简介:AbstractImportance:Several methods have been established in recent decades that allow use of spot urine to estimate dietary sodium intake. However, their accuracies have been controversial in children.Objective:To validate the performance of three commonly used methods—the Kawasaki, Tanaka, and International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) methods. Additionally, this study explored the accuracies of the Tanaka and INTERSALT methods by using spot urine samples taken at four separate times.Method:Forty-one adolescents aged 14 to 16 years completed two non-consecutive 24-hour urine collections and their mean values were used as reference data. The second-morning urine was used for assessment with the Kawasaki method; a casual spot urine and spot urine samples taken at four separate times (morning, afternoon, evening, and overnight) were used for assessment with the Tanaka and INTERSALT methods.Results:The mean differences were 1801 mg, 542 mg, 47 mg, and -31 mg for the Kawasaki, Tanaka, INTERSALT1 (with potassium), and INTERSALT2 (without potassium) methods with their required spot urine, respectively. The proportions of relative difference levels within ± 10% were 4.9% for the Kawasaki method, 19.5% for the Tanaka method, 36.6% for the INTERSALT1 method, and 36.6% for the INTERSALT2 method.Interpretation:The INTERSALT method seemed to provide minimally biased estimations of mean population sodium intake with casual spot urine. However, there is a need to be cautious regarding inconsistencies in estimation among different levels of sodium intake. The methods assessed in this study were unable to accurately estimate sodium intake at the individual level.
简介:AbstractImportance:Patients with atopic dermatitis (AD) display compromised epidermal barrier and suffer from poor quality of life. We hypothesized that quality of life could reflect in the changes in the epidermal barrier function.Objective:To determine whether the epidermal barrier function correlates with the severity of pruritus and/or life quality in children with AD.Methods:A total of 120 children, aged 0-12 years, with moderate AD were enrolled. Children were topically treated with topical corticosteroids (TCS) and an emollient for 2 weeks. The Eczema Area and Severity Index (EASI), visual analogue scale (VAS) for pruritus severity, the Infant’s Dermatitis Quality of Life Index (IDQOL) and the Children’s Dermatology Life Quality Index (CDLQI) were evaluated. Transepidermal water loss (TEWL) rates, stratum corneum (SC) hydration, and skin surface pH were measured. Correlations of epidermal barrier function with pruritus, life quality, and EASI were determined.Results:Following 2-week treatments, significant improvements were observed in EASI, TEWL, SC hydration, the VAS of pruritus, as well as DQOL (P < 0.001 for all). TEWL positively, while SC hydration negatively correlated with VAS pruritus, DQOL, and EASI (P < 0.001).Interpretation:Both TEWL and SC hydration levels can serve as indicators of the severity of pruritus and quality of life in children with AD.
简介:摘要目的探讨DEK-CAN融合基因阳性急性髓系白血病(AML)患者的临床特征及预后。方法回顾性分析2014年8月至2018年1月郑州大学第一附属医院收治的6例DEK-CAN融合基因阳性AML患者的临床资料,总结其临床特征、治疗及转归。结果6例患者均为女性,中位年龄29岁(4~64岁)。6例患者中,原始粒细胞白血病部分分化型(M2)5例,急性单核细胞白血病(M5)1例。外周血白细胞数升高5例,骨髓病态造血1例,嗜碱性粒细胞增多2例。6例患者免疫表型均CD34、CD13、CD38、CD33阳性。融合基因检测示患者DEK-CAN均为阳性,NPM1突变均为阴性,3例合并FLT3-ITD突变,2例合并WT1突变。染色体核型分析示2例未见分裂象,其余均为t(6;9)。6例患者中仅1例儿童患者第1个疗程诱导化疗取得完全缓解,5例成年患者第1个疗程化疗均未达到完全缓解,且在短期内死于并发症。结论DEK-CAN融合基因阳性AML患者预后极差,初次诱导缓解率低,死亡率高。
简介:摘要目的通过对骨盆指病例报道的文献系统评价,探讨骨盆指的临床及影像学特征。材料与方法计算机检索PubMed、Embase、The Cochrane Library、中国期刊全文数据库、维普网和万方数据库,对纳入文献进行资料提取及系统评价。结果文献系统评价共纳入28篇中英文报道,大多数病例为偶然发现,少数病例可导致与其相关的临床症状;影像学显示骨盆指大多数为发生于髂骨呈指骨样或肋骨样外观骨性结构,绝大多数表面光整且骨节具有完整的皮髓质结构,在各骨节或骨盆起始部位具有一个或多个假关节结构。结论骨盆指大多无特征临床表现而被偶然发现,影像学特征性表现为发生于骨盆且具有假关节的指样或肋骨样骨突起。识别这种良性异常并进行鉴别诊断对于避免不必要的临床干预非常重要。
简介:摘要:手术室作为医院的重要科室,既需要与临床科室进行业务的交互,也有一套手术室本科室的管理操作流程,因此手术室的信息化也是至关重要的。我院因历史原因,一直对手术室的信息化建设存在着重医生轻护理的不均衡发展现象。所以我院需要抛弃原有的思路,让科室内所有业务都均衡发展。我们根据护理的实际业务情况进行分析,对手术护理管理系统进行设计,包含了手术病人排班、患者术前接送管理,手术患者手术物品清点管理等功能模块。通过对手术护理管理系统的使用,减少了手术室护士的工作量,提高了工作的效率,同时也提高了领导者对手术室的管理程度。
简介:摘要:医院门诊是医疗服务的第一窗口,门诊服务的满意度直接关系着整个医院的服务质量,也会影响到医院的经济效益和社会声誉。目前,在整个中国的医疗大环境下,甲等医院,特别是特大型三甲医院的门诊“三长一短”现象尤其特出,“看病难”就此成了问题的重要表现。随着医疗卫生事业的发展和病人对医院医疗服务需求的提高,传统门诊模式的弊端开始呈现倍增的扩大。门诊流程的优化及再造成为医院管理者们重点关注的焦点。
简介:摘要硫氧还蛋白(Trx)系统由Trx、硫氧还蛋白还原酶(TR)和还原型烟酰胺腺嘌呤二核苷酸磷酸组成。Trx是一种重要的抗氧化分子,可抵抗多种应激引起的细胞死亡,在氧化还原反应中发挥着突出作用。TR是含硒(硒代半胱氨酸)的蛋白质,主要有3种形式:TR1(主要分布在胞质)、TR2(主要分布在线粒体)和TR3(主要分布在睾丸)。TR能调节细胞生长和凋亡,细胞癌变后,TR表达增加,促进细胞生长和转移。Trx系统与神经退行性疾病、寄生虫感染、获得性免疫缺陷综合征、类风湿性关节炎、高血压病、心肌炎等密切相关。Trx系统能清除体内活性氧,使细胞内外处于平衡状态,且其与硫氧还蛋白相互作用蛋白(TXNIP)相互作用,对于糖代谢调节和肿瘤治疗具有重要作用。Trx系统是许多疾病进行药物治疗的一个重要靶点。
简介:摘要目的探讨MR引导的Unity放疗系统在临床应用中的可行性。方法临床试验入选24例患者,按治疗部位分为头颈组、胸腹组、盆腔组、脊柱组和肢体组,总共384个治疗分次。在无外置激光的情况下进行摆位,统计在线治疗流程中不同阶段所需时间和每个分次的配准误差。每周利用MR几何形变模体检测MR图像几何形变大小。并利用ArcCheck对参考计划、在线计划及离线计划进行剂量验证。结果头颈组、胸腹组、盆腔组、肢体组、脊柱组平均治疗时间分别为29.1、27.6、26.6、25.6、32.0 min。5个组左右、上下、前后方向平均摆位误差分别为头颈组(0.08±0.06)、(0.16±0.13)、(0.08±0.05) cm,胸腹组(0.23±0.18)、(0.50±0.47)、(0.12±0.1) cm,盆腔组(0.25±0.19)、(0.32±0.25)、(0.11±0.09) cm,肢体组(0.46±0.38)、(0.26±0.26)、(0.13±0.07) cm,脊柱组(0.33±0.30)、(0.34±0.23)、(0.08±0.06) cm。在中心区域MR几何形变大小在0.3 mm以内,直径500 mm的球体区域内形变大小在2.1 mm内。所有参考计划、在线计划、离线计划平均γ通过率分别为97.92%、97.84%、94.58%。结论MR引导放疗具有较大临床应用潜力,但MR引导的Unity放疗系统流程较为复杂,各部门的协同性对治疗的影响较大,还需进一步优化。