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Objective To explore the prognostic value of MCF in elderly patients with cardiac amy-loidosis using CMR.Methods A retrospective analysis was conducted on 54 elderly patients with cardiac amyloidosis diagnosed in our hospital.All patients underwent CMR imaging.They were di-vided into a survival group of 25 cases and a mortality group of 29 cases based on clinical out-comes.Correlations of MCF with CMR parameters and biochemical indicators were evaluated.Cox regression analysis was performed to identify independent predictors of patient survival.Survival analysis was used to assess the value of MCF in predicting patient prognosis.Results The surviv-al group had significantly higher MCF than the mortality group[(70.63±24.72)%vs(43.59± 13.36)%,P=0.001].As MCF increasing,LVEF level was in an increasing trend,while LVMI,LVGPWT,ECV,and troponin T and NT-proBNP levels showed a decreasing trend.Multivariate Cox regression analysis revealed that MCF was an independent predictor of patient survival(HR=0.922,95%CI:0.866-0.981,P=0.011).Kaplan-Meier survival curve showed that the patients with MCF>57%had significantly higher survival rates than those with MCF ≤57%(P<0.01).Conclusion MCF is an effective imaging indicator for evaluating the prognosis of elderly patients with cardiac amyloidosis,which can help identify high-risk patients and guide clinical treatment.
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Objective:To analyze the epidemiological and clinical characteristics of hospitalized patients with dengue fever in Guangdong Province in 2019, so as to provide reference for clinical diagnosis and treatment of dengue fever.Methods:The general data, laboratory examination data, clinical manifestations and prognosis data of 480 inpatients with dengue fever admitted to Eight People′s Hospital Affiliated to Guangzhou Medical University between January 4 and October 31, 2019 were analyzed retrospectively. The clinical and onset characteristics of patients with dengue fever were described.Results:Among 480 dengue patients, 442(92.1%) were dengue fever, 38(7.9%) were severe dengue, and 136(28.3%) had underlying diseases. The peak age of onset was mainly in young adults aged 20 to 49 years old, accounting for 66.0%(317/480) in total. The seasonal peak was mainly in August to October. There were 399(83.1%) local cases and 61(12.7%) imported cases. The most common clinical manifestations were fever (98.1%, 471/480), chills (72.9%, 350/480), headache (58.5%, 281/480) and bone/joint/muscle pain (67.1%, 322/480), followed by digestive tract symptoms and respiratory tract symptoms. Among 446 serum samples, 358 (80.3%) were dengue virus (DENV)-1, 54 (12.1%) were DENV-2, 34 (7.6%) were DENV-3. The main laboratory tests of the patients were leucopenia (65.8%, 316/480), low hematocrit (30.2%, 145/480), thrombocytopenia (48.3%, 232/480), neutropenia (44.8%, 215/480), elevated alanine aminotransferase (ALT) (37.7%, 181/480) and aspartate aminotransferase (AST) (59.4%, 285/480). Treatment mainly adopted symptomatic support treatment and active prevention of complications. The length of stay was (5.8±3.1) days (range 1.0-38.0 days). A total of 461(96.0%) patients were cured or improved.Conclusions:In 2019, the majority of dengue fever patients in Guangdong Province are young adults aged 20 to 49 years old, and the proportion of severe patients is high, with DENV-1 infection as the main type. After symptomatic support treatment and active prevention of complications, most of the dengue fever patients have a good prognosis.
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Objective:To compare the clinical efficacy of drug coated balloon (DCB) vs. plain old balloon (POB) on in-stent restenosis (ISR) of femoropopliteal artery occlusive disease of the lower limb. Methods:The clinical data of 91 ISR patients admitted at Shanxi Bethune Hospital from Jul 2016 to Dec 2017 were retrospectively analyzed. The primary patency rates were compared.Results:There were 43 patients treated with drug coated balloons and 48 patients treated with plain old balloons. The surgical procedure was successful in all cases, and the symptoms of lower limb ischemia were significantly improved after surgical procedure. The primary patency rate of patients who were treated by drug coated balloons was significantly higher than by plain old balloons at 12 months after surgery (83.7% vs. 62.5%, P<0.05). Conclusion:The use of drug coated balloons could acquire more satisfactory short-term clinical efficacy for ISR patients of femoropopliteal artery occlusive disease.
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Due to low autoimmune function, imperfect development of various organs, coupled with a variety of invasive operations and other factors, premature infants are high-risk groups of invasive fungal infection.Invasive candida infection in premature infants accounts for more than 80% of invasive fungal infection. The main infection rate of invasive candida albicans was candida albicans. However, in recent years, the infection rate of non-candida albicans such as candida albicans, tropical candida, smooth candida and other non-candida albicans showed a gradual upward trend.In addition to blood culture, the latest diagnostic methods such as plasma (1-3)-β-D-glucan test and candida polymerase chain reaction are helpful for the diagnosis of invasive fungal infection. At the same time, attention should also be paid to prophylactic antifungal therapy and empirical antifungal therapy in premature infants.
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Objective:To analyze the clinical characteristics of patients with different types of coronavirus disease 2019 (COVID-19).Methods:A total of 272 eligible COVID-19 patients who were admitted to Guangzhou Eighth People′s Hospital, Guangzhou Medical University from January 22 to February 15, 2020 were retrospectively enrolled. General characteristics, the first laboratory examination and imaging data of these patients were collected. According to the clinical classification, there were 236 cases in non-severe group (mild+ common type) and 36 cases in severe group (severe+ critical type). Comparisons between groups were performed by t test, chi-square test or rank-sum test when appropriate. Results:There were 23 males and 13 females in the severe group, 103 males and 133 females in the non-severe group, and the difference was statistically significant ( χ2=5.149, P=0.023). The age of severe group was (60.5±11.2) years, which was higher than that of non-severe group (46.8±15.7) years. The difference was statistically significant ( t=6.43, P<0.01). The lymphocyte (LYM) count, platelet (PLT) count and arterial partial pressure of oxygen (PaO 2) in the severe group were 0.90(0.55, 1.10)×10 9/L, 170.00(143.50, 198.00)×10 9/L and 73.50(69.70, 83.00) mmHg(1 mmHg=0.133 kPa), respectively, which were all lower than those in the non-severe group (1.42(1.09, 1.95)×10 9/L, 187.00(148.00, 230.00)×10 9/L and 96.00(83.20, 108.00) mmHg, respectively). The differences were all statistically significant ( Z=5.59, 2.00 and 5.00, respectively, all P<0.05). The levels of creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), C reaction protein (CRP) and procalcitonin (PCT) in the severe group were 123.00(79.00, 212.00) U/L, 32.10(27.00, 47.40) U/L, 305.50(216.00, 396.00) U/L, 37.02(23.92, 63.66) mg/L and 0.09(0.05, 0.19) μg/L, respectively, which were all higher than those in the non-severe group (68.00(48.00, 103.00) U/L, 20.10(16.70, 26.20) U/L, 179.00(150.00, 222.00) U/L, 26.55(18.11, 36.96) mg/L and 0.04(0.03, 0.06) μg/L respectively), and the differences were all statistically significant ( Z=3.89, 5.60, 5.12, 2.85 and 5.43, respectively, all P<0.01). No significant differences were observed in white blood cell count, creatine kinase isoenzyme and blood lactate between the two groups ( Z=1.53, 0.41 and 1.00, respectively, all P>0.05). Conclusion:Gender, age, LYM count, PLT count, PaO 2, CK, AST, LDH, CRP and PCT could be used to provide reference for clinical classification of COVID-19 patients.
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Objective To investigate the single nucleotide polymorphism at G-395A site of the Klotho (KL) gene and to analyze its correlation with the coronary heart disease(CHD) and serum Cystatin C(Cys C) level in the elderly Chinese Han population in central China.Methods A case-control study was conducted in 278 elderly Chinese Han population in this department,who were divided into CHD group(138 cases)and control group(140 cases) according to bear angiography coronary or not.G-395A polymorphism of KL gene was determined by TaqMan Gene probe method,and the relationship between G-395A polymorphism and coronary heart disease and serum Cys-C level was analyzed.Results Compared with the control group,the frequency of GG genotype of G-395A in CHD group was significantly higher,and the frequency of AA genotype and AG genotype was not statistically significant.The levels of Cys-C in the GG genotype were higher than those in the AA and AG genotypes both in the control group and coronary heart disease group.Conclusion In the elderly Han population in central China,the risk of suffering coronary heart disease is higher among the GG genotype of the G-395A locus of the KL gene.KL gene G-395A site gene mutation may affect the development of atherosclerosis by affecting blood Cys-C levels.
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Objective To compare the reliability and validity of 2 incontinence- associated dermatitis (IAD) risk assessment tools (IAD risk assessment scale and PAT) in patients with incontinence, and to search for the best risk assessment tool. Methods A total of 101 IAD cases were chosen from the Affiliated Hospital of Nantong University.Reliability was evaluated by the inter- rater reliability,internal consistency,item sensitivity analysis and retest reliability; validity was evaluated by the structure validity and predictive validity. Results Cronbach α was 0.313 (IAD risk assessment scale) and 0.421(PAT);Cronbach α coefficient was the highest after the items that Change sheets and mats and relevant factors were removed respectively in two tools,which were 0.431, 0.428; The correlation between the total scores were 0.711 (P<0.01)(IAD risk assessment scale)and 0.498 (PAT)(P<0.01);Area under curve were 0.661 (IAD risk assessment scale),0.864 (PAT); the best cut-off value to forecast a poor prognosis was 53.5 (IAD risk assessment scale),6.5 (PAT). Conclusions The reliability and validity of IAD risk assessment scale and PAT are low. The change of sheets and mats and Related influencing factors are needed to be adjusted and revised.
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Objective To investigate the clinical characteristics of chronic invasive fungal rhinosinusitis.Methods Clinical features and outcomes of 46 proven cases of chronic invasive fungal rhinosinusitis admitted in Huashan Hospital,Fudan University from January 2009 to December 2016 were retrospectively reviewed.Results Of the 46 patients enrolled,left sphenoid sinus,ethmoid sinus and maxillary sinus were affected in 24,23 and 20 cases,respectively,while right maxillary sinus,ethmoid sinus and sphenoid sinus were affected in 18,16 and 15 eases,respectively.Left and right frontal sinus were affected in 9 and 6 cases,respectively.The central nervous system and orbit were the most commonly affected sites in external nasal involvements,noted in 22 cases respectively.Left sphenoid (17 cases) and ethmoid sinus (15 cases) involvements were most common in central nervous system affected patients.Left sphenoid (14 cases) and ethmoid sinus (13 cases) involvements were most common in orbit affected patients.Aspergillus species were the primary pathogens observed in 42 eases.Zygomycete,candida and dark filamentous fungus were observed in two,one and one case,respectively.Pathologically,37 of the cases were chronic nongranulomatous type and the left 9 were chronic granulomatous type who were all immunocompetent hosts.The initial symptoms usually included headache,dizziness and nasal discomforts including nasal obstruction and purulent secretion.The chief complaints usually included headache,dizziness,and visual disturbances including blurred vision,vision loss or even blindness.Antifungal treatment combined with surgical interventions for removal or drainage focus lesions achieved significant effect,and 42 patients were cured.Conclusions Chronic invasive fungal rhinosinusitis should be taken into consideration in the presence of nasal discomforts or nonspecific symptoms such as headache and dizziness.The possibility of chronic invasive fungal rhinosinusitis should be cautious after the emergence of vision abnormalities.
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Objective To explore the effect of stoma bag for preventing and treating incontinence-associated dermatitis (IAD) in the patients with fecal incontinence .Methods All randomized controlled trials (RCTs) on the effect of stoma bag for preventing and treating IAD in critical patients with fecal incontinence were collected by retrieving the Chinese and foreign databases such as the Cochrane Library ,Web of Knowledge ,OVID ,Pubmed ,CNKI ,VIP and Wanfang Data .The meta analysis was performed by a-dopting RevMan 5 .3 software .Results A total of 22 RCT involving 1993 patients were included .The analysis results showed that the application simple stoma bag nursing in the patients with fecal incontinence was conducive to reduce the incidence rate of IAD [OR=0 .06 ,95% CI(0 .02-0 .13) ,P<0 .01] ,stoma bag combined with vacuum aspiration could reduce the incidence rate of IAD [OR=0 .09 ,95% CI(0 .04-0 .21) ,P<0 .01] ,stoma bag combined with skin protective agent could decrease the incidence rate of IAD [OR=0 .08 ,95% CI(0 .03-0 .22) ,P<0 .01] ,stoma bag simple application could improve the cure rate of IAD [OR=12 .97 , 95% CI(5 .92-28 .41) ,P<0 .01] ,stoma bag combined with vacuum aspiration could increase the cure rate of IAD [OR=3 .68 , 95% CI(2 .15-6 .30) ,P<0 .01] ,stoma bag combined with skin protective agent could improve the cure rate of IAD [OR=7 .01 , 95% CI(3 .95 -12 .43) ,P<0 .01] .Conclusion Stoma bags simple application ,combined with vacuum aspiration device and skin protective agent in preventing and treating fecal IAD is better than the routine skin care measures .However ,the quality of included studies is lower ,so a large sample and high-quality RCTs are needed for further study .
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Objective:To explore the role of clinical pharmacist in clinical medication by the pharmaceutical care for a patient with acute myocardial infarction complicated with gastrointestinal bleeding .Methods: Clinical pharmacist made an individualized pharma-ceutical care and provided medication guidance for the patient according to the characteristics of acute myocardial infarction and gastro -intestinal bleeding combined with the patient ’ s self factors .Results:The pharmaceutical care improved the compliance of the patient and the efficacy and safety of the drug treatment .Conclusion:The safety and rationality of drug use can be improved by the practice of clinical pharmacist in clinical medication .
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Medically unexplained physical symptoms in patients are abbreviated to MUPS. At present, they are treated as psychological disorders. Beginning with the definition of MUPS and the influence to medical diagnosis and treatment, this article discusses on the countermeasure, patient management, medical practice and medical ed-ucation on the basis of etiology analysis and systematic assessment.
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Objective: To explore the role of clinical pharmacist played in treating patients with acute myocardial infarction. Methods:The clinical pharmacists participated in the therapy for a patient with acute myocardial infarction and provided individual pharmaceutical care. The clinical pharmacist optimized the therapy by means of recognizing the drug-drug interactions and adverse drug reactions as well as evaluating the risk of thrombosis versus bleeding for the patient. Results:The therapeutic suggestions of the clinical pharmacist were accepted by the physicians. The patient was treated effectively and discharged from hospital. Conclusion: Clinical pharmacist can provide beneficial contributions to safe, effective and optimal medication.
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Objective To investigate the diagnostic value of dynamic MRI with coupling agent filled vaginal and rectumin the display of vaginal vault prolapse and rectocele. Methods Thirty three female patients, who were diagnosed with pelvic organ prolapse with Ⅲ degrees and above by gynecologic outpatient clinic and prepared to be treated with surgery were prospectively collected. All of them underwent two types of dynamic MRI, one was routine dynamic MRI (Group A) and the other was dynamic MRI with vaginal and rectum filled with coupling agent (Group B). Two radiologists evaluated and scored the display of vaginal vault and rectocele on these two groups of dynamic MRI images. According to the joint result of two radiologists, two gynecologists made surgical planning. Kappa test was used to compare the consistency of scores performedby two radiologists, and Fisher exact test was used to compare the differentiation fromboth groups, as well as the differentiation of probability of high uterosacral ligament suspension.Results The Kappa value of both groups was 0.65 and 1.00 respectively, where the consistency of Group B was superior than Group A. There were significant differences between the two groups(P<0.01), where Group B was better than Group A. Based on the imaging results of Group A, 7 patients (21.2%, 7/33) were decided to make high uterosacral ligament suspension. Based on the imaging results of Group B, 20 patients (60.6%, 20/33) were decided to make high uterosacral ligament suspension, and differences were statistical significance between the two groups(P<0.05). Conclusions Fo purpose of the displaying vaginal vault and rectocele, the dynamic MR imaging with vaginal and rectum filled with coupling agent was better than routine method. The proposed method can provide important information and reference for the establishment of surgical planning.
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BACKGROUND:Bone marrow mesenchymal stem cel transplantation for myocardial infarction becomes popularized in recent years, but transplanted cels cannot survive and proliferate under early inflammatory reaction or local ischemia/hypoxia microenvironment, eventualy hampering the therapeutic outcomes. OBJECTIVE:To investigate the therapeutic effect of PTEN-silenced bone marrow mesenchymal stem cels on acute myocardial infarction. METHODS:(1) Bone marrow mesenchymal stem cels from Sprague-Dawley rats were randomly assigned to receive no treatment, NCsiRNA transfection using Lipofectamin2000orPTEN siRNA transfection using Lipofectamin2000. Cel growth curves were described using MTT method to detect cel cycle using flow cytometry. (2) Thirty Sprague-Dawley rats were selected to prepare myocardial infarction models that were randomized into three groups (n=10 per group): blank control, negative control and RNAi group. Six hours after modeling, bone marrow mesenchymal stem cels transfected with nothing, NCsiRNA and PTEN siRNA were respectively injected into the infarcted center of the left ventricular anterior wal in these three rat groups. After 4 weeks, al rats were subjected to cardiac function detection using echocardiography, and the survival and proliferation of bone marrow mesenchymal stem cels in the rats were observed by fluorescence microscopy. RESULTS AND CONCLUSION:Compared with the other two groups, a significant increase in the absorbance values at different culture time, the proportion of cels in S+G2phase, and the number ofbone marrow mesenchymal stem cels in the myocardial tissue was found in the RNAi group (alP< 0.05). Additionaly, the left ventricular ejection fraction and left ventricular shortening fraction were significantly reduced in the RNAi group than the blank control and negative control groups at 4 weeks after cel transplantation (P< 0.05). Bothin vivoandin vitroexperimental findings showed that PTEN silencing could effectively improve cel survival and proliferation in the infarcted myocardium. Moreover, in thein vivoexperiment, an overt improvement in rat’s cardiac function was achieved.
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To explore and analyze the clinical therapeutic schedule of elderly chronic obstructive pulmonary disease combined with pulmonary tuberculosis. This clinical research analysis chooses the 2000 patients suffered elderly chronic obstructive pulmonary disease combined with pulmonary tuberculosis treated in the hospital during June of 2014 and June of 2015 as the object of observation. These 2000 cases are randomly divided into experimental group and control group. The patients in the control group are treated with the common method; based on the common method, those in the experimental group are treated with the atomization inhalation treatment of compound ipratropium bromide and budesonide and have rifampicin. The clinical effects of two groups are observed and contracted. The clinical treatment, CRP and other clinical evaluation indexes of experimental group are superior to the control group [P<0.05]. There are significant differences between two groups with the statistical significance. The atomization inhalation treatment of compound ipratropium bromide and budesonide and rifampicin are implied into the elderly chronic obstructive pulmonary disease combined with pulmonary tuberculosis that can remarkably improve the effect of clinical treatment has higher clinical promotional value
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A 73-year-old female patient developed a generalized tonic-clonic seizure on the 6[th] day after treatment with moxifloxacin 400 mg daily intravenously for appendicitis. This patient had atrial fibrillation and history of a surgery for intracerebral hemorrhage, with impaired renal function and liver function, but without history of seizures. Moxifloxacin was discontinued and switched to cefuroxime. The patient remained seizure-free at discharge four days later. The naranjo adverse drug reaction probability scale score was 4, indicating a possible adverse reaction to moxifloxacin. The potential risk factors related to moxifloxacin-induced seizures are discussed. It highlights that pre-existing central nervous system disease, elderly female with lower bodyweight and severe renal impairment may be the risk factors involved in moxifloxacin-induced seizures
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<p><b>OBJECTIVE</b>To evaluate the effects of aminoguanidine on methylglyoxal-mediated oxygen-glucose deprivation (OGD) injury in the cultured human brain microvascular endothelial cells (HBMEC).</p><p><b>METHODS</b>Cultured HBMEC cells were pretreated with methylglyoxal before oxygen-glucose deprivation injury. Cell vitality was determined by MTT method, cell mortality was assessed by LDH release method, cell apoptosis was examined by Annexin V/PI formation method, and the advanced glycation end products (AGEs) were detected by Western-blot.</p><p><b>RESULTS</b>Methylglyoxal induced HBMEC injury in a dose-dependent manner. At 2 mmol/L of methylglyoxal, the cell viability was 56.1% when methylglyoxal-pretreated cells exposed to oxygen-glucose deprivation, the cell inhibition rate was 90.0%. Aminoguanidine (1 mmol/L) inhibited methylglyoxal and OGD induced LDH release and Annexin V/PI formation. Furthermore, aminoguanidine (1 mmol/L) also decreased advanced glycation end products (AGEs) formation induced by methylglyoxal and oxygen-glucose deprivation.</p><p><b>CONCLUSION</b>Aminoguanidine protected methylglyoxal mediated-oxygen-glucose deprivation injury in the cultured HBMEC, which may be associated with anti-glycation activity.</p>
Subject(s)
Humans , Apoptosis , Cell Hypoxia , Cell Survival , Cells, Cultured , Drug Antagonism , Endothelial Cells , Metabolism , Pathology , Endothelium, Vascular , Cell Biology , Glycation End Products, Advanced , Metabolism , Guanidines , Pharmacology , Pyruvaldehyde , PharmacologyABSTRACT
Between May 2009 and February 2012,60 patients scheduled for laparoscopic appendectomy were randomly assigned to receive either transumbilical single-port laparoscopic appendectomy (TUSPLA) or three-port laparoscopic appendectomy (TPLA).The operative duration was significantly longer in TUSPLA than TPLA cases.No statistically significant differences existed in hospital stay,visual analog scale (VAS) score,analgesia requirement or complication rate.The abdominal scar was inconspicuous for TUSPLA.It suggested that TUSPLA with conventional instrumentation is technically feasible and safe with scarless healing.
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Natural cyclopeptides are hot spots in chemical and pharmaceutical fields because of the wide spreading bio-resources, complex molecular structures and various bioactivities. Bio-producers of cyclopeptides distribute over almost every kingdom from bacteria to plants and animals. Many cyclopeptides contain non-coded amino acids and non-pepditic bonds. Most exciting characteristic of cyclopeptides is a range of interesting bioactivities such as antibiotics gramicidin-S (2), vancomycin (3) and daptomycin (4), immunosuppressive cyclosporin-A (1) and astin-C (8), and anti-tumor aplidine (5), RA-V (6) and RA-VII (7). Compounds 1-4 are being used in clinics; compounds 5-8 are in the stages of clinical trial or as a candidate for drug research. In this review, the progress in chemical and bioactive studies on these important natural bioactive cyclopeptides 1-8 are introduced, mainly including discovery, bioactivity, mechanism, QSAR and synthesis.
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OBJECTIVE@#To explore the effect of modified uvulopalatopharyngoplasty with partial resection of the musculus uvulae and preservation of the mucosa of uvulae for obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#Thirty-six patients with OSAHS were enrolled and determined by physical examination, Muller's Test, and cephalometry whose obstructive plane were in oropharynx. One group (n = 18) only received uvulopalatopharyngoplasty with uvulae preservation, while the other group (n = 18) received uvulopalatopharyngoplasty with partial resection of the musculus uvulae and preservation of the mucosa of uvulae. Polysomnography (PSG), Epworth Sleepiness Scale (ESS) and Level of Snore were measured one day before operation and seix months after operation.@*RESULT@#The apnea hypopnea index (AHI), lowest SaO2 (LSaO2), ESS and Level of Snore have changed in both groups (P 0.05) in validity ratio between two groups. Postoperative Level of Snore were significantly different between two groups while AHI, LSaO2, ESS were not significantly different between two groups.@*CONCLUSION@#Uvulopalatopharyngoplasty with partial resection of the musculus uvulae and preservation of uvulae mucosa is an effective surgical method for patients with OSAHS which obstructive plane is in oropharynx. It can decrease not only the level of snore but also the limited ratio of shrink in uvulae after routine surgery.