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Objective:To observe of the effects of micro-video breakthrough education and thematic workshops in the care of internal fistulae in maintenance haemodialysis patients, to provide a basis for improving prognosis of patients.Methods:This study was a randomized controlled trial. A total of 90 cases of maintenance haemodialysis patients with endocardial fistula were selected in Huzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine from January to December in 2022 as the observation samples using convenience sampling method. They were divided into the experimental group and the control group with 45 cases in each group by the method of random number table. The control group used the conventional nursing care for maintenance haemodialysis endocardial fistula to administer nursing care, the experimental group introduced the micro-video breakthrough education and thematic workshop as a combined mechanism of intervention. The self-care behaviors with arteriovenous fistula and other observation indexes between the two groups were compared.Results:There were 23 males and 22 females in the control group, aged (58.07 ± 3.00) years old. There were 24 males and 21 females in the experimental group, aged (58.93 ± 4.07) years old. After care, the total internal fistula self-care behaviour score in the experimental group was (49.44 ± 1.84) points, and (38.93 ± 2.19) points in the control group, the difference between the two groups were statistical significant ( t = 24.65, P<0.05). For health management adherence, the score of fluid intake, dialysis regimen, medication and dietary dimension were (15.82 ± 1.37), (12.87 ± 1.39), (17.24 ± 1.33) and (21.60 ± 1.03) points in the experimental group, and (11.20 ± 0.92), (9.98 ± 1.14), (12.11 ± 1.01) and (17.40 ± 1.10) points in the control group, the difference between the two groups were statistical significant ( t values were 10.78 to 20.62, all P<0.05). For positive psychological capital, the scores of self-efficacy, resilience, hope and optimism were (38.69 ± 1.22), (39.27 ± 1.10), (33.29 ± 1.52) and (33.40 ± 1.39) points, and were (31.16 ± 1.26), (31.04 ± 1.15), ( 26.13 ± 1.52) and (27.09 ± 7.28) points in the control group, the difference between the two groups were statistical significant ( t values were 5.71 to 34.77, all P<0.05). The total complication rate of the experimental group was 8.89% (4/45), lower than 28.89% (13/45) in the control group, and the differences were all statistically significant ( χ2 = 5.87, P<0.05). Conclusions:The combined application of micro-video breakthrough education and special workshops in maintenance hemodialysis patients with internal fistula is beneficial to the improvement of their internal fistula self-care ability, health management compliance and positive psychological capital, and can reduce the probability of internal fistula complications.
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OBJECTIVE To explore the intestinal absorption characteristics of saikosaponins. METHODS Based on everted intestinal sac model, using accumulative absorption amount (Q) and absorption rate constant (Ka) as indexes, UHPLC-MS/MS technique as a method, the absorption of saikosaponin A, B2, C, D and F from total saponins of Bupleurum chinense (8 g/mL, by crude drug) in the duodenum, jejunum and ileum was detected. RESULTS The correlation coefficients (r) of the regression equations for the absorption of saikosaponins A, B2, C and F in the duodenum, jejunum and ileum were all higher than 0.95, while the r of saikosaponin D in the above intestinal segments was lower than 0.95; compared with the absorption of the same composition in the duodenum, the Q and Ka of saikosaponin A and C circulating in jejunum and ileum for 120 min, as well as the Q and Ka of saikosaponin F circulating in the ileum for 120 min were significantly decreased (P<0.05). CONCLUSIONS Saikosaponin A and the other 4 saikosaponins are all absorbed in the duodenum, jejunum and ileum; among them, saikosaponin A, B2, C and F are linearly absorbed, which conforms to the zero-order absorption characteristics, but saikosaponin D shows non- linear absorption.
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Persistent fetal vasculature syndrome (PFVS) is a rare congenital vitreous dysplasia, which is classified as anterior, posterior and combined types according to the location of the vascular abnormalities. The clinical manifestations of PFVS are diverse, and early surgical intervention is very important. The main objective of surgical treatment is to remove the anterior and posterior traction between fibrovascular membranes and retina as well as lens, and to reconstruct clear visual axis. Surgical treatments include pupilloplasty, lensectomy with or without intraocular lens implantation and vitrectomy via limbal or scleral approach. For new technologies, the applications of ophthalmic viscosurgical device and femtosecond lasers have desirable results . In addition to focusing on improving the success rate of surgery, it is also necessary to systematically and comprehensively assess the overall preoperative condition and postoperative visual function of the patients. PFVS eyes have limited improvement in postoperative vision, which is related to the extent of lesion involvement and the occurrence of complications. Eyes with macular dysplasia and tractional retinal detachment, as well as elongated ciliary process, have a poor prognosis of vision after surgery. How to improve postoperative vision in the eye affecting the posterior segment of the eye with PFVS from the microscopic anatomical relationship between the fibrous vascular pedicle and the retina is worth further study. On the other hand, reducing surgical trauma and optimizing surgical procedures in order to improve postoperative visual acuity and reduce postoperative complications are also the key research directions of future PFVS treatments.
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Retinopathy of prematurity (ROP) is a proliferative vascular retinal disease. Cryotherapy, laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor, scleral buckling surgery and vitrectomy are the main treatments. Treated with cryotherapy or laser photocoagulation or intravitreal injection of anti-vascular endothelial growth factor, patients with a history of ROP have thicker foveas, and the morphology of the fovea and the development of the retinal vessels in the macular area are affected, resulting in abnormal vision development. However, the specific mechanisms by which different treatments of ROP affecting the development of the macula are not yet clear. It still need further study with large samples to verify and explore, whether changes in the levels of intraocular vascular endothelial growth factor changing the process of normal macular development and how the abnormal development of the macula affects visual function.
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Preterm birth (PTB) is a common complication in perinatal medicine, its high morbidity as well as the resulting complications and sequelae affect the quality of children's lives, or even cause death. It is crucial to early, accurate predict PTB and timely adopt scientific and reasonable intervention measures for reduction of the mortality of preterm infants and improve prognosis. Ultrasound is the most common method to predict PTB. The research progresses of ultrasound in predicting PTB were reviewed in this article.
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Objective To explore the effects of vascular risk factors on cognitive function among the elderly in community. Methods A cross-sectional study was conducted in 1 269 elderly people ( aged 65 and over) who were randomly selected from three communities. Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE),and blood samples were collected for labo-ratory examination. Logistic regression analysis was used to analyze the vascular risk factors affecting cogni-tive function. Results Age (( 73. 1 ± 6. 6), ( 71. 3 ± 4. 9),t=4. 603,P<0. 05),education level ( χ2=12. 727,P<0. 05),hypertension (χ2=9. 106,P<0. 05) and LDL-C (χ2=5. 157,P<0. 05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age,gender and ed-ucation,the logistic regression analysis showed that hypertension(β=0. 378,P=0. 006,OR(95%CI)=1. 44 (1. 10-1. 91)),systolic blood pressure ≥140 mmHg( β=0. 350,P=0. 011,OR( 95% CI)= 1. 42( 1. 08-1. 86),1 mmHg=0. 133 kPa),and high LDL-C( β=0. 355,P=0. 014,OR(95%CI)=1. 43( 1. 08-1. 89)) were the risk factors of MCI in the elderly in the community. Hypertension alone or high LDL-C (β=0. 365, P=0. 029,OR(95%CI)=1. 44(1. 04-2. 00)) alone was risk factor for mild cognitive impairment in the eld-erly in the community. The risk of mild cognitive impairment in the elderly with hypertension and high LDL- C was 2. 00 times higher than that in the healthy elderly ( β=0. 696,P<0. 05,OR( 95%CI)= 2. 00( 1. 36-2. 97)). Conclusion Mild cognitive impairment in the elderly is closely related to hypertension and elevat-ed LDL-C levels. Multiple vascular risk factors can further increase the risk of cognitive impairment.
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Objective@#To explore the effects of vascular risk factors on cognitive function among the elderly in community.@*Methods@#A cross-sectional study was conducted in 1 269 elderly people (aged 65 and over) who were randomly selected from three communities.Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE), and blood samples were collected for laboratory examination.Logistic regression analysis was used to analyze the vascular risk factors affecting cognitive function.@*Results@#Age ((73.1±6.6), (71.3±4.9), t=4.603, P<0.05), education level (χ2=12.727, P<0.05), hypertension (χ2=9.106, P<0.05) and LDL-C (χ2=5.157, P<0.05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age, gender and education, the logistic regression analysis showed that hypertension(β=0.378, P=0.006, OR(95%CI)=1.44(1.10-1.91)), systolic blood pressure ≥140 mmHg(β=0.350, P=0.011, OR(95%CI)=1.42(1.08-1.86), 1 mmHg=0.133 kPa), and high LDL-C(β=0.355, P=0.014, OR(95%CI)=1.43(1.08-1.89)) were the risk factors of MCI in the elderly in the community.Hypertension alone or high LDL-C (β=0.365, P=0.029, OR(95%CI)=1.44(1.04-2.00)) alone was risk factor for mild cognitive impairment in the elderly in the community.The risk of mild cognitive impairment in the elderly with hypertension and high LDL-C was 2.00 times higher than that in the healthy elderly (β=0.696, P<0.05, OR(95%CI)=2.00(1.36-2.97)).@*Conclusion@#Mild cognitive impairment in the elderly is closely related to hypertension and elevated LDL-C levels.Multiple vascular risk factors can further increase the risk of cognitive impairment.
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<p><b>OBJECTIVE</b>To investigate the polymorphisms of the coding gene and the human T cell epitopes of antigen GlnA1, Mpt70, LppX, GroES and LpqH on Mycobacterium tuberculosis complex (MTBC) strains in thirteen provinces of China.</p><p><b>METHODS</b>A total of 173 clinical MTBC isolates from thirteen provinces were selected to test the gene sequences of the five antigens, using PCR and DNA sequencing methods. Sequences were compared and sliced by BioEdit, and the variations of the human and nonhuman T cell epitopes were analyzed. The rates on synonymous mutation (dS), non-synonymous mutation (dN) and dN/dS values were calculated by Mega 6.0 software.</p><p><b>RESULTS</b>Among the 173 strains, there were two non-synonymous mutations in the non-epitope region of glnA1, one non-synonymous mutations in epitope domain of mpt70, one non-synonymous mutation and one synonymous mutation in the epitope domain of lpqH; while groES showed no mutation. lppX had five non-synonymous mutations and one synonymous mutation in the epitope domain. Nine strains presented higher polymorphism at the same gene locus of position 152 in lppX. And seven of the fifteen epitopes contained in lppX were altered and the dN/dS value of this gene was 0.19.</p><p><b>CONCLUSIONS</b>Data from the human T cell epitope domains of MTBC antigens Mpt70, LppX and LpqH contained epitope diversity, indicated that these antigens may have involved in diversifying the selection to evade the host immunity. GlnA1 had the polymorphism in epitope domain, which might have little influence on the immuno-response. While GroES seemed relatively conservative, it could play an important role on identification, diagnosis and the development of potential Mycobacterium tuberculosis vaccine.</p>
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Humans , Antigens, Bacterial , Genetics , Bacterial Proteins , Genetics , China , Epitopes, T-Lymphocyte , Genetics , Mycobacterium tuberculosis , Genetics , Polymerase Chain Reaction , Polymorphism, Genetic , Sequence Analysis, DNAABSTRACT
Through the analysis of the status quo of lack of medical students′humanistic quality , this paper discussed the current increase medical students humanities quality:the necessity of the development of the harmoni-ous society needs , remarkable physician training needs , the growth of self-actualization needs .This paper pointed out that under the perspective of cultural consciousness of medical students improve humane quality way :accurate positioning “self-improvement” action subject , sets up the “benevolence” goal, integration of domestic and for-eign high-quality learning resources , learning to use new media network platform , improving “knowledge and ac-tion should go hand in hand” in practice.
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Objective To design an adjustable frame for four limbs disinfection, and applied it to clinic, to prevent skin damage of eatagmatic limb due to heighten the limb for the preoperative disin-fection.Methods 180 patients who need to heighten limb for diaplasis were divided into the observation group and the control group averagely according to the sequence of operation time.Patients in the observa-tion group were heighten limbs by using the adjustable frame, while the control group were heighten limbs onto the fluid frame by traditional methods.Skin lesions, the contamination of the limb and the time for disinfection were observed.Results Skin lesions of the observation group and the control group were 2% and 20%, re-spectively,the difference was statistically significant.There was no case in the observation group was contami-nated and 16 cases were contaminated in the control group, the difference was statistically significant.The aver-age time for disinfection in the observation group was (17.6 ± 2.4)minutes, in the control group,(21.3 ± 3.2) minutes, the difference was also statistically significant.Conclusions Using the adjustable frame for limbs disinfection can reduce the skin damage, shorten the disinfection time and improve work efficiency.