Objective: To evaluate the prognostic value of left ventricular ejection fraction (LVEF) reserve assessed by gated SPECT myocardial perfusion imaging (SPECT G-MPI) for major adverse cardiovascular event (MACE) in patients with coronary artery disease. Methods: This is a retrospective cohort study. From January 2017 to December 2019, patients with coronary artery disease and confirmed myocardial ischemia by stress and rest SPECT G-MPI, and underwent coronary angiography within 3 months were enrolled. The sum stress score (SSS) and sum resting score (SRS) were analyzed by the standard 17-segment model, and the sum difference score (SDS, SDS=SSS-SRS) was calculated. The LVEF at stress and rest were analyzed by 4DM software. The LVEF reserve (ΔLVEF) was calculated (ΔLVEF=stress LVEF-rest LVEF). The primary endpoint was MACE, which was obtained by reviewing the medical record system or by telephone follow-up once every twelve months. Patients were divided into MACE-free and MACE groups. Spearman correlation analysis was used to analyze the correlation between ΔLVEF and all MPI parameters. Cox regression analysis was used to analyze the independent factors of MACE, and the optimal SDS cutoff value for predicting MACE was determined by receiver operating characteristic curve (ROC). Kaplan-Meier survival curves were plotted to compare the difference in the incidence of MACE between different SDS groups and different ΔLVEF groups. Results: A total of 164 patients with coronary artery disease [120 male; age (58.6±10.7) years] were included. The average follow-up time was (26.5±10.4) months, and a total of 30 MACE were recorded during follow-up. Multivariate Cox regression analysis showed that SDS (HR=1.069, 95%CI: 1.005-1.137, P=0.035) and ΔLVEF (HR=0.935, 95%CI: 0.878-0.995, P=0.034) were independent predictors of MACE. According to ROC curve analysis, the optimal cut-off to predict MACE was a SDS of 5.5 with an area under the curve of 0.63 (P=0.022). Survival analysis showed that the incidence of MACE was significantly higher in the SDS≥5.5 group than in the SDS<5.5 group (27.6% vs. 13.2%, P=0.019), but the incidence of MACE was significantly lower in the ΔLVEF≥0 group than in theΔLVEF<0 group (11.0% vs. 25.6%, P=0.022). Conclusions: LVEF reserve (ΔLVEF) assessed by SPECT G-MPI serves as an independent protective factor for MACE, while SDS is an independent risk predictor in patients with coronary artery disease. SPECT G-MPI is valuable for risk stratification by assessing myocardial ischemia and LVEF.
Humans ; Male ; Middle Aged ; Aged ; Coronary Artery Disease/diagnostic imaging* ; Stroke Volume ; Myocardial Perfusion Imaging ; Retrospective Studies ; Ventricular Function, Left ; Myocardial Ischemia

OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies

Embolization, Therapeutic

Objective:To analyze the main inputs and outputs of China's health reform,to propose suggestion on improving health policy.Methods:Using health economics input and output analysis methods.Results:From 2009 to 2016,more than 50％ of Chinese health personnel were distributed in the hospital and increased by year,more than 70％ of the government's main health expenditure were paid for disease treatment,the total number of new patients was 2.44 billion,and the number of inpatients was 100 million.The actual medical burden of individual residents in China was 49.36％ in 2016.The prevalence of chronic diseases among residents increased by 9％ from 2008 to 2013.Conclusion:China should put more new health investment and resources into disease prevention and control,so as to improve the health level and health input and output performance of residents.

Objective To evaluate the reliability and validity of the repeatable Battery for the assessment of neuropsychological status (RBANS)in elderly patients with vascular cognitive impairment(VCI).Methods General information and medical history were collected for 102 elderly patients with VCI,and the Mini-Mental State Exam(MMSE)and RBANS were conducted.Eight weeks later,91 of the patients were re-evaluated on RBANS.Data were analyzed for correlation,reliability and validity.Results The RBANS total score was negatively correlated with age(r =-0.464,P＜0.01)and disease course of diabetes (r =-0.387,P ＜ 0.01),and was positively correlated with education level(r=0.510,P＜ 0.01).The internal consistency measure,Cronbach's alpha,for RBANS total scores was 0.87 at an 8 week interval,and the test-retest reliability of single-item scores ranged from 0.61 to 0.77.Moreover,the correlation coefficient between the RBANS total score and the MMSE total score was 0.622.MMSE was correlated with several RBANS indexes,including immediate memory(r =0.672,P＜ 0.05),attention(r=0.612,P＜ 0.05),visual span(r=0.488,P＜ 0.05),delayed memory(r=0.492,P＜ 0.05),and language(r=0.298,P＜ 0.05).Likewise,RBANS was correlated with a number of MMSE categories,such as recall(r=0.473,P＜0.05),calculation(r=0.597,P＜0.05),delayed memory(r =0.489,P＜0.05),command(r=0.351,P＜0.05),reading comprehension(r=0.325,P＜ 0.05),command execution(r=0.511,P＜ 0.01),sentence construction (r =0.303,P ＜ 0.05),and pattern reproduction (r =0.443,P＜0.05).Conclusions The Chinese version of RBANS has good reliability and validity in elderly patients with VCI and can be used as a cognitive measurement tool in these patients.

Objective To analyze the causes of severe adverse reaction after painless abortion and to offer some advices for prevention and cure.Methods Clinical files and results of 3 patients with severe adverse re-action after painless abortion were analyze.Results Total of 130-140 mg· kg -1 propofol intravenous injection and oxytocin 10 u intramuscular injection was used in three patients underwent painless abortion.Three patients have the symptoms of chills , fever , nausea , vomiting , low blood pressure , damages of multiple organs and elevation of peripheral white blood cell and neutrophilic granulocyte.The shock occurred within 0.5-4 h after operation.Conclusion The symptoms of severe adverse reac-tion after transfusion are very serious.Early diagnosis and rational man-agement are the key to the successful salvage.

BACKGROUNDDiabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome.

METHODSThe study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher's exact test. An independent Student's t-test was used to compare normally distributed continuous data.

RESULTSPatients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications (8.9% vs. 3.0%, P = 0.021), urinary tract infections (12.0% vs. 2.8%, P < 0.001), and gastrointestinal symptoms (15.0% vs. 6.8%, P = 0.003). No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group ((8.0 ± 5.1) vs. (6.2 ± 3.7) days and (16.5 ± 3.8) vs. (13.3 ± 3.8) days, P < 0.001, respectively). Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors (71.9% vs. 85.9%, P < 0.001) and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups (16.1% and 15.9%, respectively), who were able to ambulate outdoors before the fracture, became housebound till the final follow-up.

CONCLUSIONSDiabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics thereafter.

Aged ; Aged, 80 and over ; Chi-Square Distribution ; Diabetes Mellitus ; physiopathology ; Female ; Hip Fractures ; physiopathology ; Humans ; Male ; Middle Aged ; Perioperative Period ; Treatment Outcome

To characterize the complete genome sequence of coxsackievirus B1 (CVB1) MSH/KM9/2009 strain isolated from Yunnan, China,2009. Eight overlapping clones covering the whole viral genome (excluding the poly-A tail) were obtained by RT-PCR and sequenced, and their nucleotide and amino acid sequences were compared with other known CVB1 strains. The genome of the CVB1 MSH/KM9/2009 strain had 7384 nucleotides in length, and contained a 741nt non-translated region (NTR) at the 5' end and a 94nt NTR at the 3' end. The entire open reading frame contained 6 549 nt, encoding a 2 183-aa polyprotein. In the coding region, there was no nucleotide deletion or insertion, but some changes of amino acid were unique. The complete genome sequence alignments showed that the CVB1 isolate MSH/KM9/2009 strain shared the highest nucleotide (80.9%, 81.6%, 80.5% and 80%) and amino acid (95.6%, 95.8%, 96.2% and 95.6%) identities to the CVB1 M16560, pmMC, Tucson B1 and CVB1Nm strain, respectively. Phylogenetic tree analysis showed that the MSH/KM9/2009, CVB1 M16560, pmMC, Tucson B1 and CVB1Nm strain clustered into same group. The newly isolated CVB1 strain MSH/KM9/2009 from Yunnan Province belonged to genotype CVB1.
Base Sequence ; Child, Preschool ; China ; Coxsackievirus Infections ; virology ; Enterovirus ; classification ; genetics ; isolation & purification ; Female ; Genome, Viral ; Genotype ; Humans ; Infant ; Male ; Open Reading Frames ; Phylogeny ; Viral Proteins ; genetics

OBJECTIVETo explore the safety and effectiveness of endoscopic mucosal resection (EMR) in the treatment of colorectal polyps.

METHODEMR was applied in the treatment of colorectal polyps.

RESULTSA total of 3578 polyps in 2609 patients were all completely resected except 2 cases and the integrated rate of samples was 99.6%. Intra- and post-operation complications occurred in 22 cases(0.8%), including 7 intraoperative bleeding, 5 postoperative bleeding, and 10 thermal burn, which were cured by symptomatic treatment. A total of 1530 (58.6%) cases were followed-up with 3-12 months and no relapse was found in former place of excision.

CONCLUSIONEMR can be applied in resection of colorectal polyps effectively and safely.

Aged ; Endoscopy, Gastrointestinal ; Humans ; Intestinal Mucosa ; surgery ; Intestinal Polyps ; surgery ; Postoperative Hemorrhage ; Recurrence

Objective To explore the effect of continue nursing out of hospital on the rehabilitation patients with first onset schizophrenia and to provide theoretical guidance for the development of hospital extended care.Methods Totals of 120 patients with first onset schizophrenia were randomly divided into study group and control group,each group 60 cases. Study group received continue nursing interventions out of hospital in two stages,control group only received conventional treatment,nursing,discharge instruction,and followed up one year.Medication compliance,disease recurrence and reemployment of patients were recorded.After patients discharged six months and one year,they were investigated with Brief psychotic symptoms scale (BPRS) and comprehensive assessment of quality of life questionnaire (GQOLI-74).Results In study group,there was 39 patients complied doctors' advice,7 patients' disease recurred and 13 patients were reemployment,while 26 patients complied doctors' advice,17 patients' disease recurred and 4 patients were reemployment in control group,and the differences were statistically significant (x2 =5.673,5.208,5.551,respectively;P＜0.05).There was no significant difference on the BPRS scores in two groups before implemented continue nursing outside hospital ( P ＞ 0.05 ) ; while after implemented continue nursing,the total score of BPRS in study group was (54.34 ± 6.608 ) higher than ( 43.63 ± 5.47 ) in control group,and the differences were statistically significant(t =6.749,P ＜ 0.01 ).One year later,the EQOL-74 score in physical function (62.14 ± 7.16),psychological function ( 61.54 ± 7.14) and social function ( 60.42 ± 5.28 ) in study group were higher than that of control group that was (62.14 ± 7.16),( 61.54 ± 7.14 ),( 60.42 ± 5.28 )respectively,and the differences were statistically significant ( t =3.304,3.259,3.959,respectively; P ＜ 0.01 ).Comparison of medication compliance,and ratio between two groups,the differences were statistically significant (P ＜ 0.05).Condusions Continue nursing care can improve the social function of patients with first onset schizophrenia,improve their quality of life,promote their recovery and return to society.