RESUMEN
With the continuous advancement of health informatization and the wide application of medical big data, electronic health records came into being and spread rapidly. However, because electronic health records contain a large amount of private information, privacy protection is the primary consideration for the sustainable development of electronic health records. By analyzing the shortcomings of privacy protection of electronic health records in law, technology, management and protection consciousness, this paper put forward some countermeasures, such as perfecting the relevant laws and regulations of privacy protection of electronic health records, improving the technical level, improving the management defects of electronic health records, and cultivating the privacy protection consciousness of professionals and the public, so as to improve the overall privacy protection level of China’s health records information management system and provide effective protection for the privacy information of Chinese residents’ electronic health records.
RESUMEN
With the continuous advancement of health informatization and the wide application of medical big data, electronic health records came into being and spread rapidly. However, because electronic health records contain a large amount of private information, privacy protection is the primary consideration for the sustainable development of electronic health records. By analyzing the shortcomings of privacy protection of electronic health records in law, technology, management and protection consciousness, this paper put forward some countermeasures, such as perfecting the relevant laws and regulations of privacy protection of electronic health records, improving the technical level, improving the management defects of electronic health records, and cultivating the privacy protection consciousness of professionals and the public, so as to improve the overall privacy protection level of China’s health records information management system and provide effective protection for the privacy information of Chinese residents’ electronic health records.
RESUMEN
Objective@#To investigate the prevalence and influencing factors of electronic cigarette (e-cigarette) use among adolescents in Haidian District, Beijing, so as to provide insights into tobacco control among adolescents.@*Methods@#The students in junior high school, high school and vocational high school were recruited from Haidian District using the stratified cluster random sampling method in October of 2019, and subjects' demographic features and use of e-cigarettes were collected using the Questionnaire for Survey on Tobacco Prevalence among Adolescents in China in 2019. The factors affecting e-cigarette use were identified among adolescents using the multivariable logistic regression analysis.@*Results@#A total of 658 adolescents were investigated, including 315 junior high school students ( 47.87% ), 221 high school students ( 33.59% ), and 122 vocational high school students ( 18.54% ), and there were 261 boys ( 39.66% ), and 397 girls ( 60.34% ). There were 605 students that had heard of electronic cigarettes ( 91.95% ), 63 students that had used e-cigarettes (9.57%), and 23 students with current use of e-cigarettes ( 3.50% ), and there were 39 students that had never used electronic cigarettes but had a tendency of use in the future ( 6.55% ). Multivariable logistic regression analysis identified parental smoking ( OR=2.408, 95%CI: 1.179-4.916 ), close friends' smoking ( OR=3.597, 95%CI: 1.715-7.544 ) and cigarette smoking ( OR=23.029, 95%CI: 11.092-47.812 ) as factors affecting e-cigarette use among adolescents.@*Conclusions@#The prevalence of electronic cigarette uses is 9.57% among adolescents in Haidian District, Beijing. Parental smoking, peer smoking and use of cigarettes may facilitate the use of e-cigarettes among adolescents.
RESUMEN
The effectiveness of SARS-CoV-2 vaccines and therapeutic antibodies has been limited by the continuous emergence of viral variants, and by the restricted diffusion of antibodies from circulation into the sites of respiratory virus infection. Here, we report the identification of two highly conserved regions on Omicron variant RBD recognized by broadly neutralizing antibodies. Based on this finding, we generated a bispecific single-domain antibody that was able to simultaneously and synergistically bind these two regions on a single Omicron variant RBD as revealed by Cryo-EM structures. This inhalable antibody exhibited exquisite neutralization breadth and therapeutic efficacy in mouse models of SARS-CoV-2 infections. The structures also deciphered an uncommon cryptic epitope within the spike trimeric interface that may have implications for the design of broadly protective SARS-CoV-2 vaccines and therapeutics.
RESUMEN
Nasopharyngeal carcinoma (NPC) is one of the common head and neck malignant tumors. Radiotherapy is the main treatment for NPC. The comprehensive application of chemotherapy strategies (induction, concurrent and adjuvant) in radiotherapy has improved the efficacy in the treatment of locally advanced NPC. Based on current evidence, concurrent chemoradiotherapy combined with adjuvant or induction chemotherapy has been recommended as the standard treatment for locally advanced NPC. However, there are still many deficiencies in the standard treatment, and the application of induction and adjuvant chemotherapy remains controversial. Establishing a more ideal and individualized chemoradiotherapy for locally advanced NPC is still the research direction in the future.
RESUMEN
Since the performance appraisal of national tertiary public hospitals was carried out, higher requirements have been put forward for the operation and management of hospitals. Under the premise of ensuring the quality of medical service and medical safety, how to save hospital operating costs and improve the efficiency is an urgent problem for hospital managers. Supported by information upgrading, a tertiary hospital in Guangzhou reformed the treatment process and carried out pre-hospitalization in surgical departments. Data showed that pre-hospitalization can significantly shorten the length of stay, reduce hospitalization costs, and improve the operation efficiency of the hospital.
RESUMEN
Antibody-dependent enhancement (ADE) has been reported in several virus infections including dengue fever virus, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus infection. To study whether ADE is involved in COVID-19 infections, in vitro pseudotyped SARS-CoV-2 entry into Raji cells, K562 cells, and primary B cells mediated by plasma from recovered COVID-19 patients were employed as models. The enhancement of SARS-CoV-2 entry into cells was more commonly detected in plasma from severely-affected elderly patients with high titers of SARS-CoV-2 spike protein-specific antibodies. Cellular entry was mediated via the engagement of Fc{gamma}RII receptor through virus-cell membrane fusion, but not by endocytosis. Peptide array scanning analyses showed that antibodies which promote SARS-CoV-2 infection targeted the variable regions of the RBD domain. To further characterize the association between the spike-specific antibody and ADE, an RBD-specific monoclonal antibody (7F3) was isolated from a recovered patient, which potently inhibited SARS-Cov-2 infection of ACE-2 expressing cells and also mediated ADE in Raji cells. Site-directed mutagenesis the spike RBD domain reduced the neutralization activity of 7F3, but did not abolish its binding to the RBD domain. Structural analysis using cryo-electron microscopy (Cryo-EM) revealed that 7F3 binds to spike proteins at a shift-angled pattern with one "up" and two "down" RBDs, resulting in partial overlapping with the receptor binding motif (RBM), while a neutralizing monoclonal antibody that lacked ADE activity binds to spike proteins with three "up" RBDs, resulting in complete overlapping with RBM. Our results revealed that ADE mediated by SARS-CoV-2 spike-specific antibodies could result from binding to the receptor in slightly different pattern from antibodies mediating neutralizations. Studies on ADE using antibodies from recovered patients via cell biology and structural biology technology could be of use for developing novel therapeutic and preventive measures for control of COVID-19 infection.
RESUMEN
The COVID-19 pandemic is spreading rapidly, highlighting the urgent need for an efficient approach to rapidly develop therapeutics and prophylactics against SARS-CoV-2. We describe here the development of a phage-displayed single-domain antibody library by grafting naive CDRs into framework regions of an identified human germline IGHV allele. This enabled the isolation of high-affinity single-domain antibodies of fully human origin. The panning using SARS-CoV-2 RBD and S1 as antigens resulted in the identification of antibodies targeting five types of neutralizing or non-neutralizing epitopes on SARS-CoV-2 RBD. These fully human single-domain antibodies bound specifically to SARS-CoV-2 RBD with subnanomolar to low nanomolar affinities. Some of them were found to potently neutralize pseudotyped and live virus, and therefore may represent promising candidates for prophylaxis and therapy of COVID-19. This study also reports unique immunogenic profile of SARS-CoV-2 RBD compared to that of SARS-CoV and MERS-CoV, which may have important implications for the development of effective vaccines against SARS-CoV-2.
RESUMEN
The newly identified 2019 novel coronavirus (2019-nCoV) has caused more than 800 laboratory-confirmed human infections, including 25 deaths, posing a serious threat to human health. Currently, however, there is no specific antiviral treatment or vaccine. Considering the relatively high identity of receptor binding domain (RBD) in 2019-nCoV and SARS-CoV, it is urgent to assess the cross-reactivity of anti-SARS-CoV antibodies with 2019-nCoV spike protein, which could have important implications for rapid development of vaccines and therapeutic antibodies against 2019-nCoV. Here, we report for the first time that a SARS-CoV-specific human monoclonal antibody, CR3022, could bind potently with 2019-nCoV RBD (KD of 6.3 nM). The epitope of CR3022 does not overlap with the ACE2 binding site within 2019-nCoV RBD. Therefore, CR3022 has the potential to be developed as candidate therapeutics, alone or in combination with other neutralizing antibodies, for the prevention and treatment of 2019-nCoV infections. Interestingly, some of the most potent SARS-CoV-specific neutralizing antibodies (e.g., m396, CR3014) that target the ACE2 binding site of SARS-CoV failed to bind 2019-nCoV spike protein, indicating that the difference in the RBD of SARS-CoV and 2019-nCoV has a critical impact for the cross-reactivity of neutralizing antibodies, and that it is still necessary to develop novel monoclonal antibodies that could bind specifically to 2019-nCoV RBD.
RESUMEN
Objective:To evaluate the optimized efficacy of sevoflurane inhalation combined with caudal ropivacaine for abdominal surgery in low birth weight neonates.Methods:Eighty low birth weight neonates of either sex, with gestational age<37 weeks, weighing 1.5-2.5 kg, of American Society of Anesthesiologists physical statusⅡorⅢ, scheduled for elective laparotomy, were divided into 2 groups ( n=40 each) using a random number table method: sevoflurane combined with caudal block with ropivacaine group (SCB group) and sevoflurane plus remifentanil group (SR group). Anesthesia was induced and maintained with sevoflurane inhalation in the two groups.Caudal anesthesia was performed with 0.2% ropivacaine 1 ml/kg in the left lateral position after successful intubation in group SCB.Cis-atracurium 0.1 mg/kg was given, and remifentanil was infused at 0.5 μg·kg -1·min -1 in group SR.Inhaling sevoflurane was stopped at the end of operation in the two groups, and rescue analgesia was performed when the FLACC score was greater than 3 within 6 h after operation.The operation time, emergence time, extubation time, and duration of postanesthesia care unit (PACU) stay were recorded.The occurrence of adverse reactions during the emergence period and PACU stay and requirement for rescue analgesia within 6 h after surgery were recorded.The complications of caudal block were recorded in group SCB. Results:There was no significant difference in the operation time between the two groups ( P>0.05). Compared with group SR, the emergence time, extubation time, and duration of PACU stay were significantly shortened, and the incidence of adverse reactions during the emergence period and PACU stay and requirement for rescue analgesia within 6 h after surgery were decreased in group SCB ( P<0.05). The caudal block-related complications were not found in group SCB. Conclusion:Sevoflurane combined with caudal ropivacaine can be used as an optimized strategy helpful for the quality of anesthesia recovery in low birth weight newborns undergoing abdominal surgery.
RESUMEN
Objective To investigate the behavioral characteristics of preschool children aged 5-6 years with attention deficit hyperactivity disorder ( ADHD) comorbid with enuresis. Methods Conner’s Parent Symptom Questionnaire and Digital Cancellation Test were used to investigate 42 children with ADHD (ADHD group),36 children with ADHD comorbid with enuresis ( ADHD+NE group) and 48 normal con-trols. Results In the Conner’s Parent Symptom Questionnaire,the score of the conduct factors ((0. 79± 0. 13),(0. 83± 0. 50)), learning factors (( 1. 55 ± 0. 49),(1. 92± 0. 62)),mind-body factors (( 0. 61 ± 0. 35),(0. 67± 0. 22)),hyperactivity impulse factors ((1. 96 ± 0. 48),(2. 21± 0. 69)), anxiety factors ((0. 76±0. 53),(1. 02±0. 58)) and hyperactivity indices ((1. 57±0. 14),(2. 19±0. 33)) in ADHD group and ADHD+NE group were higher than those of the control group((0. 59±0. 39),(0. 64±0. 28),(0. 35± 0. 74),(0. 82±0. 63),(0. 51±0. 40),(0. 86±0. 59),(all P<0. 05)). The scores of learning factors,hy-peractivity impulse factors,anxiety factors and hyperactivity indices in ADHD+NE group were higher than those in ADHD group(P<0. 05). In the digital cancellation test,the gross scores((52. 37±1. 48),(57. 42± 1. 05))and net scores ((39. 15±8. 84),(38. 99±5. 72)) of ADHD group and ADHD+NE group were lower than those in the control group (( 89. 40 ± 7. 82), ( 80. 16 ± 12. 54)) (均 P<0. 05). The error scores ((38. 16±9. 60),(40. 59±9. 28)) and error rate(0. 40±0. 27,0. 59±0. 44) of ADHD group and ADHD+NE group were higher than those of the control group ((14. 01±5. 32),(0. 15±0. 08))(all P<0. 05). The error rate of ADHD + NE group were higher than those of preschool ADHD group (P< 0. 05 ). Conclusion The behavioral problems of preschool children aged 5-6 years with ADHD comorbid with enu-resis are more serious and anxiety is more obvious,which should be paid attention to.
RESUMEN
Hepatocellular carcinoma ( HCC) is a common malignant tumor that seriously endangers human health. Surgical resection is the main radical treatment for early and mid-stage HCC, but the recurrence rate is high. At present, there is no effectively and universally accepted adjuvant therapy to reduce the high postoperative recurrence rate. With the development of precise radiotherapy technology, the safe and higher radiation doses can be used in tumors locally. Therefore, radiotherapy is increasingly applied to the treatment of HCC. At present, the position of radiotherapy in the treatment of advanced HCC has become more and more clear. However, the position in the adjuvant treatment of HCC has not been clear. This article will review the research of radiotherapy as adjuvant therapy for surgery in HCC, so as to provide reference for the application of clinical adjuvant therapy for HCC.
RESUMEN
For the treatment of early non-small cell lung cancer,surgery is still one of the most important curative treatments.Lung segment or subsegment resection under video-assisted thoracoscopic surgery is becoming more and more popular.With the development of radiotherapy technology,Stereotactic Body Radiotherapy (SBRT) has achieved the similar or the same curative effect as surgery.It has become an indisputable curative treatment for patients who can not or refuse surgery,and there are still some disputes among those who can operate.Therefore,this review will elaborate on these treatment methods in order to help update the concept and provide more treatment methods and obtain more benefits for patients.Although it is no randomized clinical trial to compare SBRT with surgery,we suggest that SBRT is the curative treatment for patients who can not or refuse surgery.Especially for the elderly,or patients with cardiopulmonary diseases,diabetes and other high-risks.SBRT should become the main treatment methods,because its curative effect is not inferior to surgery and its complications are fewer and lighter.Therefore,for the treatment of non-small cell lung cancer in the early stage,it is more importent to choose individualized treatment methods so as to more benefit.
RESUMEN
Objective@#To explore the preventive effect and possible molecular mechanism of dietary supplementation of N-carbamylglutamate (NCG) in the implantation of carbon disulfide (CS2) into embryo implantation disorders.@*Methods@#embryo implantation disorder model was established by single intraperitoneal exposure to CS2 on the 3rd, 4th, and 5th days after pregnancy. Endometrial tissues were collected for 24h after exposure to CS2 for western-blot and immunohistochemical staining.@*Results@#The number of embryo implantation was increased in NCG+CS2 group, compared with CS2 alone group. Day 4 of pregnancy when CS2-exposed after 24 h, the expression of pAKT protein in NCG+CS2 group was significantly increased (P<0.05), the expression level of pAMPK protein in NCG+CS2 group was significantly decreased, compared with CS2 alone group, respectively. Immunohistochemical results showed that pAKT, pAMPK, AKT and AMPK proteins were expressed in luminal epithelial cells, glandular epithelial cells and stromal cells of endometrium; Day 4 of pregnancy when CS2-exposed after 24 h, deep staining of ATK and pAKT protein in NCG+CS2 group, the AMPK and pAMPK protein staining became lighter.@*Conclusion@#Dietary supplementation of NCG can interfere with the embryo loss induced by CS2 by altering the total amount of AKT/AMPK molecules.
RESUMEN
For the treatment of early non-small cell lung cancer, surgery is still one of the most important curative treatments. Lung segment or subsegment resection under video-assisted thoracoscopic surgery is becoming more and more popular. With the development of radiotherapy technology, Stereotactic Body Radiotherapy (SBRT) has achieved the similar or the same curative effect as surgery. It has become an indisputable curative treatment for patients who can not or refuse surgery, and there are still some disputes among those who can operate. Therefore, this review will elaborate on these treatment methods in order to help update the concept and provide more treatment methods and obtain more benefits for patients. Although it is no randomized clinical trial to compare SBRT with surgery, we suggest that SBRT is the curative treatment for patients who can not or refuse surgery. Especially for the elderly, or patients with cardiopulmonary diseases, diabetes and other high-risks. SBRT should become the main treatment methods, because its curative effect is not inferior to surgery and its complications are fewer and lighter. Therefore, for the treatment of non-small cell lung cancer in the early stage, it is more importent to choose individualized treatment methods so as to more benefit.
RESUMEN
Radiotherapy is one of the main therapeutic methods of lung cancer, whereas the lung injury induced by radiotherapy restricts the quality of life and clinical efficacy. It is a challenge to improve the clinical efficacy and reduce lung injury.Based upon clinical experience, certain measures can be taken to alleviate the lung injury after thoracic radiotherapy. The severity and complications of lung cancer and the concurrent chemoradiotherapy-induced injury should be comprehensively understood to establish individual therapeutic strategy. The diagnostic skills, biological characteristics of tumors, the diffusion, metastasis and recurrence of tumors and lymphatic drainage should be mastered and considered in the formulation of treatment target areas to minimize unnecessary radiation for every 1 mm. During the formulation and evaluation of radiotherapy plans, we should understand the biological characteristics of the lung and lung injury repair and stick to the principle of high-dose radiation for small-volume lung rather than low-dose radiation for large-volume lung. A better treatment plan should be established to reduce every 1% of lung DVH as possible even at the expanse of conformality. Simultaneous modulated accelerated radiotherapy and two-phase radiotherapy are employed to distinguish normal tissues from subclinical tumors from the dose and fractioned dose aspects, which further enhance the tumor control and alleviate lung injury. The lung ventilation function is lost at a dose of 20 Gy or higher. Extensive attention should be delivered to reduce the radiation dose to the lung, especially for the repair of non-functional lung fibrosis. Precise and individualized radiotherapy should be adopted to reduce unnecessary radiation and protect the normal lung tissues, which improve the clinical efficacy and enhance the quality of life.
RESUMEN
Objective To investigate the efficacy of dexmedetomidine in preventing postoperative delirium in elderly patients undergoing laparoscopic radical resection for cervical cancer. Methods Eighty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients, aged 65-75 yr, weighing 45-80 kg, scheduled for elective laparoscopic radical resection for cervical cancer, were divided into 2 groups (n= 40 each) using a random number table: dexmedetomidine group (group D) and routine group (group R). Dexmedetomidine was infused at a rate of 0. 5 μg·kg-1 ·h-1 after anesthesia induction until the end of operation in group D, while the equal volume of normal saline was given instead in group R. Delirium rating scale was used to assess the development of delirium within 3 days after operation. Blood samples were collected from the jugular bulb before anesthesia induction (T0 ), at the end of operation (T1 ) and at 1, 6 and 24 h after operation (T2-4 ) to determine the serum concentrations of S100β protein, neuron-spe-cific enolase, tumor necrosis factor-alpha and interleukin-1beta (IL-1β) by enzyme-linked immunosorbent assay. Results Compared with group R, the incidence of postoperative delirium was significantly de-creased (38%∕2%), the serum concentrations of S100β protein, neuron-specific enolase, tumor necrosis factor-alpha and IL-1β were decreased at T1-4 , and the serum concentrations of IL-1β protein were de-creased at T2-4 in group D (P<0. 05). Conclusion Infusing dexmedetomidine at 0. 5 μg·kg-1 ·h-1 from the end of anesthesia induction until the end of operation can effectively prevent the development of delirium following laparoscopic radical resection for cervical cancer, and the mechanism is related to inhibiting in-flammatory responses and reducing brain injury in elderly patients.
RESUMEN
Objective To explore the intellectual profile of children with autism spectrum disorders (ASD) combined with hypophrenia.Methods The study followed a matching design,37 children with ASD combined with hypophrenia and 40 with simply intelligence disability while paired based on gender and age were selected.The intellectual profile of the studied children was determined with the Wechsler intelligence scale for children-Chinese edition (WISC-R) scale.Results The full intelligence quotient (FIQ) of the ASD group and the control group were (54.70±8.26) and (54.60-±7.17),the differences were not statistically significant(P>0.05).Verbal intelligence quotient(VIQ) and performance intelligence quotient(PIQ) of ASD group were(54.70±8.26) and (64.51±12.25) and the control group were(56.70±8.02) and(57.25±9.43).Children with ASD scored lower on VIQ and higher on PIQ.There was significant difference between the two groups(t=3.582,P<0.01;t=2.928,P<0.01).There was statistically significant difference on VIQ-PIQ of ASD group(t=8.14,P<0.01).The group with ASD had a profile characterized by a high score on Puzzle and Block Design with a low comprehension score.The score of FIQ,VIQ as well as information,arithmetic,comprehension,Picture arrangement were negatively correlated with ABC (r=-0.36,P<0.05;r=-0.40,P< 0.05;r=-0.41,P<0.05;r=-0.44,P<0.01;r=-0.44,P<0.01;r=-0.35,P<0.05).Conclusion Children with autism spectrum disorders with hypophrenia have special cognitive profile,which can be used to provide basis for making intervention strategies.
RESUMEN
OBJECTIVE:To explore the feasibility of question-and-answer practice teaching in the pharmacy department of our hospital. METHODS:The practice teaching of pharmacy department was taken as a pilot,and the question-and-answer practice teaching was used in emergency and outpatient pharmacies,inpatient pharmacy,PIVAS,drug warehouse,clinical pharmaceutics room,preparation room and drug testing laboratory. The effects of the practice teaching on internships,teachers,pharmacy depart-ments and patients were excavated. RESULTS & CONCLUSIONS:Satisfaction of teachers,pharmacy,patients and clinics for the question-and-answer practice teaching was 100%,and satisfaction of internships was 94.5%. The question-and-answer practice teaching has improved their professional knowledge and competence,resolved difficulty of patients about drug counseling and helped the improvement of overall business level in department.
RESUMEN
Aim To investigate the apoptosis of human gastric carcinoma AGS cells induced by cecropinXJ. Methods Human gastric carcinoma AGS cells and human normal epithelial cells GES-1 were co-cultured with different concentrations of cecropinXJ ranging from 0. 01 to 1 000 mg·L-1 for 24 h. MTT assay was used to observe the effects of cecropinXJ on the proliferation of AGS cells and GES-1 cells. The ultrastructural changes of the AGS cells were observed by transmission electron microscopy. Hoechst staining was used to de-tect cell apoptosis. The changes of intracellular reac-tive oxygen species ( ROS) and mitochondrial potential were analysed by flow cytometery. The expression of Bax, Bcl-2, caspase-3 and cytochrome C in mRNA level was investigated by qRT-PCR. Western blot was used to determine the protein expression of Bax, Bcl-2, caspase-3 and cytochrome C. Results CecropinXJ significantly suppressed the proliferation of AGS cells in vitro (P<0. 05) in a dose-dependent manner, IC50 =61. 19 mg·L-1 , but had no inhibitive effects on the proliferation of GES-1 cells. After treatment for 24 h, cecropinXJ induced AGS cells nuclear condensation, and increased ROS production, disrupted mitochondri-al integrity. The results of qRT-PCR and Western blot demonstrated cecropinXJ could up-regulate the expres-sion of Bax and down-regulate the expression of Bcl-2 , promote the release of cytochrome C and activate caspase-3. Meanwhile, cecropinXJ promoted caspase-3 activity in a dose-dependent manner, and cell death ratio of AGS cells induced by cecropinXJ was signifi-cantly reduced by caspase-3 and caspase-9 specific in-hibitors treatment. Conclusion CecropinXJ can in-duce apoptosis of AGS cells by downregulating Bcl-2 , upregulating Bax and activating caspase-3 , which may be one of its anti-tumor mechanisms.