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1.
Zhonghua Jie He He Hu Xi Za Zhi ; 44(9): 800-805, 2021 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-34496521

RESUMO

Objective: To retrospectively analyze the high risk factors of death in patients with chronic obstructive pulmonary disease (COPD) and to explore the influence of aspiration on the long-term survival rate of COPD patients. Methods: A retrospective analysis of clinical data of inpatients, who were admitted to the First Affiliated Hospital of Guangzhou Medical University from April 2012 to December 2013 due to COPD exacerbations and had radionuclide aspiration test, was conducted. Meanwhile, we phoned the patients' family members, whose phone numbers were recorded in the electronic patient record system, to follow up the patients' survival status, and learn the causes of death from their death records if patients died during follow-up period. Inquired the resident administration patients belonging to according to their original address to get patient's current contact information if changed. Besides, if family members of patients failed to provide death record, we should look up information concerned from the medical records room of the hospital where they died. Results: The follow-up for the last patient was performed on February 20, 2017.The time span of this study is 58 months, starting from the radionuclide aspiration test for the first patient and ending with the follow-up for the last patient. 16 of the 53 patients(16/53, 30.2%)were tested positive whose average age was slightly higher than patients without aspiration (76.0±6.8 vs 70.9±9.9), but there was no significant difference between them(P=0.064). The aspiration rates among patients over and under the age of seventy were 14/35 and 2/18 respectively, and there was a significant difference between them(P = 0.03). Compared to the aspiration-negative patients, the aspiration-positive patients had higher incidence rate of pneumonia in COPD exacerbations (11/16 vs 9/37, χ²= 9.383, P = 0.002).The major cause of death in the patients with and without aspiration were respectively severe pneumonia and pulmonary encephalopathy(P<0.05 in both cases).Among COPD patients who took radionuclide aspiration test, the median survival time of the patients with and without aspiration were about 3 and 5 years respectively. The high-risk factors influencing long-term survival of the COPD patients with aspiration included ICU-involved medical history and accompanying pneumonia. Conclusions: The incidence rate of aspiration is relatively high in COPD patients over 70 years old. Compared to COPD patients without aspiration, COPD patients with aspiration have higher incidence rate of pneumonia and shorter median survival time. ICU-involved medical history and severe pneumonia are the two high-risk factors influencing long-term survival of COPD patients with aspiration.To improve the survival time of COPD patients with aspiration, we need to attach importance to the prevention and treatment of aspiration.


Assuntos
Pneumonia , Doença Pulmonar Obstrutiva Crônica , Idoso , Progressão da Doença , Humanos , Pacientes Internados , Pulmão , Estudos Retrospectivos
2.
Zhonghua Yi Xue Za Zhi ; 101(32): 2502-2504, 2021 Aug 24.
Artigo em Chinês | MEDLINE | ID: mdl-34407574

RESUMO

The number of patients suffering from both dry eye and mental disorders (especially anxiety and depression) has risen rapidly in ophthalmic clinics. However, the mental disorders related dry eye has not received enough attention. At present, it lacks related information of basic data, and there is no standard for the clinical diagnosis and treatment. To this end, this article aims to determine the role of mental factors in the pathogenesis of dry eye, to strengthen the relevant basic and clinical research, to standardize its clinical diagnosis and treatment, and thus to promote the prevention and treatment of the mental disorder related dry eye in China.


Assuntos
Síndromes do Olho Seco , Transtornos Mentais , Ansiedade , Transtornos de Ansiedade , China , Humanos
3.
Zhonghua Yi Xue Za Zhi ; 101(32): 2514-2518, 2021 Aug 24.
Artigo em Chinês | MEDLINE | ID: mdl-34407576

RESUMO

Objective: To evaluate the association of meibomian gland dysfunction (MGD) and body mass index (BMI) in Chinese adults. Methods: A total of 2 419 patients were retrospectively recruited between May and October 2013 from 33 ocular surface disease clinic in China. There were 780 males (32.2%) and 1 639 females (67.8%), aged 18-89 (46±16) years. BMI value of each patient was respectively calculated, and the patients were divided into underweight, normal weight, overweight and obesity groups accordingly. Meibomian gland-related examinations were performed in right eyes. Results: The number of the patients in four groups were 196, 1 556, 567 and 100, respectively. Compared with normal weight group, the rates of moderate to severe MGD (59.1%, 71.0% vs 49.9%) in overweight group and obesity group were higher, and the differences were statistically significant (both P<0.05). The scores of change in eyelid margin, meibomian gland dropout and meibum expressibility were significantly higher in overweight group and obesity group, compared with normal weight group (all P<0.05). Additionally, after stratified by age, all the above-mentioned three scores of obese patients were significantly higher than those of non-obese patients in young adult group. Multivariate logistic regression analysis showed that moderate to severe MGD was correlated with overweight (OR=2.19, 95%CI: 1.06-4.50, P=0.033) and obesity (OR=3.70, 95%CI: 2.57-5.04, P=0.008). Conclusion: Moderate to severe MGD significantly correlates with high BMI in Chinese adults.


Assuntos
Doenças Palpebrais , Disfunção da Glândula Tarsal , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Masculino , Glândulas Tarsais , Estudos Retrospectivos , Lágrimas , Adulto Jovem
4.
Water Res ; 203: 117504, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34388501

RESUMO

An integrated computational fluid dynamics (CFD)-kinetic model framework was developed to numerically describe the hydrodynamic and kinetic phenomena in a liquid-solid two phases Fluidized-bed reactor Fenton/granular activated carbon (FBR-Fenton/GAC) system. The model obtained excellent accuracy for predicting chemical oxygen demand (COD) removal in reverse osmosis concentrate (ROC) treatment under different operation conditions. Hydrodynamic evaluation demonstrated that under the quasi-steady state, the GAC particles were uniformly circulated in the bed region with two pairs of counter-rotating recirculation cells, and a clear interface layer formed between the solid and the liquid phases. Superficial liquid velocity highly affected the fluidized bed expansion and solid volume fraction, while its impact on the overall COD removal efficiency was negligible. Chemical evaluation revealed that GAC/H2O2 catalytic reaction enhanced the •OH production in FBR-Fenton/GAC process by 2.7 folds as compared to homogenous Fenton process. Fenton reaction mainly occurred in the upper liquid region and its kinetics for •OH generation significantly diminished by 75% within the first 10 min. GAC/H2O2 reaction took place in the fluidized bed region for continuous •OH generation with a relatively stable rate from 1.21 × 10-6 to 0.60 × 10-6 M/s. Along the ROC treatment with FBR-Fenton/GAC process, the simulated COD degradation rate decreased along the reaction time with 2.05 × 10-6 M/s and 2.93 × 10-7 M/s at 2 min and 60 min, respectively. Faster COD removal was attained in the fluidized bed region due to combining effects of •OH oxidation and GAC adsorption. The overall predicted COD concentration reduced from 122 to 35 mg/L, •OH oxidation and GAC adsorption contributed 59% and 41%, respectively, to the total COD removal.


Assuntos
Poluentes Químicos da Água , Purificação da Água , Carvão Vegetal , Hidrodinâmica , Peróxido de Hidrogênio , Cinética , Eliminação de Resíduos Líquidos
5.
Sci Total Environ ; 798: 149289, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34340085

RESUMO

Reverse osmosis (RO) is being used in many water reclamation facilities to produce high quality water that can be reused for different purposes. As a part of the RO process, a reject stream is produced as the reverse osmosis concentrate (ROC), which contains elevated levels of contaminants compared to the source water. Effective treatment and safe disposal of ROC via cost-effective means is very challenging. This study aims to develop a robust microbubble ozonation-biological process for industrial ROC treatment with a target effluent chemical oxygen demand (COD) lower than 60 mg/L. As compared to macrobubble ozonation, microbubble ozonation exhibited better ozone dissolution and 29% higher COD removal efficiency with the same ozone dosage. Under the optimum operating conditions with ozone dosage of 30 mg/L, ROC natural pH of 8.67 and ozonation duration of 1 h, microbubble ozonation achieved 42% COD removal efficiency while increasing the BOD5/COD ratio (ratio of biological oxygen demand over 5 days to the corresponding chemical oxygen demand) in ROC from 0.042 to 0.216. A biological activated carbon (BAC) column with an empty bed contact time (EBCT) of 120 min was combined with microbubble ozonation for continuous ROC treatment. Over the 100-day operation, the combined system performed consistent organics removal with an average effluent COD of 45 mg/L. Both LC-OCD data and fluorescence EEM spectra confirmed humic substances were the dominant organic species in ROC. Ozone pre-treatment could achieve significant removal of humic substances in raw ROC. ATP analysis found that ozone pre-treatment enhanced BAC biofilm activity by around 5 folds. 5 min acute toxicity assessment with Aliivibrio fischeri showed 4 times reduction of bioluminescence inhibition in ozone treated ROC. From the environmental point of view, Life cycle assessment (LCA) results demonstrated that Ozone-BAC system had significant environmental burdens on climate change and human toxicity due to the electricity production process. These environmental impacts can be mitigated by optimizing the ozonation process with reduced ozone dosage or utilizing renewable energy sources for electricity generation.


Assuntos
Ozônio , Poluentes Químicos da Água , Carvão Vegetal , Meio Ambiente , Humanos , Microbolhas , Osmose , Poluentes Químicos da Água/análise
6.
Poult Sci ; 100(8): 101294, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34237550

RESUMO

Cold temperature is a common environmental stressor that induces pathophysiological stress in birds with profound economic losses. Current methods used for preventing cold stress, such as reducing ventilation and using gas heaters, are facing challenges due to poor indoor air quality and deleterious effects on bird and caretaker health. The aim of this study was to examine if the novel designed warmed perch system, as a thermal device, can reduce cold stress-associated adverse effects on laying hens. Seventy-two 32-week-old DeKalb hens were randomly assigned to 36 cages arranged to 3 banks. The banks were assigned to 1 of 3 treatments: cages with warmed perches (WP; perches with circulating water at 30°C), air perches (AP, regular perches only), or no perches (NP) for a 21-d trial. The room temperature was set at 10°C during the entire experimental period. Rectal temperature and body weight were measured from the same bird of each cage at d 1, 8, 15, and 21 during the cold exposure. Egg production was recorded daily. Feed intake, egg and eggshell quality were determined during the 1st and 3rd wk of cold stress. Plasma levels of corticosterone, thyroid hormones (3, 3', 5-triiodothyronine and thyroxine), interleukin (IL)-6 and IL-10, were determined after 1 d and 21 d of cold exposure. Compared to both AP and NP hens, WP hens were able to maintain their body temperature without increasing feed intake and losing BW. The eggs from WP hens had thicker eggshell during the 3rd wk of cold exposure. Warmed perch hens also had a lower thyroxine conversion rate (3, 3', 5-triiodothyronine/thyroxine) at d 1, while higher plasma concentrations of IL-6 at d 21. Plasma levels of corticosterone, 3, 3', 5-triiodothyronine, and IL-10 were not different among treatments. Our results indicate that the warmed perch system can be used as a novel thermal device for preventing cold stress-induced negative effects on hen health and welfare through regulating immunity and metabolic hormonal homeostasis.


Assuntos
Abrigo para Animais , Percas , Criação de Animais Domésticos , Bem-Estar do Animal , Animais , Galinhas , Temperatura Baixa , Resposta ao Choque Frio , Corticosterona , Feminino , Oviposição , Óvulo
7.
Zhonghua Shao Shang Za Zhi ; 37(1): 9-16, 2021 Jan 20.
Artigo em Chinês | MEDLINE | ID: mdl-33499564

RESUMO

Objective: To explore the effects of B-cell lymphoma-2/adenovirus E1B 19 000 interacting protein 3 (BNIP3) on the migration and motility of human dermal microvascular endothelial cells (HDMECs) under hypoxia and the mechanism. Methods: The experimental research method was applied. (1) HDMECs were divided into normoxia group received routine culture and hypoxia 6, 12, 24 h groups treated under hypoxia with oxygen volume fraction of 2% for corresponding time according to the random number table (the same grouping method below). Western blotting was used to detect the protein expressions of BNIP3 and microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ) in HDMECs. (2) HDMECs were divided into normoxia+ unloaded group, normoxia+ BNIP3 knockdown group, hypoxia+ unloaded group, and hypoxia+ BNIP3 knockdown group which were transfected with unloaded virus or BNIP3 knockdown virus and were subjected to normoxic or hypoxic treatment. The BNIP3 protein expression was detected by Western blotting and immunofluorescence staining. The scratch area at 24 h post scratching was detected by scratch test, and the healing rate of scratch was calculated. The curve distance of cell movement was measured with the living cell workstation, and the speed of movement was calculated within 3 hours. (3) HDMECs were grouped and treated as experiment (2). Western blotting and immunofluorescence staining were performed to detect the protein expression of LC3Ⅱ. The number of sample was 3 in the above-mentioned experiments. Data were statistically analyzed with one-way analysis of variance and least significant difference test. Results: (1) Compared with those of normoxia group, the protein expressions of BNIP3 and LC3Ⅱ of cells in hypoxia 6, 12, 24 h groups were significantly increased (P<0.01). (2) After 6 hours of culture, compared with that of hypoxia+ unloaded group, the BNIP3 protein expressions of cells in normoxia+ unloaded group and hypoxia+ BNIP3 knockdown group were significantly decreased (P<0.05 or P<0.01). The red fluorescence denoting BNIP3 protein expression of cells in normoxia+ unloaded group and normoxia+ BNIP3 knockdown group was weak, the red fluorescence of cells in hypoxia+ unloaded group was strong, and the red fluorescence of cells in hypoxia+ BNIP3 knockdown group was significantly decreased compared with that in hypoxia+ unloaded group. After scratching for 24 hours, the scratch of cells in hypoxia+ unloaded group basically healed, while the remaining scratch area in the other three groups were large. The healing rates of scratch of cells in normoxia+ unloaded group, normoxia+ BNIP3 knockdown group, hypoxia+ unloaded group, and hypoxia+ BNIP3 knockdown group were (61±4)%, (58±4)%, (88±4)%, and (57±4)%, respectively. The healing rate of scratch of cells in hypoxia+ unloaded group was significantly higher than that in normoxia+ unloaded group (P<0.01) and hypoxia+ BNIP3 knockdown group (P<0.05). Within 3 hours of observation, the range of cell movement in hypoxia+ unloaded group was significantly larger than that in normoxia+ unloaded group, the range of cell movement in hypoxia+ BNIP3 knockdown group was significantly smaller than that in hypoxia+ unloaded group, and the curve movement velocity of cells in hypoxia+ unloaded group was significantly higher than that in normoxia+ unloaded group and hypoxia+ BNIP3 knockdown group (P<0.01). (3) After 6 hours of culture, compared with hypoxia+ unloaded group, the LC3Ⅱ protein expressions of cells in hypoxia+ unloaded group and hypoxia+ BNIP3 knockdown group were decreased significantly (P<0.05 or P<0.01). After 6 hours of culture, the red fluorescence denoting LC3 protein expressions of cells was weak in normoxia+ unloaded group and normoxia+ BNIP3 knockdown group, the red fluorescence of cells was significantly enhanced in hypoxia+ unloaded group, and the red fluorescence of cells was significantly inhibited in hypoxia+ BNIP3 knockdown group. Conclusions: BNIP3 can promote the migration and motility of HDMECs under hypoxia, and autophagy may be involved in the regulation migration of HDMECs by BNIP3.


Assuntos
Adenoviridae , Células Endoteliais , Movimento Celular , Humanos , Hipóxia , Proteínas Proto-Oncogênicas c-bcl-2
8.
Water Res ; 190: 116692, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33279748

RESUMO

In recent years, fluidized-bed Fenton (FBR-Fenton) process has gained more attention in treating recalcitrant industrial wastewater. FBR-Fenton combines the effectiveness of homogeneous Fenton and sludge reduction of heterogeneous Fenton. Comparing to other modified Fenton processes, FBR-Fenton has greater economical and scaling up potential. However, large consumption of Fenton reagents and strict pH control are still the bottlenecks hampering the full-scale application of FBR-Fenton. While prior reviews mainly focused on the operation and performance of FBR-Fenton process, the present study critically discussed the challenges and bottlenecks for its full-scale industrial application. This study also comprehensively reviewed the development strategies for tackling these drawbacks, mainly over the recent five years. Homogeneous FBR-Fenton, heterogeneous FBR-Fenton and heterogeneous FBR-photo-Fenton processes were classified for the first time according to their reaction mechanisms and system designs. Important operational and design parameters affecting the cost-effectiveness of all FBR-Fenton technologies were reviewed, including the fundamentals, common practices and even innovative steps for enhancing the process performance. Up-to-date applications of FBR-Fenton technologies in recalcitrant wastewater/compounds treatment were also summarized, and it was found that upscaling of heterogeneous FBR-Fenton and heterogeneous FBR-photo-Fenton processes was still very challenging. Strategies to overcome the key technical limitations and enhance process cost-effectiveness were discussed in the future perspective part. Furthermore, modelling techniques such as computational fluid dynamics model and artificial neural network were suggested to be promising modelling techniques for speeding up the full-scale applications of FBR-Fenton technologies.


Assuntos
Eliminação de Resíduos Líquidos , Purificação da Água , Hidrodinâmica , Peróxido de Hidrogênio , Oxirredução , Esgotos , Águas Residuárias
9.
Chemosphere ; 263: 127980, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33297029

RESUMO

Ozonation is a well-known and widely applied advanced oxidation process (AOP) for industrial wastewater treatment, while the ozonation efficiency might be limited by low mass transfer, poor solubility, and rapid decomposition rate of ozone molecules in the aqueous phase. The present study aims to investigate the feasibility of combined microbubble-catalytic ozonation process (M-O3/Fe/GAC) for improving the ozonation efficiency during treatment of petrochemical wastewater (PCW). M-O3/Fe/GAC process optimization was carried out with different pH conditions, ozone dosages and catalyst loadings. The optimum operating conditions were identified as 50 mg L-1 ozone dosage, real PCW pH (7.0-7.5) and 4 g L-1 catalyst loading. Among different ozonation processes, M-O3/Fe/GAC process achieved the highest chemical oxidation demand (COD) removal efficiency of 88%, which is 18% and 43% higher than those achieved by the microbubble and macrobubble ozonation processes, respectively. Phenolic compounds presented in PCW could be reduced by 63% within 15 min in M-O3/Fe/GAC treatment process. Long-term continuous flow studies suggested M-O3/Fe/GAC process to be the most cost-effective technology for PCW treatment with an operating cost of S$0.18 kg-1 COD and S$0.4 m-3 with good catalyst stability. Liquid size exclusion chromatography with organic carbon detection (LC-OCD) data suggested humic substances to be the dominant organic species in PCW, M-O3/Fe/GAC could achieve significant humic substances removal and biodegradability enhancement in PCW. Kinetics and mechanism studies revealed that organics removal in M-O3/Fe/GAC was 1.8 times higher than that in microbubble ozonation process, and hydroxyl radical (●OH) was the dominant oxidant specie for organics removal in M-O3/Fe/GAC process.


Assuntos
Ozônio , Poluentes Químicos da Água , Purificação da Água , Catálise , Microbolhas , Oxirredução , Águas Residuárias , Poluentes Químicos da Água/análise
10.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(12): 1448-1452, 2020 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-33333665

RESUMO

Objective: To analyze the antibody levels and dynamic changes in patients infected with 2019-novel coronavirus(2019-nCoV). Methods: The average age of 72 corona virus disease 2019 (COVID-19) patients was (45.53±16.74)years(median age:47 year), including (44.88±17.09) years(median age:46 year) for 38 males and (46.32±16.52)years (median age:46 year) for 34 females in Loudi City, Hunan Province. There is no significant difference in genders between the severe and mild groups (χ²=0.916, P>0.05). There is a significant difference in the age between the severe and mild groups (F=3.315, P<0.05). The blood samples of 72 discharged patients were collected and the consistence of IgM and IgG antibodies were detected by chemiluminescence method. SPSS25.0 was used for gender, age, case type and antibody analysis of variance, χ2 test and other analysis. Results: The average time of the serum samples collection of 72 patients was (34.89±9.02)days (median time: 34 days) from onset of COVID-19, and (14.53±8.35) days (median time: 14 days) from discharge. The positive rate of IgM or IgG was 97.22% (70/72), and the positive rate of IgM and IgG was 48.61% (35/72) and 97.22% (70/72) respectively. Serum COVID-19 antibodies were detected in 72 patients from 1st to 40th days after discharge. The average concentration of IgM in 1-7 days, 8-14 days, 15-21 days, 22-28 days, above 29 days were 21.91(7.07-52.84)AU/ml, 14.16(6.19-32.88)AU/ml, 11.36(6.65-42.15)AU/ml, 8.15(3.66-30.12)AU/ml, 2.98(0.46-6.37)AU/ml. There was no significant difference in the time of IgM antibody concentration (H= 8.439, P>0.05). The average concentrations of IgG in 1-7 days, 8-14 days, 15-21 days, 22-28 days, 29 days and above were 169.90 (92.06-190.91) AU/ml, 163.89 (91.19-208.02) AU/ml, 173.31 (95.06-191.28) AU/ml, 122.84 (103.19-188.34) AU/ml, 101.98 (43.75-175.30) AU/ml, respectively, (H=2.232, P>0.05). The IgM becomes negative after the 3rd week of discharge and decreases rapidly with time. The IgG concentration higher than IgM during the same period, and keep at high level without any change, and decrease in the fourth week. Among them, 5 cases developed "re-infection" within 1-3 weeks after discharge, and the rate of "re-infection" was 6.94% (5/72 cases). Conclusions: After the COVID-19 patients are discharged from the hospital, the level of antibodies produced varies greatly among individuals, but the overall changes in antibodies have a certain pattern. It is recommended to strengthen the antibody monitoring during hospitalization and after discharge from the hospital to reduce the "re-infection" rate and potential risk of infection.


Assuntos
COVID-19 , Adulto , Anticorpos Antivirais , Feminino , Humanos , Imunoglobulina G , Imunoglobulina M , Masculino , Pessoa de Meia-Idade , SARS-CoV-2
11.
Zhonghua Yan Ke Za Zhi ; 56(10): 787-795, 2020 Oct 11.
Artigo em Chinês | MEDLINE | ID: mdl-33059422

RESUMO

Dry eye is the most common ocular surface disease, the core pathogenesis of which is ocular surface inflammation. Anti-inflammation is one of the important clinical treatments of dry eye. Since the definitely immunosuppressive effect, topical ophthalmic cyclosporine A (CsA) has been used in dry eye for many years. A large number of studies have been published in recent years, including its therapeutic effects, indications and applications. This article will introduce the mechanism of ophthalmic CsA, summarize its clinical treatment effects in dry eyes of different countries, different causes, and different severity. Meanwhile we will analyze the pros and cons and the applied prospects of ophthalmic CsA with various forms, and generalize the indications, treatment suggestions and safety of CsA used in dry eye, in order to provide references for the clinical applications. (Chin J Ophthalmol, 2020, 56:787-795).


Assuntos
Ciclosporina , Síndromes do Olho Seco , Ciclosporina/uso terapêutico , Síndromes do Olho Seco/tratamento farmacológico , Humanos , Inflamação , Soluções Oftálmicas/uso terapêutico
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1155-1159, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741187

RESUMO

Objective: To understand the provision of preventive medicine curriculum system in the training programs of clinical medicine in the era of Healthy China. Methods: A total of 36 training programs of clinical medicine were selected from different areas of China for a statistical analysis on their basic information, involvement of concept of preventive medicine in program objectives, and provision of preventive medicine curriculum system. Results: Of all the 36 training programs of clinical medicine, 22(61%) have no mentions of prevention medicine in their program objectives; only one university's training program states preventive medicine together with basic medicine and clinical medicine as one of the three main disciplines. The total class hours for the core courses of preventive medicine (hygiene, medical statistics, epidemiology, evidence-based medicine, and social medicine) range from 80 to 252, with an average of (156.7±43.2) hours. The average percentage of class hours for preventive medicine courses among the total class hours is 4.3%±1.1% (range: 2.5%-7.5%), and obvious differences exist among universities. Conclusions: In current training programs of clinical medicine, the proportion of prevention medicine curriculum is insufficient, the percentage of hours for preventive medicine course is very low, and the differences among various universities are obvious. It is urgently needed to strengthen preventive medicine curriculum in training programs for clinical medical students in new era. It is suggested to further promote the concept of putting prevention first, improve the curriculum system of clinical medicine, intensify the integrated development preventive medicine and clinical medicine and pay attention to clinical research ability enhancement for the further improvement of training program of clinical medicine.


Assuntos
Currículo , Educação Médica/organização & administração , Medicina Preventiva/educação , China , Humanos
13.
Zhonghua Xue Ye Xue Za Zhi ; 41(6): 483-489, 2020 Jun 14.
Artigo em Chinês | MEDLINE | ID: mdl-32654462

RESUMO

Objective: This study aimed to explore the characteristics and clinical value of clonal heterogeneity in acute myeloid leukemia (AML) . Method: A high-throughput sequencing was carried out to detect 68 related genes in 465 AML patients. Clonal heterogeneity was analyzed based on variant allele frequency (VAF) and flow cytometry results combined with clinical data. Results: Gene mutations were discovered in 338 (81.4%) newly diagnosed patients, and 2 or more clones were significantly increased in patients with DNMT3A, NRAS, and RUNX1 mutations (DNMT3A, χ(2)=15.23; P<0.001; NRAS, χ(2)=19.866; P<0.001; RUNX1, χ(2)=23.647; P<0.001) . The number of clones significantly differed between groups at different ages (χ(2)=17.505, P=0.022) . The proportion of carrying 2 and ≥3 clones increased in patients aged more than 60 years old. There was a significant difference in the clonal heterogeneity between newly diagnosed patients and relapsed or secondary patients (χ(2)=11.302, P=0.010) . Moreover, the proportion of patients with clonal heterogeneity gradually increased according to their prognostic risk (χ(2)=17.505, P=0.022) . Based on the clone analysis, the proportion of primary clones of patients with RUNX1 mutation was higher (χ(2)=4.527, P=0.033) . The analysis of clonal heterogeneity and efficacy demonstrated that patients with three or more clones had significantly lower overall survival (OS) and progression-free survival (PFS) compared to other patients (OS, χ(2)=13.533; P=0.004; PFS, χ(2)=9.817; P=0.020) , while in the intermediate-risk group, patients with a significant clonal heterogeneity also exhibited a significant decrease in PFS (χ(2)=10.883, P=0.012) . Cox regression multivariate analysis revealed that carrying three or more clones was an independent factor affecting prognosis, and OS and PFS were significantly lower than those of patients without clones (OS, HR=3.296; 95% CI, 1.568-6.932; P=0.002; PFS, HR=3.241; 95% CI, 1.411-7.440; P=0.006) . Conclusion: Clonal heterogeneity may reflect the biological characteristics of a tumor, suggesting its drug resistance, refractory, and invasiveness, and further evaluate the treatment effect and prognosis of patients.


Assuntos
Leucemia Mieloide Aguda , Células Clonais , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Mutação , Prognóstico
14.
Water Res ; 183: 116119, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32663698

RESUMO

Fluidized bed reactor Fenton (FBR-Fenton) process was adopted for reverse osmosis concentrate (ROC) treatment with three types of carriers, including sand, zeolite and granular activated carbon (GAC). Adsorption studies demonstrated that GAC achieved the best adsorption performance (maximum COD removal of 78% in 15 h) among the three carriers, and the adsorption of ROC organic matters followed a two-stage adsorption model. Fenton oxidations were carried out in three fluidized beds after column saturation, and FBR-Fenton/GAC process achieved highest COD removal (72%) and most BOD5/COD ratio enhancement (from 0.03 to 0.3) in ROC. Long-term operation data demonstrated good performance stability of GAC as the carrier. In addition, GAC fluidized bed obtained highest total iron removal rate via iron crystallization process. Continuous in-situ GAC regeneration with more than 90% recoveries of surface area, pore volume and adsorption capacity were observed along the ROC treatment with FBR-Fenton/GAC process. Mechanism studies revealed that better COD removal performance in FBR-Fenton/GAC process was attributed to the combining effects of homogenous Fenton reaction, GAC adsorption and GAC/H2O2 catalytic reaction.


Assuntos
Carvão Vegetal , Poluentes Químicos da Água , Adsorção , Filtração , Peróxido de Hidrogênio , Osmose
15.
Zhonghua Yi Xue Za Zhi ; 100(12): 933-937, 2020 Mar 31.
Artigo em Chinês | MEDLINE | ID: mdl-32234169

RESUMO

Objective: To investigate the relationship between gene mutation characteristics, mutation burden and general condition, disease subtype and karyotype of patients with myelodysplastic syndrome (MDS), and its clinical value. Methods: High-throughput sequencing was used to detect 65 blood tumor-related genes in 191 MDS patients and 9 secondary acute myelocytic leukemia patitents(SAML), and to analyze the characteristics of abnormal genes, mutation burden, as well as the relationship with disease subtypes, chromosome karyotypes and age. Results: Mutations were found in 148 patients (77.5%), including 47 abnormal genes and 186 mutation sites. And gene mutations were found in 9 SAML patients, the number of mutations was significantly higher than that in MDS patients (χ(2)=11.911, P=0.018). Among the abnormal genes, the mutation frequency of U2AF1 (37.3%) and ASXL1 (41.6%) were higher, and there were significant differences in mutation burden among different abnormal genes (F=91.946, P<0.001). There were differences in the number of gene mutations among different subtypes of MDS, and the number of EB-2 gene mutations was the highest (2.2±1.5). In SLD, MLD, EB-1 and EB-2, the proportion of carrying ≥ 3 mutations increased gradually (χ(2)=52.471, P=0.037). TP53 mutation was associated with abnormal karyotype (r(φ)=0.177, P=0.019), especially with complex karyotype (r(φ)=0.440, P<0.001), while NPM1 mutation is associated with normal karyotype (r(φ)=0.173, P=0.024). The number of mutations carried by patients under 30 years old was the least, and the number of mutations increased with the increase of age. The number of mutations was the most in patients aged 60 to 79 years old (P=0.017), and the mutation frequency of epigenetic related genes increased with the increase of age (P=0.041). Conclusions: The mutation characteristics and mutation load of MDS-related genes are closely related to clinical factors such as disease subtype, chromosome karyotype and patient age.


Assuntos
Leucemia Mieloide Aguda , Síndromes Mielodisplásicas , Adulto , Idoso , Humanos , Cariótipo , Pessoa de Meia-Idade , Mutação , Síndromes Mielodisplásicas/genética , Prognóstico
16.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(3): 180-182, 2020 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-32164083

RESUMO

A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). The article provides the pulmonary rehabilitation (PR) methods in the principle of 4S (simple, safe, satisfy, save) for patients with pneumonia caused by the novel coronavirus, shows how to establish a ventilative and convectional PR environment to prevent the spread of virus through droplets, how to guide the patients to carry out PR, how to carry out respiratory muscle training, effective cough, expectoration, sneeze, general exercise, digestive function rehabilitation and psychological rehabilitation, and how to clean and disinfect the PR environment.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus , Pneumonia Viral/reabilitação , Reabilitação/métodos , Sistema Respiratório/fisiopatologia , COVID-19 , China , Infecções por Coronavirus/complicações , Infecções por Coronavirus/reabilitação , Tosse , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , Respiração Artificial , Mecânica Respiratória , SARS-CoV-2
17.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(2): 136-139, 2020 Feb 12.
Artigo em Chinês | MEDLINE | ID: mdl-32062884

RESUMO

Objective: To explore the effect of a breathing trainer on relieving the peak airway pressure caused by forced exhalation at the end of deep inspiration, gentle coughing at the end of calm inspiration and forced coughing at the end of deep inspiration in patients undergoing mechanical ventilation. Methods: From July to September 2018, 15 patients undergoing mechanical ventilation were selected from the First Affiliated Hospital of Guangzhou Medical University, including 5 patients with invasive ventilation (3 with tracheotomy and 2 with endotracheal intubation), and 10 patients with non-invasive ventilation through mask. The patients included 14 males and 1 female, aging 48-79 years, with an average age of (68±10) years. A Breathing Trainer developed by both Dongguan Yongsheng Medical Products Co., Ltd. and Guangzhou Institute of Respiratory Health was used to relieve the peak airway pressure. A one-way expiratory valve connected with a spring at the expiratory end of the Breathing Trainer was not opened until the pressure inside the airway was higher than 20 cmH(2)O (1 cmH(2)O=0.098 kPa), and opened completely when the pressure was higher than 35 cmH(2)O. Both before and after the Breathing Trainer was connected to the respiratory circuit, the patients were asked to exhale hard at the end of deep inspiration, to cough gently at the end of calm inspiration and to cough forcefully at the end of deep inspiration and the airway pressure were measured respectively. Each action was tested 3 times, and the interval time of each test was 1 min, and the interval of each action was 10 min. Results: Among the patients with tracheotomy or endotracheal intubation for invasive mechanical ventilation, when the patients exhaled hard at the end of deep inspiration,coughed gently at the end of gentle inspiration and coughed forcefully at the end of deep inspiration, the peak airway pressure measured before the ventilation circuit was connected to the Breathing Trainer was (30.0±4.5), (31.4±5.0) and (34.9±5.0)cmH(2)O, respectively, which was significantly higher than that after the ventilation circuit was connected to the Breathing Trainer(26.3±2.9), (26.7±3.5) and (29.0±4.1) cmH(2)O (all P<0.01). Among the patients with non-invasive mechanical ventilation wearing face masks, when the patients exhaled hard at the end of deep inspiration, coughed gently at the end of gentle inspiration and coughed forcefully at the end of deep inspiration, the peak airway pressure was (17.7±1.9), (16.6±2.5) and (18.9±2.5) respectively, before the ventilation circuit was connected to the Breathing Trainer, and was (18.9±2.5), (16.3±1.9) and (18.8±2.0) cmH(2)O respectively, after the ventilation circuit was connected to the Breathing Trainer. There was no significant difference between them (P>0.05). Conclusion: The application of Breathing Trainer in the mechanical ventilation circuit of tracheotomy or endotracheal intubation could significantly reduce the peak airway pressure caused by hard exhalation and cough. It could be used as an active cough assist device for mechanical ventilation patients to prevent high airway pressure.


Assuntos
Tosse/complicações , Intubação Intratraqueal , Pico do Fluxo Expiratório/fisiologia , Respiração Artificial , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Respiração com Pressão Positiva , Respiração
18.
Zhonghua Nei Ke Za Zhi ; 59(1): 35-39, 2020 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-31887834

RESUMO

Objective: To explore the relationship between driver gene mutation (JAK2, MPL and CALR) and disease type in BCR-ABL negative myeloproliferative neoplasms (MPNs) including primary myeloid fibrosis (PMF), essential thrombocytosis (ET) and polycythemia vera (PV). Methods: A total of 32 MPN related genes were detected by high-throughput sequencing in 156 MPN patients. The relationships between disease type and patients' general performance, the characteristics of driver gene mutations, concomitant gene mutations were analyzed. Results: In the population with JAK2 V617F positive mutation, the proportion of patients over 60 years old in PMF was higher than that with ET or PV. By high-throughput sequencing, 22 concomitant gene mutations were detected in 46 patients with JAK2, MPL or CALR mutations, including 4 (8.3%) in PV, 20 (29.4%) in ET, and 22 (55.0%) in PMF. DNMT3A mutation was detected only in patients with PV, while splicing factor related genes including SF3B1, SRSF2 and U2AF1 were only accompanied by PMF. According to the variation allele frequency (VAF) value of JAK2 V617F mutation, the VAF value associated with PV was the highest (68.15%), followed by PMF (37.7%) and ET (23%). However, there were significant differences in the incidence of JAK2 V617F homozygous among 3 different diseases. In patients with JAK2 mutation, the proportion of other gene mutations in PV and ET was significantly lower than that in PMF. Conclusions: Under the condition of common driver gene mutations (JAK2, MPL and CALR), patients' age, VAF value and homozygous state, concomitant gene mutations are closely related to different disease type. These correlations help to improve clinical understanding of disease characteristics and risk assessment.


Assuntos
Calreticulina/genética , Proteínas de Fusão bcr-abl/genética , Janus Quinase 2/genética , Transtornos Mieloproliferativos/genética , Receptores de Trombopoetina/genética , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/genética , Calreticulina/metabolismo , Feminino , Proteínas de Fusão bcr-abl/metabolismo , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Janus Quinase 2/metabolismo , Masculino , Pessoa de Meia-Idade , Mutação , Transtornos Mieloproliferativos/sangue , Transtornos Mieloproliferativos/metabolismo , Policitemia Vera/genética , Mielofibrose Primária/genética , Receptores de Trombopoetina/metabolismo , Trombocitemia Essencial/genética
20.
Zhonghua Nei Ke Za Zhi ; 58(11): 803-807, 2019 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-31665854

RESUMO

Objective: To investigate the influence of additional clonal chromosome abnormalities in Ph negative cells (CCA/Ph(-)) on the efficacy of chronic myeloid leukemia (CML) after tyrosine kinase inhibitors (TKI) treatment. Methods: The clinical data of 28 CML patients with CCA/Ph(-) treated in Henan Cancer Hospital from July 2014 to December 2017 were analyzed retrospectively. The univariate analysis was carried out by Kaplan-Meier method. Multivariate analysis was done by Cox proportional risk model. Results: A total of 28 CCA/Ph(-)patients were recruited including 17 males and 11 females with median age of 42.5 years old. The most common CCA/Ph(-)were trisomy 8 (60.7%), monosomy 7 (14.3%). 64.3% CCA/Ph(-)were transient and 35.7% recurrent (more than 2 times). Cytopenia in two or three lineages of peripheral blood was seen in 42.9% patients. As to the efficacy, 89.3% patients achieved major cytogenetic response (MCyR), 25% with major molecular response (MMR). The median follow-up time was 26.5 months. Treatment failure (TF) of TKI occurred in 32.1% patients with median duration of response 8 (1-41) months. Univariate analysis showed that TF rate was significantly correlated with the frequency of CCA/Ph(-)and cytopenia (all P<0.05). The MMR rate was also significantly correlated with cytopenia (P<0.05). Cytopenia of two lineages or pancytopenia was an independent risk factor related to MMR rate (RR=3.868, 95%CI 1.216-12.298, P=0.022) . Conclusions: Cytopenia in CCA/Ph(-)appears to be an independent risk factor of MMR in CML patients with TKI treatment. The recurrent CCA/Ph(-)may link to higher treatment failure rate. Drug withdrawal or alternative strategy should be considered according to response and the ABL kinase mutations.


Assuntos
Aberrações Cromossômicas , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Inibidores de Proteínas Quinases/uso terapêutico , Adulto , Feminino , Humanos , Estimativa de Kaplan-Meier , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Mutação , Prognóstico , Estudos Retrospectivos , Falha de Tratamento
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