Background:Clinical features and outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios (HRs) of endpoints of short-term all-cause mortality (SAM),long-term all-cause mortality (LAM),long-term cardiovascular death (LCD) and long-term HF rehospitalization (LHR) among patients with HFmrEF and HF with preserved ejection fraction (HFpEF),HF with reduced ejection fraction (HFrEF) were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6 ± 2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF (reference) HR:1.07,95％ confidence interval (CI):1.00-1.15 (I2=63％,P =0.0005);HFmrEF:HFrEF (reference) HR:0.80,95％ CI:0.73-0.88 (I2=70％,P ＜ 0.0001).However,HFmrEF patients had the lowest rate in LAM (30.94％),SAM (2.73％),LCD (17.45％),LHR (26.36％) compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special "separation phenomenon" showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.

Animals ; Brain ; metabolism ; physiology ; Circadian Rhythm ; physiology ; Female ; Fluorodeoxyglucose F18 ; pharmacokinetics ; Heart ; physiology ; Male ; Mice ; Mice, Inbred C57BL

Asthma ; blood ; Child ; Child, Preschool ; Complement Membrane Attack Complex ; analysis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Male ; Vascular Cell Adhesion Molecule-1 ; blood

Objective To investigate the effect of clinical pathway on inpatients for rehabilitation. Methods The hospital expense, the ex-pense for medicine and length of stay in hospital were compared in patients with cerebral hemorrhage, cerebral infarction, spinal cord injury and spastic cerebral palsy before (January 1st, 2012 to April 30th, 2013) and after (May 1st, 2013 to December 31st, 2015) clinical pathway implementation, 50 inpatients for each disease, totally 200 patients. Results The length of stay in hospital reduced after of clinical pathway implementation, in all the diseases (t>5.226, P<0.001), with the decrease of hospital expense for cerebral infarction (t=3.327, P<0.001). There was no significant increase in any expense in the disease (t<1.777, P>0.05). Conclusion The implementation of rehabilitation clinical pathway can reduce the length of stay in hospital for the patients rehabilitation in hospital, without increasing their cost.

Objective To explore the characteristics of etiology,clinical,electroencephalogram(EEG) and prognosis of infantile spasms(IS) with focal seizures(FS).Methods The significance of age onset,seizure patterns and atteration,etiology,video-EEG(VEEG) and evolution of FS correlating to epileptic spasms(ES),which occurred in 12 cases with IS by means of clinical observation,cranial CT or MRI,VEEG monitory and follow up were investigated.Twelve cases were divided into group A,B,C according to the stages of FS occurring prece-ding,coinciding and following ES.Results Ten cases with IS were identified from focal cortical dysplasia,tuberous scleroses complex,temporal lobe cyst or scleroses and hypoxic-ischemic encephalopathy and others.Clinical manifestation presented FS at certain times during the course of the disease,and other characteristics of frequent attacks,asymmetric spasms or tonic spasms,some atypical seizures in the eyes and the head,motionless staring and focal motor seizures and other.The correlation of ES to FS occurred during one ictal episode as follows:FS→ES(6 cases),ES→FS→ES(1 case),ES→FS(3 cases).FS appeared more frequently,atypical,predominantly involving ocular,facial,oral movement or generalized convulsion,migrating or alternating seizures,associated with epileptic discharges of posterior parietal-occipital and parietal-temporal-occipital origins in group A and early period of group B;whereas in the late period of group B and group C,FS occurred less frequently and more stable,presenting complex partial seizures or secondarily generalized seizures originated mainly from frontal and surrounding areas in the lateralized or bilateral hemispheres.Regarding the natural evolution and development of IS,2 cases with early FS developed into IS;6 cases with IS evolved into Lennox-Gastaut syndrome or symtomatic generalized epilepsy,4 cases got into FS,1 case maintained in a peculiarly epileptic state with FS as well as ES until the operation at 4.5 years old,and the other case was not identified clearly.Conclusions IS coincided with FS is a special kind of aged-related FS associated with secondarily generalized seizures and epileptic encephalopathy.The multiple etiology,seizure patterns,ictal-interictal EEG,clinical evolution and prognosis of the disorder,indicate a complicated interaction of the immature cortico-subcortical abnormalities in the critical developmental period and thereafter,can be identified as a peculiar form of clinical epileptic syndrome.

Objective To evaluate the effect of training for therapists based on Kirkpatrick's Four-level Model. Methods Totally 39 ther-apists who completed 2014 Beijing Clinical Shortage of Manpower Training Programs (Therapist) were investigated with Kirkpatrick's Four-level Model, named reaction, learning, behavior and results. Results For reaction level, the total satisfaction was high, but different with the degree of education, especially in the items of Participate in Training, Type of Cases, Organizing on Practice Training, Organizing Case Discussions and Get A Lot of Benefits from the Training (F>4.59, P<0.05). For learning level, the test scores were significantly differ-ent before and after the training (t>9.53, P<0.001). For behavior level, the self-reports of the therapists, and the reports from their depart-ment directors and colleagues all agreed that their ability improved after training (t>4.44, P<0.001). For results level, eleven therapists passed the rehabilitation therapist test, two therapists participated in some researches, and one published an article. Conclusion The thera-pists satisfied in the training, that may improve the ability of therapists to contribute to their organization.

The effects of continuous subcutaneous insulin injection (CSII, n=306) and multiple subcutaneous insulin injection (MSII, n=310)on hyperglycemia in patients with diabetes mellitus were compared. The results suggest that the effect of CSII is more prompt and efficient with lower incidence of hypoglycemia as compared with MSII.

Objective To explore the methods of training for therapists. Methods The students participated in 2014 Beijing Clinical Shortage of Manpower Training Programs (Therapist) by Beijing Quality Control and Improvement Center of Medical Rehabilitation accepted theoretical and operating training and tests. They were interviewed for the situation of training program. Results 39 students had completed the training with the average age of (28.41±6.05) years. The average scores of theory test was (76.23±5.70), and it was (87.18±8.00) of operation. The score of theory test was more than that before the training (P<0.01). From interview, a total of 59 recommendations were obtained, which focused on the quality of training of training provider and the support from sending institutes. Conclusion Beijing Clinical Shortage of Manpower Training Programs (Therapist) has improved the academic and operative level of therapists.

Objective To analyze the expression level of HSP72 and HSP73,the subtypes of HSP70, in peripheral blood lymphocytes from lung carcinoma patients on both basic and heat injury conditions,and to explore the significance of HSP70 in the development of lung cancer.Methods Lung cancer patients were selected'as experimental group,and the health people with similar age,gender,vocational history and inhabi- tation to the experimental group were chosen as control group.The blood lymphocytes from both groups were isolated,cultured and treated with heat injury at either 37℃or 42℃.The expressions of HSP72 and HSP73 in the isolated lymphocytes were determined by Flow Cytometry.Results There were much higher expressions of HSP72 and HSP73 in control group(21.97?2.40 vs 12.77?0.66)than which in experimental group(HSP72 19.0?2.12 vs HSP73 11.74?0.68,P

Female ; Hemoperfusion ; Humans ; Male ; Organophosphate Poisoning ; Pesticides ; poisoning ; Poisoning ; therapy ; Renal Dialysis