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May 2017, Volume 20, No.14 Abstracts

 QEEG Changes in Patients with Carotid Stenosis before and after the Carotid Artery Stenting  FU Yong1*,LI Xi-zhi2,LU Shu-jun2,GUO Yu-jie1,SHENG Yu-guo3
1.EEG Room,Department of Neurology,Binzhou Medical University Hospital,Binzhou 256603,China
2.Department of Neurology,Binzhou Medical University Hospital,Binzhou 256603,China
3.Department of Vascular and Interventional Radiology,Binzhou Medical University Hospital,Binzhou 256603,China
*Corresponding author:FU Yong,Attending physician,Main research in electrophysiological;E-mail:sd3723@126.com
    【Abstract】  Objective  To study the quantitative electroencephalogram(QEEG) power spectrum changes in patients with carotid stenosis before and after the carotid artery stenting(CAS) and explore its value for assessing the improvement in brain function in these patients after CAS.Methods  This retrospective study was conducted in 36 patients performed CAS in Binzhou Medical University Hospital from January 2014 to October 2015.Electroencephalogram(EEG) was performed in the patients before and after the procedure and the results were recorded.The relative power ratio of(δ﹢θ)/(α﹢β)(DTABR) at bilateral prefrontal electrodes(FP1,FP2),central electrodes(C3,C4),occipital electrodes(O1,O2) and temporal electrodes(T3,T4) in the patients after CAS were calculated and compared with those before the procedure.Results  Before the procedure,EEG results were normal in 9 cases,mild abnormalities in 15 cases,moderate abnormalities in 10 cases,and severe abnormalities in 2 cases;after the procedure,EEG results were normal in 12 cases,mild abnormalities in 17 cases,moderate abnormalities in 6 cases,and severe abnormalities in 1 case,which showed that the EEG results of the patients before and after the CAS had no significant differences(Z=-1.882,P=0.060).Compared with before the CAS,after the CAS,DTABR at bilateral occipital electrodes(O1,O2) did not change significantly(P>0.05),but the DTABR at bilateral prefrontal electrodes(FP1,FP2),central electrodes(C3,C4),and temporal electrodes(T3,T4) decreased substantially(P<0.05).Conclusion  QEEG changed a lot at the prefrontal areas after the CAS,which may be associated with the cerebral carotid artery blood flow distribution.So QEEG can be regarded as an effective index for evaluating the degree of improvement in brain function in patients with carotid stenosis after CAS.
    【Key words】  Carotid stenosis;Stents;Quantitative electroencephalogram;Relative power ratio
 
Effect Research of Empowerment Education Related with Food Intolerance on Ulcerative Colitis Patients  ZHANG Ying-ying1,ZHU Li-ying1,HU Fang2*,LI Kai-yu1,GAO Sen-yang1,LIU Gang1
1.Department of General Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China
2.Department of Nursing,Tianjin Medical University General Hospital,Tianjin 300052,China
*Corresponding author:HU Fang,Co-chief superintendent nurse;E-mail:hxc5286@sina.com
    【Abstract】  Objective  To investigate the intervention effect of empowerment education related with food intolerance on ulcerative colitis(UC)patients,and to provide basis for clinical supervision.Methods  89 UC patients who had been hospitalized in Tianjin Medical University General Hospital from September 2013 to August 2014 were selected.The patients were divided into experimental group(n=47)and control group(n=42)according to their willingness of accepting empowerment education.Experimental group received face-to-face empowerment education related with food intolerance,and control group received traditional health education of telephone follow-up,6-month sustained intervention was made biweekly.Enzyme-linked immunosorbent assay(ELISA)was applied to detect food intolerance conditions of patients;before intervention and six months after intervention,short form health survey(SF-36)was used to access patients′ quality of life;body mass index(BMI)and levels of serum total protein(TP),albumin(ALB),prealbumin(PA)and transferrin(TRF)were measured to evaluate patients′ nutritional status;the extent of disease activity of patients was accessed by using Southerland DAI scoring system.Results  The positive rate of food intolerance of UC patients was 67.4%(60/89).For patients in experimental group,14 were negative food intolerance,6 mild intolerance,1 moderate intolerance and 26 severe intolerance;while for patients in control group,the above four numbers were 15,4,1 and 22 respectively,the comparison of occurrence of food intolerance between two groups was not significantly different(Z=0.416,P=0.677).Before intervention,there was no significant difference between the two groups in SF-36 scores of every dimension(P>0.05);after intervention,scores of physical function,general health,social function,emotional function,mental health in experimental group were all higher than those in control group as well as in the same group before intervention(P<0.05).Before intervention,there were no significantly differences between the two groups in levels of BMI,TP,ALB,PA,and TRF(P>0.05);after intervention,ALB level in experimental group was higher than that in control group and the same group before intervention(P<0.05).Before intervention,there was no significantly difference between the two groups in the Southerland DAI score(t=0.219,P=0.827);after intervention,the Southerland DAI score in experimental group was lower than that in control group(t=2.726,P=0.008).Conclusion  The empowerment education related with food intolerance of UC patients can improve their quality of life,nutritional status and prognosis of the disease.
    【Key words】  Colitis,ulcerative;Food intolerance;Empowerment education;Disease activity extent
 
Optimal Starting Age for Xinjiang Uygur Women Undergoing Once-in-a-lifetime HPV DNA Test for Cervical Cancer Screening  KOU Fei,YAN Xiao-long,WEI Yu-jie,LIU Ming-zhu,JING Ming-xia*
Department of Preventive Medicine,Shihezi University School of Medicine,Shihezi 832002,China
*Corresponding author:JING Ming-xia,Professor;E-mail:mxjing@shzu.edu.cn
    【Abstract】  Background  The incidence and mortality rates of cervical cancer are higher in Xinjiang Uygur women compared with the national average.Furthermore,cervical cancer in Xinjiang Uygur women presents different characteristics with younger onset age compared with it in the Han women.It was found that some of the Uygur women only undergo the human papillomavirus(HPV) DNA test for screening cervical cancer once during the lifetime.Objective  To estimate the effects of regimens about once-in-a-lifetime HPV DNA test for cervical cancer screening with different starting ages in Xinjiang Uygur women,so as to predict the optimal age for these women undergoing the screening.Methods  We constructed a Markov model with a simulated cohort of 100 000 Xinjiang Uygur women based on the data obtained from field surveys and references between 2013 and 2016,in combination with basic principles to construct the Markov model,cervical cancer natural history and screening regimens.The parameters used in the Markov model were from the previous relative studies,and the cycle was determined as 1 year.By repeated cycle operations,the effects of using four regimens of once-in-a-lifetime HPV DNA test for cervical cancer screening which varied with different screening starting ages(30,35,40 and 45) were predicted and compared.Results  The number of cervical cancer cases were 967,1 005,1 027,1 044 and the number of deaths were 9,11,13,10 respectively in the starting age of 30,35,40 and 45 for cervical cancer screening.Compared with the natural population,the incidence and mortality rates of cervical cancer were all lower in women underwent the screening,specifically,the incidence rate of cervical cancer dropped by 70.66%,69.51%,68.84%,68.32%,respectively and the mortality rate of cervical cancer fell 70.00%,63.33%,56.67%,66.67%,respectively,in the females who started to screen cervical cancer at the age of 30,35,40 and 45.Sensitivity analysis found that the optimal starting age for screening the cervical cancer was 30 despite different parameters were taken as the sensitivity of HPV DNA test and coverage rate,and these proved that the model has good stability.Conclusion  Thirty is the optimal starting age for cervical cancer screening,which reduce the incidence and mortality rates of cervical cancer effectively.
    【Key words】  Uterine cervical neoplasms;Screening;Age;Markov chains;Uygur nationality
 
Natural YMDD Mutations in HBV/HIV Co-infected Patients  JIANG Zhong-sheng*,HU Jia-guang,WEN Xiao-feng,ZHANG Peng,MENG Da-li,LIU Zhi-juan,KE Liu,QIN Chuan
Department of Infectious Diseases,Liuzhou General Hospital,Liuzhou 545006,China
*Corresponding author:JIANG Zhong-sheng,Chief physician;E-mail:jiangzs1111@126.com
    【Abstract】  Objective   To investigate whether there are natural tyrosine-methionine-aspartate-aspartate(YMDD) mutations in patients with hepatitis B virus(HBV) and HIV co-infection before receiving the highly active antiretroviral therapy(HAART).Methods  The participants enrolled in this study were 80 patients with HIV and HBV co-infection treated in Department of Infectious Diseases,Guangxi Liuzhou General Hospital from June 2013 to June 2016.Direct sequencing was used to detect the status of YMDD in the HBV DNA polymerase gene in the serum of the patients before receiving the HAART.Results  No natural YMDD mutations were found in these patients.Conclusion  The natural YMDD mutations are not found in HBV and HIV co-infection patients before receiving the HAART by direct sequencing.But this result needs to be further confirmed by the method with higher sensitivity.
    【Key words】  Hepatitis B;HIV;YMDD mutation;Drug tolerance
 
Expression of Soluble Triggering Receptor Expressed on Myeloid Cell-1 in Spontaneous Bacterial Peritonitis  ZHANG Xiao-ping1*,ZHAO Hong-jun2,MA A-huo1,QIN Yue-hua1,SUN Ai-jing3,WANG Xiao-li1,WANG Xing-mu3
1.Department of Gastroenterology,Shaoxing People′s Hospital,Shaoxing 312000,China
2.Department of Neurology,Shaoxing People′s Hospital,Shaoxing 312000,China
3.Central Laboratory,Shaoxing People′s Hospital,Shaoxing 312000,China
*Corresponding author:ZHANG Xiao-ping,Associate chief physician;E-mail:1147262991@qq.com
    【Abstract】  Objective  To investigate the expression of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) in spontaneous bacterial peritonitis(SBP).Methods  The participants enrolled in this study were 23 cirrhotic patients with ascites and SBP(SBP group),and 66 cirrhotic patients with ascites but without SBP(non-SBP group),admitted in Department of Gastroenterology,Shaoxing People′s Hospital from June 2013 to December 2014.Based on the severity of SBP,patients in the SBP group were divided into mild SBP subgroup(14 cases) and severe SBP subgroup(9 cases).White blood cells(WBC) count,C-reactive protein (CRP),procalcitonin(PCT) and sTREM-1 in serum and exfoliated cells,polymorphonuclear leukocytes(PMN) count,lactate dehydrogenase(LDH) and sTREM-1 in ascitic fluid were measured in all the patients.Results  SBP group had higher WBC, CRP, PCT and sTREM-1 in serum and exfoliated cells, PMN count, LDH and sTREM-1 levels in ascitic fluid than non-SBP group did(P<0.05).Ascitic fluid bacterial culture results were negative in all the patients in non-SBP group,but positive in 56.5%(13/23) of the patients in SBP group.WBC,CRP,PCT and sTREM-1 in serum and exfoliated cells, PMN count, LDH and sTREM-1 levels in ascitic fluid did not differ significantly between mild SBP subgroup and severe SBP subgroup(P>0.05).Pearson rank correlation coefficient analysis found that,serum sTREM-1 level was positively correlated with ascitic fluid sTREM-1 level in SBP group(r=0.737,P<0.001) and non-SBP group(r=0.275,P=0.025).Conclusion  The sTREM-1 levels elevated in both the serum and ascites in cirrhotic patients with ascites and SBP,and they did not vary with the severity of SBP.Ascitic and serum sTREM-1 can be a reliable predictor for SBP.
    【Key words】  Peritonitis;Ascites;Soluble triggering receptors expressed by myeloid cell-1
 
Value of Alpha-enolase in the Diagnosis of Malignant Pleural Effusion  LI Ru-fang,LIU Ling,WANG Xu-ming,WU Jiang-hai,FENG Jia-gang,ZHAO Zhi-huan*
No.2 Department of Respiratory Medicine,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China
*Corresponding author:ZHAO Zhi-huan,Chief physician;E-mail:jczzh@sina.com
    【Abstract】  Objective  To study the clinical value of alpha-enolase in the diagnosis of malignant pleural effusion.Methods  Inpatients with pleural effusions were recruited from the Department of Respiratory Medicine and Department of Thoracic Surgery,First Affiliated Hospital of Kunming Medical University from September 2014 to September 2015.Enzyme-linked immunosorbent assay(ELISA) was used to detect the concentration of alpha-enolase in pleural effusions.Receiver operating characteristic(ROC) curve was adopted to evaluate the value of alpha-enolase in the diagnosis of malignant pleural effusion.Results  Of the 150 patients with pleural effusions,there were 50 patients with malignant pleural effusions(29 cases of lung adenocarcinoma,1 case of small cell lung cancer,20 cases of undifferentiated type of lung cancer),50 with exudative pleural effusions due to tuberculosis,and 50 with parapneumonic effusions.The concentrations of alpha-enolase in pleural effusions differed significantly among these 3 kinds of patients(P<0.05),specifically,they were higher in patients with malignant pleural effusions than in those with exudative pleural effusions due to tuberculosis or with parapneumonic effusions(P<0.05),but no significant differences in concentrations of alpha-enolase were found between patients with exudative pleural effusions due to tuberculosis and those with parapneumonic effusions(P>0.05).For diagnosing malignant pleural effusion,the area under the curve(AUC) of ROC of alpha-enolase was 0.866,the optimum cut-off point was 4.22 μg/L based on the maximum value of Youden′s index(0.74),the sensitivity and specificity at the optimum cut-off point was 88%,86%,respectively.Conclusion  The concentration of alpha-enolase in malignant pleural effusion is significantly higher than that in exudative pleural effusion due to tuberculosis and in parapneumonia pleural effusion.The high sensitivity and specificity of the alpha-enolase in the diagnosis of malignant pleural effusion indicates that it can act a new tumor marker for malignant pleural effusion.
    【Key words】  Pleural effusion,malignant;Phosphopyruvate hydratase;Sensitivity;Specificity
 
Negative Binomial Regression Model Analysis on the Relationship between Hepatitis E and Meteorological Factors in Changsha  XIE Zhi*,LIU Ru-chun,CHEN Tian-mu,ZHANG Heng,HU Wei-hong
Changsha Center for Disease Control and Prevention,Changsha 410000,China
*Corresponding author:XIE Zhi,Attending physician;E-mail:9267692@qq.com
    【Abstract】  Objective  To explore the relationship between hepatitis E and meteorological factors.Methods  The monthly reported cases of hepatitis E and meteorological data in Changsha from 2004 to 2015 were collected.Through the comparison of discrete test and model fitting effect indicators,advantages and disadvantages of Poisson regression model and negative binomial regression model were evaluated.The optimal model was selected to analyze the meteorological factors of the incidence of hepatitis E.Results  From 2004 to 2015,there were 1 355 cases reported with hepatitis E in Changsha.The annual incidence was (0.21-2.77) per 100 000 people.There were sporadic cases in each month,but most occurred between February and May.According to the results of correlation analysis of meteorological data,monthly total precipitation,monthly average air pressure,monthly average wind speed,monthly average temperature,monthly average relative humidity,monthly days of raining and monthly sunshine hours were enrolled into the model.The indicators of discrete test and model fitting effect showed that the effect of negative binomial regression model was better than that of Poisson regression model.Negative binomial regression model analysis showed that monthly average temperature 〔b=-0.024,95%CI (-0.036,-0.013)〕,monthly days of raining 〔b=0.047,95%CI(0.032,0.062)〕,monthly sunshine hours 〔b = 0.003,95%CI (0.001,0.005)〕 were influence factors of hepatitis E in Changsha (P<0.05).Conclusion  Lowered average temperature,more rainy days and longer sunshine hours are the meteorological factors of increased number of cases with hepatitis E.
    【Key words】  Hepatitis E;Weather and invasion;Binomial distribution;Root cause analysis
 
1Effect of Sericin on Apoptosis Related Factors in Streptozotocin-induced INS-1 Cells  WANG Xiao-jie1,LIU Mei-xiao1,XIE Yun-peng2,MAO Xiao-xia3,SUN Yi-chan1,CHEN Zhi-hong4*
1.Institute of Basic Medical Sciences,Chengde Medical University,Chengde 067000,China
2.Department of Neurosurgery,Affiliated Hospital of Chengde Medical University,Chengde 067000,China
3.Institute of Traditional Chinese Medicine,Chengde Medical University,Chengde 067000,China
4.Department of Human Anatomy,Chengde Medical University,Chengde 067000,China
*Corresponding author:CHEN Zhi-hong,Professor;E-mail:czh1971@163.com
    【Abstract】  Objective   To investigate the effect of sericin on apoptosis related factors Bcl-2 and Bax in Streptozotocin(STZ)-induced INS-1 cells.Methods  This study was conducted from June 2015 to March 2016.INS-1 cells were divided into normal group(without any treatment),STZ group(STZ addition) and sericin group(STZ and sericin treatment).The survival rate of INS-1 cells was measured with CCK-8 assay.Apoptosis rate of INS-1 cells was detected with flow cytometry.The expression of apoptosis related factors Bcl-2 and Bax mRNA and protein were determined by RT-PCR and Western blotting,respectively.Results  Compared with the STZ group,both the normal group and the sericin group had higher survival rate of INS-1 cells(P<0.05).Flow cytometry assay found that,both the normal group and sericin group had lower apoptosis rate of INS-1 cells than STZ group did(P<0.05).Compared with the normal group,the STZ group had lower expressions of Bcl-2 mRNA and protein,Bcl-2 mRNA/Bax mRNA and Bcl-2/Bax(P<0.05),but higher expressions of Bax mRNA and protein in INS-1 cells(P<0.05).Higher expressions of Bcl-2 mRNA and protein,Bcl-2 mRNA/Bax mRNA and Bcl-2/Bax and lower expressions of Bax mRNA and protein in INS-1 cells were observed in the sericin group compared with the STZ group(P<0.05).Conclusion  Sericin could inhibit the apoptosis of STZ-induced INS-1 cells,and increase the Bcl-2/Bax ratio.
    【Key words】  Sericins;Streptozocin;Apoptosis inducing factor;Genes,Bcl-2;Bcl-2-associated X protein
 
Effect of Anoxia on Expression of Vascular Endothelial Growth Factor and CD34 in Hepatic Alveolar Echinococcosis Protoscolex  ZHANG Huai,ZHANG Shi-jie*,CHEN Qian,WANG Yan,SU Zheng-ming,WU Xiang-wei,SUN Hong
The First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi 832000,China
*Corresponding author:ZHANG Shi-jie,Professor,Main research directions:hepatobiliary surgery;E-mail:zhangshijiewk1@sina.com
    【Abstract】  Objective   To investigate the expression level of vascular endothelial growth factor(VEGF) and CD34 in the hepatic alveolar echinococcosis protoscolex under the condition of vitro anoxia.Methods  From April to October in 2016,the 30 cases gerbils of abdominal infection with hepatic alveolar echinococcosis for 18 weeks were selected for experiment,and were sacrificed by cervical dislocation.The smooth clusters of hepatic alveolar echinococcosis tissues isolated in abdominal cavity or tissues adhere to the abdominal wall,mesentery,liver surface were selected.The hepatic alveolar echinococcosis protoscolex was cultured to divide into control group and experiment group(RPMI 1640 medium containing 100 μmol/L cobalt chloride).The hepatic alveolar echinococcosis protoscolex activity was observed by inverted microscope at the beginning,and the 6th,12th,18th,24th hour of the culture process.At the 12th and 24th hour of the culture process,enzyme-linked immunosorbent assay(ELISA) was used to detect the expression level of hypoxia-inducible factor 1 alpha(HIF-1α),VEGF and CD34 in hepatic alveolar echinococcosis protoscolex.Western blotting method was applied to detect the expression of VEGF and CD34.Results  The echinococcosis protoscolex activity at the 0th,6th,12th,18th,24th hour of the culture process was not significantly different between control group and experiment group(P>0.05).Compared with the control group,the expression level of HIF-1α,VEGF,CD34 were significantly increased at the 12th and 24th hour of the culture process in the experiment group(P<0.05).Conclusion  Hypoxia can increase the expression level of VEGF and CD34 in echinococcosis protoscolex,and this may be one of the important mechanisms of invasive growth presented by hepatic alveolar echinococcosis.
    【Key words】  Echinococcosis,hepatic;Anoxia;Vascular endothelial growth factors;CD34
 
11Mechanism of SU11274 Reversing the Resistance to Erlotinib Induced by Hepatocyte Growth Factor in Non-small Cell Lung Cancer Cells  YAN Chun-hua,WU Ye-dan,AN Chang-shan*
Department of Respiratory Medicine,Affiliated Hospital of Yanbian University,Yanji 133000,China
*Corresponding author:AN Chang-shan,Chief physician,Professor;E-mail:cs_an2003@aliyun.com
    【Abstract】  Background  Hepatocyte growth factor(HGF) can induce non-small cell lung cancer(NSCLC) cells exerting resistance to epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)in vitro,suggesting that HGF induced c-Met phosphorylation may be associated with the mechanism of erlotinib resistance in sensitive NSCLC.Objective  The study aimed to demonstrate that c-Met inhibitor SU11274 can reverse the erlotinib resistance induced by HGF in sensitive NSCLC cells in nude mice.Methods  This study was conducted from March 2014 to January 2015.Two cell lines including H292 and human embryonic fibroblast MRC-5 were chosen.The HGF produced by MRC-5 cells in cell culture supernatants was quantitated by enzyme-linked immunosorbent assay(ELISA).The proliferation of H292 cells was measured by using MTT assay and the expressions of c-Met and its downstream signaling proteins were examined by Western blotting.We selected forty-nine 6-week old nude mice and equally divided them into 7 groups,group C(control group),group H,group HS,group HD,group E,group HE,group HES,treated with H292 cell suspension,HGF,HGF+SU11274,HGF+1% DMSO,erlotinib,HGF+erlotinib,HGF+erlotinib+SU11274,respectively.The tumor growth was observed and the growth curve was drawn.The tumor weight was recorded.The expressions of c-Met and downstream signaling proteins in tumor tissues were determined via immunohistochemistry.Results  ELISA assay found that the HGF level in the culture supernatant of MRC-5 cells was(1 262±90) pg/ml.MTT assay showed that in the mixture of H292 and MRC-5 cells culture supernatant with erlotinib concentration of IC50,the proliferation of H292 cells was 97.07%.The expressions of p-Met,p-STAT3,p-AKT and p-ERK1/2 in the culture supernatant of H292 with MRC-5 cells were higher than those in the H292 cell culture supernatant(P<0.05).Intervention method and duration exerted significant interaction effects on the tumor volume(P<0.001).Intervention method produced main effect on the tumor volume(P<0.001).Intervention duration had main effect on the tumor volume(P<0.001).The tumor volume was smaller in HES group than in HE group measured on the 7th,11th,14th,18th,21st and 25th days of intervention(P<0.05).The tumor mass differed significantly between the groups(F=39.120,P<0.001).HES group had less tumor mass than HE group did(P<0.05).Significant differences in the expressions of c-Met,p-Met,p-STAT3,p-AKT and p-ERK1/2 were found between the groups(P<0.05).The expressions of c-Met,p-Met,and p-STAT3 proteins were lower in HES group than those in HE group(P<0.05).Conclusion  HGF secreted by MRC-5 induces erlotinib resistance in H292 cells in nude mice.c-Met inhibitor SU11274 reverses the resistance of HGF-induced sensitive NSCLC cells to erlotinib in vivo.The mechanism may be related to the inhibition of HGF-induced activation of c-Met and its signaling pathway proteins.
    【Key words】   Carcinoma,non-small-cell lung;Hepatocyte growth factor;Proto-oncogene proteins c-Met;SU11274;Erlotinib
 
Effect of Unpaid Blood Donation on Health-related Quality of Life  ZHANG Xiao-mei1,ZHU Yan-bo1*,WANG Hong-jie2,ZHANG Wei-dong2,YU Xiao-han3,SHI Hui-mei3,YAO Yuan1,LU Jia1,SUO Yan-feng1,YAN Hui1,LI Tong1,LI Yan-ni1
1.College of Management,Beijing University of Chinese Medicine,Beijing 100029,China
2.Beijing Red Cross Blood Center,Beijing 100088,China
3.College of Basic Medicine,Beijing University of Chinese Medicine,Beijing 100029,China
*Corresponding author:ZHU Yan-bo,Professor,Doctoral supervisor;E-mail:yanbo0722@sina.com
    【Abstract】  Objective   To investigate the health-related quality of life(HRQoL) of unpaid blood donors and to explore its influencing factors.Methods  From July to November 2015,voluntary blood donors and their companions(non-blood donors) in the blood donation house and blood collecting vehicle of Beijing Red Cross Blood Center were investigated.The blood donation volunteers were entrusted to distribute questionnaires and to assist in the investigation.The electronic questionnaires were released on the professional survey website to investigate the personal information,living habits,blood donation information.The 36-item Short-Form Health Survey Questionnaire(SF-36) was used to survey their HRQoL.Results  A total of 749 questionnaires were sent out,725 were recovered,662 were effective with an effective response rate of 88.38%.There was significant difference in the score of physiological function(PF),role physical(RP),bodily pain(BP),general health status(GH),physical component summary(PCS),vitality(VT),social function(SF),mental health(MH),psychological component summary(MCS) among people of different blood donating times(P<0.05);the scores of PF,RP,BP,GH,PCS,VT,SF and MCS among people with a donation of 1 to 4 times,5 to 9 times,and ≥ 10 times were higher than those of non-blood donors;the score of SF among people with a donation of 5 to 9 times was higher than those of people with a donation of 1 to 4 times;the scores of GH,PCS,VT,SF,MH and MCS among people with a donation ≥ 10 times were higher than those of people with a donation of 1 to 4 times,and their scores of MH and MCS were higher than those of people with a donation of 5 to 9 times(P<0.05).Multivariate linear regression analysis showed that the times of blood donation was the influencing factor of PF and RP scores(P<0.05).The times of blood donation,educational level and BMI were the influencing factors of BP,PCS,and SF score(P<0.05).The times of blood donation,educational level,exercise habit,sleeping time and BMI were the influencing factors of GH score(P<0.05).The times of blood donation,exercise habit and BMI were the influencing factors of VT score(P<0.05).The times of blood donation,educational level,drinking habits,exercise habits,and BMI were the influencing factors of MH and MCS score(P<0.05).Conclusion  The HRQoL of unpaid blood donors is better than that of the non-blood donors.Many blood donation acts are closely related to high HRQoL.At the same time,HRQoL of unpaid blood donors will also be affected by factors such as behaviors and lifestyles.
    【Key words】   Health-related quality of life;Unpaid blood donation;Root cause analysis
 
Initial Development and Evaluation of Reliability and Validity of Cognition of Unpaid Blood Donation Questionnaire  ZHU Yan-bo1*,LU Jia1,ZHANG Xiao-mei1,SHI Hui-mei2,YU Xiao-han2
1.School of Management,Beijing University of Chinese Medicine,Beijing 100029,China
2.School of Basic Medicine,Beijing University of Chinese Medicine,Beijing 100029,China
*Corresponding author:ZHU Yan-bo,Professor,Doctoral supervisor;E-mail:yanbo0722@sina.com
    【Abstract】  Objective   To develop the cognition of unpaid blood donation questionnaire and assess its reliability and validity.Methods  From July to November 2015,unpaid blood donors and non-donors accompanied them,and voluntary blood donors in the blood donation huts and blood collecting vehicles of Beijing Red Cross Blood Center were selected by convenient sampling method,and conducted with field investigation and internet survey.Based on Maslow′s hierarchy of needs theory,the cognition of blood donation questionnaire(beta version) was designed.The different behaviors of blood donation were tested by the questionnaire,and the items were screened,and the performance of the questionnaire formed by reserved items was further evaluated.Results  A total of 749 questionnaires were sent out,725 were collected,and 662 valid questionnaires were obtained.The effective response rate was 88.38%.The questionnaire included 21 items.Seven items were deleted after item analysis,and the cognition of unpaid blood donation questionnaire of 14 items was finally made.Three common factors were extracted by exploratory factor analysis,and 60.24% of the total variation was explained.According to the content of each item,factor 1 was named "positive cognition of blood donation"(including 7 items),factor 2 named "negative cognition of blood donation "(including 5 items),factor 3 named "knowledge of blood donation"(including 2 items).Among the 662 subjects,155(23.41%) had not donated blood,292(44.11%) had a donation of 1 to 4 times,101(15.26%) had a donation of 5 to 9 times,114(17.22%) had a donation of 10 times or more.There were significant differences in the scores of positive cognition of blood donation,negative cognition of blood donation and knowledge of blood donation,and total scores among blood donors of different donating times(P<0.001).The overall Cronbach′s α coefficient was 0.872,and the overall Cronbach′s α coefficient of positive cognition of blood donation,negative cognition of blood donation and knowledge of blood donation was 0.850,0.765,and 0.924 respectively.Conclusion  With scientific and standardized designing and development,the questionnaire has good reliability and validity,and can be used as a tool for the evaluation of the cognition status of blood donation.
    【Key words】  Unpaid blood donation;Cognition;Questionnaire development;Reliability;Validity
 
Mediating Effect of Unpaid Blood Donation Cognition between Unpaid Blood Donation and Health  LI Tong1,ZHU Yan-bo1*,LI Yan-ni1,YAN Hui1,YU Xiao-han2,SHI Hui-mei2,YAO Yuan1,WANG Hong-jie3,ZHANG Wei-dong3,GUO Xue-zhi4,WANG Le-rong1,SHI Mu-ran1,LU Jia1,SUO Yan-feng1
1.School of Management,Beijing University of Chinese Medicine,Beijing 100029,China
2.School of Basic Medical Sciences,Beijing University of Chinese Medicine,Beijing 100029,China
3.Beijing Red Cross Blood Center,Beijing 100088,China
4.Health Management and Promotion Committee,CIATCM,Beijing 100102,China
*Corresponding author:ZHU Yan-bo,Professor,Doctoral supervisor;E-mail:yanbo0722@sina.com
    【Abstract】  Objective  To test the mediating effect of unpaid blood donation cognition between unpaid blood donation and health.Methods  Field and online questionnaire surveys were used in this study.The participants were unpaid blood donors and some of their companions without donating blood.The field questionnaire survey was carried out in Beijing Red Cross Blood Center′s blood collecting sheds and vehicles,and online questionnaire survey was implemented on professional survey websites from May to September 2016.Printed and electronic Unpaid Blood Donation Cognition Questionnaire and Chinese version of 36-item Short Form Heath Survey Questionnaire (SF-36) were respectively used in the field and online survey for assessing the unpaid blood donation cognition and status of health.Times of unpaid blood donation was used to group the participants.Hierarchical linear regression was adopted to explore the mediating effect of unpaid blood donation cognition between unpaid blood donation and health.Results  A total of 1 093 participants received the surveys,94.33% of them (1 031/1 093) returning responsive questionnaires were selected as the final participants.Fifteen point zero four percent(155/1 031) of them had not donated blood,39.96%(412/1 031) had donated blood unpaidly 1-4 times,21.82%(225/1 031) had done that 5-9 times,and 23.18%(239/1 031) had done that ≥10 times.Among the participants,unpaid blood donation cognition,PCS and MCS scores differed significantly among those who had donated blood unpaidly(P<0.001);participants who had donated blood unpaidly had higher unpaid blood donation cognition,PCS and MCS scores than those who had not;participants who had donated blood unpaidly 5 times or over had higher unpaid blood donation cognition,PCS and MCS scores than those who had done that 1-4 times;participants who had donated blood unpaidly ≥10 times had higher unpaid blood donation cognition scores than those who had done that 5-9 times(P<0.05).Unpaid blood donation was positively correlated with PCS(rs=0.285,P<0.05),MCS(rs=0.288,P<0.05) and unpaid blood donation cognition(rs=0.344,P<0.05).Unpaid blood donation cognition was positively associated with PCS(r=0.233,P<0.05) and MCS(r=0.253,P<0.05).Unpaid blood donation cognition played the role as an intermediary in part between unpaid blood donation and PCS,and between unpaid blood donation and MCS,accounting for 23.78% and 32.43% of the total mediating effect,respectively.Conclusion  Unpaid blood donation cognition exerts partial mediating effect between unpaid blood donation and health,accounting for about 1/3 of the total effect.
    【Key words】  Unpaid blood donation;Quality of life;Mediating effect
 
Traditional Chinese Medicine Constitution of Unpaid Blood Donation Population  SHI Hui-mei1,ZHU Yan-bo2*,ZHANG Xiao-mei2,WANG Hong-jie3,ZHANG Wei-dong3,YU Xiao-han1,LU Jia2,SUO Yan-feng2,LI Tong2,LI Yan-ni2,YAN Hui2,WANG Le-rong2,SHI Mu-ran2
1.School of Basic Medical Science,Beijing University of Chinese Medicine,Beijing 100029,China
2.School of Management,Beijing University of Chinese Medicine,Beijing 100029,China
3.Beijing Red Cross Blood Center,Beijing 100088,China
*Corresponding author:ZHU Yan-bo,Professor,Doctoral supervisor;E-mail:yanbo0722@sina.com
    【Abstract】  Objective   To explore the effect of unpaid blood donation on traditional Chinese medicine(TCM) constitution.Methods  The unpaid blood donors and their companions in the blood donation house and vehicle of Beijing Red Cross Blood Center from July to November 2015 were selected by convenient sampling method.Their general information and blood donation information were investigated,and the Constitution in Chinese Medicine Questionnaire was used to investigate their constitution of Chinese medicine.Results  A total of 749 questionnaires were sent out,725 were acquired and 681 were valid.The effective response rate was 90.92%.There were 167 non-blood donors,and 514 blood donors,of which 296 had a blood donation of 1 to 4 times,102 had a blood donation of 5 to 9 times,and 116 had a blood donation ≥10 times.There were significant differences in the scores of gentleness constitution,and qi-deficiency constitution,yang-deficiency constitution,blood-stasis constitution,and qi-depression constitution among blood donors of different donating times(P<0.05);the scores of qi-deficiency constitution among blood donors with a donation of 1 to 4 times was lower than that of non-blood donors;the scores of gentleness constitution among blood donors with a donation of 5 to 9 times and ≥10 times was higher than that of non-blood donors,while their scores of qi-deficiency constitution and yang-deficiency constitution were lower than that of non-blood donors;the scores of blood-stasis constitution,qi-depression constitution of blood donors with a donation ≥10 times were lower than that of non-blood donors and the blood donors with a donation of 1 to 4 times(P<0.05).The scores of qi-depression constitution were significantly different in males of different donating times,and among them,the scores of qi-depression constitution of blood donors with a donation ≥10 times was lower than that of non-blood donors(P<0.05).There were significant differences in the scores of gentleness constitution,qi-deficiency constitution,yang-deficiency constitution,phlegm-dampness constitution,dampness-heat constitution,blood-stasis constitution,and qi-depression constitution among females of different donating times(P<0.05);among them,the scores of gentleness constitution of blood donors with a donation of 5 to 9 times was higher than that of non-blood donors and blood donors with a donation of 1 to 4 times,their scores of qi-deficiency constitution,yang-deficiency constitution,dampness-heat constitution,and blood-stasis constitution were all lower than those of non-blood donors and blood donors with a donation of 1 to 4 times,and their scores of qi-depression constitution was lower than that of non-blood donors(P<0.05).The score of gentleness constitution of blood donors with a donation ≥10 times was higher than that of non-blood donors,their scores of qi-deficiency constitution,yang-deficiency constitution,phlegm-dampness constitution,dampness-heat constitution,and qi-depression constitution were lower than that of non-blood donors,and their scores of phlegm-dampness constitution and qi-depression constitution were lower than that of blood donors with a donation of 1 to 4 times(P<0.05).Conclusion  The constitution status of blood donors is better than that of non-blood donors,and the more donating times they have,the better constitution they are in.Especially the donors who donated more times.In addition,with an increasing number of blood donation,the constitution of females will be better than that of the males.
    【Key words】   Unpaid blood donation;Constitution in Chinese medicine questionnaire;Gentleness constitution;Qi-deficiency constitution
 
Effect of Cholinesterase Inhibitorson on  Cognition of Patients with Mild to Moderate Alzheimer′s Disease:a Meta-analysis  NIU Qian1,2,WANG Lei2,CAO Kai1,SHAO Shuang1,GUO Xiu-hua1*
1.School of Public Health,Capital Medical University,Beijing 100069,China
2.Beixiaguan Community Health Services Center,Beijing 100081,China
*Corresponding author:GUO Xiu-hua,Professor;E-mail:guoxiuh@ccmu.edu.cn
    【Abstract】  Objective  To discuss the effect of cholinesterase inhibitors(donepezil,galanthamine,huperzine A,rivastigmine) on the treatment of patients with mild to moderate Alzheimer′s Disease(AD).Methods  From January 1994 to March 2016,PubMed,EMBase,Cochrane Library,Web of Science,CNKI,Wanfang Data Knowledge Service Platform,VIP Network,and China Biomedical Network was searched by computer retrieval to enroll randomized,double-blind,placebo-controlled trials of cholinesterase inhibitors treating patients with mild to moderate AD.Data extraction and quality evaluation were conducted to the included literatures.The data including the first author,the time of publication,medicine,one-day dose,gender,age,the time of observation,the baseline MMSE and the outcome indicators were extracted.RevMan 5.3 software was used to analyze the effect of donepezil,galanthamine,huperzine A,and rivastigmine on improving the scores of Alzheimer′s Disease Assessment Scale-cognitive Subscale(ADAS-cog) and mini-mental state examination(MMSE) among patients with AD.Results  We enrolled 30 literatures totally,of which 15 on donepezil,7 on galanthamine,4 on huperzine A and 4 on rivastigmine.Meta-analysis showed that the ADAS-cog scores of the group of 5 mg donepezil,group of 10 mg donepezil,group of 24 mg galanthamine,group of 32 mg galantamine and group of 12 mg rivastigmine were lower than those of the placebo group〔WMD=-2.13,95%CI(-2.69,-1.57),P<0.001;WMD=-2.03,95%CI(-2.80,-1.25),P<0.001;WMD=-3.05,95%CI(-3.54,-2.55),P<0.001;WMD=-2.64,95%CI(-3.55,-1.73),P<0.001;WMD=-2.17,95%CI(-3.30,-1.04),P<0.001〕.There was no significant difference in the ADAS-cog score between group of 400 μg huperzine A and the placebo group 〔WMD=-2.95,95%CI(-8.19,2.29),P=0.270〕.The MMSE scores of the group of 5 mg donepezil,group of 10 mg donepezil,group of 400 μg huperzine A and group of 12 mg rivastigmine were higher than those of the placebo group〔WMD=1.07,95%CI(0.55,1.59),P<0.001;WMD=1.20,95%CI(0.91,1.50),P<0.001;WMD=2.47,95%CI(1.15,3.78),P<0.001;WMD=1.23,95%CI(0.35,2.11),P=0.006〕.Begg rank correlation test and Egger linear regression test showed that P value of the literatures included in ADAS-cog scale was 0.511 and 0.755 respectively;P value of the literatures included in MMSE scale was 0.441 and 0.212 respectively.No publication bias was observed.Conclusion  Except for huperzine A,other cholinesterase inhibitors have significant effect on the treatment of cognitive decline among patients with mild to moderate AD.The treatment effect of huperzine A needs to be further demonstrated by including high quality literatures.
    【Key words】   Alzheimer disease;Cholinesterase inhibitors;Meta-analysis
 
Tripterygium Glycosides Combined with Glucocorticoid for Primary Nephrotic Syndrome in Adults:a Meta-analysis  ZHANG Yang-yang,ZENG Shu-fei,YAN Bing,CHEN De-zhen,LIU Fan-na,YIN Liang-hong*
The First Affiliated Hospital of Jinan University,Guangzhou 510632,China
*Corresponding author:YIN Liang-hong,Professor,Chief physician,Doctoral supervisor;E-mail:13725251458@126.com
    【Abstract】  Objective   To systematically evaluate the efficacy and safety of Tripterygium glycosides combined with glucocorticoid in the treatment of primary nephrotic syndrome(PNS) in adults.Methods  We did a review of the studies about randomized controlled trials of Tripterygium glycosides combined with glucocorticoid versus full dose of glucocorticoid alone for PNS in adults as of March 2016 from CBM,CNKI,VIP,Wanfang data,Cochrane Library,PubMed and SCI and paper periodicals(traditional Chinese medicine,integrated traditional Chinese and western medicine and kidney disease).Meta-analysis of the overall response rate(ORR) and incidence of adverse reactions was performed by using stata 12.0.Results  A total of 18 articles with 1 236 patients(620 in the control group and 616 in the experimental group) in all were included.Meta-analysis showed that compared with control group,experimental group had higher ORR〔RR=1.21,95%CI(1.11,1.32),P<0.001〕,and lower incidence of adverse reactions〔RR=0.51,95%CI(0.37,0.70),P<0.001〕.Subgroup analysis demonstrated that,the ORR of Tripterygium glycosides combined with medium dose of glucocorticoid was higher than that of full dose of glucocorticoid alone〔RR=1.11,95%CI(1.02,1.20),P=0.015〕,and the ORR of Tripterygium glycosides combined with full dose of glucocorticoid was higher than that of full dose of glucocorticoid alone〔RR=1.31,95%CI(1.22,1.41),P<0.001〕.Asymmetric funnel plot of the ORR demonstrated publication bias.Conclusion  For PNS in adults,Tripterygium glycosides combined with glucocorticoid is a promising treatment for it has higher efficacy and lower incidence of adverse reactions than full dose of glucocorticoid alone.However,this needs to be further confirmed by more high-quality studies since the methodological quality of the included articles in this study is not high.
    【Key words】  Nephrotic syndrome;Tripterygium wilfordii;glucocorticoid;Meta-analysis
 
Influence of Burnout on the Quality of Life of Patients with Acute Coronary Syndrome  YU Xiao-ju1,SHI Yun-ke1,ZHANG Min1*,YANG Yan-fei2,LIU Ling1,GUO Tao1,XIAO Jian-ming1
1.Department of Cardiology,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China
2.Department of Cardiology,Kunming Children′s Hospital,Kunming 650034,China
*Corresponding author:ZHANG Min,Chief physician;E-mail:minniech2003@21cn.com
    【Abstract】  Background  Previous study have found that burnout can lead to poor physical recovery of patients with acute coronary syndrome(ACS) in the process of rehabilitation,but it is still not clear whether it will cause a decline in the quality of life of patients with ACS in the process of rehabilitation.Objective  To observe the influence of burnout on the quality of life of patients with ACS in the process of rehabilitation.Methods  The patients with first ACS in the Department of Cardiology,the First Affiliated Hospital of Kunming Medical University from January 2014 to February 2015 were selected,and their general information and clinical data were collected.On the day of discharge,patients were assigned into high burnout group and low burnout group according to their burnout degree by the General Burnout Subscale of Copenhagen Burnout Inventory.Regular follow-up was carried out on the day of discharge,and 1 month,half a year and a year after discharge.The quality of life of patients was assessed by 8-item short-form generic health-related quality-of-life questionnaire(SF-8) and Seattle Angina Questionnaire(SAQ),and generalized estimation equations were constructed to analyze whether the repeated measured quality of life in the high burnout group and low burnout group were different.Results  Ninety-one subjects were enrolled in this study,42 in the high burnout group and 49 in the low burnout group.After adjustment of confounding factors such as gender,age and cultural degree,physical health score and mental health score of high burnout group were lower than those of low burnout group(Z=-3.21,-2.07,P<0.05);the score of physical limited degree(PL),anginal stability(AS),attack frequency angina(AF),treatment satisfaction(TS),and degree of illness perceptions(DP) in high burnout group was lower than those of low burnout group(Z=-5.23,-3.55,-3.76,-4.09,-4.92,P<0.05).Conclusion  Burnout will lead to a decline in the quality of life of patients with ACS during rehabilitation.
    【Key words】   Coronary artery disease;Acute coronary syndrome;Fatigue;Quality of life
 
Influence of Facial Attractiveness on the Fair Distribution in Preschool Children  JIN Peng1,2,SHI Jian-nong1,3,ZHANG Zhen1*
1.Key Laboratory of Behavioral Science,Institute of Psychology,CAS,Beijing 100101,China
2.University of Chinese Academy of Sciences,Beijing 100191,China
3.Department of Learning and Philosophy,Aalborg University,Aalborg 9220,Denmark
*Corresponding author:ZHANG Zhen,Assistant researcher;E-mail:zhangzhen@psych.ac.cn
    【Abstract】  Objective   To investigate the effect of facial attractiveness on the fair distribution in preschool children.Methods  From June to July 2013,40 4-year-old children and 40 6-year-old children were randomly selected from a kindergarten in Beijing for a third-party distribution task.Children saw different photograph pairs in each task,one was high facial attractiveness,the other was low facial attractiveness.Then the children were assigned to allocate 1,2,3 tokens to the high and low facial attractiveness recipients.Each number were allocated twice.Participants completed 6 test trials.Repeated measures ANOVA was used to analyze the number of tokens allocated to the high and low facial attractiveness recipients by the children.Results  Repeated measures ANOVA found that facial attractiveness and age exerted significant interaction effect on the distribution of the children〔F(1,76)=15.55,P<0.05〕.Simple effect analysis demonstrated that,both recipients with high and low facial attractiveness received similar amount of tokens distributed by 4-year-old children(F=1.93,P=0.43),while 6-year-old children preferred to allocate tokens to high facial attractiveness recipients(F=27.84,P<0.01).When allocating 1 token,facial attractiveness had significant main effect on the distribution of the children〔F(1,76)=5.85,P<0.05〕.As for the allocation of 2 tokens,facial attractiveness and age produced obvious interaction effect on the distribution of the children〔F(1,76)=11.63,P<0.05〕;simple effect analysis found that 4-year-old children distributed similar amount of tokens to both the recipients with high and low facial attractiveness(F=0.27,P=0.60),whereas 6-year-old children inclined to distribute tokens to the recipients with high facial attractiveness(F=28.56,P<0.01).With regard to distributing 3 tokens,facial attractiveness and age made significant interaction effect on the distribution of the children〔F(1,76)=7.04,P<0.05〕;simple effect analysis showed that 4-year-old children distributed similar amount of tokens to both the recipients with high and low facial attractiveness(F=0.03,P=0.86),but 6-year-old children tended to distribute tokens to the recipients with high facial attractiveness(F=15.41,P<0.01).Conclusion  The attractiveness of the recipient′s face may affect the fair distribution of preschool children.And with the increasing of the age,children have more preference for the high facial attractiveness recipients.
    【Key words】   Resource allocation;Child,preschool;Facial attractiveness;Fairness
 
Predictive Value of Different Scoring Systems for Risk Stratification in Patients with Acute Non-variceal Upper Gastrointestinal Bleeding  CAO Xin1,SHOU Song-tao1*,ZHAO Zhen2,WANG Li-jun1
1.Tianjin Medical University General Hospital,Tianjin 300070,China
2.Beijing Charity Hospital,China Rehabilitation Research Center,Beijing 100068,China
*Corresponding author:SHOU Song-tao,Chief physician;E-mail:stshou66@sina.com
    【Abstract】  Background  Acute non-variceal upper gastrointestinal bleeding(ANVUGIB) in adults is a common clinical emergency characterized by acute onset,fast-changing conditions,and threatening life when it is serious.How to quickly and accurately assess the condition,rapid diagnosis,and develop a reasonable treatment regimen is the key to improving the prognosis of ANVUGIB patients by effectively utilizing existing medical resources.Objective  To compare the accuracy of Glasgow-Blatchford bleeding score(GBS),AIMS65 and Rockall scoring systems for the risk prediction of outcome in ANVUGIB patients.Methods  We conducted the risk stratification of 246 patients with ANVUGIB admitted in Department of Emergency,Tianjin Medical University General Hospital from 2013 to 2015 by using GBS,AIMS65,Rockall scoring systems,respectively based on analyzing the baseline characteristics of the patients.We compared the sensitivity,specificity,positive predictive value,negative predictive value and area under the curve(AUC) of the receiver operating characteristic(ROC) of these 3 scoring systems in the prediction of the probability of needing interventions,rebleeding and death.Results  Of the 246 patients,95(38.6%) received interventions,15(6.1%) had rebleeding,and 4(1.6%) died.When the patients had GBS <2 points,no one needed interventions,had rebleeding and died;when the patients had AIMS65 score <2 points,19 patients needed interventions,1 had rebleeding and 2 died;but when the patients had Rockall score <2 points,6 needed interventions,1 had rebreeding and no one died.When the GBS,AIMS65 score and Rockall score of the patients were all ≤2 points,in terms of predicting the probability of needing interventions in the ANVUGIB patients,the sensitivity of GBS,AIMS65 and Rockall scoring systems were 100.0%,80.0%,93.7%,respectively,the specificity of them were 26.5%,45.7%,15.9%,respectively,positive predictive value of them were 46.1%,48.1%,and 41.2%,respectively,negative predictive value of them were 100.0%,78.4%,80.0%,respectively,AUC of them were 0.675〔95%CI(0.580,0.679)〕,0.643〔95%CI(0.545,0.741)〕,0.653〔95%CI(0.553,0.752)〕,respectively;in regard to predicting the probability of rebleeding in the ANVUGIB patients,the sensitivity of GBS,AIMS65 and Rockall scoring systems were 100.0%,93.3%,93.3%,respectively,the specificity of them were 17.3%,37.7%,12.6%,respectively,positive predictive value of them were 7.3%,8.9%,6.5%,respectively,negative predictive value of them were 100.0%,98.9% and 96.7%,respectively,AUC of them were 0.809〔95%CI(0.638,0.941)〕,0.720〔95%CI(0.643,0.873)〕,0.800〔95%CI(0.597,0.907)〕,respectively;in the aspect of predicting the probability of death in the ANVUGIB patients,the sensitivity of GBS,AIMS65 and Rockall scoring systems were 100.0%,100.0%,and 75.0%,respectively,the specificity of them were 16.5%,36.0%,12.4%,respectively,positive predictive value of them were 1.9%,1.9%,and 1.8%,respectively,negative predictive value of them were 100.0%,98.9% and 100.0%,respectively,AUC of them were 0.848〔95%CI(0.707,0.930)〕,0.804〔95%CI(0.723,0.976)〕,0.838〔95%CI(0.597,0.968)〕,respectively.Conclusion  GBS is more suitable for emergency predicting the risk of outcome in patients with ANVUGIB.Patients with GBS ≤2 points can be considered as low-risk patients.They can receive outpatient treatment,by which bed shortages can be relieved and medical resources can be saved to some extent.
    【Key words】   Gastrointestinal hemorrhage;ANVUGIB;GBS;AIMS65;Rockall;Risk stratification
 
Different Target Sedation Scores for Mechanical Ventilation Patients in Long-distance Inter-hospital Transport  HUANG Fei-yue,ZHANG Ke-biao,GU Man-ping*
Department of Emergency Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China
*Corresponding author:GU Man-ping,Co-chief superintendent nurse;E-mail:liybuaa@163.com
    【Abstract】  Objective   To investigate the effect of different target sedation scores on mechanical ventilation patients in long-distance inter-hospital transport.Methods  The participants enrolled in this study were 117 invasive mechanical ventilation patients who needed to be transferred to the First Affiliated Hospital of Chongqing Medical University from far away from May 2015 to May 2016.In accordance with the parity of the transfer date,they were divided into the control group(60 transferred on odd days),and the observation group(57 transferred on even days).During the transport,both groups received intravenous infusion of fentanyl and propofol for conscious sedation.The controlled target of sedation score assessed by Riker Sedation-Agitation Scale(SAS) was 4 points for the control group,and 2 points for the observation group.The heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),peripheral oxygen saturation(SpO2) measured at different time points and incidence of adverse events(airway shift,catheter slippage,falling off the bed,vomiting,stress injury) during the transport were compared between the groups.Results  The HR measured before the administration of propofol and fentanyl,at the time of starting transferring,30,and 150 min after the starting of transferring did not differ significantly between the groups(P>0.05);while the HR measured at 60,90,and 120 min after the starting of transferring in the observation group was decreased than that in the control group,respectively(P<0.05).Two groups had no obvious difference in the RR measured before the administration of propofol and fentanyl(P>0.05),but it was found that the RR was decreased in the observation group measured at the time of starting transferring,30,60,90,120,and 150 min after the starting of transferring(P<0.05).There were no substantial differences in the MAP levels measured before the administration of propofol and fentanyl,at the time of starting transferring,30,and 120 and 150 min after the starting of transferring between the groups(P>0.05);however,compared with the control group,the MAP levels were higher in the observation group at the time of 60 min after the starting of transferring(P<0.05),and they were lower in the observation group at the time of 90 min after the starting of transferring(P<0.05).During the whole observation period(before the administration of propofol and fentanyl,at the time of starting transferring,30,60,90,120,and 150 min after the starting of transferring),the SpO2 levels between the two groups displayed no significant differences(P>0.05).The observation group had lower incidences of airway shift,catheter slippage,falling off the bed and less overall adverse events than the control group(P<0.05),while there were no significant differences between the two groups in the incidences of vomiting and stress injury(P>0.05).Conclusion  For transferring invasive mechanical ventilation patients,using the sedative regimen with 2 points assessed by SAS as the controlled target not only ensure the hemodynamic stability,but also effectively control the occurrence of adverse events.
    【Key words】  Respiration,artificial;Patient transfer;Hemodynamics;Deep sedation
 
Research Progress of B-cell Activating Factor/a Proliferation-inducing Ligand System and Systemic Lupus Erythematosus  SUN Tian-shui
China Medical University,Shenyang 110122,China
    【Abstract】  Systemic lupus erythematosus(SLE)is an autoimmune disease.Its pathogenesis is not entirely clear,and its present therapeutic method and effect are not accurate.In recent years,studies on B-cell activating factor(BAFF),a new family member of tumor necrosis factor,and its relationship with the incidence and clinical treatment of SLE have been reported.The paper summarizes the relevant researches from the following aspects:research process of BAFF/a proliferation-inducing ligand(APRIL) system;the role of BAFF/APRIL system in the pathogenesis of SLE;relationship between BAFF/APRIL system and different clinical phenotypes of SLE and research process of this system being a biomarker of disease activity;the relationship between BAFF/APRIL system and targeted therapy of SLE.The paper provides references for the further study of BAFF/APRIL system and SLE.
    【Key words】   Lupus erythematosus,systemic;B-cell activating factor;A proliferation-inducing ligand;Review
 
Research Progress of Therapeutic Leisure and Its Model of Psychological Counseling  DENG Ling-yu,YIN Ke-li*,ZHOU Xiao-cong,YANG Yu-xue
School of Educational Science & Management,Yunnan Normal University,Kunming 650500,China
*Corresponding author:YIN Ke-li,Professor,Master supervisor;E-mail:yayasles@163.com
    【Abstract】  Therapeutic leisure is a kind of leisure activity playing a preventive and therapeutic role in psychological problems and mental illness.It has three characteristics:not only promoting physical health,but also focusing on the harmony of body and mind;participating in activities with others;having artistic and spiritual originality and expressive force.For individuals,leisure behaviors having therapeutic effects include active living,physical activity,religious participation,spiritual practice,exposure to nature,etc.For therapists and counselors,the psychological model of therapeutic leisure consists of leisure counseling,recreational therapy model and community therapy model,etc.The function and psychological mechanism of therapeutic leisure need to be systematically studied in the future,the research methods of therapeutic leisure need innovation,and the prescription of therapeutic leisure of the population with different characteristics or needs should be also investigated.
    【Key words】  Recreation therapy;Therapeutic leisure;Psychotherapy;Prescriptions
 
Misdiagnosis of Acute Left Heart Failure:Two Cases Report  LIU Shi-ping*,QIU Li,LUO Shu,FENG Fei
Department of Emergency,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China
*Corresponding author:LIU Shi-ping,Associate chief physician;E-mail:liusp456@163.com
    【Abstract】  Acute left heart failure,in a dangerous condition,proceeds rapidly,and timely and accurate diagnosis of it is the key to improve the prognosis of the patients.However,due to various reasons,there are still some patients cannot get timely and correct diagnosis.The article summarizes the diagnostic procedure of two patients with acute left heart failure.Both of them suffered from sudden difficulty in breathing,and were misdiagnosed as spontaneous pneumothorax and poor curative effect on AECOPD respectively.For patients with acute left heart failure who shows extreme difficulty in breathing,doctors should be familiar with their characteristic clinical manifestations,and cannot be affected by their superficial phenomenon.With the obviously accelerated heart rate,the possibility of patients developing left heart failure should be suspected.If there were difficulties in diagnosis,BNP level can contribute to the timely diagnosis of acute left heart failure,and thus avoid misdiagnosis and missed diagnosis.
    【Key words】  Heart failure;Dyspnea;Diagnosis;Natriuretic peptide,brain
 
Multiple Myeloma Misdiagnosed as Subacute Interstitial Nephritis:One Case Report and Literature Review  REN Rong1,REZIWANGULI·Abudula2,JIANG Hong1*
1.Department of Nephrology,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China
2.Department of Nephrology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China
*Corresponding author:JIANG Hong,Chief physician;E-mail:jangh-yt@163.com
    【Abstract】  Multiple myeloma(MM) is a haematological malignancy characterized by monoclonal proliferation of plasma cells.Kidney injury is one of the common and serious complications of MM,which has a high rate of missed diagnosis and misdiagnosis due to the insidious onset and complicated clinical manifestations.This multiple myeloma nephropathy was misdiagnosed as subacute interstitial nephritis for the lack of typical early clinical symptoms,discernible changes of serum immune globulin and pathologic manifestations of cast nephropathy.From our misdiagnosis experience and the pertinent literature,we concluded that,it is conducive to diagnosing MM by serum and urine protein electrophoresis,measurement of free light chains in urine and bone marrow aspiration in the early stage of MM.Additionally,the bone marrow aspiration can also contribute to the diagnosis of MM effectively,if the distal tubule is full of acidophilia,melicera and lam

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