of pneumoconiosis (P<0.01). The rate of adoring social security in the 4 138 surviving patients was 98.4%. Conclusion: The situation of prevention and treatment of pneumoconiosis in Zibo City is challenging. It is necessary to strengthen the special control of dust hazards in mining and manufacturing industries in key areas such as Zichuan District, Boshan District and Zhangdian District.
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OBJECTIVE To provide a reference for the safe use of drugs in patients with complex venous thromboembolism （VTE） and acute renal insufficiency. METHODS Clinical pharmacists participated in the management of anticoagulant therapy for a patient with complex VTE complicated with acute renal insufficiency， and evaluated the patient as high-risk thrombosis and bleeding based on their medical history， laboratory test results， etc.； combined with the complexity of thrombosis and renal insufficiency， clinical pharmacists suggested that enoxaparin sodium should be used in the acute stage of thrombosis （5 to 21 days after onset）， and then warfarin should be adopted for oral anticoagulation treatment. Because the patient’s anticoagulation was not up to the standard （the target range of the international normalized ratio was 2-3）， clinical pharmacists suggested increasing the warfarin dose， detecting the warfarin metabolism genotype， and adjusting the warfarin dose according to the genotype； at the same time， clinical pharmacists developed an anticoagulation monitoring plan to ensure the safety of anticoagulation treatment. RESULTS Doctors had adopted all the recommendations of clinical pharmacists. The patient did not experience adverse events such as bleeding or worsening of thromboembolism during anticoagulation in the hospital. When the anticoagulation met the standards， the patient was allowed to be discharged with medication. CONCLUSIONS By participating in the anticoagulation treatment management of patients with complex VTE and acute renal insufficiency， clinical pharmacists have assisted doctors in formulating personalized anticoagulation plans to promote the compliance with the anticoagulation treatment standard and ensure the safety and effectiveness of medication for patients.
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Objective To investigate the current status of interventional radiology resources, radiation protection equipment, and the rate of wearing of personal dosimeters in Qingdao, China, and to provide a data basis for strengthening radiation protection and health management for interventional radiation workers. Methods A questionnaire survey was performed on all medical institutions with interventional radiation services in Qingdao. The data from April 1, 2020 to March 31, 2021 were pooled and analyzed. Results A total of 31 medical institutions in Qingdao were investigated, including 23 (74.20%) tertiary hospitals and 8 (25.80%) secondary hospitals. There were 88 pieces of interventional radiation equipment in total in Qingdao, 89.77% of which were in tertiary hospitals. A total of 921 interventional professionals participated, with 865 (93.92%) from tertiary hospitals and 56 (6.08%) from secondary hospitals. The mean annual number of visits to interventional services was 5.72 per 1000 people. Among personal protective equipment, the equipment rates of lead-rubber aprons, lead-rubber caps, and lead-rubber collars were highest, all being 100%. The rate of equipment of interventional protective gloves was lowest, which was only 51.61%. The mean number of each accessory protective equipment for each interventional machine was less than 1. The rate of wearing of dual-dosimeters was 84.36%. Conclusion Tertiary hospitals were dominant among the medical institutions in this survey of interventional radiology services in Qingdao. The most frequently equipped personal protective goods were lead-rubber aprons, caps, and collars. The equipment rates of interventional protective gloves and protective accessories and the rate of wearing of dual-dosimeters were relatively low.