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比阿培南治疗肝衰竭重度感染患者的效果研究

中华医院感染学杂志 2015年第23期25卷 5371-5373页

作者：阚晓王延峰李芹王洋秦来英王倩俎燕会山东大学附属济南市传染病医院介入科山东济南250021 章丘市人民医院内科山东章丘250200 山东大学附属济南市传染病医院肝病科山东济南250021

目的研究肝衰竭重度感染患者病原菌的分布,探讨其危险因素、临床特点及治疗转归,评价比阿培南治疗肝衰竭重度感染患者的疗效性和安全性。方法选取2.12.2.-2.15年1月在医院住院的306例肝衰竭重度感染患者,对常见感染指标进行监测,并对... 详细信息

目的研究肝衰竭重度感染患者病原菌的分布,探讨其危险因素、临床特点及治疗转归,评价比阿培南治疗肝衰竭重度感染患者的疗效性和安全性。方法选取2.12.2.-2.15年1月在医院住院的306例肝衰竭重度感染患者,对常见感染指标进行监测,并对采集的标本进行细菌培养,应用比阿培南治疗,观察临床表现变化、疗程及不良反应发生情况,数据采用SPSS 11.5软件进行统计分析。结果 306例肝衰竭重度感染患者中自发性细菌腹膜炎占64.71%,呼吸道感染占2..4.%,其他部位感染占8.82.;大肠埃希菌在血液、腹水及尿液培养中分别占4..39%、58.69%、50.00%;而肺炎链球菌在痰液培养最常见为2..4.%;应用比阿培南治疗一周总有效率为89.2.%、痊愈率为63.73%,治疗两周总有效率为91.50%、痊愈率为86.2.%。结论肝衰竭患者感染发生率高,预后差,最常见的重度感染为自发性细菌性腹膜炎;比阿培南治疗肝衰竭合并重度感染患者安全有效且不良反应少。

关键词：比阿培南治疗肝衰竭重度感染

Age, estimated glomerular filtration rate and ejection fraction score predicts contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease： insight from the TRACK-D study

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Chinese Medical Journal 2014年第12期127卷 2332-2336页

作者： li jing li Yi wang Xiaozeng Yang Shuguang Gao Chuanyu Zhang Zheng Yang Chengming jing Quanming wang Shouli Ma Yingyan wang Zulu liang Yanchun Han Yaling Department of Cardiology Shenyang Northern HospitalShenyangLiaoning 110016China Department of Cardiology Jinan Military 88th HospitalTaianShandong 271000China Department of Cardiology Henan Provincial Peoples HospitalZhengzhouHenan 450003China Department of Cardiology First Affiliated Hospital of Lanzhou UniversityLanzhouGansu 730000China Department of Cardiology Daping Hospital and the Research Institute of Surgery of the Third Military Medical UniversityChongqing 400038China Depal tment of Cardiology The 306th'Hospital of People's LiberationArmy Beijing 10000 China

Background The occurrence of contrast induced acute kidney injury （CIAKI） has a pronounced impact on morbidity and *** aim of the present study was to appraise the diagnostic efficacy of age,estimated glomerular filtration rate （eGFR） and ejection fraction （AGEF） score （age/EF（％）＋1 （if eGFR was ＜60 ml·min-1·1.73 m2.） as an predictor of CIAKI in patients with diabetes mellitus （DM） and concomitant chronic kidney disease （CKD）.Methods The AGEF score was calculated for 2.998 patients with type 2.DM and concomitant CKD who had undergone coronary/peripheral arterial *** was defined as an increase in sCr concentration of 0.5 mg/dl （4..2.mmol/L） or 2.％ above baseline at 72.hours after exposure to the contrast *** hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score *** diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic （ROC） *** The AGEF score ranged from 0.4. to *** AGEF score tertiles were defined as follows：AGEFlow ≤0.92.（n=1 006）; 0.92.＜AGEFmid ≤1.16 （n=1 000）,and ACEFhigh ＞1.16 （n=992..The incidence of CIAKI was significantly different in patients with low,middle and high AGEF scores （AGEFlow=1.1％,AGEFmid=2.3％ and AGEFhigh=5.8％,P ＜0.001）.By multivariate analysis,AGEF score was an independent predictor of CIAKI （odds ratio=4.96,95％ CI：2.32.10.58,P ＜0.01）.ROC analysis showed that the area under the curve was 0.70 （95％ CI：0.64.-0.753,P ＜0.001）.Conclusion The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography.

关键词： AGEF score contrast induced acute kidney injury diabetes chronic kidney disease

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阵发性心房颤动发作风险的人工智能预测模型

中国心血管病研究 2024年第3期22卷 196-202页

作者：李盼盼韩宇臣李峰陈雨郭军暨南大学附属第一医院心内科广东省广州市510630 深圳大微医疗科技开发有限公司

目的建立一种基于2.0}h心电图数据开发的集成模型,从而对房颤高危人群发生房颤的风险,及实时预测阵发性房颤患者房颤的发作。方法连续回顾性收集2.18年1月1日至2.2.年12.31日在暨南大学第一附属医院心电报告诊断为阵发性心房颤动的患者... 详细信息

目的建立一种基于2.0}h心电图数据开发的集成模型,从而对房颤高危人群发生房颤的风险,及实时预测阵发性房颤患者房颤的发作。方法连续回顾性收集2.18年1月1日至2.2.年12.31日在暨南大学第一附属医院心电报告诊断为阵发性心房颤动的患者共310例,经筛选后共有12.0}患者作为心房颤动组纳入本研究。同时以1∶4.比例随机选择4.6例心电图报告正常的患者作为非心房颤动组。两组患者最终一起被随机分配,得到训练集(n=4.4.、验证集(n=62.和测试集(n=12.0},比例为7∶1∶2.以进行心电模型训练。建立心电神经网络模型和心率神经网络模型,最后使用逻辑回归将心电神经网络模型和心率神经网络模型结合得到集成模型。结果经过训练、验证和测试,人工智能集成算法的曲线下面积为0.94.95%CI 0.75~0.94.,其敏感度、特异度、准确度、精确度和F1分数分别为56.0%、98.0%、90.0%、93.0%和0.70。与临床风险模型和现有的房颤预测模型HARMS2.AF评分相比,AI算法的性能更好(P1)。结论人工智能集成算法可能是预测房颤风险,实时预测房颤发作的有效方法,可以作为一种早期预警工具。这对房颤的筛查,个体化抗凝方案的制定具有重要的临床意义。

关键词：人工智能 2.0}h动态心电图阵发性心房颤动风险预测

中医迷你临床演练评估在中医内科学两段式见习教学中的应用

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中医教育 2024年第2期43卷 145-148页

作者：李玲玲吕玉婷王永森曹志群赵玉洁山东中医药大学第一临床医学院济南250014 山东中医药大学附属医院消化内一科济南250014

目的探讨中医迷你临床演练评估在中医内科学两段式见习教学中的应用价值。方法选取2.2.年9-12.在山东中医药大学附属医院消化内一科试点两段式教学的116名中医学五年制医学生,按照随机数字表法分为试验组和对照组,每组58名。对照组... 详细信息

目的探讨中医迷你临床演练评估在中医内科学两段式见习教学中的应用价值。方法选取2.2.年9-12.在山东中医药大学附属医院消化内一科试点两段式教学的116名中医学五年制医学生,按照随机数字表法分为试验组和对照组,每组58名。对照组采用传统见习带教模式教学,试验组采用中医迷你临床演练评估对学生进行临床教学,并使用中医迷你临床演练评估测评量表对2.学生进行考核评价,比较2.学生的临床综合能力考核成绩及满意率。结果见习前,2.见习学生临床综合能力各项目考核成绩比较,差异均无统计学意义(P>0.05)。见习后,2.学生临床综合能力各项目考核成绩高于见习前,差异有统计学意义(P1)。见习后试验组学生临床综合能力各项目考核成绩高于对照组,差异有统计学意义(P1)。试验组学生对临床教学的总满意率高于对照组(P<0.05)。结论在两段式教学改革过程中,应用中医迷你临床演练评估教学法进行教学,可提高见习学生的临床综合能力,有利于其更好地掌握中医临床技术。

关键词：中医内科学两段式教学改革中医迷你临床演练评估

基于DNA甲基化探讨电针改善痰湿型PCOS患者胰岛素抵抗及IVF-ET妊娠结局的作用机制

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中华生殖与避孕杂志 2024年第4期44卷 359-365页

作者：官璐相珊连方吴海萃李园山东中医药大学第一临床医学院济南250014 山东中医药大学附属医院生殖与遗传科济南250014

目的基于INSR基因甲基化以及胰岛素代谢信号通路探讨电针改善痰湿型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者胰岛素抵抗及体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)妊娠结局的作用机制。方法... 详细信息

目的基于INSR基因甲基化以及胰岛素代谢信号通路探讨电针改善痰湿型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者胰岛素抵抗及体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)妊娠结局的作用机制。方法采用前瞻性随机对照研究,纳入2.2.年1月至2.2.年12.期间于山东中医药大学附属医院生殖与遗传科就诊拟行IVF-ET助孕的痰湿型PCOS患者100例,采用随机数字表法均分为电针治疗(试验组)50例,伪针刺激(对照组)50例,采用固定拮抗剂方案促排卵,两组患者分别于取卵前1个月经周期经净始予电针治疗和伪针刺激,每周2.,直至扳机日。收集颗粒细胞。观察比较两组患者痰湿证候积分、胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR)、促性腺激素(gonadotropin,Gn)的用量及使用时间、获卵数、受精率、优质胚胎数、临床妊娠率、流产率和活产率。采用亚硫酸氢盐扩增子测序测定颗粒细胞中INSR基因启动子区甲基化水平的变化;实时荧光定量PCR和Western blotting测定INSR、PI3K、GLUT{2.mRNA和蛋白的含量。结果试验组治疗后痰湿证候积分(15.2.±1.57)、HOMA-IR(2.82.0.39)较治疗前(2..65±3.61、3.3{2.0.56)明显降低,差异均具有统计学意义(P2.。试验组治疗前后证候积分差值(-5.76±2.86)、HOMA-IR差值(-2.67±0.06)的绝对值明显大于对照组(-1.6{2.0.8{2.-0.11±0.0{2.,差异均具有统计学意义(P2.)。试验组患者Gn用量[(2.19.53±338.2.)U]及使用时间[(10.16±1.2.)d]较对照组[(2.2.5.65±{2.{2.2.)U、(10.9{2.1.{2.)d]明显减少(P=0.005,P=0.02.),优质胚胎数[(3.5{2.1.0{2.枚]较对照组[(2.66±1.87)枚]明显增多(P=0.01{2.,受精率[66.91%(552.82.)]、临床妊娠率[63.2.%(31/{2.)]和活产率[51.02.(2./{2.)]较对照组[60.2.%({2.5/789)、{2..67%(2./{2.)、31.2.%(15/{2.)]明显升高,差异均具有统计学意义(P=0.005,P=0.033,P=0.0{2.);两组患者的获卵数、早期流产率差异均无统计学意义(均P>0.05)。试验组患者颗粒细胞中INSR基因启动子区38、{2.、56、59、9{2.1{2.位点甲基化水平较对照组明显降低,差异均具有统计学意义(均P2.15{2.156、162.点甲基化水平差异均无统计学意义(均P>0.05)。与对照组相比,试验组患者卵巢颗粒细胞中INSR、PI3K、GLUT{2.因mRNA和蛋白表达均上调,差异均有统计学意义(均P3K、GLUT{2.因表达上调,从而改善患者胰岛素抵抗,提高其胚胎的质量,最终改善妊娠结局。

关键词：多囊卵巢综合征电针治疗甲基化痰湿胰岛素抵抗

Application of next-generation sequencing technology to precision medicine in cancer: joint consensus of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology

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Cancer Biology & Medicine 2019年第1期16卷 189-204页

作者： Xuchao Zhang Zhiyong liang Shengyue wang Shun Lu Yong Song Ying Cheng jianming Ying Weiping liu Yingyong Hou Yangqiu li Yi liu Jun Hou Xiufeng liu jianyong Shao Yanhong Tai Zheng wang li Fu Hui li Xiaojun Zhou Hua Bai Mengzhao wang You Lu jinji Yang Wenzhao Zhong qing Zhou Xuening Yang jie wang Cheng Huang Xiaoqing liu Xiaoyan Zhou Shirong Zhang Hongxia Tian Yu Chen Ruibao Ren Ning liao Chunyan Wu Zhongzheng Zhu Hongming {24. Yanhong Gu liwei wang yunpeng liu Suzhan Zhang Tianshu liu Gong Chen Zhimin Shao Binghe Xu qingyuan Zhang Ruihua Xu lin Shen Yilong Wu Guangdong Lung Cancer Institute Medical Research Center Cancer Center of Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences affiliated Guangdong Provincial People's hospital South China University of Technology Department of Pathology Peking Union Medical College Hospital Chinese Academy of Medical Sciences National Research Center for Translational Medicine Shanghai Rui Jin Hospital Shanghai Jiao Tong University School of Medicine Lung Tumor Clinical Medical Center Shanghai Chest Hospital Shanghai Jiao Tong University Division of Respiratory Medicine Jinling Hospital Nanjing University School of Medicine Department of Oncology Jilin Cancer Hospital Department of Pathology National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Pathology West China Hospital Sichuan University Department of Pathology Zhongshan Hospital Fudan University Department of Hematology First Affiliated Hospital Institute of Hematology School of Medicine Jinan University Laboratory of Oncology Affiliated Hospital of the Academy of Military Medical Sciences Department of Oncology First Clinical College of South China University of Technology/Guangdong Lung Cancer Institute People's liberation Army Cancer Center of Bayi hospital {2. to Nanjing {4. of Chinese Medicine Department of Pathology Sun Yat-sen University Cancer Center Department of Pathology Affiliated Hospital of the Academy of Military Medical Sciences Department of Pathology Beijing Hospital Department of Breast Cancer Pathology and Research Laboratory of Cancer Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin’s Clinical Research Center for Cancer Department of Pathology Jinling Hospital Nanjing University School of Medicine State Key Laboratory of Molecular Oncology Department of Medical Oncology National Cancer Center/Canc

Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules ***, it represents a promising tool for the analysis of molecular targets for the initial diagnosis of disease, monitoring of disease progression, and identifying the mechanism of drug resistance. On behalf of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology(CSCO) and the china Actionable Genome Consortium(CAGC), the present expert group hereby proposes advisory guidelines on clinical applications of NGS technology for the analysis of cancer driver genes for precision cancer therapy. This group comprises an assembly of laboratory cancer geneticists, clinical oncologists, bioinformaticians,pathologists, and other professionals. After multiple rounds of discussions and revisions, the expert group has reached a preliminary consensus on the need of NGS in clinical diagnosis, its regulation, and compliance standards in clinical sample collection. Moreover, it has prepared NGS criteria, the sequencing standard operation procedure(SOP), data analysis, report, and NGS platform certification and validation.

关键词： Next-generation sequencing technology cancer consensus

Effect of Buyang Huanwu Decoction on the proliferation,migration and adhesion of endothelial progenitor cells in rats with acute myocardial infarction

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Journal of Hainan Medical university 2021年第14期27卷 1-6页

作者： Zhi-hao Wen De-qing Huang Ming-{2.an Huang Chao-Xin {4. qing-Gao wang Yi-Qiang liang Yan {4.g Ya-Ping Cao Qian-Yu li Department of Cardiovascular Medicine The First Affiliated Hospital of Guangxi University of Chinese MedicineNanning 530023China Department of Emergency The First Affiliated Hospital of Guangxi University of Chinese MedicineNanning 530023China Clinical Pharmacology Base of the first {2. hospital of Guangxi {4. of Chinese Medicine Nanning 530023China National Clinical Research Center for Traditional Chinese Medicine Cardiovascular Diseases Guangxi University of Traditional Chinese MedicineNanning 530200China

Objective:To investigate the intervention effect of Buyang Huanwu Decoction on endothelial progenitor cell function(EPCs),and to explore the therapeutic mechanism of Buyang Huanwu ***:This research take 54.rats were divided into blank group,the control group,model group,Chinese medicine,western medicine group and combine traditional Chinese and western medicine group,tonifying Yang also five decoction and atorvastatin calcium for acute myocardial infarction(AMI)rats group intervention,by using the method of density gradient centrifugation separation training each rat endothelial progenitor cells,using tetramethyl azo salt trace enzyme reaction colorimetry,used in the determination of adhesion ability and improved Boyden chamber,the method of analysis and comparison between groups of endothelial progenitor cells proliferation,adhesion and ***:In 7 days,14.days and 4.weeks,acute myocardial infarction model of rat peripheral blood EPCs count,proliferation,migration and adhesion ability were compared with control group were significantly decline,tonifying Yang also five decoction group,western medicine control group and combine traditional Chinese and western medicine group of peripheral blood EPCs count,proliferation,migration and adhesion ability compared with model group were significantly increased(Plial function of AMI rats than traditional Chinese medicine or western *** clinical studies on statins may better improve the endothelial function of AMI patients,and provide a new research entry point for improving the long-term prognosis of AMI patients.

关键词： Buyang Huanwu Decoction Acute myocardial infarction Rats Function of endothelial progenitor cells

Transanal total mesorectal excision for rectal cancer: a multicentric cohort study

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Gastroenterology Report 2020年第1期8卷 82-82页

作者： liang Kang Yuan-Guang Chen hao Zhang Hong-Yu Zhang Guo-Le lin Ying-Chi Yang Wen-hao Chen Shuang-ling Luo Ning Chen Wei-Dong Tong Zhan-long Shen De-Hai Xiong Yi Xiao Zhong-Tao Zhang jian-Ping wang Department of Colorectal Surgery The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangzhouGuangdongP.R.China Department of Gastrointestinal Surgery The First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongP.R.China Department of General Surgery Dongguan Kanghua HospitalDongguanGuangdongP.R.China Department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqingP.R.China Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP.R.China Department of General Surgery Beijing Friendship HospitalBeijingP.R.China Department of Colorectal Surgery Zhongnan Hospital of Wuhan UniversityWuhanHubeiP.R.China Department of General Surgery Peking University Third HospitalBeijingP.R.China Department of Gastrointestinal Surgery Daping HospitalThird Military Medical UniversityChongqingP.R.China Department of Gastrointestinal Surgery Peking University People’s HospitalBeijingP.R.China Department of General Surgery Chongqing Three Gorges Center HospitalChongqingP.R.China

In the original version of this manuscript,the following line in the abstract read:‘among the 2.1 patients,175(82.9%)had complete TME and 33(15.6%)had incomplete TME’.This has now been corrected to:‘among the 2.1 p... 详细信息

关键词： rectal excision patients

A new treatment for cognitive disorders related to in utero exposure to alcohol

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Neural Regeneration Research 2013年第18期8卷 1702-1713页

作者： Shuang li Yan Zhang Feng Zhu Bin Zhang jianying lin Chunyang Xu Wancai Yang Wei {4. Ruiling Zhang Second affiliated hospital Xinxiang Medical University Department of Physiology Xinxiang Medical University first affiliated {2. Xinxiang Medical University Department of Immunology Xinxiang Medical University Henan Key Laboratory of Biological Psychiatry Xinxiang Medical University School of Basic Medical Sciences Xinxiang Medical University

Maternal alcohol consumption during pregnancy has detrimental effects on fetal central nervous system development. Maternal alcohol consumption prior to and during pregnancy significantly affects cognitive functions in offspring, which may be related to changes in cyclin-dependent kinase 5 because it is associated with modulation of synaptic plasticity and impaired learning and memory, in this study, we examined adult offspring in a materna~ alcohol consumption model in rats. Y-maze test results showed that in utero exposure to alcohol impairs learning and memory capacities. Cyclin-dependent kinase 5 mRNA and protein expressions in the hippocampus of the offspring were significantly elevated, as assa{2.d by quantitative real-time PCR and reverse transcription-PCR, immunofluorescence, and immuno-precipitation. Our experimental findings strongly suggest that altered cydin-dependent kinase 5 may mediate impaired learning and memory in adult rats that were exposed to alcohol by maternal consumption while in utero.

关键词： neural regeneration neurogenesis pregnancy ethanol hippocampus development offspring learning and memory cyclin-dependent kinase 5 grants-supported paper neuroregeneration