Objective:To study the iodine nutritional status of pregnant women in the third trimester in the Southwest of Shandong Province, analyze its impact on their cardiac electrical activity, and provide a basis for scientific supplementation of iodine during pregnancy.Methods:From January 2021 to June 2022, a cross-sectional survey was conducted using cluster random sampling method. According to the inclusion and exclusion criteria, 200 pregnant women in the third trimester were selected from 3 tertiary hospitals in three cities in the Southwest of Shandong Province, and were divided into the third trimester group ( n = 600), and 100 non-pregnant women were selected as the control group ( n = 300). The urinary iodine content was detected by arsenic-cerium catalytic spectrophotometry, and the pregnant women in the third trimester group were subdivided into iodine deficiency subgroup [G1 subgroup, median urinary iodine (MUIC) < 150 μg/L] based on the MUIC, iodine excess subgroup (G2 subgroup, MUIC≥500 μg/L) and moderate iodine subgroup (G3 subgroup, 150 μg/L≤MUIC < 500 μg/L). Chemiluminescence immunoassay was used to measure the serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT 4) and free triiodothyronine (FT 3). The cardiac electrical indexes were detected by a 12-lead surface electrocardiogram (ECG) machine. Results:There was no statistically significant difference in urinary iodine levels between pregnant women in the third trimester group and non-pregnant women in the control group among the 3 tertiary hospitals in the Southwest of Shandong Province ( H = 3.63, 3.27, P > 0.05). In the third trimester group, the proportion of pregnant women in the G1, G2 and G3 subgroups was 27.67% (166/600), 6.83% (41/600) and 65.50% (393/600), respectively. There was a statistically significant difference in urinary iodine levels between the subgroups and the control group ( H = 11.56, P < 0.001). The serum FT 3 and FT 4 levels in the G2 subgroup were lower than those in the G1 and G3 subgroups ( P < 0.001), but there was no statistically significant difference in serum TSH levels among the three subgroups ( P > 0.05). The normal rates of ECG in the G1, G2, G3 subgroups, and the control group were 38.55% (64/166), 41.46% (17/41), 92.37% (363/393), and 95.33% (286/300), respectively. The difference between the groups were statistically significant (χ 2 = 461.25, P < 0.001), the normal rate of ECG in the G1 and G2 subgroups was lower than that in the control group ( P < 0.001). Short P-R intervals and ST-T changes were the most common abnormal ECG in the third trimester group. Conclusions:The incidence of iodine deficiency, iodine excess, and other abnormal iodine nutritional status in pregnant women in the third trimester of the Southwest of Shandong Province is relatively high. Short P-R intervals, ST-T changes, and other arrhythmia caused by this are more common. It is necessary to strengthen monitoring of iodine nutritional status and ECG during pregnancy, and adjust intervention strategies such as iodine supplementation in a timely manner.

Objective:To explore the clinical value of synchronized 12-lead Holter in the diagnosis of coronary heart disease myocardial ischemia.Methods:A total of 101 patients with coronary heart disease who came to the Affiliated Hospital of Jining Medical College from May 2019 to May 2020 were selected. They all received conventional electrocardiogram(ECG) and synchronized 12-lead Holter examinations. The value of different examination methods in the diagnosis of myocardial ischemia was compared, and the characteristics of myocardial ischemia in patients with different degrees of coronary artery disease were analyzed.Results:The detection rates of synchronized 12-lead Holter for myocardial ischemia in single-vessel coronary artery disease and multi-vessel coronary artery disease were 28.71% (29/101) and 56.44%(57/101), respectively, which were slightly higher than 17.82%(18/101) and 45.54% (46/101) of conventional ECG, but with no statistically significant difference ( P>0.05), the total myocardial ischemia detection rate of synchronized 12-lead Holter was 85.15%(86/101), which was higher than 63.37%(64/101) of conventional ECG ( P<0.05). The mean frequency of myocardial ischemia in coronary heart disease diagnosed by synchronized 12-lead Holter was higher than that of conventional ECG, and the duration and amplitude of ST-segment depression were higher than those in conventional ECG ( P<0.05). The detection rates of lateral and inferior myocardial ischemia on synchronized 12-lead Holter were 16.28%(14/86) and 22.09%(19/86), respectively, which were higher than 0 of conventional ECG. The detection rate of myocardial ischemia in the anterior septum/anterior wall was 61.62%(53/86), which was lower than 100.00% (64/64)of the conventional ECG ( P<0.01). Synchronized 12-lead Holter in the diagnosis of coronary cardiac myocardial ischemia was highly consistent with that by coronary angiography, the Kappa value was 0.648, and the sensitivity, specificity, accuracy and negative predictive value were 93.33%, 81.82%, 92.08% and 60.00%, respectively, which were higher than 54.44%, 63.64%, 55.45%, 14.58% of conventional ECG ( P<0.05). The number of myocardial ischemic attacks in patients with multi-vessel disease of coronary heart disease was more than that of single vessel disease ( P<0.05), the mean frequency of myocardial ischemia was higher than that of single vessel disease, and the duration and amplitude of ST-terminal depression were higher than those of patients with single-vessel disease ( P<0.05). Conclusions:Synchronized 12-lead Holter is more effective than conventional ECG in the diagnosis of myocardial ischemic attack of coronary heart disease, and it is more consistent with coronary angiography. It can clarify the frequency and extent of myocardial ischemic attacks and help identify the location of myocardial ischemia. It can be used as an important basis for screening myocardial ischemia attacks of coronary heart disease.

Objective:To study the predictive value of hour-specific total serum bilirubin(TSB) nomogram combined with clinical risk factors in the risk of hyperbilirubinemia.Method:Perinatal clinical data of newborns born in Shanghai Pudong New Area Health Care Hospital for Women and Children, Shanghai Pudong New Area People's Hospital and Shanghai Pudong Hospital from August 2017 to July 2018 were collected in this prospective study. Transcutaneous bilirubin (TcB) was monitored before discharge from hospital. Enrolled neonates were followed up for 28 days. The patients were assigned to neonatal hyperbilirubinemia group (NHB) and non-hyperbilirubinemia group (Non-HB) according to the occurrence of hyperbilirubinemia. The predictive value of models for the risk of hyperbilirubinemia was evaluated by receiver operating characteristic (ROC) curves and Logistic regression analysis.Result:A total of 8 664 newborns were included in this study, with 1 196 cases of hyperbilirubinemia, with an incidence of 13.8%. Logistic regression analysis showed that maternal blood type O, premature rupture of membranes, male gender, gestational age 35~37 weeks, subcutaneous ecchymosis/cranial edema, and breastfeeding were independent risk factors for NHB ( P<0.05). The area under receiver operative characteristic curve (ROC) of predischarge bilirubin risk zone only was 0.874(95% CI 0.861~0.885, P<0.05)and for all independent risk factors was 0.664 (95% CI 0.647~0.680, P<0.05). The area under ROC curve was 0.891 (95% CI 0.880~0.902, P<0.05) by combining predischarge bilirubin risk zone with clinical risk factors. Conclusion:Predischarge bilirubin risk zone combined with clinical risk factors can reasonably predict neonatal hyperbilirubinemia well.

OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.
Classification ; Diagnosis ; Electrons ; Endometrial Neoplasms ; Female ; Glycolysis ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Metabolism ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Tumor Burden

A review of management problems found in lifesaving access to emergency care in healthcare organizations at all levels in China, and a reference international critical and emergency care systems and their quality and safety management standards were made by the authors. Based on such and special needs of such access, the paper studied the domestic lifesaving access to emergency care service workflow, and abstracted common management issues on the lifesaving access to emergency care. The study identified key elements of lifesaving access to emergency care management through case analysis, and formulated standard terms for such key elements. Hence a set of standards is developed for quality management fitting healthcare organizations at all levels in China′s lifesaving access to emergency care, serving as the guidance for their standardized management and evaluation.

Objective To explore the application value of circulating tumor cell (CTC) counting in the diagnosis of patients with colorectal cancer.Methods From July to October in 2015,a total of 61 patients firstly diagnosed with colorectal cancer,at stagc] to Ⅳ were enrolled.At the same period,20 individuals (healthy volunteers or patients with benign colorectal diseases) were selected as controls.Peripheral blood (7.5 mL) was taken before therapy.Peripheral blood CTC were counted by immunomagnetic beads enrichment combined with fluorescent staining method in two hours.The positive detection rate of CTC for colorectal cancer,especially early colorectal cancer was analyzed.And the priority of combination it with carcino-embryonic antigen (CEA) was also investigated.Chi-square test,t test and rank-sum test were used for statistical analysis.Results Two patients could not be pathological staged,due to the lack of whole body imaging evaluation.There were 30 patients with colorectal cancer at early stage (stage Ⅰ to Ⅱ) and 29 patients at advanced stage (stage Ⅲ to Ⅳ).The difference in CEA level between patients at early stage and advanced stage ((3.3±1.1) μg/L vs (20.4±3.3) μg/L) was statistically significant (t=-2.74,P=0.008).The median cell number of CTC of colorectal cancer group and control group was 1 (interquartile range=4) and 0,respectively,and the difference was statistically significant (Z=2.721,P=0.007).Taken 0/7.5 mL and 5 μg/L as the cut-off value of CTC and CEA,the detection rates of CTC for colorectal cancer and early colorectal cancer were 65.6％ (40/61) and 63.3％ (19/30),respectively;the detection rates of CEA for colorectal cancer and early colorectal cancer were 29.5 ％ (18/61) and 13.3％ (4/30).When CTC combined with CEA,the detection rates for colorectal cancer and early colorectal cancer were 73.8％ (45/61) and 66.7％ (20/30),respectively.Conclusions CTC has certain detection value in colorectal cancer especially early colorectal cancer.If it combined with CEA,the detection rate is much higher.

Objective To understand hand hygiene(HH) compliance among health care workers(HCWs) and incidence of healthcare-associated infection(HAI) in surgical patients before and after the intervention, analyze the effect of HH on cost-effectiveness of HAI.Methods From December 2012-June 2014, 78 HCWs in the department of neurosurgery of a hospital were as the intervention objects of HH compliance, 325 patients who underwent craniocerebral clean operation were as the surveyed objects, HH compliance among HCWs, incidence of HAI in surgical patients, cost of HH, and hospitalization expense before and after intervention were compared respectively.Results HH compliance among HCWs before and after intervention were 35.24% (216/613) and 73.75%(486/659)respectively (X2=180.091,P<0.001);incidence of HAI in surgical patients before and after intervention were 31.85%(50/157)and 18.45%(31/168)respectively(X2=7.782,P<0.001).Hospitalization expense before and after intervention were (89 524.90±38 856.70)￥ and (61 401.00±29 237.80)￥ respectively;average length of hospital stay before and after intervention were 36.70 days and 26.90 days respectively(t=3.296, 3.511,respectively, both P<0.01).Conclusion Improving HH compliance among HCWs can reduce the incidence of HAI and hospitalization cost, and shorten the average length of hospital stay of patients.

Objective To investigate the change of peripheral blood lymphocyte immunophenotype in the patients with malignant carcinoma and its clinical significance .Methods The flow cytometry was adopted to detect the expression levels of peripheral blood T lymphocyte subpopulations ,CD19+ cells ,CD3-CD56+ cells ,CD3+CD56+ cells in 167 patients with malignant carcinoma (inclu‐ding respiratory tract cancers ,gastrointestinal cancers and reproductive system cancer) and 170 normal controls as the healthy con‐trol group .The contrastive analysis was performed .Furthermore the analysis was conducted according to whether having tumor me‐tastasis and chemotherapeutic cycles .Results The total absolute value of the lymphocytes and the proportion of CD3+CD4+ cells in the patients with malignant carcinoma were significantly lower than those in the healthy control group (P<0 .05) ,but the propor‐tions of CD3+CD8+ ,CD3+CD56+ and CD3-CD56+ cells were significantly higher than those in the healthy control group (P<0 .05) .The proportion of CD3+CD4+ cells in the patients with tumor metastasis were significantly lower than those in the ones without tumor metastasis ;but the proportions of CD3+ CD8+ ,CD3-CD56+ and CD3+ CD56+ cells were significantly higher than those in the ones without tumor metastasis ,the differences were statistically significant(P<0 .05) .In the chemotherapy treatment , the proportions of CD3+CD4+ ,CD3+CD56+ and CD3-CD56+ cells were gradually increased with the increase of chemotherapeutic cycles ,but the proportion of CD3+CD8+ cells was gradually reduced .Conclusion In the process of development ,progression and treatment of tumor ,the cellular immunity function plays a dominant role ,which could be used as one of indexes for clinically moni‐toring the cellular immune function in the patients with tumor .

Objective To investigate thc cvent-based prospective memory (EBPM)and time-based prospective memory(TBPM)in the inpatients with abstinent alcohol dependence and the relationships between prospective memory and symptoms.Methods 32 male patients with alcohol dependence and 30 normal controls matched by age,education,HAMD and HAMA were assessed with a neuropsychological battery of tests including EBPM and TBPM tasks.Results A statistically significant in EBPM was observed between patients with alcohol dependence and normal controls (3.91 ± 0.69 vs.4.47 ± 0.63,t =-3.348,P ＜ 0.0 1) and the same result in TBPM (3.28 ±0.77 vs.4.20 ±0.66,t=-5.032,P＜0.01).The positively correlation was showed between the duration of abstinence and EBPM (r =0.444,P ＜ 0.05),as well as TBPM (r =O.423,P ＜ 0.05) in the patients.Conclusion The results suggest abstinent alcohol dependence patients impairs both EBPM and TBPM.PM shows correlated with duration of abstinence moderately in the patients.

OBJECTIVE: To investigate the impact of radiofrequency coblation for the treatment of Tl glottic cancer. METHOD: Six patients with early-stage glottic cancer (Tla = 5, Tlb = 1) treated with coblation were enrolled in this study. The outcome of the surgery were analyzed. RESULT: No complication happened during the follow-up of 6 to 12 months. All patients achieved satisfactory post-operative voice. CONCLUSION Although current probe design limits the potential for resection of some tumors, radiofrequency coblation appears to be an attractive evolving technique for the endoscopic resection of selected glottic cancer.
Aged ; Carcinoma, Squamous Cell ; surgery ; Catheter Ablation ; methods ; Glottis ; pathology ; Humans ; Hypothermia, Induced ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome