OBJECTIVE: To investigate the relationship between the different defect length of vessels and the options of vascular repair, and to compare the different options of repair because of the longitudinal biomechanical effect. METHODS: A clinical analysis was undertaken to evaluate the major arterial and venous injuries in human extremities repaired by end-to-end anastomoses or venous autograft(177 cases, 185 vessels). Compared the defect length of the same kind of vessels repaired by different options (Student-t test). Evaluated the defect length to repair arterial injuries between by end-to-end anastomoses and by vein graft by means of 95% confidence interval. RESULTS: There was significant difference between the defect length of brachial artery repaired by end-to-end anastomosis and femoral artery and popliteal artery repaired by autogenous vein graft (P lt; 0.01). The upper limit of confidence interval in the defect length of brachial artery, femoral artery and popliteal artery was 3.17 cm, 2.81 cm and 2.44 cm respectively by end-to-end anastomosis by means of 95% confidence interval. The lower limit of confidence interval in the defect length of brachial artery, femoral artery and popliteal artery was 2.82 cm, 2.41 cm and 2.17 cm respectively by vein graft by means of 95% confidence interval. The defect length of brachial artery, femoral artery and popliteal artery repaired by vein graft was linear correlation with the length of graft. CONCLUSION: Because of the longitudinal biomechanical difference of arteries and veins in human extremities, different options of repair are necessary to different arterial injuries.
目的 探讨慢性阻塞性肺疾病（COPD）患者中微量元素铜和锌与炎症介质的关系。 方法 2010年11月－2011年3月间测量15例COPD急性加重期患者入院时及治疗后和13例健康者为对照组的血清铜、锌、C反应蛋白（CRP）、白介素-6（IL-6），血浆中金属硫蛋白，以及氧化应激产物丙二醛的浓度变化。并对铜、锌浓度变化与CRP、IL-6进行相关分析。 结果 COPD组血清中铜浓度、CRP、IL-6水平高于对照组（P＜0.05），同时急性加重期患者血清中铜的浓度、CRP、IL-6水平以及丙二醛值高于缓解期患者（P＜0.05）。而急性加重期患者血清中锌浓度低于缓解期组和对照组（P＜0.05）。血浆中抗氧化物质金属硫蛋白在三组间差异无统计学意义（P＞0.05）。在微量元素与炎症因子的相关分析中发现，铜与CRP（r=0.602，P＜0.001）、IL-6（r=0.533，P＜0.001）呈正相关，锌与IL-6呈负相关（r=?0.336，P＜0.05）。 结论 在COPD氧化应激发病机制中，铜可能发挥促氧化应激的作用，而锌可能发挥抗氧化应激的作用。微量元素稳态的紊乱有可能是COPD急性加重的危险因素。
Event-related desynchronization (ERD) is the basic feature of electroencephalogram (EEG), and the brain-computer interface based on motor imagery (MI-BCI) with the foundation of the analysis of ERD is of great significance in motor function recovery. The valid ERD characteristics extracted from EEG are the key to the performance of the BCI, so the study of which kind of stimulation mode can prompt subjects to generate more obvious characteristics of ERD is crucial. Four different stimulation modes are designed in this paper, and the effects of motion imagery tasks under static text stimulation, grip video stimulation, serial motion video stimulation of fingers as well as serial motion video stimulation of fingers with sound on the characteristics of ERD are analyzed. Combining the analysis of time-frequency spectrum, the power spectral density curve, ERD value and brain topographic map, it is shown that the ERD under serial motion video stimulation of fingers and serial motion video stimulation of fingers with sound modes is much stronger and has wider range of activation, and the BCI based on the analysis of ERD will have a better effect on practical application. As a result, the recognition and acceptance of the users of BCI system are improved in some extent.
Motor imaging therapy is of great significance to the rehabilitation of patients with stroke or motor dysfunction, but there are few studies on lower limb motor imagination. When electrical stimulation is applied to the posterior tibial nerve of the ankle, the steady-state somatosensory evoked potentials (SSSEP) can be induced at the electrical stimulation frequency. In order to better realize the classification of lower extremity motor imagination, improve the classification effect, and enrich the instruction set of lower extremity motor imagination, this paper designs two experimental paradigms: Motor imaging (MI) paradigm and Hybrid paradigm. The Hybrid paradigm contains electrical stimulation assistance. Ten healthy college students were recruited to complete the unilateral movement imagination task of left and right foot in two paradigms. Through time-frequency analysis and classification accuracy analysis, it is found that compared with MI paradigm, Hybrid paradigm could get obvious SSSEP and ERD features. The average classification accuracy of subjects in the Hybrid paradigm was 78.61%, which was obviously higher than the MI paradigm. It proves that electrical stimulation has a positive role in promoting the classification training of lower limb motor imagination.
Objective Calcium phosphate bioceramics has a broad appl ication prospect because of good biocompatibil ity, but porous scaffolds with complex shape can not be prepared by the traditional methods. To fabricate porous calcium phosphate ceramics by rapid prototyping and to investigate the in vitro osteogenic activities. Methods The porous calcium phosphate ceramics was fabricated by rapid prototyping. The bone marrow mesenchymal stem cells (BMSCs)were isolated from bone marrow of Beagle canine, and the 3rd passage BMSCs were seeded onto the porous ceramics. The cell/ceramics composite cultured in osteogenic medium were taken as the experimental group (group A) and the cell/ceramics composite cultured in growth medium were taken as the control group (group B). Meanwhile, the cells seeded on the culture plate were cultured in osteogenic medium or growth medium respectively as positive control (group C) or negative control (group D). After 1, 3, and 7 days of culture, the cell prol iferation and osteogenic differentiation on the porous ceramics were evaluated by DNA quantitative analysis, histochemical staining and alkal ine phosphatase (ALP) activity. After DiO fluorescent dye, the cell adhesion, growth, and prol iferation on the porous ceramics were also observed by confocal laser scanning microscope (CLSM). Results DNA quantitative analysis results showed that the number of BMSCs in all groups increased continuously with time. Plateau phase was not obvious in groups A and B, but it was clearly observed in groups C and D. The CLSM observation indicated that the activity of BMSCs was good and the cells spread extensively, showing good adhesion and prol iferation on the porous calcium phosphate ceramics prepared by rapid prototyping. ALP quantitative analysis results showed that the stain of cells on the ceramics became deeper and deeper with time in groups A and B, the staining degree in group A were ber than that in group B. There was no significant difference in the change of the ALP activity among 4 groups at the first 3 days (P gt; 0.05); the ALP activity increased obviously in 4 groups at 7 days, group A was significantly higher than other groups (P lt; 0.05) and groups C, D were significantly higher than group D (P lt; 0.05). Conclusion The porous calcium phosphate ceramics has good cytocompatibil ity and the designed pores are favorable for cell ingrowth. The porous ceramicsfabricated by rapid prototyping has prominent osteogenic differentiation activity and can be used as a choice of scaffolds for bone tissue engineering.
目的 研究同型半胱氨酸转硫途径、维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期（AECOPD）中的作用。 方法 2010年2月－4月间筛选AECOPD患者16例和健康志愿者（对照组）13例，测定AECOPD患者加重期、缓解期及对照组的肺功能、血清硫化氢（H2S）、丙二醛（MDA）、叶酸、维生素B12、C反应蛋白、白介素6、血浆同型半胱氨酸、胱硫醚、半胱氨酸和维生素B6的浓度。计算半胱氨酸转化率（半胱氨酸浓度/胱硫醚浓度）与胱硫醚转化率（胱硫醚浓度/同型半胱氨酸浓度）参与分析。 结果 ① 加重期血清MDA水平[（7.3 ± 5.1）nmol/L ]比缓解期[（3.0 ± 1.4）nmol/L ]和对照组[（3.0 ± 2.2）nmol/L ]均升高（P＜0.01）；血清MDA水平与第1秒用力呼气容积/用力肺活量（FEV1/FVC）、第1秒用力呼气容积占预计值百分比（FEV1%预计值）呈负相关。② 加重期血清H2S水平与血浆维生素B6水平较缓解期与对照组降低（P＜0.01）；缓解期血清H2S水平[（47.2 ±5.1） μmol/L ]高于对照组[（38.8 ± 2.1） μmol/L ]，P＜0.01；血清H2S水平、血浆维生素B6水平均与FEV1%预计值呈正相关（r=0.651、0.680，P＜0.01），均与血清MDA水平呈负相关（r=-0.334、-0.448，P＜0.05）。③ 加重期半胱氨酸转化率（3.97 ± 2.41）低于缓解期（5.92 ± 2.18）与对照组（6.14 ± 3.15）差异有统计学意义（P＜0.05）；而胱硫醚转化率则相反。④ 叶酸与维生素B12水平各组间均无差异。 结论 提高AECOPD患者维生素B6及H2S浓度可能能促使AECOPD患者向稳定状态转归，减轻氧化应激损伤。维生素B6与H2S可能成为AECOPD患者的一个新的治疗点。Objective To study the roles of homocysteine (Hcy) transsulfuration pathway, Vitamin B6 and endogenous hydrogen sulfide in treating patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Sixteen AECOPD patients and 13 healthy controls (Control group) from February to April 2010 were recruited in this study. Lung function, serum hydrogen sulfide (H2S), malondialdehyde (MDA), folate, vitamin B12, C-reactive protein (CRP), interleukin-6 (IL-6), Hcy, cystathionine, cystein (Cys) and vitamin B6 were all measured for all the patients in the acute exacerbation period and alleviation period and healthy controls. The conversion rate of Cys (expressed as Cys/cystathionine) and the conversion rate of cystathionine (expressed as cystathionine/Hcy) were calculated for analysis. Results Serum MDA level for patients in the acute exacerbation period (AE period) [(7.3 ± 5.1) nmol/L] was significantly higher than that in the alleviation period [(3.0 ± 1.4) nmol/L] and in the healthy controls [(3.0 ± 2.2) nmol/L] (P ＜ 0.01). Serum MDA level was negatively correlated with percentage of FEV1 in predicted FEV1 (FEV1% pred) and FEV1/FVC. Serum H2S level and plasma vitamin B6 level for patients in the AE period were significantly lower than those in the alleviation period and in the healthy controls (P ＜ 0.01), and serum H2S level was significantly higher in the alleviation period [(47.2 ± 5.1) μmol/L] than in the controls [(38.8 ± 2.1) μmol/L] (P ＜ 0.01). Both serum H2S and plasma vitamin B6 levels were correlated positively with FEV1% pred for patients in the AE period and healthy controls (r=0.651, 0.680; P ＜ 0.01), but negatively correlated with serum MDA level (r=-0.334, -0.448; P ＜ 0.05). The conversion rate of Cys for patients in the AE period (3.97 ± 2.41) was significantly lower than that in the alleviation period (5.92 ± 2.18) and the control group (6.14 ± 3.15) (P ＜ 0.05), but the conversion rate of cystathionine was just the opposite (P ＜ 0.05). There were no significant differences in the levels of serum folate and vitamin B12 among the three groups. Conclusion Raising the Vitamin B6 and H2S level may facilitate stabilizing of conditions in patients with AECOPD and reduce oxidative stress. Therefore, it may become a new treatment method for AECOPD.
【摘要】目的 探索与实践临床药学(七年制)专业的建设,以培养具有医药学专门知识的高级临床药师。方法 在山东大学首办七年制临床药学专业,通过专业课程建设、毕业实习环节、加强专业教学和实习管理、增进交流等,拓宽办学思路。结果 成功开办了临床药学(七年制)专业,但专业有以下不足:①社会了解度不够,学生专业思想不稳固；②课程设置有缺陷；③临床课教学和实习质量有待提高。结论 七年制临床药学专业在山东大学的成功开办,在国内是有较强的示范性和试验性意义。但专业在社会了解度、课程设置、临床课教学和实习质量上有待提高。
Objective To systematically evaluate the effects of cognitive behavioral therapy (CBT) on improving depression, anxiety and quality of life in patients with maintenance hemodialysis (MHD). Methods We searched PubMed, EMbase, CENTRAL (Issue 8, 2016), Web of Science, CINAHL, PsycoINFO, CBM, CNKI and WanFang Data from inception to Sep. 1st, 2016, to collect randomized controlled trials (RCTs) which studied the effects of CBT on improving depression, anxiety and quality of life in patients with MHD. Literature screening, data extraction, and the risk of bias assessment of all eligible studies were conducted by two reviewers independently. Then, meta-analysis was conducted using RevMan 5.3 software. Results A total of 14 RCTs involving 1 492 patients were included. The results of meta-analysis showed that CBT could significantly improve the depression (SMD=–0.85, 95%CI –0.96 to –0.74,P<0.000 01), anxiety (SMD=–1.16, 95%CI –1.37 to –0.94,P<0.000 01), and quality of life (SMD=0.88, 95%CI 0.21 to 1.56,P=0.010) of MHD patients after 2 months' intervention; however, these effects were not been found within 2 months' intervention (allP values>0.05). Conclusion CBT is efficacious in improving MHD patients' depression, anxiety and quality of life after 2 months' intervention, while these effects within 2 months are still not certain. Because of the limitation of quantity and quality of included studies, more high-quality studies are needed to confirm the above conclusion.
ObjectiveTo systematically evaluate the prevalence of diabetes in the elderly with frailty.MethodsPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect cross-sectional studies on the prevalence of diabetes in the elderly with frailty from inception to November 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; meta-analysis was then performed by using Stata 15.0 software.ResultsA total of 21 cross-sectional studies involving 22 403 subjects were included. The pooled prevalence of diabetes in the elderly with frailty was 34% (95%CI 26% to 43%). Subgroup analysis showed that the prevalence of diabetes in patients with frailty in Asia and South America was higher than those in Europe and North America. The prevalence of diabetes in patients with frailty using physical frailty measures to evaluate frailty was higher than using multidimensional frailty measures. The prevalence of diabetes in patients with frailty in outpatient and hospital were higher than those in the community.ConclusionsCurrent evidence suggests that the prevalence of diabetes is high in the elderly with frailty.
This article conducts a mid-term evaluation of the implementation effect of the “West China-Chenghua Urban Area Medical Service Alliance” from 2016 to 2019 based on structure-process-outcome model. The structure of the alliance included five organizational sections, including the leadership group, West China departments, grassroots organizations, information platforms, and residents and health fan teams, aiming to provide integrated, homogeneous, and accessible medical services centered on residents’ health. The process of the alliance mainly included the joint reforms led by the “combination of government and hospital” and the management mechanism of “politics-people-medicine-network” four links. Alliance performance: in terms of grassroots services, the number of diagnoses and treatments increased, the number of diseases received increased, and the homogenization of test was initially achieved; in terms of grassroots training, several high-quality community doctors were trained, and the number of talents introduced increased; in terms of grassroots scientific research, 3 large-scale scientific research projects were undertaken and 4 articles were published in national-level publications; in terms of grass-roots awards, 5 honorary titles at national, provincial, and municipal levels were gained, and award-winning “zero” breakthrough in national skill competitions and academic conferences was achieved; in terms of alliance satisfaction, the employees in primary medical institutions and West China Hospital of Sichuan University and the residents in Chenghua District were all had high degree of satisfaction. The alliance has achieved innovation in management and services, and the employees and residents are highly satisfied, which is conducive to promoting the realization of the homogeneity of regional medical service capabilities. However, the salary system and capacity improvement of grassroots medical staff should be further explored.