Objective To systematically evaluate correlation between exon-1 (locus 49, A/G) and promoter (locus -318, C/T) polymorphisms of Chinese population cytotoxic T lymphocytes associated antigen-4 (CTLA-4) gene and Graves’ Disease (GD). Methods Relevant studies were electronically searched in CNKI, VIP, CBM, PubMed, EMbase and The Cochrane Library from 1980.1 to 2011.12. According to the inclusion and exclusion criteria, we selected and screened all case-control studies on the correlation between CTLA-4 exon -1 (locus 49, A/G) and promoter (locus -318, C/T) polymorphisms of Chinese population and GD. Then we extracted the data and assessed the methodological quality of the included studies. Meta-analysis was performed using RevMan 5.0 and STATA 12.0 software. Results (1) Ten studies on exon-1 were included. Results of meta-analyses showed that Chinese population with genotype G/G had a higher GD risk than those with genotype A/A (OR=3.38, 95%CI 2.07 to 5.51) and A/G (OR=1.72, 95%CI 1.31 to 2.25). Also, the allele G showed significant association with increased GD risk compared to the allele A (OR=1.87, 95%CI 1.44 to 2.41). (2) Five studies on promoter-318 were included. Results of meta-analyses showed that Chinese population with genotype T/T presented no increased relative risk compared to those with genotype C/C (OR=0.75, 95%CI 0.26 to 2.12) or C/T (OR=0.92, 95%CI 0.31 to 2.73). Meanwhile, the allele T showed no increased relative risk compared to the allele C (OR=0.83, 95%CI 0.61 to 1.12). Conclusion The allele G at the locus 49 of exon -1 of Chinese population is significantly associated with increased GD risks, yet the correlation between promoter –318 C/T polymorphism and GD hasn’t been demonstrated. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to test the above conclusion.
ObjectiveTo investigate the clinical nursing path of health education in patients with gout. MethodsA total of 220 patients with gout treated in People's Hospital of Jiangyou from September 2010 to November 2011 were randomly divided into observation group and control group with 110 patients in each.After routine health education for the control group and clinical nursing path health education for the observation group,we compared patients'compliance with doctors,gout-related indicators and health education satisfaction degree between the two groups of patients. ResultsThere was no statistically significant difference in compliance with doctors between the two groups before health education (P>0.05).After health education,the score of five single items on compliance with doctors and the total score for patients in the observation group were all significantly improved (P<0.05).For patients in the control group,the scores of each item and the total score were also significantly improved (P<0.05) except the item of regular drug-taking and regular health examination (P>0.05).After health education,all scores and the total score of the observation group were higher than those of the control group (P<0.05). ConclusionFor health education for gout patients,clinical nursing path is better than routine health education in scores of compliance with doctors,improvements of symptoms,and health education satisfaction degree of the patients.
ObjectiveTo analyze the choice of initial antibiotic treatment for health care-associated pneumonia (HCAP). MethodA retrospective study was conducted in patients with HCAP hospitalized in the Emergency Department of West China Hospital from January 1st to December 31st, 2014. A total of 156 HCAP patients were divided into anti-multidrug-resistant treatment group (group A, n=72) and quinolone monotherapy group (group B, n=84). The baseline characteristics, comorbidities, severity, pathogen distribution, antibiotics and clinical outcomes were compared between the two groups. ResultsIn group B, there were 46 males and 38 females with the age of (59.9±10.9) years, and the pneumonia severity index (PSI) score was 89.5±22.7; in group A, there were 44 males and 28 females with the age of (62.2±12.2) years, and the PSI score was 94.4±23.6. The differeces between the two groups were not significant (P>0.05). The duration of using antibiotics in group B was (14.5±3.7) days, which was longer than that in group A[(12.8±3.8) days, P=0.005]. The detection rate of multidrug-resistant bacteria, the proportion of changing antibiotics, the average length of hospitalization, the proportion of using mechanical ventilation, the proportion of patients transferred into Intensive Care Unit and 30 days mortality in group B was 17.9%, 34.5%, (16.9±3.6) days, 11.9%, 9.5%, and 4.8%, respectively; which were similar to those in group A[15.3%, 22.2%, (17.3±3.9) days, 16.8%, 12.5%, and 4.2%, respectively] (P>0.05). ConclusionsIt is unnecessary for all HCAP patients to receive anti-multidrug-resistant treatment. We should regard the risk factors and the popular local features of microbiology to determine the choice of antibiotic treatment.
Online Mendelian Inheritance in Man (OMIM) is a knowledge source and data base for human genetic diseases and related genes. Each OMIM entry includes clinical synopsis, linkage analysis for candidate genes, chromosomal localization and animal models, which has become an authoritative source of information for the study of the relationship between genes and diseases. As overlap of disease symptoms may reflect interactions at the molecular level, comparison of phenotypic similarity may indicate candidate genes and help to discover functional connections between genes and proteins. However, the OMIM has used free text to describe disease phenotypes, which does not suit computer analysis. Standardization of OMIM data therefore has important implications for large-scale comparison of disease phenotypes and prediction of phenotype-genotype correlations. Recently, standard medical language systems, term frequency-inverse document frequency and the law of cosines for document classification have been introduced for mining of OMIM data. Combined with Gene Ontology and various comparison methods, this has achieved substantial successes. In this article, we have reviewed various methods for standardization and similarity comparison of OMIM data. We also predicted the trend for research in this direction.
ObjectiveTo explore the application of tracking method in intravenous treatment in primary hospitals, in order to improve the quality of nursing of intravenous therapy. MethodsFor the 22 events of venous transfusion adverse reactions between January and March 2013, we used tracking methodology for tracking and analyzing the reasons. Through this, we regulated and implemented specific improvement scheme, perfected rules and regulations to improve the work process. ResultsThrough reason analysis and improving regulations, the number of intravenous infusion adverse reactions was decreased from 22 in the first quarter to 0 in the fourth quarter of the year. ConclusionTracking methodology used for regulating the intravenous treatment behaviors of basic-level hospitals nurses can reduce the occurrence of adverse transfusion reaction
ObjectiveTo explore clinical outcomes of complete mechanical cervical side-to-side esophago-gastric tube anastomosis. MethodsClinical data of 60 patients with esophageal carcinoma (EC)who underwent complete mechanical cervical side-to-side esophago-gastric tube anastomosis in the 153rd Central Hospital of People's Liberation Army from June 2010 to June 2012 were retrospectively analyzed. There were 41 male and 19 female patients with their age of 46-78 (64.2±6.4)years and body weight of 58.6±12.6 kg. There were 39 patients with mid-thoracic EC, 15 patients with lower-thoracic EC, and 6 patients with upper-thoracic EC. There was 1 patient with stageⅠ EC, 32 patients with stage Ⅱ EC, 23 patients with stage Ⅲ EC, and 4 patients with stage Ⅳ EC. Six to 12 months after the operation, all the patients received a survey questionnaire regarding their quantity and quality of food intake as well as gastroesophageal reflux (GER). Fifty-two patients received barium swallow, and 38 patients received gastroscopy and esophageal mucosal biopsy during follow-up. ResultsAll the 60 patients were successfully discharged. Average length of hospital stay was 12.0±2.6 days. Average time for anastomosis was 18.4±3.2 minutes. The incidence of anastomotic leak was 1.7% (1/60). During follow-up, all the 60 patients restored normal food intake, and 14 patients (23.3%)had GER symptoms. Barium swallow showed the average anastomotic diameter of 1.6±0.2 cm (range, 1.2 to 2.2 cm). In 45° trendelenburg position, 31 patients (59.6%)had barium GER, but none of the patients had prolonged barium retention, intrathoracic gastric dilation or disturbed gastric emptying. Gastroscopy of 38 patients showed full anastomotic opening in 24 patients (63.2%)and irregular or semiclosed anastomosis in the other 14 patients (36.8%). Mucosal biopsy under gastroscopy showed chronic inflammation in 18.4% (7/38)patients. ConclusionComplete mechanical cervical side-to-side esophago-gastric tube anastomosis can significantly prevent anastomotic stenosis, leak and intrathoracic stomach symptoms with good clinical outcomes.
ObjectiveTo summarize clinical experience and results of surgical treatment of subaortic membrane (SM). MethodsClinical data of 32 SM patients who underwent surgical resection of SM between March 2009 and September 2013 in Beijing Anzhen Hospital were retrospectively analyzed. There were 22 male and 10 female patients with their age of 0.5-14.0 (3.6±3.2)years and body weight of 5.5-43.0 (17.2±9.5)kg. Among the 32 patients, 7 patients had isolated SM, and 25 patients had other intracardiac lesions including ventricular septal defect in 21 patients, mitral regurgi-tation in 1 patient, patent ductus arteriosus (PDA)in 1 patient, SM occurrence after PDA occlusion in 1 patient and surgical correction for coarctation of the aorta in another patient. Eighteen patients had aortic insufficiency (AI)in different degree. ResultsSM diagnosis was missed by preoperative echocardiography in 1 patient. Mean cardiopulmonary bypass time was 71.7±21.7 minutes, aortic cross-clamping time was 48.7±15.1 minutes, ICU stay was 2.2±1.7 days, and postoperative hospital stay was 7.9±2.5 days. There was no in-hospital death in this group. Postoperatively, 1 patient had second-degree atrioventricular block which returned to sinus rhythm 6 days after the operation. All the patients were followed up for 2-54 months after discharge. During follow-up, AI of 6 patients with isolated SM was relieved, and AI of 5 SM patients with other intracardiac lesions was relieved (P=0.003). Among the 7 patients with isolated SM, preoperative moderate AI in 4 patients changed to mild AI in 3 patients and trivial AI in 1 patient, and preoperative mild AI in 3 patients changed to trivial AI in 2 patients. Among the 25 patients with other intracardiac lesions, preoperative mild AI in 8 patients changed to trivial AI in 3 patients, and preoperative moderate AI in 3 patients changed to mild AI in 1 patients and trivial AI in another patient. There was no SM recurrence during follow-up in this group. ConclusionSM diagnosis may be missed by preo-perative echocardiography, and early surgical correction is needed once the diagnosis is established. Meticulous surgical techniques are necessary during the operation. Postoperative SM recurrence may happen, so regular follow-up is required after discharge.