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Objective: To explore the feasibility of needling the Belt Vessel (BV) for low back pain. Methods: The relevant literature was systematically reviewed; the relationship between the BV and low back pain was illustrated; the clinical features of BV-related low back pain as well as the key points of acupoint selection in treatment were summarized, and the efficacy of needling the BV for treating low back pain was observed. Results: The BV is closely related to low back pain. The main clinical manifestations of BV-related low back pain include sagging distension in the low back, enlarged abdomen, and pain radiating to the groin. The main acupoints for treating low back pain via needling the BV include Mingmen (GV4), Wushu (GB27) and Ashi points near the transverse process of the third lumbar spine. Needling the BV can swiftly and effectively relieve both the low back pain and associated symptoms. Conclusion: Needling the BV can effectively alleviate the typical BV-related low back pain.
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Objective:To analyze the role of preoperative circulating tumor cell(CTC) and circulating tumor vascular endothelial cells (CTEC) in the diagnosis of gastric cancer and its correlation with the clinicopathological characteristics of gastric cancer.Methods:Sixty-two gastric cancer patients and 11 patients of benign gastric diseases were enrolled. Subtraction enrichment (SE) and immunofluorescence staining-chromosome fluorescence in situ hybridization (i·FISH) were used to integrate the unique SE-i ·FISH technology platform detecting patients′ CTC and CTEC.Results:The number of CTC in the gastric cancer group was significantly higher than that in the control group ( t=2.693, P=0.009); the number of CTEC in the gastric cancer group was higher than the control group ( t=2.015, P=0.048). With the cut-off value being set at 9 cells/6 ml in blood, the sensitivity of CTC in the diagnosis of gastric cancer is 84%, and the specificity is 82% (AUC=0.876, 95% CI, 0.792-0.963, P<0.01); When set at 6 cells/6 ml, the sensitivity of CTEC in the diagnosis of gastric cancer is 50%, and the specificity is 100%(AUC=0.727, 95% CI, 0.603-0.851, P=0.02). CTC positive is closely related to tumor location(χ 2=4.292, P=0.038 ) and TNM stage(CTC≥10, χ 2=4.848, P=0.028; CTC≥11, χ 2=6.234, P=0.013). CTEC positive is closely related to serum CA19-9(χ 2=4.858, P=0.028) and serum CA724 (χ 2=4.108, P=0.043 ) . Conclusion:SE-i·FISH technology has high sensitivity and specificity in the detection of CTC and CTEC of gastric cancer.
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Objective:To analyze the epidemiological characteristics of breakthrough varicella cases with different doses of varicella vaccine immunization history in Beijing Tongzhou from 2013 to 2017.Methods:Data about varicella incidence and immunization history were obtained through spot investigation and consulting the information systems of Chinese Disease Control and Prevention and Beijing′s Immunization Programme. Descriptive epidemiological method was used for statistical analysis.Results:From 2013 to 2017, Tongzhou District reported 2 102 cases of varicella in primary and middle schools and kindergartens, which included 989 cases of primary varicella, 966 breakthrough varicella cases with one-dose vaccine immunization history, and 147 breakthrough varicella cases with two-dose vaccine immunization history. There were significant differences in gender, age, and occupation among the three groups. Among the primary cases, the incidence of fever and moderate and severe rash was 46.71% and 34.68%; among the breakthrough cases with one-dose immunization history, the incidence of fever and moderate and severe rash was 41.20% and 17.39%; among the breakthrough cases with two-dose immunization history, the incidence of fever and moderate and severe rash was 26.53% and 7.48%. There were significant differences in the incidence of fever and rash among the three groups. The median number of varicella morbidity interval was 5.11 years in one-dose immunization history group and 2.44 years in two-dose immunization history group, and the difference between them was statistically significant.Conclusions:The symptoms of fever and rash in breakthrough varicella cases become less atypical as the dose of vaccination increases. Because the clinical symptoms are relatively mild, breakthrough cases as a source of infection in collective units are more likely to be neglected.
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Objective:To investigate the effect of early acupuncture treatment on limb function in patients with acute cerebral infarction (ACI).Methods:A total of 114 patients with first-episode ACI in our hospital from March 2018 to March 2019 were selected and randomly divided into three groups, 38 cases in each group. The control group was treated with conventional western medicine therapy, while the experimental group A and group B were given acupuncture treatment on the basis of the control group. The group A started treatment at 3rd days and the group B started at 10th day after admission. All three groups were treated for 2 weeks. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit. The Fugl Meyer assessment of motor function (FAM) was used to evaluate the motor function. The Barthel Index (BI) was used to evaluate the activities of daily living, and the rehabilitation status was evaluated according to muscle strength grading. The levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were detected by ELISA to evaluate the clinical efficacy.Results:The total effective rate was 94.7% (36/38) in group A, 84.2% (30/38) in group B and 73.7% (22/38) in control group. The difference was statistically significant ( χ2=14.748, P<0.01). After treatment, NIHSS scores of three groups were significantly decreased ( F=97.619, P<0.01), and the scores of FAM, BI and muscle strength in group A were significantly lower than those in the group B ( t=12.580, P<0.01); FAM, BI scores and muscle strength of three groups were significantly increased ( F=134.525, 35.100, 164.160, all Ps<0.001), and those of group A were significantly higher than those in group B ( t=8.634, 7.260, 20.305, all Ps<0.001). After treatment, serum NGF (148.80 ± 22.17 pg/ml, 132.14 ± 20.40 pg/ml vs. 125.82 ± 18.31 pg/ml, F=12.926), BDNF (5.01 ± 1.14 ng/ml, 4.10 ± 1.09 ng/ml vs. 3.92 ± 0.95 ng/ml, F=11.481) in the group A and group B were significantly higher than those in the control group ( P<0.01), and serum NGF, BDNF in group A were significantly lower than those in the group B ( t=5.046, 5.277, all Ps<0.01). Conclusions:Early acupuncture treatment can increase the levels of serum NGF and BDNF, promote the recovery of nerve factors and limb function, and the curative effect of acupuncture treatment starting at 3rd days after admission is better than 10th day.
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Objective:To evaluate the diagnostic value of Essen stroke risk score(ESRS) combined with neutrophil lymphocyte ratio(NLR) in coronary heart disease(CHD).Methods:From July 1, 2015 to June 30, 2019, patients who were hospitalized in the Second Affiliated Hospital of Anhui Medical University for suspected CHD and underwent coronary angiography were selected as the study objects.According to the results of coronary angiography, these patients were divided into CHD group (stenosis rate ≥ 50%) and control group(stenosis rate<50%). The clinical, laboratory and angiographic data of the two groups were collected, including NLR, ESRS and coronary narrow degree integral(Gensini integral method). Logistic regression model and receiver operator characteristic(ROC) were used to evaluate the diagnostic value of ESRS combined with NLR in CHD.Results:During the study period, 325 patients were enrolled, including 219 CHD patients and 106 controls.The age, hypertension, diabetes mellitus, peripheral artery disease, ESRS, NLR and fasting blood glucose levels in the CHD group were significantly higher than those in the control group(all P<0.05). Spearman correlation analysis showed that ESRS( r=0.515, P<0.001) and NLR( r=0.250, P<0.001) were positively correlated with coronary Gensini score.Two logistic regression models were established, where model 1 was logit(P1)=-2.072+ 0.566×ESRS+ 0.299×NLR+ 0.173×fasting blood glucose(the diagnostic accuracy rate was 71.7%) and model 2 was logit(P2)=-1.169+ 0.594×ESRS+ 0.302×NLR(the diagnostic accuracy rate was 70.8%). There was no significant difference in the diagnostic accuracy between the two models( P=0.499). Finally, logistic regression model 2 was selected as the joint diagnostic model.The area under curve of ESRS, NLR and logistic regression model 2 was 0.713, 0.634 and 0.736, respectively, and the difference was statistically significant(all P<0.05). The diagnostic threshold of ESRS was 2, and the diagnostic threshold of NLR was 2.74.The 95% CI of the joint diagnostic model 2 was (0.684, 0.783), which showed a sensitivity of 60.27% and a specificity of 78.30%.This model was superior to the diagnostic efficacy of ESRS( P=0.047) and NLR( P<0.001). Conclusion:The joint diagnostic model of ESRS combined with NLR is superior to the single index in the diagnosis of CHD, which may thus be used to predict the occurrence of CHD.
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OBJECTIVE: To investigate the current status of occupational stress and quality of life( QOL) in medical staffs of Shenzhen City. METHODS: A total of 992 medical stuffs from 4 hospitals of Shenzhen City were selected as study subjects by using the stratified random sampling method. The Occupational Stress Inventory Revised Edition and SF-36 Questionnaire were used to investigate the occupational stress and QOL. RESULTS: The rate of high occupational strain in medical staffs of Shenzhen is 48. 8%. According to the results of multivariate stepwise regression analysis,the influencing factors for physical component summary of QOL were profession,education,occupational strain,personal coping resource,length of service and work hours( P < 0. 05). The influencing factors of mental component summary of QOL were age,occupational strain,personal coping resource,length of service,work hours and gender( P < 0. 05). CONCLUSION: Occupational stress is a factor influencing the physical and mental health of medical staffs in Shenzhen City. High occupational stress and lack of coping resources can reduce the QOL.
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Objective@#To investigate the current status of occupational stress in medical staff in Shenzhen, China, and to provide a reference for developing health administrative policy and reducing occupational stress in medical staff.@*Methods@#From January to June, 2018, a cross-sectional survey was performed in 992 medical workers who were selected from 2 municipal hospitals and 2 district hospitals by stratified random sampling. General information was collected, Occupational Stress Inventory-Revised Edition was used to investigate occupational stress, and univariate and multivariate analyses were performed based on a descriptive analysis of related results.@*Results@#For the medical staff in Shenzhen, the scores of Occupational Role Questionnaire, Personal Stress Questionnaire, and Personal Resources Questionnaire were 185.67±17.55, 108.45±15.56, and 122.74±16.56, respectively. Age, degree of education, type of work, job title, professional title, and permanent or temporary job were influencing factors for occupational task (P<0.05) ; age, working years, type of work, and night shift were influencing factors for personal stress response (P<0.05) ; working years, type of work, professional title, and weekly working hours were influencing factors for personal coping resources (P<0.05) .@*Conclusion@#There is a high degree of occupational stress among medical staff in Shenzhen, and it is recommended to improve medical resources in Shenzhen, reduce occupational stress among medical staff, and increase coping resources.
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Objective To understand the intention of pediatricians turnover in Shenzhen and its influencing factors.Methods From September to December 2016,a multi-stage stratified cluster sampling method was used to select 948 pediatricians from Shenzhen to conduct a questionnaire survey.The questionnaire cover the following:1.Basic information:general demographic characteristics (gender,age,marriage,education,etc.);2.Work status survey:turnover intention,experiences with violence against medical workers,professional job satisfaction,and work stress,etc.Univariate analysis and multivariate analysis were used to identify factors for pediatrician's turnover intention.Results Among the 948 pediatricians in Shenzhen,62.5% had turnover intention;age,title,education,seniority,monthly income,medical institution nature,medical institution level,length of sleep,job satisfaction,work stress,experience with violence and family support all affect the pediatrician's turnover intention (P < 0.05);multivariate logistic regression analysis showed that age,education,monthly income,job satisfaction,work stress and experience with violence were the influencing factors of pediatrician's turnover intention (P < 0.05).Conclusions The pediatrician's turnover intention in Shenzhen is not low.Relevant measures should be taken by the government,hospital administrators,children patients and their family to ensure the supply of children's medical services.
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Objective@#To understand the intention of pediatricians turnover in Shenzhen and its influencing factors.@*Methods@#From September to December 2016, a multi-stage stratified cluster sampling method was used to select 948 pediatricians from Shenzhen to conduct a questionnaire survey. The questionnaire cover the following: 1. Basic information: general demographic characteristics(gender, age, marriage, education, etc.); 2. Work status survey: turnover intention, experiences with violence against medical workers, professional job satisfaction, and work stress, etc. Univariate analysis and multivariate analysis were used to identify factors for pediatrician′s turnover intention.@*Results@#Among the 948 pediatricians in Shenzhen, 62.5% had turnover intention; age, title, education, seniority, monthly income, medical institution nature, medical institution level, length of sleep, job satisfaction, work stress, experience with violence and family support all affect the pediatrician′s turnover intention(P<0.05); multivariate logistic regression analysis showed that age, education, monthly income, job satisfaction, work stress and experience with violence were the influencing factors of pediatrician′s turnover intention(P<0.05).@*Conclusions@#The pediatrician′s turnover intention in Shenzhen is not low. Relevant measures should be taken by the government, hospital administrators, children patients and their family to ensure the supply of children′s medical services.
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Objective To observe the therapeutic effect of central venous catheter drainage and intrapleural injection of urokinase on tuberculous pleurisy patients.Methods 60 hospitalized patients with tuberculous pleurisy were selected,and they were divided into two groupsby simple random grouping method.Both two groups received 3HRZE/6HR anti-tuberculosis treatment.30 patients in the observation group were treated with central venous catheter drainage and intrapleural injection of urokinase.30 patients in the control group were treated with conventional pleurocentesis.The duration of pleural effussion drainage,incidence of pleural thickening,hospitalization time and expense,and the adverse reaction rate were observed during treatment.Results In the observation group,the curative effect at 1 week was 46.7%,the duration of pleural effussion drainage was (20.5 ± 6.7)days,the incidence rate of pleural thickening was 26.7%,the hospitalization time was (9.4 ± 2.7) days,the hospitalization expense was (6 675.4 ± 1 818.4) RMB,the incidence rate of adverse reaction was 3.3%.In the control group,the curative effect at 1 week was 20.0%,the duration of pleural effussion drainage was (25.1 ± 7.7) days,the incidence rate of pleural thickening was 46.7%,the hospitalization time was (10.3 ± 2.8)days,the hospitalization expense was (7 508.9 ± 1 692.1) RMB,the incidence rate of adverse reaction was 20..0%.There were statistically significant differences between the two groups in the curative effect at 1 week (x2 =4.800,P =0.028),duration of pleural effussion drainage (t =2.484,P =0.016),incidence of pleural thickening (t =4.444,P =0.035) and incidence rate of adverse reaction (x2 =4.043,P =0.044).No statistically significant differences were observed between the two groups in hospitalization time(t =1.270,P =0.209) and expense (t =1.838,P =0.071).Conclusion In comparison to conventional pleurocentesis,the treatment of central venous catheter drainage and intrapleural injection of urokinase for tuberculous pleurisy is markedly efective,it is safe and Worthy of popularizing in clinical application.
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OBJECTIVE: To investigate the effects of rosuvastatin combined with tirofiban on serum inflammatory factors and renal function in acute coronary syndrome patients with diabetes after percutaneous coronary intervention (PCI).METHODS: A total of 120 acute coronary syndrome patients with diabetes receiving PCI selected from cardiology department of our hospital during Apr. 2014-Mar. 2015 were divided into control group and observation group according to random number table, with 60 cases in each group. Except for routine treatment, control group was given Rosuvastatin calcium tablets orally after surgery (10 mg each day, for consecutive 7 d); observation group was given Rosuvastatin calcium tablets orally before and after surgery (20 mg before surgery; 10 mg each day after surgery, for consecutive 7 d), and then given Tirohydrochloric acid sodium chloride injection during surgery [10 μg/kg intravenously, 0. 15 μg/(kg· min) with intravenous pump for 36 h]. Clinical efficacies of 2 groups were compared. The changes of serum inflammatory factors (TNF-α, IL-6, IL-10) and renal function indexes (Scr, CysC, eGFR), the incidence of radiographic contrast nephropathy were compared before surgery and 24, 72 h after surgery. The occurrence of cardiovascular events was followed up for one year. RESULTS: There were no statistical significance in baseline information between 2 groups before treatment (P>0. 05). The number of complete remission case and total response rate in observation group were increased significantly higher than control group (P<0. 05), while number of invalid cases was significantly lower than control group (P<0. 05). Compared with before surgery, the levels of serum inflammation factor in 2 groups were decreased significantly 24, 72 h after surgery, while the levels of Scr and CysC were increased significantly in control group 24, 72 h after surgery and in observation group 24 h after surgery; the level of eGFR was decreased significantly, while the level of CysC was increased significantly in observation group 72 h after surgery, with statistical significance (P<0. 05). The improvement of serum inflammation factors and renal function indexes in observation group were more significant than control group (P<0. 05); the incidence of radiographic contrast nephropathy was significantly lower than control group (P<0. 05). The incidence of 1-year angina pectoris and total incidence of cardiovascular events were significantly lower than control group (P< 0. 05). CONCLUSIONS: Rosuvastatin combined with tirofiban can promote the recovery of renal function in acute coronary syndrome patients with diabetes after PCI, reduce the levels of serum inflammatory factors and decrease the incidence of radiographic contrast nephropathy and post-treatment cardiac events. Its effects are different from rosuvastatin alone.
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Objective To investigate the effect of doxycycline on the proliferation of human small cell lung cancer H446 cells in vitro and its possible mechanisms. Methods H446 cells were treated with different concentrations of doxycycline for 24,48,72 or 96 h. Cell proliferation was measured by CCK-8 assay,IC50 was caculated by Bliss,and cell apoptosis was examined by TUNEL assay. The protein and mRNA expression of Bcl-2 and Bax in H446 cells were detected by Western blot and real time-PCR,respectively. Re-sults Doxycycline inhibited the proliferation of H446 cells in a concentration-time dependent manner. The half inhibitory concentra-tions(IC50)of doxycycline on cell proliferation in H446 cells were approximately 24.10 mg/L for 24 h treatment group,10.98 mg/L for 48 h treatment group,8.20 mg/L for 72 h treatment group and 8.03 mg/L for 96 h treatment group,respectively. Furthermore,doxycy-cline treatment could also induce the apoptosis of H446 cells in a concentration-dependent manner. Moreover,doxycycline treatment dramatically down-regulated the expression of Bcl-2 and up-regulated the expression of Bax in H446 cells both at the protein and at the mRNA levels. The differences were statistically significant(P<0.05). Conclusion Doxycycline can inhibit the proliferation of H446 cells by inducing apoptosis via down-regulating the expression of Bcl-2 and up-regulating the expression of Bax. Doxycycline has great potential as a chemotherapeutic agent for human small cell lung cancer.
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To study the biological characteristics and mutations of influenza A(H1N1)pdm09 virus isolated from one case of pneumonia of unknown etiology (PUE),which would provide references for clinical treatment and disease control,the throat swab specimen from the PUE case was isolated in the Madin-Darby Canine Kidney (MDCK) cells,and then the antigenicity,pathogenicity and drug resistance of influenza A (H1N1) pdm09 virus were analyzed after sequencing.As a result,one influenza virus strain was isolated from the specimen and named as A/FujianGulou/SWL64/2016(H1N1).The similarities of nucleotide sequences and amino acids sequences compared with the vaccine strain A/California/07/2009 (H1N1) were 96.9%-98.9% and 96.7%-99.5%,respectively.Eighteen amino acids had mutated in the HA and 4 mutations,K163Q,S185T,S203T and D222N,were involved in 3 different epitopes,which indicated that the antigenic drift had occurred in the influenza virus.The D222N mutation associated with receptor binding site made the virus infect lower respiratory tract more easily.The virus was still amantadine-resistance and oseltamivir-sensitive.In conclusion,the influenza A (H1N1) pdm09 virus in this study have occurred antigenic drift and has the molecular characterization of causing severe pneumonia,so further surveillance should be performed to prevent and control the influenza epidemic.
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Objective To analyze the distribution of common drug-resistance genotypes of multi-drug resistant bacteria (MDRB) in second class and below hospitals in 3 big areas of Chongqing City for perfecting the bacterial drug resistance surveillance network in local area.Methods In 7206 detected strains of MDRB, the re-cultured pure colonies of top five bacteria in the bacterial strains numer were taken and performed the common drug resistant genotyping detection and comparative analysis by PCR technique and sequencing.Results Acinetobacter spp.was dominated by the genotypes carrying TEM,SUL and GyrA genes,Klebsiella pneumoniae was dominated by the genotypes carrying SHV,GyrA genes,Escherichia coli was dominated by the genotypes carrying TEM,CTX-M,SUL,GyrA,aac (3) Ⅱ genes,Pseudomonas aeruginosa was dominated by genotypes carrying SUL,GyrA genes,Staphylococcus was dominated by genotypes carrying GyrA,aac (6 ′)-aph ′′ genes;among the five strains of MDRB,the majority were the strains with multiple expression of two kinds or four kinds of common drug-resistance genes,in which the detection rate of Escherichia coli multiple expression was highest,reaching 92.74%,the detection rate of Staphylococcus multiple expression was lower.The detection rates of common drug resistant genotypes carried by MDRB had statistical difference among various areas and various years (P<0.05);in the comparison with the gene sequences of corresponding bacteria in NCBI Blastn database,the sequencing results of 7 common drug resistant genotypes carried by 5 kinds of MDRB were basically consistent.Conclusion The common drug-resistant genotypes carried by MDRB detected in the second class and below hospitals of Chongqing City and their distribution are basically consistent with the monitoring levels in the local tertiary hospitals and whole nation.Therefore the antibacterial surveillance of infection pathogenic bacteria should be strengthened in these hospitals,and medication should be rationally used so as to delay the development of pathogenic bacterial drug resistance in local area.
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Objective To study the effect of temporary in vitro preservation of parathyroid on the activity of cells in the process of parathyroid auto-transplantation and function of postoperative in order to improve the survival rate of transplantation.Methods (1)Experimental rabbits for the study were randomly divided into three groups:group A,group B,group C,with 8 rabbits in each group.Then we remove the bilateral inferior parathyroid,in group A,the parathyroid glands were immediately formaldehyde-fixed;in group B and group C,the parathyroid glands were placed in normal saline in 4 ℃ and in room temperature (22-24 ℃) for 30 minutes respectively and then fixed;HE staining was performed on the left parathyroid glands to observe the morphology of the cells;Electron microscopic examination of the right parathyroid glands were performed to observe the ultrastructural changes of the cells.(2)Experimental rabbits were randomly divided into three groups:group D group E and group F,with 8 rabbits in each group,after total thyroidectomy,the double inferior parathyroid glands were took out,in group D,the parathyroid glands were immediately transplanted in bilateral anterior cervical muscles;in group E and group F,the parathyroid glands were placed in normal saline 4 ℃ and in room temperature (22-24 ℃) for 30 minutes respectively and then transplanted.All animals were monitored of serum calcium and PTH on preoperative 1 d and postoperative 1 d,3 d,5 d,7 d;the parathyroid was took out for HE staining to observed survival of parathyroid tissue and pathology damage when 7d after operation.Results (1) The normal parathyroid gland is mainly dominated by the chief cells,the nucleus of the chief cell was round and centered under electron microscope;there were no significant change in the morphology of parathyroid cells,and the mitoehondria of the cells were slightly swollen under 4 ℃;but the parathyroid gland cells were slightly swollen and partially vacuole degeneration,the morphology of the nucleus was irregular,and the mitochondria were extremely swollen and deformed,and the ridge was broken under room temperature.(2)three groups of rabbits after transplantation of parathyroid,serum calcium and PTH decreased significantly,and increased gradually,there was significant difference on the 7th day after the operaion between the two groups (P<0.05);(3)in group D,the normal parathyroid cells densely distributed in the anterior cervical muscle tissue;in group E,A large number of parathyroid cells survived in muscle tissue,with some vacuolated;in group F,only part of healthy parathyroid ceils scattered in the muscle.Conclusion Parathyroid should be preserved in 4 ℃ normal saline during the operation,and the transplant should be completed in 30 minutes as far as possible.
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Objective To explore the effects of fish oil lipid emulsion on risk of infection in patients with Crohn's disease (CD) after enterectomy.Methods The prospective study was conducted.The clinical data of 70 patients with CD who planned to receive enterectomy in the Nanfang Hospital of South Medical University between June 2015 and May 2017 were collected.All the patients were allocated into the fish oil group and control group by random number table method,and then underwent enterectomy by the same doctors' team.Patients in the fish oil group received daily intravenous infusion of 100ml 10% fish oil lipid emulsion from day 1 to 5 postoperatively or longer) based on conventional treatment [combined other parenteral nutrition (PN) were selected according to patients' conditions];patients in the control group received conventional treatment (intravenous infusion of PN were selected according to patients' conditions).Observation indicators:(1) postoperative infection situations between groups;(2) risk of postoperative infection and nutrition-related indexes between groups;(3) comparison of duration of postoperative hospital stay between groups.Measurement data with normal distribution were represented as-x ±s.The comparisons between groups were evaluated with the independent-sample t test and repeated measures data were analyzed by the repeated measures ANOVA.The comparisons of count data were analyzed using the chi-square test or Fisher exact probability.Odds ratio and 95% confidence interval (CI) for incidence of complications were calculated.Results Sixty-five patients were screened for eligibility,including 33 in the fish oil group and 32 in the control group.(1) Postoperative infection situations between groups:18 patients in the 2 groups were complicated with postoperative infection.Abdominal infection,wound infection,anastomotic fistula,pulmonary infection and wound infection combined with intestinal fistula were detected in 7,4,4,2 and 1 patients,respectively.Incidence of postoperative infection in the fish oil group and control group were respectively 15.2%(5/33) and 40.6%(13/32),with a statistically significant difference between groups (x2 =5.265,OR=0.261,95%CI:0.080-0.853,P<0.05).(2) Risk of postoperative infection and nutrition-related indexes between groups:numbers of white blood cell (WBC) and centriole cell and level of hemoglobin (Hb) from day 1 to 5 post-operatively were respectively from (12.7±2.5) × 109/L,(10.7±2.2)×109/L,(103±17) g/L to (9.8±4.1) ×109/L,(7.5±4.1)×109/L,(101±13)g,/L in the fish oil group and from (12.3±2.5) × 109/L,(10.1±2.3) ×109/L,(106±16) g/L to (11.8±5.1) ×109/L,(9.6±5.1)× 109/L,(100±14) g/L in the control group,showing no statistically significant difference in changing trend of above indexes between groups (F =1.316,0.930,0.181,P>0.05).The levels of procalcitonin,C-reactive protein and albumin (Alb) from day 1 to 5 postoperatively were respectively from (1.92± 1.41) ng/mL,(30± 10) mg/L,(30.0±4.1) g/L to (1.00±0.96) ng/mL,(30±27)mg/L,(34.1±4.3)g/L in the fish oil group and from (2.15±1.16)ng/mL,(26±7)mg/L,(31.1±3.9) g/L to (2.02± 1.86) ng/mL,(58± 56) mg/L,(28.5± 2.6) g/L in the control group,showing statistically significant differences in changing trend of above indexes between groups (F=5.053,6.056,6.709,P>0.05).(3) Comparison of duration of postoperative hospital stay between groups:duration of postoperative hospital stay in the fish oil group and control group were respectively (9±4)days and (12±6) days,with an average shortened time of 3 days,showing a statistically significant difference between groups (t =-2.443,P < 0.05).Conclusion Intravenous infusion of fish oil lipid emulsion could reduce risk of postoperative infection in patients with CD after enterectomy,and also improve postoperatively patients' nutritional status and shorten duration of hospital stay.
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Objective To evaluate and analyze the CT imaging of preoperative SOX regimen neoadjuvant chemotherapy in the treatment of advanced gastric cancer.Methods A total of 33 patients with advanced gastric cancer treated in our hospital from January 2010 to February 2015 were enrolled for the study and given tegafur gimeracil oteracil potassium capsule plus oxaliplatin for injection as preoperative adjuvant chemotherapy.And all the patients were given surgery after 3 cycles of SOX regimen chemotherapy, and surgical resection of the tumor was taken as the final pathology gold standard.The CT imaging data of the patients before and after the chemotherapy was counted and then analyzed and compared with the pathological data to clarify the value of CT imaging in the evaluation of SOX regimen neoadjuvant chemotherapy for advanced gastric cancer.Results The effective rate was 33.33% and the ineffective rate was 66.67% in the preoperative SOX regimen neoadjuvant chemotherapy for advanced gastric cancer through clear surgical pathology.The correlation between tumor volume reduction and pathological grading was the strongest(r=0.581, P<0.001).By ROC analysis, the best area value(AUC) of the tumor volume reduction rate was 0.834.When the tumor volume reduction rate with 36.94% was taken as the effective threshold for SOX regimen neoadjuvant chemotherapy, the sensitivity and specificity of the evaluation were the best with 74.62% and 83.01% respectively.Conclusion sCT volume measurement can be used as a reliable clinical data to evaluate the efficacy of preoperative SOX regimen neoadjuvant chemotherapy in the treatment of advanced gastric cancer and have certain guiding significance in the late treatment of patients with advanced gastric cancer.
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OBJECTIVE:To compare clinical efficacy of bivalirudin vs. tirofiban combined with heparin in the treatment of acute ST elevation myocardial infarction (STEMI) complicated with diabetes mellitus (DM). METHODS:195 patients diagnosed as STEMI complicated with DM were selected for retrospective study,and divided into bivalirudin group(100 cases)and tirofiban group(95 cases)according to the different treatment plan. All patients received emergency PCI within 12 hours and conventionally took aspirin and clopidogrel before and after PCI. Bivalirudin group was given bivalirudin 0.75 mg/kg intravenously before PCI, and continuous intravenous dripping of 1.75 mg/(kg·h)till the end of operation. Tirofiban group was given heparin 100 U/kg and ti-rofiban 10 μg/kg intravenously before PCI,and continuous intravenous dripping of 0.75 μg/(kg·h)tirofiban for 36 h. Postoperative reperfusion indexes,UCG monitoring indexes and safety were compared between 2 groups,and the content of serum BNP were compared before and after treatment. RESULTS:For the TIMI grade,TIMI frame count,the peak of CK-MB and peak time,ST segment decline percentage immediately after PCI,contents of serum BNP,LVEF,LVESD,LVEDD 7,30 d after treatment,the differences were not statistically significant between 2 groups (P>0.05). The incidence of MACE events was 36.8% in tirofiban group and 41.0% in bivalirudin group,there was no statistical significance between 2 groups(P>0.05). The incidence of bleeding events was 24.2% in tirofiban group and 7.0% in bivalirudin group,the difference was statistically significant (P<0.05). CON-CLUSIONS:Bivalirudin and tirofiban combining with heparin have same efficacy in the treatment of STEMI complicated with DM,while bivalirudin may significantly reduce the incidence of bleeding events during primary PCI.
الملخص
OBJECTIVE:To study the percutaneous permeability of Hydrocortisone cream with different substrates in diabetic model rats. METHODS:The Hydrocortisone O/W(oil/water)cream,water-soluble cream and oil-soluble cream were respectively prepared. Wistar rats were randomly divided into normal control group and model group. Model group was given streptozotocin(40 mg/kg)to reproduce diabetic model. Franz diffusion cell percutaneous test and HPLC were used to detect the percutaneous permea-bility rates of Hydrocortisone O/W cream,water-soluble cream and oil-soluble cream in rats of 2 groups. RESULTS:Compared with normal control group,the percutaneous permeability rates of Hydrocortisone O/W cream and water-soluble cream were obvi-ously increased,with significant difference(P0.05). CONCLUSIONS:Hydrocortisone O/W cream and water-soluble cream are easier to go through the skin of diabetic model rats,and Hydrocortisone oil-soluble cream is hard.
الملخص
Objective To study the impact of narrow band ultraviolet B (NB-UVB) irradiation on the expression of T helper 17 (Thl7) and CD4,CD25 and regulatory T (Treg) cells and their related cytokines transfor-ming growth factor beta 1 (TGF-β1) and interleukin-6 (IL-6) to further clarify how NB-UVB treatment helps patients with psoriasis vulgaris.Methods Ninety patients with active stage and stationary stage psoriasis vulgaris (45 cases each) were treated with NB-UVB for 8 weeks.Fifty healthy persons were used as normal controls.Peripheral blood levels of Th17 and Treg were measured by flow cytometry.An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of TGF-β1 and IL-6 before and after treatment.Clinical efficacy was evaluated in terms of the area of psoriasis and severity index (PASI) scores.Restlts Before treatment,the patients showed significantly higher levels of Thl7 cells in their peripheral blood than the controls.Their ratios of Th17 to Treg cells and their serum levels of IL-6 were also significantly higher.The percentage of Treg cells and the serum level of TGF-β1 were significantly lower in the patients.After the NB-UVB treatment,the Th17 cells,the ratio of Th17 to Treg cells and IL-6 had all decreased significantly.The percentage of Treg cells and TGF-β1 levels were significantly high-er compared with before phototherapy.The total effectiveness rate was 86.7%,and the average PASI scores had de-creased significantly.The PASI scores were positively correlated with the percentage of Th17,the Th17 to Treg ratio,and the serum level of IL-6,and negatively correlated with the percentage of Treg cells and TGF-β1.Conclusion The imbalance between Th17 and Treg cells and their cytokines may play an important role in the pathogenesis of pso-riasis.NB-UVB is able to significantly down-regulate the levels of Th17,IL-6 and the progression of Treg levels and TGF-β1 expression.It can regulate the balance between Thl7and Treg cells,which may be one of the mechanisms of NB-UVB treatment for psoriasis.The clinical data demonstrate that NB-UVB treatment is a safe and effective therapy for psoriasis vulgaris.