The correlation between peri-coronary fat attenuation index and different grades of hypertension based on coronary CT angiography / 实用放射学杂志

Objective lo analyze the difference of peri-coronary tat attenuation index(pr Al)on different grades of hypertension(HT),and to explore the value of pFAI in evaluating the risk of HT patients.Methods Retrospective data on hospitalized patients who underwent coronary computed tomography angiography(CCTA)examination for chest pain were collected.A total of 415 clini-cally confirmed HT patients were selected as observation group(including 132 patients in grade 1 HT group,137 patients in grade 2 HT group,146 patients in grade 3 HT group),and 187 non-hypertension patients during the same period as control group.The differ-ence of fat attenuation index(FAI)in three main coronary arteries[left anterior descending artery(LAD),left circumflex artery(LCX),right coronary artery(RCA)]was compared,and the correlation between pF AI and HT patients was analyzed.Results RCA-FAI(-78.86 HU±7.66 HU)and LAD-FAI(-80.62 HU±7.50 HU)were higher in HT group than those in control group(-84.46 HU± 8.00 HU,-83.43 HU±7.51 HU,P＜0.05).pFAI value was higher in grade 3 HT group than that in grade 1 HT group and grade 2 HT group(P＜0.05),while there were no differences between grade 1 HT group and grade 2 HT group(P＞0.05).After adjusting the influence of traditional risk factors and coronaryartery disease,RCA-FAI had relatively closer relationship with HT grades(r=0.47,P＜0.001).Conclusion LAD-FAI,RCA-FAI in the HT group are higher than those in control group and RCA-FAI has relatively closer relationship with HT grades,suggesting that RCA-FAI may be an imaging indicator to evaluate the pro-gression of HT and predict the risk of HT.

Expression and significance of lncRNA SNHG25 in prostate cancer based on the TCGA database / 现代泌尿外科杂志

【Objective】 To analyze the expression of lncRNA SNHG25 in prostate cancer and its significance, so as to explore the biomarkers and potential therapeutic targets for the diagnosis and prognosis of this disease. 【Methods】 Based on the TCGA database, differential, survival, and clinical correlation analyses of SNHG25 were performed.SNHG25 expression in prostate cancer was analyzed in the UALCAN database to determine its relationship with the clinical and pathological characteristics.The lncRNA-miRNA-mRNA correlation analysis was performed.The relevant ceRNA regulatory network was constructed.Prostate cancer samples were divided into high and low SNHG25 expression groups, and differential SNHG25 related genes were filtered and then enriched. 【Results】 SNHG25 expression was significantly upregulated in prostate cancer specimens compared to normal prostate specimens (P0.05).Regulatory networks of SNHG25/miR-330-3p/DLX1 and RPL22L1 were constructed. 【Conclusion】 SNHG25 is highly expressed in prostate cancer tissues and correlated with poor prognosis.SNHG25 expression does not significantly correlate with age, T-stage, N-stage, and Gleason score.SNHG25/miR-330-3p/DLX1 and RPL22L1 regulatory networks may play an important role in the development of prostate cancer.SNHG25 may become a biomarker and potential therapeutic target for prostate cancer.

Associations of mobile phone use with male semen quality and sex hormones / 环境与职业医学

Background Experimental studies have shown that radiofrequency electromagnetic waves emitted by mobile phones can cause adverse effects on male reproductive health, including decreased semen quality and altered sex hormones. However, the results of epidemiological studies on the relationship between mobile phone use and male semen quality are inconsistent. Furthermore, there are few epidemiological studies on the association of mobile phone use with sex hormones. Objective To explore the associations of mobile phone use with male semen quality and sex hormones. Methods A total of 2045 men visited the reproductive medicine center of a hospital in Wuhan and ordered infertility examination were recruited from December 2018 to January 2020. Information on mobile phone use was obtained using a questionnaire. Among them, 1232 and 1694 men were eligible for semen quality analyses and sex hormone analyses, respectively. Multiple linear and logistic regression models were used to analyze the associations of mobile phone use with male semen quality and sex hormones. Results After adjusting for potential confounders, there was no statistically significant associations of mobile phone use with sperm progressive motility, sperm total motility, sperm concentration, sperm count, or serum luteinizing hormone (P>0.05). However, serum total testosterone showed a declined tendency with increasing daily duration of mobile phone use (Ptrend=0.08). Compared with men with daily mobile phone use of 0-2 h, men with daily mobile phone use of 2.1-5, 5.1-8, and >8 h showed decreased serum total testosterone concentrations by 6.29% (95%CI: 0.40%-11.84%), 6.01% (95%CI: 0.60%-12.19%), and 7.87% (95%CI: 0.40%-14.79%), respectively. Conclusion Mobile phone use is not associated with male semen quality and serum luteinizing hormone, but increasing daily duration of mobile phone use is potentially associated with a tendency to lower male serum total testosterone.

Role of inflammation induced by the novel immunosuppressant caerulomycin A in kidney inj ury / 安徽医科大学学报

Objective @# To investigate the effect of high concentration of Caerulomycin A (Cae A) on HK2 in renal tubular epithelial cells and to explore the role of cytoplasmic nucleotide⁃binding oligomerization domain⁃like receptor protein 3 (NLRP3) in this process.@*Methods @# The effect of different concentrations of Cae A on the viability of HK2 cells was determined by MTT; the expression of kidney injury molecule (KIM⁃1) and NLRP3 was detected by real⁃time quantitative PCR , Western blot and immunofluorescence , while the effect of Cae A on the mRNA expression of IL⁃1β , IL⁃18 , IL⁃33 , MCP⁃1 , TNF⁃α was also measured by real⁃time quantitative PCR. HK2 cells were divided into control group , high concentration of Cae A group and high concentration of Cae A plus NLRP3 inhibitor CY⁃09 group , and the expression of KIM⁃1 and NLRP3 protein was detected by Western blot.@*Results @#The results of MTT showed that high concentration of Cae A could inhibit HK2 cell viability. Real⁃time quantitative PCR , Western blot and immunofluorescence assays showed that high concentration of Cae A upregulated the expression of KIM⁃1 and NLRP3 , as well as the mRNA levels of IL⁃1β , IL⁃18 , IL⁃33 , MCP⁃1 , TNF⁃α , while CY⁃09 could down⁃regulate the expression of NLRP3 and KIM⁃1.@*Conclusion @# High concentration of Cae A significantly inhibited the viability of HK2 cells and induced damage and inflammatory response to HK2 with some nephrotoxicity that might be achieved via NLRP3 pathway.

Altered Caffeine Metabolism Is Associated With Recurrent Hypoglycemia in Type 2 Diabetes Mellitus: A UPLC-MS-Based Untargeted Metabolomics Study.

Background: Recurrent hypoglycemia (RH) is well known to impair awareness of hypoglycemia and increase the risk of severe hypoglycemia; the underlying mechanism requires further understanding. We aimed to investigate the metabolic characteristic profile for RH in type 2 diabetes mellitus (T2DM) patients and explore the potential metabolic mechanism and prevention strategies. Methods: We screened 553 community-based T2DM patients. T2DM with RH (DH group, n=40) and T2DM without hypoglycemia (DC group, n=40) were assigned in the case-control study, matched by propensity score matching. Non-targeted, global metabolite profiling was conducted using ultra-high performance liquid chromatography-mass spectrometry. Principal component analysis and supervised projections to latent structures-discriminant analysis were constructed to evaluate the potential biomarkers. Metabolites with a fold change of >2.0 or <0.5, a t-test q-value <0.05, and variable importance in projection value of >1 were identified as significantly differential metabolites. MetaboAnalyst was performed to analyze the related metabolic pathways. Results: We identified 12 significantly distinct metabolites as potential biomarkers of RH, which were enriched in five pathways; the caffeine metabolic pathway was the most dominant related one. Caffeine and its main downstream metabolites (theophylline and paraxanthine, all q <0.05) were significantly lower during RH. The combination of these metabolites can serve as a reliable predictor biomarker for RH (area under the curve = 0.88). Regarding lipid metabolism, triglyceride was upregulated (P=0.003) and the O-Acylcarnitine was downregulated (q < 0.001). Besides, RH was accompanied by lower phenylalanine (q=0.003) and higher cortisone (q=0.005) levels. Conclusions: RH in T2DM is accompanied by caffeine, lipolysis, phenylalanine, and cortisone metabolism abnormalities. Caffeine might be a reliable candidate biomarker and potential prevention strategy for RH, but further validation studies are needed. Clinical Trial Registry: Chi CTR 1900026361, 2019-10-3.

Glycyrrhiza uralensis ethanol extract inhibits dendritic cell maturation and ameliorates asthma / 国际生物医学工程杂志

Objective:To investigate the immunoregulatory effects of Glycyrrhiza uralensis ethanol extract(GUEE) on the maturation of dendritic cells (DCs) and the adjuvant effect of GUEE on OVA in na?ve BALB/c mice and an ovalbumin (OVA)-induced asthma mouse model. Methods:GUEE was prepared, and the effects of different concentrations of GUEE on the maturation of DCs and the secreted cytokines as well as the effects of GUEE on bacterial lipopolysaccharide (LPS)-induced DC maturation were examined in vitro. The effect of GUEE on the morphology of mouse bone marrow derived DCs was observed using microscopy. Molecular expression levels on the surface of DCs were detected using flow cytometry. The levels of interleukin-1β (IL-1β), IL-6, IL-12, and tumor necrosis factor-α (TNF-α) in the supernatant of DCs cultures were measured by enzyme-linked immunosorbent assay (ELISA). The maturation status of DCs was detected by flow cytometry by injecting different concentrations of GUEE into the paws of mice and isolating the draining lymph nodes 24 h later. The naive BALB/c mice were co-immunized with OVA, and the changes in regulatory T cells (Treg) were detected by flow cytometry. An OVA-protein-induced mouse asthma model was established to investigate whether GUEE as a tolerogenic adjuvant has an antigen-specific therapeutic effect on asthmatic mice. Pulmonary pathological changes were analyzed by hematoxylin-eosin staining (HE) and PAS staining. OVA-specific antibodies in serum and the frequencies of Tregs, CD4 + IFN-γ + and CD4 + IL-4 + T cells in the spleen were detected by ELISA and flow cytometry, respectively. Results:GUEE suppressed DCs maturation induced by LPS both in vitro and in vivo (all P<0.05), and reduced proinflammatory cytokine production, including IL-1β, IL-6, IL-12 and TNF-α in the absence or presence of LPS (all P<0.05). Moreover, co-immunization with OVA and GUEE increased the amount of Tregs in na?ve BALB/c mice ( P<0.05). In OVA-induced asthmatic mice, OVA and GUEE co-immunization and GUEE alone treatment substantially ameliorated the inflammation of lung tissues, decreased the levels of IgG 1 and the amount of CD4 + IL-4 + T cells, and increased the amount of Tregs (all P<0.05). Conclusions:GUEE alone or as the tolerogenic adjuvant can ameliorate allergic diseases through inhibition of DC maturation and type 2 helper T cell responses and induction of Tregs.

Is Gadoxetic Acid Disodium (Gd-EOB-DTPA)-Enhanced Magnetic Resonance Imaging an Accurate Diagnostic Method for Hepatocellular Carcinoma? A Systematic Review with Meta-Analysis.

BACKGROUND: Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid (Gd- EOB-DTPA) has become a widely used liver-specific contrast agent worldwide, but its value and limitations as a diagnostic technique with Hepatocellular Carcinoma (HCC), have not been assessed. INTRODUCTION: A review of the latest evidence available on the diagnostic value of Gd-EOB-DTPA- enhanced MRI for the evaluation of HCC is reported. METHODS: A systematic, comprehensive literature search was conducted with PubMed, Scopus, EMBASE, the Web of Science, the Cochrane Library, CNKI, vip, wanfangdata and CBM from inception to June 31, 2020. The QUADAS-2 tool was used to evaluate the quality of the included studies. Pooled Sensitivity (SEN), Pooled Specificity (SPE), pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (dOR) and summary receiver operating characteristic (SROC) curves were calculated to assess the diagnostic value of the individual diagnostic tests. RESULTS: A total of 47 articles were included, involving a total of 6362 nodules in 37 studies based on per-lesion studies. There were 13 per-patient studies, including a total of 1816 patients. The results of the meta-analysis showed that the per-lesion studies pooled weighted values were SEN 0.90 [95% confidence interval (CI): 0.87-0.92], SPE 0.92 (95% CI: 0.90-0.94), PLR 11.6 (95% CI: 8.8-15.2), NLR 0.11 (95% CI: 0.09-0.14) and dOR 107.0 (95% CI: 74.0-155.0). The AUC of the SROC curve was 0.96. The per-patient studies pooled weighted values were SEN 0.84 [95% confidence interval (CI): 0.78-0.89], SPE 0.92 (95% CI: 0.88-0.94), PLR 10.4 (95% CI: 7.4-14.6), NLR 0.17 (95% CI: 0.12-0.24) and dOR 61.0 (95% CI: 42.0-87.0). The AUC of the SROC curve was 0.95 and subgroup analyses were performed. CONCLUSION: The diagnostic value of Gd-EOB-DTPA for HCC was quantitatively evaluated in a per-lesion study and a per-patient study using a systematic review of the literature. A positive conclusion was drawn: Gd-EOB-DTPA-enhanced imaging is a valuable diagnostic technique for HCC. The size of the nodules and the selection of the imaging diagnostic criteria may affect the diagnostic sensitivity.

Effect of ACTN4 on cell proliferation of esophageal squamous cell carcinoma by targeting NDUFV1 / 安徽医科大学学报

Objective @#To investigate the expression of alpha-actinin-4 (ACTN4) and the effect on cell proliferation in esophageal squamous cell carcinoma (ESCC) ．@*Methods @#The expression of ACTN4 in ESCC tissues and paired normal tissues was detected by immunohistochemistry，and the correlation between ACTN4 and the clinicopathologi- cal features was analyzed statistically．The ACTN 4 shRNA lentiviral plasmids were constructed ，and the stable ECA109 strain with ACTN4 shRNA knockdown was established using lentivirus packaging technology．The knock- down efficiency on protein level was checked by Western blot，and cell proliferation was detected by colony forma- tion assays．The downstream target proteins were validated in ESCC cell line ECA109 based on the previous pro- teomics analyses in melanoma cell line A375 with or without ACTN4 shRNA knockdown. @*Results @#The expression of ACTN4 in ESCC tissues was significantly higher than that of normal tissues．ACTN4 shRNA stable knockdown ECA109 cell strains were successfully constructed． The results of colony formation assays showed that ACTN4 knockdown inhibited the cell proliferation and down-regulated NADH ∶ Ubiquinone oxidoreductase core subunit V1 ( NDUFV1) protein expression in ECA109 cells．@*Conclusion @#Upregulation of ACTN4 in ESCC cells promotes the cell proliferation and enhances the protein expression of NDUFV1 .

Detection and molecular characteristics of bovine rotavirus A in dairy calves in China

Background@#Bovine group A rotavirus (BoRVA) is a major cause of severe gastroenteritis in newborn dairy calves. Only one study has investigated the G and P genotypes among dairy calves in a few regions of China, which were G6 and P[5]. Therefore, data on the prevalence and molecular characteristics of BoRVA in dairy calves in China remains limited. @*Objectives@#The purpose of this study was to investigate the prevalence and molecular characteristics of BoRVA in dairy calves in China. @*Methods@#269 dairy calves diarrheic samples from 23 farms in six provinces in China were collected to detect BoRVA using reverse transcription polymerase chain reaction. @*Results@#71% of samples were determined to be BoRVA-positive. Two G genotypes (G6, G10) and two P genotypes (P[1], P[5]) were identified, and G6P[1] BoRVA was the predominant strain. Moreover, the VP7 and VP4 gene sequences of these dairy calf BoRVA strains revealed abundant genetic diversity. Interestingly, eight out of 17 complete G6 VP7 sequences were clustered into G6 lineage VI and analysis showed the strains were closely related to Chinese yak BoRVA strains. @*Conclusions@#The results of this study show that BoRVA circulates widely among dairy calves in China, and the dominant genotype in circulation is G6P[1], first report on molecular characteristics of complete P[5] VP4 genes in chinese dairy calves. These results will help us to further understand the prevalence and genetic evolution of BoRVA among dairy calves in China and, thus, prevent the disease more effectively.

Construction of early warning index for critical condition of severe community-acquired pneumonia in emergency department / 中国实用护理杂志

Objective:Based on the clinical indicators of severe community-acquired pneumonia in emergency department, the early warning indicators of critical condition were constructed.Methods:The general information, vital signs before entering ICU, laboratory indexes and the survival rate in 30 days of 118 patients with community-acquired pneumonia were retrospectively collected in the emergency care unit of Peking Union Medical College Hospital from January to December 2018. The indexes of death patients (24 cases) and alive patients (98 cases) underwent comparative analysis, using ROC curve to predict the clinical outcome and reliable parameters of emergency patients with community-acquired pneumonia. The best cutoff value was determined according to Youden index and then undergoing multiple factors Logistic stepwise regression analysis. Then early warning model of critical degree was finally built.Results:Eleven indicators were used to predict the criticality of patients with acute community-acquired pneumonia, including AVPU (alert, voice, pain, unresponsive) score, Glasgow Coma Scale(GCS), heart rate, pulse oxygen saturation (SpO 2), fraction of inspiration O 2, oxygenation index,potential of hydrogen, blood potassium (K +), bilirubin, urea nitrogen, and C reactive protein, the optimal cutoff values were 2 points, 8 points, 91 times per minute, 0.94, 41%, 81.20%, 7.38, 4.0 mmol/L, 10.90 μmol/L, 2.23 mmol/L, and 41.5 mg/L. Multiple Logistic stepwise regression showed that the independent factors for predicting death were GCS score, SpO 2 and urea nitrogen, and the predictive ability of the early-warning model was 83.7%. Conclusions:GCS score, SpO 2 and urea nitrogen are effective early warning indicators for the severity of severe community-acquired pneumonia in emergency department, which are conducive to the rapid and efficient early identification and treatment of critically ill patients. Therefore, they are worthy of promotion and application in clinical practice.

Detection and molecular characteristics of bovine rotavirus A in dairy calves in China

Background@#Bovine group A rotavirus (BoRVA) is a major cause of severe gastroenteritis in newborn dairy calves. Only one study has investigated the G and P genotypes among dairy calves in a few regions of China, which were G6 and P[5]. Therefore, data on the prevalence and molecular characteristics of BoRVA in dairy calves in China remains limited. @*Objectives@#The purpose of this study was to investigate the prevalence and molecular characteristics of BoRVA in dairy calves in China. @*Methods@#269 dairy calves diarrheic samples from 23 farms in six provinces in China were collected to detect BoRVA using reverse transcription polymerase chain reaction. @*Results@#71% of samples were determined to be BoRVA-positive. Two G genotypes (G6, G10) and two P genotypes (P[1], P[5]) were identified, and G6P[1] BoRVA was the predominant strain. Moreover, the VP7 and VP4 gene sequences of these dairy calf BoRVA strains revealed abundant genetic diversity. Interestingly, eight out of 17 complete G6 VP7 sequences were clustered into G6 lineage VI and analysis showed the strains were closely related to Chinese yak BoRVA strains. @*Conclusions@#The results of this study show that BoRVA circulates widely among dairy calves in China, and the dominant genotype in circulation is G6P[1], first report on molecular characteristics of complete P[5] VP4 genes in chinese dairy calves. These results will help us to further understand the prevalence and genetic evolution of BoRVA among dairy calves in China and, thus, prevent the disease more effectively.

Pharmacologic treatment for insomnia in the elderly / 中华老年医学杂志

Insomnia is a common disorder in the elderly and seriously affects life quality of the elderly.This article reviews the efficacy and safety of pharmacological agents for the treatment of insomnia in the elderly, in order to provide a reference for clinical practice.

Comparison of HES 130/0.4 and acetate Ringer′s solution versus HES 130/0.4 and normal saline for volume therapy in patients undergoing non-cardiac surgery with general anesthesia: a randomized, blinded, parallel-controlled, multicenter clinical trial / 中华麻醉学杂志

Objective:To compare the efficacy of HES 130/0.4 and acetate Ringer′s solution (A-HES) and HES 130/0.4 and normal saline (NS-HES) for volume therapy in the patients undergoing non-cardiac surgery with general anesthesia.Methods:Two hundred and fifty American Society of Anesthesiologist physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-32 kg/m 2, undergoing noncardiac surgery with general anesthesia, were divided into group A-HES and group NS-HES using the stratified block randomization technique.A-HES and NS-HES 15 ml/kg were intravenously infused over 1 h immediately after induction of anesthesia in A-HES and NS-HES groups, respectively.Mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were recorded before and after infusion, and the maximum changing rate of MAP and HR and the maximum change in CVP were calculated.The pH value, BE and HCO 3- were recorded before infusion and at 15 min after the end of infusion, and Hb, Hct, electrolytes, blood glucose, blood biochemical parameters and parameters of coagulation function were measured.The occurrence of abnormal blood biochemical parameters, blood glucose, and parameters of coagulation function, intraoperative requirement for vasoactive drugs, occurrence of HES-related adverse events, and intraoperative fluid intake and output were recorded. Results:A total of 251 cases were actually enrolled in this study, with 125 cases in group A-HES, and 126 cases in group NS-HES.Compared with group NS-HES, no significant change was found in the maximum changing rate of MAP and HR and the maximum change in CVP ( P>0.05) in group A-HES, and non-inferiority analysis showed that group A-HES was not inferior to group NS-HES.Compared with group NS-HES, the concentrations of BE and HCO 3-, K + , Ca 2+ and Mg 2+ were significantly increased, the concentrations of Na + and Cl - were decreased, the PT was shortened, the incidence of abnormal PT was decreased at 15 min after the end of infusion ( P< 0.05), and no significant change was found in the other parameters mentioned above in group A-HES ( P>0.05). Conclusion:The volume expanding effect of A-HES and its effect on liver and kidney function are not significantly different from those of NS-HES, however, A-HES has certain advantages in maintaining acid-base balance, electrolyte stability and coagulation function.

Symptom network topological features predict the effectiveness of herbal treatment for pediatric cough / 医学前沿

Pediatric cough is a heterogeneous condition in terms of symptoms and the underlying disease mechanisms. Symptom phenotypes hold complicated interactions between each other to form an intricate network structure. This study aims to investigate whether the network structure of pediatric cough symptoms is associated with the prognosis and outcome of patients. A total of 384 cases were derived from the electronic medical records of a highly experienced traditional Chinese medicine (TCM) physician. The data were divided into two groups according to the therapeutic effect, namely, an invalid group (group A with 40 cases of poor efficacy) and a valid group (group B with 344 cases of good efficacy). Several well-established analysis methods, namely, statistical test, correlation analysis, and complex network analysis, were used to analyze the data. This study reports that symptom networks of patients with pediatric cough are related to the effectiveness of treatment: a dense network of symptoms is associated with great difficulty in treatment. Interventions with the most different symptoms in the symptom network may have improved therapeutic effects.

Resistin-Inhibited Neural Stem Cell-Derived Astrocyte Differentiation Contributes to Permeability Destruction of the Blood-Brain Barrier.

Neuroinflammation is an important part of the development of neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's and amyotrophic lateral sclerosis. Inflammatory factors destroy the balance of the microenvironment, which results in changes in neural stem cell differentiation and proliferation behaviour. However, the mechanism underlying inflammatory factor-induced NSC behavioural changes is not clear. Resistin is a proinflammatory and adipogenic factor and is involved in several human pathology processes. The neural stem cell microenvironment changes when the concentration of resistin in the brain during an inflammatory response disease increases. In the present study, we explored the effect and mechanism of resistin on the proliferation and differentiation of neural stem cells. We found that intracerebroventricular injection of resistin induced a decrease in GFAP-positive cells in mice by influencing NSC differentiation. Resistin significantly decreased TEER and increased permeability in an in vitro blood-brain barrier model, which is consistent with the results of an HBMEC-astrocyte coculture system. Resistin-inhibited astrocyte differentiation is mediated through TLR4 on neural stem cells. To our knowledge, this is the first study reporting the effect of resistin on neural stem cells. Our findings shed light on resistin-involved neural stem cell degeneration mechanisms.

Identification of critical degree of emergency hypoxemia patients based on pulse oxygen saturation / 中国实用护理杂志

Objective To explore the risk stratification of pulse oxygen saturation (SpO2) in patients with emergency hypoxemia patients, and to provide evidence for the identification of critical illness. Methods Self-designed clinical data registration form for patients with emergency hypoxemia , and prospective collection of 344 hypoxemia patients in the emergency department of Peking Union Medical College Hospital from March to April in 2018, including baseline data (name, gender, age, ID number, date, registration time), hospitalization method, past history, patient complaint and diagnosis, triage level, SpO2, whether to enter the rescue room, etc. Results All of 344 emergency hypoxemia patients, there were 163 cases (21.2% ) of ambulances, and 107 cases (31.1% ) of patients requiring immediate rescue. There were 54 cases (25.7%) and 53 cases (39.6%) in need of immediate rescue in day shift (8:00-20:00) and night shift (20:00-8:00 next day), with 9:00-10:00, 14:00-15:00, 20:00-24:00 in the majority. There was a statistical difference in the way of hospitalization, triage, and SpO(2 25.780, t=4.722, all P<0.05). SpO2 risk stratification was 0.905 in patients without pulmonary disease, and SpO2 risk stratification in patients with lung disease was 0.765. Conclusions Patients with hypoxemia account for a certain proportion in the emergency department and are in critical condition. The degree of critical condition of patients can be evaluated based on whether they have lung diseases, and the risk stratification of patients can be accurately determined with the help of SpO2, so as to further guide the hierarchical treatment measures for patients with emergency hypoxemia and rationally optimize the χ2=29.537, allocation of emergency resources.

Identification of critical degree of emergency hypoxemia patients based on pulse oxygen saturation / 中国实用护理杂志

Objective@#To explore the risk stratification of pulse oxygen saturation (SpO2) in patients with emergency hypoxemia patients, and to provide evidence for the identification of critical illness.@*Methods@#Self-designed clinical data registration form for patients with emergency hypoxemia, and prospective collection of 344 hypoxemia patients in the emergency department of Peking Union Medical College Hospital from March to April in 2018, including baseline data (name, gender, age, ID number, date, registration time), hospitalization method, past history, patient complaint and diagnosis, triage level, SpO2, whether to enter the rescue room, etc.@*Results@#All of 344 emergency hypoxemia patients, there were 163 cases (21.2%) of ambulances, and 107 cases (31.1%) of patients requiring immediate rescue. There were 54 cases (25.7%) and 53 cases (39.6%) in need of immediate rescue in day shift (8:00-20:00) and night shift (20:00-8:00 next day), with 9:00-10:00, 14:00-15:00, 20:00-24:00 in the majority. There was a statistical difference in the way of hospitalization, triage, and SpO2 (χ2=29.537, 25.780, t=4.722, all P<0.05) . SpO2 risk stratification was 0.905 in patients without pulmonary disease, and SpO2 risk stratification in patients with lung disease was 0.765.@*Conclusions@#Patients with hypoxemia account for a certain proportion in the emergency department and are in critical condition. The degree of critical condition of patients can be evaluated based on whether they have lung diseases, and the risk stratification of patients can be accurately determined with the help of SpO2, so as to further guide the hierarchical treatment measures for patients with emergency hypoxemia and rationally optimize the allocation of emergency resources.

Application of serratus anterior muscle flap transfer in lateral part deformity of expander to implant breast reconstruction / 中华医学美学美容杂志

Objective To explore the application and clinical significance of serratus anterior muscle flap transfer in correction of lateral part deformity of expander to implant breast reconstruction.Methods Six patients who received expander-to-implant breast reconstruction were enrolled.After silicone implant replacing the tissue expander,all 6 cases represented lateral part deformity of the reconstructed breast.The turn-over serratus anterior muscle flap was used as lateral coverage of the deformed breast.Results Of all patients (6 cases),breast aesthetics were improved with incisions well-healed.There were no complications such as capsular contracture,hematoma,infection or insicional dehiscence.Conclusions Serratus anterior muscle flap can provide sufficient lateral coverage for expander-to-implant breast reconstruction.It is safe,simple and cheap to apply in improving the aesthetics of breast reconstruction.

The control effect and pulmonary function outcome of standardized treatment management for children with bronchial asthma / 国际儿科学杂志

Objective To analyze the effects on control rate and the outcome of pulmonary function in children with bronchial asthma (abbreviated asthma) who were received the two years standardized treatment and management,and to explore the sensitive parameters of control effects in children with asthma.Methods Using the retrospective analysis,asthmatic children were selected from January 2014 to January 2015 in Beijing Children's Hospital,allergy and asthma outpatient clinics.All the patients were received asthma control treatment and management according to GINA guidelines (2014 version).They were assessed on asthma control level at one year and two years follow up visits respectively and their pulmonary function were evaluated at the same time.According to response status to therapy and adjustment of step up and down,children were divided into two groups,the stable control group and the difficult to control group.The parameters of sex,age,asthma,combined with rhinitis,allergen sensitization and pulmonary function were compared between the two groups.Results A total of 149 patients were enrolled in this study.The treatment levels were 20.2％,67.1％ and 12.7％ respectively at grade 2,grade 3 and ≥ 4 grade.After Treatment management for one year and two years,the asthma control level were assessed as good control was 81.8％ and 83.2％ respectively (P ＜ 0.05) Each parameter of pulmonary function excepted FEV1/FVC at the one year visit point after treatment and management was significantly higher than that at enrollment (P ＜ 0.05).After two years of treatment and management,PEF％ pred and FEF25 ％ pred was higher than that at first follow up visit (P ＜ 0.05).There were no significantly different on the distribution of sex,age,course of asthma,allergic rhinitis,allergen sensitization and initial control treatment level between the stable control and the difficult to control groups.Asthma control stability status assessment and analysis at the one year follow up visits showed that PEF％ pred was significantly higher in the group of stable control than that in group of difficult to control (97.3 ± 14.3 vs 93.1 ± 15.1,P ＜ 0.05).Asthma control stability starus assessment and analysis at two years follow up visits showed that the positive rate of allergen sensitization was significantly lower in the group of stable control than that in group of difficult to control (P ＜ 0.05),while FEV1/FVC was significantly higher in the group of stable control than that in group of difficult to control (81.0 ± 9.47vs77.4 ± 8.95,P＜0.05).Conclusion School age children asthma control level were improved with longer time regular treatment and management as well as the pulmonary function improvement.Multiple allergenic sensitization and lower PEF％ pred value and FEV1/FVC are suggestive parameters for children with difficult to control asthma.

A study on the relationship between quality care services and patient needs of large general hospital outpatient / 中国实用护理杂志

Objective To investigate the construction of outpatient quality care services and the needs of patient for outpatient service,and to explore the relevance of the two projects.Methods A total of 152 cases of outpatient department registered nurse of Beijing Union Hospital and 281 cases of hospitalized patients on May,2017 were selected,and then developed the Content Questionnaire on Quality Nursing Work of Outpatient Nurse and the Questionnaire on Outpatient Needs Status to carry out investigation.Results This kind of hospital patients with college or university in 216 cases(76.9%,216/281),personal monthly income of 5.0-10.0 thousand accounted for 44.8%(126/281);outpatient nurses aged ≥46 in 83 cases(54.6%,83/152),the working time≥20 years in 120 cases(78.9%,120/152),college degree or above in 137 cases(90.1%,137/152),97 nurses(63.8%,97/152)in charge.The clinic nursing work relates to the rate of above 85%for disease treatment and consultation,health education,guidance service,self-service system services,on-site inspection,consulting room environment,and the cost of nurses working hours and the most frequent content for the on-site inspection and diagnosis of diseases,counseling,health education,medical order service.The order of patients' needs from high to low was disease and consultation,health education,guidance service,order service,on-site inspection,self-service system,registration service,waiting environment and consulting room environment.There was no correlation between the patient's needs and the rate of nursing,the length of work,and the frequency of work(P＞0.05).There were significant differences in the demand for health education on each department(F =3.047,P ＜0.05),education level,medical order service and on-site inspections have significant difference on demand(F=3.809,3.409,P＜0.05),family income,sources of patients were not statistically significant in the comparison(P＞0.05).The outpatient quality care services had lower improved demand(≤26%),and the first six item that needed to improve are disease and medical consultation,self-service system,treatment order service,waiting environment,health education,guidance services.Conclusions In view of the characteristics of outpatient medical staff and patients in large general hospitals,we will improve the quality of outpatient service and meet the needs of patient outpatient service,which will help to deepen the medical reform and improve the quality of medical service.