Objective To investigate the feasibility of collecting exhaled breath condensate ( EBC)fromartificially ventilated patients with modified EcoScreen condenser. Methods ①In vitro test with lung simulator: the modified EcoScreen condenser was connected to lung simulator and mechanically ventilated for 60 min through three different types of connected tube as follows: dry ventilator pipe disconnected to humidifier, connected to the unheated humidifier, and connected to heated humidifier.Meanwhile, the changes of the peak pressure of inspiration ( PI) and tidal volume ( VT ) were observed. The volume of condensate was measured at last. ②In vivo test from artificially ventilated patients: 10 patients were artificially ventilated and their EBCs were collected with the modified EcoScreen condenser through dry pipe disconnected to humidifier for 20 min. The changes of PI, VT , respiratory frequency( f) , heart rate( HR) , mean arterial blood pressure ( MAP) , and blood oxygen saturation ( SpO2 ) were observed. Results ①In vitro test with lung simulator: At the end of the ventilating through the dry pipe disconnected to humidifier for 60 min,2. 2 mL condensate wascollected. Neither the change of PI or VT nor the obstruction of the collecting tube by iced condensate were observed. The ventilating through dry pipe connected to unheated humidifier had to stop at 50 min as the obstruction of the collecting tube caused by ice. 5 mL condensate was collected. It was observed that VTdecreased and PI increased. After ventilation through dry pipe connected to heated humidifier for 60 min,10. 5 mL condensate was collected while PI slightly increased and VT decreased. ② In vivo test from artificially ventilated patients: After ventilation through dry pipe disconnected to humidifier for 20 min, 2 mL EBC was collected without significance changes in PI, VT, f, HR, MAP, and SpO2 . Conclusions The modified EcoScreen condenser can be favourably applied to artificially ventilated patients for collecting EBC.It is recommended to performfor 20 min through the pipe disconnected to humidifier to obtain sufficient EBC without condensate dilution and airway obstruction. It is warranted more attention to the clinical and mechanical monitoring in this procedure.
As the largest ecosystem of human body, intestinal microorganisms participate in the synthesis and metabolism of uric acid. Developing and utilizing intestinal bacteria to degrade uric acid might provide new ideas for the treatment of hyperuricemia. The fecal samples of people with low uric acid were inoculated into uric acid selective medium with the concentration of 1.5 mmol/L for preliminary screening, and the initially screened strains that may have degradation ability were domesticated by concentration gradient method, and the strains with high uric acid degradation rate were identified by 16S rRNA sequencing method. A strain of high-efficiency uric acid degrading bacteria was screened and domesticated from the feces of people with low uric acid. The degradation rate of uric acid could reach 50.2%. It was identified as Escherichia coli. The isolation and domestication of high efficient uric acid degrading strains can not only provide scientific basis for the study of the mechanism of intestinal microbial degradation of uric acid, but also reserve biological strains for the treatment of hyperuricemia and gout in the future.
Health technology assessment (HTA) is becoming more and more popular recently. For populations in China that share at least half of the global disease burden of liver cancer, it is extremely vital to give rise to an efficient secondary prevention strategy. The China central government launched liver cancer screening program in rural areas in 2005, and then extended to populations in urban in 2012. The studies of health technology assessment of liver cancer screening are based on available evidence, from an HTA perspective, aims to evaluate performance of liver screening, economic burden and cost-effectiveness and some other issues, in order to raise suggestions for possible directions in research and public health program related to liver cancer screening in China.
Diabetes mellitus patients are usually at high risk of developing tuberculosis, the immune dysfunction caused by long-term high blood sugar, which can increase the susceptibility to tuberculosis. Severe tuberculosis could accelerate the course of diabetes mellitus and pose great difficulty to the clinical treatment. Therefore, early detection of potential tuberculosis patients in diabetes mellitus patients through tuberculosis screening and implementation of “three early” treatment can greatly improve the quality life of patients. This review summarizes the feasibility of tuberculosis screening in patients with diabetes mellitus, and to provide reference for the prevention and control of diabetes mellitus combined with tuberculosis.
The incidence of obesity and type 2 diabetes mellitus (T2DM) in adolescents has been rapidly increasing over the past two decades due to dramatic changes in dietary structure and physical activity. The incidence of diabetic retinopathy (DR), a serious vision-threatening complication of diabetes, is also increasing yearly in the adolescent population with T2DM. Due to the insidious onset of retinal diseases in the early stages, regular screening is important for the timely diagnosis of DR. However, there are still problems such as low attention of the population and insufficient screening rate. In the future, we should strengthen the health education of the adolescent population and optimize the control of risk factors such as blood glucose and blood pressure. At the same time, appropriate screening strategies should be actively developed, and the use of telemedicine and emerging technologies should be promoted for early detection of treatable lesions to improve patient prognosis.
ObjectiveTo explore the nutritional status of inpatients with chronic kidney disease (CKD) and analyze the factors affecting nutritional risk, to provide theoretical basis for further nutritional support.MethodsConvenience sampling method was adopted to select 719 inpatients with CKD as research subjects in a tertiary hospital in Chengdu, Sichuan Province from January to March 2018. Nutritional Risk Screening 2002 was used for nutritional risk screening, and chi-square test, t test, one-way analysis of variance, and multiple linear regression analysis were used to explore the influencing factors of nutritional risk.ResultsAmong the 719 cases, whose average nutritional risk score was 1.79±1.11, 158 cases had nutritional risk, accounting for 22.0%. There were statistically significant differences in nutritional risk score between patients of age<60 years and ≥60 years, between males and females, between patients with CKD stage 1-3 and stage 4-5, between patients with serum albumin level <30 g/L and ≥30 g/L, and between patients with and without anaemia (P<0.05). The results of multiple linear regression analysis showed that the nutritional risk score of CKD patients was negatively correlated to serum albumin level (P=0.016), positively correlated to age (P<0.001), and higher in females than that in males (P=0.001).ConclusionsInpatients with CKD have a higher nutritional risk, with age, gender and serum albumin as the main influencing factors. Based on the above factors, the medical staff should continue to take targeted intervention measures to assess the nutritional status of CKD inpatients early and conveniently, so as to provide scientific basis for further nutritional support and nutritional nursing.
ObjectiveTo evaluate the risk of bias and reliability of conclusions of systematic reviews (SRs) of lung cancer screening. MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 2, 2016), Web of Knowledge, CBM, WanFang Data and CNKI to collect SRs of lung cancer screening from inception to February 29th, 2016. The ROBIS tool was applied to assess the risk of bias of included SRs, and then GRADE system was used for evidence quality assessment of outcomes of SRs. ResultsA total of 11 SRs involving 5 outcomes (mortality, detection rate, survival rate, over-diagnosis and potential benefits and harms) were included. The results of risk of bias assessment by ROBIS tool showed:Two studies completely matched the 4 questions of phase 1. In the phase 2, 6 studies were low risk of bias in the including criteria field; 8 studies were low risk of bias in the literature search and screening field; 3 studies were low risk of bias in the data abstraction and quality assessment field; and 5 studies were low risk of bias in the data synthesis field. In the phase 3 of comprehensive risk of bias results, 5 studies were low risk. The results of evidence quality assessment by GRADE system showed:three studies had A level evidence on the outcome of mortality; 1 study had A level evidence on detection; 1 study had A level evidence on survival rate; 3 studies on over-diagnosis had C level evidence; and 2 studies on potential benefits and harms had B level evidence. ConclusionThe risk of bias of SRs of lung cancer screening is totally modest; however, the evidence quality of outcomes of these SRs is totally low. Clinicians should cautiously use these evidence to make decision based on local situation.
ObjectiveTo investigate the status-quo of urban and rural residents' depression in the communities of Chengdu city and its influencing factors. MethodsA multi-stage stratified cluster sampling survey was carried out from February to October 2010. Residents aged from 35 to 70 years in 4 urban and rural communities of Chengdu were investigated in the incidence of depression. The health survey questionnaire and PHQ-2 Depression Screening Scale were used for the household investigation. Data was analyzed using SPSS 18.0 software, and the risk factors were also analyzed using multivariate logistic methods. ResultsA total of 2 027 residents were interviewed, including 1 015 urban (616 women and 399 men, with mean age of 58.90 ±9.48 years) and 1 012 rural residents (582 women and 430 were men, with mean age of 54.94 ±9.64 years). The results showed that the overall depression prevalence rate of residents aged from 35 to70 years old in Chengdu was 2.91% (59/2 027); and the prevalence was 4.33% (44/1 015) in urban and 1.48% (15/1 012) in rural. The prevalence was significantly higher in urban areas than that in rural areas (χ2=13.296, P < 0.001). The results of multivariate analysis showed that a significant difference was found in the prevalence of depression among the different marital status groups, and more divorced people suffered from depression. No statistically significant correlation was found between the factors (including occupation, education level and family income status) and depression. ConclusionThe prevalence of depression among residents in urban and rural communities of Chengdu was high, and the divorced population should be paid more attention to in the prevention and treatment of depression.
ObjectiveTo establish a screening model for obstructive sleep apnea hypopnea syndrome (OSAHS) through data analysis, and explore the risk factors of OSAHS. MethodsA total of 558 patients who underwent polysomnography in the Sleep Monitoring Room of Zigong Fourth People’s Hospital were recruited in the study. Among them there were 163 cases in a snore group and 395 cases in an OSAHS group. Risk factors of OSAHS were screened by both univariate analysis and multivariate analysis, then the model was established by means of binary logistic regression analysis. Finally, the screening model was evaluated by receiver operating characteristic (ROC) curve of the combined predictive factor. ResultsThe screening model of OSAHS was established as: X=–10.286+0.280×body mass index+1.057×snoring degree+1.124×sex+0.085×Epworth score+0.036×age. In this equation, sex value was 1 for men and 0 for women. If the value of X is higher than 1.123, it is likely that OSAHS would occur, and the probability (P)=ex/(1+ex). The sensitivity of the screening model was 77.70%, the specificity was 85.89%, the area under the ROC curve was 0.890, and the 95% confidence interval ranged from 0.862 to 0.918. ConclusionThis study demonstrates that a screening model based on the snoring degree, Epworth score, and body measurement data is a valuable tool to predict and screen OSAHS in patients with snoring, and the screening model could be useful in clinical diagnosis of OSAHS.
Lung cancer is a malignant tumor with the highest incidence and mortality in China. Early diagnosis and early treatment is the key to improve the survival and prognosis of patients with lung cancer. In recent years, many studies have focused on biomarkers of lung cancer. Emerging biomarkers tests have shown some potential in lung cancer screening. Combining biomarkers, imaging omics and artificial intelligence to establish a comprehensive model for lung cancer screening and prediction may be the development direction for improving lung cancer screening in the future. This paper summarizes the application of biomarkers in lung cancer screening, introduces the emerging biomarkers and new technologies, and discusses the application prospects of biomarkers in lung cancer screening, in order to providea theoretical basis for improving screening, early diagnosis and early treatment of lung cancer.