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OBJECTIVE To study the ameliorative effect and potential mechanism of curcumin on diabetes model rats with depression based on cAMP response element binding protein （CREB）/brain-derived neurotrophic factor （BDNF） signaling pathway. METHODS The diabetes model rat with depression was established by high fat and high sugar diet+intraperitoneal injection of streptozotocin+chronic unpredictable stress-induced depression. The successfully modeled rats were randomly divided into model group， positive control group （0.18 g/kg metformin and 1.8 mg/kg fluoxetine， gavage）， curcumin low-dose and high-dose groups （30， 60 mg/kg， gavage） and curcumin high-dose+CREB inhibitor group [60 mg/kg curcumin （gavage）+5 mg/kg CREB inhibitor 666-15 （intraperitoneal injection）]， with 12 rats in each group. Another 12 healthy rats were selected as the normal group. Each group was given a corresponding intervention for 4 weeks， the fasting blood glucose level of rats was detected， and the depression of rats was assessed. The levels of corticosterone （CORT） and inflammatory factors [tumor necrosis factor-α （TNF-α）， interleukin- 1β （IL-1β）， IL-6] in serum， and the levels of norepinephrine （NE） and 5-hydroxytryptamine （5-HT） in hippocampal tissue were determined. The pathological changes and neuronal apoptosis were observed in the hippocampal tissue of rats in each group； the expression levels of CREB， BDNF mRNA and protein in hippocampal tissue were detected. RESULTS Compared with the normal group， the hippocampal tissue of rats in the model group was severely damaged， and neurons were scattered， while the fasting blood glucose， the forced swimming immobility time， the tail suspension immobility time， serum levels of CORT， TNF-α， IL-1β and IL-6， and neuron apoptosis indexes were all increased or prolonged significantly （P＜0.05）. The levels of NE and 5-HT， the number of surviving neurons， and the expression levels of CREB and BDNF mRNA and protein in hippocampal tissue were decreased significantly （P＜0.05）. Compared with the 的model group， the damage to hippocampal tissue was relieved in the positive control group and curcumin groups， while the above indexes were improved significantly （P＜0.05）. The improvement effect of curcumin high-dose group was better than that of curcumin low-dose group （P＜0.05）. CREB inhibitor could significantly reverse the ameliorative effect of high-dose curcumin on the model rats （P＜0.05）. CONCLUSIONS Curcumin can improve the depression of diabetes model rats with depression， and relieve neuronal damage and inflammatory response， the mechanism of which may be associated with activating CREB/BDNF signaling pathway.
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OBJECTIVE To provide reference for the clinical application and further research and development of Shenling baizhu powder. METHODS Using the methods of textual research and bibliometrics， the key information such as the composition， dose， processing and usage of Shenling baizhu powder in ancient and modern literature were systematically summarized and sorted out， and the number of publications， keywords， and other contents of modern literature were visually analyzed. RESULTS & CONCLUSIONS Shenling baizhu powder was first collected in Taiping Huimin Hejiju Fang （abbreviated “Jufang”）， the composition of core drugs and most widely used dose ratio in previous generations were the same as those in Jufang， basically focusing on powder making and being taken after mixed with liquid； the dosage was concentrated on 2-3 qian； the function and application of it had been expanded to a certain extent compared with Jufang； its clinical application had gradually extended from internal medicine to surgery， gynecology， pediatrics， ophthalmology， dermatology， etc.， covering all aspects of the disease caused by spleen deficiency in general； the composition mechanism revolved around “strengthening the spleen， replenishing qi and removing dampness”； the recommended prescription drugs were all selected from the corresponding varieties in the pharmacopoeia. Modern research mainly focuses on clinical practice， with traditional Chinese medicine or traditional Chinese and Western medicine combined with this formula as the main modified treatment for various intestinal diseases， diarrhea diseases， and lung diseases. The efficacy and application are the frontier hot spots today， and the mechanism of action has begun to be explored. The usage in the literature and the inclusion in the pharmacopoeia are inconsistent， and further research is needed.
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BACKGROUND@#Diabetic wound healing remains a major challenge due to the impaired functionality of angiogenesis by persistent hyperglycemia. Mesenchymal stem cell exosomes are appropriate candidates for regulating the formation of angiogenesis in tissue repair and regeneration. Here, we explored the effects of exosomes derived from human amniotic mesenchymal stem cell (hAMSC-Exos) on the biological activities of human umbilical vein endothelial cells (HUVECs) treated with high glucose and on diabetic wound healing and investigate lncRNAs related to angiogenesis in hAMSC-Exos. @*METHODS@#hAMSCs and hAMSC-Exos were isolated and identified by flow cytometry or western blot. A series of functional assays such as cell counting kit-8, scratching, transwell and tube formation assays were performed to evaluate the potential effect of hAMSC-Exos on high glucose-treated HUVECs. The effect of hAMSC-Exos on diabetic wound healing were tested by measuring wound closure rates and immunohistochemical staining of CD31. Subsequently, the lncRNAs profiles in hAMSC-Exos and hAMSCs were examined to screen the lncRNAs related to angiogenesis. @*RESULTS@#The isolated hAMSC-Exos had a size range of 30–150 nm and were positive for CD9, CD63 and CD81. The hAMSC-Exos facilitate the functional properties of high glucose-treated HUVECs including the proliferation, migration and the angiogenic activities as well as wound closure and angiogenesis in diabetic wound. hAMSC-Exos were enriched lncRNAs that related to angiogenesis, including PANTR1, H19, OIP5-AS1 and NR2F1-AS1. @*CONCLUSION@#Our findings demonstrated hAMSC-Exos facilitate diabetic wound healing by angiogenesis and contain several exosomal lncRNAs related to angiogenesis, which may represent a promising strategy for diabetic wound healing.
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The view of life in Huang Di Nei Jing discusses the essence of human life by exploring the origin, structure and existence of human life, elucidates the overall quality of human life by observing the state and length of human life, and summarizes the characteristics of human life by analyzing the commonalities and unique characteristics of human life with other lives. On the one hand, this life view respects the objectivity and regularity of life, and enabling people to calmly face death but actively seeking higher possibilities of life, which reflects the reasonable self-awareness of ancient doctors towards human life. On the other hand, it affirms the intrinsic value of life, advocates meeting the subjective value of life and pursuing the external value of life, and expresses the self-pursuit of exploring the existence value of human life, which makes the life view in Huang Di Nei Jing quite humanistic. This humanistic life view has important reference significance for modern medical practice. Reasonable absorbing the humanistic spirit of the life view in Huang Di Nei Jing is conducive to the return of modern medicine to the medical essence of saving the dying and healing the wounded, as well as the establishment of the medical value of people-oriented.
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Objective·To describe the level of multiple symptom distress and physical activity in children and adolescents with cancer,analyze symptom distress profiles,and explicit the relationship between latent profiles and physical activity.Methods·From November 2021 to March 2023,the convenient sample method was used to recruit children and adolescents with cancer aged 10-18 years old,who had been treated for more than 1 month in the Departments of Hematology/Oncology,Shanghai Children's Medical Center and Xin Hua Hospital,Shanghai Jiao Tong University School of Medicine.The questionnaires,including General Information Questionnaire,Memorial Symptom Assessment Scale 10-18(MSAS 10-18)and Modified Chinese Version of Children's Leisure Time Activities Study Survey(CLASS-C),were used.Latent profile analysis was used to identify whether the level of multiple symptom distress in children and adolescents with cancer was population heterogeneity and its explicit characteristics.Whether there were differences in physical activity levels among different profiles of symptom distress was also analyzed.Results· A total of 165 valid questionnaires were collected,with an effective response rate of 91.7％.The symptom distress scores of the top five occurrence rates of symptoms in children and adolescents with cancer were lack of energy with a median of 1(1,2)point,nausea 1(1,2)point,lack of appetite 2(2,3)points,sweat 1(1,2)point,and pain 1(1,2)point.The physical activity level of the patients was mainly light,with a median of 2 530.00(1 577.50,3 721.00)min/week,and moderate to vigorous physical activity was relatively lower[70.00(10.00,197.50)min/week].The patients with cancer could be divided into two latent profiles:"high fatigue-high nausea-high hair loss-high sleepy"and"high fatigue-low nausea-low vomiting-low sleepy",which were named as high symptom distress(n=47,30.6％)and low symptom distress(n=l 18,69.4％)separately.Multivariate Logistic regression analysis showed that patients with acute lymphoblastic leukemia were more likely to be classified as high symptom distress group,and outpatients in the latest hospital visit were more likely to classified as low symptom distress group(both P＜0.05).In addition,patients with high symptom distress had a higher level of light physical activity(P＜0.05),and had a lower level of moderate to vigorous physical activity,but the difference was not statistically significant.Conclusion·There is population heterogeneity in the multiple symptom distress in children and adolescents with cancer.Disease type(acute leukemia)and the way of the latest hospital visit(through outpatient department)are the predictors of symptoms profiles of patients with cancer.Patients who experience high symptom distress have higher level of light physical activity,and perhaps lower level of moderate to vigorous physical activity.
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Recent studies have shown that changes in the gut and skin microbiome can directly affect the occurrence of acne. Regulating the skin and gut microbiome has brought new directions for the treatment of acne, and the most direct way to achieve this goal is to restore the balance of the microbiome through the use of probiotics. This review summarizes the relationship between acne and microbiome, and research progress in probiotics for the treatment of acne.
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OBJECTIVE@#To explore the predictive value of acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), quick sequential organ failure assessment (qSOFA) and modified early warning score (MEWS) in evaluating the prognosis of patients in intensive care unit (ICU) of secondary hospitals, and to provide guidance for clinical application.@*METHODS@#The clinical data of adult critical patients admitted to the ICU of Wanzhou District First People's Hospital from October 2022 to April 2023 were retrospectively analyzed. According to the clinical outcome of ICU, the patients were divided into improvement group and death group. The general information, blood routine, heart, liver and kidney function indicators, coagulation indicators, blood gas analysis, APACHE II score, SOFA score, qSOFA score, MEWS score at the time of admission to the ICU, the number of cases of invasive mechanical ventilation (IMV) and continuous blood purification (CBP) were compared between the two groups. Univariate analysis was performed, and multivariate Logistic regression analysis was used to analyze the related factors of death. Receiver operator characteristic curve (ROC curve) was used to analyze the predictive value of the four scores in ICU patients.@*RESULTS@#A total of 126 patients were included, of which 45 patients died in the ICU and 81 patients improved and transferred out. Univariate analysis of death-related critically ill patients showed that procalcitonin (PCT), serum creatinine (SCr), blood urea nitrogen (BUN), albumin (ALB), prothrombin time (PT), activated partial prothrombin time (APTT), D-dimer, pH value, HCO3-, blood lactic acid (Lac), number of patients treated with IMV and CBP, APACHE II score, SOFA score, qSOFA score and MEWS score were significantly different between the two groups (all P < 0.05). Multivariate Logistic regression analysis showed that the APACHE II score [odds ratio (OR) = 1.115, 95% confidence interval (95%CI) was 1.025-1.213, P = 0.011], SOFA score (OR = 1.204, 95%CI was 1.037-1.398, P = 0.015), MEWS score (OR = 1.464, 95%CI was 1.102-1.946, P = 0.009), and APTT (OR = 1.081, 95%CI was 1.015-1.152, P = 0.016) were independent risk factors affecting the mortality of critically ill patients in the ICU. ROC curve analysis showed that APACHE II, SOFA, qSOFA, and MEWS scores could predict the prognosis of critically ill ICU patients, among which SOFA score had the strongest predictive effect, and the area under the curve (AUC) was 0.808. There was a statistically significant difference in the time required for the four scores (F = 117.333, P < 0.001), among which the MEWS scoring required the shortest time [(1.03±0.39) minutes], and the APACHE II scoring required the longest time [(2.81±1.04) minutes].@*CONCLUSIONS@#APACHE II, SOFA, qSOFA, and MEWS scores can be used to assess the severity of critically ill patients and predict in-hospital mortality. The SOFA score is superior to other scores in predicting severity. The MEWS is preferred because its assessment time is shortest. Early warning score can help secondary hospitals to detect potentially critical patients early and provide help for clinical rapid urgent emergency decision-making.
Тема - темы
Adult , Humans , Sepsis/diagnosis , ROC Curve , Retrospective Studies , Critical Illness , Early Warning Score , Organ Dysfunction Scores , Intensive Care Units , Prognosis , HospitalsРеферат
Objective @# To investigate the effects of different occlusal veneer preparation designs and fiber posts on the fracture load and failure mode of endodontically treated maxillary premolars with pulp-piercing wedge-shaped defect．@*Methods @# 60 maxillary first premolars were randomly divided into group A and group B after Root Canal Therapy (RCT) and severe defects(n = 30) ．Group A was filled with glass fiber post and resin core，and group B was filled with resin core only．Then the occlusal veneer( G2) ，buccal-occlusal veneer( G3) and buccal-proximal-occlusal veneer ( G4 ) were applied to the isolated teeth．The teeth filled with composite resin ( G1 ) and full crown ( G5) were set as negative and positive control respectively，with 6 samples in each group．The sample was subjected to 5 000 hot and cold cycles and 20 000 vertical compression load aging．Finally，all the samples were loaded with static load until the sample broke at the speed of 0．5mm / min．The fracture load and failure mode of each sample were recorded. @*Results @# Both the fracture load in group A and B was G5 ＞G3 ＞G2 ＞G4 ＞G1，and the fracture load in G2，G3，G4，G5 was significantly higher than that in G1 (P＜0. 05) ，and there was no significant difference between group A and B (P＞0. 05) ．The fracture form of G3 was mostly unbonding of the repair body，which was conducive to re-repair．@*Conclusion @#Buccal ( occlusal) veneer is the most effective in repairing pulp-piercing wedge-shaped defects．The fiber post could not significantly enhance the fracture load of the pulp-piercing wedge- shaped defects teeth.
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The bile acid-responsive G-protein-coupled receptor TGR5 is expressed in monocytes and macrophages, and plays a critical role in regulating inflammatory response. Our previous work has shown its role in promoting the progression of non-small cell lung cancer (NSCLC), yet the mechanism remains unclear. Here, using Tgr5-knockout mice, we show that TGR5 is required for M2 polarization of tumor-associated macrophages (TAMs) and suppresses antitumor immunity in NSCLC via involving TAMs-mediated CD8+ T cell suppression. Mechanistically, we demonstrate that TGR5 promotes TAMs into protumorigenic M2-like phenotypes via activating cAMP-STAT3/STAT6 signaling. Induction of cAMP production restores M2-like phenotypes in TGR5-deficient macrophages. In NSCLC tissues from human patients, the expression of TGR5 is associated with the infiltration of TAMs. The co-expression of TGR5 and high TAMs infiltration are associated with the prognosis and overall survival of NSCLC patients. Together, this study provides molecular mechanisms for the protumor function of TGR5 in NSCLC, highlighting its potential as a target for TAMs-centric immunotherapy in NSCLC.
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Objective:To compare the dosimetric difference between intensity-modulated photon radiaotherapy (IMRT) planning and intensity-modulated proton radiotherapy (IMPT) planning for glioma.Methods:The clinical data of 15 glioma patients who underwent IMRT in ion medical center of the First Affiliated Hospital of USTC from November 2020 to April 2022 were retrospectively analyzed. IMRT planning and IMPT planning were designed for the image of each patient in the therapy planning system. Main dosimetric parameters were compared including plan target volume (PTV), coverage index (CI), dose homogeneity index (HI), and maximal dose (D max) and mean dose (D mean) of organs at risk between both plans. Results:There were no significant differences between IMRT planning and IMPT planning in terms of D max and D mean of PTV1 and PTV2, CI and HI (all P > 0.05). Compared with IMRT planning, brainstem D mean [6.92 GyE (0.09 GyE, 12.58 GyE) vs. 24.41 GyE (2.59 GyE, 34.18 GyE)], left optic nerve D max [0.78 GyE (0.04 GyE, 25.18 GyE) vs. 20.42 GyE (6.38 GyE, 37.17 GyE)], left optic nerve D mean [0.10 GyE (0.01 GyE, 11.63 GyE) vs. 9.74 GyE (2.99 GyE, 20.87 GyE)], right optic nerve D mean [1.57 GyE (0.13 GyE, 14.90 GyE) vs. 14.08 GyE (2.66 GyE, 23.67 GyE)], left len D max [0 GyE (0 GyE, 2.91 GyE) vs. 4.84 GyE (1.42 GyE, 5.48 GyE)], left len D mean [0 GyE (0 GyE, 1.73 GyE) vs. 3.84 GyE (1.25 GyE, 4.30 GyE)], right len D max [0.25 GyE (0.04 GyE, 4.55 GyE) vs. 4.28 GyE (1.58 GyE, 5.84 GyE)], right len D mean [0.16 GyE (0.01 GyE, 1.95 GyE) vs. 3.73 GyE (1.04 GyE, 4.86 GyE)], pituitary D max [6.97 GyE (0.18 GyE, 39.70 GyE) vs. 36.60 GyE (2.74 GyE, 45.19 GyE)], pituitary D mean [1.36 GyE (0.06 GyE, 13.85 GyE) vs. 24.74 GyE (2.42 GyE, 32.80 GyE)], hippocampus D max [5.10 GyE (0.24 GyE, 26.52 GyE) vs. 35.83 GyE (5.03 GyE, 46.11 GyE)], hippocampus D mean [0.36 GyE (0.04 GyE, 25.65 GyE) vs. 18.79 GyE (2.37 GyE, 28.10 GyE)] in IMPT planning were lower, and the differences were statistically significant (all P < 0.05). There were no statistical differences in brainstem D max [51.98 GyE (0.66 GyE, 53.43 GyE) vs. 53.29 GyE (3.87 GyE, 53.48 GyE)], right optic nerve D max [9.60 GyE (0.01 GyE, 43.32 GyE) vs. 25.37 GyE (3.45 GyE, 41.25 GyE)] of both plans (all P > 0.05). Conclusion:In the radiotherapy for glioma, IMRT and IMPT can meet the dose demand in clinic. Furthermore, IMPT planning can protect organs at risk and reduce radiation dose in hippocampus, brainstem, optic nerve, lens and pituitary.
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Objective:To investigate whether the real-world marital status is a factor affecting the survival of patients with early stage breast cancer.Methods:According to the data of 62 845 patients with early stage (T 1-2N 0M 0) breast cancer who received treatment from January 2012 to December 2015 in the Surveillance, Epidemiology and End Results (SEER) database, univariate survival analysis for 7 factors including age, race, surgery, T stage, tumor differentiation, molecular type and marital status was performed by Kaplan-Meier method. The 5-year cancer specific survival (5-CSS) rate was calculated. Multivariate Cox proportional hazards model was used to analyze the death risk of patients with different marital status (married, unmarried and bad marriage). Results:Univariate analysis showed that 7 factors were correlated with the survival of patients with early stage breast cancer (all P < 0.001). Multivariate analysis showed that marital status was an independent factor affecting the survival of patients, and the death risk of unmarried patients and patients with bad marriage was 2.014 times (95% CI 1.714-2.367, P < 0.001) and 2.559 times (95% CI 2.254-2.905, P < 0.001) higher than that of married patients, respectively. In tumor differentiation, molecular type, T stage and race subgroups, univariate analysis showed that the rates of 5-CSS in married patients were higher than those in unmarried patients and patients with bad marriage (all P < 0.001); multivariate analysis showed that the risk of death in patients with bad marriage (except undifferentiated type) was higher than that in married patients (all P < 0.001), and the risk of death in unmarried patients (except undifferentiation, Luminal B type, black and other races) was also higher than that in married patients (all P < 0.01). Conclusions:Marital status is one of the factors influencing the survival of patients with early stage breast cancer.
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Since the outbreak of a new round of COVID-19 in Xi’an on December 9, 2021, the response capability of the city’s and even the province’s health system to major public health emergencies has been severely tested and challenged. Faced with the rapid spread of the Delta strain and its multiple hidden transmission chains, The First Affiliated Hospital of Xi’an Jiaotong University, as the largest comprehensive tertiary hospital in Northwest China, has successfully applied the 4R crisis management theory to prevent the pandemic spread and continue the clinic work as well. Balancing of epidemic prevention and medical service with scientific, orderly and standardized procedures has been achieved. Hence, we have contributed to the "The First Affiliated Hospital of Xi’an Jiaotong University model" for controlling the epidemic and restoring normal production and life as soon as possible under the guidance and command of the National Health Commission and provincial and municipal health administrative institutions at all levels. The First Affiliated Hospital of Xi’an Jiaotong University has improved the present management system and enhanced its management level amid epidemic prevention and control. This paper aims to provide new epidemic prevention experience under the changeable environment by explaining and summarizing our theoretical basis, operation mode and practical effects of our management system.
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OBJECTIVE：To establish the fingerprint of Papaveris Pericarpium， and to determine the contents of 5 components，such as morphine ，codeine，thebaine，papaverine and narcotine. METHODS ：HPLC method was adopted. The determination was performed on a Agilent ZORBAX Eclipse XDB-C18 column with mobile phase consisted methanol -sodium heptanesulfonate with gradient elution at the flow rate of 1.0 mL/min. The detection wavelength were set at 238 nm（papaverine） and 216 nm（morphine，codeine，narcotine，thebaine）. The column temperature was 20 ℃，and sample size was 10 µL. HPLC fingerprints of 15 batches of Papaveris Pericarpium were established by using the Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition），and the common peaks were determined in combination with the spectra of mixed control. The contents of morphine ，codeine，thebaine，papaverine and narcotine were determined simultaneously by the same method. The cluster analysis was conducted by using SPSS 19.0 software. RESULTS ：There were 13 common peaks in 15 batches of Papaveris Pericarpium ，and the similarity was greater than 0.99. Five chromatographic peaks were identified ，which were morphine，codeine，thebaine，papaverine and narcotin. The results of cluster analysis showed that 15 batches of Papaveris Pericarpium could be clustered into two categories ，S1-S7 and S 8-S15，belonging to two cities. The linear ranges of five components were 10.21-102.10，10.43-104.30，1.54-30.70，2.36-47.28，2.32-57.90 μg/mL，respectively（all r＞0.998）. RSDs of precision，stability（24 h）and repeatability tests were all less than 2％. The average recoveries were 99.46％（RSD＝1.08％，n＝ 6），97.84％（RSD＝1.55％，n＝6），91.10％（RSD＝1.74％，n＝6），96.43％（RSD＝1.25％，n＝6）、94.82％（RSD＝1.20％，n＝6）， respectively. The contents of 5 components were 2.342 9-4.082 2，0.430 4-0.889 7，0.055 2-0.090 4，0.299 3-0.558 8，0.343 2- 0.656 2 mg/g. CONCLUSIONS ：The established HPLC fingerprint and content determination method is simple ，feasible，sensitive and accurate. It combined with the cluster analysis could reflect characteristics and int ernal quality of chemical components in Papaveris Pericarpium . Papaveris Pericarpium in different cities possess regionalization characteristics ，but its quality isbasically stable.
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Objective:To detect the potential biomarkers in the serum of adolescents with depressive disorder and provide the basis for clinical diagnosis of depression.Methods:A total of 45 adolescents with depression who met the inclusion criteria and 47 healthy controls (HC group) were screened.Patients with depression were treated with sertraline (100 mg/d) for 4 weeks.The patients before sertraline treatment were called DN-MDD group and then were called DT-MDD group after sertraline treatmant.Hamilton Depression Scale (HAMD) was used to evaluate the efficacy of the two groups before and after treatment.The serum was collected for UPLC-MS/MS to determine the changes in profiles of endogenous metabolites.And the software of SPSS 21.0, XCMS and Analyst 3.0 were used to analyze the data.The reliability and feasibility of clinical diagnosis were further analyzed by ROC via GraphPad 8.0.Results:After 4 weeks of sertraline treatment, the patients' HAMD score decreased (before: 19.71±1.72, after: 15.36±1.91) and the effective rate reached 51% ( P<0.01). Multivariate statistical analysis showed that HC group and DN-MDD group and DT-MDD group had significant differences in metabolic profile.Compared with healthy controls, 11 different metabolites were found in the plasma of DN-MDD group including glycerate, adenosine, creatine and so on.After treatment, concentrations of glucose, glutamate, aspartate, sucrose, creatine, pyruvate and adenosine were significant changes in serum of adolescent depression patients.Area under ROC curve of glucose and glutamic acid were >0.9, and the AUC of aspartic acid, sucrose, creatine, pyruvate and adenosine were >0.7, suggesting that these 7 metabolites had different degrees of diagnostic ability. Conclusion:There are different metabolic profiles between adolescents with or without depression, and the antidepressant sertraline is helpful to maintain the level of substance metabolism which can be used as one of the treatment methods for adolescent depression.Our research may support the new strategy for clinical diagnosis and treatment of adolescent depression.
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Objective:To explore the clinical effect of "information knowledge belief practice" model, namely "IKAP theory" nursing intervention model on patients with peritoneal dialysis(PD).Methods:The clinical data of 120 patients with PD treated in The Second Hospital of Tianjin Medical University from January 2020 to December 2020 were analyzed retrospectively. The patients were randomly divided into control group and observation group, with 60 cases in each group. In the observation group, there were 32 males and 28 females with an age range of (56.16±10.25) years, including 18 cases of diabetic nephropathy, 22 cases of chronic glomerulonephritis and 20 cases of hypertensive nephropathy. In the control group, there were 34 males and 26 females, with an age range of (56.27±10.34) years, including 14 cases of diabetic nephropathy, 18 cases of chronic glomerulonephritis and 28 cases of hypertensive nephropathy. The patients in the control group were given routine nursing. In addition to the routine nursing, the patients in the observation group also adopted IKAP mode for nursing intervention. The levels of hemoglobin (HB), serum albumin (ALB), comprehensive nutrition assessment score (SGA) and nursing satisfaction of the two groups were compared before and 6 months after the intervention. The comparison of measurement data before and after intervention in the intervention group was analyzed by paired sample t-test. Frequency data were compared and analyzed by Chi-square ( χ2) test. Results:Before the intervention, there was no significant difference in ALB, Hb levels and SGA between the observation group and the control group( t=1.001~1.743, all P>0.05). After the intervention, the SGA score of the observation group was lower than that of the control group, while the levels of ALB and Hb were higher than those of the control group, and the differences between the two groups were statistically significant ( t=3.411~5.050, all P<0.05). The satisfaction of patients in the observation group was 95%, while that in the control group was 78.33%, and the difference between the two groups was statistically significant ( χ2=7.212, P<0.05). Conclusions:For peritoneal dialysis patients, IKAP nursing intervention can not only effectively improve their nutritional status, but also increase their satisfaction with nursing. IKAP nursing intervention model is worthy of clinical promotion.
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Objective:To analyze the clinical characteristics, diagnosis and treatment process, and prognosis of human immunodeficiency virus (HIV) positive patients with systemic lupus erythematosus (SLE).Methods:A retrospective study was used to collect and analyze the clinical characteristics, treatment and prognosis of eight HIV-positive patients with SLE treated in Yunnan Provincial Infectious Diseases Hospital from August 2017 to January 2020.Results:All of the eight patients were diagnosed with SLE after HIV infection. All of the patients were female. CD4 + T lymphocyte counts were >500/μL in four cases, 350 to 499/μL in two cases, and 200 to 349/μL in the remaining two cases. Case 6 presented with butterfly erythema on the face. In Case 1, hemoglobin was 40 g/L and urine occult blood was (+ + ). The hemoglobin of Case 2 was 76 g/L, the platelet count was 2×10 9/L, and the granulocyte count was 0.6×10 9/L. The lung computed tomography (CT) examination of Case 3 showed diffuse exudative lesions in both lungs. The 24 h urinary protein levels of Case 4 and 5 were 2 231.6 mg and 2 761.0 mg, respectively, and urine occult blood were (+ + ). The total bilirubin of Case 4 was 70.0 μmol/L and alanine aminotransferase (ALT) was 49 U/L. The total bilirubin of Case 7 was 129.6 μmol/L and ALT was 56 U/L. The lung CT examination of Case 8 showed moderate to massive pericardial effusion in the pericardium. Seven patients received antiviral therapy and immunotherapy, and their conditions were stable without relapse. Case 1 was refractory SLE complicated with autoimmune hemolytic anemia. After treated with rituximab combined with cyclophosphamide the patient achieved clinical remission. Case 7 was injection drug user and died after giving up treatment. Conclusions:The clinical characteristics of HIV-positive patients with SLE are heterogeneous, and the prognosis is generally good after antiviral therapy and immunotherapy. For patients with refractory SLE complicated with autoimmune hemolytic anemia, clinical remission can also be achieved through active treatment.
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Objective:Through the establishment and application of the biosafety autopsy pathology platform in Huoshenshan Hospital, the feasibility and application effect of the biosafety autopsy pathology platform were analyzed.Methods:The feasibility and application effect of the biosafety autopsy pathology platform were analyzed by layout design, instruments and equipment preparation, testing methods examination, and effect evaluation.Results:A total number of 26 cases of systematic autopsy and 8 cases of minimally invasive autopsy (puncture) were performed on the biosafety autopsy pathology platform, and no one was infected. Some pathology original findings were identified, including COVID-19 and pathological characteristics of identification, SARS respiratory failure mechanism and treatment significance, systemic distribution and spreading mechanism of the new coronavirus, the " storm" of inflammation pathological basis, some tumor markers rise in pulmonary pathological cell source and the overcast with fibrosis characteristics, such findings play important roles in the clinical diagnosis and treatment of COVID-19.Conclusions:The study of autopsy pathology is of great significance for the prevention and control of emerging infectious disease, which calls for early intervention. To promote the standard construction of biosafety autopsy platform is the key to the pathological study of emerging infectious diseases. Pathological research and clinical diagnosis and treatment should be combined to inform each other.
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Based on the current situation and task of fighting COVID-19, and combined with emergency management mode of public health emergencies and participation of multi-times emergency rescue practices along with the case analysis and literature review and brain-storming, we constructed a basic framework of the emergency command system of public health emergencies in COVID-19 epidemic prevention and control background. The framework contained four modules: the response mechanism, the organizational structure, the emergency capacity, and the supervisory mechanism and the advantages and key points in implementing this emergency command system was discussed.
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Objective To investigate the dosimetry differences of target and OARs of an integrated design of fields in IMRT and the mainstream IMRT technique for post-radical mastectomy.Methods A total of 41 patients with post-radical mastectomy who received IMRT were eligible,the conventional fixing two-degrade collimator and the integrated IMRT fields were designed respectively.The dosimetry parameters of target and OARs,monitor units and delivery time of both plans were compared.Results The dose distribution for targets and OARs of both plans met clinical requirements.The dosimetry parameters of target of both plans showed no statistically significant difference (P＞0.05).Compared with the conventional technique,the integrated IMRT plans showed significant advantages,the ipsilateral lung V5 decreased by9.7％ (t=2.407,P＜0.05),V10 11.2％ (t=2.160,P＜0.05),V20 17.3％ (t=2.465,P＜0.05),V30 13.4％ (t=2.119,P＜0.05),D 13.8％ (t=2.258,P＜0.05).And the heart V30 decreased by 28.4％ (t =2.589,P＜0.05),D 23.2％ (t=2.409,P＜0.05).The dosimetric differences of other OARS were not statistically significant (P＞0.05).Conclusions The new method can effectively reduce exposed volume and exposed dose of ipsilateral lung and heart without affecting the target dose coverage.The method has universal applicability to patients with post-radical mastectomy who received IMRT,with important clinical significance.
Реферат
Objective@#To investigate the dosimetry differences of target and OARs of an integrated design of fields in IMRT and the mainstream IMRT technique for post-radical mastectomy.@*Methods@#A total of 41 patients with post-radical mastectomy who received IMRT were eligible, the conventional fixing two-degrade collimator and the integrated IMRT fields were designed respectively. The dosimetry parameters of target and OARs, monitor units and delivery time of both plans were compared.@*Results@#The dose distribution for targets and OARs of both plans met clinical requirements. The dosimetry parameters of target of both plans showed no statistically significant difference (P>0.05). Compared with the conventional technique, the integrated IMRT plans showed significant advantages, the ipsilateral lung V5 decreased by 9.7%(t=2.407, P<0.05), V10 11.2%(t=2.160, P<0.05), V20 17.3%(t=2.465, P<0.05), V30 13.4%(t=2.119, P<0.05), Dmean 13.8%(t=2.258, P<0.05). And the heart V30 decreased by 28.4%(t=2.589, P<0.05), Dmean 23.2%(t=2.409, P<0.05). The dosimetric differences of other OARS were not statistically significant(P>0.05).@*Conclusions@#The new method can effectively reduce exposed volume and exposed dose of ipsilateral lung and heart without affecting the target dose coverage. The method has universal applicability to patients with post-radical mastectomy who received IMRT, with important clinical significance.