ABSTRACT
Objective Comprehensively considering the effectiveness and safety of massage, a method for evaluating the pros and cons of oscillation excitation and pulse excitation for lumbar oblique-pulling manipulation was proposed, and lumbar oblique-pulling manipulation under oscillation excitation was optimized. Methods A multi-rigid body biomechanical model of thoracolumbar spine was established. The manipulation force was used as the input force of the model. Using MATLAB/Simulink, variation of the displacement and acceleration of each lumbar segment with time was simulated. For the optimization of lumbar massage manipulation, the core elements of massage force, namely, frequency (f) and operand (n) were changed, and then the maximum relative displacement and maximum acceleration of each lumbar segment were compared. A new index z was proposed to comprehensively evaluate effectiveness and safety of the manipulation. Results The maximum relative displacement of each lumbar segment was almost equal when lumbar oblique-pulling manipulation under two kinds of excitation was applied. For lumbar oblique-pulling manipulation, the maximum acceleration of each lumbar segment under oscillation excitation was significantly smaller than that under pulse excitation. When the frequency of massage was 1-2.5 Hz, the overall effect of massage was better, and the overall effect had no relation with the operands, and the force of massage lasted for one operand; when the frequency of message was 3.33 Hz and the operands were more than 5, the massage had the best effect, meanwhile the strength of each lumbar segment was relatively large; when the frequency of massage exceeded 5 Hz, and the overall performance of massage was not good. Conclusions Lumbar oblique-pulling manipulation under oscillation excitation is safer than that under pulse excitation. The research findings provide doctors with a reasonable range of operating parameters for lumbar oblique-pulling manipulation under pulse excitation.
ABSTRACT
Cancer-associated fibroblasts(CAFs)are one of the most important cellular components in the external microen-vironment of tumors. CAFs can interact with tumor cells and secrete a variety of soluble factors such as growth factors,chemokines,and so on. CAFs are also involved in the proliferation,invasion,migration,metastasis and drug resistance of colorectal cancer through regu-lating multiple signaling pathways that play a key role in the progression of colorectal cancer. Recent studies have found that CAFs re-lated markers and genes can be used as reference indicators for the predicting prognosis of colorectal cancer. Therefore,targeting CAFs may be a key target for early diagnosis,treatment and prognosis of colorectal cancer. This article summarizes the characteristics of CAFs,recruitment and activation process,and its role in the development of colorectal cancer in order to provide a new scientific di-rection for the mechanism of action and clinical application of CAFs in colorectal cancer.
ABSTRACT
Objective To investigate the effects of emodin on the migration and invasion ability and expressions of E-cadherin and Slug of human hepatoma cell lines HepG2; To discuss the possible mechanisms of anti-hepatocellular carcinoma.Methods HepG2 cells were cultured in vitro. The experimental group was treated with emodin at concentrations of 10μmol/L and 20μmol/L as. The negative control group was treated with the same volume of RPMI-1640 medium, while the positive control group was treated with 10μmol/L floxuridine. The cell matrix adhesion assay, wound healing and transwell chamber in vitro invasion assay were used to observe the effects of emodin on HepG2 cell adhesion rate and migration and invasion ability. Western blot analysis was used to observe the changes of expressions of E-cadherin and Slug.Results Compared with the negative control group, emodin inhibited significantly HepG2 cell adhesion rate and migration and invasion ability were in a dose-dependent manner (P<0.05,P<0.01); Western blot analysis showed that the protein expression of E-cadherin increased significantly, and the level of Slug decreased significantly in a dose-dependent manner (P<0.05,P<0.01).Conclusion Emodin can significantly inhibit migration and invasion of HepG2 cells, which mechanism may up-regulate expressions of E-cadherin and down-regulate Slug.
ABSTRACT
Objective To investigate the clinical application of nasal-insertion type ileus-tube in the treatment of adhesive small intestinal obstruction. Methods A total of 221 patients with simple adhesive small intestinal obstruction, who were admitted to authors’ hospital during the period from January 2010 to Aug. 2014, were enrolled in this study. The patients were randomly divided into nasal-insertion type ileus-tube group (n=111) and nasogastric tube group (n=110). After the procedure, the patients were kept under close observation, focusing on the abdominal distention, gastrointestinal decompression amount, the recovery time of anal exhaustion and defecation, the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film, etc. The cure rate, effective rate and transit-operation rate were calculated. The results were compared between the two groups. Results The tube placement operation was successfully performed in all patients. Compared with the nasogastric tube group, in the nasal-insertion type ileus-tube group the recovery time of abdominal distention, anal exhaustion and defecation and the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film were obviously shorter, and the gastrointestinal decompression amount was larger. In the nasal-insertion type ileus-tube group the cure rate and effective rate were significantly increased, while the transit-operation rate was decreased; the differences between the two groups were statistically significant (P<0.05). Conclusion For the treatment of adhesive small intestinal obstruction, the placement of nasal-insertion type ileus-tube is effective and reliable. This technique can strikingly improve the clinical symptoms, therefore, it is worthy of promotion and application in clinical practice.
ABSTRACT
Objective: To explore the semen quality and potential risk factors of males from the infertility clinic in south area of Zhejiang.Methods A cross-sectional study was conducted to evaluate the semen quality and risk factors in 3 01 7 males attending infertility clinic in south Zhejiang.Subjects were grouped by semen quality.The generalized linear models were used to analyze the data.Results Medians of semen parameters were 2.5 ml for volume,76 ×1 06 per ml for semen concentration,1 60 ×1 06 for total sperm count,50.0%for sperm progressive motility,62.0%for total motility,and 6.9%for normal morphology.Only 32.9% of semen samples had normal semen parameters according to WHO criteria. Abstinence duration was significantly positive associated with semen volume,concentration,and total sperm count (P<0.01 ).Single factor analysis showed that smoking,contacts of environmental pollutants,and obesity had slight detrimental effects on sperm quality.However,there were no significant differences by multiple factor analysis (P >0.05 ). Conclusion A sizable proportion of semen quality from males attending infertility clinic in south Zhejiang are low according to WHO criteria.The difference of area,life styles and environmental factors may cause the change of semen quality and that need to be further studied.
ABSTRACT
H5 subtype avian influenza (AIV-H5) is a major causative agent of animalloimia a rapid and sensitive molecular biological diagnosis is crucial to the control program of AIV-H5. AIV-H5 real-time fluorescent reverse transcription loop-mediated isothermal amplification (qRT-LAMP) was established by means of heat treatment of the samples. The sensitivity, specificity and repeatability of this method were assessed and the performance of Calcein,SYBR Green I,HNB,SYTO 81 in colorimetric detection was comparatively analyzed to screen the optimum dye. The results showed the sensitivity of this method was 100 times higher than that of standard real-time fluorescent RT-PCR, and the detection limit was one copy of the gene per reaction. This method had no cross-reactivity with other common avian respiratory tract infectious disease-related pathogens such as IBV and NDV. The present study suggested Calcein was the optimum dye. Small-scale tests suggested this method was reliable for survey monitoring of AIV-H5 on the spot, indicating its potential applications in field investigation.
Subject(s)
Animals , Chickens , Hemagglutinin Glycoproteins, Influenza Virus , Genetics , Influenza A Virus, H5N1 Subtype , Genetics , Influenza in Birds , Diagnosis , Virology , Poultry Diseases , Diagnosis , Virology , Reverse Transcriptase Polymerase Chain Reaction , Methods , Sensitivity and SpecificityABSTRACT
Objective To study the mechanisms of vertebrae semi-dislocation of Tuina manipulation for treating patients with lumbar intervertebral disc protrusion (LIDP) by observing the three-dimensional (3D) displacement of lumbar before and after Tuina manipulation. Methods Ten LIDP patients were selected and evenly divided into two groups: Group 1 as tendon-smoothing manipulation group (relaxing group), Group 2 as tendon-smoothing plus adjusting manipulation group (adjusting group). Besides, Group 3 as control group was established by 5 healthy volunteers treated with tendon-smoothing manipulation. Before and after manipulation intervention, all subjects were scanned from L1 to L5 segment by using Philips 64 spiral CT under equal conditions for accessing the volume data. ITK reconstruction software was used to reconstruct each lumbar skeleton for finite element analysis. The 3D displacements and angular displacements among three groups were compared. Results 3D displacement from L1 to L5 segment all changed in three groups. For adjusting group, the angular displacements at X-axis in L3 segment was (1.77±0.46)°, and that in L4 segment at X-axis and Y-axis was (1.78±0.53)° and (1.89±0.75)°, respectively, which was significantly larger than relaxing group and control group (P<0.05); the angular displacements at X-axis from L1 to L5 segment were (1.50±0.47)°, (1.55±0.57)°, (1.77±0.46)°, (1.78±0.53)°, (1.61±0.39)°, respectively, which were significantly larger than control group (P<0.05); displacement at Y-axis in L3 segment was (2.87±0.74) mm, and that at X-axis in L4 segment was (1.68±0.64) mm, which were significantly larger than relaxing group and control group (P<0.05); displacement at X-axis in L1, L4 and L5 segment was (1.28±0.21),（1.68±0.64）, (1.30±0.51） mm, and that at Y-axis in L1 to L3 segment was (1.92±0.42), (2.25±0.61), (2.87±0.74) mm, which was significantly larger than control group (P<0.05). The angular displacements and displacements of L1 to L5 segment in relaxing group were larger than those in control group, but without any significant differences. Conclusions Compared with relaxing manipulation, adjusting manipulation played a more obvious adjusting role in instability and degenerative lumbar vertebra, especially for angular displacements in X-axis, and displacements in X-axis and Y-axis. Namely, the mechanisms of vertebrae semi-dislocation of adjusting manipulation were to make horizontal and rotational displacements at lumbar vertebra other than upper and lower displacement. The effect of relaxing manipulation was not so obvious on lumbar structure of LIDP patients.
ABSTRACT
Objective To compare the influence of whole sevoflurane inhaling and target-controlled infusion of propofol for the myocardial protective effect on patients with heart valve replacement surgery. Methods 30 adult patients who went through heart valve replacement surgery with cardiopulmonary by pass were selected, including ASA staging II-III and cardiac function classification (NYHA) II-III. All patients were randomly divided equally into sevoflurane group (Group S) and propofol group (Group P) . Patients were monitored before anesthetic induction. Group S got 1%sevoflurane (fresh gas flow 6 L/min) with concentration of the vaporizer increased from 1%to 3%with 1 minute interval during anesthetic induction. Group P got target-controlled infusion of propofol during anesthetic induction,the initial target plasma concentration was set at 0.8μg/mL,and the concentration increased 0.5 μg/mL every minute until intubation. All the patients got fentanyl 5 μg/kg and rocuronium 0.6 mg/kg, and intubation was conducted when BIS decreased lower than 60 and mean arterial pressure (MAP) 0.05) . The pre-opertaive cTnI, CK, CK-MB and LAC were within the normal range, but increased siginicantly on T2, T3 and T4, and was more significant on T3 ( < 0.01) between two groups, and the intra-group comparison showed no difference on other time points. Conclusion When myocardial injury markers used as myocardial protection outcome variables, whole sevoflurane inhaling could not reduce the release of cTnI compared to propofol TIVA in heart valve replacement surgery.
ABSTRACT
Objective To evaluate the technique and clinical outcomes of modified transperitoneal laparoscopic radical prostatectomy. Methods A total of 285 patients received the operation with mean age of 67 years (50-76 years) from January 2008 to April 2012.Mean level of PSA was 15.7 μg/L (1.8 -50.0 μg/L),and mean prostatic volume was 44 ml (26 -74 ml). No lymph node or seminal vesicle involvement was found by CT or MR and radionuclide bone scan revealed no metastasis.271 cases were confirmed diagnosis by prostatic biopsy and 14 were detected through pathological studies of TURP specimens.Gleason score ranged from 6 to 8.14 cases were in clinical stage T1b,29 cases in T1c,214 cases in T2 and 28 cases in T3a.Transperitoneal approach and modified technique involving bladder neck dissection,nervesparing technique and vesicoureteral anastomosis were applied on patients. Results Mean operative time was 105 min (55 -150 min).Mean intraoperative estimated blood loss was 240 ml (50-800 ml).Rectal injures occurred in 2 cases and were repaired under laparoscopy.Drainage tube and urinary catheter were removed 48 -72 h and 5 -8 d postoperatively.Postoperative hospital stay was 7 d (5 - 11 d).Positive surgical margin was present in 58 patients.Mean follow-up time was 29 months (3 -50 months).Complete continence were found in 208 patients immediately after catheter removal.68 patient recovered continence within 3 months and 9 patients remained incontinence 3 months after surgery. Normal erection presented in 42 of the 57 cases with nerve-sparing. Conclusions Transperitoneal laparoscopic radical prostatectomy is safe and efficient.Higher efficiency and lower complication rate have been achieved through modified laparoscopic technique involving bladder neck dissection,nerve-sparing technique and vesicoureteral anastomosis.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of 1,2-dichloroethane (1,2-DCE) on the behavior and the brain neurotransmitter levels in mice.</p><p><b>METHODS</b>Thirty mice were randomly divided into four groups, which were control group and groups of low, middle and high exposure (225, 450 and 900 mg/m3) to 1,2-DCE for 10 days (3.5 h a day) by inhalation. After the last exposure, the open field test was performed immediately. After exposure all mice were killed and the brain tissues were taken up rapidly. The levels of aspartate (Asp), glutamate (Glu) and gamma-aminobutyric acid (GABA) in the brain were detected by high performance liquid chromatography (HPLC).</p><p><b>RESULTS</b>Levels of Asp and Glu in all exposure groups increased with doses. As compared to the control group, levels of Glu in all exposure groups increased significantly (P < 0.05). Levels of GABA in the low exposure group were significantly lower than those in control group, but those in the high exposure group were significantly higher than those in control group. The results of the open field test showed that effect of low exposure to 1,2-DCE on the behavior was stimulant, but the high exposure to 1,2-DCE inhibited behavior of exploration, excitement and sport.</p><p><b>CONCLUSIONS</b>Subacute exposure to 1,2-DCE could result in the change of amino acid neurotransmitter content and ratio in the brain, thereby change the behavior of mice appeared, which might be the mechanism of neurotoxicity caused by 1,2-DCE in part.</p>
Subject(s)
Animals , Female , Mice , Aspartic Acid , Behavior, Animal , Brain , Metabolism , Ethylene Dichlorides , Toxicity , Glutamic Acid , Mice, Inbred Strains , Neurotransmitter Agents , Metabolism , gamma-Aminobutyric AcidABSTRACT
Objective To evaluate the effect of clopidogrel premedication on in-hospital major adverse cardiovascular and cerebral events (MACCE) and bleeding outcomes before coronary artery bypass graft surgery (CABG). Method A total of 2021 patients who underwent CABG from July 2003 to September 2005 were divided into either clopidogrel ( n = 479) or no clopidogrel (1542) group before CABG. Patients with clopidogrel administration ( n = 479) were subdivided into < 5 d ( n = 154) ,5～7d(n = 183)and >7d(n = 142) group according to timing of clopidogrel withdrawal before surgery. In-hospital MACCE and perioperative bleeding outcomes were analyzed among groups. Results Patients who took clopidogrel before surgery had nonsignificantly rates of bleeding and in-hospital MACCE compared with those patients not administered clopidogrel. No differences were found about the incidence of total bleeding,minor bleeding,transfusions of red blood cells,fresh frozen plasma,whole blood and in-hosptial MACCE among three subgroups.The < 5 d group had higher incidence of major bleeding and more platelets transfusions than 5 ～ 7 d [47.8% vs. 31.9%,P < 0.017; (0.08 ±0.38) U vs. (0.00±0.00) U,P <0.017,respectively]and >7 d group [47.8% vs. 20.3%,P <0.017; (0.08±0.38) U vs. (0.00±0.00) U,P <0.017,respectively). However,there were no significant differences between 5 ～ 7 d and > 7 d group ( P > 0.05). Conclusions Gopidogrel administration before CABG does not increase the incidence of in-hospital MACCE events. However,the perioperative risk of bleeding will rise if the patients withhold clopidogrel less than five days before surgery.
ABSTRACT
Objective To assess the prevalence, and characteristics, and in-hospital and long-term prognosis of coronary artery disease (CAD) with metabolic syndrome, and to determine the factors affecting the prognosis of CAD most. Method The DESIRE (drug-eluting stent impact on revascularization) registry covered a database of 2368 patients with coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in a period between July 2003 and September 2004. The median long-term follow-up time was 3.5 years ranged from 293 to 1855 days. The metabolic syndrome (MS) was diagnosed on the Definition of the Metabolic Syndrome modified by the Adult Treatment Panel (ATP) Ⅲ in 2005, by using the body mass index (BMI) instead of waist circumference. The relationship between metabolic syndrome (MS) and the incidences of major adverse cardiac as well as cerebral events (MACCE) in a large cohort of patients treated for revascularization was analyzed by using logistic analysis and Cox regression with SPSS 11.0 software. Results The Ms was present in 45.6% patients (high fast glucose (FG) in 44.5% patients, high triglycerides (TG) in 45.0% patients, low high density lipoprotein (HDL) in 50.8% patients, high BP in 61.4% patients, high BMI in60.7% patients). After follow-up, the ratio of MACCE in CAD patients with metabolic syndrome increased significantly (18.9% vs. 15.6%, P <0.036). The most dangerous factors of MS were high FG, hypertension and obesity (OR=1.787, 95%CI=1.132-2.845, P =0.014). Conclusions The MS contributes the high risk factors of MACCE in CAD patients with or without diabetes. The most dangerous combination of risk factors in MS is the combination of high FG, hypertension and obesity.
ABSTRACT
Objective To evaluate the short-term and long-term outcomes of patients with ST-segment elevation myocardial infarction (STEMI) compared with those with non-STEMI after percutaneous coronary intervention (PCI). Method The DESIRE Ⅱ (Drug-Eluting Stent Impact on Revascularization Ⅱ) was a single-center registered retrospective study of coronary revascularization in our institution between July 2003 and September 2009.Data of demographics, clinical features and revascularization record of STEMI and non-STEMI patients from the DESIRE Ⅱ trial were analyzed. The patients were followed up in OPD or by telephone after discharge. MACCE (major adverse cardiocerebral events) including death, neo-myocardial infarction, stroke and revascularization were recorded. The clinical outcomes of patients of two types were evaluated. Results There were 6005 patients studied with a median follow-up of 566 days. A total of 1009 STEMI and non-STEMI patients were analyzed. The patients with non-STEMI ( n = 206) had higher prevalence of hypertension and history of higher frequency of myocardial infarction as well as revascularization compared with patients with STEMI ( n = 803). The patients with non-STEMI had higher ratio of treatment for multivessel disease (43.7% vs. 34.4%, P = 0.039). There were no significant differences in in-hospital mortality and long-term outcomes (one year survival rate: 96% vs. 98%)between patients with STEMI and non-STEMI. The predictors of 1-year mortality were LVEF and blood creatine.Conclusions Despite different chnical features, patients with STEMI and non-STEMI after PCI had similar both short-term and long-term outcomes.
ABSTRACT
Objective To understand the application of drug eluting stent (DES) in renal functional insufficient patients, and to assess its safety and effectiveness, especially the occurrence of stent thrombosis(ST) after DES implantation and its related factors. Methods The subjects were all the patients underwent percutaneous coronary intervention (PCI) as well as at least one DES admitted to Beijing Anzhen Hospital consecutively from July 2003 to June 2005. All patients were divided into 2 groups: Group Ⅰ with normal or mild renal insufficiency (Ccr≥60 ml/min),and Group Ⅱ with moderate to severe renal functional insufficiency (Ccr ＜ 60 ml/min). All of the clinical, angiography and intervention data were recorded. ST was adjudicated by the definition of ARC Dublin. The rates of MACCE in hospital and during the follow-up between the 2 groups were compared. Results There were 2377 patients enrolled in the study, of which 2020 ( 85.0% ) patients presented Ccr ≥ 60 ml/min, and 357( 15.0% ) presented Ccr ＜ 60ml/min. The case fatality during follow-up in group Ⅰ was significantly higher than that in group Ⅱ (4. 5% vs. 1.2%, P ＜ 0. 001 ). However, the incidences of ST were not significantly different between each stage of disease( P ＞0. 05 ). The results from Cox regression showed that renal functional insufficiency was not a risk factor of death,whereas multivessel coronary artery disease [OR = 1. 929(95% CI: 1. 178 -3. 157),P =0. 009] ,diabetes [OR = 1. 914(95% CI:1. 055 -3. 470) ,P =0. 033] and age [OR = 1. 051 (95% CI:1. 005 -1. 099 ) ,P = 0. 030] were independent risk factor of death after DES implantation in patients with moderate to severe renal functional insufficiency. Conclusions Compared with normal renal function or mild renal patients, the longterm case fatality is higher in moderate and severe renal functional insufficiency patients. However, the higher case fatality does not due to the increase of ST.
ABSTRACT
Objective To evaluate the prognosis of drug-during stent (DES) implantation in elderly patients versus non-elderly patients, and to determine the clinical outcome of complete revascularization strategy versus incomplete revascularization strategy in elderly patients. Methods Patients who were treated with at least 1 DES in our hospital were enrolled in the study. They were divided into 3 groups: the elderly group (aged 75～89 years), the presenium group (age 60～74years) and the non-elderly group (aged 40～59 years). The patients aged 60～89 years were further divided into complete revascularization group and incomplete revascularization group according the Percutaneous interventional the rapy (PCI) strategy. Clinical characteristics, angiographical and interventional data were collected. Results The success rate of PCI procedure was 99.3% in elderly group(n=137), 98.7% in presenium group(n= 1006), and 99.3% in non-elderly group(n= 1031).There were no significant differences among the three groups(P>0.05). The in-hospital mortality was highest in the elderly group among the three groups (1.5%, 0.4%, 0.1%, P<0.05), but the in-hospital rates of re-infarction, repeated revascularization and stroke had no significant differences among the three groups (P>0.05). During follow-up, the rates of death and stroke were highest in the elderly group(3.1%, 2.3%, 0.7%, P<0. 01;1.5% , 1.3%, 0.3%, P<0.05, respectively),but the rates of re-infarction and repeated revascularization among the three groups had no significant differences (all P>0.05). By Cox regression analysis, serum creatinine (OR= 2.961,95%CI=1. 643～5.338,P<0.01), gender (OR=2.661,95%C1=1.376～5.145 ,P<0.01), age(OR=2.687,95%CI=1.329～5.434, P<0.01), multi-vessel disease(OR= 1.735,95 %CI= 1.132～2.661, P<0.05), and old myocardial infarction (OR = 2.041 ; 95% CI = 1.026～4.061; P<0.05) were the independent predictors for all-cause death in patients aged 60～74 years. The in-hospital mortality was higher in the incomplete revascularization group than in complete revascularization group in patients aged 60～74 years (1.4% vs. 0.2%, P<0.05). Multiple logistic regression analysis revealed that the incomplete revascularization strategy was not the independent predictor of in-hospital death (OR=0.307; 95%CI=0.011～8.467; P>0.05). Conclusions Although DES implanting is successfully procedured in presenium and elderly patients, it is associated with higher in-hospital mortality, especially in patients aged ≥75 years . Presenium and elderly patients are to be more benefit from complete revascularization strategy, but the incomplete revascularization strategy does not influence the long-term outcomes.
ABSTRACT
Objective To investigate the effect of PCI/CABG for the patients with coronary artery disease(CAD) with LVEF≤40%. Methods 196 CAD patients with LVEF≤40% were divided into PCI (n = 106) and CABG group (n=90). The clinical factors, revaseularization, medication, and in-hospital and follow-up malignant cardiological events(MACCE) were retrospectively compared,and the survival curve were drew by COX regression.Results Survival rate of the PCI group and CABG group in 30-day (96% vs. 94% ), 1-year(95 % vs. 92% ), and 2-year(93% vs. 87% )were similar. There was no MACCE within 30 days in the two groups(92% vs. 92% ) and 1-year survival rate without MACCE was similar in the two groups(86% vs. 88% ). CABG group had higher 2- year survival rate without MACCE than PCI group (83%vs. 72% ). But the COX survival curves of the two group were not signifi-cantly different (P=0. 662). Conclusion The patients with LVEF ≤ 40% undergoing PCI have short-term and long-term survival rate similar to those accepting CABG.
ABSTRACT
Objective To assess the effect of anemia on long-term outcomes in patients with acute coronary syndrome(ACS) undergoing pereutaneous coronary intervention(PCI). Methods In 3136 patients presenting with ACS,636 patients were anemic. The clinical features, mortality and major cardiocerebral events including non-fatal acute myocardial infaret,revascularization and non-fatal cerebral stroke were compared in patients with or without anemia. The average follow-up period was 550 days. Results Anemic patients were older and had a higher percentage of comorbidities compared with nonanemic cohorts. Compared with nonanemic patients, anemic patients had higher mortality (4.7% versus 1.5% ,P <0. 001) and a higher major adverse end point events,including nonfatalmyocardial infarction, stroke and revaseularization (14.2% versus 11.0%, P = 0.032). After adjustment for comorbidities, anemia was associated with a higher risk of mortality after percutaneous coronary intervention (adjusted hazard rate ratioRR2. 166 ;95% CI 1. 298-3. 612 ;P =0.003). Conclusion Anemia before PCI is an independent factor for predicting the long-term mortality of ACS.
ABSTRACT
<p><b>OBJECTIVE</b>In mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.</p><p><b>METHODS</b>An enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.</p><p><b>RESULTS</b>From June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.</p><p><b>CONCLUSION</b>An outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.</p>
Subject(s)
Animals , Humans , Bacteremia , Epidemiology , Microbiology , China , Epidemiology , Disease Outbreaks , Meningitis, Bacterial , Epidemiology , Microbiology , Shock, Septic , Epidemiology , Microbiology , Streptococcal Infections , Epidemiology , Microbiology , Streptococcus suis , Swine , Swine Diseases , MicrobiologyABSTRACT
Objective To elucidate the clinical characteristics and prognosis of non-ST segment elevation acute coronary syndrome (NSTE-ACS)patients with metabolic syndrome. Methods SUNDAY(The Strategies for UA/NSTEMI and Delay of AngioplastY Registry)study was a retrospective registry of 1 013 patients with unstable angina or NSTEMI from Jan 2000 through Dec 2002. In this analysis , we compared the clinical features and prognosis with patients with or without metabolic syndrome and studied the relation between the number of markers-the MS score and prognosis. Results There were 743 patients with complete data and 343 patients(46.2%)satisfied the definition of Chinese metabolic syndrome .The latter were younger [(59.66?9.67)age vs. (61.11?10.37)age,P=0.052], with higher BMI ,SBP, DBP, blood glucose and disordered blood-lipid(P0.05) and coronary angiographic alterations(left main artery and trivessel) (P=0.006). Conclusion There were prevenlence in NSTE-ACS patients with metabolize syndrome and the later were younger .As the MS score increased so did obesity, dyslipidemia ,blood pressure, fasting glucose. Similarly, an increasing MS score was significantly related to more severe coronary angiographic alterations and cardiac events.
ABSTRACT
<p><b>OBJECTIVE</b>To describe the clinical and epidemiological features of dead cases with human Streptococcus suis infections, and to find the target population for preventing death and the related indicators.</p><p><b>METHODS</b>Epidemiological investigation on human Streptococcus suis infections was implemented used unified questionnaires. Analysis on dead cases and survival cases (as contrast) was done.</p><p><b>RESULTS</b>The population with highest fatality rate was in 40-49 age group. 97.37% of dead cases had toxic shock syndrome. The mean interval from onset to admission was 0.76 days, and the mean course was 2.11 days. The progression among dead cases was faster than that among survival cases. Chief clinical manifestations of dead cases that are more frequent than survival cases are purpura (73.68%), diarrhea (50.0%), dyspnea (21.05%), conjunctival congestion (34.21%), etc. Renal impairment and liver involvement in dead cases were more significant than that in survival cases. No significant difference between mean incubation period, exposure rates of main risk factors in dead cases and in survival cases was found.</p><p><b>CONCLUSION</b>Preventing toxic shock syndrome might reduce the fatality rate. The target population for preventing death is aged > or = 40. Liver function and renal function testing might be indicators for monitoring the progression of human Streptococcus suis infections.</p>