Objective To probe into the role of nursing classification and marking management in ICU nursing management. Methods According to the admission date,the first 87 patients hospitalized in our department were assigned into the control group and another 84 into the intervention group.Then the human resources were divided based on the ABCD nursing classification and marking management for ICU.The two groups were compared in terms of adverse events.Results The incidences of pressure sores, non-planned extubation,improper clinostatism for using respirator,hypoglucycaemia during reinforced treatment with insulin, respirator-associated pulmonary pneumonia,tube-associated infection,and multidrug resistant bacteria in the intervention group were all significantly lower than those in the control group (allP<0.05).Conclusion The nursing classification and marking management for ICU nursing management can enhance the nursing quality.

Objective To investigate the expression of phosphorylated mammalian target of rapamycin (p-mTOR) and phosphorylated eukaryotic translation initiation factor 4E binding protein 1 (p-4EBP1) in pathologic scar,and comprehend its role and significance in the pathologic scar formation.Methods SP immunohistochemical method was used to detect the expression of p-mTOR and p-4EBP1 in 20 cases of keloid,20 cases of hypertrophic scar,20 cases of non-pathologic scar and 20 cases of normal skin tissue.The positive rates of expression in different tissues were analyzed,and the relationship in pathological scar was explored.Results The positive rates of p-mTOR and p-4EBP1 in keloidand hypertrophic scar were 75.0％ (15/20),60.0％ (12/20) and 60.0％ (12/20),50.0％ (10/20),nom-pathologic scars were 20％ (4/20),10％ (2/20);normal skin tissue were 10％ (2/20),5％ (1/20),which were higher respectively compared with the two control groups (P＜ 0.05);there was a highly positive correlation between p-mTOR and p-4EBP1 expression in pathologic scar (r=0.323,P＜0.05).Conclusions p-mTOR and p-4EBP1 might be involved and cooperated in promoting the progress of pathologic scars.

Objective To analyze the image quality of coronary arteries by dual-source computed tomography (DSCT) in children with congenital heart disease(CHD). Methods Image quality of coronary arteries were scored by two radiologists with an ordinal grading system. Score 3 or 4 was considered to be good image quality and diagnostic. Score differences among 3 groups of various baseline heart rate levels, 3 groups of various age levels and 4 coronary branches were analyzed by using ANOVA. Multiple linear regression analysis was used to test the effects of age, heart rate, tube voltage, tube current, pitch, contrast volume, contrast injection rate on the coronary image scores. Results A total of 72 consecutive patients were enrolled. 71.2% (205/288) of coronary artery branches was good enough for diagnosis. Image quality of left main coronary artery (LM, score 3.64±0.49), left anterior descending (LAD, score 2.97±0.40), right coronary artery (RCA, score of 2.82±0.70), left circumflex (LCX, score 2.76±0.73) were in a descending order (F=29.00, P<0.01). Image scores of age groups of 0--1 years old (2.80±0.65), >1--3 years old (2.81±0.74), >3--14 years old (3.58±0.52) were in an ascending order (F= 20.16,P<0.01). Image scores of heart rate groups of<100 bpm (3.54±0.56),100--150 bpm (2.86± 0.70) and >150 bpm (2.81±0.63) were in a descending order (F=16.72, P<0.01). Multiple linearregression analysis demonstrated that multiple impact factors affected image quality of LM, LAD, LCX and RCA. Age(r=0.013 ,P<0.01)and contrast volume(r=0.292, P<0.01)had positive correlation with LM score. Age(r=0.509, P<0.01) and voltage (r=0.292, P=0.011) had positive correlation with LAD score. Heart rate(r= -0.179, P<0.05) had negative correlation with LAD score. Age (r=0.063, P< 0.01) had negative correlation with LCX score. Age (r=0.486,P<0.01) and voltage (r=0.220, P<0.05) had positive correlation with RCA score. Conclusions Dual-source CT could clearly shows coronary arteries of children with CHD over the age of 3 or with heart rate less than 100 bpm. Limitations of Dual-source CT coronary angiography for CHD children included young age and fast heart rate.

OBJECTIVE: To evaluate the hearing results and the effects of the prognostic factors following myringoplasty. METHOD: Retrospective cohort 165 inpatients (175 ears) with preoperative conductive hearing loss were analyzed using multiple linear regression statistical analysis. They have undergone sandwich temporalis fascia myringoplasty between January 1999 and November 2003. Patients have been followed-up for more than 2 years. RESULT: The average air-bone gap improvement for all 175 myringoplasty procedures was 7.1 dBHL. Multiple linear regression statistical analysis was subsequently carried out on these prognostic factors on hearing outcomes and yielded the following relative importance of the predictive is as follows: mean preoperative air conduction threshold, duration of dry ear, duration of disease, age. There is a strong correlation between subjective audition and pure tone threshold audiometry. CONCLUSION A relatively better preoperative hearing, a relatively longer duration of dry ear, a relatively shorter duration of disease and a relatively younger age were found to be significant prognostic factors influencing the postoperative air-bone gap improvement of myringoplasty. Subjective audition improvement coupled with objective pure tone threshold audiometric improvement.
Adolescent ; Adult ; Audiometry, Pure-Tone ; Child ; Female ; Hearing ; Hearing Loss, Conductive ; surgery ; Humans ; Male ; Middle Aged ; Myringoplasty ; Regression Analysis ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective:To evaluate the effect of remimazolam on hemodynamics when used for anesthesia induction in patients undergoing coronary artery bypass grafting (CABG).Methods:Sixty patients of either sex, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ-Ⅲ, with ejection fraction>35%, cardiac index (CI) >2.0 L·min -1·m -2 and body mass index <28 kg/m 2, undergoing CABG under general anesthesia, were divided into 2 groups ( n=30 each)using a random number table method: remazolam group (group R) and midazolam group (group M). Group R received intravenous remimazolam 0.08 mg/kg, and group M received intravenous midazolam 0.05 mg/kg, and both groups used sufentanil, etomidate, and rocuronium bromide for anesthesia induction to maintain the BIS value at 40-65. Before anesthesia induction, at 1-2 min after intravenous injection of remimazolam/midazolam-sufantanil-etomidate, immediately before tracheal incubation, at 30 s-15 min after tracheal intubation, and immediately before skin incision, blood pressure, heart rate, mean arterial pressure, CI, stroke volume index, systemic vascular resistance index, and left heart systolic index were measured, and vasoactive drugs were used to maintain the stability of vital signs and to record the cardiovascular events. Results:Compared with group M, the incidence of hypotension and usage rate of vasoactive drugs were significantly decreased, and the incidence of decrease in CI and stroke volume index by more than 20% and changes in left heart systolic index were decreased in group R( P<0.05). Conclusions:Remimazolam can reduce the disturbance of hemodynamics to a certain extent when used for anesthesia induction as compared with midazolam in patients undergoing CABG.

OBJECTIVE: To observe the effect of auricular magnetotherapy on depression and quality of life in stroke patients with depression after recovery. METHODS: Ninety-three stroke patients with depression were randomly divided into a conventional group(a control group), a conventional combined with magnetotherapy group (an observation 1 group), a conventional combined with vaccaria seed group (an observation 2 group), 31 cases in each group. Conventional treatments were applied in the three groups. On the basis of conventional treatments, auricular magnetotherapy was added in the observation 1 group, and in the observation 2 group, vaccaria seed was applied at gan (CO), xin (CO), pi (CO), shen (CO), shenmen (TF), pizhixia (AT), press 3 times a day, replace once every 3 days, alternate ears and treating for 4 weeks. The scores of 17 Hamilton Depression Scales (HAMD-17) and stroke-specific quality of life scales (SS-QOL) were observed before and after treatment in each group. Depression was assessed at follow-up 4 weeks after treatment, and the clinical efficacy of each group was compared. RESULTS: A total of 83 cases completed the test. After treatment and follow-up, the scores of HAMD decreased in the observation 1 group and observation 2 group compared with that before treatment (all <0.01). The total score of HAMD in the observation 1 group was lower than that in the observation 2 group and control group (all <0.01). After treatment, the depression, suicide, initial insomnia, middle insomnia, final insomnia, work and interest dimension scores in the observation 1 group were lower than those in the observation 2 group and control group (<0.05, <0.01). Compared with that before treatment, the total score of SS-QOL in the observation 1 group increased (<0.01), and there was no significant difference in total score of SS-QOL before and after treatment in the observation 2 group and control group (both >0.05). After treatment, the total score of SS-QOL in the observation 1 group and observation 2 group were higher than that in the control group (<0.01, <0.05), there was no significant difference between the two groups (>0.05). The scores of energy, family characters, and emotional dimensions in the observation 1 group were higher than those in the observation 2 group and control group (<0.05, <0.01). The score of personality and upper limb function were higher than those in the control group (<0.05, <0.01); the score of the family role dimension of the observation 2 group was significantly higher than that in the control group (<0.01). The total effective rate in the observation 1 group was 72.4% (21/29), which was higher than 44.4% (12/27) in the observation 2 group (<0.05) and 11.1% (3/27) in the control group (<0.01). CONCLUSION Auricular magnetotherapy can improve the depressive symptoms of convalescent stroke patients with depression and improve their quality of life.
Acupuncture Points ; Acupuncture, Ear ; Depression ; etiology ; therapy ; Humans ; Magnetics ; Quality of Life ; Stroke ; complications ; Treatment Outcome

Objective:To investigate the molecular mechanism of VRC01 resistance in HIV-1 subtype B′ strains isolated from a patient (DRVI01) with broadly neutralizing antibody (bNAb).Methods:Sequences of the HIV-1 subtype B′ strains isolated from patient DRVI01 were compared with those of HIV-1 subtype B′ strains that were isolated at the same time but sensitive to VRC01 antibody. Key amino acids that might affect the neutralization of VRC01 were selected according to literature reports. Effects of the selected amino acids on VRC01 neutralization were verified by site-directed mutation and sequence exchange of membrane proteins from different patients.Results:Single-point mutations of E279D and R282K in LoopD region and N460A and N463Q in V5 region reversed the viral sensitivity to VRC01 neutralization. Combined mutations in two or three above-mentioned sites significantly increased the viral sensitivity to VRC01 antibody compared with single-point mutations. Contrary to literature reports, the glycosylation site mutation of N276 had no influence on the viral sensitivity to VRC01.Conclusions:HIV-1 subtype B′ strains isolated from patient DRV01 with bNAb carried the mutations of D279 and K282 in LoopD region and N460 and N463 in V5 region, resulting in resistance to VRC01 antibody.

In March 2020, the outflow of age limited videos from ICU in Spain inspired us to rethink whether there is age discrimination in the allocation of scarce medical resources. This paper frist reflected on the problem of age discrimination caused by this phenomenon from four moral intuitions: the sacred view of life, the quality of life and values, public health ethics and Chinese culture, and then examined whether it is illegal from the legal level, finally pointed out the negative impact on the society, and put forward that taking age as the standard for the allocation of scarce medical resources is not suitable for China’s national conditions.

In March 2020, the outflow of age limited videos from ICU in Spain inspired us to rethink whether there is age discrimination in the allocation of scarce medical resources. This paper frist reflected on the problem of age discrimination caused by this phenomenon from four moral intuitions: the sacred view of life, the quality of life and values, public health ethics and Chinese culture, and then examined whether it is illegal from the legal level, finally pointed out the negative impact on the society, and put forward that taking age as the standard for the allocation of scarce medical resources is not suitable for China’s national conditions.

ObjectiveTo determine the characteristics， viral load and immunological status of HIV-infected persons and their spouses who became HIV-positive， and the reasons for HIV seroconversion in 55 HIV discordant couples in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunan Province. MethodsData on the 55 couples meeting the criteria of having a previously positive spouse were retrieved from the AIDS Integrated Prevention and Control Data Information System of the China Disease Control and Prevention Information System during 2015-2021. General socio-demographic information， age at diagnosis， exposure history， CD4⁺T lymphocyte count， and antiviral treatment were collected. Descriptive analysis and chi-square test were used to compare the distribution of pre-HIV-positive spouses and their HIV seroconverted spouses. ResultsA total of 55 spouses from HIV discordant couples had HIV seroconversion. Of them， 72.7% （40/55） of pre-HIV-positive spouses were husbands. The most recent CD4⁺T lymphocyte count in the pre-HIV-positive spouses was （328.31±246.27） cells·μL^-1 at the time of diagnosis of their seroconverted spouses， of which 36.3% （20/55） had a CD4⁺T lymphocyte count of less than 200 cells·μL^-1. Furthermore， of those pre-HIV-positive spouses with low CD4⁺T lymphocyte count， 45.0% （9/20） had an undetectable viral load， 15.0% （3/20） <400 copies·mL^-1， and 25.0%（5/20） ≥400 copies·mL^-1. Additionally， 16.4% （9/55） of the pre-HIV-positive spouses did not have a viral load test. The main reasons for HIV seroconversion among HIV-negative spouses in the discordant couples were poor condom use， poor compliance with antiviral therapy， and treatment discontinuation. ConclusionThe follow-up management of HIV discordant couples should be strengthened in Dehong Prefecture， especially the monitoring of viral load levels and immunological status of pre-HIV-positive spouses， to improve their compliance with antiviral therapy and reduce treatment discontinuation， which would effectively prevent and control HIV transmission between spouses.