RESUMO
[Objective]To investigate the effect of Baoyuan Jiedu Decoction(BJD)on serum lipids and white adipose tissue browning in cancer cachexia mice.[Methods]The specific pathogen free C57BL/6 mice were divided into normal group,model group,BJD group and megestrol acetate(MA)group.After 21 days of intervention,the changes of body weight,food intake,water consumption and tumor volume of the mice were observed,multidimensional mass spectrometry-based shotgun lipidomics(MDMS-SL)was used to determine the content of serum lipid of mice,white adipose tissue morphology and lipid droplet area were detected by hematoxylin-eosin(HE)staining,the expressions of white adipose tissue browning related genes were detected by Real-time quantitative polymerase chain reaction(Real-time PCR);and the protein expression of uncoupling protein 1(UCP1)was detected by Western blot and immunohistochemistry(IHC)staining.[Results]Compared with model group,the mice in BJD group were generally in good condition,and their food intake,water consumption and weight were increased significantly(P<0.05),and the volumes of tumors were significantly suppressed(P<0.05).Compared with normal group,there were 61 kinds of abnormal lipids in the serum of model group,while 30 kinds of lipids were influenced by BJD treatment(P<0.05).Compared with model group,BJD alleviated the mass loss and lipid droplets(P<0.05),inhibited the mRNA expression of UCP1,Cidea,Prdm16(P<0.05)and the protein expression of UCP1(P<0.05)in epididymal white adipose tissue(eWAT)and inguinal white adipose tissue(iWAT)of cancer cachexia mice.[Conclusion]BJD can inhibit weight loss,relieve the disorder of serum lipid,and inhibit the white adipose tissue browning of iWAT and eWAT of cancer cachexia mice.
RESUMO
Objective To explore the effect of head CT blend signs on short-term outcomes in patients with spontaneous supraten-torial intracerebral hemorrhage(ICH)after craniotomy.Methods A total of 435 patients with spontaneous supratentorial ICH who un-derwent craniotomy in the Department of Neurosurgery,Jinyang Hospital Affiliated to Guizhou Medical University from January 2019 to December 2022 were enrolled retrospectively.The patients were divided into the blend sign group(n=105)and control group(n=330)based on the CT features at admission.The general clinical data,imaging data,surgical data,complications and prognosis were collected and compared between the two groups.The outcome was assessed by the mRS(modified Rankin scale)at discharge.Multivariate Logistic regression model was used to analyze the independent correlation between CT blend sign and poor outcomes.Results During the follow-up period,there was no significant differences in the proportion of patients with poor outcomes between the two groups.The poor outcomes after craniotomy was independently correlated with age,smoking history,diabetes history and Glasgow coma scale(GCS)at admission,but not with blend signs.Conclusion Head CT blend signs on admission is not associated with the poor outcomes in patients with sponta-neous supratentorial ICH after craniotomy.
RESUMO
Objective To evaluate the effect of centralized procurement of artificial joint consumables on total arthro-plasty placement surgery.Methods Through a retrospective study,t-test was conducted on the medical quality and effi-ciency,hospitalization cost per time structure through July-December,2021 to July-December,2022 centralized pro-curement of joint replacement surgery in a tertiary hospital in Shanghai.Results After centralized procurement,the amount of knee arthroplasty surgery decreased,and the time of hip replacement surgery was increased,and the difference was statistically significant(P<0.05).The total cost,cost of consumables,arthrotomy fee of the two types of arthroplasty surgery were significantly decreased,and the difference was statistically significant(P<0.05).In addition,the average cost of other consumables hospitalization of knee joint surgery patient increased,and the difference was statistically significant(P<0.05).Conclusion After centralized procurement of artificial joint consumables,the cost of total knee arthroplasty and total hip arthroplasty has decreased significantly,and the quality and efficiency of medical care have not changed significantly.At the same time,hospital managers should pay more attention to the rational use of consumables after centralized procurement.In addition,it calls for increasing the price of surgery to reflect the value of physician services.
RESUMO
The relationship between antagonism and symbiosis exists not only in the biological world,but also among the subspecialties of large tertiary grade A general hospitals.In the context of symbiosis theory,the following recommendations based on the four basic elements of subspecialty symbiosis systems were proposed to provide a theoretical basis for exploring the path of high-quality development of subspecialties:enhance the capacity of the symbiosis unit itself and clarify the role of the unit;establish efficient information system and make full use of management platform;improve interest coordination mechanism and strengthen inter-subspecialty ties;implement relevant support policies and solid sense of symbiotic to synergy provide a theoretical basis for exploring pathways for high quality development of subspecialties.
RESUMO
Objective To analyze the literature on artificial intelligence in forensic research from 2012 to 2022 in the Web of Science Core Collection Database,to explore research hotspots and developmen-tal trends.Methods A total of 736 articles on artificial intelligence in forensic medicine in the Web of Science Core Collection Database from 2012 to 2022 were visualized and analyzed through the litera-ture measuring tool CiteSpace.The authors,institution,country(region),title,journal,keywords,cited references and other information of relevant literatures were analyzed.Results A total of 736 articles published in 220 journals by 355 authors from 289 institutions in 69 countries(regions)were identi-fied,with the number of articles published showing an increasing trend year by year.Among them,the United States had the highest number of publications and China ranked the second.Academy of Forensic Science had the highest number of publications among the institutions.Forensic Science Inter-national,Journal of Forensic Sciences,International Journal of Legal Medicine ranked high in publica-tion and citation frequency.Through the analysis of keywords,it was found that the research hotspots of artificial intelligence in the forensic field mainly focused on the use of artificial intelligence technol-ogy for sex and age estimation,cause of death analysis,postmortem interval estimation,individual identification and so on.Conclusion It is necessary to pay attention to international and institutional cooperation and to strengthen the cross-disciplinary research.Exploring the combination of advanced ar-tificial intelligence technologies with forensic research will be a hotspot and direction for future re-search.
RESUMO
Objective To investigate the relationship between nuclear factor(NF)-κB signaling pathway and gender differences in alcoholic liver fibrosis. Methods C57BL/6 N mice at 7-8 weeks of age were randomly divided into: male normal group, male model group, female normal group and female model group of 20 mice each. The normal group was fed with control liquid diet for 8 weeks, and the model group was fed with alcoholic liquid diet for 8 weeks combined with 31.5% ethanol gavage (5g/kg twice a week) to establish an alcoholic liver fibrosis model. The mice were executed at the end of 8 weekends, and the alanine aminotransferase (ALT), aspartate aminotransferase (AST) activity, estradiol (E
RESUMO
BACKGROUND@#Links between alterations in gut microbiota composition and amyotrophic lateral sclerosis (ALS) have previously been reported. This study aimed to examine the microbiota in the nasal cavity of ALS.@*METHODS@#Sixty-six ALS patients and 40 healthy caregivers who live in close proximity with patients were enrolled. High throughput metagenomic sequencing of the 16S ribosomal deoxyribonucleic acid (rDNA) gene V3-V4 region of nasal microbiota was used to characterize the alpha and beta diversity and relative abundance of bacterial taxa, predict function, and conduct correlation analysis between specific taxa and clinical features.@*RESULTS@#The nasal microbiome of ALS patients showed lower alpha diversity than that of corresponding healthy family members. Genera Gaiella , Sphingomonas , Polaribacter _1, Lachnospiraceae _NK4A136_group, Klebsiella , and Alistipes were differentially enriched in ALS patients compared to controls. Nasal microbiota composition in ALS patients significantly differed from that in healthy subjects (unweighted UniFrac P = 0.001), while Linear discriminant analysis Effect Size (LEfSe) analysis indicated that Bacteroidetes and Firmicutes dominated healthy nasal communities at the phylum level, whereas Actinobacteria was the predominant phylum and Thermoleophilia was the predominant class in ALS patients. Genus Faecalibacterium and Alistipes were positively correlated with ALS functional rating scale revised (ALSFRS-R; rs = 0.349, P = 0.020 and rs = 0.393, P = 0.008), while Prevotella -9 and Bacteroides operational taxonomic units (OTUs) were positively associated with lung function (FVC) in ALS patients ( rs = 0.304, P = 0.045, and rs = 0.300, P = 0.048, respectively). Prevotella -1 was positively correlated with white blood cell counts (WBC, rs = 0.347, P = 0.021), neutrophil percentage (Neu%, rs = 0.428, P = 0.004), and neutrophil-to-lymphocyte ratio (NLR, rs = 0.411, P = 0.006), but negatively correlated with lymphocyte percentage (Lym%, rs = -0.408, P = 0.006). In contrast, Streptococcus was negatively associated with Neu% ( rs = -0.445, P = 0.003) and NLR ( rs = -0.436, P = 0.003), while positively associated with Lym% ( rs = 0.437, P = 0.003). No significant differences in nasal microbiota richness and evenness were detected among the severe and mild ALS patients.@*CONCLUSIONS@#ALS is accompanied by altered nasal microbial community composition and diversity. The findings presented here highlight the need to understand how dysbiosis of nasal microbiota may contribute to the development of ALS.
Assuntos
Humanos , Esclerose Lateral Amiotrófica/microbiologia , Fezes/microbiologia , Microbiota/genética , Microbioma Gastrointestinal/genética , Bactérias/genética , RNA Ribossômico 16S/genéticaRESUMO
Seeds are the source for the production of Chinese medicinal materials. The seed authenticity and quality of directly affect the effectiveness and safety of Chinese medicinal materials. The seed quality is faced with the problems such as mixed sources, existence of adulterants and seeds stocked for years, low maturity, and low purity. To ensure the high-quality and sustainable development of the Chinese medicinal material industry, it is urgent to standardize the seed market and identify and evaluate the quality of the seeds circulating in the market. Seed identification methods include visual inspection, microscopic observation, micro-character identification, chemical fingerprinting, molecular identification, electronic nose, X-ray diffraction, electrochemical fingerprinting, spectral imaging, and artificial intelligence. These methods have different application scopes and unique advantages and disadvantages. According to the different species of Chinese herbal medicines and different requirements of testing sites, suitable methods can be selected to achieve rapid and accurate identification with low costs. In the future, the seed identification methods should be developed based on emerging technologies with interdisciplinary knowledge, and intelligent, nondestructive, and single-grain detection methods are needed for the modern Chinese medicinal material industry. This paper introduces the seed identification technologies currently applied in research and production, compares the principles, applicability, advantages, and disadvantages of different technologies, and provides an outlook on the future development of seed identification technologies, aiming to provide a reference for the identification and quality evaluation of seeds of Chinese medicinal material.
RESUMO
ObjectiveTo establish a method based on specific polymerase chain reaction (PCR) that can accurately and rapidly identify Astragalus membranaceus var. mongholicus (AMM) seeds and A. membranaceus (AM) seeds. MethodThe Chloroplast Genome Information Resource (CGIR) and IdenDSS were used to obtain the characteristic DNA fragments of AMM and AM, and the specific single nucleotide polymorphism (SNP) sites of AMM and AM were screened out, on the basis of which the specific primers MG-F/MG-R of AMM and MJ-F/MJ-R of AM were designed. The specific PCR method for identifying AMM and AM was established and optimized, and the specificity and applicability of the method were investigated. ResultThe specific PCR conditions for the identification of AMM were primers MG-F/MG-R, annealing at 62 ℃, and 28 cycles. After PCR amplification and gel electrophoresis, the specific band appeared at about 220 bp, with no band for the seeds of AM or adulterants. The specific PCR conditions for identifying the AM were primers MJ-F/MJ-R, annealing at 58 ℃, and 28 cycles. After PCR amplification and gel electrophoresis, the band appeared at about 150 bp, with no band of AMM or adulterants. ConclusionThe specific PCR method established in this study can accurately and quickly identify the seeds of AMM and AM, which provides a basis for the classification and accurate identification of Astragalus seeds and adulterants.
RESUMO
Investigate the biofilm-forming ability and drug resistance of Hypervirulent Klebsiella pneumoniae (HvKP) to provide scientific basis for the treatment of HvKP-infection. A total of 96 Klebsiella pneumoniae strains isolated from clinical infection specimens in Changsha Central Hospital from January to December in 2021 were retrospectively collected, and the clinical data of patients were collected. The string test preliminarily distinguished between HvKP and classic Klebsiella pneumoniae (CKP). The biofilm-forming ability of clinical strains of Klebsiella pneumoniae (KP) was determined by microplate method. The Vitek 2 Compact automatic microbial identification/drug sensitivity analysis system was used for bacterial identification and drug sensitivity test. The clinical data of patients, biofilm forming ability and drug resistance in the HvKP group and those in the CKP group were compared and analyzed. The results showed that a total of 20 strains of HvKP were isolated from 96 non-repetitive KP, and the detection rate was 20.8%. HvKP mainly come from respiratory specimens, up to 75.0%.The prevalence of hepatobiliary diseases and the infection rate of multiple sites in patients with HvKP infection were higher than those in patients with CKP infection, and the difference was statistically significant(χ2=5.184,7.488;P=0.023,0.006).There was no significant difference between the two groups in terms of gender, age, ICU admission, hypertension, diabetes, coronary heart disease, lung disease, urinary system disease, central nervous system disease and laboratory test indexes (all P>0.05).17 (85.0%) strains of HvKP can form biofilm, including 2 strains with weak biofilm-forming ability (10.0%), 10 strains with moderate biofilm-forming ability (50.0%) and 5 strains with strong biofilm-forming ability (25.0%). Among the 76 CKP, 71 (93.4%) could form biofilm, including 13 (17.1%) with weak biofilm-forming ability, 30(39.5%) with moderate biofilm-forming ability and 28 (36.8%) with strong biofilm-forming ability. There was no significant difference in biofilm-forming ability between HvKP and CKP (χ2=1.470,P=0.225).The overall resistance rate of HvKP was not high, but a multi-resistant HvKP resistant to carbapenems was found. The detection rate of multi-resistant HvKP (5.0%) was lower than that of multi-resistant CKP (28.9%), and the difference was statistically significant (χ2=4.984, P=0.026).The resistance rate of HvKP to piperacillin/tazobactam, aztreonam, ciprofloxacin, levofloxacin, ceftazidime, cefepime, tobramycin, minocycline, doxycycline, and compound sulfamethoxazole was lower than that of CKP, and the difference was statistically significant (all P<0.05). In conclusion, most of hypervirulent Klebsiella pneumoniae can form biofilm in this study, but the difference of biofilm-forming ability is not obvious compared with classic Klebsiella pneumoniae. HvKP maintains high sensitivity to commonly used antibacterial drugs, but the drug resistance monitoring of the bacteria cannot be ignored.
RESUMO
Investigate the biofilm-forming ability and drug resistance of Hypervirulent Klebsiella pneumoniae (HvKP) to provide scientific basis for the treatment of HvKP-infection. A total of 96 Klebsiella pneumoniae strains isolated from clinical infection specimens in Changsha Central Hospital from January to December in 2021 were retrospectively collected, and the clinical data of patients were collected. The string test preliminarily distinguished between HvKP and classic Klebsiella pneumoniae (CKP). The biofilm-forming ability of clinical strains of Klebsiella pneumoniae (KP) was determined by microplate method. The Vitek 2 Compact automatic microbial identification/drug sensitivity analysis system was used for bacterial identification and drug sensitivity test. The clinical data of patients, biofilm forming ability and drug resistance in the HvKP group and those in the CKP group were compared and analyzed. The results showed that a total of 20 strains of HvKP were isolated from 96 non-repetitive KP, and the detection rate was 20.8%. HvKP mainly come from respiratory specimens, up to 75.0%.The prevalence of hepatobiliary diseases and the infection rate of multiple sites in patients with HvKP infection were higher than those in patients with CKP infection, and the difference was statistically significant(χ2=5.184,7.488;P=0.023,0.006).There was no significant difference between the two groups in terms of gender, age, ICU admission, hypertension, diabetes, coronary heart disease, lung disease, urinary system disease, central nervous system disease and laboratory test indexes (all P>0.05).17 (85.0%) strains of HvKP can form biofilm, including 2 strains with weak biofilm-forming ability (10.0%), 10 strains with moderate biofilm-forming ability (50.0%) and 5 strains with strong biofilm-forming ability (25.0%). Among the 76 CKP, 71 (93.4%) could form biofilm, including 13 (17.1%) with weak biofilm-forming ability, 30(39.5%) with moderate biofilm-forming ability and 28 (36.8%) with strong biofilm-forming ability. There was no significant difference in biofilm-forming ability between HvKP and CKP (χ2=1.470,P=0.225).The overall resistance rate of HvKP was not high, but a multi-resistant HvKP resistant to carbapenems was found. The detection rate of multi-resistant HvKP (5.0%) was lower than that of multi-resistant CKP (28.9%), and the difference was statistically significant (χ2=4.984, P=0.026).The resistance rate of HvKP to piperacillin/tazobactam, aztreonam, ciprofloxacin, levofloxacin, ceftazidime, cefepime, tobramycin, minocycline, doxycycline, and compound sulfamethoxazole was lower than that of CKP, and the difference was statistically significant (all P<0.05). In conclusion, most of hypervirulent Klebsiella pneumoniae can form biofilm in this study, but the difference of biofilm-forming ability is not obvious compared with classic Klebsiella pneumoniae. HvKP maintains high sensitivity to commonly used antibacterial drugs, but the drug resistance monitoring of the bacteria cannot be ignored.
RESUMO
Objective To identify immune-related dysregulation mechanisms and potential diagnostic predictive biomarkers in osteoporosis. Methods Gene expression data for both osteoporosis and control populations were retrieved from the GSE35958 and GSE56815 datasets. Immune-related differentially expressed genes (DEGs) were obtained by screening DEGs and were compared with the immunology database and analysis portal (ImmPort) database. Enrichment analysis of these immune-related DEGs was conducted using the Clusterprofiler software package. A protein-protein interaction network was built with the STRING database, which is a search tool for finding interacting genes/proteins, and the top 10 genes with the highest network connectivity were identified as candidate genes. Subsequently, the diagnostic predictive effect of candidate genes was evaluated using receiver operating characteristic (ROC) curves, logistic regression, and column plots. Finally, PCR and Western blot analysis were applied to detect the differential expression of these genes in bone marrow tissue of patients with osteoporosis. Results A total of 138 immune-related DEGs were obtained through intersection analysis. The results of the enrichment analysis indicated that these genes were involved in biological functions such as immune inflammation and signaling pathways including T cell receptors, mitogen activated protein kinase (MAPK), rat sarcoma virus oncogene homologs (Ras), osteoclast differentiation, and B cell receptors. In addition, among the candidate genes, upregulated vascular endothelial growth factor A (VEGFA) and epidermal growth factor receptor (EGFR) and downregulated AKT1, SRC, and JUN in osteoporosis showed the highest connectivity. Among them, VEGFA, EGFR, JUN, and AKT1 demonstrated the best diagnostic predictive value. Conclusion The screening of immune-related DEGs will enhance the understanding of osteoporosis and facilitate the development of immunotherapy targets.
Assuntos
Humanos , Fator A de Crescimento do Endotélio Vascular/genética , Biomarcadores , Osteoporose/genética , Biologia Computacional/métodos , Receptores ErbB/genética , Perfilação da Expressão Gênica/métodosRESUMO
Objective:To observe the clinical outcomes of continued pregnancy in pregnant women with cesarean scar pregnancy (CSP).Methods:A retrospective analysis was performed on the pregnancy outcomes of 55 pregnant women who were diagnosed with CSP at the Second Affiliated Hospital of Army Medical University during the first trimester of pregnancy from August 1st, 2018 to October 31st, 2021 and strongly requested to continue the pregnancy.Results:Of the 55 pregnant women, 15 terminated the pregnancy in the first trimester, 1 underwent hysterotomy at 23 weeks of gestation due to cervical dilation, and 39 (71%, 39/55) continued pregnancy to the third trimester achieving live births via cesarean section. The gestational age of the 39 pregnant women delivered by cesarean section was 35 +6 weeks (range: 28 +5-39 +2 weeks), of whom 7 cases at 28 +5-33 +6 weeks, 20 cases at 34-36 +6 weeks, and 12 cases at 37-39 +2 weeks. The results of pathological examination were normal placenta in 3 cases (8%, 3/39), placenta creta in 4 cases (10%, 4/39), placenta increta in 9 cases (23%, 9/39) and placenta percreta in 23 cases (59%, 23/39). Among the 36 pregnant women who were pathologically confirmed as placenta accreta spectrum disorders (PAS) after surgery, the last prenatal ultrasonography showed placenta previa in 27 cases (75%, 27/36) and not observed placenta previa in 9 cases. The median intraoperative blood loss, autologous blood transfusion, and allogeneic suspended red blood cell infusion of 39 pregnant women during cesarean section were 1 000 ml (300-3 500 ml), 300 ml (0-2 000 ml) and 400 ml (0-2 400 ml), respectively. The uterine preservation rate was 100% (39/39), and only 1 case received cystostomy due to intracystic hemorrhage. The birth weight of the newborn was 2 580 g (1 350-3 800 g), and 1 case of mild asphyxia. Conclusions:Pregnant women with CSP who continue pregnancy under close monitoring after adequate ultrasound evaluation and doctor-patient communication could achieve better maternal and infant outcomes, but pregnant women with CSP are highly likely to continue pregnancy and develop into PAS. Effective hemostasis means and multidisciplinary team cooperation are needed in perinatal period for ensuring maternal and fetal safety.
RESUMO
Objective:To investigate the relationship between microRNA (miR)-1, miR-133b and hepatic fibrosis in patients with hepatic alveolar echinococcosis.Methods:From October 2020 to April 2021, patients who were definitely diagnosed as hepatic alveolar echinococcosis (9 cases), cirrhosis (9 cases) and hepatocellular carcinoma (5 cases) in the First Affiliated Hospital of Xinjiang Medical University were selected as the research subjects, and healthy volunteers in the same period were taken as the control (10 cases). Peripheral blood samples of all subjects were collected to prepare plasma, and the expression levels of miR-1 and miR-133b in peripheral blood were detected by quantitative real-time PCR. At the same time, tissue samples around the liver lesion (proximal), and the corresponding tissues about 5 cm from the lesion (distal) were collected from 5 patients with hepatic alveolar echinococcosis, and immunohistochemical staining was used to detect the cell activation related indicators [cyclinD1, cyclin dependent kinase 1 (CDK1), α-smooth muscle actin (α-SMA)], fibrosis indicators (Collagen Ⅰ, Collagen Ⅲ), transforming growth factor-β1 (TGF-β1) signal pathway related genes [TGF-β1, TGF-β1 receptor type Ⅰ/Ⅱ (TGF-β1RⅠ, TGF-β1RⅡ)] and its downstream related proteins (SMAD2, SMAD3).Results:The quantitative real-time PCR results showed that there were significant differences in the expression levels of miR-1 and miR-133b in the peripheral blood of patients with hepatic alveolar echinococcosis, cirrhosis, hepatocellular carcinoma and the control group ( H = 16.54, 28.40, P < 0.001); the expression levels of miR-1 and miR-133b in hepatic alveolar echinococcosis group were higher than those in control group, cirrhosis group ( P < 0.05). The expression levels of CDK1 (0.46 ± 0.02, 0.42 ± 0.01), α-SMA (0.54 ± 0.09, 0.51 ± 0.07), TGF-β1 (0.55 ± 0.15, 0.51 ± 0.13), TGF-β1RⅠ (0.58 ± 0.09, 0.57 ± 0.08), and TGF-β1RⅡ(0.40 ± 0.05, 0.39 ± 0.05) between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients were statistically significantly different ( t = 5.56, 3.17, 3.18, 4.27, 5.65, P = 0.005, 0.034, 0.034, 0.024, 0.011). There was no statistically significant difference in the expression levels of CyclinD1, Collagen Ⅰ, Collagen Ⅲ, SMAD2 and SMAD3 between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients ( t = 3.06, 3.06, 2.86, 1.43, 1.50, P = 0.055, 0.055, 0.064, 0.247, 0.230). Pearson correlation analysis showed that miR-1 in the patients' peripheral blood was positively correlated with TGF-β1RⅠ in the proximal tissue of the liver lesion ( P = 0.001); there was no correlation between miR-1, miR-133b and CDK1, α-SMA, TGF-β1, TGF-β1RⅡ( P > 0.05). Conclusions:The expression of TGF-β1 signaling pathway related factors in the proximal tissue of liver lesion in patients with hepatic alveolar echinococcosis is up-regulated. The expression of miR-1 and miR-133b in peripheral blood is upregulated, and miR-1 is positively correlated with TGF-β1RⅠ level in proximal tissue of liver lesion, suggesting that miR-1 may promote the occurrence of liver fibrosis in hepatic alveolar echinococcosis.
RESUMO
Objective:To develop a scientific and comprehensive job competency evaluation scale for pre hospital emergency nurses, and to test its reliability and validity.Methods:Based on the theory of nurse medical quality responsibility model, the first draft of the scale was formed through literature review, Delphi method, and other research methods. A questionnaire survey was conducted among 563 pre hospital nurses from 6 tertiary A hospitals in Shandong Province. SPSS 27.0 statistical software was used for factor analysis to test the reliability and validity of the scale.Results:The final competency evaluation scale for pre hospital emergency nurses included 6 dimensions and 40 items. Cronbach′s α coefficient of the total scale was 0.921, and the Spearman Brown split half reliability coefficient was 0.756. Conclusion:The job competency evaluation scale for pre hospital emergency nurses constructed in this study has good reliability and validity, and can be used to evaluate the job competency of pre hospital emergency nurses.
RESUMO
Objective:To investigate the prevalence of cataract, cataract surgical coverage and surgical outcomes in people aged 50 years and older in Kandze Tibetan areas of Sichuan Province, and to evaluate the effectiveness of the prevention and treatment of blindness in the region.Methods:A cross-sectional study was conducted to study the population aged 50 years and above in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, from October 2017 to April 2018 using the Rapid Assessment of Avoidable Blindness (RAAB) method.A total of 5 000 permanent residents aged 50 years and older were selected using a stratified, cluster sampling method with reference to the data from the 2010 China Population Census with the RAAB software, and each cluster consisted of 50 people, for a total of 100 clusters.The survey was conducted by two survey teams, and all subjects underwent visual acuity and ophthalmic examinations at home to investigate relevant cataract prevalence, surgical coverage, surgical barriers, and postoperative outcomes according to WHO Standards.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Kandze Prefecture People's Hospital (No.GZZYY-2016-11). Written informed consent was obtained from each subject.Results:Of 5 000 eligible participants, 4 763 were examined, with a response rate of 95.3%.Referred to the visual impairment standard of WHO and the pinhole visual acuity, the prevalence of bilateral blindness, severe, moderate and mild visual impairment was 0.6%(95% [confidence interval, CI]: 0.4%-0.9%), 0.9%(95% CI: 0.6%-1.2%), 2.4%(95% CI: 2.0%-2.9%) and 5.2%(95% CI: 4.6%-5.9%), respectively.The prevalence of cataract blindness was 0.7%(95% CI: 0.4%-1.0%) in females, significantly higher than 0.2%(95% CI: 0.1%-0.5%) in males( P<0.05). The prevalence of cataract blindness was 2.3% among Tibetan, higher than 1.0% among Han Chinese, showing a statistically significant difference ( P<0.05). By the number of eyes, the cataract surgical coverage was 60.8%(95% CI: 55.5%-65.8%) in females, which was lower than 70.1%(95% CI: 63.7%-75.7%) in males, with a statistically significant difference ( P<0.05). By the number of cases, the surgical coverage for cataract blindness in both eyes was 82.0%(95% CI: 75.2%-87.6%), with blindness defined as the pinhole visual acuity <0.05 in the dominant eye.A total of 171 people with untreated cataract received a questionnaire about barriers to cataract surgery.The most important barrier was unaware that treatment was available at 77.8%, followed by inconvenient transportation or being unaccompanied to the hospital at 11.7%.A total of 364 eyes underwent cataract surgery, of which 336 eyes underwent intraocular lens implantation, and the intraocular lens implantation rate was 92.3%.There were 216 eyes with a postoperative cataract visual acuity ≥0.3, accounting for 59.3%(216/364). Conclusions:In the Kandze Tibetan area of Sichuan Province, cataract is still the main cause of blindness among people aged 50 and above, and surgery for cataract remains the focus of blindness prevention work.The cataract surgical coverage in this area is high, but the postoperative outcomes are still poor compared with the WHO reference index for post-cataract surgery (1998), and corresponding measures must be taken to improve the quality of surgery.
RESUMO
Objective: To investigate the clinical, radiological, histological and molecular features and the differential diagnosis of fibrocartilaginous mesenchymoma (FM). Methods: Four cases of FM diagnosed in the Department of Pathology, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from 2020 to 2022 were analyzed. Related literature was also reviewed. Results: Case 1 was a 10-year-old girl with bone destruction in the sacrum and L5 articular processes revealed by CT scan. Case 2 was a 7-year-old girl with an aggressive lesion in her right distal ulna. Case 3 was an 11-year-old boy with a lesion in the metaphysis of his left proximal tibia. Case 4 was an 11-year-old boy with bone destruction in the distal portion of a radius. Microscopically, the four tumors all consisted of numerous spindle cells, hyaline cartilage nodules, and bone trabeculae. The hypocellular to moderately cellular spindle cell component contained elongated cells with slightly hyperchromatic, mildly atypical nuclei arranged in bundles or intersecting fascicles. Benign-appearing cartilaginous nodules of various sizes and shapes were scattered throughout the tumors. There were areas mimicking epiphyseal growth-plate characterized by chondrocytes arranged in parallel columns and areas of enchondral ossification. The stroma was rich in mucus in case 1. Mutation of GNAS and IDH1/IDH2 and amplification of MDM2 gene were not found in any of the three tested cases. Conclusions: FM is very rare and tends to affect young patients. It most frequently occurs in the metaphysis of long tubular bones, followed by the iliac-pubic bones and vertebrae. FM is characterized by a mixed population of spindle cells, hyaline cartilage nodules and trabeculae of bone, without specific immunophenotypes and molecular alternations. As a borderline, locally aggressive neoplasm, surgical removal with a wide margin is generally the treatment of choice for FM.
Assuntos
Humanos , Masculino , Feminino , Criança , Mesenquimoma/patologia , China , Osteogênese , Cartilagem/patologia , Tomografia Computadorizada por Raios XRESUMO
This study explored the feasibility of mineral element content and ratios of nitrogen isotopes to discriminate the cultivation mode of Dendrobium nobile in order to provide theoretical support for the discrimination of the cultivation mode of D. nobile. The content of 11 mineral elements(N, K, Ca, P, Mg, Na, Fe, Cu, Zn, Mn, and B) and nitrogen isotope ratios in D. nobile and its substrate samples in three cultivation methods(greenhouse cultivation, tree-attached cultivation, and stone-attached cultivation) were determined. According to the analysis of variance, principal component analysis, and stepwise discriminant analysis, the samples of different cultivation types were classified. The results showed that the nitrogen isotope ratios and the content of elements except for Zn were significantly different among different cultivation types of D. nobile(P<0.05). The results of correlation analysis showed that the nitrogen isotope ratios, mineral element content, and effective component content in D. nobile were correlated with the nitrogen isotope ratio and mineral element content in the corresponding substrate samples to varying degrees. Principal component analysis can preliminarily classify the samples of D. nobile, but some samples overlapped. Through stepwise discriminant analysis, six indicators, including δ~(15)N, K, Cu, P, Na, and Ca, were screened out, which could be used to establish the discriminant model of D. nobile cultivation methods, and the overall correct discrimination rates after back-substitution test, cross-check, and external validation were all 100%. Therefore, nitrogen isotope ratios and mineral element fingerprints combined with multivariate statistical analysis could effectively discriminate the cultivation types of D. nobile. The results of this study provide a new method for the identification of the cultivation type and production area of D. nobile and an experimental basis for the quality evaluation and quality control of D. nobile.
Assuntos
Dendrobium , Minerais , Análise Discriminante , Análise Multivariada , Isótopos de NitrogênioRESUMO
OBJECTIVE@#To investigate the application of 3D printing percutaneous surgical guide plate in closed reduction and cannulated screw internal fixation of femoral neck fracture.@*METHODS@#The clinical data of 12 patients with femoral neck fracture from March 2019 to March 2022 were retrospectively analyzed. Patients were divided into observation group and control group according to different operation plans, with 6 cases in each group. The observation group received percutaneous operation guide plate assisted closed reduction and hollow screw internal fixation, while the control group received closed reduction and hollow compression screw internal fixation. The operation time, intraoperative blood loss, fluoroscopy times, and Kirschner needle puncture times were compared between two groups. The location of screws were recordedon postoperative X-ray films, follow-up time, time of complete fracture healing, Harris score of hip joint and the incidence of complications were recorded on postoperative X-ray films.@*RESULTS@#The operation time of observation group (32.17±6.18) min was shorter than that of control group (53.83±7.31) min (P<0.05). The amount of intraoperative bleeding in the observation group (18.33±2.94) ml was less than that in the control group (38.17±5.56) ml(P<0.05). The times of fluoroscopy in the observation group (7.50±1.05) were less than those in the control group (21.00±4.82) (P<0.05). The number of Kirschner needle punctures (8.00±0.63) in observation group was less than that in control group (32.67±3.08) (P<0.05). The follow-up time was(12.88±0.74) months in observation group and (12.83±0.72) months in control group, there was no significant difference between two groups (P>0.05). One year after operation, Harris score of hip joint in the observation group was(82.00±4.52) points, while that in the control group was(81.00±3.41) points, there was no significant difference between two groups(P>0.05). The time of complete fracture healing in the observation group was (7.50±1.05) months, while that in the control group was (7.67±1.21) months, there was no significant difference between two groups(P>0.05). The parallelism of the screws in the observation group was (0.50±0.11) ° and (0.76±0.15) °, which were lower than that in the control group (1.57±0.31) ° and (1.87±0.21) ° (P<0.05). The screw distribution area ratio (0.13±0.02) cm2 in the observation group was higher than that in the control group (0.08±0.01) cm2 (P<0.05). No complications such as necrosis of femoral head, nonunion of fracture, shortening of femoral neck and withdrawal of internal fixation occurred in both groups.@*CONCLUSION@#The application of 3D printing percutaneous surgical guide plate improves the accuracy and safety of closed reduction and cannulated screw internal fixation for femoral neck fracture. It has the advantages of minimally invasive, reducing radiation exposure, fast and accurate, shortening the operation time and reducing intraoperative bleeding.
Assuntos
Humanos , Estudos Retrospectivos , Resultado do Tratamento , Fraturas do Colo Femoral/cirurgia , Fixação Interna de Fraturas , Parafusos Ósseos , Impressão TridimensionalRESUMO
OBJECTIVE@#To investigate the effect of Cyr61 on imatinib (IM) resistance in chronic myeloid leukemia (CML) and its mechanism.@*METHODS@#Cyr61 level in cell culture supernatant was determined by enzyme-linked immunosorbent assay. The expression of Cyr61 and Bcl-xL were measured by real-time PCR and Western blot. Cell apoptosis was analyzed using an Annexin V-APC Kit. Expression of signal pathways related proteins was determined by Western blot.@*RESULTS@#The level of Cyr61 obviously increased in K562G cells (IM resistance to CML cell line K562). Down-regulating the expression of Cyr61 decreased the resistance of K562G cells to IM and promoted IM induced apoptosis. In CML mouse model, down-regulating the expression of Cyr61 could increase the sensitivity of K562G cells to IM. The mechanism studies showed that Cyr61 mediated IM resistance in CML cells was related to the regulation of ERK1/2 pathways and apoptosis related molecule Bcl-xL by Cyr61.@*CONCLUSION@#Cyr61 plays an important role in promoting IM resistance of CML cells. Targeting Cyr61 or its related effectors pathways may be one of the ways to overcome IM resistance of CML cells.