Objective To explore the Influence of different health education approaches to standard anticoagulation of non-valvular atrial fibrillation. Methods 400 patients with NVAF were randomly divided into the research group (n=200) and the control group (n=200). Baseline clinical information was recorded. Both groups were given regular education and treatment. The control group was randomly divided into two subgroups. One subgroup (patients or/and family members) was given knowledge lectures of atrial fibrillation, atrial fibrillation anticoagulant, and application of warfarin. The other was given the knowledge through booklets. Standard anticoagulation fulfillment rate, ischemic stroke, other events of artery embolism, major bleeding, minor bleeding and death in the two groups were observed after 1 year. The cost for different education approaches was also compared between the 2 subgroups. Results (1)In the research group, standard anticoagulation fullfillment rate (40.53%) was higher than that of the control group(15.96%) (P<0.01). The rate of ischemic stroke (2.63%) was also lower than the control group (4.49%) (χ2=4.49, P<0.05). The death rate was lower in the research group than those in the control group, but minor bleeding rate was higher, without statistically significance (P>0.05).Other artery embolism rate , major bleeding, minor bleeding, death rate had no statistical difference. (2)Knowledge lecture group (10.8±1.0 min) spend more time than the booklet group (1.0±0.5 min) (P<0.01). The booklet group (5.1±1.1 yuan) costed more in terms of money than the knowledge lecture group (1.8±0.5 yuan) (P<0.01). (3)The knowledge lecture group showed higher standard anticoagulation fulfillment rate (47.96%) than that of booklet group (32.60%) (χ2=7.33, P<0.01). There was no statistical difference in ischemic stroke rate, other artery embolism rate, major bleeding rate, minor bleeding rate and the death rate. Conclusions Detailed, correct anticoagulant education and guidance can improve NVAF patients with standard anticoagulation, and reduce the risk of ischemic stroke. Knowledge lecture consumes more time but can improve the standard anticoagulation fulfillment rate.

Objective To understand the risk factors of neurogenic pulmonary edema in the patients with severe hand foot and mouth disease(HFMD). Methods According to neurogenic pulmonary edema or not ,79 patients with severe HFMD were divided into two groups. The difference was analyzed on the clinical symptoms, signs,the outcomes of laboratory and electroencephalogram (EEG) examination between the two groups. Then the risk factors of neurogenic pulmonary edema was analyzed by logistic regression analysis.Results There were significant differences of the EV71 infection rate,high body temperature,myoclonia,limb weakness,the disability of eyeball regulation,tachycardia, hypertension or hypotension, the extension of capillary filling time, leucocytosist, creatine kinase isoenzyme, hyperglycaemia between two groups. However, there were no significant differences of fever, fever time, vomiting, somnolence, convulsion, limb tremor, c-reactive protein and EEG between two groups. Tachycardia, hypertension or hypotension, hyperglycaemia were significant risk factors for neurogenic pulmonary edema by logistic regression analysis. And hyperglycaemia was the most significant prognostic factor(odd ratio 27. 075, P = 0. 000 2). Conclusion Tachycardia, hypertension or hypotension,hyperglycaemia are the significant risk factors for neurogenic pulmonary edema. It is especially important for hyperglycaemia to predict neurogenic pulmonary edema.

We analyszed 108 examination papers that were taken when the students of 8 groups had finished theexercitation. The attainment was 73.6?4.4 points. Among the 400 selective questions, the difficult questions whichwere concentrated only on a few diseases accounted for 35.3%. There was mush difference between the proportion of theselective questions and that of the demands of the teaching program in different system of diseases. There was few or noselective question in the important diseases of the teaching program. It is suggested that the proposition of difficultquestions must include the important diseases in the teaching program. The diseases that are not commonly encountereddiseases may be deleted from the teaching program, but the commonly encountered must be put in the teaching program.It is necessary to reinforce the ability of students to analyse and resolve problems[

Objective To explore predictive value of endometrial receptivity and pregnancy outcome by hysteroscopy examination at the phase of implantation window in unexplained infertile women.Methods From Oct.2007 to Mar.2009,93 unexplained infertile women underwent hysteroscopy examination at 7-9 days after a spontaneous ovulation in Family Planning Research Institute of Guangdong Province.According to the endometrial glandular openings and vascular shape,79 cases without pathological endometrial changes were divided into 60 cases in good endometrium group and 19 cases in poor endometrium group.The following clinical parameters were analyzed and compared between two groups,including endometrial configuration,thickness,secretion,the development and number of pinopodes,vascular distribution,and the level of sex hormone,leukemia inhibitory factor (LIF) and glycodelin in the uterine flushing,and pregnancy outcome.Results (1)There was no statistical difference in the level of serum estrogen and progesterone at the phase of implantation window,which were (518 ± 176)pmol/L,(40 ±20)nmol/L in good group and (513 ±244) ptnol/L,(37 ± 19) nmol/L in poor group (P<0.05).The endometrium thickness at periovulatroy and implantation window days (1.06 ±0.10)cm/(1.16 ± 0.08)cm in good group did not show significant difference with (0.93 ±0.12) cm /(1.02 ±0.10) cm in poor group (P>0.05).The proportion of type A,B and C endometrium at periovulatory days were 63% (12/19),37% (7/19) and 0 (0/19) in good group and 23% (14/60),77% (46/60) and 0 (0/60) in poor group.When compared with those of type A or B between two groups respectively,it all showed statistical difference (P<0.05).However,at phase of implantation window,endometrium configurations were all type B at both groups.(2)90% (17/19)of women in good group and 7% (4/60)of women in poor group showed normal endometrial secretion function,which showed significant differences (P< 0.01).(3)The percentage of fully developed pinopodes and abundant pinopodes [84% (16/19) and 90% (17/19)] in good group were significantly higher than 42% (25/60)and 57% (34/60) in poor group (P<0.05).(4) The level of CD_(34) expression and microvessel density[MVD; (40.1 ± 1.2) positive unit(PU) and(21.7 ±4.0)/high power field (HP)] in good group were significantly higher than(18.1 ± 1.3) PU and (8.5 ± 1.3)/HP in poor group (P< 0.01).(5)The level of LIF and glycodelin in uterine flushing [(72 ± 54)ng/L and (196 ±20)μg/L] in good group were significantly higher than (15±16) ng/L and (116 ±26) μg/L in poor group (P<0.05).(6) The rate of clinical pregnancy,spontaneous abortion and term delivery were 74% (14/19),0 (0/14) and 100% (14/14) in good group and 23% (14/60),14% (2/14) and 86% (12/14) in poor group,the rate of clinical pregnancy and term delivery in good group were significantly increased when compared with those in poor group (P<0.01).Conclusions Hysteroscopy examination at the phase of implantation window could reflect the development of glandular openings and vasculature.It is a preferable method to evaluate the endometrial receptivity and predict pregnancy outcome.

Objective To investigate the effect of Thunder-fire Moxibustion on nocturnal urinary symptoms in patients with benign prostatic hyperplasia (BPH). Methods According to hospitalized number from January to December 2018, 61 BPH patients with frequent nocturnal urination were divided into control group (treated with routine nursing and drug therapy) and observation group, where the Thunder-fire moxibustion was used once a day for one course of treatment every 10 days for 3 courses of treatment. The effect was observed by looking into the number of nocturnal urine and the prostate symptoms. Result After the treatment, the number of nocturnal urine in the observation group was smaller than that in the control group, and the IPSS score in the observation group was lower than that in the control group (P ＜0.001), and no adverse reactions were observed. Conclusion The Thunder-fire Moxibustion combined with drug therapy can improve nocturnal urinary symptoms of benign prostatic hyperplasia in a safe way.

OBJECTIVETo analyze the status of acute upper respiratory infection and influenza-like illness (ILI) among community residents in Jinan in 2015, and to make a understand of the patient's medical treatment behavior and influenza vaccination coverage status in 2014.

METHODSBalloting method and convenient sampling method were used to launch a household survey. The residents who had been in Jinan for more than 3 months were selected, to investigate the residents' attack ratio of acute upper respiratory and influenza-like from Jan. 8 to Feb. 7, 2015. Totally, 1 300 persons from 410 families were involved in this survey which recovered 1 241 valid questionnaires with the efficiency of 95.5%. Based on the national age-urban demographic statistics in 2010, the attack rates of acute respiratory infections, influenza-like illness were estimated by the direct standardization method, and the influenza vaccination rates were also calculated in this study. χ(2)-test method was used to compare the different status of incidence and vaccination among residents with different features.

RESULTSThe attack rate of acute upper respiratory infection and influenza-like illness in Jinan from January 8, 2015 to February 7, 2015 were 30.2% (375 cases), and 6.1% (76 cases), respectively, with a standardized rate of 29.1% and 5.4%. 5.3% (66 cases) of the residents have vaccinated with the influenza vaccine inoculation, with an adjusted rate of 3.8%. The attack rate difference of acute upper respiratory tract infections was statistically significant between each age group (χ(2)=17.121, P= 0.002). The 0-4 age group had a highest attack rate (45.4%) of acute respiratory infection, while the 15-24 age group got the lowest (26.5%). 38.9% (146 cases) of patients went for a treatment in hospital. Among them, 37.7% (55 cases) of them selected the county level hospitals for treatment, 37.7% (55 cases) selected the community level hospitals, and 24.6% (36 cases) selected the individual clinic. Significant differences of influenza-like illness attack rate between each age group were also found in this study (χ(2)=76.79, P<0.001). 0-4 age group had the highest attack rate (22.7%). 81.6% (62 cases) of the ILI sought treatment in the hospital, of which 53.2% (33 cases) selected county level hospital or above, and 33.9% (21 cases) selected community hospital, and 12.9% (8 cases) selected the individual clinic.

CONCLUSIONThe attack rate of acute upper respiratory infections among the residents of Jinan was high, whereas that of influenza-like illness was relatively low. 0-4 age group had a higher risk of ILI than other age groups. Most of the cases were likely to take the treatment in large hospitals. In general, the coverage rate of influenza vaccination was relatively low.

Ambulatory Care Facilities ; China ; Hospitals ; Humans ; Influenza Vaccines ; administration & dosage ; Influenza, Human ; epidemiology ; Respiratory Tract Infections ; epidemiology ; Surveys and Questionnaires ; Vaccination ; statistics & numerical data

Objective:To study the infection of human rhinovirus, respiratory syncytial virus and human adenovirus in Jinan from April 2018 to March 2019, and analyze epidemiological characteristics of human adenovirus.Methods:All of 1969 nasopharyngeal swabs were collected from hospitalized patients with acute respiratory tract infections in The Fourth People’s Hospital of Jinan, Qilu Children′s Hospital of Shandong University, Peoples Hospital of Zhangqiu District from April 2018 to March 2019, fluorescence quantitative PCR was used to detect the positive rate of human rhinovirus, respiratory syncytial virus and human adenovirus. Seven adenovirus positive samples were isolated and examined by sequencing, then we determined adenovirus type, constructed gene phylogenetic trees for analysis.Results:Of the 1969 samples, 242 were positive, the total positive rate was 12.30% (242/1969), the positive rate was 3.00% (59/1969) for rhinovirus, 6.30% (124/1969) for respiratory syncytial virus (RSV), and 3.86% (76/1969) for adenovirus. There was no significant difference in the detective rate of rhinovirus in different age groups (Fisher′s exact test value =8.376, P=0.720), the positive rates of RSV and adenovirus in different age groups was statistically significant ( χ2=19.28, 12.16; P=0.001, 0.016). There was a statistically significant difference in the positive rate of adenovirus between different sexes ( χ2=14.33, P<0.001), and there was no statistically significant difference in the positive rate of rhinovirus and RSV between males and females ( χ2=0.30, 2.90, P=0.862, 0.089). Comparing the positive rates of viral nucleic acid in different months, we found that the positive rate of rhinovirus, RSV and adenovirus separately reached the highest in October, December and November (8.61%, 26.50% and 8.84%). We constructed a gene phylogenetic tree after seven positive samples of adenoviruses were sequenced, by the molecular typing method we detected that seven adenovirus-positive samples were all HAdV-2 type. Conclusions:By comparing the epidemiological trends of human rhinovirus, RSV and human adenovirus in Jinan from April 2018 to March 2019 in different ages, genders, and months, providing reference basis for the early prevention and clinical treatment of acute respiratory tract infection.

Objective:To characterize and analyze the genetic variation of hemagglutinin (HA) of influenza A (H1N1) pdm09 subtype virus in Shandong Province, and explore the genetic variation patterns for providing reference for influenza monitoring, epidemic prevention and control, and vaccine strain selection.Methods:HA gene sequences of the recommended strains of influenza vaccine from 2009 to 2024 and the representative strains of each branch were downloaded from the GISAID Influenza Data Platform, and were phylogenetically analyzed and characterized in terms of amino acid site variation with the HA gene sequences of 298 influenza A (H1N1) virus strains isolated from Shandong Province. A phylogenetic tree was constructed using the maximum likelihood (ML) method of the IQ-TREE online tool, and the amino acid site variants were viewed using MegAlign software. The potential glycosylation sites of the HA gene were predicted using the NetNGlyc 1.0 online software.Results:The HA gene homology of the 298 influenza A (H1N1) viruses isolated in Shandong Province ranged from 91.2% to 100.0%. The evolutionary branches were gradually distantly related over time, but the direction of evolution was roughly the same as that in other provinces. Amino acid mutations in the HA occurred every year and most were found in the antigenic determinants.Conclusions:The HA genes of influenza viruses isolated in Shandong Province from 2009 to 2024 are still in the process of continuous evolution, and continuous monitoring of the epidemiological trends and the evolutionary directions of influenza viruses is essential for early warning of influenza virus pandemics.

Objective: To understand the viral spectrum of influenza-like illness (ILI), Shandong province during 2013-2014. Methods: The data of 36 ILI outbreaks were collected and analyzed. Multiple respiratory pathogens were detected with RT-PCR in pharynx swab specimens. Results: Totally, 35 outbreaks occurred in winter and spring, and dispersed in 12 cities; 27 outbreaks happened in primary and secondary schools. Many of the outbreaks, 17 (47.2%), were caused by influenza virus type B (FluB), followed by FluA H1 and H3, 5 (13.8%) outbreaks, respectively. Mixed infection caused 7 outbreaks. Totally 437 samples were collected, with 235 (53.8%) positive specimens, in which FluB was mostly detected, 142 (32.5%). Except Flu, parainfluenza virus type 2 (PIV2) was the most frequently detected, followed by coronavirus (CoV). The constituent ratio of FluB under 15 years of age was the highest, such as CoV in 25-59 years old group and FluA H1 in others groups. Conclusions ILI outbreaks occurred mostly in primary and secondary schools. Virus was the main pathogen, with the dominant strains of FluB. However, the dominant strain in different age groups was different.