Objective:To explore the effect of group visits on health condition among follow-up patients with chronic heart failure.Methods:Totally 126 outpatient follow-up patients with heart failure were divided into intervention group and control group by random number table from 2018 to 2019. The intervention group consisted of 63 cases and control group consisted of 59 cases. The intervention lasted 6 months. The intervention group received group visits, while the control group received routine outpatient follow-up. Medication adherence, quality of life and heart failure related indicators were evaluated at baseline and after 6 months of intervention.Results:At 6 months after intervention, the scores of medication adherence, total quality of life, body, emotion and others dimensions of the intervention group were (5.79±1.38), (30.11±8.22), (12.65±5.53), (5.24±4.57) and (12.22±4.76) points. These scores of the control group were (5.31±1.09), (37.26±9.02), (15.87±5.21), (7.03±5.14), (14.36±5.54) points. The differences between the two groups were statistically significant ( t values were -4.581-2.161, P<0.05 or 0.01). The BNP and proportion of New York Heart Association (NYHA) I the intervention group were (180.87±174.92) ng/L and 84.1% (53/63). These indicators of the control group were (351.02±268.13) ng/L and 67.8% (40/59). The differences between the two groups were statistically significant ( t value was -4.177, χ2 value was 4.484, P<0.01 or 0.05). Conclusions:Group visits program is an effective management mode to provide intensive patient education and foster peer support, improving medication adherence and quality of life of follow-up patients with heart failure.

Objective:To explore the application effect of group management in follow-up management of patients with chronic heart failure.Methods:By the convenient sampling method, patients with chronic heart failure who were admitted to Department of Cardiology of Peking University First Hospital in 2018 and participated in heart failure follow-up clinic management after discharge were selected as research objects. The patients were divided into the intervention group and the control group by the random number table method. Finally, 63 patients were included in the intervention group and 59 patients were included in the control group. The control group was followed up by heart failure clinic and the intervention group was followed up by group management. Atlanta Heart Failure Knowledge Test-V2 (AHFKT-V2) , the Heart Failure European Self-care Behavior Scale (EHFScBS) , heart function grade of NYHA and Type B natriuretic peptide (BNP) were used to compare intervention effects.Results:Six months after the intervention, the total score of AHFKT-V2, scores of nutrition, behavior, symptom management, and medication dimensions of the intervention group were all higher than those of the control group, the total score of EHFScBS was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Six months after the intervention, the heart function grade of NYHA and BNP of the intervention group were better than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The group management model can effectively improve heart failure related knowledge, self-care behaviors, heart function grade of NYHA and BNP of patients with heart failure follow-up.

Objective To measure the accuracy of multi-leaves collimator (MLC) leaves positions in intensity modulated radiation therapy (IMRT) for verification purpose.Methods Solid water homogeneous phantom with size of 30 cm× 30 cm was scanned by CT scanner.The scanned images were delivered to radiation therapy plan system (TPS) to formulate the therapy plan.The MLC leaves created 5 strips of exposure field,each 3 cm long and 0.6 cm wide.The strip-to-strip distance was 3 cm.With 6 MV X-rays,the SSD was 100 cm at the maximum dose point.The MU per strip was 250 MU.EBT2 radiochromic films each of 25 cm×25 cm were placed on the 30 cm×30 cm homogeneous solid phantom and covered with 1 cm thick solid phantom slabs for delivering of IMRT.Results For 7 of 8 accelerators,the differences of film-measured and TPS-planned MLC leaf position for every fence field were within ± 0.5 mm as required by IAEA,with only other one being-0.6 mm,not consistent with the IAEA requirements.The film-measured position difference between each pair and all pairs of leaves for 8 accelerators were all in line with IAEA's requirements.The film-measured actual width difference between each pair and all pairs of leaves was within ±0.75 mm as required by IAEA for 4 accelerators and outside ±0.75 mm for the other three,not consistent with the IAEA requirements.The standard deviation of film-measured actual width between each pair and all pairs of leaves for 6 accelerators were ≤ 0.3 mm,as required by IAEA,whereas ＞0.3 mm for the other two,not consistent with IAEA requirements.Conclusions The film dosimetric verification of IMRT is an important part of its quality assurance,featuring simple,reliable and highly accurate positioning and can meet measurement requirement.

Objective: To explore the long-term effects of radiation injury and to provide scientific basis for the evaluation of the effects of ionizing radiation injury by carrying out medical follow-up of patients involved in the " 5.7" radiative source accident in Nanjing in 2014. Methods: Through interviewing and investigating, we inquired about the new disease history of the exposed patients from rehabilitation treatment to medical follow-up peroid. Physical and laboratory examinations were carried out. According to relevant standards, physiological and biochemical indexes such as hematopoietic system, immune system, endocrine system, ophthalmology, circulatory system, digestive system, urinary system and bone mineral density were systematically evaluated, with the long-term effects being evaluated. Results: The patient′s vital signs were good without new diseases. The indexes of hematopoietic system, immune system and endocrine system tended to be normal, the circulatory system, digestive system and urinary system showed degenerative changes, the ophthalmic examination showed visual acuity continue to decline, and bone mineral density examination indicated low bone mass. Conclusions Physiological and biochemical indicators of the patients gradually returned to normal without obvious symptoms of radiation damage. Further medical follow-up observation still needs to continue.

Objective? To explore the effect of cardiovascular family-care APP on self-management behavior of patients with coronary heart disease. Methods? The hospitalized patients with coronary heart disease who were admitted in the department of cardiovascular medicine of a Class Ⅲ Grade A hospital from May 2016 to May 2018 were recruited by non-probability sampling method. All the research subjects were randomly divided into intervention group and control group by random number table. The intervention group consisted of 143 cases and control group consisted of 147 cases. The intervention lasted 12 months. The intervention group received health management of cardiovascular family-care APP, while the control group received routine discharged-guidance and outpatient clinic follow-up. Self-management behavior and risk factors of coronary heart disease were evaluated at baseline and 6 months and 12 months after intervention. Results? At 6 months after intervention, the total score of self-management behavior, medical management and emotional management in the intervention group were significantly higher than those in the control group, with statistical significance (P＜0.05). At 12 months after intervention, the total score of self-management behavior and medical management in intervention group were significantly higher than those in control group, with statistical significance (P＜0.05). After 6 months of intervention, BMI, alcohol consumption, blood pressure control of the intervention group were better than those of the control group, with statistical significance (P＜0.05). After 12 months of intervention, the control of blood pressure in the intervention group was better than that in the control group (P＜ 0.05). Conclusions? Cardiovascular family-care APP can promote the establishment of good self-management behavior in patients with coronary heart disease. Self assessment on smoking, drinking, diet, exercise, stress, anxiety and depression can be increased in app,and relevant research can be carried out

The interplay between mechanoresponses and a broad range of fundamental biological processes, such as cell cycle progression, growth and differentiation, has been extensively investigated. However, metabolic regulation in mechanobiology remains largely unexplored. Here, we identified glucose transporter 1 (GLUT1)-the primary glucose transporter in various cells-as a novel mechanosensitive gene in orthodontic tooth movement (OTM). Using an in vivo rat OTM model, we demonstrated the specific induction of Glut1 proteins on the compressive side of a physically strained periodontal ligament. This transcriptional activation could be recapitulated in in vitro cultured human periodontal ligament cells (PDLCs), showing a time- and dose-dependent mechanoresponse. Importantly, application of GLUT1 specific inhibitor WZB117 greatly suppressed the efficiency of orthodontic tooth movement in a mouse OTM model, and this reduction was associated with a decline in osteoclastic activities. A mechanistic study suggested that GLUT1 inhibition affected the receptor activator for nuclear factor-κ B Ligand (RANKL)/osteoprotegerin (OPG) system by impairing compressive force-mediated RANKL upregulation. Consistently, pretreatment of PDLCs with WZB117 severely impeded the osteoclastic differentiation of co-cultured RAW264.7 cells. Further biochemical analysis indicated mutual regulation between GLUT1 and the MEK/ERK cascade to relay potential communication between glucose uptake and mechanical stress response. Together, these cross-species experiments revealed the transcriptional activation of GLUT1 as a novel and conserved linkage between metabolism and bone remodelling.
Animals ; Biomechanical Phenomena ; Blotting, Western ; Bone Remodeling ; drug effects ; Cells, Cultured ; Glucose Transporter Type 1 ; antagonists & inhibitors ; genetics ; Humans ; Hydroxybenzoates ; pharmacology ; Immunohistochemistry ; MAP Kinase Signaling System ; drug effects ; Mice ; Mice, Inbred C57BL ; Osteoprotegerin ; metabolism ; Periodontal Ligament ; cytology ; RANK Ligand ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Tooth Movement Techniques ; Transcriptional Activation

Objective To explore the characteristics of respiratory parameters in patients with different body mass index during general anesthesia with tracheal intubation. Methods 102 patients scheduled for otitis me-dia surgery were divided into low weight group(B1,n=32),normal weight group(B2,n=36)and overweight or obese group(B3,n = 34 ). After general anesthesia with tracheal intubation,the tidal volume of anesthetic ma-chine wasadjusted to maintain the end tidal carbon dioxide partial pressure between 35 - 45 mmHg. At 10 min (T1),30min(T2)and 60 min(T3)after adjustment,arterial PH,arterial partial pressure of oxygen(PaO2),arte-rial carbon dioxide pressure(PaCO2),inspiratory tidal volume(VTi),expiratory tidal volume(VTe),end tidal carbon dioxide partial pressure(PETCO2),peak airway pressure(Ppeak),plateau airway pressure(Pplat)and dy-namic lung compliance(Cdyn)were recorded. Results PH and PaO2 were not significantly different at T1-3 among the three groups(P>0.05). As compared with group B1 and B2,PaCO2 was lower in group B3. In comparison with group B2,VTi,VTe and Cdyn were higher in group B1 and lower in group B3(P < 0.05). Ppeak and Pplat were lower in group B1 but higher in group B3(P<0.05). PETCO2 was higher in group B1(P>0.05)while lower in group B3 (P < 0.05). Conclusions With the increase in BMI during general anesthesia with tracheal intubation ,the VTi,VTe,Cdyn,PETCO2 and PaCO2 decrease significantly,but Ppeak and Pplat elevate markedly. BMI is a refer-ence index for setting respiratory parameters.

OBJECTIVETo explore the application of a novel device of collecting large amount of fecal mucosa for detecting the DNA methylation and screening colorectal cancer.

METHODSPreoperative complete fecal sample and surgical specimen of 10 patients with colorectal cancer, and complete fecal sample and normal bowel mucosal samples confirmed by colonoscopy of 6 hospitalization cases at The Third Affiliated Hospital, Nanjing University of TCM from March to April 2014 were collected. A self-made bowel mucosa collector (consisting of upper, middle, lower three containers of 1 000 ml volume, with filter screen in each bottom whose pore diameter is 100, 200 and 300 mesh.) was used to collect mucosal exfoliation cells. Fecal DNA kit was applied to extract DNA of exfoliation cells and the concentration and purity of DNA were measured by UV spectrophotometer (A260/A280), meanwhile DNA methylation of fecal fluid and mucosal tissues was detected by bisulfite sequencing pCR(BSP).

RESULTSDNA methylation sequencing showed that FBN1, SPG20, and SNCA genes presented methylation in CpG island in fecal fluid and cancer tissues from 10 colorectal cancer patients, but did not presented methylation in fecal fluid and mucosa from 6 control cases. When fecal amount was below 100 g, collection rate of fecal fluid was 60% to 80%; when fecal amount was over 100 g, collection rate of fecal fluid was unstable. When fecal amount was 50 to 100 g, DNA A260/A280 value was 1.6 to 1.8, and DNA concentration was 5.0 to 56.1 ng/L.

CONCLUSIONCollection rate of fecal fluid with this self-made fecal mucosa collector is quite stable when managing fecal amount of 50 to 100 g once, and can obtain higher purity and concentration of DNA, meeting the demand of methylation detection for screening colorectal cancer.

Colonoscopy ; Colorectal Neoplasms ; diagnosis ; CpG Islands ; DNA Methylation ; Early Detection of Cancer ; methods ; Feces ; chemistry ; Humans ; Intestinal Mucosa

OBJECTIVETo analyze the genetic cause for a child with growth retardation and mental retardation and discuss the application of array-based comparative genomic hybridization (aCGH) in its molecular genetic diagnosis.

METHODSConventional karyotyping of peripheral blood for the family was carried out. aCGH was performed to further ascertain the size and origin of the additional chromosome fragments.

RESULTSIn the trio family here, the karyotype of the father was normal, the karyotype of the mother was 46,XX, t(6;9)(q26;q21)and the proband child's was 47,XX,+der(9)?t(6;9)(q26;q21). aCGH showed that the extra chromosomal fragments originated from chromosome 9p24.3-q21.13 and the size was 78.26 Mb, and the repeat region included the 9p trisomy's clinical area. At the same time, it was confirmed that 6q26-q27 was trisomic and the fragment that related to development delay was 6.6 Mb. We determined that the proband's karyotype was 47,XX,+der(9)t(6;9)(q26;q21.13)mat finally.

CONCLUSIONThe patient's abnormal chromosome has originated from her mother with balance translocation. The duplications of 9p24.3-q21.13 and 6q26-q27 may lead to growth retardation and mental retardation. Accompanied with the cytogenetic methods, aCGH can accurately identify the origin and size of the abnormal chromosomes, contributing to the genetic analysis.

Child, Preschool ; Chromosome Disorders ; genetics ; Chromosomes, Human, Pair 6 ; genetics ; Chromosomes, Human, Pair 9 ; genetics ; Comparative Genomic Hybridization ; methods ; Female ; Humans ; Trisomy ; genetics

OBJECTIVETo investigate the status and risk factors for hematogenous occupational exposure in medical staff in an infectious disease hospital, and to provide a scientific basis for targeted preventive and control measures.

METHODSThe occupational exposure of 395 medical workers in our hospital was monitored from January 2012 to December 2014, among whom 79 individuals with occupational exposure were subjected to intervention and the risk factors for occupational exposure were analyzed.

RESULTSThe high-risk group was mainly the nursing staff (69.6%). The incidence of hematogenous occupational exposure was high in medical personnel with a working age under 3 years, aged under 25 years, and at the infection ward, accounting for 63.3%, 72.1%, and 72.2%, respectively. Hepatitis B virus, hepatitis C virus, Treponema pallidum, and human immunodeficiency virus were the primary exposure sources. Sharp injury was the major way of injury (91.1%), with needle stick injury accounting for the highest proportion (86.1%). Injury occurred on the hand most frequently (91.1%). The high-risk links were improper disposal during or after pulling the needle, re-capturing the needle, and processing waste, accounting for 46.8%, 17.7%, and 12.7%, respectively. Seventy-nine professionals with occupational exposure were not infected.

CONCLUSIONThe main risk factor for hematogenous occupational exposure in medical staff in the infectious disease hospital is needle stick injury. Strengthening the occupational protection education in medical staff in infectious disease hospital, implementing protective measures, standardizing operating procedures in high-risk links, and enhancing the supervision mechanism can reduce the incidence of occupational exposure and infection after exposure.

Hospitals ; Humans ; Incidence ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Medical Staff, Hospital ; Needlestick Injuries ; epidemiology ; Occupational Diseases ; prevention & control ; Occupational Exposure ; prevention & control ; Risk Factors