目的:研究呼吸操改善慢性阻塞性肺疾病(COPD)患者肺功能的機制。方法:對本院46例COPD 患者隨機分成對照組和治療組,按常規內科治療并對其有計劃地進行健康知識教育。治療組在常規內科治療加康復指導基礎上,增加呼吸操訓練。測定治療前后6分鐘步行距離、血清白三烯、呼出氣中一氧化氮濃度(fractional exhaled nitric oxide, FENO)。結果:治療組較對照組6分鐘步行能力改善,血清白三烯水平下降(Plt;0.05)、呼氣NO含量下降(Plt;0.05)。結論:加強COPD患者的健康指導及呼吸操訓練可改善患者肺功能狀況,明顯提高生活質量
Objective A series of bioinformatics methods were used to identify ferroptosis related biomarkers in lupus nephritis (LN). Methods We retrieved sequencing data of GSE112943 from the GEO (Gene Expression Omnibus) database and screened LN differentially expressed genes. We searched for ferroptosis-related gene (FRG) through FerrDb database, and screened LN-FRG. We conducted enrichment analysis on the LN-FRGs using David online bioinformatics database and screened the core LN-FRG using cytoHubba. We used external data sets to verify the core LN-FRGs, constructed competing endogenous RNA networks, and conducted molecular docking analysis. Results A total of 37 LN-FRGs were selected through screening. These genes are mainly enriched in inflammation, immune regulation and ferroptosis related signaling pathways. Through the cytoHubba and external dataset validation, the key core LN-FRG of ATF3 (activating transcription factor 3) was ultimately identified, and its expression was significantly increased in LN (P<0.05). Molecular docking analysis showed that ATF3 was closely bound to SLC7A11 and NRF2, and may participate in the occurrence and development of LN through the microRNA-27-ATF3 regulation axis. Conclusion The pivotal gene ATF3 may participate in the inflammation and immune injury of LN through ferroptosis.
【摘要】 目的 通過對早期妊娠卵黃囊的觀察，探討其在早孕超聲診斷中的臨床價值。 方法 2008年5月-2009年1月應用陰道超聲診斷儀觀察536例早孕患者卵黃囊的形態、大小及卵黃囊的數目，根據結果分為卵黃囊正常及異常組，比較卵黃囊的增長情況與妊娠預后的關系。 結果 504例正常組中，501例正常妊娠結局的卵黃囊大小從孕5~11周持續增長，此后逐漸縮小，孕12周后消失；另3例為宮外孕而中止妊娠。卵黃囊異常組32例。正常組和異常組的卵黃囊大小及形態有統計學意義（Plt;0.05）。 結論 卵黃囊超聲影像學改變可作為診斷早孕及預測妊娠發展和轉歸的可靠手段。【Abstract】 Objective To evaluate the clinical value of yolk sac in the diagnosis of early pregnancy by observing the change of yolk sac. Methods The yolk sacs in 536 pregnant women were measured by ultrasonogaphy from May 2008 to January 2009, and the correlation of the growth condition of the normal or abnormal yolk sac with pregnancy outcome were observed. Results In the normal group (504 patients), the yolk sac size of 501 patients continued to grow from five to 11 weeks of pregnancy, then gradually reduced and disappeared after 12 weeks of pregnancy. The other three patients terminated pregnancy because of ectopic pregnancy. Thirty-two cases of abnormal yolk sac were found. The results showed the size and shape of yolk sacs were significantly different between normal and abnormal groups (Plt;0.05). Conclusion The change of yolk sacs by ultrasonography during early pregnancy can be used as a good measure to diagnosis early pregnancy and predict the development and prognosis of pregnancy.
Objective To identify the clinical features and risk factors for mortality associated with severe influenza B pneumonia of adults admitted to respiratory intensive care unit (ICU). Methods Patients with confirmed influenza B infection and respiratory failure between February 2020 and February 2022 who were admitted to the ICU were sequentially included. Demographic features, clinical data, microbiological data, complications, and outcomes were collected. Univariate logistic regression analysis was performed to identify risk factors associated with hospital mortality. A comparison with severe influenza A pneumonia was made to explore the characteristics of influenza B virus-associated pneumonia. Results A total of 23 patients with influenza B pneumonia were included. The survival group included 18 patients and the death group included 5 patients, with an ICU mortality of 21.7%. The median age in the death group was 64 (64, 72.5) years, which was significantly older than the survival group, with a median age 59 (30.25, 64.25) years (P=0.030). Univariate logistic regression analysis indicated that SOFA score [odds ratio (OR) 1.307, 95% confidential interval (CI) 1.013 - 1.686, P=0.039], decreased hemoglobin (OR 0.845, 95%CI 0.715 - 0.997, P=0.046), and high blood urea nitrogen (BUN) (OR 1.432, 95%CI 1.044 - 1.963, P=0.026) were independent risk factors for hospital mortality. Compared with influenza A pneumonia, patients with severe influenza B pneumonia had more complications (60.0% vs. 87.0%, P=0.023). Conclusions The mortality of severe influenza B virus-associated pneumonia with was high. Increased SOFA score, anemia, and high BUN were risk factors for ICU mortality of severe influenza B infection in adults.
Objective To establish a modeling method for an animal model simulating the decline of digestive function after a large amount of tissue necrosis of the pancreas due to acute injury after severe acute pancreatitis (SAP). Methods Twenty male SD rats were randomly divided into the model group and the sham operation group according to the random number table method, with 10 rats in each group. First, the SAP model was established by retrograde bile duct injection of sodium taurocholate in the model group, whereas the sham operation group received physiological saline injection. Fluid infusion began 2 hours later, twice a day, with an 8-hour interval, for 2 days. The traditional Chinese medicine Dachengqi Decoction without Decoction Granules was formulated into a suspension in proportion and administered by gavage once at 18 hours and once at 24 hours after the operation to ensure the blood volume of rats and reduce inflammatory damage. Normal drinking water was allowed 48 hours after modeling. After 72 hours, ordinary feed was given for feeding. The feeding lasted for 14 days (the total duration of the experiment was 17 days). The body weight, vitality status and stool characteristics of the rats were observed and recorded on the day of open feed feeding and 14 days later. Fourteen days after feeding, the animals were sacrificed and samples were collected for examination of blood glucose, fecal elastase and hematoxylin-eosin staining pathological scores. Results All 10 rats in the model group were successfully modeled with a 100% survival rate. The body weight of rats in the model group 14 days after ordinary feeding was lower than that on the day of open diet [(180.80±4.39) vs. (222.90±6.14) g, P<0.001], and lower than that of rats in the sham operation group 14 days later [(180.80±4.39) vs. (221.70±7.45) g, P<0.001]. Compared with the sham operation group, inflammatory cell infiltration injury still existed in the pancreatic tissue of the model group, and some pancreatic tissues showed pathologically related changes of chronic injury. The pathological score of the model group was higher than that of the sham operation group [7.5 (7, 9) vs. 0 (0, 0), P<0.001]; the blood glucose concentration increased [(13.000±1.531) vs. (8.070±0.851) mmol/L, P<0.001]. The secretion of fecal elastase, a metabolite of trypsin in vivo, was significantly decreased [(5.451±0.936) vs. (8.593±1.105) mg/mL, P<0.001]. Conclusion The use of short-term liquid supplementation, traditional Chinese medicine anti-inflammatory treatment, and early dietary stimulation can effectively combat early severe inflammatory damage in SAP, protect the life of model rats, and enable them to survive and experience digestive dysfunction, thus establishing an experimental animal model of digestive dysfunction in the late stage of SAP.
Objective To analyze the application of lean healthcare management in optimizing services in foreign operating rooms, and provide a theoretical reference for further optimizing service processes in domestic operating rooms with lean healthcare management. Methods PubMed and Web of Science databases were searched literature about lean healthcare management in optimizing foreign hospital operating room service process. The search period was from the establishment of databases to November 2024. The number of publications, publishing institutions, authors, citation frequencies, keywords, the use of lean management tools and the improvement status were analyzed.Results A total of 71 literatures were included. Among them, 17 literatures were published from 2008 to 2014, and the number of related literatures increased significantly since 2015, with 54 literatures published by 2024; 9 literatures were published by universities and 62 literatures were published by hospitals. In terms of the distribution of countries and regions where the literatures were published, there were 34 literatures from the United States, 12 from the United Kingdom, 5 from Italy, 4 from Switzerland, and 3 from Canada. The keywords basically presented the combination ofthemes related to operating room management and lean healthcare management improvement fields, such as lean six sigma, quality improvement, and operating room efficiency. The five lean tools with the highest frequency of occurrence in the 71 included literatures were value stream mapping, fishbone diagram, A3 report, PDCA cycle management, and 5S. Conclusions There is an imbalance in the development of lean healthcare management research, with the number of publications in developed countries being far higher than that in developing countries. Lean healthcare management is conducive to improving surgical safety, work efficiency, and patient-doctor satisfaction. Lean healthcare management should further adapt to the actual situation, unify the lean management indicators in operating rooms, conduct cross-departmental cooperation, maximize the effectiveness of lean improvement tools, and achieve modern medical management.