Objective To study the clinical value of combined detection of serum interleukin(IL)-8 ,tumor necrosis factor(TNF)-α,alvedar cell surface antigen Ⅱ(KL-6) and surface protein D(SP-D) in the diagnosis of idiopathic pulmonary fibrosis(IPF) .Meth-ods Seventy three patients with IPF were selected as the research subjects ,other 73 patients with bacterial pneumonia were taken as the bacterial pneumonia group .The levels of serum IL-8 ,TNF-α,KL-6 and SP-D were detected by enzyme-linked immunosorbent assay (ELISA) .The serum levels of IL-8 ,TNF-α,KL-6 and SP-D were compared between the IPF group and bacterial pneumonia group .The sensitivity and specificity of IPF detection were compared between the 4-index combined detection and single item de-tection .Results The levels of IL-8 ,TNF-α,KL-6 and SP-D in the IPF group were significantly higher than those in the bacterial pneumonia group (P<0 .05) .The positive rate of single detection of four indexes in the IPF group was significantly higher than that in the bacterial pneumonia group (P<0 .05) .The sensitivity and specificity of the 4-index combined detection for diagnosing IPF were 90 .4% and 93 .2% respectively ,which were significantly higher than the those of single index detection (P<0 .05) .Con-clusion The combined detection of IL-8 ,TNF-α,KL-6 and SP-D has better sensitivity and specificity in IPF diagnosis compared with single detection of IL-8 ,TNF-α,KL-6 and SP-D .

Chemiluminescence method was used to measure: (1) active oxygen species generation induced by respiratory burst of polymor-phonuclear leucocytes (PMNs) from human blood stimulated with phorbol myristate acetate (PMA); (2) superoxide (O2) induced by xan-thine-xanthine oxidase system; (3) hydroxyl radicals ( ? OH ) generated by Vit C- Cu2+- zy-mosan; (4) the release of hydrogen peroxide (H2O2). Effects of polydatin IV on these active oxygen species were observed. The resultsshowed early stage of respiratory burst of PMNs was inhibited,but the later stage was delayed by polydatin IV, (2), (3) adn (4) were scavenged by polydatin IV and their median inhibitory concentrations (IC50?mol ? L-1) were 14.6,29.6 and 13.0 respectively. The results suggested that polydatin IV was a scavenger.

Objective To investigate the distribution of complications and the relationship with neurologic subtype and gross motor function in preterm infants with cerebral palsy (CP). Methods The type, grade of Gross Motor Function Classification System (GMFCS), intelligence,speech, ophthalmologic consultation, brainstem auditory evoked potential and electroencephalogram of 135 preterm infants with CP were reviewed. Results There were 284 complications in total, (2.10±1.33) per child, and was significantly different among various types of CP (F=5.50, P<0.001). The incidence of mental retardation and speech disorder was significant different among various types (P<0.05). The incidence of mental retardation, speech disorder, visual impairment and epilepsy increased significantly (P<0.05) in spastic quadriplegia infants,compared with those with diplegia and hemiplegia. The incidence of mental retardation, speech disorder, visual impairment and musculoskeletal disorder was significantly different (P<0.05) among various grades of GMFCS. The frequency of complications was more in children unable to walk (GMFCS Ⅳ~Ⅴ) than able to walk (GMFCS Ⅰ~Ⅲ) for children over 2 years old (t=70.05, P<0.001). Conclusion The incidence of mental retardation, speech disorder, visual and hearing impairment, secondary musculoskeletal disorder and the multiple disorders are related with neurologic subtype and/or the grade of GMFCS.

Objective To investigate the trend of early neural development in premature infants. Methods At the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index (MDI) and the psychomotor development index (PDI) in preterm (corrected age) and full-term infants. Results At 12 months, there was no significant difference in corrected age PDI scores among different gestational age groups (<32 , 32–33+6 and 34–36+6 weeks) (P=0.820). The actual age MDI and PDI scores of full-term infants and premature infants in 34~36+6 weeks group were significantly higher than those of premature infants in <32 and 32-33+6 weeks groups, and the PDI score of full-term infants was significantly higher than that of premature infants in 34-36+6 weeks group (P<0.05). There was no significant difference in actual age PDI scores among different birth weight groups (P=0.166). The actual age MDI and PDI of full-term infants and premature infants in birth weight≥2500 g group were significantly higher than those of premature infants in <1500 g, 1500~1999 g and 2000~2499 g groups (P<0.05). At 24 months, the actual age MDI scores of full-term infants were significantly higher than those of premature infants in different gestational age and birth weight groups (P<0.05). The actual age MDI curve of premature infants in birth weight <1500g group showed a downward trend, while the actual age PDI curve showed a significant upward trend. Conclusion The neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.

Objective:To analyze the influencing factors of patient loyalty in internet diagnosis and treatment, for references for improving the service quality and promoting the sustainable development of internet diagnosis and treatment.Methods:In November 2023, a simple random sampling method was used to select patients who had received internet diagnosis and treatment as the survey objects and conduct a questionnaire survey on performance expectations, effort expectations, social influence, promotion conditions, price values, patient trust and patient loyalty. By establishing an unified theory of acceptance and use of technology model of influencing factors of patient loyalty in internet diagnosis and treatment, the hypotheses were put forward. The structural equation model (SEM) test and mediation effect test were used to verify the hypothesis path and variable mediation effect, and explore the influencing factors of internet patient loyalty.Results:A total of 1 800 patients were included in this study, including 1 188 patients(66.0%) who received internet diagnosis and treatment≥3 times/month. According to the SEA test, performance expectations ( β=0.296, P<0.001), social influence ( β=0.146, P=0.014), promotion conditions ( β=0.366, P<0.001), price values ( β=0.452, P=0.017), and patient trust ( β=0.459, P<0.001) had a direct positive impact on patient loyalty; Social influence ( β=0.147, P<0.001) and promotion conditions ( β=0.084, P<0.001) had a direct positive impact on patient trust. According to the mediation effect test, patient trust partially mediated the relationship between social influence and patient loyalty ( β=0.071, P=0.018), as well as the relationship between promoting conditions and patient loyalty ( β=0.748, P=0.041). Conclusions:Performance expectations, social influence, promotion conditions, price values, and patient trust had a positive impact on patient loyalty, among which social influence and promotion conditions could enhance patient loyalty by strengthening patient trust. It was suggested that relevant institutions should focus on the service quality of internet diagnosis and treatment, further improve performance expectations, expand social impact, improve promotion conditions and regulate price values, so as to enhance the patient loyalty, promote the wide application and rapid development of internet diagnosis and treatment.

OBJECTIVETo investigate the genetic association between cirrhosis and polymorphisms in the genes encoding major histocompatibility complex, class II (HLA)-DR beta 1 (DRB1) and HLA-DP beta 1 (DPB1).

METHODSA population of 168 parent/offspring trios, in which the proband had a diagnosis of hepatitis B virus infection with clinical signs of cirrhosis.The HLA-DRB1 and DPB 1 gene polymorphisms of rs24755213 and rs202176660 were detected by PCR and single nucleotide polymorphism (SNP) genotyping.Correlation analysis and haplotype relative risk analysis were carried out.

RESULTSA/G genotypes were detected in rs24755213 of HLA-DRB1 and C/T genotypes were detected in rs202176660 of DPB1.The rs24755213 allele was associated with cirrhosis (P=0.014), with the G allele identified as a protective factor (Z=-2.33) and the A allele identified as a hazard factor (Z=2.33).The rs202176660 allele was also associated with cirrhosis (P =0.026), with the T allele identified as a protective factor (Z=-2.06) and the C allele identified as a hazard factor (Z=2.06).The haplotypes of G/T and A/C in rs24755213 and rs202176660 respectively were associated with cirrhosis (P =0.037 and 0.002, Z=-2.12 and 2.09 respectively).

CONCLUSIONIn this group of Chinese patients with hepatitis B virus-related cirrhosis, polymorphisms in the HLA-DRB 1 and DPB1 genes were associated with cimhosis.

Alleles ; Genotype ; HLA-DP beta-Chains ; genetics ; HLA-DRB1 Chains ; genetics ; Haplotypes ; Humans ; Liver Cirrhosis ; genetics ; Polymorphism, Genetic

Objective:To explore the effect of "ten needles in the stomach" on sleep perception of patients with spleen-gastric damp-heat insomnia based on the theory of "stomach discord, then sleep restlessness", to provide references for clinical diagnosis and treatment.Methods:The study subjects were 300 patients with insomnia from the sleep department and outpatient department of Shijiazhuang Traditional Chinese Medicine Hospital. According to the random number method, they were divided into the stomach ten needle group, the diazepam group, and the stomach ten needle plus diazepam group, with 100 in each group. Among them, the stomach ten needles group received "stomach ten needles" acupuncture treatment, the diazepam group was given diazepam therapy, and the stomach ten needles plus diazepam group was given diazepam combined with "stomach ten needles" acupuncture treatment. The Pittsburgh Sleep Quality Index (PSQI) scores, the self-rating disease symptom scale (SCL-90) scores, nighttime polysomnography (PSG) monitoring indicators, and the mean sleep latency (MSL) values were compared before and after treatment in the three groups. The difference in clinical efficacy between the two groups were observed.Results:The total effective rate was 94.0% (94/100) in the combined group, 77.0% (77/100) in the diazepam group, and 85.0% (85/100) in the stomach ten needle group. There were significant differences among the three groups ( χ2=11.56, P<0.01). After treatment, the daytime dysfunction, hypnotic drugs, sleep disturbance, sleep efficiency, sleep time, sleep time, sleep quality score and total score of the combined group were significantly lower than those in the diazepam group and the stomach ten needle group ( F=5.70, 3.65, 5.23, 6.37, 3.66, 6.19, 7.54, 6.40, all Ps<0.01); The scores of SCL-90 and MSL were significantly lower than those in the diazepam group and stomach ten needle group ( F=8.97, 7.53, all Ps<0.01). In the combined group, NWAK [(1.36 ± 0.87) times vs. (2.69 ± 1.15) times, (2.11 ± 1.05) times, F=5.88], SOL [(13.62 ± 5.85) min vs. (25.06 ± 9.42) min, (19.78 ± 7.63) min, F=6.49], N1/TST [(5.69 ± 1.09)% vs. (12.65 ± 2.58)%, (8.49 ± 2.45)%, F=5.13], N2/TST [(51.07 ± 10 2.06)% vs. (58.36 ± 2.18)%, (55.61 ± 2.04)%, F=9.86] were significantly lower than those in the diazepam group and stomach ten needle group ( P<0.01), SE [(90.33 ± 2.89)% vs. (85.39 ± 2.75)%, (87.53 ± 2.69)%, F=8.36], TST [(449.32 ± 23.65) min vs. (421.66 ± 25.33) min, (431.26 ± 25.98) min, F=8.26], REM/TST [(23.87 ± 4.52)% vs. (14.52 ± 3.87)%, (18.36 ± 3.25)%, F=5.34], N3/TST [(18.69 ± 2.02)% vs. (10.31 ± 1.64)%, (14.89 ± 1.74)%, F=7.69] were significantly higher than those in the diazepam group and stomach ten needle group ( P<0.01). Conclusion:Based on the "stomach discord, sleep restlessness" theory, the ten needles on the stomach can treat insomnia and improve psychological state and sleep quality, with the functions of clearing the damp and heat of the middle joker, regulating the lifting and lowering of qi in the middle.

Objective:To study on the effect of "stomach ten acupuncture" combined with domperidone tablets on clinical symptoms and sleep quality of gastrointestinal neurosis patients with insomnia based on the theory of "stomach harmonious leading to restless".Methods:Randomized controlled trial. From March 2020 to March 2021, 98 patients with gastrointestinal neurosis and insomnia in our hospital who met the inclusion criteria were randomly divided into two groups, with 49 patients in each group. The control group took domperidone tablets orally, and the observation group was treated with "stomach ten acupuncture" on the basis of the control group. Both groups were treated for 8 weeks. Before and after treatment, TCM syndromes were scored, the severity of gastrointestinal symptoms was assessed with Gastrointestinal Symptom Rating Scale (GSRS), anxiety and depression were assessed with Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and sleep quality was assessed with Pittsburgh Sleep Quality Index Scale (PSQI).Results:After treatment, the scores and total scores of epigastric pain, belching, abdominal distension, anorexia, noisy acid regurgitation, tiredness and asthenia, constipation and loose stools in the observation group were significantly lower than those in the control group ( t values were 19.61, 19.30, 23.10, 22.05, 20.43, 21.81, 20.51, 16.38, respectively, P<0.01); the scores and total scores of typical symptoms, abdominal pain symptoms, reflux symptoms, diarrhea symptoms, constipation symptoms were significantly lower than those in the control group ( t values were 10.10, 11.14, 11.04, 9.31, 11.24, 5.30, respectively, P<0.01); HAMA and HAMD scores were significantly lower than those in the control group ( t values were 6.96 and 6.85, respectively, P<0.01). The scores of time to fall asleep (1.15 ± 0.56 vs. 2.11 ± 0.75, t=7.18), time to sleep (0.92 ± 0.63 vs. 1.52 ± 1.12, t=3.27), sleep quality (1.02 ± 0.66 vs. 1.96 ± 0.80, t=6.35), sleep efficiency (0.86 ± 0.62 vs. 1.68 ± 0.85, t=5.46), sleep disorders (0.92 ± 0.36 vs. 1.48 ± 0.55, t=5.96), daytime dysfunction (0.96 ± 0.42 vs. 1.97 ± 0.87, t=7.32), hypnotics (0.98 ± 0.45 vs. 1.81 ± 0.62, t=7.58) and total scores (6.85 ± 1.47 vs. 12.73 ± 2.95, t=12.49) were significantly lower than those in the control group ( P<0.01). Conclusion:The "stomach ten acupuncture" combined with domperidone tablets can improve the clinical symptoms and sleep quality of gastrointestinal neurosis patients with insomnia.

Extracorporeal membrane oxygenation (ECMO) is an important treatment for extracorporeal cardiopulmonary life support for clinically critical patients. Currently, ECMO tubing is commonly fixed by tie-wraps or tourniquets, which have shortcomings such as easy loosening and potential damage to the tubing. Improper fixation of the catheter can lead to a series of adverse events, such as accidental disconnection of the tubing, rupture of the tubing, tubing folding, and air ingress into the tubing. In order to overcome the above problems, the research team of Zhongda Hospital, Southeast University invented a device for ECMO line fixation and obtained a national utility model patent of China (patent number: ZL 2019 2 2282849.3). The tool is mainly composed of several devices, including a line fixation clamp, a clip fixation device, and a base plate, which is uniquely designed and easy to operate. During ECMO therapy, this device ensures effective stabilization of the ECMO tubing, preventing unexpected incidents due to catheter loosening and facilitating the observation of ECMO catheter insertion markings. Pipeline can be effectively fixed to avoid the occurrence of accidents due to the loosening of the catheter, and at the same time, it is convenient to observe the placement scale of the ECMO catheter. The novelty and uniqueness of the fixation device materials also effectively prevent the occurrence of pressure injuries during its use.

To determine the physicians′compliance of hour-1 bundle for sepsis. A management system of hour-1 bundle for sepsis was established. The clinical data of 286 sepsis patients were collected, who were classified into 3 months before the bundle (control group), 9 months during process (observation group) and 3 months after bundle (study group). The compliance of hour-1 bundle implementation was compared in three groups. The results showed that with the application and implementation of the management system, the compliance of hour-1 bundle for sepsis in the control group, observation group and study group was 58.3%(28/48), 69.1%(105/152) and 88.4%(76/86) respectively (χ 2=7.053, P=0.029). The 28 day mortality in sepsis patients was 41.7%(20/48), 34.9%(53/152) and 23.3%(20/86) respectively (χ 2=5.576, P=0.062).The management system of hour-1 bundle for sepsis can effectively improve the physicians′ compliance.