Objectives To evaluate the effectiveness of bedside noninvasive scoring system in diagnosis of coronary heart disease (CAD).MethodsSix hundred and twelve patients with suspected CAD in our hospital were enrolled (343 males and 269 females) from September 2008 to October 2010,with an average age of 55 ± 7 y.The detailed history was taken; physical examination,resting electrocardiogram,blood biochemistry,treadmill exercise test and/or 12 lead Holter monitoring,64 or 256 rows CT coronary artery imaging and coronary artery angiography were performed in all patients.The risk factors for CAD were screened by multiple questionnaire surveys with Delphi method.The risk factors were stratified according to the results of expert survey: heavy smoking,diabetes mellitus,typical angina,positive treadmill exercise test and positive Holter monitoring electrocardiogram were included in the highest risk factors with an integrated scores of 8 ; dyslipidemia of 3 items,hypertension complicated with left ventricular hypertrophy were high risk factors with an integrated scores of 6; males≥40 y,medium smoking,dyslipidemia of 2 items,pathoglycemia,heavy drinking,positive ECG and post-menopause females were moderate risk factors with integrated scores of 4; Low risk factors contain moderate drinking and dyslipidemia of item,were classified as low risk factors with an integrated scores of 2. The bedside noninvasive scoring system was evaluated in all patients and the results were compared with those from multi-slice spiral CT or coronary angiography.ResultsWhen integrated score ≥ 24 was set as the cut-off level for diagnosis of CAD,thesensitivity,specificity,positive predictive value and accuracy were 89.95％,85.63％,94.03％and 88.73％ respectively.When integrated score≤ 14 was set as the exclusion criteria of CAD,the sensitivity,specificity,positive predictive value and accuracy were of 93.10％,82.86％,98.09％ and 84.80％ respectively.The accuracy was lower than that of multi-slice spiral CT or coronary angiography( P ＜0.05 ).ConclusionsThe bedside noninvasive scoring system is effective for preliminary diagnose of CAD,but need to be further improved.

In this study, porous polymer (PLA/PCL) membrane was first treated with ethanol to become hydrophilic, and then immersed into DMEM with 50% fetal bovine serum to enhance the affinity to cells. MSCs cultured in osteogenic medium were loaded into the membrane at density of 5 x 10(6)/cm2 for 7 days, and scanning electrical microscope was used to observe the growth of the MSCs. The growth of MSCs inside the constructs was functionally well, and the cells proliferated with the time of culture. We concluded from current study that the membrane had satisfactory biocompatibility and the constructs could be used to guided bone regeneration.
Animals ; Biocompatible Materials ; Bone Marrow Cells ; cytology ; Bone Regeneration ; Bone Substitutes ; Cell Differentiation ; Cell Division ; Cells, Cultured ; Extracellular Matrix ; Female ; Guided Tissue Regeneration ; Lactic Acid ; Membranes ; Membranes, Artificial ; Mesenchymal Stromal Cells ; cytology ; Polyesters ; Polymers ; Tissue Engineering

Objective To investigate the correlation between myocardial microcirculation and inflammation in acute myocardial infarction(AMI)by myocardial contrast echocardiography(MCE).Methods Eighty-one AMI patients(AMI group)and 30 healthy adults(normal control group)were enrolled.White blood cell(WBC),hypersensitive C reactive protein(hsCRP)and neutrophilic gtanulocyte percentage(G%)were measured in patients and healthy adults.According to different count of WBC,AMI group was devided into A group(n=40,WBC≥10×109/L)and B group(n=41,WBC＜10×109/L).Myocardial contrast intensity(A),blood flow rate(β)and myocardial blood volume(MBF=A×β)of each segment were measured by MCE during 5-7 days of hospitalization.Results Compared with control group.WBC,hsCRP in A group and hsCRP in B group were significantly elevated(P＜0.05).A,β and MBF in A group were significantly lower than those in B group(P＜0.05).WBC and hsCRP in A group had significant negative correlations with β respectively(BWBC=-0.67,P＜0.05;BhsCRP=-0.5 1,P＜0.05).Conclusions The level of plasma inflammatory factors were remarkably increased after AMI,which had a positive correlation with low microcirculation perfusion.

Objective:To explore the relationship between cervical microecology and cervical squamous intraepithelial lesions (SIL).Methods:All subjects were recruited from the health care center or gynecology of the Affiliated Wuxi No.2 People′s Hospital of Nanjing Medical University from March to May of 2019, including 12 subjects normal cervix with 37-47 years old, 21 low-grade squamous intraepithelial lesion (LSIL) subjects with 39-48 years old, 5 high-grade squamous intraepithelial lesion (HSIL) subjects with 38-45 years old and 3 cervical squamous cell carcinoma subjects with 42-43 years old. All subjects were required to fill in a questionnaire, and performed cervical examination. Meanwhile, the microecology of cervical secretions was analyzed by the next generation sequencing (NGS) and the NGS results were analyzed by bioinformatics. Subjects were divided into human papilloma virus (HPV)-negative groups, low-risk HPV (lrHPV), 16/18 high-risk HPV (hrHPV) and other hrHPV infection groups based on HPV test results of NGS. The Venn diagram of data, microecology diversity, the relative abundance and co-occurrence of species, and the receiver operating characteristic (ROC) curve were analyzed.Results:A total of 909 species at the species level were obtained from the cervical secretions of all the subjects, and there was overlap among the groups. There was no significant difference in total HPV infection rate, 16/18 hrHPV infection rate and other hrHPV infection rates among subjects with different cervical lesions (all of P>0.05). Grouped by HPV infection, the 16/18 hrHPV-infected and other hrHPV-infected subjects had increased cervical microecology diversity ( U=39.00 and 43.00, all of P<0.05), and the relative abundance of Lactobacillus crispatus (L.crispatus) had no differences among the groups ( H=4.37, P=0.213 6). Grouped by cervical conditions, the cervical microecology diversity of the subjects with cervical lesions increased ( H=14.60, P=0.002 2), while the L.crispatus relative abundance decreased ( H=13.98, P=0.000 8). Among all the detected species, Mycoplasma, Chlamydia and Streptococcus B had a co-occurrence, while Lactobacillus iners, Gardnerella vaginalis, Atopobium vaginae, and Prevotella bivia had a co-occurrence. As the SIL diagnostic index, the area under the ROC curve (AUC) of the relative L.crispatus relative abundance was 0.874 [95% confidence interval ( CI):0.732-0.957]. L.crispatus combined with Lactobacillus jensenii (L.jensenii) and Mycoplasma had an AUC of 0.943 [95 %CI: 0.822-0.991] in the SIL diagnosis. Conclusions:The decreased L.crispatus relative abundance and the increased cervical microecology diversity may be related to HPV infection and cervical lesions; simplified NGS data may be helpful to the SIL diagnosis.

Objective To explore the effects of whole process management pattern on the complication of PICC among cancer patients. Methods From October 2012, we started to build up the whole process management pattern to plan, implement, check and cope with integration of 4 stages key element including environment, safety, quality and patient′s health for PICC patients, and it carried out in the whole hospital. We compared the number of PICC cases, success rate of first PICC insertion and incidence of complication between the time of January to October 2012 and the time of November 2012 to December 2013, and compared the patients′satisfaction of nursing quality. Results After the whole process management pattern used, the total number of PICC climbed from 275 cases to 475 cases and the success rate of first PICC insertion increased from 94. 9% to 98. 9% with statistical difference (χ2 =11. 58,P<0. 01). The incidences of complication declined, of which the rate of mechanical phlebitis was 1. 8%, infection related catheter 2. 1%, and all complications were lower than before the whole process management pattern used (χ2 =5. 99,25. 17, respectively; P <0. 01). The patients′satisfaction increased from 93. 1% to 97. 1% with statistical difference (χ2 =6. 53,P<0. 05). Conclusions The whole process management pattern declines the complications of PICC among cancer patients, and promotes patients safety, releases clinical pressure and enhanced patients′satisfaction and quality of specific nursing.

Objective: To investigate the effects of epidural analgesia on puerpera and neonatal. Methods: A total of 150 puerpera were continuously enrolled from May 2017 to May 2018 in Zhoushan Maternal and Child Health Care Hospital, and were divided into analgesia group (102 cases) and non-analgesia group (48 cases) according to their prenatal wishes.The analgesia group was given epidural anesthesia for analgesic delivery, while the control group had no analgesia intervention.Differences in the expression of serum pain and stress hormones were compared between two groups at the time of prenatal, postpartum 1h and 24h.At the same time, differences in neonatal NACS scores were compared between two groups at the time of postpartum 1h, 8h and 24h. Results: No statistically significant differences were found between the two groups in prenatal serum pain and stress hormones, but at the time of postpartum 1h and 24h, serum pain media neuropeptide Y (NPY) (t=5.041, P=0.000; t=4.984, P=0.000), 5-hydroxytryptamine (5-HT) (t=3.083, P=0.002; t=4.203, P=0.000), prostate E2 (PGE2) (t=6.764, P=0.000; t=4.364, P=0.000) and stress hormone angiotensin Ⅱ (AngⅡ) (t=3.670, P=0.000; t=2.911, P=0.004), adrenocorticotropic hormone (ACTH)[(212.54±38.65) ng/mL vs.(231.43±34.82)ng/mL, t=3.510, P=0.001; (163.82±33.21) ng/mL vs.(175.21±32.48) ng/mL, t=2.105, P=0.045)]and cortisol (Cor)[(344.56±57.39) μg/L vs.(381.81±59.23)μg/L, t=3.670, P=0.000; (241.27±43.44) μg/L vs.(262.56±37.97) μg/L, t=2.911, P=0.004)] in the analgesia group were significantly lower than those in the non-analgesia group.There were no statistically significant differences in NACS score, complications and Apgar score between the two groups (all P>0.05). Conclusion The analgesic effect of full-course epidural delivery in analgesic delivery is remarkable, which can effectively reduce maternal stress reaction, and it is safe and has less adverse effect on neonates.