Objective:To analyze the correlation of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)levels with the severity of coronary heart disease in elderly patients.Methods:Clinical data of 200 elderly patients with coronary heart disease in the hospital from January 2017 to July 2019 were retrospectively collected.Data of 80 healthy elderly patients undergoing regular physical examinations in our hospital during the same period were collected and used as the healthy control group.All patients received laboratory tests using relevant parameters and coronary angiography on admission, with complete records of examination results for analysis.Based on SYNTAX scores from angiography of coronary artery lesions, all 200 elderly patients with coronary heart disease were further divided into a low-risk lesion subgroup, an intermediate-risk lesion subgroup and a high-risk lesion subgroup.The correlation of serum Lp-PLA2 and NLRP3 levels with the severity of coronary lesions was analyzed in elderly patients with coronary heart disease.Results:The mean SYNTAX score was 27.6±10.1.There were 60 cases with low-risk lesions, 68 cases with intermediate-risk lesions and 72 cases with high-risk lesions, accounting for 30.0%, 34.0% and 36.0%, respectively.The control group had the lowest serum levels of Lp-PLA2 and NLRP3, followed by the low-risk lesion, intermediate-risk lesion and high-risk lesion subgroups( F=305.026, 9.173 and 582.029, all P<0.001). Bivariate Pearson correlation analysis showed that serum levels of Lp-PLA2 and NLRP3 were positively correlated to the Syntax score in elderly patients with coronary heart disease( r=0.545 and 0.689, all P<0.001). Conclusions:Serum levels of Lp-PLA2 and NLRP3 are correlated to the severity of coronary artery disease in elderly patients with coronary heart disease.Overexpression of these two markers may indicate growing severity of coronary artery disease.Testing for serum Lp-PLA2 and NLRP3 levels in elderly patients with coronary heart disease can be considered to evaluate coronary lesions and treatment options in the future.

Abstact:Objective To evaluate the method change from JSCC to IFCC for ALT,AST,GGT and LDH Detection.Methods The accuracy,precision,linearity and reportable range of the new detection method for ALT,AST,GGT and LDH,and the comparison analysis on the two different reagents were evaluated.Results All the accuracy bias of the testing items were within the required 1/2TEa,and all the within-run precision and between run precision were within the required 1/4TEa and 1/3TEa respectively.The linear verification results got the regression equation of the theoretical and measured valuesY =aX+b,in which a was within the range of 0.97~1.03,b was within an acceptable range.The reportable range verification re-sults showed that after the samples being diluted by different proportions,the measured/expected values were all between 90% and 110%,indicating that within a certain range of sample dilution the test esults were reliable.The comparison results showed the R 2 closed to 1.Conclusion The evaluation of the method change for ALT,AST,GGT and LDH detection met the basic requirements of the experiments in clinical diagnosis.

Objective: To study the extraction technology of ursolic acid from sambucus chinensis Lindl. Methods: The method of ethanol extraction and agglutination separation was adopted for extracting ursolic acid. Results: The extraction rate was 90%, its purification was 98%, the product was recognized to be ursolic acid by physicochemical contents and spectral identification. Conclusion: This method is advanced, practical, reasonable and feasible. It can be applied in industrial production.

Object To research and choose the best technology c onditions for extracting ursolic acid from Sambucus chinensis Li ndl. Methods According to physicochemical character of ursolic aci d, orthogonal design and tests of extract technology for ursolic acid were ca rried on, and four factors were chosen such as concentration, qu an tity of ethanol, extracting time, concentration of clearing agent, and three lev els of each factor were used for orthogonal design and test. Results That was the best technology condition that ursolic acid was extracted by means of ethyl alcohol (90%) of 7 times as much as raw materials, and it is heat ed 2 times (each 1 h), and the concentration of clearing agent was 3%. Conclusion That is a better technology for industrial producti on because it is advanced and rational, practical and feasible.

OBJECTIVE To determine the distribution of allergens in patients with allergic rhinitis in Wenzhou area. METHODS Patients with AR symptoms from January 2013 to December 2014 were given skin prick test (SPT). The clinical data about SPT was retrospectively colleceted to analyze SPT results. RESULTS 1. Among 2991 individuals, the total positive rate of SPT was 82.0%, with Dermatophagoides farinae (Der. f) and Dermatophagoides pteronyssinus (Der.p) as the most common allergens; the positive rate of inhalant allergen was obviously higher than that of ingestive ones, with significantly statistical difference(χ2=2006.557,P<0.01). Most of patients were allergic to double allergens; the intensity of Der.f and Der.p mainly presented as (++++), with no significant difference(Z=-0.391, P=0.696). 2. There was significant difference of variation with seasons(χ2=34.254, P<0.01). 3. No significant difference of positive rate were observed in different AR-courses(χ2=16.102, P<0.01). 4. Significant difference of positive rate was found among different age-groups; The positive rate was increased along with growing age, got peak at group of 10-12 years old, and then got down after that. CONCLUSION Dust mite was the main allergen coursed AR in Wenzhou area. Seasons and age were two important factors effecting on positive of SPT and onset of AR. The positive rate of allergens was related to age.

Objective:To examine potential predisposing risk factors for coronary heart disease(CHD)in elderly patients and the correlation between serum uric acid levels and the predisposing risk factors in elderly patients with CHD.Methods:Clinical data of 200 elderly inpatients with CHD(CHD group)and 150 elderly outpatients without CHD(control group)at our hospital from January 2017 to January 2019 were retrospectively analyzed.Peripheral venous blood was collected from patients immediately after admission, and serum uric acid levels were measured.Baseline information of patients was recorded.Potential predisposing risk factors of CHD were identified by single-factor and multiple-factor analysis, and serum uric acid levels were compared against predisposing risk factors.The correlation between serum uric acid levels and predisposing risk factors in elderly patients with CHD was analyzed.Results:According to preliminary single-factor analysis, smoking, diabetes mellitus, low high-density lipoprotein cholesterol(HDL-C)hypolipidemia, family history of CHD and glomerular filtration rate seemed to be predisposing risk factors for elderly patients with CHD( χ2=6.739, 15.655, 6.331, 9.615, 23.279, P<0.05). Multiple-factor analysis showed that smoking, diabetes mellitus, low HDL-C hypolipidemia, family history of CHD and glomerular filtration rate were predisposing risk factors for elderly patients with CHD( OR=1.777, 2.381, 1.883, 1.967, 3.205, all P<0.05). Serum uric acid levels in elderly CHD patients with smoking, diabetes mellitus, low HDL-C hypolipidemia, family history of CHD or glomerular filtration rate<100 ml/min were higher than in patients without any of those conditions, and the difference was statistically significant( t=8.017, 5.907, 8.509, 7.164, 13.839, P<0.001). Spearman correlation analysis showed that serum uric acid levels were positively correlated with risk factors such as smoking, diabetes mellitus, and family history of CHD in elderly patients with CHD( r=0.409, 0.422, 0.422, all P<0.001), and were negatively correlated with low HDL-C hypolipidemia and glomerular filtration rate( r=-0.428 and -0.481, all P<0.001). Conclusions:High level serum uric acid is closely related to many CHD risk factors such as smoking and diabetes mellitus and may be an independent risk factor for the onset of CHD.

Objective:To verify the clinical efficacy and safety of Qufeng Tongxuan method in treating low- and moderate-volume intracerebral hemorrhage at acute stage.Methods:A prospective, multicenter, randomized, double-blind, placebo-controlled study was performed; patients with low- and moderate-volume intracerebral hemorrhage at the basal ganglia and/or thalamus accepted treatment in 16 hospitals from September 2019 to April 2022 were enrolled. These patients were divided into experimental and control groups with a block randomized method by SAS software. Patients in control group were given conventional western medicine treatment; those in experimental group accepted Qufeng Tongxuan method (sequential therapy of Shexiang Huayu Xingnao granules and Zhilong Huoxue Tongyu granules) besides conventional western medicine treatment. NIHSS was used to assess neurological function before treatment and on 7 th, 14 th, 30 th, and 90 th d of treatment. Prognoses of these patients were assessed by modified Rankin scale (mRS) before treatment and on 180 th d of treatment. Brain CT was performed before treatment and on 7 th and 14 th d of treatment to calculate the hematoma volume. Before treatment and on 14 th d of treatment, changes of coagulation function, liver and kidney functions of the 2 groups were compared. Adverse reactions during treatment in the 2 groups were recorded. Results:No significant differences in NIHSS scores were noted between the 2 groups before treatment, on 7 th, 14 th, and 30 th d of treatment ( P>0.05); NIHSS scores in experimental group on 90 th d of treatment were signficantly lower than those in control group ( P<0.05); NIHSS scores in experimental group decreased gradually before treatment and on 7 th, 14 th, 30 th and 90 th d of treatment, with statistical significances ( P<0.05). No significant differences in mRS scores were noted between the 2 groups before treatment ( P>0.05); mRS scores in experimental group on 180 th d of treatment were signfciantly lower than those in control group ( P<0.05). No significant difference in hematoma volume was noted between the 2 groups before treatment and on 7 th and 14 th d of treatment ( P>0.05); both groups had gradually decreased hematoma volumes before treatment and on 7 th and 14 th d of treatment, respectively, with significant differences ( P<0.05); the volume difference of hematoma between 14 th d of treatment and before treatment in experimental group (6.42[4.10, 11.73]) was significantly higher than that in control group (4.00[1.25, 10.58], P<0.05). No significant differences in liver and kidney function indexes or coagulation function indexes were noted between the 2 groups before treatment and on 14 th d of treatment ( P>0.05). Adverse reaction incidence was 9.52% ( n=12) in experimental group and 10.34% ( n=12) in control group, without statistical difference ( P>0.05). Conclusion:Under premise of conventional western medicine treatment, Qufeng Tongxuan method can promote hematoma absorption and improve neurological deficit symptoms in low- and moderate-volume intracerebral hemorrhage at acute stage, without obvious adverse reactions.

OBJECTIVE: To investigate the development present situation of the department of critical care medicine in Inner Mongolia Autonomous Region (hereinafter referred to as Inner Mongolia), in order to promote the standardized and homogeneous development of critical care medicine in Inner Mongolia, and also provide a reference for discipline construction and resource allocation. METHODS: A survey study was conducted in comprehensive intensive care unit (ICU) of tertiary and secondary hospitals in Inner Mongolia by online questionnaire survey and telephone data verification. The questionnaire was based on the Guidelines for the Construction and Management of Intensive Care Units (Trial) (hereinafter referred to as the Guidelines) issued by the National Health Commission in 2009 and the development trend of the discipline. The questionnaire covered six aspects, including hospital basic information, ICU basic information, personnel allocation, medical quality management, technical skill and equipment configuration. The questionnaire was distributed in September 2022, and it was filled out by the discipline leaders or department heads of each hospital. RESULTS: As of October 24, 2022, a total of 101 questionnaires had been distributed, 85 questionnaires had been recovered, and the questionnaire recovery rate had reached 84.16%, of which 71 valid questionnaires had been collected in a total of 71 comprehensive ICU. (1) There were noticeable regional differences in the distribution of comprehensive ICU in Inner Mongolia, with a relatively weak distribution in the east and west, and the overall distribution was uneven. The development of critical care medicine in Inner Mongolia was still lacking. (2) Basic information of hospitals: the population and economy restricted the development of ICU. The average number of comprehensive ICU beds in the western region was only half of that in the central region (beds: 39.0 vs. 86.0), and the average number of ICU beds in the eastern region was in the middle (83.6 beds), which was relatively uneven. (3) Basic information of ICU: among the 71 comprehensive ICU surveyed, there were 44 tertiary hospitals and 27 secondary hospitals. The ratio of ICU beds to total beds in tertiary hospitals was significantly lower than that in secondary hospitals [(1.59±0.81)% vs. (2.11±1.07)%, P < 0.05], which were significantly lower than the requirements of the Guidelines of 2%-8%. The utilization rate of ICU in tertiary and secondary hospitals [(63.63±22.40)% and (44.65±20.66)%, P < 0.01] were both lower than the bed utilization rate required by the Guidelines (75% should be appropriate). (4) Staffing of ICU: there were 376 doctors and 1 117 nurses in tertiary hospitals, while secondary hospitals had 122 doctors and 331 nurses. There were significant differences in the composition ratio of the titles of doctors, the degree of doctors, and the titles of nurses between tertiary and secondary hospitals (all P < 0.05). Most of the doctors in tertiary hospitals had intermediate titles (attending physicians accounted for 41.49%), while most of the doctors in secondary hospitals had junior titles (resident physicians accounted for 43.44%). The education level of doctors in tertiary hospitals was generally higher than that in secondary hospitals (doctors: 2.13% vs. 0, masters: 37.24% vs. 8.20%). The proportion of nurses in tertiary hospitals was significantly lower than that in secondary hospitals (17.01% vs. 24.47%). The ratio of ICU doctors/ICU beds [(0.64±0.27)%, (0.59±0.34)%] and ICU nurses/ICU beds [(1.76±0.56)%, (1.51±0.48)%] in tertiary and secondary hospitals all failed to meet the requirements above 0.8 : 1 and 3 : 1 of the Guidelines. (5) Medical quality management of ICU: compared with secondary hospitals, the proportion of one-to-one drug-resistant bacteria care in tertiary hospitals (65.91% vs. 40.74%), multimodal analgesia and sedation (90.91% vs. 66.67%), and personal digital assistant (PDA) barcode scanning (43.18% vs. 14.81%) were significantly higher (all P < 0.05). (6) Technical skills of ICU: in terms of technical skills, the proportion of bronchoscopy, blood purification, jejunal nutrition tube placement and bedside ultrasound projects carried out in tertiary hospitals were higher than those in secondary hospitals (84.09% vs. 48.15%, 88.64% vs. 48.15%, 61.36% vs. 55.56%, 88.64% vs. 70.37%, all P < 0.05). Among them, the placement of jejunal nutrition tube, bedside ultrasound and extracorporeal membrane oxygenation were mainly completed independently in tertiary hospitals, while those in secondary hospitals tended to be completed in cooperation. (7) Equipment configuration of ICU: in terms of basic equipment, the ratio of the total number of ventilators/ICU beds in tertiary and secondary hospitals [0.77% (0.53%, 1.07%), 0.88% (0.63%, 1.38%)], and the ratio of injection pump/ICU beds [1.70% (1.00%, 2.56%), 1.25% (0.75%, 1.88%)] didn't meet the requirements of the Guidelines. The equipment ratio was insuffcient, which means that the basic needs of development had not been met yet. CONCLUSIONS The development of comprehensive ICU in Inner Mongolia has tended to mature, but there is still a certain gap in the development scale, personnel ratio and instruments and equipment compared with the Guidelines. Moreover, the comprehensive ICU appears the characteristics of relatively weak eastern and western regions, and the overall distribution is uneven. Therefore, it is necessary to increase efforts to invest in the construction of the department of critical care medicine.
Humans ; Intensive Care Units ; Critical Care ; Surveys and Questionnaires ; Tertiary Care Centers ; China