3.Moral Defense for Ethical Review of Medical Technology Clinical Admittance
Gang HUANG ; Huorong SHENG ; Dongfang YAO ; Zhe LYU ; Huanhuan CAO ; Peihuan LI ; Daping LI ; Enchang LI
Chinese Medical Ethics 2015;(3):312-314
This paper discussed the main point specifically from the three aspects which are the certainty and uncertainty of technological function , the predictability and unpredictability of technological efficiency , and“should do”or“not should do”of technological application .It presented an ethics argument of medical technology clinical admittance restriction and defends the standpoint -what we can do does not mean what we should do , aiming to provide moral theoretical support of ethical review of medical technology application .
4.Effect of doctor-patient interaction based on information platform on hypertensive patients management in community
Quanhou LI ; Fang LIU ; Aie CHEN ; Bo CAO ; Weiling YANG ; Huanhuan MA ; Wei ZHANG ; Qing GU
Chinese Journal of Health Management 2016;10(5):343-348
Objective To explore the effect of doctor-patient interaction based on information platform on hypertensive patients' self-efficacy and treatment compliance in community. Methods A convenience sampling method was used, and 280 patients with hypertension in Huaxin community health service centre were included. Patients were divided into interactive group (89 cases) and control group (191 cases) according to their wishes. Control group received a regular follow-up at community clinics, while interactive group participated in the doctor-patient interaction based on information platform at the same time of regular community clinic visit for 3 months. All patients were investigated using Self-efficacy Assessment Scale for Hypertensives and Treatment Compliance Questionnaire before and after intervention, which was used for effectiveness analysis. Results Before intervention, two groups showed no significant difference in self-efficacy (t=1.635,P>0.05), but there was significant difference in treatment compliance [interactive group:8.00(5.00) vs. control group:10.00(3.00)] (Z=4.409,P<0.05). After the intervention, two groups showed no significant difference in treatment compliance (Z=0.784,P>0.05), but there was significant difference in self-efficacy (interactive group:34.42 ± 4.49 vs. control group:32.63 ± 5.53) (t=2.867, P<0.01), which in interactive group was higher. Before and after the intervention, self-efficacy and the treatment compliance had significantly increased in interactive group (P<0.05). while not significantlyincreased in control group (P>0.05). Before intervention, there was a significant positive correlation between the total score of self-efficacy and treatment compliance(r=0.500, P<0.001), drug therapy compliance (r=0.327, P<0.001) and Non-drug treatment compliance (r=0.469, P<0.001) in two groups, while there was lower positive correlation after intervention. Conclusion The doctor-patient interaction project of community hypertension supervision based on informatization platform is effective on the improvement of self-efficacy and the treatment compliance through the enhanced doctor-patient communication, particularly in promoting the role of self-efficacy to accelerate the improvement of health behaviors, compliance behavior and treatment compliance.
5.Effects of acupuncture and moxibustion on serum contents of hematopoietic growth factor in mice with marrow inhibition.
Mei LU ; Tingting XIAO ; Daming CAO ; Huanhuan ZHANG ; Jianwei LI ; Guang'an WANG
Chinese Acupuncture & Moxibustion 2015;35(3):264-268
OBJECTIVETo observe serum contents of granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) in mice with marrow inhibition before and after acupuncture and moxibustion treatment, so as to discuss the molecular biological mechanisms of acupuncture and moxibustion on improving marrow inhibition and increasing white cells after chemotherapy.
METHODSEighty clean-grade male Kunming mice were selected and randomly divided into a normal group, a model group, an acupuncture group and a moxibustion group according to the weight, 20 cases in each one. Mice in the model group, acupuncture group and moxibustion group were injected with cyclophosphamide (CTX) to establish mice models of marrow inhibition, while mice in the normal group received intraperitoneal injection of 0.9% NaCl. Four hours after model establishment, mice in the acupuncture group and moxibustion group were treated with acupuncture or moxibustion at "Dazhui" (GV 14), "Geshu" (BL 17), "Shenshu" (BL 23) and "Zusanli" (ST 36), respectively. Mice in the normal group and model group were immobilized without any treatment. All the treatment was given once a day for consecutive 5 days. Mice blood samples were collected from caudal vein. With manual examination, the white blood cells in peripheral blood were measured on each day from model establishment to end of treatment. Enzyme linked immunosorbent assay (ELISA) method was used to measure the serum contents of GM-CSF and G-CSF 3 days and 5 days after treatment.
RESULTSCompared with the normal group, the white cells in the model group were all reduced at each time point (all P<0.05), and the serum contents of GM-CSF and G-CSF were significantly reduced (all P<0.05). Three days after treatment, compared with the model group, the white cells in the acupuncture group and moxibustion group were increased, and the difference in acupuncture group was significant (P<0.05); the serum contents of GM-CSF and G-CSF were significantly lifted (P<0.05). Four days after treatment, compared with the model group, the white cells in the acupuncture group and moxibustion group were increased (both P<0.05). Five days after treatment, compared with the model group, the white cells in the acupuncture group and moxibustion group were increased and close to the normal level; the serum contents of GM-CSF and G-CSF were significantly lifted (all P<0.05).
CONCLUSIONThrough increasing serum contents of GM-CSF and G-CSF in CTX mice, acupuncture and moxibustion could prompt maturation and proliferation of myeloid hematopoietic cells, which is benefit to the reconstruction of hematopoietic function and relieve the marrow inhibition caused by CTX, and thus lift peripheral white blood cells.
Acupuncture Therapy ; Animals ; Bone Marrow ; drug effects ; Cyclophosphamide ; adverse effects ; Granulocyte Colony-Stimulating Factor ; blood ; Granulocyte-Macrophage Colony-Stimulating Factor ; blood ; Male ; Mice ; Moxibustion
6.Efficiency of second trimester screenings for Down syndrome using alpha-fetoprotein and β-human chorionic gonadotropin duplex in 32 188 cases in south Zhejiang
Zhuhua CAI ; Ge ZHENG ; Wenxia CAI ; Ligui JIN ; Huanhuan JIN ; Yuehong LIN ; Shuchun ZHOU ; Jie DAI ; Huamei CAO
Chinese Journal of Perinatal Medicine 2011;14(12):716-719
Objective To evaluate the efficiency of second trimester screenings for Down syndrome using alpha-fetoprotein and β-human chorionic gonadotropin duplex.MethodsPregnant women of south Zhejiang were screened for Down syndrome fetuses by maternal alpha-fetoprotein and β-human chorionic gonadotropin duplex during second trimester.The high-risk women underwent prenatal diagnosis by amniocentesis,cell culture and chromosome analysis.The newborns followed up by the maternal and child tertiary health care network and suspected to have Down syndrome were diagnosed by peripheral blood chromosome analysis.Statistical analysis was performed using two-sample t test and x2 test.Risk probability of Down Syndrome was calculated by random screening software. Results From Oct.2007 to May 2009,1130 of 32 188 singleton pregnant women in second trimester received prenatal screening were discovered with high risk(≥1 ∶ 270).Prenatal diagnosis was performed in 90.79% cases (1026/1130) of high risk women and seven fetuses were diagnosed as Down syndrome by amniotic fluid chromosome analysis,and the pregnancies were terminated.Among the other 104 cases without prenatal diagnosis one Down syndrome baby was delivered.Six of 31 058 pregnancy women with low risk delivered Down syndrome babies with the incidence of Down syndrome of 0.19‰ (6/31 058).Detection rate of second trimester screenings for Down syndrome using alpha-fetoprotein and β-human chorionic gonadotropin duplex was 57.14%(8/14).False positive rate was 3.48% (1122/32 188).Positive predictive value was 7.08‰(8/1130).During the same period,there were 23 813 pregnant women who didn't receive screening and 15 fetuses with Down syndrome were diagnosed after birth.There was no statistical difference in the prevalence rate of Down syndrome between those pregnant women who received prenatal screening or not [0.43‰ (14/32 188) vs 0.63‰ (15/23 813),x2 =1.004,P>0.05].The prevalence of Down syndrome was 0.52‰ (29/56 001) in this area. ConclusionsThe prenatal screening and diagnosis could reduce the birth rate of Down syndrome patients.However,detection rate,false positive rate and positive predictive value of which were lower than reports in other studies.It's possible that the reference data might be not suitable for Chinese.
7.Production of human papillomavirus type 6 virus-like particles and detection of its neutralizing antibodies
Huirong PAN ; Shaowei LI ; Bo LIU ; Ziheng ZHU ; Huanhuan CAO ; Ying GU ; Tong CHENG ; Yingbin WANG ; Jun ZHANG ; Ningshao XIA
Chinese Journal of Microbiology and Immunology 2009;29(1):71-76
Objective To produce human papillomavirus type 6(HPV-6)virus-like particles with Escherichia coli expression system and study its immunogenicity.Methods HPV-6 L1 gene was inserted into pmkaryotic expression vector pTO-T7 and then expressed in Escherichia coli ER2566.The HPV-6 L1 protein was purified by ammonium sulfate precipitation,ion-exchange chromatography,and hydrophobic interaction chromatography.Then the purified HPV-6 L1 self-assembled into virus-like particle after removing 1,4dithiothreitol(DTr).The morphology of the virus-like particles was investigated with dynamic light scatter and transmission electron microscopy,and the immunogenicity was determined with in vitro pseudownons neutralization as8ay.Results HPV-6 L1 was expressed in soluble form in Escherichia coli.Following the removal of DTT,purified HPV-6 L1 protein could assemble into virus-like particles as 25 am in the radius.And the animal immunization test showed HPV-6 virus-like particles can elite hish titer neutralizing antibodies.Conclusion The bacterially expressed HPV-6 L1 VLP is highly immunogenieity and easy to produce.And it can be good candidate of HPV-6 vaccine.
8.The effect on postoperative pain and complications in patients with health education for senile fracture characteristics of traditional Chinese medicine
Mingxia ZHANG ; Xiaoying PENG ; Huanhuan CAO ; Xingxing LU ; Chunxiao YU
China Modern Doctor 2015;(10):146-148
Objective To explore the effect of postoperative pain and complications in patients with health education for senile fracture characteristics of traditional Chinese medicine. Methods A retrospective analysis was performed on the clinical data of 98 cases of senile fracture patients in our hospital from October 2013 to October 2014,and were divided into control group (50 cases) and observation group (50 cases),and were given characteristics of traditional Chinese medicine health education and routine nursing care.The total effective rate,pain score,the incidence of com-plications of the two groups were observed and compared. Results The total effective rate of the observation group was significantly higher than that of control group(P<0.05).The pain score of observe group was significantly lower than that of control group (P<0.05);the incidence rate of complications of observation group was significantly lower than that of control group (P<0.05). Conclusion The implementation of patients before treatment,after treatment of senile fracture characteristics of traditional Chinese medicine and rehabilitation period of the full range of health education, can ef-fectively alleviate the effect of postoperative pain,and reduce the complication rate of reduction.
9.Phenotypic and genetic analysis of four patients with 13q33-q34 microdeletion.
Huanhuan WANG ; Bing XIAO ; Xing JI ; Jingmin ZHANG ; Ying CAO ; Lin NI ; Hui YE ; Lixiao SHEN
Chinese Journal of Medical Genetics 2017;34(4):509-513
OBJECTIVETo explore the correlation between 13q33-q34 microdeletion and clinical phenotype.
METHODSRoutine chromosomal banding was performed to analyze the karyotype, while array-based comparative genomic hybridization (aCGH array) and single nucleotide polymorphism array(SNP array) were employed to investigate the genome copy number variations.
RESULTSThe karyotype of patient 1 was 46, XY, 9qh+,13qs. Patient 2 showed 46, XX, der (13). Patient 3 showed 46, XX, r(13) (p11.2q32) [43]/45, XX, 13[4]/46, XX, r(13;13) [2]/47, XX, 2r(13;13) [1]. Patient 4 did not undergo chromosome karyotyping analysis. Array analysis showed that four patients have different microdeletions in 13q33-34 region and had common features of 13q33-q34deletion including intellectual disability, facial dysmorphism, microcephaly, hypotonia, low birth weight and genital abnormality.
CONCLUSIONThe severity of phenotypes showed no correlation with the size of deletion in 13q33-q34. The lower percentage of patients with congenital heart disease suggested a complex pathogenesis of such disease. EFNB2, LIG4 and SOX1 in 13q33-34 region are promising candidates for mental retardation. LIG4 was also a likely candidate for microcephaly.
Child, Preschool ; Chromosome Banding ; methods ; Chromosome Deletion ; Chromosomes, Human, Pair 13 ; genetics ; Female ; Genetic Testing ; methods ; Humans ; Infant ; Intellectual Disability ; genetics ; Male
10.Effects of acute and chronic trauma on degree centrality of brain functional images in patients with post-traumatic stress disorder who lost their only child
Bo LIU ; Yifeng LUO ; Rongfeng QI ; Jiyuan GE ; Huanhuan DAI ; Qingyue LAN ; Li ZHANG ; Feng CHEN ; Zhihong CAO ; Lingjiang LI ; Guangming LU
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(6):506-512
Objective:To investigate the effects and significance of acute and chronic trauma on brain degree centrality (DC) in patients with post-traumatic stress disorder (PTSD) who lost their only child at resting state.Methods:Retrospectively, the study enrolled a total of 51 parents with PTSD, including 35 PTSD parents whose children was lost in emergencies (acute bereaved PTSD group) and 16 PTSD parents whose children was lost of chronic causes such as diseases (chronic bereaved PTSD group). Fifty local adults were also included as healthy controls (HC group). The clinical administered PTSD scale(CAPS) was used to evaluate the severity of the subjects' clinical symptoms.Resting-state functional magnetic resonance imaging(fMRI) data of all subjects were collected and DC values were calculated.SPSS 22.0 software was used for statistical analysis.Covariance analysis was performed among three groups, while post hoc was performed between any two groups.What's more, correlation analyses were utilized between abnormal brain regions and the scores of CAPS.Results:Significant group effects were found in multiple regions, including the right inferior temporal gyrus (MNI: x, y, z=66, -27, -21), right temporal pole (MNI: x, y, z=54, 15, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15), bilateral medial superior frontal gyri (MNI: right x, y, z=6, 63, 12; left x, y, z=-3, 60, 18), left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with HC group, the DC of two patient groups increased in the right inferior temporal gyrus (MNI: acute x, y, z=63, -27, -21; chronic x, y, z=63, -21, -27); the DC of acute bereaved PTSD group decreased in the right temporal pole (MNI: x, y, z=45, 21, -15) and the right orbital inferior frontal gyrus (MNI: x, y, z=48, 24, -12), while the DC of chronic bereaved PTSD group decreased in the left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with chronic bereaved PTSD group, the DC of acute bereaved PTSD group increased in the left inferior parietal angular gyrus (MNI: x, y, z=-33, -39, 42) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51), while decreased in the right temporal pole (MNI: x, y, z=51, 12, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15) and bilateral medial superior frontal gyri (MNI: left x, y, z=0, 57, 15; right x, y, z=3, 57, 15). In chronic bereaved PTSD group, the DC of the left postcentral gyrus was negatively correlated with C1 (avoid trauma-related thoughts, feelings) score in CAPS ( r=-0.606, P=0.028). In acute bereaved PTSD group, the DC of the left medial superior frontal gyrus was negatively correlated with D4 (high vigilance) score ( r=-0.416, P=0.020). Conclusion:There exist functional abnormalities of multiple brain regions in acute and chronic bereaved parents with PTSD.The high arousal symptoms of the former may be related with the abnormalities of prefrontal-amygdala neural circuit, while the latter show higher avoidance which may be associated with the dysfunction of somatosensory brain regions such as postcentral gyrus.