1.Efficacy of daily use of a test emollient combined with topical glucocorticoids applied at the weekend for delaying the recurrence of atopic dermatitis in children during the maintenance period: a randomized, blank-controlled, multicenter clinical study
Chunping SHEN ; Ping LI ; Xiaoyan LUO ; Yuan LIANG ; Ying LIU ; Mutong ZHAO ; Shan WANG ; Jing TIAN ; Lei JIAO ; Yang WANG ; Zhen LUO ; Shijuan YU ; Xiao FANG ; Hua WANG ; Lin MA
Chinese Journal of Dermatology 2023;56(8):756-762
Objective:To evaluate the efficacy of daily use of a test emollient combined with topical glucocorticoids applied at the weekend for delaying the recurrence of atopic dermatitis (AD) in children during the maintenance period.Methods:A randomized, blank-controlled, multicenter clinical study was conducted in children with moderate AD from Beijing Children′s Hospital, Capital Medical University, Children′s Hospital of Chongqing Medical University and Shenzhen Children′s Hospital from March 2021 to February 2022. A total of 127 children aged 0 - 12 years with moderate AD were treated with topical glucocorticoids combined with emollients during the run-in period, 112 out of them achieved the investigator′s global assessment (IGA) score ≤ 1 point, and then the 112 patients were randomly divided into a test group (56 cases) and a control group (56 cases) at a ratio of 1∶1. Patients in the test group received treatment with a test emollient twice a day in combination with topical glucocorticoids applied at the weekend, and those in the control group were only treated with topical glucocorticoids at the weekend. Patients in the two groups were followed up at baseline, week 2 (± 3 d), week 4 (± 5 d), and week 12 (±7 d), as well as at the time of AD relapse, and the effect of the test emollient on the remission rate of AD in children during the maintenance period was evaluated, so were its effects on the dosage of topical glucocorticoids, pruritus, sleep, and skin pH. The occurrence of treatment-related adverse events was evaluated and recorded at the same time. Study endpoints were defined as AD relapse during the maintenance period, end of 12-week follow-up, or occurrence of serious adverse events. Comparisons of efficacy indicators between groups were conducted by using chi-square test, Kaplan-Meier survival analysis, Satterthwaite t′ test and Mann-Whitney U test. Results:In the full-analysis set, 45 (80.36%) patients with AD maintained remission in the test group (56 cases) and 30 (53.57%) in the control group (56 cases), and the remission rate difference between the two groups was 26.79% (95% confidence interval [ CI]: 10.09%, 43.49%; χ2 = 9.11, P = 0.003) ; the 12-week follow-up during the maintenance period showed that the time to first relapse was 75.05 ± 25.07 days in the test group, which was significantly longer than that in the control group (49.55 ± 33.92 days, t′ = 4.52, P < 0.001). At the study endpoint, the test group showed significantly decreased AD disease severity score (eczema area and severity index [EASI] score: 0.00 [0.00, 1.20] points vs. 0.60 [0.00, 4.00] points), pruritus visual analog scale (VAS) score (0.00 [0.00, 2.00] points vs. 2. 00 [0.00, 10.00] points), and sleep VAS score (0.00 [0.00, 0.00] points vs. 1.00 [0.00, 4.00] points) compared with the control group ( Z = -2.77, 2.43, 3.48, P = 0.006, = 0.015, < 0.001, respectively), while there was no significant difference in the pH value at the lesional sites between the test group and control group ( t = 0.97, P = 0.335). For the group aged 0 - 2 years, the average daily glucocorticoid dosage at the weekend in AD children during the maintenance period was significantly lower in the test group than in the control group ( Z = -1.97, P = 0.049) ; for the group aged >2 - 12 years, there was no significant difference in the average daily glucocorticoid dosage at the weekend between the two groups ( Z = -0.25, P = 0.802). During the study period, no significant difference was observed in the incidence of treatment-related adverse events between the test group (2/56, 3.57%) and control group (3/56, 5.36%; P = 1.000), and no serious adverse events occurred. Conclusion:Compared with the weekend treatment with topical glucocorticoids alone, the daily use of the test emollient combined with topical glucocorticoids at the weekend could markedly improve the remission rate of AD, prolong the time to relapse, and reduce the disease severity at relapse in children with AD during the maintenance period, which provides a new option for maintenance treatment of children with AD.
2.The criteria and exploration of the neurosurgical base for standardized residency training
Shijuan SHI ; Wei YANG ; Mi TIAN ; Lin YANG ; Feiyan WENG ; Xia CAO ; Shiyong LIU ; Chunqing ZHANG ; Song LI ; Ping ZHAO ; Shengqing LÜ
Chinese Journal of Medical Education Research 2022;21(9):1211-1215
Here, we took base construction of neurosurgery as example to discuss and analyze according to requirements and evaluation indexes of base construction in Xinqiao Hospital, and put forward the specific objectives, measures and implementations of base construction. Foremost, we summarized experiences and overcame shortcomings through interpreting and implementing scheme of our base construction, which would help to improve the construction of standardized residency training base in China.
3.Clinicopathological and prognostic analysis of medullary thyroid carcinoma co-existent with Hashimoto's thyroiditis
Wei LIU ; Yanmei CUI ; Fengying PENG ; Shijuan YANG ; Weifeng ZHU ; Weijin XIAO ; Lihua ZHONG
Chinese Journal of General Surgery 2022;37(9):684-688
Objective:To investigate the clinicopathological features and prognosis of medullary thyroid carcinoma (MTC) co-existent with Hashimoto's thyroiditis (HT).Methods:Seven cases of MTC co-existent with HT were collected from Fujian Cancer Hospital between Jan 2007 and May 2021. Its clinicopathological features were analyzed.Results:All patients were adult female with a median age of 49 years, and 6 of them were unilateral MTC. The tumor diameter ranged from 0.4 to 7.0 cm. The thyroid tissue surrounding the tumor showed HT. The follow-up time was 16 to 152 months, with a median time of 61 months, 5 patients (tumor diameter <1 cm) were biochemically cured, 1 patient (tumor diameter >1 cm) was anatomically cured. The another patient died due to tumor progression 30 months after surgery, the tumor cells in which were highly atypia and more mitoses (5~8/10HPF) necrosis and vascular invasion were also observed.Conclusion:MTC with HT are mostly sporadic cases, and most of them have a fair prognosis.
4.Efficacy of second-line therapy with dasatinib in the treatment of chronic myeloid leukemia
Jiafu HOU ; Jie LI ; Shijuan LIU ; Yanmeng GENG ; Ying ZHANG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(9):1315-1319
Objective:To investigate the clinical efficacy of second-line therapy with dasatinib in the treatment of chronic myeloid leukemia.Methods:Sixty patients with chronic phase chronic myeloid leukemia who received treatment in Hongqi Hospital of Mudanjiang Medical University between January 2015 and January 2021 were included in this study. They were randomly divided into control and observation groups, with 30 patients in each group. The control group was treated with conventional chemotherapy, and the observation group was treated with conventional chemotherapy combined with oral dasatinib. All patients were treated for 6 months. Clinical efficacy, immune function indexes, quality of life score, and incidence of adverse reactions (abnormal liver function, rash, fatigue, peripheral edema, nausea and vomiting, alopecia) were compared between the two groups.Results:Objective response rate (ORR) in the observation group was significantly higher than that in the control group [83.33% (25/30) vs. 53.33% (16/30), χ2 = 6.23, P < 0.05). Before treatment, there were no significant difference in immune function indicators between the two groups ( t = 0.03, 0.20, 0.44, all P > 0.05). After treatment, CD 4/CD 8, CD 3+ and natural killer cells in the observation group were (1.03 ± 0.32), (43.77 ± 6.62)%, (31.12 ± 3.38)%, respectively, which were significantly higher than (0.74 ± 0.28), (35.79 ± 6.27)%, (28.22 ± 2.84)% in the control group ( t = 3.69, 4.78, 3.60, all P < 0.05). The scores of social functioning, material well-being life, mental health, somatic health in the observation group were (85.48 ± 6.25) points, (80.12 ± 6.34) points, (79.94 ± 6.48) points, and (77.92 ± 5.81) points, respectively, which were significantly higher than (72.79 ± 5.89) points, (63.47 ± 5.82) points, (68.87 ± 6.08) points, (63.14 ± 6.12) points in the control group ( t = 7.91, 10.59, 6.82, 9.59, all P < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group [16.67% (5/30) vs. 40.00% (12/30), χ2 = 4.02, P < 0.05). Conclusion:Second-line therapy with dasatinib for chronic phase chronic myeloid leukemia is effective and safe. It can effectively improve the efficacy and safety of chemotherapy and can also improve immunological function and quality of life.
5.Status and influencing factors of career success of ICU nurses
Xiumei ZOU ; Si LIU ; Shijuan CHEN ; Yanping ZHOU ; Zhongwen SUN
Chinese Journal of Modern Nursing 2021;27(34):4734-4738
Objective:To investigate the current status of career success of ICU nurses and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 178 ICU nurses from 7 Class Ⅲ Grade A hospitals in Guangzhou, Guangdong Province from April to May 2021 were selected as the research objects. General questionnaire and Chinese version of Career Success Scale were used to conduct the survey through the questionnaire network platform.Results:A total of 178 electronic questionnaires were filled in and 167 valid electronic questionnaires were recovered. The total score of career success of ICU nurses was (35.68±6.07). Multiple linear regression analysis showed that gender of ICU nurses, whether they had regular specialized skills training, and the cooperative relationship of doctors and nurses in departments were the influencing factors of career success scores of nurses ( P<0.05) . Conclusions:The career success level of ICU nurses needs to be improved. It is recommended that nursing managers should clarify the career development path of nurses, broaden the career development space of nurses and enhance their professional autonomy and work enthusiasm.
6.Detection of Chlamydia in multiple visceral organs of mice inoculated with Chlamydia through different routes
Lili SHAO ; Jingyue MA ; Tingting LIAN ; Shijuan WEI ; Jie REN ; Quanzhong LIU
Chinese Journal of Dermatology 2019;52(8):554-560
Objective To certify that Chlamydia can spread from the genital tract to the gastrointestinal tract for long-lasting colonization.Methods Totally,120 female C57BL/6J mice aged 5-6 weeks were divided into 4 experimental groups to be inoculated with purified Chlamydia muridarum (C.muridarum) elementary bodies in the vagina (n =35),gastric area (n =30),anus and rectum (n =30),retro-orbital venous plexus (n =5) respectively.Moreover,corresponding negative groups inoculated with sucrose phosphate glutamate buffer (n =5) were set up for each experimental group.On days 3,7,and every 7 days,vaginal and rectal discharges were collected with swabs from the mice,and the number of live C muridarum orgnisms in exfoliated cells infected with C muridarum in the swabs was determined.Indirect immunofluorescence assay and quantitative PCR (qPCR) were performed to determine the number of live chlamydial organisms and the copy number of chlamydial genomes in the mouse genital tract (vagina,uterus,oviduct and ovary),gastrointestinal tract (stomach,small intestine,cecum,colon,rectum)and parenteral tissues (heart,liver,spleen,lung,kidney) on days 7,14,28,56 and 105 after the inoculation.The number of live chlamydial organisms and copy number of chlamydial genomes were transformed logarithmically with a base of 10.The degree of hydrosalpinx and inflammation in the genital tract,and histopathological changes of the gastrointestinal tract were observed.The infectivity and virulence of C.muridarum in the genital tract and gastrointestinal tract were evaluated in the intragastric inoculation group and intra-anal and intrarectal inoculation group on days 28 and 56 after the inoculation.Blood samples were obtained from the mouse caudal vein in the retro-orbital venous plexus inoculation group on days 3,5,7,10 and 14 after the inoculation,the number of live chlamydial organisms and the copy number of chlamydial genomes in the blood samples were determined,and chlamydial infectivity in the genital tract and gastrointestinal tract was evaluated on day 56.Results On day 7 after the inoculation in the vagina,both C.muridarum live organisms and genomes were detected in the genital tract,gastrointestinal tract and parenteral tissues of all the mice.The largest common logarithm of the number of C.muridarum inclusion forming units (IFU) was observed in the vagina (6.26 ± 0.56),with the common logarithm of the copy number of chlamydial genomes in the vagina being 7.30 ± 0.23,and the common logarithms of the number of Chlamydia IFU and genomic copy were 2.60 ± 1.95 and 4.87 ± 0.09 respectively in the rectum.On day 28,no live Chlamydia was detected in the heart,lung or other parenteral tissues,while live Chlamydia could be found in the genital tract and gastrointestinal tract.The common logarithms of the number of Chlamydia IFU and genomic copy were 3.47 ± 1.06 and 5.80 ± 1.49 respectively in the vagina,and 4.00 ±0.35 and 5.14 ± 0.81 respectively in the rectum.On day 56,live Chlamydia could only be detected in the gastrointestinal tract.On day 105,live Chlamydia and its genomes could be still detected in the gastrointestinal tract,and the common logarithms of the number of Chlamydia IFU and genomic copy could be up to 2.60 ± 0.65 and 4.29 ± 0.57 respectively in the rectum.On days 28 and 56 after the inoculation,both live Chlamydia and its genomes could be detected in the gastrointestinal tract of all the mice in the intragastric inoculation group and intra-anal and intrarectal inoculation group.Chlamydia could survive in the blood for about 14 days in the retro-orbital venous plexus inoculation group,and live Chlamydia was detected in anal-rectal swabs in all the mice on day 14.On day 56 after the intravaginal inoculation with C.muridarum,severe hydrosalpinx,chronic inflammation and oviduct dilation occurred in the genital tract of 5 mice,but there was no obvious infiltration of inflammatory cells in the gastrointestinal tract,and inflammatory pathological changes were not observed in the gastrointestinal tract of mice after inoculation with Chlamydia through other routes either.Conclusion The infection with Chlamydia in the genital tract can lead to systemic dissemination,and Chlamydia can be spread to the gastrointestinal tract,and colonize and survive in the gastrointestinal tract for a long time.
7.Construction and identification of the recombinant M13-IN5 phage and its effect on Chlamydia trachomatis
Tingting LIAN ; Shijuan WEI ; Yuanjun LIU ; Jie REN ; Sheng WANG ; Yuanli GUO ; Rui GUO ; Quanzhong LIU ; Lili SHAO
Chinese Journal of Dermatology 2018;51(12):859-864
Objective To construct active phages against Chlamydia trachomatis,and to evaluate its effect on Chlamydia trachomatis.Methods The M13 phage was recombined with the IN5 sequences encoding the capsid protein VP1 of chlamydiophage phiCPG1,and then the recombinant M13-IN5 phage was obtained.PCR amplification,enzyme digestion and sequencing were performed to verify whether the target fragment was inserted into the phage successfully.The viability of the phage was evaluated by plaque formation assay.Cell counting kit-8 (CCK8) assay was conducted to evaluate the effect of M13 phage and recombinant M13-IN5 phage at the titer of 1011 plaque-forming units (PFU)/ml on the proliferation of Hela cells,and Hela cells uninfected with chlamydia served as the blank control group.Western blot analysis was performed to determine the expression of the IN5 loop protein in the recombinant M13-IN5 phage,M13 phage and Escherichia coli ER2738 at exponential growth phase.Cultured standard Chlamydia trachomatis serovar E strain was treated with M13 phage and recombinant M13-IN5 phage at the titer of 1011 PFU/ml separately,and chlamydia control group without the treatment with phages was set up.After 36-hour infection,confocal microscopy was performed to detect the location of the M13 phage and the recombinant M13-IN5 phage.Moreover,iodine staining was conducted to count inclusion bodies at 36,48,60 and 72 hours separately after infection.Statistical analysis was carried out by a two-sample t-test for comparisons between two groups,one-way analysis of variance (ANOVA) for intergroup comparison,and Bonferroni test for multiple comparisons.Results The bioactive recombinant M13 phage containing the IN5 loop gene was constructed successfully,and Western blot analysis confirmed that the recombinant phage expressed IN5 loop/p Ⅲ fusion protein with a high titer of 3.05 × 1011 PFU/ml.As CCK8 assay showed,there was no significant difference in proliferation of Hela cells among the blank control group,M 13 phage group and recombinant M13-IN5 phage group (A450 values:3.63 ± 0.01,3.55 ± 0.02,3.70 ± 0.01,respectively,F =12.0,P > 0.05).Confocal microscopy showed overlap between the phage fluorescence and chlamydial inclusion body fluorescence.The M13-IN5 phage group and M13 phage group both showed significantly decreased number of inclusion bodies compared with the control group (both P < 0.05) at 36 and 72 hours after chlamydial infection,and the number of inclusion bodies was significantly lower in the M 13-IN5 phage group than in the M13 phage group (P > 0.05).After 48,and 60 hours of chlamydial infection,the number of inclusion bodies did not differ among the M13 phage group,M13-IN5 phage group and control group (both P > 0.05).Conclusions The recombinant M13-IN5 phage was bioactive and could successfully express the IN5 loop protein.In the in vitro experiments,the recombinant phage could enter into chlamydia inclusion bodies,and markedly inhibited the infection of Chlamydia trachomatis.
8.Correlation among family cohesion, cancer pain sensation and belief-perception of patients with primary liver cancer
Shijuan SUN ; Chunting LI ; Shumei LIU
Chinese Journal of Modern Nursing 2018;24(29):3562-3564
Objective To observe the family cohesion, cancer pain sensation and belief-perception of patients with primary liver cancer and to analyze the correlations among them. Methods From December 2014 to December 2017, we selected 129 inpatients with primary liver cancer of the First Bethune Hospital of Jilin University as subjects by convenience sampling. The family cohesion, cancer pain sensation and belief-perception of patients were evaluated with the family adaptability and cohesion evaluation scale, second edition (FACESⅡ), Pain Intensity Numerical Rating Scale (PINRS) and Pain Beliefs and Perceptions Inventory (PBPI). Besides, Pearson correlation analysis was used to analyze the correlations among them. Results The scores of family cohesion and pain sensation of patients with primary liver cancer were (56.00±5.12) and (5.53±1.18) respectively. In pain belief and perception, the highest score was (1.35±0.05) in the dimension of "feeling pain is very mysterious". Pearson correlation analysis showed that primary liver cancer patients' family cohesion had negative correlations with cancer pain as well as the items of pain belief and perception (r=-0.426, -0.523,-0.434, -0.451, -0.420;P<0.05). Conclusions The family cohesion of primary liver cancer patients is in a low level affecting the cancer pain sensation and belief-perception of patients, which suggests nurses attach importance to patients' family cohesion, encourage family members to pay attention to patients and increase communication so as to improve treatment effects of patients.
10.Application of systematic nursing intervention in nursing of elderly hypertensive patients
Yingfang LIN ; Xiaoyue KOU ; Xuemei CHEN ; Xiaoqin LIU ; Shijuan FAN
Journal of Clinical Medicine in Practice 2017;21(6):1-3,7
Objective To explore the clinical nursing effect of nursing intervention in elderly patients with hypertension.Methods A total of 100 elderly hypertensive patients were randomly divided into two groups.The patients in the control group were given routine nursing,and patients in the experimental group were treated with systematic nursing.Compliance,blood pressure,blood glucose,blood lipid level,social support,hypertension knowledge score and satisfaction were compared before and after treatment.Results The compliance after intervention in the experimental group was significantly higher than that in the control group,SBP,DBP and 2 h PPG levels were significantly lower than that of the control group,and the total score of social support after intervention was significantly higher than that of the control group.K score,A score and KAB scores of experimental group were significantly higher than that of control group,and B score was significantly lower than that of the control group.The overall satisfaction of experimental group was significantly better than that of the control group,and there was significant difference (P < 0.01).Conclusion Nursing effect of nursing intervention in elderly patients with hypertension is significant,and it has draw great significance.

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