ABSTRACT
Objective:To study the safety and feasibility of early enteral feeding during therapeutic hypothermia guided by intestinal ultrasound in neonates with hypoxic-ischemic encephalopathy (HIE).Methods:From January 2019 to December 2021, neonates with HIE who received therapeutic hypothermia in the neonatology department of our hospital were retrospectively selected. They were assigned into the ultrasound-guided observation group (admitted from May 2020 to December 2021) and the control group (admitted from January 2019 to April 2020). In the ultrasound-guided observation group, intestinal ultrasound was performed during therapeutic hypothermia. Based on clinical manifestations and ultrasound results, a small amount of enteral feeding [20 ml/(kg·d)] was initiated and gradually increased to total enteral feeding after rewarming. In the control group, 5 ml (once every 3 h) of glucose and sodium chloride solution was given during 72 h of therapeutic hypothermia. After rewarming, enteral feeding was started and gradually increased to total enteral feeding without intestinal ultrasound. The time to start enteral feeding, the time to achieve total enteral feeding, the incidences of feeding intolerance, necrotizing enterocolitis (NEC) and late-onset sepsis were compared between the two groups.Results:A total of 17 cases were in the ultrasound-guided observation group and 18 cases in the control group. The median time to start enteral feeding and to achieve total enteral feeding in the ultrasound-guided observation group were earlier than the control group [36.0 (33.5, 39.0) h vs. 77.0 (74.0, 79.3) h, 6.0 (5.5, 6.5) d vs. 8.0 (7.0, 9.0) d, P<0.001]. No significant difference existed in the incidence of feeding intolerance between the two groups. Neither groups had NEC or late-onset sepsis. Conclusions:Early enteral feeding during therapeutic hypothermia in neonates with HIE is safe and feasible. Intestinal ultrasound helps implementing feeding plan and achieving early total enteral feeding.
ABSTRACT
【Objective】 To analyze the efficacy of scrotum cold compress combined with antibiotics on necrospermia patients with seminal tract infection. 【Methods】 We made a retrospective analysis of the patients who were confirmed as necrospermia by more than 2 times of semen examination and positive by sperm bacteria culture at the Andrology Department of our center from January 2019 to September 2022. The experiment group patients who were cured by scrotum cold compress combined with sensitive antibiotics and L-carnitine were divided into experiment group A (1 time/day) and experiment group B (2 times/day) according to the daily times of scrotum cold compress. Meanwhile, only sensitive antibiotics and L-carnitine were administered in the control group patients. We recorded the improvement of sperm parameters and the number of negative sperm bacterial cultures in different groups at 4 weeks, 8 weeks, and 12 weeks of treatment. 【Results】 A total of 145 patients were enrolled in the study. According to the principle of randomization, 49 patients in group A, 49 patients in group B, and 47 patients in the control group were enrolled. After 4 weeks of treatment, there was no significant difference between the experiment group and the control group in terms of abstinence time, the number of negative sperm bacterial cultures, semen pH, sperm ratio of forward motility, or the sperm survival rate (all P>0.05). In terms of the sperm survival rate, group B (53.1±14.1) was superior to group A (46.2±16.4) (P<0.05). In the results of the treatment at 8 weeks, the number of negative sperm bacterial cultures was significantly higher in the experiment group (74/98) than in the control group (26/47) (χ2=5.14, P<0.05). Sperm ratio of forward motility was higher in the experiment group (26.5±11.9) than in the control group (22.8±12.6). The experimental group (53.1±14.6) also had a significantly higher sperm survival rate than the control group (47.6±13.4) (P<0.05). However, the number of negative sperm bacterial cultures, sperm ratio of forward motility, and the sperm survival rate were lower in experiment group A (35/49, 25.5±10.3, 51.1±15.0) than in experiment group B (39/49, 27.5±13.2, 55.1±14.2), but there was no statistical difference between the two groups (all P>0.05). After 12 weeks of treatment, the number of negative sperm bacterial cultures in the experimental group (67/98) was significantly higher than that in the control group (21/47) (χ2=6.11, P<0.05). Sperm ratio of forward motility in the experiment group (30.9±11.2) was higher than that in the control group (24.7±13.4) (P<0.05). The experiment group (56.3±13.0) had a significantly higher sperm survival rate than the control group (46.7±12.0, P<0.01). However, in terms of the number of negative sperm bacterial cultures, sperm ratio of forward motility, and the sperm survival rate, there were no statistical differences between group A (31/49, 28.8±10.0, 55.9±12.7) and group B (36/49, 32.8±12.1, 56.7±13.4) (all P>0.05). 【Conclusion】 Scrotum cold compress combined with antibiotics is superior to only antibiotic treatment on necrospermia patients with seminal tract infection, especially in the sperm ratio of forward motility and sperm survival rate, but it has little relationship with the times of cold compressions per day. Therefore, the method deserves application in this type of patients’ diagnosis and treatment.
ABSTRACT
【Objective】 To explore the status and characteristics of voluntary blood donors in rural areas of Dali Bai Autonomous Prefecture (referred as Dali), and to provide basis for scientific and effective voluntary blood donation in rural population in regions inhabited by ethnic groups. 【Methods】 The data of rural blood donors who donated blood in Dali from 2010 to 2019 were collected, including demographic data as nationality, gender, age, educational background, as well as the blood donation frequency and blood infection screening (index) results. The above data of urban blood donors who donated blood in Dali during the same period were selected to investigate the increasing trend of blood donation rate. SPSS26.0 was used for statistical analysis of the collected data of rural and urban blood donation population. 【Results】 From 2010 to 2019,the number of blood donors in Dali increased from 13 949 to 19 479,with an increasing rate of 39.64%. The number of rural blood donors increased from 2 623 to 8 727,among which the number of ethnic minority groups increased from 1 779 to 5 059.The ratio of male to female blood donors was 70.30% (1 844/2 623) vs 29.70% (779/2 623) in 2010,56.37% (4 919/8 727) vs 43.63%(3 808/8 727) in 2019. Those with educational level of junior middle school or below were the most, accounted for 43.97%(38 443/85 836),with ethnic donors of 24.47%(23 583/85 836). The proportion of donors aged between 36 and 45 was the highest[40.73% (30 477/74 827) ], with ethnic donors of [28.56% (21 374/74 827), and the proportion of repeated blood donors was 54.87%(35 279/64 299),with ethnic donors of 49.89%(18 080/36 240) [the proportion of repeated blood donors in urban donors in the same period was 48.13% (55 677/115 675) ] (P0.05). 【Conclusion】 It is of great significance to explore the characteristics of blood donors in rural areas (especially regions inhabited by ethnic groups) and the reasons for disqualification, in order to scientifically carry out the recruitment of voluntary blood donors and further promote blood donation for rural residents
ABSTRACT
Objective:To evaluate the efficacy and safety of belimumab combined with standard regimen in the treatment of active lupus nephritis (LN).Methods:It was a single-center, pre - and post-control retrospective study. The Data of active LN patients treated with belimumab combined with standard regimen in the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University from June 1, 2020 to June 30, 2022 were collected for analyzing the renal response rate and adverse reactions after belimumab treatment.Results:A total of 17 patients were included, including 14 females (82.35%). The age of the first medication was (26.06±2.64) years old, the median time of illness before the use of belimumab was 24.00 (8.50, 48.50) months, and the recurrence times before the use of belimumab was (1.24±1.03) times. All the 17 patients underwent renal biopsy. The main pathological types were type IV in 11 cases (11/17), type Ⅲ+V in 2 cases (2/17), type IV+V in 3 cases (3/17), and type V in 1 case (1/17). The dose of glucocorticoids was (22.95±8.30) mg/d in 1 year before belimumab administration. In 12 patients with LN who completed 24 weeks of belimumab treatment plan, the 24-hour urinary protein showed a downward trend, and there was a statistically significant difference compared with the baseline at 24 week [0.49 (0.15, 2.19) g vs. 2.83 (1.14, 4.11) g, Z=-2.100, P=0.036]. Compared with the baseline, serum albumin at 24 week increased by 29.36%, with statistically significant difference [(34.50±3.34) g/L vs. (26.67±5.75) g/L, t=-3.840, P=0.030]. The systemic lupus erythematosus disease activity index-2K score continued to decline, with statistically significant difference compared with baseline at 24 week (5.00±3.02 vs. 12.00±2.82, t=6.163, P<0.001). The lymphocyte count increased, and the difference was statistically significant compared with the baseline at 24 week [0.72(0.28, 2.39)×10 9/L vs. 0.30(0.19,0.34)×10 9/L, Z=-2.073, P=0.038]. There was a statistically significant difference between the glucocorticoids dosage at 24 week and the average glucocorticoids dosage 1 year before treatment [(11.25±6.35) mg/d vs. (22.60±9.75) mg/d, t=4.225, P=0.003]. After observation of belimumab for (38.13±22.93) weeks, patients had a complete response rate of 64.71% (11/17), a partial response rate of 17.65% (3/17), and an overall response rate of 82.35% (14/17). Relapse occurred in 1 case.No infusion-related reactions occurred in 17 patients. During the treatment, a total of 5 adverse events occurred, including 2 cases of pulmonary infection, 1 case each of sepsis, upper respiratory tract infection, and cytomegalovirus infection, which all improved after treatment and the subsequent treatment was not affected. Conclusion:Belimumab combined with standard regimen can improve the response rate of LN, reduce the recurrence rate, reduce the dosage of glucocorticoids, and control the overall adverse events with good prognosis.
ABSTRACT
Objective:To study the safety and feasibility of gasless transoral endoscopic thyroidectomy though vestibular approach using self-retaining retractor for papillary thyroid carcinoma.Methods:The clinical data of 39 papillary thyroid carcinoma patients undergoing gasless transoral endoscopic thyroidectomy were collected at Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from Nov 2020 to Jun 2021.Results:All cases successfully underwent laparoscopic surgery without conversion to open surgery. The mean duration of operation was (142±35) min, and the postoperative mean hospital stay was (4.1±0.8) days. The mean maximum diameter of the tumor was (8.5±4.5) mm, and the mean number of lymph node harvest of by central compartment dissection was 7.7±5.9. Postoperative complications were transient hypoparathyroidism in 2 cases but recovered in 1 month. Scalp hydrop in 1 patient,fading subsequently. Transient sensory change around the lower lip in 3 cases, which recovered in 6 months. No patient suffered from recurrent laryngeal nerve palsy or hematoma, no permanent hypoparathyroidism occurred, nor of the postoperative bleeding .Conclusion:The gasless transoral endoscopic thyroidectomy viaoral vestibular approach is a feasible approach in selected papillary thyroid carcinoma patients.
ABSTRACT
Long-term clinical practice shows that Mongolian medicine not only has a unique effect on frequently-occurring and common diseases, but also has particularly remarkable effects on difficult diseases such as cardiovascular diseases, cancer, etc. Molecular imaging technology, which based on imaging technology, displays special molecules on the tissue, cell, and subcellular level. By reflecting the changes on molecular level in vivo, lesions can be located, quantitatively and qualitatively imaged and analyzed. Non-invasive imaging in vivo is the most significant feature of molecular imaging technology. In the research of Mongolian medicine treatment, molecular imaging technology can present the characteristics of the lesions before and after treatment in vivo and in real time, dynamically evaluate the effect of drug treatment, and provide new ideas for exploring the efficacy of Mongolian medicine and developing new drugs.
ABSTRACT
Objective@#To understand the current situation of psychological and behavioral development of Tibetan children aged 0-5 years in Tibet, and to provide basic data for analyzing the relationship between stunning and children s psychological and behavioral development.@*Methods@#A total of 2 788 Tibetan children aged 0-71 months were randomly selected from seven districts and counties in Tibet from September to November 2020 by stratified PPS method and cluster sampling method for questionnaire survey and physical examination. Multivariate Logistic model was used to analyze the effect of stunting on psychological and behavioral development.@*Results@#The detection rate of psychological and behavioral development deviation of Tibetan children aged 0-5 years in Tibet was 24.68%, among which the detection rates of development deviation in language, gross motor skill, fine motor skill, and social emotional were 8.07%, 9.15%, 12.02% and 12.73%, respectively. After adjusting for potential mixed factors, the OR value (95% CI ) of the risk of psychological and behavioral development deviation of stunted children was 1.34(1.05-1.70). There was positive association with the three dimensions of language, fine motor skill, and social [ OR value (95% CI ) was 1.44(1.01-2.05 ), 1.50(1.06-2.12) and 1.54(1.14-2.07)], respectively. Subgroup analysis showed significant differences in age (0-35 months old: OR =1.16, 95% CI =0.88-1.53; 36-71 months old: OR =2.28, 95% CI =1.44-3.62) and gender (boys: OR =1.69, 95% CI =1.23-2.32; girls: OR =0.98, 95% CI =0.67-1.42) in the association between stunting and psychological and behavioral development.@*Conclusion@#The detection rate of psychological and behavioral development deviation of 0-5 year old Tibetan children is high. Stunting is associated with the risk of psychological and behavioral development. Early screening and comprehensive intervention of children s nutritional and neurodevelopmental should be carried out, especially among older age boys.
ABSTRACT
【Objective】 To observe the effect of glutaraldehyde polymerized bovine hemoglobin injection (code: HSRP1) oxygen-carrying fluid on early perfusion of severe hemorrhagic anemia in rabbits. 【Methods】 The rabbit model of controlled severe hemorrhagic anemia was established. Twelve modeled rabbits were divided into glutaraldehyde polymerized bovine hemoglobin injection (code: HSRP1) group and sodium lactate ringer′s injection (LR) group, with 6 rabbits in each group(half male and half female). HSPR1 group and LR group were treated with HSRP1 and LR, respectively. The survival rate of experimental rabbits was observed, and the indexes of hemodynamics, venous blood gas, plasma hemoglobin, base surplus, lactic acid and bicarbonate were measured before and after blood loss, as well as each point within 24 h after infusion. 【Results】 The survival rate of HSRP1 group was significantly different from that of LR group (P<0.05); After exsanguination, the mean arterial pressure of each group was significantly different from that before exsanguination (P<0.05), but there was no significant difference between HSPR1 group and LR group after infusion; In the second stage of perfusion, the blood lactate concentration and base excess in the HSRP1 group were significantly different from those in the LR group at each time point (P<0.05), at 2 h after perfusion, the respiratory rate started to differ significantly from that of the LR group (P<0.05), heart rate was significantly different from LR group at 4 h after perfusion(P<0.05); There were no significant differences between HSRP1 group and LR group in plasma venous oxygen partial pressure, venous oxygen saturation and plasma hemoglobin at all time points. 【Conclusion】 HSPR1 is used for severe traumatic hemorrhagic shock in rabbits, and can improve the survival rate of experimental rabbits by providing oxygen to hypoxic tissues and correcting anaerobic metabolism. As a new oxygen-carrying fluid, HSPR1 can correct the oxygen supply balance of patients with severe hemorrhagicanemia in early stage.
ABSTRACT
Objective:To explore superior mediastinal lymph node zoning of thyroid cancer for accurate anatomical definition as a reference for surgical access. Methods:A method for zoning superior mediastinal lymph nodes for thyroid cancer was proposed. From Sep 2018 to Nov 2019, 36 cases of thyroid cancer with superior mediastinal lymph nodes metastases were reviewed. The diagnosis, surgical approaches, pathology, characteristics of lymph node metastasis, complications and follow-up results were analyzed.Results:The superior mediastinal lymph nodes were grouped into 10 areas: 1, 2Ra, 2Rb, 2La, 2Lb, 3A, 3P, 4R, 4La and 4Lb. According to the location of the superior mediastinum metastatic lymph nodes, direct vision approach through the neck incision, laparoscope-assisted approach, thracoscepy, laparoscope-assisted combined with thrascopy approach or conventional median sternotomy was performed for regional lymph node dissection. The average follow-up time was (10±4) months. No residual or recurrence of tumor in superior mediastinal area was found.Conclusions:The zoning of the superior mediastinal lymph nodes in thyroid cancer can be used as a guide for surgical approach to lymph node dissection .
ABSTRACT
In the past, it was thought that insulin autoantibodies (IAA) produced by exogenous insulin and its analogues rarely had clinical significance. However, in recent years, with the increase in the incidence of diabetes and the use of insulin, more and more exogenous IAA produced by insulin causes serious clinical harm, and clear detection methods and treatment methods are limited. A large proportion of such patients are therefore missed, which seriously affects the blood glucose control and quality of life of patients with type 2 diabetes who receive insulin therapy. This article reviews the current diagnosis and treatment progress of exogenous insulin antibody syndrome in patients with type 2 diabetes.
ABSTRACT
The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.
ABSTRACT
Development of thoracolumbar vertebra (TLV) and rib primordium (RP) is a common evolutionary feature across vertebrates, although whole-organism analysis of the expression dynamics of TLV- and RP-related genes has been lacking. Here, we investigated the single-cell transcriptome landscape of thoracic vertebra (TV), lumbar vertebra (LV), and RP cells from a pig embryo at 27 days post-fertilization (dpf) and identified six cell types with distinct gene expression signatures. In-depth dissection of the gene expression dynamics and RNA velocity revealed a coupled process of osteogenesis and angiogenesis during TLV and RP development. Further analysis of cell type-specific and strand-specific expression uncovered the extremely high level of HOXA10 3'-UTR sequence specific to osteoblasts of LV cells, which may function as anti-HOXA10-antisense by counteracting the HOXA10-antisense effect to determine TLV transition. Thus, this work provides a valuable resource for understanding embryonic osteogenesis and angiogenesis underlying vertebrate TLV and RP development at the cell type-specific resolution, which serves as a comprehensive view on the transcriptional profile of animal embryo development.
ABSTRACT
The epidemic of coronavirus disease 2019 (COVID-19) has become a severe and complicated situation. As of February 23, 2020, there have been more than 77,038 confirmed cases of new coronavirus infection nationwide. COVID-19 is highly infectious and has a long incubation period and a variety of clinical manifestations, which has a great impact on society and economy and also seriously affects the daily operation of hepatobiliary surgery. This article discusses and recommends the medical protection measures required for outpatient, ward, and operation of hepatobiliary surgery, in order to reduce the risk of nosocomial infection in hepatobiliary surgery during the COVID-19 epidemic.
ABSTRACT
Objective:To assess the bacterial profiles and antimicrobial susceptibility patterns in uropathogens, and help to inform the empiric treatment decisions for urinary tract infection in outpatient settings.Methods:A single institutional retrospective analysis was performed on positive urine cultures from outpatient settings between January 1998 and December 2018. To analyze changes over time, trends analysis were undertaken on bacterial profiles, antimicrobial susceptibility and resistance.Results:A total of 1.172 pathogenic bacteria were isolated after exclusion of duplicate strains originated from the same patient, including 991(84.6%) Gram-negative bacterial strains and 181(15.4%) Gram-positive strains. The most common Gram-negative uropathogens were Escherichia coli (60.8%) and Klebsiella pneumonia (8.1%). Enterococcus faecalis (4.6%) was the predominant Gram-positive strain. The detection rate of Escherichia coli increased significantly, from 50.8% to 63.2% ( χ2=7.978, P=0.046), and no significant difference was observed in the distribution of major uropathogenic bacteria over the 20 years (all P>0.05). The proportion of extended-spectrum β-lactamase (ESBLs) producing strains increased significantly across the 20 years ( P<0.05). The resistance rates of Escherichia coli to amoxicillin and clavulanate potassium, aztreonam, ceftazidime, ciprofloxacin and sulbactam + cefoperazone increased significantly (all P<0.05). All the isolates sustained high susceptibility to tazobactam + piperacillin, amikacin, imipenem and nitrofurantoin (95.0%, 95.7%, 97.9% and 91.1%). Similar to those of Escherichia coli, Klebsiella pneumoniae remained a high and stable sensitivity to tazobactam+piperacillin, amikacin and imipenem during the 20 years (79.1%, 88.0% and 80.3%). However, the proportion of ESBLs producing strains increased significantly ( P<0.05). Among Gram-positive bacteria isolates, the sensitivity rates of Enterococcus faecalis to ampicillin, nitrofurantoin and penicillin G were 100.0%. No vancomycin resistant strain was detected in Gram-positive bacteria. Conclusions:From 1998 to 2018, Escherichia coli and Klebsiella pneumoniae are the most common Gram-negative bacteria uropathogens obtained in outpatient settings. Significant increases of resistance to some antimicrobial agents such as second- and third-generation cephalosporins and fluoroquinolones are observed during the 20 years and high susceptibilities to tazobactam+piperacillin, amikacin, imipenem and nitrofurantoin sustain over time. Local treatment strategies of urinary tract infections on outpatient basis should be made according to epidemiology of drug resistance and individual characteristics to control the spread and curb the prevalence of drug resistant.
ABSTRACT
Objective@#To study infection of coxsackievirus A6 (CV-A6) in Mongolian gerbils.@*Methods@#To screen the optimal ages of Mongolian gerbils, five groups with different ages were infected with 1×105 TCID50 dose of CV-A6 XS45 strain by intraperitoneal, and symptom scores of Mongolian gerbils were collected. Then to estimate the dose-effect, three doses of virus were injected to the Mongolian gerbils. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry(IHC) were used to determine virus load and tissues infection in muscle, brain and intestinal tract.@*Results@#Mongolian gerbils infected with 1×105 TCID50 dose CV-A6 consistently exhibited clinical signs, and the morbidity (death) rates of five age groups were up to 100%. There was a positive correlation between the trend of symptom scores changes and ages. The morbidity (death) rates of three doses (1×103 TCID50, 1×104 TCID50, 1×105 TCID50) also were up to 100% in 28 days Mongolian gerbils. The correlation between the trend of symptom scores changes and doses were negative. Virus loads were detected in muscle, brain and intestinal tract of pathogenesis animal. The virus loads of muscle were higher than others. IHC results showed virus infection and cytopathic effects in three tissues.@*Conclusions@#Mongolian gerbils had high susceptibility to CV-A6, and were best for animal model of CV-A6 infection.
ABSTRACT
Objective To investigate the clinico-pathological features and renal outcomes of primary IgA nephropathy (IgAN) with glomerular IgM deposition.Methods Primary IgAN diagnosed with biopsy from January 2006 to December 2011 were recruited.Patients were divided into groups according to IgM deposition (Group A) and without IgM deposition (Group B).In addition,Group A was subdivided into two groups based on the position of IgM deposits as the mesangium (Group A1) and both mesangium and capillary wall (Group A2).Renal outcomes were defined as end stage renal disease (ESRD) and/or the doubling of baseline serum creatinine.Clinico-pathological features were retrospectively compared.Kaplan-Meier was conducted for renal outcomes,and Cox regression model was used to analyze the prognostic value of IgM deposition and the position of IgM deposition in the progression of nephropathy in IgAN patients.Results 939 patients were enrolled with 422 (44.9％) having IgM deposition (Group A).Of the 422 patients,382 patients were divided as Group A 1,whereas 40 patients were noted as Group A2.Compared to Group B,hemoglobin,serum protein,albumin and serum IgG levels in group A were significantly lower,and the cholesterol and serum IgM levels were significantly higher (all P ＜ 0.05).There was no significant difference in serum creatinine,estimated glomerular filtration rate (eGFR),urinary protein,blood pressure and uric acid between group A and B.In terms of pathological manifestations,patients in Group A exhibited more severe histological lesions including glomerular sclerosis,S1,M1 and interstitial inflammatory cell infiltration (all P＜0.05).Immunofluorescence showed that the proportion of IgG,C1q and Fg deposition in group A was significantly higher than that in group B (all P ＜ 0.05).By Kaplan-Meier,cumulative renal survival rate has no significant difference between Group A and B (Log-rank test x2=0.019,P=0.891).Univariate and muhivariable Cox regression analysis showed that IgM deposition had no significant effect on the renal progression in IgAN patients.Subgroup analysis showed that patients in Group A2 exhibited higher urine protein,creatinine and blood pressure,and lower eGFR and serum albumin,also had worse histological lesions including M1,E1 and T1-2 of Oxford classification (all P＜0.05),Immunofluorescencc showed that the proportion of IgG,C1q and Fg deposition in group A2 was significantly higher than that in group A1 (all P ＜ 0.05).By Kaplan-Meier,renal survival rates calculated from outcomes were lower in Group A2 (Log-rank test x2=1 8.207,P ＜ 0.001).In addition,IgM deposited both in the mesangium and capillary wall was a risk factor for renal progression of IgAN patients with IgM deposition by a univariate Cox hazards regression mode and multivariable-adjusted Cox models (HR=3.621,95％CI 1.924-6.814,P＜ 0.001;HR=2.309,95％CI 1.176-4.533,P=0.015respectively).Conclusions The IgAN patients with IgM deposition relatively had more severe clinicopathological changes,especially those with IgM deposited both in the mesangium and capillary wall.In this study,IgM deposition was not found to be an independent risk factor for the prognosis of kidney in IgAN patients.However,IgM deposited both in the mesangium and capillary wall was an independent risk factor for renal prognosis in IgAN patients with IgM deposition.
ABSTRACT
Objective:To observe the clinical effect of Xuefuzhuyu decoction in the treatment of cancerous fever .Methods:Ac-cording to the admission order , 62 cases of patients with cancerous fever were divided into observation group (32 cases) and control group(30 cases).The observation group was treated with Xuefuzhuyu decoction , while the control group was treated with naproxen . The treatment course was 7 days.The changes of body temperature and KPS score were compared between the groups before and after the treatment,and the clinical efficacy of the two groups were evaluated .Results:After the 5-7-day treatment, the average body tem-perature in the observation group was significantly lower than that in the control group (P<0.05).After the treatment, the total effec-tive rate of the observation group was 75％, which was much higher than that (50％) of the control group (P<0.05).The rate of KPS score keeping stable or ≥10 in the observation group was much higher than that in the control group (P<0.05).Conclusion:Xuefuzhuyu decoction is effective and safe in the treatment of cancerous fever with better efficacy than naproxen , which can improve pa-tients' quality of life with important clinical significance .
ABSTRACT
Objective To investigate the autopsy clinicopathological characteristics of pulmonary thromboembolism(PTE)and to improve the understanding of PTE.Methods The clinicopathological data of 47 death cases of PTE verified by autopsy in the Chongqing Medical University during 2004? 2015 were retrospectively analyzed.Results A total of 784 cases of autopsy were completed during these 12 years,of which 47 cases(6.0％) were proved as PTE (2 cases complicating fat embolism) and 46 cases (97.9％) were fatal pulmonary embolism (FPE).The analysis on 47 cases of autopsy data found that each case had at least 1 risk factor and 43 cases (91.3％) had two or more risk factors,and the most common risk factors were traumatic fracture(55.3％) and surgery (53.2 ％).The frequent clinical symptoms were dyspnea (40.4 ％),cardiac arrest (31.9 ％) and syncope(27.7 ％);24 cases (51.1％) were complicated with deep venous thrombus (DVT) of lower limbs,8 cases (17.0％) of complicating right cardiac thrombus and 1ease (2.1％) of basilar artery embolism were found.The embolism location was dominated by main pulmonary artery (59.6 ％),including 20 cases (42.6 ％) of straddling type pulmonary embolism.Twenty-two cases (46.8 ％) were suspiciously diagnosed as PTE before death,but none was given anticoagulation or thrombolytic therapy.Only 1 case had low molecular heparin to prevent thrombosis.Conclusion PTE is more likely to occur in those patients with high risk factors,especially traumatic fractures and surgeries.Its clinical symptoms have no specificity,lack triad syndrome,has higher misdiagnosis rate,missed diagnosis rate and fatality rate.The treatment on suspected PTE patients by clinicians is insufficient.
ABSTRACT
Objective To investigate the autopsy clinicopathological characteristics of pulmonary thromboembolism(PTE)and to improve the understanding of PTE.Methods The clinicopathological data of 47 death cases of PTE verified by autopsy in the Chongqing Medical University during 2004? 2015 were retrospectively analyzed.Results A total of 784 cases of autopsy were completed during these 12 years,of which 47 cases(6.0％) were proved as PTE (2 cases complicating fat embolism) and 46 cases (97.9％) were fatal pulmonary embolism (FPE).The analysis on 47 cases of autopsy data found that each case had at least 1 risk factor and 43 cases (91.3％) had two or more risk factors,and the most common risk factors were traumatic fracture(55.3％) and surgery (53.2 ％).The frequent clinical symptoms were dyspnea (40.4 ％),cardiac arrest (31.9 ％) and syncope(27.7 ％);24 cases (51.1％) were complicated with deep venous thrombus (DVT) of lower limbs,8 cases (17.0％) of complicating right cardiac thrombus and 1ease (2.1％) of basilar artery embolism were found.The embolism location was dominated by main pulmonary artery (59.6 ％),including 20 cases (42.6 ％) of straddling type pulmonary embolism.Twenty-two cases (46.8 ％) were suspiciously diagnosed as PTE before death,but none was given anticoagulation or thrombolytic therapy.Only 1 case had low molecular heparin to prevent thrombosis.Conclusion PTE is more likely to occur in those patients with high risk factors,especially traumatic fractures and surgeries.Its clinical symptoms have no specificity,lack triad syndrome,has higher misdiagnosis rate,missed diagnosis rate and fatality rate.The treatment on suspected PTE patients by clinicians is insufficient.
ABSTRACT
Objective To investigate the protective and therapeutic effect of chalcone ketones compound(code:L2H17,hereinafter referred to as L2)on mice infected with influenza A virus.Methods BALB/c mice were randomly divided into six groups:normal group,model group,positive drug-treated group,L2 treated groups (3 different concentrations).The mice were adapted for 72 hours,before a model was established by intranasal infection.Mice in each group were given medicine by i.g once daily for 6 days starting 24 h before virus challenge.Survival was observed daily for 14 days.The mortality,median survival time,rate of death protection and rate of prolonging life were determined to observe the therapeutic effect of chalcone(L2) against influenza virus infection.The whole lungs were taken under aseptic conditions on days 3 and 5 post-infection to calculat lung indexes and lung index inhibition.The left lung was fixed with 4% formaldehyde for pathological biopsy,the right lung was soaked in RNAstore to detect lung tissue viral load,and the double antibody sandwich ELISA method was used to detect the expression of inflammatory cytokines IL-6 and TNF-α in order to observe the therapeutic effect of L2 on viral pneumonia caused by influenza virus infection.Results Compared with the model group,the L2 80 mg/kg treatment group exhibited significant increases in median survival time(11 d),the rate of death protection (50%),and the rate of prolonging life(24.1%)but a moderate 50% decrease in mortality.In addition,the lung index decreased significantly both on d 3 and 5 after virus infection (P<0.05).The pathological results also improved significantly.The L2 80 mg/kg dose group had a significantly lower viral load of lung tissue on d 3 and 5 post-infection(P<0.05).Compared with model group,the expression of inflammatory factor IL-6 became lower to different degrees.Conclusion L2 has a protective effect on mice infected with influenza virus by reducing the degree of pathological changes of pneumonia caused by influenza viruses.