2.Introduction of American Military Medical Triage
Yun-Li CHANG ; Fang WANG ; Fang YANG ;
Chinese Medical Ethics 1994;0(06):-
Because of lots of ethical problems,military medical triage has been unaccepted by general doctors.But it's adopted by American Army in front of facts of the war.The main principles of the military medical triage are justice and efficiency.They practice the military medical triage through tow steps.First,all patients are assigned into urgent,immediate ,delayed,minimal or ambulatory and expectant status in decreasing order of medical urgency.Second,choosing the model of triage depends on nonaustere,austere or extreme conditions.The ethical issues of American military medical triage focus on four aspects - how to deal with minimally injured patient treatment first,how to treat expectants,how to care for noncombatant casualties and who decide the model of triage.
3.Evaluation of the implementation effect of continuous nursing care in patients after percutaneous coronary intervention
Fang LIU ; Yun CHANG ; Xiaoxian WU
Chinese Journal of Practical Nursing 2017;33(16):1223-1226
Objective To evaluate the implementation effect of continuous nursing care in patients after percutaneous coronary intervention. Methods Totally 200 patients underwent coronary intervention were equally divided into the control group and the experimental group. Randomization was done by sealed envelopes. Routine nursing was applied inthe control group while the patients inthe experimental group werenursed continuously. Compliance of taking medication, the incidence of major adverse cardiac events (MACE events), satisfactory rate of the patients and the occurrence of stent restenosis were compared between the two groups. Results There was a significant difference between the experimental group and the control group in compliance of taking medication from the 6th month. According to the Morisky measurement, the score of the 6th month in the experimental group was 8.00 ± 0.00, while the control group was 7.66 ± 0.82. There was a statistical significance between the two groups (t=-4.086, P<0.01); the score of the 12th month in the experimental group was 7.94 ± 0.48, and for the control group, the score was 7.28 ± 1.58, the difference was statistically significant (t=-3.899, P<0.01). The major adverse cardiac events (MACE events) were 1% (1/100) and 4%(4/100) for the experimental and control group respectively. The satisfactory rate of the patients in the experimental group and the control group were 98%(98/100) and 81%(81/100) separately. The difference between the two groups was of statistical significance (χ2=36.39, P<0.01). The restenosis rate of the two groups was 1.2% (1/82) and 2.5% (2/79) separately, which was of no significance (χ2=0.392, P=0.613). Conclusions Continuous nursing can significantly improve the patients′ medication compliance, reduce the occurrence of MACE events, and improve the satisfaction of nursing care.
5.Preliminary study on Aspergillus fumigatus-induced IKKα controlled maspin protein expression in respiratory epithelial cells of rats.
Fang ZHANG ; Yun-fang AN ; Chang-qing ZHAO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2013;48(1):48-53
OBJECTIVETo study if the expression of maspin protein in respiratory epithelial cells was downregulated through IκB kinase-α (IKKα)-controlled mechanism in an Aspergillus fumigatus-induced model in rat.
METHODSInactivated Aspergillus fumigatus hyphae (AFH) suspension was used to induce respiratory epithelial cells (REC) cultured in vitro in rat, with PBS buffer as control. By RT-PCR, the mRNA expression of maspin was quantified, and by immunocytochemistry, the expression of maspin and IKKα in REC was observed. Furthermore AFH (from level 1 to level 3) suspension was prepared to induce REC. Then Western blot hybridization technique was used to detect the expression of maspin and IKKα protein. All data were processed by analysis of variance and two-variable correlation analysis.
RESULTSBy RT-PCR, a statistically significant (t = 2.463, P < 0.05) expression of maspin mRNA was found (0.128 ± 0.059 in AFH group, 2.972 ± 0.353 in control group). By Immunocytochemistry, the difference of maspin protein color in different groups was shown statistically significant in integrated scoring (t = 3.721, P < 0.05, weak positive in AFH group, moderately positive in control group). While in IKKα color study, the difference between the two groups was also statistically significant (t = 6.825, P < 0.05) in integrated scoring, with a moderate positive in AFH group and weak positive in control group. By Western Blot hybridization, grayscale ratio of maspin and β-actin was 0.912 ± 0.023 in control group, 0.607 ± 0.030, 0.476 ± 0.019, 0.416 ± 0.017 in AFH 1-3 groups, respectively, with a statistically significant difference within the four groups (F = 281.91, P < 0.05); While grayscale ratio of IKKα and β-actin was 0.624 ± 0.012 in control group, 0.739 ± 0.020, 0.778 ± 0.010, 0.927 ± 0.017, respectively, in AFH 1-3 groups; with a statistically significant difference within the four groups(F = 200.91, P < 0.05). Moreover, the difference between any two groups from both AFH group (including subgroup 1, 2 and 3) and control group was statistically significant. Two-variable correlation analysis indicated a negative correlation between expression of maspin and IKKα (r = -0.911, P < 0.05).
CONCLUSIONSInduced by Aspergillus fumigatus, the rat respiratory epithelia might upregulate the expression of IKKα with a downregulated expression of maspin protein.
Animals ; Aspergillus fumigatus ; Cell Line ; Epithelial Cells ; metabolism ; Gene Expression Regulation ; I-kappa B Kinase ; metabolism ; Rats ; Respiratory System ; cytology ; Serpins ; metabolism
6.Analysis of frailty and its related factors in elderly patients with stage 3-5 non-dialysis chronic kidney disease
Yun GAO ; Jing CHANG ; Yanfei WANG ; Xiangyang FANG ; Wenwen HOU ; Qianmei SUN
Chinese Journal of Geriatrics 2021;40(1):82-86
Objective:To investigate the prevalence of frailty in elderly patients with stage 3-5 non-dialysis chronic kidney disease(ND-CKD)and to analyze its related factors.Methods:A cross-sectional study was conducted.Patients ≥65 years old with stage 3-5 CKD who had never undergone dialysis in the nephrology department and the internal medicine department of our hospital between October 2017 to September 2018 were enrolled.Patients were divided into the non-frail group and the frail group according to the Fried frailty phenotype.Clinical data and laboratory results were collected and comprehensive geriatric assessment was carried out to evaluate participants' medication, comorbidities, daily living ability, nutritional status, depression, cognitive and physical performance.The relevant factors for frailty were analyzed.Results:A total of 193 elderly patients with stage 3-5 ND-CKD were enrolled, 106 male and 87 female, including 68 outpatients and 125 inpatients, with a median age of 79.00(73.00, 85.00)years.There were 143 frailty patients(74.1%), including 41 outpatients and 102 inpatients, accounting for 60.3% and 81.6% of the eligible outpatients and inpatients respectively.Multivariable Logistic regression analysis showed that CKD stage( OR=9.74, 95% CI: 1.12-84.54)and polypharmacy( OR=3.69, 95% CI: 1.09-12.42)were associated with frailty in outpatients, and CKD stage( OR=11.75, 95% CI: 1.38-99.99)and malnourishment or risk of malnutrition( OR=4.22, 95% CI: 1.40-12.74)were correlated with frailty in inpatients. Conclusions:The prevalence of frailty is high in elderly patients with stage 3-5 ND-CKD.CKD stage, polypharmacy and malnourishment or the risk of malnutrition are closely correlated with frailty.
8.Correlative study between MRI signal intensity of the lumbar intervertebral disc and collagen content in the nucleus pulposus
Wen-Chang YU ; Jian-Yong YANG ; Wen-Quan ZHUANG ; Yun-Bin CHEN ; Shi-Fang ZHENG ;
Chinese Journal of Radiology 1999;0(10):-
Objective To study correlation between MRI signal intensity of the lumbar intervertebral disc and collagen content in the nucleus pulposus.Methods Thirty-one cases with lumbar intervertebral disc herniation(male 21,female 10)received percutaneous lumbar disketetomy.Thirty-one specimens of nucleous pulposus were obtained from percutaneous lumbar disketctomy procedure and collagen content in them was measured with reformed hydroxyproline measurement method.The signal intensity(SI) of lumbar intervertebral disc and cerebrospinal fluid was measured in T_2 WI sagittal image and then ratio of disc SI to cerebrospinal fluid SI was calculated.The Pearson analysis was used to analyze the correlation between the collagen content and SI ratio and disc SI on T_2 WI.Results Collagen content and SI ratio were (231.0?63.5)mg/g and 0.19?0.07,respectively.There was negative correlation between them (r=-0.61,P
9.Expression of C2A domain of synaptotagmin Ⅰ fusion protein and its imaging in the ischemia-reperfusion rat model
Kang-yun, SUN ; Jun-dong, ZHOU ; Fei, SHEN ; Wei, FANG ; Jin-chang, WU
Chinese Journal of Nuclear Medicine 2010;30(5):312-315
Objective To evaluate myocardial apoptosis with 99Tcm-C2A-GST myocardial imaging using the recombined C2A domain of Synaptotagmin Ⅰ by gene engineering. Methods ( 1 ) The C2A gene was inserted into the prokaryotic glutathione S-transferate (GST) fusion protein expression plasmid pGEX-6P-1. The recombinant plasmid was transformed into E. coli BL21. C2A-GST fusion protein was purified after BL21 was induced with isopropyl-β-D-1-thiogalactopyranoside (IPTG). (2)The activity of fusion protein was identified by cell binding test with fluorescein-5-isothiocyanate (FITC)-C2A-GST. (3) The C2A-GST fusion protein was labeled with 99Tcm using 2-iminothiophene hydrocoride method. Radiochemical purity was determined with thin layer chromatography. (4)99Tcm-C2A-GST (7.4 MBq) was injected to ischemia-reperfusion rat models through tail vein. The image was acquired with SPECT at 1 h after injection, and then hearts were removed, rinsed with saline and dyed with triphenyl tetrazolium coride (TTC). The ischemic myocardium was separated from the viable myocardium and was weighted. Its radioactivity was measured by gamma counting. The difference of uptake of radiotracer between ischemic myocardium and normal myocardium was compared using percentage activity of injected dose per gram of tissue ( % ID/g) with standard deviation. SPSS 12.0 and t-test were used for data analysis. Results ( 1 ) C2A-GST fusion protein wassuccessfully expressed and its relative molecular weight was 3.8 × 104. (2) FITC-C2A-GST binding to apoptotic cells could be observed by fluorescent microscopy. (3) The radiochemical purity of 99Tcm-C2A-GST was (98.90 ±0.43)%. (4)The imaging studies showed that there was focal uptake of radioactivity in the ischemic myocardium. In vitro uptake of 99Tcm-C2A-GST was (2.41 ±0.32) % ID/g by the ischemic myocardium, however 99Tcm-C2A-GST-N-hydroxysuccinimide (C2A-GST-NHS) was (0. 82 ± 0. 24) % ID/g. There was statistically significant difference between those two groups (t = 10. 6, P <0.01 ). Conclusion The C2A domain of Synaptotagmin Ⅰ expressed by gene engineering can be used as the tracer for noninvasive detection of ischemic myocardium in the ischemia-reperfusion rat model.
10.Effects of sulphur dioxide inhalation on allergic rhinitis in mice.
Ai WANG ; Yun-Fang AN ; Chang-Qing ZHAO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2008;43(7):509-513
OBJECTIVETo observe the effect of sulphur dioxide (SO2) inhalation on the pathogenesis of allergic rhinitis (AR) in mice, and investigate the toxic effect of SO2 on respiratory tract mucosa.
METHODSFifty male Kunming strain mice were randomly allocated to five groups, i. e., control group, AR group and AR plus different concentrations of SO2 group (three sub-groups). Nasal cavity irrigating solution was gathered from nasal cavity, and blood from the orbital venous sinus after anesthesia The concentrations of IL-5 and IL-13 in the peripheral serum and nasal cavity irrigating solution were measured by ELISA. The number of eosinophils (EOS) per square millimeter in sinus mucosa was calculated by hematoxylin-eosin. The expression of SP-D in nasal mucosa was analyzed by immunohistochemistry technique.
RESULTSWith increasing concentrations of SO2, the levels of IL-5 and IL-13 in the peripheral serum, and the density of Eos in sinus mucosa increased simultaneously. A positive correlation existed between the concentration of inhaled SO2 and the elevation of both IL-5, IL-13 and Eos infiltration in nasal mucosa. The coefficient correlation relatively were 0.894, 0.874, 0.894, 0.891 and 0.870 (P <0.01). The expression of SP-D in 56 mg/m3 and 112 mg/m3 SO2 groups was higher, while it was lower in 168 mg/m3 SO2 group (P < 0. 001).
CONCLUSIONSThe study showed that sulphur dioxide inhalation facilitates the onset of allergic rhinitis in mice. SO2-related Th2-derived cytokines as well as the infiltration of EOS in nasal mucosa help to aggravate the development of allergic rhinitis.
Air Pollutants ; toxicity ; Animals ; Eosinophils ; immunology ; Inhalation ; Interleukin-13 ; blood ; Interleukin-5 ; blood ; Male ; Mice ; Mice, Inbred Strains ; Nasal Mucosa ; drug effects ; immunology ; Rhinitis, Allergic, Perennial ; etiology ; Sulfur Dioxide ; toxicity