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In order to address issues such as the decline in diagnostic performance of deep learning models due to imbalanced data distribution in psoriasis vulgaris,a VGG13-based deep convolutional neural network model is proposed by integrating the processing capability of the improved fuzzy KMeans clustering algorithm for highly clustered complex data and the predictive capability of VGG13 deep convolutional neural network model.The model is applied to the diagnosis of psoriasis vulgaris,and the experimental results indicate that compared with VGG13 and resNet18,the proposed approach based on deep learning and improved fuzzy KMeans is more suitable for identifying psoriasis features.
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Objective: To systematically evaluate the impact of acupuncture on exercise-induced fatigue (EIF). Methods: Scopus, Springer Link, Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), and China Biology Medicine Disc (CBM) were systematically searched to identify randomized controlled trials (RCTs) studying acupuncture treatment of EIF from the inception till August 2020. The risk of bias in the included studies was assessed using the Cochrane handbook. RevMan 5.3 was used to conduct statistical analysis on the extracted data. Results: A total of 11 RCTs were included for meta-analysis, involving 531 patients. It was revealed that acupuncture produced more significant effects in alleviating subjective fatigue [standardized mean difference (SMD)=-3.08, 95％ confidence interval (CI) (-4.35, -1.81), P<0.001], increasing the hemoglobin content [weighted mean difference (WMD)=3.89, 95％CI (1.37, 6.42), P=0.003], reducing the lactate dehydrogenase content [WMD=-10.63, 95％CI (-17.67, -3.59), P=0.003], reducing the blood lactic acid content [SMD=-2.65, 95％CI (-4.47, -0.83), P=0.004], and down-regulating the levels of serum creatine kinase [SMD=-0.79, 95％CI (-1.10, -0.48), P<0.001] and blood urea nitrogen [WMD=-1.47, 95％CI (-1.84, -1.11), P<0.001] than the control groups. Conclusion: Based on the existing evidence, acupuncture can be recognized as effective in improving EIF and is worthy of promotion in clinical settings.
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Objective:To evaluate the efficacy and safety of Oryz-Aspergillus enzyme and pancreatin tablets (Combizym ?) in the treatment of postprandial distress syndrome (PDS) in the elderly, compared with gastrointestinal motility drugs. Methods:A prospective randomized controlled trial was designed and registered in the China Clinical Trials Registry (ChiCTR-IPR-16008185). The elderly patients with PDS were randomly divided into three groups, including Mosapride group with Mosapride citrate tablets 5 mg 3 times per day for 2 weeks; Combizym ? group with Combizym tablets 244 mg 3 times per day for 2 weeks; combined treatment group with both drugs and same doses for 2 weeks. The modified Nepean dyspepsia index (NDSI) score, discomfort intensity score and PDS score were calculated on patients before treatment, at the end of first and second week of treatment, as well as 4 weeks after treatment finished, respectively. Adverse effects were evaluated. Results:A total of 323 patients from 16 tertiary hospitals in China were enrolled in this study. Among them, 105 patients were in Mosapride group, 109 in Combizym ? group and 109 in combined treatment group. There were 148 males (45.8%) and 175 females (54.2%) with median age 71.4±9.0 years (60-100 years). Baseline characteristics of three groups were comparable. After treatment, the NDSI scores in three groups all decreased significantly ( P<0.001), while they were similar between groups ( P>0.05). The discomfort intensity score and PDS score in three groups showed a significant reduction after treatment ( P<0.001), especially in the combined treatment group. Compared with Mosapride group, the scores in Combizym ? group decreased significantly after one or two weeks [discomfort intensity score: after one week, 4.0(2.5, 8.0) vs. 6.0(3.0, 10.0); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 6.0); all P<0.05. PDS score: after one week, 6.0(3.0, 9.0) vs. 7.0(3.5, 10.5); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 7.0); all P<0.05]. The efficacy rate in all patients after first week of treatment was over 15.0%. The efficacy rates after two weeks were 55.2%, 68.8% and 73.4% in Mosapride group, Combizym ? group and combined treatment group, respectively. After two week treatment, the efficacy rates in Combizym ? group ( P=0.041) and combined group ( P=0.006) were higher than that of Mosapride group. The recurrence rate of Mosapride group was 9.5%, which was significantly higher than that of Combizym ? group (1.8%, P<0.05) and combined treatment group (1.8%, P<0.05). There were no serious adverse effects in the three groups. Conclusions:The efficacy of Oryz-Aspergillus enzyme and pancreatin tablets is comparable with that of Mosapride in elderly PDS patients, with fewer adverse effects and low recurrence rate. Combination regimen indicates better efficacy than that of Oryz-Aspergillus enzyme and pancreatin tablets or Mosapride alone.
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Objective@#To evaluate the efficacy and safety of Oryz-Aspergillus enzyme and pancreatin tablets (Combizym®) in the treatment of postprandial distress syndrome (PDS) in the elderly, compared with gastrointestinal motility drugs.@*Methods@#A prospective randomized controlled trial was designed and registered in the China Clinical Trials Registry (ChiCTR-IPR-16008185). The elderly patients with PDS were randomly divided into three groups, including Mosapride group with Mosapride citrate tablets 5 mg 3 times per day for 2 weeks; Combizym® group with Combizym tablets 244 mg 3 times per day for 2 weeks; combined treatment group with both drugs and same doses for 2 weeks. The modified Nepean dyspepsia index (NDSI) score, discomfort intensity score and PDS score were calculated on patients before treatment, at the end of first and second week of treatment, as well as 4 weeks after treatment finished, respectively. Adverse effects were evaluated.@*Results@#A total of 323 patients from 16 tertiary hospitals in China were enrolled in this study. Among them, 105 patients were in Mosapride group, 109 in Combizym® group and 109 in combined treatment group. There were 148 males (45.8%) and 175 females (54.2%) with median age 71.4±9.0 years (60-100 years). Baseline characteristics of three groups were comparable. After treatment, the NDSI scores in three groups all decreased significantly (P<0.001), while they were similar between groups (P>0.05). The discomfort intensity score and PDS score in three groups showed a significant reduction after treatment (P<0.001), especially in the combined treatment group. Compared with Mosapride group, the scores in Combizym® group decreased significantly after one or two weeks [discomfort intensity score: after one week, 4.0(2.5, 8.0) vs. 6.0(3.0, 10.0); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 6.0); all P<0.05. PDS score: after one week, 6.0(3.0, 9.0) vs. 7.0(3.5, 10.5); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 7.0); all P<0.05]. The efficacy rate in all patients after first week of treatment was over 15.0%. The efficacy rates after two weeks were 55.2%, 68.8% and 73.4% in Mosapride group, Combizym® group and combined treatment group, respectively. After two week treatment, the efficacy rates in Combizym® group (P=0.041) and combined group (P=0.006) were higher than that of Mosapride group. The recurrence rate of Mosapride group was 9.5%, which was significantly higher than that of Combizym® group (1.8%, P<0.05) and combined treatment group (1.8%, P<0.05). There were no serious adverse effects in the three groups.@*Conclusions@#The efficacy of Oryz-Aspergillus enzyme and pancreatin tablets is comparable with that of Mosapride in elderly PDS patients, with fewer adverse effects and low recurrence rate. Combination regimen indicates better efficacy than that of Oryz-Aspergillus enzyme and pancreatin tablets or Mosapride alone.
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Objective:To explore the relationship between the dark triad, basic psychological needs satisfaction and guilty proneness.Methods:Totally 595 college students were randomly selected from Zhengzhou University.They were tested with the dirty dozen(DD), the balanced measure of psychological needs scale(BMPN) and guilt-proneness-5(GP-5). SPSS 22.0 and AMOS 21.0 were used for data analysis, including descriptive analysis, correlation analysis and confirmatory factor analysis. Bootstrap measure was used for mediating effect test.Results:(1)The correlation analysis showed that the dark triad (29(21, 37)), Machiavellianism (4(4, 8)) and psychopathy(5(4, 9)) were negatively correlated with guilty proneness (20(16, 23)), and the correlation coefficients were -0.10, -0.22 and -0.18 respectively(all P<0.01). While narcissism (16(12, 21)) was not correlated with guilty proneness ( r=0.04, P>0.01). The satisfaction of basic psychological needs (56(54, 60)) was positively correlated with guilty proneness ( r=0.31, P<0.01). (2)The relationship between the dark triad and guilty proneness was partially mediated by basic psychological needs satisfaction, and the mediating effect accounted for 62.96%. Conclusion:The dark triad influences guilty proneness through basic psychological needs satisfaction.
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Objective@#To investigate the changes of alkaloids in Chinese medicine Phellodendron amurense.@*Methods@#High performance liquid chromatographywas used to detect the content of berberine, corkaline, jatrorrhizine, palmatinebefore and after processing in different processed products of Chinese medicine Phellodendron amurense. The column was Ecosil C18 column (250 mm × 4.6 mm, 2.5 μm), and the mobile phase was acetonitrile: 0.2% phosphoric acid buffer solution (55:45)(0.4 g of sodium lauryl sulfate per 100 ml of 0.2% phosphoric acid aqueous solution), detection wavelength was 265 nm, column temperature was 35 ℃, flow rate was 1.0 ml/min, and injection volume was 3.0 μl.@*Results@#The best processing temperature of brine-dried cork, anthrax, and wine-running cork was below 160 ℃. Themass fraction of total alkaloid was 4.512 7%, 2.789 4% and 4.047 1% at 100 ℃. Among them, the wine-dried cork and salt water-filled cork products and raw products had a high mass indicating that the auxiliary materials for increasing the dissolution rate of alkaloids were salt and wine. Compared with the raw products, the content of berberine and palmatine in salt water-running cork and wine-running cork was obvious. The content of berberine and palmatine in anthrax was significantly decreased, and the content of corkaline and jatrorrhizine did not change significantly.@*Conclusions@#The changes of alkaloids before and after in different processing of Cortex Phellodendron have showed some differences. The different processing and temperature have a direct influence on the changes of its composition, which can changes the chemical properties of Chinese medicine Phellodendron amurense before and after processing.
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BACKGROUND/AIMS: Stem cell therapy has been applied to treat a variety of autoimmune diseases, including Crohn's disease (CD), but few studies have examined the use of umbilical cord mesenchymal stem cells (UC-MSCs). This trial sought to investigate the efficacy and safety of UC-MSCs for the treatment of CD. METHODS: Eighty-two patients who had been diagnosed with CD and had received steroid maintenance therapy for more than 6 months were included in this study. Forty-one patients were randomly selected to receive a total of four peripheral intravenous infusions of 1×106 UC-MSCs/kg, with one infusion per week. Patients were followed up for 12 months. The Crohn's disease activity index (CDAI), Harvey-Bradshaw index (HBI), and corticosteroid dosage were assessed. RESULTS: Twelve months after treatment, the CDAI, HBI, and corticosteroid dosage had decreased by 62.5±23.2, 3.4±1.2, and 4.2±0.84 mg/day, respectively, in the UC-MSC group and by 23.6±12.4, 1.2±0.58, and 1.2±0.35 mg/day, respectively, in the control group (p < 0.01, p < 0.05, and p < 0.05 for UC-MSC vs control, respectively). Four patients developed a fever after cell infusion. No serious adverse events were observed. CONCLUSIONS: UC-MSCs were effective in the treatment of CD and produced mild side effects.
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Humans , Autoimmune Diseases , Crohn Disease , Fever , Infusions, Intravenous , Mesenchymal Stem Cells , Stem Cells , Umbilical CordABSTRACT
Objective@#To evaluate the effectiveness and safety of the use of noninvasive high-frequency oscillation ventilation (nHFOV) in very low birth weight infants.@*Method@#A total of 36 cases received nHFOV between January 2016 and October 2016 in Children′s Hospital, Zhejiang University School of Medicine, including 24 males and 12 females, with the gestational age of (27.5±2.5) weeks and birth weight of(980±318)g. The data of the ventilator settings, side effects, and changes of the respiratory function before and after nHFOV were collected and analyzed retrospectively. Nonparametric tests or t tests or χ2 tests were used.@*Result@#Thirty-two (89%) out of the 36 cases successfully avoided intubation or re-intubation after using of nHFOV. nHFOV was used as the rescue treatment after failure of other noninvasive ventilation in 17 cases, and as the prophylactical treatment preventing re-intubation after extubation in the remaining 19 cases. There were significant decreases in the incidences of apnea and desaturation(SpO2<0.85), the level of PaCO2, and the FiO2 24 h after the initiation of the nHFOV as the rescue therapy((1.2±1.1)vs.(6.3±2.1)episodes , (1.1±1.2) vs.(4.3±1.5) episodes, (43±8) vs.(56±10) mmHg, 0.30±0.07 vs. 0.39±0.11, respectively; 1 mmHg=0.133 kPa, t=7.562, 8.913, 4.179, 3.437 respectively, all P<0.01). No significant changes were found in FiO2 and PaCO2 levels 24 h after initiation of nHFOV as the prophylactical therapy after extubation (0.42±0.12 vs.0.40±0.10, (49±8)vs.(48±7)mmHg, t=0.872 and 0.501 respectively, both P>0.05), except for the significant decreases in the mean airway pressure ((7.9±2.6)vs.(9.6±1.6)cmH2O, 1 cmH20=0.098 kPa, t=2.198, P=0.041). There were 4 cases suffered from nasal septum injury, while no other nHFOV related complications were noted.@*Conclusion@#nHFOV can be applied in preterm infants as a rescue treatment after the failure of other noninvasive ventilation, or prophylactically used in patients who have high risk of re-intubation.
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As a landmark masterpiece in the development of acupuncture-moxibustion history,Zhen Jiu Jia Yi Jing (A-B Classic of Acupuncture and Moxibustion) has been studied by numerous scholars. This article tried to find out the acupoints selection rules for heat diseases inA-B Classic of Acupuncture and Moxibustion by taking the heat diseases as the focus and using statistical methods, for promoting the application in clinic.
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<p><b>OBJECTIVE</b>To evaluate whether intraoperative autologous donation (IAD) can reduce perioperative blood transfusion for patients underwent mitral valve replacement (MVR).</p><p><b>METHODS</b>A total of 318 patients received implementation of IAD from January 2011 to December 2013 were analyzed retrospectively, and compared with 517 patients of the previous 36-month period (from January 2008 to December 2012). The method of small-volume retrograde autologous priming, strict blood transfusion standard along with IAD together constituted a progressive blood-saving strategy. Statistical methods including Students' t-test, Pearson's χ(2) test, Kruskal-Wallis analysis and multivariate Logistic regression model were used for comparisons of the data.</p><p><b>RESULTS</b>There were no significant difference between IAD group and non-IAD group considering preoperative patient demographics, characteristics and preoperative comorbidities. However, IAD group significantly reduced number of patients transfused with intra/post-operative packed red-blood cell (PRBC) (55(17.0%) vs. 215 (42.1%), χ(2)=53.0, P=0.000), and had significantly reduced postoperative chest tube output (150(380) ml vs. 700(660) ml, H=195.648, P=0.000), length of stay ((16±6) d vs. (20±8)d, t=9.60, P=0.000). But hematocrit were lower in IAD group (30%±5% vs.33%±4% at end of operation, t=7.76, P=0.000; 30%±4% vs. 32%±5% at discharge, P=0.000, t=3.86). Multivariate logistic aggression analysis revealed that age, IAD and smoking history were factors influencing the probability of intra or postoperative blood transfusion.</p><p><b>CONCLUSION</b>Implementation of blood conservation strategies based on intraoperative autologous donation in mitral valve replacement surgery can significantly reduce intra/postoperative blood transfusion as well as postoperative complications.</p>
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Humans , Blood Transfusion, Autologous , Bloodless Medical and Surgical Procedures , Cardiac Surgical Procedures , Methods , Hematocrit , Logistic Models , Mitral Valve , General Surgery , Postoperative Complications , Retrospective StudiesABSTRACT
It is well known that pulmonary hypertension(PH) is one severe complication of bron-chopulmonary dysplasia( BPD) that is associated with high mortality. Aberrant pulmonary vascular growth, abnormal vasoreactivity and pulmonary vascular remodeling may ultimately lead to PH. Symptoms of PH of-ten overlap those of BPD itself. Furthermore,the emergence of symptoms may indicate that the disease has already progressed to a late, less reversible phase, thereby supporting arguments for screening all infants at risk. Echocardiography is non-invasive and widely available,and is currently the most commonly used screen-ing modality for PH in infants with BPD. Because the incidence of associated cardiovascular anomalies is high,cardiac catheterization and CT scanning of the chest should be considered in all infants who have signifi-cant PH despite optimal management of their lung disease. Early diagnosis and aggressive specific drug thera-py can improve the outcome for these patients.
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Objective To evaluate the effects of exposure to MALs on immunity against Mycobacterium tuberculosis in human alveolar macrophages .Methods Plate counting were used to evaluate the effect of resisting Mycobacterium tuberculosis in human alveolar macrophages .Culture supernatants were harvested and human TNF‐α was measured by ELISA kit .Total nitrite levels in the media were measured using the Griess reagent .Results MALs stimulation attenuated the control of intracellular mycobacterial growth in human alveolar macrophages .The production of proinflammatory cytokines TNF‐α and Nitric oxide in human alveolar macrophages induced by Mycobacterium tuberculosis purified protein derivatives tuberculin (Mt‐PPD) and human interferonγwere attenuated by pretreatment in vitro with MALs .Conclusion MALs attenuated the responses of human alveolar macrophages a‐gainst Mycobacterium tuberculosis ,which may provide the new evidence to explain the phenomena in which some component of Mycobacteria in environment impacts the immunity against Mycobacterium tuberculosis infection .
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Objective To evaluate the role of nucleotide‐binding oligomerization domain 2(NOD2) stimulation in innate immuni‐ty against M ycobacterium tuberculosis .Methods Plate counting as used to evaluate the effect of resisting M ycobacterium tubercu‐losis in human alveolar macrophages .Intracellular NOD2 expression were detected by flow cytometry .Quantitative real‐time PCR was performed to determine the NOD2 ,inducible nitric oxide synthase(iNOS) ,and DEF4B mRNA expression levels using the com‐parative threshold cycle method of relative quantitation .Reactive oxygen species(ROS) were detected by the DFCH probe .Results NOD2 stimulation enhanced the control of intracellular mycobacterial growth in human alveolar macrophages .Although ROS con‐centration did not changed ,the secretion of Nitro Oxygen and the expression of cathelicidin DEFB4 were significantly increased fol‐lowing NOD2 stimulation in human alveolar macrophages .Conclusion NOD2 stimulation may be involved in the early innate con‐trol of Mycobacterium tuberculosis primary infections inducing the generation of Nitro Oxygen and the peptides cathelicidin DEFB4 .
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Objective To discuss the application of breast surgery with radical surgery in the therapeutic effect and complications in patients with early breast cancer.Methods 110 early breast cancer patients with surgical treatment were randomly divided into two groups,each group in 55 cases,the control group was given radical surgical treatment,the observation group was given breast conserving operation,surgery were recorded in patients of the two groups.Results The results of the observation group showed operative incision length (4.02 ±1.15)cm,operation time (58.93 ±13.25)min,intraoperative blood loss (10.11 ±2.87)mLand length of hospital stay (10.74 ±2.17)d. The datas of control group showed surgical incision length (11.87 ±2.44)cm,operation time (95.72 ±26.78)min, intraoperative blood loss (85.27 ±14.28)mL and length of hospital stay (15.86 ±4.43)d,the differences were statistically significant (t =21.582,9.131,5.714,7.697,all P <0.05).Observation group occurred postoperative hand infection in 1 case,upper extremity edema in 2 cases,and no subcutaneous hemorrhage occurs.Control group had 6 cases of postoperative hand infection,10 cases of upper limb edema,and subcutaneous hemorrhage in 5 cases,the differences were statistically significant (χ2 =4.852,5.986,5.238,all P <0.05).3 months after operation,datas of observation group showed physiological state (54.18 ±6.28)points,psychological state (59.27 ±5.82)points,environmental conditions (68.45 ±7.68)points and social function (57.46 ±5.97)points.Physiological state of the control group after 3 month was (65.69 ±9.11)points,while psychological state was (68.31 ±7.33)points,environmental conditions was (78.17 ±10.54)points,social function was (68.77 ±7.15)points,the differences were statistically significant (t =7.714,7.163,5.527,9.004,all P <0.05).Conclusion Breast surgery application in patients with early breast cancer can shorten the operation time,reduce intraoperative bleeding and flow rate,shorten the length of hospital stay, reduce complications and improve postoperative quality of life,it is worth popularizing in clinical application.
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<p><b>OBJECTIVE</b>To gain insights into the role of forkhead box protein 3 (Foxp3) in the pathogenesis of hepatocellular carcinoma (HCC) by performing a comparative analysis of Foxp3 mRNA expression and promoter methylation status in HCC and normal liver tissues.</p><p><b>METHODS</b>Thirty-nine HCC and 13 normal liver tissue specimens were evaluated by real-time quantitative PCR and pyrosequencing to measure the expression of Foxp3 mRNA and determine the methylation status of its promoter, respectively. Statistical analyses of the data were conducted by rank-sum test and Spearman's rank correlation coefficient test.</p><p><b>RESULTS</b>The HCC specimens showed significantly higher mRNA expression of Foxp3 (vs. normal liver tissues, Z =-2.770, P =0.0056). Moreover, the HCC specimens showed significant hypomethylation of the Foxp3 promoter site A (vs. normal liver tissues, Z =2.118, P =0.0339), and the Foxp3 mRNA level was negatively correlated with the methylation of site A (rs =-0.344, P =0.046). None of the other four sites in the Foxp3 promoter showed a significant difference in methylation, and the overall methylation was not significantly different between the HCC and normal liver tissues.</p><p><b>CONCLUSION</b>Overexpression and low methylation of Foxp3 may be involved in the oncogenic and progression processes of HCC.</p>
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Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Metabolism , Pathology , CpG Islands , DNA Methylation , Forkhead Transcription Factors , Genetics , Metabolism , Liver , Metabolism , Pathology , Liver Neoplasms , Metabolism , Pathology , Promoter Regions, Genetic , RNA, Messenger , GeneticsABSTRACT
Objective To investigate the clinical values of antineutrophil cytoplasmic antibody (ANCA) detection in the diagnosis of rheumatic diseases .Methods 965 patients with rheumatic diseases were taken as rheumatic group ,including 256 cases of SLE , 124 of mixed connective tissue disease(MCTD) ,336 of rheumatoid arthritis(RA) ,166 of Sjogren′s Syndrome(SS) ,45 of systemic sclerosis(SSc) and 38 of dermatomyositis .400 healthy people were served as the control group .Indirect immunofluorescence (IIF) was employed to detect the cytoplasmic ANCA (c-ANCA ) ,perinuclear ANCA (p-ANCA ) .Enzyme-linked immunosorbent assay (ELISA) was utilized to assay the anti-myeloperoxidase(MPO) antibody among patients with positive ANCA .Results Difference of positive rates of serum ANCA of subjects in rheumatic group and control group showed statistical significance (P<0 .01) ,and the differences of positive rates of serum p-ANCA and c-ANCA of subjects with positive ANCA between the two group were also sta-tistically significant(P<0 .01) .The positive rate of serum p-ANCA of patients with SLE was markedly higher than those with MCTD ,RA ,SS ,SSc ,dermatomyositis and healthy people in control group (P< 0 .05) ,while that of patients with MCTD was obviously higher than those with RA ,SS ,SSc ,dermatomyositis and healthy people in control group (P<0 .05) .The positive rate of anti-MPO antibody of 165 patients with positive ANCA in rheumatic group was 58 .4% ,which was significantly higher than that in control group(3% )(P<0 .01) .The positive rate of patients with positive ANCA and impaired renal function in rheumatic group was 55 .4% ,which was obviously higher than those of patients with negative ANCA in rheumatic group (21 .8% ) and control group (6 .25% )(P<0 .01) .Conclusion Serum ANCA detection is of important significance for prevention of nephrotoxic damage in pa-tients with rheumatic diseases .
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Raf kinase inhibitor protein (RKIP)is a member of the phosphatidylethanolamine-binding protein family, which can inhibit the metastasis of tumor cells and is closely associated with the occurrence and development of tumor. Matrix metalloproteinase-9 (MMP-9)is a endopeptidase that can degrade extracellular matrix and plays an important role in invasion and metastasis of tumor.This article reviewed the advances in studies on RKIP and MMP-9 in colorectal cancer.
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Objective To investigate the diagnosis and surgical management of ureteral obstruction after renal transplantation.Method A respective study was performed on 15 cases of ureteral obstruction who received renal allografts.All of the cases were confirmed,including 5 cases of stenosis of ureterovesical junction,4 cases of stenosis of distal ureter,2 cases of blood clot blockage,2 cases of edema due to perforation of distal ureter,1 case of ureteral calculi,and 1 case of extrinsic compression of hematoma.All 14 patients underwent open surgical management to reestablish ureter with D-J catheter as stent for 12-16 weeks.One patient was subjected to percutaneous nephrostomy followed by percutaneous ureteroscopy,the obstructed site was identified at ureterovesical junction and antegrade balloon dilation and D-J stent in ureter were performed subsequently.Result Fifteen patients were diagnosed as ureteral obstruction by colour Doppler ultrasound and MRU.All of the patients were resolved the obstructions after surgical managements and the renal function got improved.No reobstruction occured during one year follow-up period.Conclusion Colour Doppler ultrasound and MRU can definitely be used to diagnose ureteral obstruction after renal transplantation.Early diagnosis and surgical management are very important.Open surgical management of the obstructed ureter is an effective method.Antigrade balloon dilation is a therapeutic approach to treat ureteral obstruction.
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Sepsis in premature is a major cause of morbidity and mortality.The definition of neonatal sepsis is complicated by the frequent presence of noninfectious conditions that resemble those of sepsis,especially in very low-birth-weight preterm infants.Although growth of an organism from a sterile site is the gold standard for definitive diagnosis,the positive rate is low.Therefore,assessment of history,risk factors,sepsis screening scores in combination with diagnostic tests are used to identify neonates who are more likely to be infected.Methods studied to prevent infection include improved hand hygiene,early feedings,immune globulin administration,prophylactic antimicrobial administration.It improves prognosis for early diagnosis and antibiotic administration.
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ObjectiveTo study the relationship between fasting plasma glucose (FPG) level and the first cerebral infarction event in the population with diabetes.Methods This was a prospective cohort stndy.8 306 diabetic subjects who determined FPG ≥ 7.0 mmol/L or treated with insulin or hypoglycemic drugs and FPG ＜7.0 mmool/L as the observation population and were followed-up for (48.01 ± 3.14) months.During the course,cerebral infarction events were determined every 6 months.Results( 1 ) By the end of following-up,with the increasing levels of the baseline FPG,the total cholesterol (TC),triglyceride (TG) levels were gradually increased in the diabetic population,the differences were significant [ TC:( 4.93 ± 1.15,5.10 ± 1.20,5.15 ± 1.28,5.33 ± 1.35 ) mmol/L,TG:( 1.70 ± 1.26,1.83 ± 1.29,2.18 ± 1.76,2.41 ± 2.08 ) mmol/L,P＜0.05 ] ; the plasma low density lipoprotein-cholesterol (LDL-C),systolic blood pressure ( SBP),diastolic blood pressure ( DBP),and body mass index (BMI) levels were also increased significantly ( P＜0.05 ).(2) The ineidence of cerebral infarction event in the group of patients with 7.0 mnol/L ≤ FPG ＜ 9.0 mmol/L was the lowest,the differences were significant ( 2.1％,P ＜0.01 ).Compared with the group of 7.0 mmol/L≤ FPG＜9.0 mmol/L,after adjusting for age,sex,BMI,SBP,DBP,TC,TG,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,smoking,diabetic duration and treatment,the relative risk for cerebral infarction events were 1.85 (95％ CI 1.09-3.15,P＜0.05) and 1.54 (95％CI 1.16-2.05,P ＜ 0.01 ) for those groups with 6.1 mmol/L ≤ FPG ＜ 7.0 mmol/L and FPG ≥ 9.0 mmol/L respectively.ConclusionThe risk of new in cidence of cerebral infarction events seems to be the lowest in the group of diabetic patients whose FPGs are wihin 7.0-9.0 mmol/L range.