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OBJECTIVE To investigate the current situation of pharmaceutical clinic service in medical institutions in China and provide experience and suggestions for promoting the development of pharmaceutical clinics. METHODS Questionnaire survey was used to investigate the development of pharmaceutical clinics in medical institutions of 31 provinces (autonomous regions and municipalities directly under the central government) in March to April 2023, and the descriptive analysis was conducted. The regression analysis was carried out for the influential factors of pharmaceutical clinic service. RESULTS A total of 1 368 questionnaires were distributed in this survey and 1 304 valid questionnaires were collected with the effective response rate of 95.32%. A total of 463 medical institutions carried out pharmaceutical clinic service, the rate of which was 35.51% (463/1 304); the rates of pharmaceutical clinics in tertiary, secondary, primary and other medical institutions were 52.80%, 17.18% and 5.88%, respectively. The frequency of opening pharmaceutical clinics was 3.17 days per week on average, with an average of 5.99 visiting pharmacists in each medical institution. Among the visiting pharmacists, clinical pharmacists accounted for the vast majority (88.68%, 2 459/2 773). There were various categories of pharmaceutical clinics, including joint clinics and pharmacist-independent clinics; among pharmacist-independent clinics, pharmaceutical specialty/specialty disease clinics were the main ones, accounting for 89.72% of the total number of pharmaceutical clinics. The value of pharmacists in pharmaceutical clinics was manifested in various forms, among which the proportion of medical institutions charging pharmaceutical clinics was 10.80%. The main experiences in developing pharmaceutical clinics were to attach importance to discipline construction and personnel training. The main difficulties in developing pharmaceutical clinics were low compensation levels and a shortage of talent.The number of clinical pharmacists, the number of visiting pharmacists in pharmaceutical clinics and additional compensation were positively correlated with the amount of pharmaceutical clinic services(P<0.05). CONCLUSIONS In recent years, pharmaceutical clinics have made significant progress; in the future, it is still necessary to further strengthen discipline construction and talent cultivation, pay attention to the value embodiment of pharmacists, to promote the healthy development of pharmaceutical clinics.
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Purpose/Significance Based on the research of the current situation of China's health and medical data policies and reg-ulations,the paper puts forward countermeasures and suggestions to strengthen the legal protection.Method/Process The current situa-tion of policies and regulations at the national and local levels is sorted out,legislative dilemmas are analyzed,extraterritorial legislative models are compared and studied,and suggestions on building and improving the legal system of health and medical data are put forward.Result/Conclusion It is necessary to clarify the legislative principles of China's health and medical data legal system,learn from the successful experience of local legislation and extraterritorial legislative practice,and adopt the"basic law+special law"model.
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OBJECTIVE To investigate the basic situation of developing pharmacy outpatient departments in Chinese tertiary medical institutions and analyze the influencing factors. METHODS The research targeted the pharmacy outpatient department managers of hospitals and conducted a survey through Sojump in March 2023. Various independent variables were selected from the hospital’s own characteristics, the management of the pharmacy outpatient departments, and the construction of the pharmacist team for Logistic and linear regression analysis, with the aim of separately analyzing the factors influencing the establishment of pharmacy outpatient departments and the factors affecting the total number of patients served by these departments throughout the year 2022. RESULTS & CONCLUSIONS A total of 1 304 medical institutions of different levels nationwide participated in this survey, with 714 tertiary hospitals. Among the tertiary hospitals, 377 (52.80%) had established pharmacy outpatient departments, including 321 grade-A tertiary hospitals, 48 grade-B tertiary hospitals and 8 other tertiary hospitals. The 377 tertiary hospitals collectively operated 1 739 pharmacy outpatient departments, covering 19 specialized fields, with the highest proportion found in the cardiovascular field (including anticoagulation) at 16.45%. Tertiary hospitals in North China, Central China, East China and South China regions had more pharmacy outpatient departments. The establishment of pharmacy outpatient departments was found to be influenced by tertiary grade-B status (P=0.010) and the annual outpatient volume of the hospital (P=0.008), although the impact was relatively small. The factors influencing the number of patients served by pharmacy outpatient departments were the annual outpatient volume of the hospital (P=0.042) and the number of pharmacists engaged in clinical pharmacy work (P=0.004). The proportion of tertiary hospitals in China that have established pharmacy outpatient departments is insufficient. It is necessary to further accelerate the construction of pharmacy outpatient departments and appropriately expand the talent pool of hospital pharmacy teams based on the needs of pharmacy outpatient departments and patients, in order to meet the requirements of medical practice and patient care.
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Objective:To evaluate the effectiveness of contrast-enhanced ultrasound in the differential diagnosis of atypical adenomyosis and fibroids using a decision tree model.Methods:The data of cases with difficulty in differentiating atypical adenomyosis from fibroids on conventional ultrasound examination at Shengjing Hospital of China Medical University from April 2021 to April 2022 were selected and analyzed. Ninety-five patients with contrast-enhanced ultrasound examination were finally selected, including 64 patients in the pathologically confirmed adenomyosis group and 31 patients in the fibroids group. The data from the qualitative analysis and the quantitative analysis of the time-intensity curve (TIC) curve were collected separately, including the temporal variability of contrast entry into the lesion, i.e.the difference between the time when the contrast agent started to enter the lesion and the time when the contrast agent finally filled the lesion completely. Indicators were first screened for inclusion in the decision tree model by univariate and multifactorial analyses, and decision tree models based on qualitative analysis indicators, and qualitative and TIC-based analyses were developed to further assess the diagnostic efficacy of both models.Results:Through the univariate analysis, it showed that the qualitative analysis indicators of lesion onset enhancement pattern, enhancement intensity, intra-lesion contrast distribution, and post-contrast lesion border were of statistical significance (all P<0.05) between the two groups. The differences in contrast arrive time (AT), contrast time to peak (TTP), |ΔAT|, and |ΔTTP| in the TIC curve analysis indexes were statistically significant between the two groups (all P<0.05). The difference in lesion temporal phase variability was statistically significant between the two groups ( P<0.05). After further screening by multifactorial analysis, the accuracy and misdiagnosis rates were 87.40% and (17.90±3.90)% in the qualitative analysis-based decision tree model respectively, and 90.50% and (21.10±4.20) % in the qualitative and TIC curve-based analysis decision tree model respectively. The ROC curves were plotted according to the two groups of models, and the areas under the curves were 0.915 and 0.931 respectively. Conclusions:A decision tree model based on ultrasonographic image analysis has diagnostic value for the differential diagnosis of atypical adenomyosis and uterine fibroids.
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【Objective】 To investigate the clinical efficacy and safety of laparoscopic radical prostatectomy in elderly prostate cancer patients aged ≥80 years in good health. 【Methods】 A total of 18 octogenarian patients who underwent laparoscopic radical prostatectomy during Aug.2016 and Mar.2020 at our hospital were selected for retrospective analysis. 【Results】 The patients were 80 to 86 years old. The preoperative serum PSA was 5.25-101.00 ng/mL. There were 2 cases in stage cT1N0M0,12 in stagec T2N0M0 and 4 in stage cT3N0M. The Gleason score was ≤6 in 4 cases,=7 in 9 cases,and ≥8 in 5 cases. During the follow-up of 22 to 65 months,the rates of urinary incontinence at 1 month,3 months,6 months,and 1 year were 50.00% (9/18),33.33% (6/18),16.67% (3/18) and 5.56 %(1/18),respectively. The postoperative urinary control recovery time was 1 to 220 days. Positive incision margin developed in 3 cases and biochemical recurrence occurred in 3 cases. The IPSS score at 3, 6 months and 1 year after surgery were lower than these before surgery (P<0.05). The overall health score of the FACD-P scale at 6 months after surgery was higher than that before surgery (P<0.05). 【Conclusion】 For well selected octogenarian prostate cancer patients in good condition,laparoscopic radical prostatectomy is a feasible,safe and effective treatment option,but long-term follow-up and prospective clinical studies with large sample size are still needed to confirm its efficacy.
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Objective To investigate the preventive therapeutic effect and possible mechanism of single chain variable fragments chimeric protein (SD) of ovalbumin epitopes internalizing receptor DEC-205 antibody on food allergy in mice. Methods Mice were randomly divided to five groups (control, PBS, scFv DEC 100 μg, SD 50 μg, SD 100 μg) and treated for 24 hours before OVA administration. After challenge, the serum level of OVA-specific IgE, IgG1, IgG2a and IL-4 were detected by ELISA. Infiltration of eosinophils and mast cells in the jejunum was observed by HE staining and toluidine blue staining respectively. The bone marrow of tibia and femur was isolated and cultured to obtain immature dendritic cells(BMDCs), which were further treated with LPS (10 ng/mL), TSLP (50 ng/mL), scFv DEC protein (1000 ng/mL) and SD protein (10,100,1000)ng/mL for 24 hours, and the IL-10 level of supernatant was assayed by ELISA. Results Compared with PBS group, the number of SD-treated mice with diarrhea was markedly reduced. The difference in rectal temperature and the levels of serum OVA-specific IgE, IgG1, IgG2a and IL-4 decreased significantly after prophylactic administration of SD; The number of eosinophils and mast cells in jejunum also decreased significantly while the IL-10 level in the supernatant of BMDCs increased significantly after SD intervention. Conclusion SD mitigates experimental FA response by fosters the immune tolerance property of dendritic cells.
Subject(s)
Mice , Animals , Ovalbumin , Interleukin-10 , Single-Chain Antibodies/genetics , Immunoglobulin E , Epitopes/therapeutic use , Interleukin-4 , Food Hypersensitivity/prevention & control , Immunoglobulin G , Recombinant Fusion Proteins/genetics , Mice, Inbred BALB C , Disease Models, Animal摘要
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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OBJECTIVE@#To explore the genetic basis for a child with succinate semialdehyde dehydrogenase deficiency.@*METHODS@#Peripheral blood samples of the proband and his parents were collected and subjected to Sanger sequencing. High-throughput sequencing was used to verify the gene variants. Bioinformatic software was used to analyze the pathogenicity of the variant sites.@*RESULTS@#Sanger sequencing showed that the proband carried a homozygous c.1529C>T (p.S510F) variant of the ALDH5A1 gene, for which his mother was a carrier. The same variant was not detected in his father. However, high-throughput sequencing revealed that the child and his father both had a deletion of ALDH5A1 gene fragment (chr6: 24 403 265-24 566 986).@*CONCLUSION@#The c.1529C>T variant of the ALDH5A1 gene and deletion of ALDH5A1 gene fragment probably underlay the disease in the child. High-throughput sequencing can detect site variation as well as deletion of gene fragment, which has enabled genetic diagnosis and counseling for the family.
Subject(s)
Child , Humans , Infant , Amino Acid Metabolism, Inborn Errors/genetics , Developmental Disabilities , Mutation , Succinate-Semialdehyde Dehydrogenase/genetics摘要
Objective:To probe the influence of obstruction sleep apnea syndrome (OSAS) on cardiac function and serum cystatin-C (CC) levels in patients with chronic heart failure (CHF), and to discuss its clinical significance.Methods:129 CHF patients suspected of OSAS were selected and divided into observation group (with apnea) and control group (without apnea) according to sleep apnea hypopnea index (AHI). The observation group included mild, moderate and severe groups. After admission, the levels of left ventricular ejection fraction (LVEF), N-terminal forebrain natriuretic peptide (NT-proBNP) and CC were collected for further analysis.Results:The levels of NT-proBNP and CC in 99 patients with CHF complicated with OSAS were higher than those in the control group, while LVEF was lower than those in the control group ( P<0.05); The levels of NT-proBNP and CC in severe group were higher than those in mild and moderate group, while LVEF was significantly lower ( P<0.05); The level of CC in mild to moderate group was higher than that in control group, while LVEF was lower than that in control group ( P<0.05). Rank correlation analysis showed that CC was positively correlated with AHI ( r=0.726, P<0.01); However, there was no significant difference in NT proBNP between mild to moderate group and control group ( P>0.05). Conclusions:OSAS can lead to the deterioration of cardiac function. The CC of CHF patients with OSAS is higher and increases with the aggravation of obstruction. CC may participate in the progression of the disease. A high level of CC may aggravate the development of the disease, and the incidence and mortality of cardiovascular events may also increase.Early prevention and treatment should be given.
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Virome is the collective term for the viral collection or viral metagenomes that are distributed in various environments. Viruses can be found in bodies of water, glaciers, plants, animals, and even some viruses, which are classified as eukaryotes, prokaryotes and subviruses. Viruses play very important role in maintaining environmental homeostasis and ecosystem balance, and are especially closely related to human health. In recent years, with the advancement of sequencing technology and data analysis, we are able to gain more insights into the virome and explore its potential role in the ecological niche by metagenomic sequencing. A large amount of viral data have been obtained from glaciers, oceans, and various plants and animals, and numerous unknown viruses have been discovered. Virome has been studied mainly through metagenomic data mining, as well as virus-like particles separation and enrichment. To date, several different methods for viral isolation and enrichment exist, and numerous bioinformatic analyses of the virome have been performed. However, there is a lack of specific and complete reviews on the enrichment and data analysis methods for the virome. Thus, our review will summarize viral isolation and enrichment methods and data analysis, and present some of the landmark research conducted by the enrichment method, to provide a reference for researchers of interest and further advance the field of virome research.
Subject(s)
Animals , Humans , Metagenome , Metagenomics , Microbiota/genetics , Virome , Viruses/genetics摘要
Objective:To survey the status of antihypertensive therapy knowledge and hypertension management among general practitioners in community health centers (CHCs) in China.Methods:Based on the eastern, western, southern and northern regions of the country, 350 CHCs were selected from 11 cities across the country with stratified sampling method for study sites, and one general practitioner was selected from each CHC. The questionnaire survey was conducted from March 12 to April 20, 2018 among 350 participants. The content of the questionnaire included the proportion of hypertensive patients in the consultation, treatment target rate, antihypertensive drugs and protocol, the medication compliance, follow-up, blood pressure self-measurement, and the impact of hierachical medical system on CHC.Results:Total 350 valid questionnaires were recovered. The survey showed that: (1) Among the patients treated by general practitioners, 46% (30%, 60%) were hypertensive patients including 41% (40%, 55%) with primary hypertension and 42% (40%, 50%) with secondary hypertension; 72% (60%, 80%) of the patients had comorbidities, including dyslipidemia, diabetes, and coronary heart disease. (2) Western medicine was the main antihypertensive treatment [90% (82%, 100%) ], calcium channel blockers were the most commonly used antihypertensive drug [46%(30%,60%)], the therapeutic protocol was mainly single agent [35% (25%, 50%) ]or free combination [50% (40%, 60%) ]; the stable(9.1±0.8), long-acting (9.0±0.9) and high standard reaching rate (8.1±1.1) antihypertensive drugs were first considered, and the standard reaching rate of hypertension treatment was 61% (50%, 75%) . (3) The regular follow-up rate, adherence to blood pressure self-test rate and long-term regular medication rate was 60%(50%,70%), 51%(40%,70%) and 65%(50%,70%), respectively. The factors affecting patients′ compliance were history of cardiovascular diseases (8.4±1.1)and patients′ cognition of disease(8.3±1.1). General practitioners believed that the positive effects of the hierarchical diagnosis and treatment system include helping to establish a closer relationship with patients [62.6% (219/350)] and improving patient compliance for community preferential reimbursement policies[58.6% (205/350) ]. The challenges faced by CHC included higher patient expectations [52.8% (185/350)] and increased outpatient visits [52.6% (184/350)]. Insufficient diagnostic equipment [68.3% (239/350)], inadequate dispensing [52.3% (183/350)] and other issues restricted the development of CHC, and the clinical competence of general practitioners [51.7% (181/350)] need to be improved.Conclusion:Patients with hypertension account for about half of the total number of visits in community health service centers, and most of them are comorbid with cardiovascular and cerebrovascular diseases or risk factors. The long-term treatment compliance and self-management of blood pressure need to be further improved.
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Objective:To assess the concept and clinical practice of general practitioners in community health service centers (CHCs) on the use of antiplatelet drugs (APD) to prevent cardiovascular diseases(CVD).Methods:Based on the eastern, western, southern and northern regions of the country, 350 CHCs were selected from 11 cities across the country with stratified sampling method for study sites, and one general practitioner was selected from each CHC. The questionnaire survey was conducted from March 12 to April 20, 2018 among 350 participants. The content of the questionnaire included the situation of CVD patients, application of APD in primary/secondary prevention of CVD (schemes and regimes), the prescription concept of APD, and influencing factors.Results:Total 350 valid questionnaires were recovered. The survey showed that among all patients general practitioners routinely took care, 46% (30%, 60%) were hypertensive patients; 96.6% (338/350) of the general practitioners said that they had carried out primary prevention, mainly for patients with hypertension, diabetes, dyslipidemia or carotid artery plaque, and 34% (20%, 45%) of the patients had taken primary prevention drugs; the use of APD only accounted for 47% (35%, 60%) , among which 87% (80%, 95%) was aspirin. The main impediments were lack of awareness of disease from patients[ (8.0±1.4) points] and lack of awareness of primary prophylaxis from general practitioners[ (7.3±1.4) points]. The survey also showed that 28% (20%, 35%) and 17% (10%, 20%) patients were diagnosed as coronary heart disease and stroke, respectively; 83% (80%, 95%) of patients with coronary heart disease or stroke used APD for secondary prophylaxis; for coronary heart disease patients, 82% (70%, 95%) taking aspirin or clopidogrel, 18% (5%, 30%) taking aspirin and clopidogrel for 11 months; for stroke patients, 85% (80%, 95%) taking aspirin or clopidogrel, 15% (5%, 20%) taking aspirin and clopidogrel for 9 months. Compared with clopidogrel, aspirin had a relatively high score for clinical experience (8.3±1.1) and reasonable cost of treatment (8.3±1.3) .Most coronary heart disease patients (68%±15%) and stroke patients (70%±17%) took APD regularly. The lack of knowledge of disease [(8.4±1.1) points] and awareness of regular medication [(8.2±1.2) points] were the main factors affecting compliance of patients.Conclusion:The use of APD in primary prevention of CVD for general practitioners is insufficient, and there is still a big gap between the standardization and the practice in secondary prevention; in particular, the selection of APDs and treatment course should strictly follow the guidelines.
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Objective To observe the effect of aerobic exercise combined with impedance training on the blood pressure variability and other blood-related indexes of patients with hypertension. Methods Ninety patients with essential hypertension were randomly divided into group A, group B and group C, each of 30. All were treated with conventional anti-hypertensive drugs. Groups B and C additionally underwent 40 minutes of aerobic training and group C also received resistance training. There were 3 training sessions a week for 12 weeks. Each subject's 24 h systolic blood pressure (24hSBP), 24 h diastolic blood pressure (24hDBP) and their standard deviations were ob-served before and after the 12 weeks. Blood indexes were examined and a plasma arteriosclerosis index was calculated. Results Before the treatment, there were no significant differences in any of the average measurements among the three groups. After the treatment, the average 24hSBP and 24hDBP of all three groups had decreased significantly, but larger decreases were observed in groups B and C. Compared with group B, the average 24hSBP and 24hDBP of group C had decreased significantly more. The average levels of atherogenic index of plasma ( AIP) and lipoprotein phospholipase A2 of groups B and C were significantly lower than before the treatment and also significantly lower than group A's average. The decrease in group C was significantly greater than in group B. Conclusions Anti-hyperten-sive drugs can lower blood pressure, but cannot effectively control blood pressure variation, reduce blood lipids or im-prove the arteriosclerosis index. Long-term, regular aerobic exercise can decrease these indicators and reduce cardio-vascular disease risk in elderly patients with hypertension. Aerobic exercise combined with mild to moderate circulato-ry resistance exercise is more effective than aerobic exercise alone.
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Astragalus membranaceus is one of the frequently used qi tonifying herbal medicines.It can regulate blood pressure.This paper reviewed the studies on the two-way regulation of blood pressure of Astragalus membranaceus in recent years,even thought the Astragalus membranaceus has been regarded to cure hyperhension due to qi deficiency.It can lower the pressure with large dosage or in liquid-fried form.Astragalus membranaceus,Astragalus membranaceus as the sovereign drug of the formulas or Astragalus membranaceus combined with western medicine can regulate blood pressure.It was found that the effect of reducing blood pressure was mainly related to the decrease of heart rate,dilation of blood vessels,inhibition of oxidative stress,reduction of calcium ion level,diuretics,change the content of growth factor and receptor,lowering uric acid,reduction of cysteine levels,and increase insulin sensitivity.Itelevated the blood pressure,mainly related to the increase of cardiac output and vasoconstriction.
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Objective To explore the intervention effect of improved nursing measures in the treatment of patients with dystonia with deep brain stimulation in MRI localization. Methods Twenty patients with dystonia treated with deep brain stimulation from January 2013 to December 2015 were selected as the control group. Twenty patients with dystonia treated by deep brain stimulation surgery with improved nursing from January 2016 to December 2018 were in the experimental group. The primary success rate of MRI localization, examination time related indexes and incidence of adverse reactions after intravenous anesthesia were observed in the 2 groups. Results The primary success rate of MRI localization in the experimental group (95.00%,19/20) was higher than that in the control group (55.00%, 11/20), and the difference was statistically significant (χ2=8.533, P<0.01).The total examination time of the experimental group (33.60±8.27) min was significantly shorter than that of the control group (44.30±13.43) min, and the difference was statistically significant (t=-3.663, P<0.05).The incidence of total adverse reactions to MRI localization after intravenous anesthesia was lower in the experimental group (5%, 1/20) than in the control group (30%, 6/20), and the difference was statistically significant (χ2=4.329, P<0.05). Conclusions Improved nursing measures can effectively improve the success rate of MRI stereotactic brain target location in patients with dystonia, providing a guarantee for accurate calculation of surgical targets, enabling the operation to achieve the best results, early detection of changes in vital signs during examination, and the close cooperation of the medical team is the guarantee for the smooth completion of MRI examination.
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Objective@#To explore the intervention effect of improved nursing measures in the treatment of patients with dystonia with deep brain stimulation in MRI localization.@*Methods@#Twenty patients with dystonia treated with deep brain stimulation from January 2013 to December 2015 were selected as the control group. Twenty patients with dystonia treated by deep brain stimulation surgery with improved nursing from January 2016 to December 2018 were in the experimental group. The primary success rate of MRI localization, examination time related indexes and incidence of adverse reactions after intravenous anesthesia were observed in the 2 groups.@*Results@#The primary success rate of MRI localization in the experimental group (95.00%,19/20) was higher than that in the control group (55.00%,11/20), and the difference was statistically significant (χ2=8.533, P<0.01).The total examination time of the experimental group (33.60±8.27) min was significantly shorter than that of the control group (44.30±13.43) min, and the difference was statistically significant (t=-3.663, P<0.05).The incidence of total adverse reactions to MRI localization after intravenous anesthesia was lower in the experimental group (5%, 1/20) than in the control group (30%, 6/20), and the difference was statistically significant (χ2 =4.329, P < 0.05).@*Conclusions@#Improved nursing measures can effectively improve the success rate of MRI stereotactic brain target location in patients with dystonia, providing a guarantee for accurate calculation of surgical targets, enabling the operation to achieve the best results, early detection of changes in vital signs during examination, and the close cooperation of the medical team is the guarantee for the smooth completion of MRI examination.
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Objective To analyze the choice preferences and factors influencing the long-term care (LTC)of disabled elderly in Beijing and to provide a reference for the development of aging service industry based on the present supply situations. Methods This cross-sectional study included the sociodemographic and disability information and the need for LTC.Statistical analysis was performed using the chi-square test and multivariate logistic regression analysis. Results About 75.5% (1 169) of respondents preferred household-based LTC,whereas only 0.8%(12)preferred community-based LTC.In a single factor analysis,gender,age,educational level,living conditions,marital status,income,medical and pension insurances,chronic diseases,vision,hearing,sense of taste and touch,and self-evaluation of health had statistically significant difference (χ2= 35.19, 195.58, 295.21, 245.88, 10.89, 30.33, 230.62, 277.87, 77.09, 51.07, 131.03, 124.50, 23.18, and 37.51,respectively, P<0.05). Multivariate analysis showed that educational level, marital status, medical and pension insurances, self-evaluation of health were correlated with household-based LTC,(odds ratio and 95%confidence interval,0.69(0.54-0.89),51.61(21.55-123.59), 0.29(0.09-0.94),0.40(0.22-0.73),and 0.63(0.45-0.88),respectively).Conclusions The services in the old-age caring industry have become inevitably diverse, and many factors affect the choice of LTC. Therefore,LTC insurance and community-based care should be established to meet the needs of the elderly.
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Objective To investigate the effects of down-regulation of lemur tyrosine kinase 3 (LMTK3) on the cytobiological behaviors of human lung cancer A549 cells.Methods The expression of LMTK3 in A549 cells was interfered with small hair RNA (shR-NA),and the expression level of LMTK3 was determined by RT-PCR.The effects of LMTK3 on the proliferation,migration,cell cycle and apoptosis of A549 cells were determined by the CCK-8 assay,scratch assay,Transwell assay and flow cytometry,respectively.Results The shLMTK3 cells with stably low expression of LMTK3 and control cells (Scramble) with normal expression of LMTK3 were successfully obtained.The relative proliferation rates of shLMTK3 cells cultured for 24,48 and 72 hours were significantly lower than those in the control cells (0.305 ±0.018 vs 0.354 ±0.011,t =5.24,P<0.01;0.461 ±0.044 vs 0.551 ±0.027,t =3.91,P <0.01;0.74 ± 0.029 vs 0.881 ± 0.028,t =7.70,P < 0.01).The relative migration rate of shLMTK3 cells 24 hours after scratching was significantly lower than that of control cells (0.51 ±0.096 vs 1.00 ± 0.029,t =4.81,P < 0.01).Transwell assay showed that the number of migration cells in shLMTK3 group was significantly less than that in Scramble group (161 ±9.29 vs 308.66 ± 17.60,t =7.42,P < 0.05).The results of flow cytometry showed that shLMTK3 cells were blocked at G1 phase (t =4.35,P < 0.05),and that the inhibition of LMTK3 had no influence on the apoptosis of A549 cells.Conclusion Down-regulation of LMTK3 expression in human lung cancer A549 cells may inhibit the proliferation and migration of A549 cells significantly,indicating that the abnormal expression of LMTK3 in lung carcinoma cells may regulate the biological behaviors and progression of tumors.
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Objective To investigate the relationship between the indexes change of lactate dehydrogenase(LDH),serum tumor associated material(BXTM),β2-microglobulin(β2-MG),C-reactive protein(CRP) and D-dimer(DD) with lymphoma cell bone marrow infiltration(BMI) degree in the patients with non-Hodgkin's lymphoma(NHL).Methods Seventy-four cases of initially treated NHL were retrospectively analyzed and divided into the bone marrow invasion group(BMI,26 cases),lymphoma cell leukemia group(LMCL,31 cases) and non-BMI group(N-BMI,17 cases).The related indexes levels in each group were detected.ROC curve was drawn and analyzed.Results The levels of LDH,β2-MG,CRP and DD levels in the BMI group and LMCL group were higher than those in the N-BMI group(P<0.05).Based on the ROC curve analysis,the optimal diagnostic cut-off points of each index in BMI were determined.The CRP and LDH had good sensitivity(100.00 %),specificity(80.00 %-100.00 %) and diagnostic accuracy(80.00 % 100.00%).In the LMCL group,the diagnostic accuracy of DD,BXTM and β2-MG was 63.30 %-100.00%.Conclusion The changes of LDH,CRP,β2-MG and DD in the patients with NHL are consistent with the BMI severity of lymphoma cells,which has a good clinical value in staging,curative effect judgment and prognosis.
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Objective To investigate the correlation between serum homocysteine (HCY) and chronic heart failure (CHF) hypercoagulable state in patients.Methods A total of 105 cases of patients with CHF was divided into three groups according to the New York Heart Association (NYHA) classification standard functions:heart functional grade Ⅱ group (42cases),cardiac function grade Ⅲ group (35 cases) and,NYHA class Ⅳ group (28cases).At the same time,40 healthy individuals were regard as the control group.HCY,fibrinogen (Fbg),D-dimer (DDI),HCY,N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by fasting venous blood samples which were collected within 24 hours after admission.Results Compared to the control group,the expression of Fbg,DDI,HCY and NT-proBNP increased,whereas,antithrombin Ⅲ (AT-Ⅲ) was reduced.Fbg,DDI,HCY,NT-proBNP,and AT-Ⅲ were found in all patient cases.Four groups were compared with each other,except for cardiac function Ⅱ group and the normal group had no significant difference between them (P > 0.05),the difference between both other groups was significantly different (P < 0.05),HCY had a positive correlation with Fbg,DDI,and NT-proBNP (r =0.268,0.295,and 0.404,P < 0.05),and negative correlation with AT-Ⅲ (r =-0.240,P < 0.05).Conclusions HCY might be a reliable indicator as a judge of CHF patients with hypercoagulable state,to detect HCY,FBG,DDI,and AT-Ⅲ in CHF patients.It benefits for judging thrombosis risk and determining the severity of the diseases.Anticoagulant therapy might be beneficial to reduce the long-term adverse events.