BACKGROUND: At present, there are many drugs and therapeutic methods for dementia at home and abroad. Both xingding and piracetam are the kind of improver for circulatory obstruction and protector for nerve cells and can slow down the functional decline of brain tissue and provide improvement for cognitive deficit.OBJECTIVE: To observe the improvement of allied application of xingding and piracetam on cognitive function in treatment of vascular dementia.DESIGNS: Case-controlled study based on patients.SETTING: Neurological Department in Affiliated Hospital of Henan University. PARTICIPANTS: Totally 91 cases of vascular dementia hospitalized in Neurological Department of First Affiliated Hospital of Henan University from October 2000 to March 2002, which were randomized into treatment group of 48 cases and the control of 43 cases.INTERVENTIONS: In treatment group, xingding injection of 20 mL and piracetam of 8 g were administrated and 50 g/L glucose injection 250 mL was added respectively for intravenous injection, once daily and 14 days made one session. In the control, piracetam of 8 g was prescribed with 50 g/L glucose injection 250 mL added for intravenous injection, once daily and 14 days made one session. There was no any difference in other medication treatment. One month later after treatment of two groups, he patients were re-examined with mini-mental state examination(MMSE) and Hasegawa dementia scale(HDS) was used to assess the cogitative improvement and neurological defect scale(NDF) was used to analysis the improvement of neurological functional symptoms.MAIN OUTCOME MEASURES: ① Scores of MMSE, HDS and NDF in two groups. ② Analysis on therapeutic effects.RESULTS: Totally 91 cases entered the analysis on the results. There was no significant difference in MMSE and HDS before treatment in two groups. In treatment group, after treatment, MMSE and HDS scores were (23.26±5.12) and(2.78±3.46) respectively, indicating significant difference(t=4.79, 15.44, P＜0.01) compared with the control(19.14 ±3.21)and(15.21±2.29) . NDF score was 13.68±7.83 after treatment and the significant difference was presented compared with the control(17.33 ±8.81) . The total effective rate(total remarkable rate + progression) was 92% in the treatment group and was 56% in the control. By the comparison between two groups, the difference was significant(χ2= 15.48, P＜0.01).CONCLUSION: After treatment, MMSE score in treatment group was higher than that in the control and HDS score was lower than that in the control, explaining that xingding allied piracetam significantly improves cogitative function in the treatment of vascular dementia.

Objective To assess the influence of community intervention on blood pressure and quality of life in aged patients with hypertension.Methods A total of 378 elderly hypertensive patients received community intervention with anti-high blood pressure agents for one year.Before and after intervention,blood pressure was recorded and genetic quality of life inventory(GQOLI-74),symptom checklist(SCL-90),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were carried out on the basis of giving unite guiding words.Results In addition to blood pressure degraded,the blood pressure control rate was improved after intervention(67.7% vs.40.1% before intervention,x2=57.59, P<0.05).Observation items of body health dimension,psychological health dimension,social function dimension were better than those recorded before intervention(P<0.05).But difference of the material life dimension was not statistically significant(P>0.05).With 41 scores as a SDS rude mark to judge the depression incidence.the incidence was decreased from 22.7% before intervention to 12.5%after intervention(x2=12.565,P<0.05).Conclusions Community intervention is a practical and valuable strategy for controlling high blood pressure and improving quality of life in aged patients.

Objective:To compare the effectiveness between three methods for purifying the immunoglobulin of egg yolk(IgY) which are polyethylene glycol (PEG) method, chloroform extraction method and chloroform / PEG method, and to provide basis for obtaining the batch of IgY.Methods:The inactivated vaccine of Vibrio parahemolyticus (V. parahemolyticus) was prepared and the hens were immunized by multi-point intramuscular injection.The eggs were collected and the IgY was purified by PEG method, chloroform extraction method and chloroform/PEG method.The protein extraction rate, the IgY titer and the purity of the antibody which purified by different methods were detected.Furthermore, the operation process, cost and safety of the three methods were analyzed.Results:The protein contents of the extraction belonging three methods from high to low in turn were chloroform extraction method, chloroform/PEG method, and PEG method.There was no significant difference in the antibody titer between three methods, and the tiler of chloroform extraction method was slightly high.The purities of purified antibody from high to low in turn were PEG method, chloroform/PEG method and chloroform method.The PEG method had better security but relatively lower extraction efficiency and higher cost.The chloroform/PEG method had high extraction efficiency and good antibody purity.Conclusion:The PEG method is suitable for a small amount of extraction in the laboratory.The chloroform/PEG method is appropriate for extracting the high quality IgY in a batch as it has high extraction efficiency and good antibody purity.

Objective To analyze the influencing factors of unstable ventilation pressure during nasal continuous positive airway pressure(NCPAP)treatment in neonates with hyaline membrane dis-ease(HMD)and construct a nomogram model.Methods A retrospective analysis was conducted in 157 HMD neonates who underwent NCPAP treatment.The patients were divided into unstable group(n=49)and stable group(n=108)based on the occurrence of unstable ventilation pressure during treatment.Logistic regression analysis was used to identify influencing factors of unstable ventilation pressure during NCPAP treatment in HMD neonates.A nomogram model was constructed using R software,and its predictive performance was evaluated using receiver operating characteristic(ROC)curves,calibration curves,and the Hosmer-Lemeshow goodness-of-fit test.Results Unstable venti-lation pressure occurred in 49 HMD neonates during NCPAP treatment,with an incidence rate of 31.21％(49/157).Univariate analysis showed that unstable ventilation pressure during NCPAP treatment had no relation to gestational age,gender,birth weight,delivery mode,neonatal Apgar score,catheter distortion,or excessive condensation in the tube(P＞0.05).However,NCPAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness were identified as influencing factors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).Multivariate Logistic regression analysis revealed that NCPAP treatment duration ≥72 h,nasal mucosa damage,secretion blockage in the airway,and restlessness were independent risk fac-tors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).A no-mogram model was constructed based on these four independent risk factors.The ROC curve demon-strated good discrimination for the nomogram model,with an area under the curve of 0.801(95％CI,0.730 to 0.861).The Hosmer-Lemeshow goodness-of-fit test showed a chi-square value of 3.550 with a P-value of 0.470,and the calibration curve had a slope close to 1,indicating good fit validity for the nomogram prediction model.Conclusion The nomogram model constructed based on NC-PAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness has good predictive value for the occurrence of unstable ventilation pressure during NCPAP treatment in HMD neonates.

Objective To investigate the influencing factors of facial pressure injury related to ventilation in prone positioning in children with severe pneumonia and to construct a nomogram predic-tion model.Methods A total of 158 children with severe pneumonia who underwent prone positioning ventilation were selected as research subjects.Clinical data were collected,and the children were di-vided into injury group(31 cases)and non-injury group(127 cases)based on whether facial pressure injury occurred.Univariate and multivariate Logistic regression analysis were used to explore the influ-encing factors of facial pressure injury related to prone positioning ventilation in children with severe pneumonia;the receiver operating characteristic(ROC)curve,consistency index,and Hosmer-Leme-show goodness-of-fit test were used to evaluate the predictive efficiency of the nomogram model for facial pressure injury related to prone positioning ventilation in children with severe pneumonia.Results Un-ivariate analysis showed that the proportion of children aged＜3 years,the proportion of those with complications,ventilation time in prone positioning,the proportions of children with sedative drugs and poor nutritional status,no decompression dressings,and the proportions of children without prone posi-tioning ventilation training for medical staff in the injury group were higher or longer than that in the non-injury group(P＜0.05).Multivariate Logistic regression analysis showed that age＜3 years,presence of complications,longer prone positioning ventilation time,no decompression dressings,and lack of prone positioning ventilation training for medical staff were independent risk factors for facial pressure injury related to prone positioning ventilation in children with severe pneumonia(P＜0.05),and a nomogram prediction model was constructed based on these factors.The consistency index of the nomogram model was 0.940,and the area under the ROC curve was 0.978(95％CI,0.958 to 0.999).The calibration curve of predicting facial pressure injury related to prone positio-ning ventilation in children with severe pneumonia approached the ideal curve,and the Hosmer-Lemeshow goodness-of-fit test showed good fitting(x2=12.416,P＜0.05).Conclusion The no-mogram prediction model constructed based on 5 independent risk factors in this study has high risk identification ability and can early identify high-risk children with facial pressure injury related to prone positioning ventilation in severe pneumonia.

Objective To analyze the influencing factors of unstable ventilation pressure during nasal continuous positive airway pressure(NCPAP)treatment in neonates with hyaline membrane dis-ease(HMD)and construct a nomogram model.Methods A retrospective analysis was conducted in 157 HMD neonates who underwent NCPAP treatment.The patients were divided into unstable group(n=49)and stable group(n=108)based on the occurrence of unstable ventilation pressure during treatment.Logistic regression analysis was used to identify influencing factors of unstable ventilation pressure during NCPAP treatment in HMD neonates.A nomogram model was constructed using R software,and its predictive performance was evaluated using receiver operating characteristic(ROC)curves,calibration curves,and the Hosmer-Lemeshow goodness-of-fit test.Results Unstable venti-lation pressure occurred in 49 HMD neonates during NCPAP treatment,with an incidence rate of 31.21％(49/157).Univariate analysis showed that unstable ventilation pressure during NCPAP treatment had no relation to gestational age,gender,birth weight,delivery mode,neonatal Apgar score,catheter distortion,or excessive condensation in the tube(P＞0.05).However,NCPAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness were identified as influencing factors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).Multivariate Logistic regression analysis revealed that NCPAP treatment duration ≥72 h,nasal mucosa damage,secretion blockage in the airway,and restlessness were independent risk fac-tors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).A no-mogram model was constructed based on these four independent risk factors.The ROC curve demon-strated good discrimination for the nomogram model,with an area under the curve of 0.801(95％CI,0.730 to 0.861).The Hosmer-Lemeshow goodness-of-fit test showed a chi-square value of 3.550 with a P-value of 0.470,and the calibration curve had a slope close to 1,indicating good fit validity for the nomogram prediction model.Conclusion The nomogram model constructed based on NC-PAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness has good predictive value for the occurrence of unstable ventilation pressure during NCPAP treatment in HMD neonates.

Objective To investigate the influencing factors of facial pressure injury related to ventilation in prone positioning in children with severe pneumonia and to construct a nomogram predic-tion model.Methods A total of 158 children with severe pneumonia who underwent prone positioning ventilation were selected as research subjects.Clinical data were collected,and the children were di-vided into injury group(31 cases)and non-injury group(127 cases)based on whether facial pressure injury occurred.Univariate and multivariate Logistic regression analysis were used to explore the influ-encing factors of facial pressure injury related to prone positioning ventilation in children with severe pneumonia;the receiver operating characteristic(ROC)curve,consistency index,and Hosmer-Leme-show goodness-of-fit test were used to evaluate the predictive efficiency of the nomogram model for facial pressure injury related to prone positioning ventilation in children with severe pneumonia.Results Un-ivariate analysis showed that the proportion of children aged＜3 years,the proportion of those with complications,ventilation time in prone positioning,the proportions of children with sedative drugs and poor nutritional status,no decompression dressings,and the proportions of children without prone posi-tioning ventilation training for medical staff in the injury group were higher or longer than that in the non-injury group(P＜0.05).Multivariate Logistic regression analysis showed that age＜3 years,presence of complications,longer prone positioning ventilation time,no decompression dressings,and lack of prone positioning ventilation training for medical staff were independent risk factors for facial pressure injury related to prone positioning ventilation in children with severe pneumonia(P＜0.05),and a nomogram prediction model was constructed based on these factors.The consistency index of the nomogram model was 0.940,and the area under the ROC curve was 0.978(95％CI,0.958 to 0.999).The calibration curve of predicting facial pressure injury related to prone positio-ning ventilation in children with severe pneumonia approached the ideal curve,and the Hosmer-Lemeshow goodness-of-fit test showed good fitting(x2=12.416,P＜0.05).Conclusion The no-mogram prediction model constructed based on 5 independent risk factors in this study has high risk identification ability and can early identify high-risk children with facial pressure injury related to prone positioning ventilation in severe pneumonia.

Porcine reproductive and respiratory syndrome virus (PRRSV) non-structural protein 7 (Nsp7) plays an important role in the induction of host humoral immune response and could serve as an ideal antigen for serological genotyping assay for PRRSV based on the significant difference in immunoreactivities of North American (NA) and European (EU) PRRSV Nsp7. In this study, Nsp7 of NA and EU PRRSVwas separately expressed and purified using prokaryotic expression system. The purified recombinant Nsp7 proteins reacted with serum antibodies against corresponding genotype PRRSV in Western blotting. However, nonspecific reaction of whole recombinant Nsp7 with antibodies against another genotype PRRSV was observed, indicating that whole NA PRRSV Nsp7 and EU PRRSV Nsp7 have similar antigenic epitopes and recombinant proteins could not be used for genotyping of antibodies against PRRSV. Based on the analysis of similar antigenic epitopes at the hydrophilic region of NA PRRSV Nsp7 and EU PRRSV Nsp7 by bioinformatics assessment, partial Nsp7 gene region deleted sequences encoding similar antigenic epitopes was constructed by fusion PCR. The recombinant truncated Nsp7 (NA-deltaNsp7 and EU-deltaNsp7, about 43 kDa) was expressed and the molecular weight was about 43 kDa. The results of Western blotting showed that NA-deltaNSP7 and EU-deltaNSP7 could be specifically recognized by positive serum to NA or EU PRRSV individually and nonspecific reaction was eliminated. This study provided a basis for further development of serological genotyping assay for North American and European genotype PRRSV infection.
Animals ; Genotype ; Porcine respiratory and reproductive syndrome virus ; classification ; genetics ; immunology ; Recombinant Proteins ; biosynthesis ; immunology ; Swine ; Viral Nonstructural Proteins ; biosynthesis ; immunology

A comprehensive profiling of the vaginal microbial communities and their variability enables an accurate description of the microbiome in women.However,there is a lack of studies available on Chinese women.In the present study,the composition of the vaginal microbiota during pregnancy and the 6-week postpartum period of 454 Chinese women was characterized by sequenc-ing the V3-V4 region of the 16S ribosomal RNA(rRNA)gene.The vaginal microbiome showed variations during pregnancy and the postpartum period based on the abortion history,hypertensive disorders,delivery mode,and maternal age.Co-variation of 22 bacterial taxa,including the Lacto-bacillus genus and two of its species,may account for the common characteristics of the vaginal microbiome under scenarios of different medical histories and pregnancy outcomes.In contrast,dis-criminant bacterial species were significantly different between women who had preterm birth(PTB)with and without premature rupture of membranes(PROM),and the community state type(CST)Ⅳ-A without any predominant Lactobacillus species in the microbiota was more prevalent during pregnancy in the PROM-PTB cases,suggesting that specific bacterial species could be considered to distinguish between different types of PTB.By providing data on Chinese women,this study will enrich the knowledge of the human microbiome and contribute to a better understanding of the association between the vaginal microbiome and reproductive health.

To establish the experts consensus on the management of delirium in critically ill patients.A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group.Each statement was assessed based on the GRADE (Grading of Recommendations Assessment,Development,and Evaluation) principle.Then the Delphi method was adopted by 36 experts to reassess all the statements.(1) Delirium is not only a mental change,but also a clinical syndrome with multiple pathophysiological changes.(2) Delirium is a form of disturbance of consciousness and a manifestation of abnormal brain function.(3) Pain is a common cause of delirium in critically ill patients.Analgesia can reduce the occurrence and development of delirium.(4) Anxiety or depression are important factors for delirium in critically ill patients.(5) The correlation between sedative and analgesic drugs and delirium is uncertain.(6) Pay attention to the relationship between delirium and withdrawal reactions.(7) Pay attention to the relationship between delirium and drug dependence/ withdrawal reactions.(8) Sleep disruption can induce delirium.(9) We should be vigilant against potential risk factors for persistent or recurrent delirium.(10) Critically illness related delirium can affect the diagnosis and treatment of primary diseases,and can also be alleviated with the improvement of primary diseases.(11) Acute change of consciousness and attention deficit are necessary for delirium diagnosis.(12) The combined assessment of confusion assessment method for the intensive care unit and intensive care delirium screening checklist can improve the sensitivity of delirium,especially subclinical delirium.(13) Early identification and intervention of subclinical delirium can reduce its risk of clinical delirium.(14) Daily assessment is helpful for early detection of delirium.(15) Hopoactive delirium and mixed delirium are common and should be emphasized.(16) Delirium may be accompanied by changes in electroencephalogram.Bedside electroencephalogram monitoring should be used in the ICU if conditions warrant.(17) Pay attention to differential diagnosis of delirium and dementia/depression.(18) Pay attention to the role of rapid delirium screening method in delirium management.(19) Assessment of the severity of delirium is an essential part of the diagnosis of delirium.(20) The key to the management of delirium is etiological treatment.(21) Improving environmental factors and making patient comfort can help reduce delirium.(22) Early exercise can reduce the incidence of delirium and shorten the duration of delirium.(23) Communication with patients should be emphasized and strengthened.Family members participation can help reduce the incidence of delirium and promote the recovery of delirium.(24) Pay attention to the role of sleep management in the prevention and treatment of delirium.(25) Dexmedetomidine can shorten the duration of hyperactive delirium or prevent delirium.(26) When using antipsychotics to treat delirium,we should be alert to its effect on the heart rhythm.(27) Delirium management should pay attention to brain functional exercise.(28) Compared with non-critically illness related delirium,the relief of critically illness related delirium will not accomplished at one stroke.(29) Multiple management strategies such as ABCDEF,eCASH and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients.(30) Shortening the duration of delirium can reduce the occurrence of long-term cognitive impairment.(31) Multidisciplinary cooperation and continuous quality improvement can improve delirium management.Consensus can promote delirium management in critically ill patients,optimize analgesia and sedation therapy,and even affect prognosis.