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Objective:To investigate the anatomy of rectus femoris muscle flap and the anterolateral thigh muscle flap and their clinical application in reconstruction of large soft tissue defects after the removal of oral malignant tumour.Methods:From December 2006 to June 2009, 8 specimens of Chinese adult cadavers fixed in 10% formaldehyde were dissected to perform anatomy of anterolateral thigh region at the School of Basic Medical Sciences, Kunming Medical University. Anatomical images were analysed using Image-Pro Plus 6.0. Then, a retrospective study was performed on 19 patients who had postoperative defects after oral malignant tumour surgery and the defects were reconstructed with the rectus femoris muscle flap and the anterolateral thigh muscle flap from March 2020 to July 2022 at the Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital, Kunming Medical University. The postoperative defects of the 19 patients ranged from 3.0 cm×6.0 cm to 5.0 cm×10.0 cm. Ten rectus femoris muscle flaps, 8 anterolateral thigh muscle flaps and 1 combined rectus femoris muscle flap and anterolateral thigh muscle flap were used. The muscular flaps sized from 4.0 cm × 8.0 cm to 6.0 cm × 11.0 cm. Regular postoperative outpatient follow-ups were conducted.Results:The lengths of vessels of the harvested rectus femoris muscle flap and anterolateral thigh muscle flap were 63.4 mm± 12.9 mm and 112.5 mm± 19.6 mm, respectively. The starting outer diameters of the lateral circumflex thigh artery, the oblique branch of the lateral circumflex thigh artery and the descending branch of the lateral circumflex thigh artery were 2.92 mm±0.72 mm, 1.88 mm±0.23 mm and 2.29 mm±0.43 mm, respectively. Postoperative follow-up lasted for 7 to 32 months, with 17.5 months in average. Seventeen flaps were completely survived and the rectus femoris muscle flap was completely mucosalised 5 weeks after surgery. However, 2 rectus femoris muscle flaps had necrosis of which one was changed to a tongue flap reconstruction and the other encountered flap necrosis during postoperative radiotherapy and healed after debridement and dressing changes. There was no postoperative complication in the donor sites. Other than the 2 patients, all other 17 patients had satisfactory clinical outcomes.Conclusion:Both of the starting outer diameters and length of vessels of the femoris muscle flap and the anterolateral thigh muscle flap meet the requirements for reconstruction of maxillofacial defects, and both muscular flaps are simple to prepare, in good reconstructive results with few complication, as well as an excellent outcome. They are feasible approaches for reconstruction of large soft tissue defects left after the removal of an oral malignant tumour.
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Objective:To compare the clinical efficacy and safety of ledipasvir/sofosbuvir (LDV/SOF) and elbasvir/grazoprevir (EBR/GZR) in treatment of patients with chronic hepatitis C (CHC).Methods:The clinical data of 143 patients with genotype 1b CHC treated in Huzhou Central Hospital from January 2020 to December 2021 were retrospectively analyzed, including 74 cases treated with LDV/SOF and 69 cases treated with EBR/GZR. The virological response after 4 and 12 weeks of treatment and 12wk after drug withdrawal was determined; and the serological and liver inflammation indexes before and after treatment in two groups were compared. SPSS 25.0 software was used for statistical analysis of the data.Results:The virological response rates of the LDV/SOF group and EBR/GZR group were 97.30% and 98.55%, 98.65% and 100.00%, 97.30% and 98.55% after 4 and 12 weeks of treatment and 12 weeks after the end of treatment, respectively (all P > 0.05). At the end of treatment, the liver inflammation indexes ALT, AST and GGT in the two groups were significantly lower than the baseline levels ( Z=-7.470 and -6.974, -9.757 and -6.832, -3.578 and -4.054, P<0.01). Adverse reactions in both groups were mild, and no serious adverse events occurred. Conclusion:Both LDV/SOF and EBR/GZR have good clinical efficacy in the treatment of genotype 1b CHC patients. And the patients are well tolerated.
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Objective:To analyze the independent diagnostic indicators and their diagnostic values for pulmonary tuberculosis complicated with pulmonary embolism.Methods:A total of 34 cases of pulmonary tuberculosis complicated with pulmonary embolism treated in Huzhou Central Hospital from March 2014 to September 2021 were enrolled. And 136 patients with simple pulmonary tuberculosis who were hospitalized during the same period were collected with a ratio of 1∶4 according to the principle of age and gender matching. The general conditions, clinical symptoms, comorbidities and laboratory indicators of the patients were retrospectively analyzed. The univariate analysis was performed using independent samples t test, Mann-Whitney U test and chi-square test. Binary logistic regression was used to analyze the related diagnostic factors for pulmonary embolism in pulmonary tuberculosis patients, and the combined factors were constructed by transforming the model equation, and the receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value and evaluate its diagnostic value. Results:The univariate analysis showed that patients with pulmonary tuberculosis complicated with pulmonary embolism had higher ratio of chest tightness (67.6%(23/34) vs 22.1%(30/136)), syncope (23.5%(8/34) vs 0.7%(1/136)), fever (55.9%(19/34) vs 36.0%(49/136)), hemostatic drug use (100.0%(34/34) vs 13.2%(18/136)), history of venous thrombosis (8.8%(3/34) vs 0.7%(1/136)), atrial fibrillation (11.8%(4/34) vs 2.2%(3/136)) and D-dimer levels (4.090 0(1.035 0, 10.790 0) mg/L vs 0.850 0(0.432 5, 2.145 0) mg/L) than those of simple pulmonary tuberculosis patients, and the differences were all statistically significant ( χ2=26.35, 28.19, 4.47, 96.44, 7.75, 6.30 and Z=-4.65, respectively; all P<0.050). The arterial partial pressure of oxygen (PaO 2)(61.90(52.95, 73.00) mmHg vs 82.00 (75.00, 87.00) mmHg, 1 mmHg=0.133 kPa) and albumin ((28.83±4.98) g/L vs (32.76±5.65) g/L) of patients with pulmonary tuberculosis complicated with pulmonary embolism were lower than those of simple pulmonary tuberculosis patients, and the differences were both statistically significant ( Z=-5.21 and t=3.71, respectively, both P<0.001). Binary regression analysis showed that chest tightness (odds ratio ( OR)=3.494, 95%confidence interval ( CI) 1.208 to 10.100, P=0.021), D-dimer ( OR=1.285, 95% CI 1.079 to 1.530, P=0.005) and PaO 2( OR=0.931, 95% CI 0.895 to 0.970, P=0.001) were the independent diagnostic indicators for pulmonary embolism in pulmonary tuberculosis patients. The areas under the ROC curve of chest tightness, D-dimer, PaO 2, and the combination of the three indicators (the combination factor) were 0.728, 0.758, 0.834, and 0.890, respectively. The optimal cut-off value of the combination factor was -3.1, with the sensitivity of 0.824 and the specificity of 0.824. Conclusions:Chest tightness, increased D-dimer and decreased PaO 2 are independent diagnostic indicators for pulmonary embolism in pulmonary tuberculosis patients. It is recommended to perform pulmonary artery computed tomography angiography promptly when the combination factor is higher than -3.1 to determine whether the patient is complicated by pulmonary embolism.
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Objective@#To analyze the characteristics of individuals positive for SARS-CoV-2 nucleic acid in a centralized isolation site for people entering China in Huzhou City of Zhejiang Province from December 18, 2021 to January 12, 2022, so as to provide insights into the prevention and control of overseas imported COVID-19. @*Methods@#The basic characteristics, nucleic acid detection and epidemiological investigations were collected from individuals positive for SARS-CoV-2 nucleic acid in a centralized isolation site for people entering China from December 18, 2021 to January 12, 2022, and the temporal distribution, population distribution, source of importation, and virus typing were descriptively analyzed.@*Results @#From December 18, 2021 to January 12, 2022, a total of 2 974 individuals in 19 flights were recorded in this centralized isolation site, and 33 cases were tested positive for SARS-CoV-2 nucleic acid, including 21 confirmed cases with common type, 9 confirmed cases with mild type, and 3 cases with asymptomatic infections. There were 11 cases with Omicron infections ( 33.33% ), 5 cases with Delta infections ( 15.15% ), and 17 cases with infection of unidentified types ( 51.52% ). The median interval ( interquartile range ) from the time of entry to the time of a positive test was 4.0 ( 7.0 ) days among all positive cases, 0 ( 4.0 ) day among cases with Omicron infections and 4.5 ( 8.5 ) days among cases with infections of Delta and unidentified types. The positive cases had a mean age of ( 36.97±8.58 ) years, and included 27 men (81.82%). There were 30 cases ( 90.91% ) receiving two and more doses of COVID-19 vaccines, and 7 cases ( 21.21% ) with a previous history of SARS-CoV-2 infections. There were 19 cases ( 57.58% ) from African countries, and 7 of 11 cases with Omicron infections were imported from African countries.@*Conclusion@#Omicron infection was predominant among individuals positive for SARS-CoV-2 nucleic acid in this centralized isolation site for people entering China from December 18, 2021 to January 12, 2022, with no severe cases detected, and most positive cases were imported from African countries.
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OBJECTIVE@#To carry out prenatal diagnosis on a fetus with abnormal findings by ultrasonography and non-invasive prenatal testing.@*METHODS@#The fetus and both parents were subjected to chromosomal karyotyping and single nucleotide polymorphism array (SNP-array) analysis.@*RESULTS@#The karyotypes of both parents were normal. The fetus carried a 46,N,der(X;16)(q28;q22) unbalanced translocation. SNP-array analysis confirmed that the derived chromosomal fragment of the fetus has originated from 16q. The fetus was diagnosed with 16q partial trisomy syndrome.@*CONCLUSION@#Combined chromosomal karyotyping analysis and SNP-array can detect chromosomal aberrations at submicroscopic level and enable accurate diagnosis of the fetus.
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Objective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.
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Objective:To analyze the clinical characteristics of brucellosis in Huzhou City, Zhejiang Province, so as to provide basis for clinicians to improve their understanding and diagnosis and treatment of brucellosis.Methods:The data of 10 cases of brucellosis in Huzhou Central Hospital from 2014 to 2019 were collected, and the epidemiological characteristics, clinical manifestations, laboratory examination results, imaging examination results, etiological examination results, diagnosis and treatment process and prognosis were summarized and analyzed by retrospective analysis method.Results:Among the 10 patients with brucellosis, 6 were males and 4 were females, aged from 32 to 71 years old, and 9 patients had a history of contact with goat, and one case was considered as food borne infection. The main clinical manifestations were fever (10 cases), sweating (2 cases), joint pain (7 cases). In imaging examination, 5 cases with splemomegaly, 1 cases with lymphadenopathy, 3 patients presented with spondylitis (including 1 case with paravertebral abscess) and 2 cases with prostatitis; Brucella was cultured in 2 patients and Brucella antibodies were positive in 10 patients. The treatment drugs included doxycycline, rifampicin and levofloxacin in two or three combinations. Eight patients were followed up for more than 1 month to more than 5 years, and the prognosis was good. Conclusions:Brucellosis lacks specificity in clinical features. Most patients with brucellosis are associated with osteoarthritis or urinary system diseases. Physicians should be vigilant, combine epidemiological features, conduct laboratory tests in time, and diagnose as soon as possible.
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Objective@#Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province.@*Methods@#A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data.@*Results@#The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05).@*Conclusions@#The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.
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Objective To study the effect of different medication time of cefuroxime sodium on nosocomial infections of surgical incision and C-reactive protein (CRP) in patients of Department of Obstetrics and Gynecology.Methods A total of 158 surgery patients in Department of Obstetrics and Gynecology who were treated in the People ~ Hospital of Qing County from July 2015 to November 2017 were enrolled in the study.According to random number method,they were randomly divided into control group and observation group,with 79 cases in each group.The observation group received the treatment of cefuroxime sodium in the perioperative period,the control group was given cefuroxime sodium treatment after surgery.The differences of the probability of a nosocomial infection and CRP between the two groups who chose different medication time were compared.Results The observation group had 45 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (40.17 ± 10.35)h.The control group had 59 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (56.35 ±9.87)h,which of the observation group were less than that of the control group,the differences were statistically significant (x2 =5.513,P =0.019;t =8.163,P =0.000).The levels of CRP and procalcitonin of the observation group after surgery were (2.34 ± 0.66) mg/L,(2.48 ± 0.79) mg/L,respectively,which were lower than those of the control group [(3.46 ± 0.84) mg/L,(3.19 ± 0.96) mg/L],the differences were statistically significant (t =9.260,P =0.000;t =5.104,P =0.000).The observation group had 2 patients appeared incision infection after surgery,the control group had 9 patients appeared incision infection after surgery,there was statistically significant difference between the two groups(x2 =4.788,P =0.029).The hospitalization time of the observation group was (6.70 ± 1.04) d,which was shorter than (8.26 ± 1.25)d of the control group,there was statistically significant difference between the two groups(t =8.513,P =0.000).The quality of life score of the observation group after surgery was (85.63 ± 15.30) points,which was higher than (71.29 ± 11.07) points of the control group,there was statistically significant difference between the two groups (t =-6.748,P =0.000).Conclusion Using cefuroxime sodium in the perioperative period can reduce the probability of nosocomial infection in surgical patients,improve the level of inflammation in vivo,shorten the hospital stay and improve the quality of life of patients.
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Objective@#To investigate the effect of histone deacetylase inhibitor apicidin on the glioblastoma U87 cells and its regulation of OCT-4 gene expression.@*Methods@#Glioblastoma U87 cells were treated with different concentrations of apicidin, and dimethyl sulfoxide instead of apicidin was negative control. Methyl thiazolyl tetrazolium (MTT) assay was used to detect the proliferative ability of U87 cells treated by apicidin. The cell apoptosis was observed under the fluorescence microscope, and the cell cycle was detected by using flow cytometry. Reverse transcription-polymerase chain reaction and Western blot was used to detect the expression of mRNA and protein of U87 cells, respectively relative to the expression of GAPDH.@*Results@#MTT assay results showed that apicidin inhibited U87 cells proliferation in a dose-dependent and time-dependent manner, and half of the inhibitory concentration of cell proliferation at 48 h was (1.74±0.13) μmol/L. The cell proportion of U87 cells in S-phase of the negative control, 0.2, 0.5, and 1.0 μmol/L apicidin was (32.68±0.49)%, (33.73±0.76)%, (42.92±0.56)%, and (56.95±0.53)%, respectively after 48 h apicidin administration (P < 0.05), while the proportion of G1 and G2 phase cells was decreased. The karyopyknosis and other apoptotic changes were detected in U87 cells after 48 h treatment of 1.0 μmol/L apicidin under the confocal fluorescence microscope. Western blot and RT-PCR showed that the mRNA and protein relative levels of U87 cells OCT-4 were reduced after 1.0 μmol/L apicidin treatment for 48 h compared with the negative control group (mRNA: 72.44±0.00 vs. 56.66±0.23; protein: 86.59±0.19 vs. 56.04±0.15, both P < 0.01).@*Conclusions@#Apicidin can inhibit the growth of glioblastoma U87 cells, induce cell cycle arrest and apoptosis. Its mechanism may be related to the expression of OCT-4 inhibited by apicidin.
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Objective@#To investigate the efficacy and safety of daclatavir combined with sofosbuvir treatment in chronic hepatitis C (CHC) in the real world.@*Methods@#A total of 56 CHC patients administrated with daclatavir (60 mg/d) combined with sofosbuvir (400 mg/d) in Huzhou Central Hospital from February to June in 2018 were enrolled. All patients were administrated with daclatavir combined with sofosbuvir for 12 weeks and followed up for 24 weeks. The virological response and the effect of antiviral therapy on hepatic fibrosis were analyzed. Non-structural protein 5A (NS5A) region mutation sequence was detected by Sanger method. Safety and the adverse events were observed. The t test, chi-square test and Mann-Whitney U test were used to analyze the data.@*Results@#Hepatitis C virus (HCV) RNA of all patients treated with daclatavir and sofosbuvir was undectable after eight-week treatment. Sustained virological response at 12 weeks post-treatment (SVR12) was 98.1% (52/53). Gender, globulin, insulin, triglyceride and hemoglobin were correlated with virus clearance (χ2= 4.47, t=2.51, U=1.98, U=2.32 and t=2.03, respectively, all P<0.05). At 12 weeks of the end of the treatment, serum procollagen type Ⅲ, collagen type Ⅳ, liver stiffness measurement (LSM) value, aspartate aminotransferase-to-platelet ratio Index (APRI) score and fibrosis index based on the four factors (FIB-4) score were all improved (U=2.03, 2.15, 2.19, 2.12 and 2.26, respectively, all P<0.05). At 24 weeks of the end of treatment, these indexes showed clear improvement (U=2.09, 2.28, 2.24, 2.33 and 2.46, respectively, all P<0.05). Eight patients had Y93H or L31M resistance-related substitution mutations. Two out of eight patients with variants had negative coversion of HCV RNA and 44.4% (20/45) showed no variants after two weeks of treatment. There was no significant difference (χ2 = 1.11, P > 0.05). During the treatment, patients developed dizziness, fatigue, nausea and vomiting, panic, insomnia, sleepiness and sexual function enhancement.@*Conclusion@#Daclatavir in combination with sophobuvir shows high virological response and good safety in the treatment of chronic hepatitis C, and liver fibrosis is improved after clearance of HCV.
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Objective To investigate the efficacy and safety of daclatavir combined with sofosbuvir treatment in chronic hepatitis C (CHC) in the real world.Methods A total of 56 CHC patients administrated with daclatavir (60 mg/d) combined with sofosbuvir (400 mg/d) in Huzhou Central Hospital from February to June in 2018 were enrolled.All patients were administrated with daclatavir combined with sofosbuvir for 12 weeks and followed up for 24 weeks.The virological response and the effect of antiviral therapy on hepatic fibrosis were analyzed.Non-structural protein 5A (NS5A) region mutation sequence was detected by Sanger method.Safety and the adverse events were observed.The t test,chi-square test and Mann-Whitney U test were used to analyze the data.Results Hepatitis C virus (HCV) RNA of all patients treated with daclatavir and sofosbuvir was undectable after eight-week treatment.Sustained virological response at 12 weeks post-treatment (SVR12) was 98.1％ (52/53).Gender,globulin,insulin,triglyceride and hemoglobin were correlated with virus clearance (x2 =4.47,t=2.51,U=1.98,U=2.32 and t =2.03,respectively,all P＜0.05).At 12 weeks of the end of the treatment,serum procollagen type Ⅲ,collagen type Ⅳ,liver stiffness measurement (LSM) value,aspartate aminotransferase-to-platelet ratio Index (APRI) score and fibrosis index based on the four factors (FIB-4) score were all improved (U =2.03,2.15,2.19,2.12 and 2.26,respectively,all P ＜ 0.05).At 24 weeks of the end of treatment,these indexes showed clear improvement (U =2.09,2.28,2.24,2.33 and 2.46,respectively,all P ＜ 0.05).Eight patients had Y93H or L31M resistance-related substitution mutations.Two out of eight patients with variants had negative coversion of HCV RNA and 44.4％ (20/45) showed no variants after two weeks of treatment.There was no significant difference (x2 =1.11,P ＞ 0.05).During the treatment,patients developed dizziness,fatigue,nausea and vomiting,panic,insomnia,sleepiness and sexual function enhancement.Conclusion Daclatavir in combination with sophobuvir shows high virological response and good safety in the treatment of chronic hepatitis C,and liver fibrosis is improved after clearance of HCV.
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OBJECTIVE： To investigate the improvement effects of water extract of Astragalus membranaceus on chronic renal failure （CRF） model rats and its effects on MAPK signaling pathway， and to investigate possible mechanism. METHODS： Male SD rats were randomly divided into control group （10 rats） and model group （50 rats）. CRF model was established by intragastric administration of 25％ Adenine suspension 200 mg/kg （once a day， for consecutive 28 d）. After modeling， modeling group was randomly divided into model group， benazepril group （positive control， 2 mg/kg）， A. membranaceus water extract low-dose， medium-dose and high-dose groups （1.5， 3， 6 g/kg，by crude drug）， with 10 rats in each group. Control group and model group were given constant volume of normal saline intragastrically， and administration groups were given relevant medicine intragastrically， once a day， for consecutive 28 d. Twelve hours after last medication， the contents of serum renal function indexes （serum creatinine， urea nitrogen， uric acid） were determined by colorimetry. ELISA method was used to detect the levels of serum inflammatory factors （IL-1β， IL-6 and TNF-α）. The activity or content of oxidative stress related indexes （SOD， CAT and MDA）in renal tissue of rats were determined by hydroxylamine method， visible spectrophotometry method and thiobarbituric acid method. The mRNA expression of apoptosis-related factors （Bax， Bcl-2， Caspase-3） in renal tissue， MAPK signaling pathway-related regulatory protein p38 MAPK， phosphorylated p38 MAPK（p-p38 MAPK）， ERK1/2， phosphorylated ERK1/2 （p-ERK1/2）， JNK and phosphorylated JNK （p-JNK） were determined by real- time PCR and Western blotting assay. RESULTS： Compared with control group， the contents of renal function indexes and the levels of inflammatory factors in serum， MDA content， mRNA expression ratio of Bax and Bcl-2 （Bax/Bcl-2）， mRNA related expression of Caspase-3， related expression of phosphorylation product of MAPK signaling pathway-related regulatory proteins （p-p38 MAPK， p-JNK， p-ERK1/2） in renal tissue were increased significantly in model group， while the activities of SOD and CAT were decreased significantly in renal tissue （P＜0.01）. Compared with model group， the contents of renal function indexes and the levels of inflammatory factors in serum， Bax/Bcl-2， related expression of phosphorylation product of MAPK signaling pathway-related regulatory proteins in renal tissue were decreased significantly in administration groups as well as MDA content and mRNA related expression of Caspase-3 were decreased significantly in benazepril group and A. membranaceus water extract medium-dose and high-dose groups； the activities of SOD and CAT in renal tissue were increased significantly in benazepril group and A. membranaceus water extract medium-dose and high-dose groups （P＜0.05 or P＜0.01）. MDA content and Bax/Bcl-2 of benazepril group were significantly lower than those of A. membranaceus water extract high-dose group （P＜0.05）. CONCLUSIONS： A. membranaceus water extract has a certain improvement effect on CRF model rats， and inhibit its inflammatory reaction， oxidant stress and cell apoptosis， the mechanism of which may be associated with inhibiting the expression of MAPK signaling pathway-related regulatory proteins.
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Objective To analyze the effect of single nucleotide polymorphism ( SNP) rs8099917 of interleukin-28B ( IL-28B) on spontaneous virus clearance and the efficacy of antiviral therapy in hepatitis C virus (HCV) infected patients in Huzhou area of Zhejiang Province.Methods A total of 268 HCV-infected patients were enrolled.The high sensitive HCV RNA quantification , HCV genotype and the IL-28B rs8099917 SNP were detected at baseline.One hundred and sixty-three patients received pegylated interferon α-2a ( Peg-IFNα-2a) and ribavirin (RBV) combined antiviral therapy (referred as PR treatment) for 48 weeks, who were followed up for 24 weeks.The remaining 44 patients were treated with sofosbuvir and daclatasvir for 12 weeks. The virological response of patients with different IL-28B rs8099917 genotypes was monitored.The count data was compared by χ2 test.Results The distributions of IL-28B rs8099917 SNP were 84.33%for TT genotype and 15.67%for GT genotype, while the GG genotype was not detected.Of the 135 patients with acute HCV infection, 61 cases had spontaneous viral clearance , 74 cases were converted to chronic infection.The spontaneous clearance rates were 47.11% for TT genotype and 28.57% for GT genotype.There was no significant difference of the spontaneous clearance rate between TT and GT genotype (χ2 ＝1.072, P＝0.30). In 163 chronic hepatitis C (CHC) patients with PR treatment, the rate of sustained virological response (SVR) after 24 weeks follow-up was 86.50%(141 cases).SVR rate in patients with TT genotype was significantly higher than those with GT genotype (91.67%vs 47.36%, χ2 ＝28.212, P＜0.05).There was no statistically significant difference of the SVR rates between genotype 1b and 2a (χ2 ＝1.525, P＞0.05).In 44 patients received sofosbuvir and daclatasvir treatment , both SVR rates of TT genotype and GT genotype were 100%. Conclusions In Huzhou area of Zhejiang Province , there is no significant correlation between IL-28B rs8099917 genotype and spontaneous clearance in patients with acute HCV infection , but the genotype of IL-28B rs8099917 is valuable for the prediction of PR treatment efficacy , the SVR rate of the TT genotype is superior to the GT genotype.The SVR rate can reach 100% in patients received combination therapy of sofosbuvir and daclatasvir independent of polymorphism of IL-28B.
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Objective To explore effects of different urostomy education paths in patients undergoing cystectomy with creation of a urostomy.Methods 42 cases of patients after radical cystectomy with creation of a urostomy were randomly divided into the control group and the observation group. The control group received the original version of urostomy education path, while observation group received modified version of urostomy education path. Knowledge of urostomy, stoma bag replacing skills, and length of hospital stay were compared between the two groups. Results Patients in the observation group who received modified version of urostomy education path showed better knowledge of urostomy and skills of replaceing stomy bag, as well as shorter hospital stay (P<0.05).Conclusions Our modified version of urostomy education path results in improved self-care ability among patients and their family members. It suggests the urostomy education needs constant innovation and enhancement on the basis of practice.
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Objective To analyze the application value of enhanced depth imaging optical coherence tomography (EDI-OCT) in measuring the lamina cribrosa thickness(LCT) in patients with branch retinal vein occlusion (BRVO).Methods The clinical data of 65 patients with unilateral BRVO treated in our hospital from September 2014 to March 2016 were selected as the observation group.The single healthy eyes of 40 healthy individuals who received physical examination in the hospital during the same period were selected as the control group.The changes of retinal nerve fiber layer (RNFL) thickness,LCT,central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc,diopter and extent of visual field defect in the two groups were determined by EDI-OCT.Results There was no significant difference in the central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc and diopter between the two groups (all P ＞ 0.05).LCT of different regions of optic disc in the observation group were lower than those in the control group (all P ＜ 0.05).The range of visual field defects in the observation group was larger than that in the control group,and the RNFL thickness was lower than that in the control group (P ＜ 0.05).LCT was positively correlated with the thickness of whole RNFL in patients with BRVO,and was negatively correlated with the visual field defects (P ＜ 0.05).Conclusion EDI-OCT is an effective means for measuring LCT.LCT of patients with glaucoma BRVO is thinner than that of normal healthy people,and LCT is positively correlated with RNFL.thickness,and negatively correlated with visual field defects.
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Objective:To compare the nutritional status between alcoholic cirrhosis and viral cirrhosis,and to provide reference information for the nutritional support strategy.Methods:95 alcoholic cirrhosis and 260 viral cirrhosis patients were involved in the study.The patients were reviewed with NRS 2002 and SGA within 48 hours after admission.The general information and liver function parameters including gender,age,BMI,Child-Pugh score,ALB,PA and Hb were recorded.Results:The NRS 2002 nutritional risk rate of alcoholic cirrhosis and viral cirrhosis patients was 76.80％ and 65.00％,respectively.The SGA malnutrition rate of alcoholic cirrhosis and viral cirrhosis patients was 67.40％ and 61.90％,respectively.There was statistically significant difference between the two groups in gender,Child-Pugh A rate,ALB,PA,Hb and NRS 2002,while there was no significant difference in age,Child-Pugh B rate,Child-Pugh C rate,BMI and SGA.Conclusion:Nutritional dysfunction exists in both of the two types of liver cirrhosis.The nutritional risk rate and the anemia rate in alcoholic cirrhosis patients are significantly worse than those in viral cirrhosis patients.
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The purpose is to introduce the structure and principle of the high intensity focused ultrasound and to discuss its value and future development in tumor. The high intensity focused ultrasound uses the biological heat effect which focuses the high intensity ultrasound on the lesions to destroy them. It is non-invasive means to destroy the lesions, reduce the damage of the normal tissues greatly, improve the quality of life..With the development, application and popularization of the technology on high intensity focused ultrasound, it will serve the human health career better.
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Objective to analysis the cause of infant diarrhea in our hospital .Methods 3 260 cases of inpatient and outpatient children with diarrhea were collected from January 2014 to February 2015 .The cases were divided into five groups according to the test result and clinical diagnosis :indigestion ,rotavirus infection group ,bacterial diarrhea group ,lactose intolerance groups and other reason groups .And ,there were divided into four groups according to the age ,too .Results (1)The incidence of diarrhea in boys (60 .73% ) was higher than that in girls(39 .26% ) .(2)The main causes for diarrhea in the fall is bacterial diarrhea (53 .36% );ro‐tavirus infection in the winter (45 .12% ) ,respectively .(3 ) The highest incidence of children with diarrhea is 1 -12 months (49 .85% ) ,the highest incidence with diarrhea in 1-12 months was lactose intolerance (79 .61% ) .Conclusion Infantile diarrhea is still a high incidence of disease in children and caused by rotavirus infection ,bacterial infection ,lactose intolerance .
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Objective:To investigate the improving effect of simvastatin on the related indices of hyperlipidemia Patients at the early stage in Talimu oil field, and analyze the correlation between the pulse wave velocity ( PWV) and the other indicators. Methods:Totally 59 patients with hyperlipidemia in Talimu oil field hospital received simvastatin for 6 months. The systolic and diastolic blood pressure, high-sensitivity C-reactive protein (hs-CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol ( LDL-C) , PWV and ankle-brachial index ( ABI) were assessed before and after the treatment. Moreo-ver, the correlation between PWV with the other factors were analyzed by a multiple linear regression method. Results: After the six-month treatment, the systolic and diastolic blood pressure showed no significant change;TC and LDL-C were significantly decreased ( P<0. 05), while HDL-C was increased. PWV was significantly decreased, and ABI was improved significantly (P<0. 05). The chan-ges in PWV were correlated with age and hs-CRP(P<0. 05 or P<0. 01). Conclusion:Simvastatin can significantly improve the relat-ed indices in the patients with hyperlipidemia, reduce PWV, increase ABI and decrease serum hs-CRP level. The determination of PWV and hs-CRP can predict the degree of atherosclerosis better, which plays an important role in the prevention of cardiovascular dis-eases.