Adolescent ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Poisoning ; mortality ; therapy ; Survival Rate ; Treatment Outcome ; Unithiol ; therapeutic use

OBJECTIVE: To develop a SVM model which is constructed by using particle swarm optimization to a predict the plasma concentration of remifentail. METHODS: This research establishes a PSO-SVM model which is constructed by using particle swarm optimization to a predict the plasma concentration of remifentanil. The model was capable of capturing the nonlinear relationship among plasma concentration, time, and the patient's signs exactly. RESULTS: The average error of PSO-SVM is -1.07%, while that of NONMEM is -2.24%. The absolute average error of PSO-SVM is 9.09%, while that of NONMEM is 19.92%. CONCLUSION: Experimental results indicate that PSO-SVM model could predict the plasma concentration of remifentanil rapidly and stably, with high accuracy and low error. For the characteristic of simple principle and fast computing speed, this method is suitable to data analysis of short-acting anesthesia drug population pharmacokinetics and pharmacodynamics.

Objective To investigate the related risk factors in patients with atrial fibrillation in order to prevent and delay the occurrence of atrial fibrillation.Methods Five hundred and fifty-eight inpatients with atrial fibrillation were retrospectively analyzed from June 2005 to June 2008.They were divided into several groups according to the age and the characteristics of the elder patients with atrial fibrillation were analyzed.Results In the 558 cases with atrial fibrillation, there were 298 males (53.4%) and 260 females (46.6%) aged from 21 to 97 years.The average age was (72.8 ±10.1) years.There were 57 cases aged 21-59 years(10.2 %)and 501 cases aged 60-97 years(89.8 %).The total number of inpatients in our hospital was 11 869, and there were 4049 cases aged<60 years, 2527 cases aged 60-69 years, 3971 cases aged 70-79 years, 1244 cases aged 80-89 years and 78 cases aged>90 years.The proportions of the inpatients with atrial fibrillation in the above five age groups of inpatients were 1.4%(57 cases), 4.2%(107 cases), 6.6% (262 cases), 9.5%(118 cases)and 17.9% (14 cases), respectively.In 558 cases with atrial fibrillation, there were 230 cases (41.2%) with paroxysmal atrial fibrillation, 44 cases (7.9%) with persistent atrial fibrillation and 284 cases (50.9%) with permanent atrial fibrillation.The most common underlying disease was hypertension in the 558 cases, followed by coronary heart disease, heart failure, diabetes, rheumatic heart disease and so on.Conclusions The prevalence of atrial fibrillation is increased with aging.Hypertension, coronary heart disease, rheumatic heart disease, heart failure, hyperthyroidism,diabetes, chronic pulmonary disease and renal failure are all the risk factors for atrial fibrillation.

Objective To discuss the relationship of hypertension with ageing and comorbidities in 6426 inpatients. Methods The data of 6426 inpatients with hypertension from May 2005 to May 2009 were analyzed retrospectively. All inpatients were divided into four groups: the young-aged group from 18 to 44 yrs (n= 312, 4. 8%), the middle-aged group from 45 to 59 yrs (n= 1529,23.8%), the elderly group from 60 to 79 yrs (n=3847, 59.9%) and the old old group from 80 to 99 yrs (n=738, 11.5%). The percentages of hypertension patients in the same age group over the same period were calculated and the comorbidities were observed respectively. Results Of 6426 hypertensive cases, there were 3438 males (53.5%) and 2988 females (46.5%), ranging from 18 to 99 yrs with the average age of (66.3± 12. 1) yrs. There were 25 504 inpatients over 18 years old including 11 208 in the youth group, 5389 in the middle-aged group, 7596 in the elderly group and 1311 in the old old group. The proportions of hypertension inpatients to total in-patients in the four age groups were 2.8%, 28. 4%, 50.7% and 56.3% respectively. In the youth and middle-aged groups, numbers of males with hypertension were more than of females, however there was no significant difference in gender in the elderly and the old old groups. Within 6426 inpatients with hypertension, 2069 (32.2 %) had diabetes mellitus, 1508 (23.5%) had hyperlipidemia, 105 (1.6 % )had sleep apnea syndrome, 1061 (16.5%) had coronary artery disease, 904 (14.1%) had heart failure, 2353 (36.6%) had stroke and 678 (10. 6%) had kidney failure. Conclusions The prevalence of hypertension increases with ageing significantly. The correlated risk factors for hypertension include diabetes mellitus, hyperlipidemia and sleep apnea syndrome, being a clustering phenomenon, especially for elder patients. These risk factors also deteriorate the damage on heart,brain, kidney and other target organs, which might ultimately result in serious cardio-cerebral vascular events. Therefore, besides control of blood pressure, we should strengthen the complex treatment on hypertension to prevent and delay the occur of complicating diseases.

OBJECTIVE To investigate the clinical application of antibiotic agents in a hospital.METHODS A cross section investigation method was used to survey the clinical application of antibiotic agents for emergency,out-patient clinic and hospitalization patients in a hospital within a day.RESULTS The usage rate of antibiotic agents for emergency patients was the maximum(54.67%) and the percentage of drug combination was multitude(23.42%).It was involved in 10 categories of antibiotic agents,cephalosporin was used at most(61.92%).The usage rate of antibiotic agents in Department of Gynecology and Obstetrics(OG) was the maximum(37.96%).Department with top defined DDD rate was Respiration Medical Department(RMD,39.90%).The average rate of etiological examination in the whole hospital was 6.67%.CONCLUSIONS It is higher in the usage rate of antibiotic agents for emergency patients.It is much more usage of antibiotic agents in OG and RMD,furthermore,the antibiotic agents are excessively used and the rate of etiological examination is low.Management should be further strengthened for rational use of antibiotic agents.

To investigate the epidemic and evolutionary trends of enterovirus (EV) in the external environment of Yunnan Province, China, molecular typing was performed on 4 EV strains that were isolated from environmental sewage in Yunnan. The VP1 region of isolates was amplified by RT-PCR using universal enterovirus primers, and the amplified VP1 region was sequenced for GenBank BLAST search and genotype analysis. The 4 EV strains were identified as ECHO7. Their nucleotide and amino acid homologies with the VP1 sequences of 68 ECHO7 strains retrieved from GenBank were measured by Mega software analysis. Our findings showed that ECHO7 strains from environmental sewage and population samples were in different evolutionary branches. These strains showed typical geographical and temporal differences; In addition, there were different transmission chains at the same time and in the same area. ECHO7 strains isolated from sewage water and patients with acute flaccid paralysis during the same period in Yunnan belonged to different clusters and evolved at different speeds. Special concerns are needed for this problem. Continuous molecular biological surveillance of human EV in the external environment of Yunnan will provide strong support for early warning of EV diseases.
China ; Databases, Genetic ; Enterovirus ; genetics ; isolation & purification ; Evolution, Molecular ; Humans ; Molecular Epidemiology ; Sequence Analysis ; Sewage ; virology

Animals ; Aorta ; drug effects ; physiology ; Blood Pressure ; drug effects ; Cadmium ; toxicity ; Female ; In Vitro Techniques ; Male ; Muscle, Smooth, Vascular ; drug effects ; physiology ; Rabbits ; Vasoconstriction ; drug effects

OBJECTIVETo investigate the short-term prognostic value of the indocyanine green clearance test when used in combination with the model for end-stage liver disease (MELD) scoring system to assess patients with hepatitis B virus acute-on-chronic liver failure (HBV-ACLF).

METHODSClinical data of 105 patients diagnosed with HBV-ACLF were retrospectively analyzed. The indocyanine green retention rate at 15 minutes (ICGR15), clinical data within 24 h after diagnosis, Child-Turcotte-Pugh (CTP) classification, MELD score, MELD combined with sodium concentration (MELD-Na) score, and King's Hospital (KCH) criteria data were collected for analysis. Measurement data were assessed by t-test and count data by the chi-square test. Short-term predictive accuracy for patients with HBV-ACLF was compared between different models using the area under the receiver operating characteristic (ROC) curve (AUC).

RESULTSThe mortality rate for all patients was 45.71%. Comparison of the survivors versus the non-survivors showed that age, total bilirubin, albumin, cholinesterase, creatinine, international normalized ratio, and incidence positive rate of relative complications (hepatorenal syndrome, hepatic encephalopathy) were significantly different between the two groups (all, P less than 0.05). The ICGR15 was found to be positively correlated with MELD score (r = 0.205, P less than 0.05). The MELD-ICGR15 model constructed by logistic regression analysis was: Logit(P) = 0.193 * MELD + 0.130 * ICGR15 - 11.256. The AUC was 0.880 and the cut-off was -0.706, with 89.6% sensitivity and 75.4% specificity. The AUC of the MELD-ICGR15 model was significantly higher than that of the ICGR15 (0.820), MELD score (0.779), MELD-Na score (0.761), KCH criteria (0.680), and CTP classification (0.631) (all, P less than 0.05).

CONCLUSIONICGR15, MELD score, and MELD-Na score had higher predictive values for HBV-ACLF than did CTP classification or KCH criteria. Furthermore, the MELD-ICGR15 model was better than any single parameter model for predicting the short-term prognosis of patients with HBV-ACLF.

Acute-On-Chronic Liver Failure ; diagnosis ; virology ; Adult ; Aged ; End Stage Liver Disease ; Female ; Hepatitis B ; complications ; Humans ; Indocyanine Green ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Young Adult

Objective To investigate the effect of folic acid combined with Helicobacter pylori (Hp) eradication therapy on chronic atrophic gastritis.Methods From December 2009 to March 2011 at the First Affiliated Hospital of Nanjing Medical University,184 patients with endoscopic and pathological diagnosis of chronic atrophic gastritis (90 Hp positive and 94 Hp negative) were selected.Hp positive patients were divided into group A and group B.Forty-three patients in group A were treated with standard triple Hp eradication therapy and follow by folic acid therapy for three months.Forty-seven patients in group B and Hp negative patients received three months of folic acid therapy.The clinical symptoms of each group were scored before treatment,one month after folie acid therapy and three months after folic acid therapy and analyzed by t test. Patients of each group received gastroscopy before treatment and three months after medicine withdrawal. Endoscopic scores,pathological scores and t test were recorded.The serum levels of pepsinogen ( Ⅰ,Ⅱ ) and gastrin 17 in venous blood of 55 Hp negative patients were detected by enzyme-linked immunosorbent assay (ELISA) method before treatment and three months after medicine withdrawal.Results Compared with three months therapy (1.15 ± 0.03),after one month folic acid therapy (1.55 ± 0.04) was statistically significant in clinical symptoms score of all patients (t =8.18,P＜0.01).By the end of therapy,clinical symptom score of group A (1.06 ± 0.04) was lower than that of group B (1.56 ±0.08),and the difference was significant (t=6.00,P＜0.01).There was significant difference in endoscopic scores of all patients between before treatment (1.57±0.95) and after treatment (1.00±0.76,t=11.12,P＜0.01).The differences in each pathological score of all patients (inflammatory scoring,active scoring,atrophy scoring,intestinal metaplasia scoring,atypical hyperplasia degree scoring) were significant between before treatment and after treatment (t=5.51,6.90,7.53,6.34,2.90,respectively,all P＜0.01).The serum level of pepsinogen Ⅰ before treatment of 55 Hp negative patients [(1.03±0.19) nmol/L] was lower than that after treatment [(2.24±0.33) nmol/L],and the difference was statistically significant (t=3.19,P＜0.01).After treatment the level of gastrin 17 [(0.86±0.05) nmol/L] was higher than that before treatment [(0.47±0.05) nmol/L],and the difference was statistically significant ( t =5.33,P＜ 0.01 ).Conclusion Folic acid in combination with Hp eradication therapy can be favorable to atrophic gastritis,which may promote the secretion of pepsinogen and gastrin.

Objective To study the composition of variant and point mutations of Norovirus GⅡ.4 in Guiyang regions.Methods From June to November 2010,cases information and fecal specimens were collected from guard-hospitals in Guiyang regions,who had caught the acute-gastroenteritis.Noroviruses in specimens were detected by a real-time reverse transcription polymerase chain reaction(real-time RT-PCR),and then partial genotyped norovirus-positive clinical samples (in random) were cloned and sequenced in VP1 gene code.Furthermore,the gene sequences were compared with the published variants at home and abroad of norovirus(GⅡ.4),including the phylogenetic analyses of genomes and variation of amino acids within individual sites.Results Those 267 specimens were GⅡ-norovirus-positive(62.68％) in 426 clinical samples.There were nine GⅡ.4-norovirus-positive VP1 gene-sequences available,and two subtype-norovirus variants (GⅡ.4 2008a and G Ⅱ.4 2008b variant) were epidemic in 2010,Guizhou province.The homology between and in subgroups were 95.90％-96.72％ and 99.45％-100％.Two amino acids within individual sites were apt to mutate.Conclusion Norovirus GⅡ genotype were predominant in summer and fall acute gastroenteritis in 2010 for Guiyang regions,and the variants were diversity.