Objective To explore the clinical curative effect of pidotimod on patients with respiratory tract infection and effect on immune function. Methods 120 children with recurrent respiratory tract infection in the Third Hospital of Qinhuangdao,the Third Staff Hospital of Baogang Group,the Third Hospital of Wulanchabu were selected,and were divided into two groups according to random number table.60 cases in control group were treated with routine treatment of anti-infection,relieving cough,eliminating phlegm,antipyretic;60 cases in experimental group were treated with pidotimod on the basis of routine treatment,oral with boiled water,0.4g per times,2 times a day,with a course of 60 days.Clinical curative effect after treatment and serum immunoglobulin (IgG,IgA,IgM)levels,T lymphocyte subsets (CD3+,CD4+,CD8+)levels and NK cells relative activities before and after treatment were compared between two groups.Results After treatment,the total effective rate of experimental group (95.00%)was significantly higher than that of control group (81.67%),and the difference was statistically significant (P<0.05);the immune indexes before treatment had no significant difference,and levels of serum immunoglobulin and T lymphocyte subsets were improved,and levels of serum immunoglobulin (IgG,IgA,IgM)and T lymphocyte subsets (CD3+,CD4+,CD8+)of experimental group were more higher than those of control group,and the difference was statistically significant (P<0.05 );relative activity of NK cells in both groups improved after treatment,but relative activity of NK cells in experimental group was significantly higher than that in control group,and the difference was statistically significant (P<0.05 );adverse reactions according minor rashes and anemia were observed in two groups,and there was no significant differece in the incidence of adverse reactions,and ADR was tolerable after symptomatic treatment.Conclusion Pidotimod could significantly improve the clinical curative effect of patients with respiratory tract infections and effectively improve the immune function of patients with recurrent respiratory tract infections with high security,which has a clinical significance.

Objective To evaluate the efficacy of nalmefene antagonizing postoperative respiratory depression induced by opioids.Methods Two hundred and forty ASA Ⅰ orⅡpatients aged 18-64 yr with body weight fluctuating within 20% of the standard body weight were included in this multicenter,randomized,double-blind,positive drug-controlled study.Anesthesia was induced with etomidate 0.3 mg/kg and TCI of sufentanil(effect-site concentration 0.4.ng/ml).Tracheal intubation was facilitated with vecuronium 0.1 mg/kg or rocuronium 0.6mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 35-45 mm Hg.Anesthesia was maintained with sevoflurane+ sufentanil TCI(Ce=0.1-0.4 ng/ml).Patients undergoing neurosurgery and liver or kidney operation were excluded.The operation time was within 3 h.The residual effects of muscle relaxants were reversed after operation.The patients were randomly divided into 2 groups(n=120 each):group Ⅰneloxone andgroup Ⅱ nalmefene.Naloxone 0.1 mg or nalmefene 0.25 μg/kg was injected iv over 30 s and was repeated 5 min later if necessary until the respiratory rate＞10 bpm,PETCO2＜45 mm Hg and apnea time＜15 s.The total amount of naloxone was≤0.4 mg while that of nalmefene≤1 μg/kg.BP,HR,SpO2,PETCO2,respiratory rate and apnea time were recorded immediately before and at 2 and 5 min after haloxone/nalmefene administration and then every 5 min until 5 min after extubation.The recovery of spontaneous breathing within 30 min after naloxone/nalmefene administration,extubation time and Ramsay sedation score at 5 min after extubation were recorded.The patients were also observed for adverse reactions.Results Spontaneous breathing recovered within 30 min after naloxone/nalmefene administration in all patients in both groups.The extubation time was significantly shorter in nalmefene group than in naloxone group.There was no significant difference in Ramsay sedation score,BP,HR,SpO2 and incidence of adverse reactions between the 2 groups.Conclusion Nalmefene is better than naloxone in antagonizing opioid-induced postoperative respiratory depression.

Objective To investigate the effect of diabetes on clinical efficacy of transcatheter arterial chemoembolization (TACE) in the treatment of non-viral hepatitis hepatocellular carcinoma (HCC). Methods Retrospectively analyzed the clinical data of 367 non-hepatitis virus HCC patients treated by TACE, included 153 diabetes mellitus cases (test group) and blood glucose of 214 patients was normal (control group). To assess the treatment effect after 1 month of TACE based on response evaluation criteria in solid tumors, include complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), and calculate the disease control rate. Through 6 to 75 months follow-up to observed long-term efficacy, record the time to progression (TTP) and overall survival (OS) time. Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis by SPSS 16.0. The single-factor analysis was used to analyze variables which variables that differed were analyzed by Cox regression. Results The disease control rate of test group was 69.9%(107/153) and control group was 74.3%(159/214), the difference was no statistically significant (P=0.125). The median time to progression (mTTP) and median overall survival (mOS) of test group were 10.0 and 15.0 months;and the mTTP and mOS of control group were 14.0 and 19.0 months, the difference were statistically significant (P=0.023 and P= 0.026). Tumor diameter ≥4.5 cm, numbers of tumor ≥3, invasion of blood vessels, α-fetoprotein≥200 μg/L, Eastern Cooperative Oncology Group score and diabetes were risk factors for OS of HCC patients. Conclusion Diabetes is unfavorable factors for overall survival of non-hepatitis HCC tread by TACE.

Objective:To analyze the relativity between 25-hydroxyvitamin D3 (25 (OH) D3) and vascular complications in type 2 diabetes mellitus (T2DM) patients at different body mass index (BMI) levels.Methods:A total of 113 T2DM patients admitted to Chizhou People’s Hospital from Oct. 2021 to Oct. 2023 were selected as the study objects. The enrolled patients were divided into normal group, overweight group and obese group according to BMI level. General data (gender, age, course of disease, smoking history, drinking history, family history of hypertension and diabetes) and laboratory indicators were collected, including triglyceride (TG), creatinine (Cr), high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), urinary albumin/creatinine ratio (UACR), albumin (Alb), blood calcium, blood phosphorus, 25 (OH) D3, etc. Spearman correlation analysis was used to analyze the correlation between diabetic vascular complications and 25 (OH) D3, and Logistic regression was used to analyze the risk factors of diabetic vascular complications among different BMI groups.Results:The disease course of overweight and obesity group was (8.51±2.39) years, (10.82±3.02) years, TG was (2.58±0.45) mmol/L, (3.24±0.64) mmol/L, TC was (6.23±1.45) mmol/L, (9.32±2.01) mmol/L, and BMI was (26.48±1.53) kg/m 2, (30.12±1.62) kg/m 2, higher than those of the control group ( P<0.05). The level of LDL-C (3.58±1.02) mmol/L and HbA1c (10.78±1.68) were higher in obese group (45.00%) ( P<0.05). Compared with those of the overweight group, the levels of hypertension, disease duration, TG, TC, LDL-C, HbA1c and BMI in the obese group were higher ( P<0.05). The levels of serum 25 (OH) D3 [ (40.25±3.35) mmol/L, (33.18±2.78) mmol/L] in overweight and obese group were lower than those in the normal group ( P<0.05), and the incidence of diabetic vascular complications was 65.22% and 87.50%, respectively, higher than those in the normal group ( P<0.05). Compared with that in the overweight group, serum 25 (OH) D3 level was lower in the obese group ( P<0.05), and the incidence of diabetic vascular complications was higher ( P<0.05). Spearman correlation analysis showed that disease duration, TG, TC, HbA1c were positively correlated with diabetic vascular complications ( P<0.05), and 25 (OH) D3 was negatively correlated with diabetic vascular complications ( P<0.05). Logistic regression analysis showed that disease duration and HbA1c level were risk factors for diabetic vascular complications in the three groups ( P<0.05), while TG, TC and low 25 (OH) D3 were risk factors for diabetic vascular complications in the hyperrecombination and obesity groups ( P<0.05) . Conclusion:The level of 25 (OH) D3 in overweight/obese T2DM patients is negatively correlated with vascular complications of diabetes, and vitamin D supplementation should be paid attention to overweight/obese T2DM patients to reduce the risk of vascular complications of diabetes.

Objective:To explore the mediating effect of smoking, emotional control, and family relationship on the association between relational bullying victimization and perpetration.Method:A total of 11 462 participants were included in the study. Mediating effect model was used to analyze the mediating effect of smoking, emotional control, and family relationship between relational bullying victimization and perpetration.Results:Family relationship (mediation effect value: 0.119, 95% CI: 0.075-0.165, mediation ratio: 8.5%) and smoking (mediation effect value: 0.061, 95% CI: 0.031-0.105, mediation ratio: 4.4%) constitute a separate mediating effect. Family relationship, emotional control, and smoking constitute a chain mediation effect (mediation effect value: 0.007, 95% CI: 0.003-0.013, mediation ratio: 0.5%); family relationship and smoking constitute a chain mediation effect (mediation effect value: 0.036, 95% CI: 0.020-0.056, mediation ratio: 2.6%); emotional control and smoking constitute a chain mediating effect (mediation effect value: 0.007, 95% CI: 0.003-0.013, mediation ratio: 0.5%). Conclusion:Smoking, emotional control, and family relationship partially mediate relational bullying victimization and perpetration.

Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.

BACKGROUND: Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. METHODS: Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test). RESULTS: We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies. CONCLUSION: The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries. TRIAL REGISTRATION ClinicalTrials.gov, NCT01597232.
Humans ; Adult ; Postoperative Complications ; Erythrocyte Transfusion/adverse effects* ; Blood Transfusion ; Hospitals ; Hemoglobins/analysis*