Objective To explore risk factors of neurosurgical patients in bed with deep vein thrombosis (DVT) and to compare the Autar Scale with the Caprini Scale for predicting DVT formation. Methods Retrospective analysis of DVT risk factors was conducted on sixty-eight cases neurosurgical patients in bed of three hospitals. In addition, used two kinds of risk assessment scales to assess patient′s level of DVT risk. Results Coma (OR=9.410,95%CI=1.689-52.423), paralysis (OR=4.950,95%CI=1.432-17.105) , infection (OR=2.927,95%CI=1.162-7.373), lower limb central venous catheterization (OR=6.072,95%CI=2.187-16.858) may be risk factors for DVT in neurosurgical patients in bed. The two risk assessment tools were used within 24 hours after admission (χ2=34.861) and within 24 hours after surgery (χ2=52.869) to predict differences in neurosurgical patients with thrombosis risk level, with statistical significance (P < 0.01). Conclusions Nurses should identify risk factors of DVT every day and take preventive measures early to reduce the risks. The Caprini Scale is better than the Autar Scale for predicting DVT formation.

ObjectiveTo study the clinical effect of using traditional Chinese medicinal therapy and interventional therapy for patients with acute necrotizing pancreatitis, and summarize the nursing points. Methods Divided 76 ANP patients into experimental group and control group randomly, there were 38 cases in these 2 groups respectively. Using traditional Chinese medicinal therapy and interventional therapy in experimental group, using interventional therapy in control group. Compared the clinical values in 2 groups. [WTHZ]Results All the clinical values were significant better in experimental group than those in control group,P

Objective To explore the risk factors of lower extremity deep venous thrombosis (LEDVT) of neurosurgical patients, and to provide references for identifying the most susceptible population and taking preventive measures. Methods A total of 68 cases of neurosurgical patients with LEDVT in three general hospitals from August 2010 to August 2013 were collected. The design method of one to one matching case-control study was used controlling age, sex and neurosurgical disease. Univariate and multivariate analyses were performed to determine the probable risk factors among two groups. Results The univariate analysis showed that coma, paralysis and limb immobilization, infection, trauma and fracture, lower limbs central venous catheterization, trachea cannula or tracheotomy, mechanical ventilation, surgical operation, dehydration and blood transfusion were significantly related to the incidence of LEDVT ( Χ2=4.50-33.23, P<0.05 or 0.01). The Logistic multivariate regression analysis showed that coma (OR=9.410, 95%CI 1.689-52.423), paralysis and limb immobilization (OR=4.950, 95%CI 1.432-17.105), infection (OR=2.927, 95%CI 1.162-7.373) and lower limbs central venous catheterization (OR=6.072, 95%CI 2.187-16.858) were independent risk factors for the development of LEDVT. Conclusions We should pay attention to patients with high risk factors of LEDVT and take preventive measures early to avert the formation of LEDVT.

A 28-year-old female patient presented with indurated erythema and nodules on the right lower limb for 2 years,with mild itching and pain.Skin examination showed a well-circumscribed irregular dark red patch measuring about 10 cm × 5 cm in size on the extensor aspect of the right thigh.On the patch,there were scattered or densely distributed mung bean-to soybean-sized quasi-circular violaceous nodules with a smooth surface,which were hard on palpation.Subcutaneous nodules with medium hardness were found on palpation,and hyperpigmentation was observed on the surface of some nodules.Local skin temperature was increased,with tenderness on palpation.Histopathologically,mononuclear cells showed nodular or sheet-like distribution in the middle and upper dermis,some of which had pale-staining cytoplasm.Moreover,plenty of plasma cells were observed.Immunohistochemistry revealed that histiocytes were stained strongly positive for S100.The number of IgG4-positive plasma cells increased obviously,and was more than 50 per high-power field (× 200).The proportion of IgG4-positive plasma cells in IgG-positive plasma cells was 45％.Finally,the patient was diagnosed with cutaneous Rosai-Dorfman disease with increased IgG4-positive plasma cells.

Objective To lay the foundation for further exploration on parasitifer's defence reaction to pneumolysin through constructing ply gene-deletion strain of Streptococcus pneumoniae and researching on its virulence change. Methods A linker fragment with erm gene in middle and homologous upstream and downstream fragment of ply gene at both sides was prepared by long flanking homology-polymerase chain reaction(LFH-PCR). The linker fragment was transformed into Streptococcus pneumoniae. ply-deficient strain was then screened out from blood plate which contains erythromycin and identified by PCR. ply-deficient strain growth in vitro was observed and virulence change was observed through infecting mouse model. Results PCR results showed that ply gene was replaced completely by erm gene. The ply deficient strain was successfully constructed. The growth of single strain culture medium showed that ply genetic defect made no influence on bacterial's external growth. While in the mice nasal cavity infecting experiment, deficient strain enter into blood after 6 h from infecting which obviously slower than that did wild-type(2 h). And the number of bacteria at each point was much smaller than that of wild-type(P ＜0. 01 ). The mice peritonaeum infecting experiment showed that median lethal time of wild-type was 3 d, while that of deficient strain was 18 d(P＜0. 01). Conclusion It is a good way to completely substitute ply gene using LFH-PCR. ply deletion made no influence on baterial's growth in vitro, but it resulting in reduction of bacterial virulence in vivo.

OBJECTIVE: To investigate characteristics of molecular etiology of children with profound sensorineural hearing loss in Hubei province, and to provide reference for deafness treatment and genetic counseling. METHOD: Three hundred and six children with profound sensorineural hearing loss in Hubei province were enrolled, their genomic DNA were extracted from peripheral blood and a deafness gene test chip was used to screen nine hot spot mutation in the GJB2, GJB3, SLC26A4, and mitochondria 12SrRNA gene. All patients with SLC26A4 gene mutation were given temporal bone CT scan. RESULT: One hundred and thirty-two (43.14%) out of 306 children were found carrying at least one pathogenic gene mutation. The mutation rates of GJB2, SLC26A4 and mitochondria DNA 12SrRNA gene were 29.41% (90/306), 13.72% (42/306) and 0.65% (2/306), respectively. None out of 306 children was detected GJB3 gene mutation. Thirty-six patients carrying SLC26A4 gene mutation were detected enlarged vestibular aqueduct by CT scan. CONCLUSION Mutations of GJB2 and SLC26A4 gene are two major pathogenic gene for genetic hearing loss in children. 235delC mutation is the main mutation type, followed by IVS7-2A> G mutation type. The screening of SLC26A4 gene common mutations contribute to the diagnosis of enlarged vestibular aqueduct syndrome.
Adolescent ; Child ; Child, Preschool ; China ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; Deafness ; genetics ; Female ; Genetic Testing ; Humans ; Infant ; Male ; Membrane Transport Proteins ; genetics ; Mutation ; Oligonucleotide Array Sequence Analysis ; Sulfate Transporters

Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection.Methods The culprit medication for drug eruption was identified by reviewing the patient′s liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments.Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway.Results The rash was poorly controlled after clinical pharmacist′s initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral).The clinical pharmacist further suggested dexamethasone intravenous drip.The patient recovered well with the combination therapy of antihistamines and glucocorticoid.Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient′s disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

Objective To analyze the expression levels of serum microRNA(miR)-211 and miR-202 in patients with Alzheimer's disease and their correlation with cognitive function,anxiety and depression.Methods A total of 90 patients with Alzheimer's disease admitted to Hebei Yanda Hospital from March 2019 to March 2022 were selected as the research group.According to the Clinical Dementia Rating(CDR)score,the patients were grouped into mild group(n=24),moderate group(n=48)and severe group(n=18).Another 90 healthy individuals who underwent physical examination were collected as the control group.The expression levels of miR-211 and miR-202 in serum were compared.Pearson method and Spearman method were used to analyze serum miR-211 and miR-202 and their correlation with cognitive function,anxiety and depression.Logistic regression analysis was used to analyze the influencing factors of Alzheimer's disease.Results The expression levels of serum miR-211(0.59±0.16,1.01±0.31)and miR-202(0.35±0.10,1.00±0.32)were significantly reduced in the research group and control group,with significant differences(t=11.422,18.393,all P<0.05).Serum miR-211(0.73±0.21,0.62±0.17,0.32±0.08)expression levels,miR-202(0.51±0.15,0.33±0.10,0.19±0.04)expression levels,mini-mental state examination(MMSE)score(22.54±1.41 score,19.35±1.01 score,16.23±1.00 score)and Montreal cognitive assessment(MoCA)score(25.35±2.60 score,18.59±1.32 score,16.59±1.24 score)in the mild,moderate and severe groups gradually decreased,and the differences were statistically significant(F=32.006,46.917,163.048,163.703,all P<0.05).Compared with mild group,the serum miR-211,miR-202,MMSE and MoCA scores of severe group and moderate group were reduced,and the differences were statistically significant(t=3.685～25.375,all P<0.05).The mild,moderate and severe groups had a gradual increase in Hamilton anxiety scale(HAMA)score(12.34±1.27 score,20.59±2.09 score and 31.29±2.19 score)and Hamilton depression scale(HAMD)score(14.35±2.13 score,23.89±2.20 score and 35.35±1.21 score),and the differences were statistically significant(F=496.059,553.939,all P<0.05).According to Pearson correlation analysis,miR-211 was positively correlated with miR-202(r=0.651,P<0.05).According to Spearman correlation analysis,miR-211 and miR-202 were positively correlated with MMSE and MoCA(r=0.539～0.585,all P<0.05)and negatively correlated with HAMA and HAMD(r=-0.651～-0.539,all P<0.05).Logistic regression analysis showed that the low expression of miR-211[OR(95%CI):5.321(1.648～17.180)]and miR-202[OR(95%CI):3.158(1.989～5.012)]were risk factors for Alzheimer's disease(P<0.05).Conclusion The serum expression levels of miR-211 and miR-202 in patients with Alzheimer's disease were reduced,indicating miR-211 and miR-202 were closely related to cognitive function,anxiety and depression.

Objective To investigate the correlation between serum Angiopoietin-like protein 4(ANGPTL4)and soluble bone marrow cell-like transcription factor-1(sTLT-1)levels and cognitive function and prognosis in elderly patients with vascular dementia(VD).Methods A total of 92 elderly patients with vascular dementia admitted to Hebei Yanda Hospital from June 2020 to June 2022 were selected as the study group.They were divided into mild(n=30),moderate(n=36)and severe groups(n=26)according to the minimum mental state examination(MMSE)score,and 92 patients with healthy physical examination during the same period were selected as the control group.According to the prognosis of patients,the cognitive dysfunction was divided into grade Ⅰ～Ⅱ and grade Ⅲ.ELISA method was used to detect the levels of serum ANGPTL4 and sTLT-1.Pearson and Spearman methods were used to analyze the correlation between serum ANGPTL4 and sTLT-1 and MOCA scores.Logistic regression analysis was used to analyze the influencing factors of the prognostic grade Ⅲ of elderly patients with vascular dementia.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum ANGPTL4 and sTLT-1 levels in the prognostic grade Ⅲ in elderly patients with vascular dementia.Results The serum ANGPTL4 level(987.57±53.25 pg/ml)in the study group was lower than that in the control group(1 108.35±62.13 pg/ml),and the serum sTLT-1(68.01±5.15 pg/ml)level was higher than that in the control group(50.12±4.57 pg/ml),with significant differences(t=14.158,24.922,all P＜0.05).Serum ANGPTL4 levels and MOCA scores were decreased sequentially in the mild,moderate and severe groups(F=33.495,66.617),while serum sTLT-1 level was increased sequentially(F=66.718),and the differences were statistically significant(all P＜0.05),respective.Pearson analysis showed that serum ANGPTL4 was negatively correlated with sTLT-1(r=-0.621,P＜0.05).Spearman analysis showed serum levels of ANGPTL4 and sTLT-1 were positively and negatively correlated with MoCA scores,respectively(r=0.545,-0.557,all P＜0.05).The serum ANGPTL4 level(953.45±51.16 pg/ml)in the prognostic patients of grade Ⅲ was lower than that of grade Ⅰ～Ⅱ(1 005.76±54.27 pg/ml),and the serum level of sTLT-1(73.14±5.40 pg/ml)was higher than that of grade Ⅰ～Ⅱ(65.28±5.02 pg/ml),with significant differences(t=4.490,6.967,all P＜0.05).Logistic regression analysis showed low expression of ANGPTL4[OR(95％CI):5.089(1.833～14.129)]and high expression of sTLT-1[OR(95％CI):4.258(1.739～10.428)]were risk factors affecting the prognosis of elderly patients with vascular dementia(P＜0.05).According to the ROC curve,the combined prediction of two for the grade Ⅲ prognosis of elderly vascular dementia patients was better than the individual prediction of ANGPTL4 and sTLT-1(Z=2.135,3.268,all P＜0.05).Conclusion Serum ANGPTL4 level was decreased but sTLT-1 level was increased in elderly patients with vascular dementia,and ANGPTL4 and sTLT-1 were closely related to cognitive function and prognosis.

Objective To investigate the effects of glucocorticoid and blood purification on cellular immune function and prognosis in children with severe sepsis/septic shock. Methods Fifty-five pediatric patients with severe sepsis/septic shock admitted to PICU of Shandong Provincial Hospital between January 2015 and June 2017 were enrolled in the study and were divided into control group,hormone group and con-tinuous blood purification group according to treatment. PCIS,PICU stay,immune function,3\7\28-day mor-tality rate,the level of HLA-DR/CD14,TNF-α and IL-10 of pre-treatment,24 h and 72 h post-treatment were studied and compared among three groups. Results (1) Three-day (26. 7% vs. 20. 0% vs. 20. 0%) and 7-day mortality rates in blood purification group,hormone group,and control group were 4/15,4/20,4/20 and 5/15,5/20,5/20,respectively,which were the highest in blood purification group,but 28-day mortality rate(5/15 vs.7/20 vs.8/20)was the lowest in blood purification group. (2) PCIS,the expressions of HLA-DR/CD14,CD4 +,CD8 +and CD4 +/CD8 +increased in all groups while they increased significantly in blood purification group(P<0. 05). The levels of TNF-α and IL-10 in peripheral blood of children decreased gradually in each group,especially in blood purification group. Conclusion Comparing with hormone group, continuous blood purification therapy can remove inflammatory mediators more quickly and effectively,reduce cytokine level and improve cellular immune function in children with severe sepsis/septic shock,and reduce their 28-day mortality.