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A 57-year-old woman was admitted to hospital with fever. She still had fever treated with multiple antibiotics, and no definite evidence for infection was found. Hypothermia and hypotension developed, and magnetic resonance imaging (MRI) examination showed enlarged anterior pituitary and multiple small nodular lesions with mild enhancement on the left side. Hormone replacement and anti-infection treatment were administrated, but fever did not improve. Remarkable lymphadenopathy was found in left supraclavicular area. The pathology of lymph node biopsy indicated peripheral T-cell lymphoma (not otherwise specified, NOS). Positron emission tomography-computed tomography (PET-CT) revealed hypermetabolism in multiple lymph nodes, infiltration of the liver and spleen. The final diagnosis were peripheral T-cell lymphoma with involvement of liver and spleen (stage Ⅳ) and anterior hypopituitarism. After chemotherapy, fever alleviated and the function of anterior pituitary recovered gradually.
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Objective:To explore the satisfaction of clinical medicine master of professional degree with curriculum training, practice training, scientific research training, tutorial training and management services, and to find out the problems and put forward countermeasures.Methods:A questionnaire was surveyed on the satisfaction of 1 585 clinical masters of professional degree from a medical university in Guangxi. SPSS 20.0 was used for statistical analysis of related data. The quantitative data were uniformly described by means and standard deviation, and variance analysis was used for comparison between groups.Results:The students were most satisfied with the tutorial training, with an average score of 4 points; they were generally satisfied with the curriculum training and management services, and it showed a growing polarization in practice training and scientific research training; in terms of allowances, participation degree of scientific research, and intensity of scientific research work, the students were not satisfied.Conclusion:For the training of clinical medicine masters of professional degree, subsidies and allowances should be increased and the ability of school management services should be enhanced; the scientific research training platform should be developed and the participation in scientific research should be promoted; the training standards should be coordinately formulated and the intensity of scientific research should be moderately strengthened.
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Objective@#To investigate the association between the preterm birth and low birth weight and parental thalassemia.@*Methods@#Pregnant women and their husbands receiving prenatal examination in local hospitals or maternal and child health centers in Jingxi and Debao in Guangxi from January to December 2017 were selected as study subjects. A total of 758 pregnant women with pregnancy outcomes and their husbands, who were both or alone diagnosed with thalassemia through thalassemia gene detection, were selected as case group and 758 pregnant women with pregnancy outcomes and their husbands, who were negative in thalassemia gene detection and hemoglobin electrophoresis test were selected as control groups. The case group were further divided into mother group, father group and both mother and farther group. Clinical and pregnancy outcome data of the study subjects were collected for the analysis on the association between parental thalassaemia and preterm birth or low birth weight by the independent sample t test, χ2 test and Cox regression analysis.@*Results@#The incidence of preterm birth in case group and control group was about 6.5% and 1.6% and the incidence of low birth weight in case group and control group was about 7.3% and 0.8%. After adjusting for possible confounding factors, Cox regression analysis results showed that mother suffering from thalassemia (aRR=3.45, 95%CI: 1.35-8.81, P=0.010), fathers suffering from thalassemia (aRR=4.93, 95%CI: 2.16-11.21, P<0.001) and both mother and farther suffering from thalassemia (aRR=5.13, 95%CI: 2.62-10.04, P<0.001) were associated with preterm birth. Mother suffering from thalassemia (aRR=12.98, 95%CI: 4.91-34.30, P<0.001), fathers suffering from thalassemia (aRR=9.40, 95%CI: 3.40-25.95, P<0.001) and both mother and farther suffering from thalassemia (aRR=10.74, 95%CI: 4.44-26.00, P<0.001) were associated with low birth weight. The newborn whose parent all suffered from thalassemia had higher risks for preterm birth (χ2=22.72, P<0.001)and low birth weight (χ2=34.03, P<0.001) compared with those only with mother or father suffering from thalassemia.@*Conclusion@#Parental thalassaemia, including both sides and single side, might increase the risks of preterm birth and low birth weight for newborn, and the risks might be higher in newborn with both mother and father suffering from thalassaemia.
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Objective To investigate the association between the value of α-thalassemia minor and the outcomes in pregnant women.Methods A total of 445 pregnant women with α-thalassemia minor were selected as thalassemia group in the Pingguo County Maternal and Child Health Hospital of Guangxi from January 2011 to December 2015,with ratio of 1 ∶ 4 healthy pregnant women was randomly recruited as non-thalassemia group.Clinical characteristics and pregnancy outcomes of the two groups were retrospectively analyzed using methods including t test,x2 test,and logistic regression model and ROC curve.Results There were no significant differences noticed in factors as age,BMI,gestational age and educational level of the two groups.Hemoglobin of the thalassemia group was significantly lower than that of the non-thalassemia group (P＜0.001).Differences on parity,ethnicities or occupation were statistically significant.Results from univariate analysis showed that the proportions of low birth weight,small for date infant and 1 min Apgar score ＜7 were higher in the thalassemia group,but the ratio of adverse pregnancy outcomes was comparable on parameters as preterm birth,stillbirth,macrosomia.Findings from the unconditional logistic regression showed that pregnancy complicated with α-thalassemia minor appeared a risk for both newboms with low birth weight (aOR=2.29,95％CI:1.32-3.95) and small for date infant (aOR=2.11,95％ CI:1.16-3.84).The ROC curve showed that α-thalassemia minor combined with multiple indicators presented a certain predictive value on neonatal birth weight.Conclusion Pregnancy complicated with α-thalassemia minor was likely to increase the risk of birth weight loss in newborns,suggesting that prenatal care for pregnant women with thalassemia be strengthened,in order to reduce the incidence of adverse pregnancy outcomes.
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Objective To investigate the association between the value of α-thalassemia minor and the outcomes in pregnant women.Methods A total of 445 pregnant women with α-thalassemia minor were selected as thalassemia group in the Pingguo County Maternal and Child Health Hospital of Guangxi from January 2011 to December 2015,with ratio of 1 ∶ 4 healthy pregnant women was randomly recruited as non-thalassemia group.Clinical characteristics and pregnancy outcomes of the two groups were retrospectively analyzed using methods including t test,x2 test,and logistic regression model and ROC curve.Results There were no significant differences noticed in factors as age,BMI,gestational age and educational level of the two groups.Hemoglobin of the thalassemia group was significantly lower than that of the non-thalassemia group (P＜0.001).Differences on parity,ethnicities or occupation were statistically significant.Results from univariate analysis showed that the proportions of low birth weight,small for date infant and 1 min Apgar score ＜7 were higher in the thalassemia group,but the ratio of adverse pregnancy outcomes was comparable on parameters as preterm birth,stillbirth,macrosomia.Findings from the unconditional logistic regression showed that pregnancy complicated with α-thalassemia minor appeared a risk for both newboms with low birth weight (aOR=2.29,95％CI:1.32-3.95) and small for date infant (aOR=2.11,95％ CI:1.16-3.84).The ROC curve showed that α-thalassemia minor combined with multiple indicators presented a certain predictive value on neonatal birth weight.Conclusion Pregnancy complicated with α-thalassemia minor was likely to increase the risk of birth weight loss in newborns,suggesting that prenatal care for pregnant women with thalassemia be strengthened,in order to reduce the incidence of adverse pregnancy outcomes.
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Objective To investigate the clinical features and risk factors of recurrent communityacquired pneumonia (CAP) in elderly patients.Methods Clinical data of elderly CAP patients admitted to the first affiliated hospital of Sun Yat-Sen university from January 2012 to December 2014 were analyzed retrospectively,including 48 cases of recurrent CAP and 299 cases of non-recurrent CAP.The clinical features were compared between two groups,and the risk factors of recurrent CAP were assessed with logistic regression analysis.Results No significant differences were observed between the two groups in age,sex,smoking,drinking,average hospital stays and total hospitalization expenses (all P ＞ 0.05).In the recurrent pneumonia group,the chronic obstructive pulmonary diseases [54.2％ (26/48) vs.35.5％ (106/299),χ2 =6.146,P=0.013],diabetes [41.7％ (20/48) vs.19.7％ (59/299),χ2 =11.317,P=0.001],the clinical symptoms include cough [79.2％ (38/48) vs.58.5％ (175/299),χ2 =7.432,P =0.006],sputum [70.8％ (34/48) vs.54.5％ (163/299),χ2 =4.488,P =0.034],fever [64.4％ (31/48) vs.40.8％(122/299),χ2 =9.488,P =0.002],poor appetite [52.1％ (25/48) vs.33.1％ (99/299),χ2 =6.483,P =0.011],choking cough [8.3％ (4/48) vs.2.7％ (8/299),χ2 =3.966,P =0.046],poor spirit [45.8％ (22/48) vs.28.4％ (85/299),χ2 =5.875,P =0.015],bilateral lung lesions [41.7％ (20/48)vs.28.8％ (68/299),χ2 =7.825,P =0.005],the complication of respiratory failure [31.3 ％ (15/48) vs.14.7％ (44/299),χ2 =8.012,P =0.005] were higher than those in non-recurrent group.Logistic regression revealed that chronic obstructive pulmonary disease (OR =2.607,95％ CI:1.268-5.358,P =0.009),diabetes (OR =2.948,95％ CI:1.457-5.966,P =0.003) and the history of respiratory failure (0R=2.778,95％CI:1.264-6.108,P=0.011) were risk factors of recurrent CAP.Conclusions Elderly patients with recurrent CAP has a higher rate of cough,sputum and fever,and the scope of lung lesions is broader.Chronic obstructive pulmonary disease,diabetes and the history of respiratory failure are the independent risk factors for recurrent CAP in the elderly.
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Middle East respiratory syndrome coronavirus (MERS-CoV) has caused outbreaks of SARS-like disease with 35% case-fatality rate, mainly in the Middle East. A more severe outbreak of MERS occurred recently in the Republic of Korea, where 186 people contracted the infections, causing great concern worldwide. So far, there has been no clinically available drug for the treatment of MERS-CoV infection. The potential drugs against MERS-CoV mainly consist of monoclonal antibodies, peptides and small molecular agents. Small molecular agents have an advantage of easier synthesis, lower cost in production and relatively higher stability. There is better chance for those candidates to gain a quick development. This article reviews the progress of developing small molecular MERS-CoV agents.
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<p><b>OBJECTIVE</b>To investigate the effect of Euphorbia fischeriana extract on latent HIV reactivation and the pathway involved in this process and discuss the value of Euphorbia fischeriana extract in eliminating HIV.</p><p><b>METHODS</b>Fresh tissues of Euphorbia fischeriana root were crushed into powder after quick freezing with liquid nitrogen and extracted with acetone followed by a three-day vacuum freeze-drying for dehydration of the extract. The extract (EFE) was separated using RP-C18 column with high-performance liquid chromatography (HPLC) and identified with mass spectrometry (MS). The activity of reactivated latent HIV was analyzed by fluorescence-activated cell sorting in a J-Lat 10.6 cell model treated with EFE (50 µg/mL) for 24 h, using TNF-α (10 ng/mL) as the positive control. The effect of a NF-κB pathway inhibitor (Bay 11-7082) on EFE activity was tested. The changes in P65 expression in the cell nuclei within 2 h and HIV protein p24 expression within 24 h were analyzed by Western blotting in cells treated with EFE.</p><p><b>RESULTS</b>EFE was obtained by one-step acetone extraction, and the concentration of prostratin in the extract was around 0.53 mmol/L. About 50% of the cells showed HIV reactivation after treatment with 50 µg/mL EFE for 24 h accompanied by a significantly increased p24 expression. The activity of EFE in reactivating latent HIV was inhibited by Bay 11-7082 in a concentration-dependent manner, and p65 accumulation was detected in the cell nuclei within 2 h.</p><p><b>CONCLUSION</b>EFE we obtained contains the active compounds of prostratin and its analogues and shows a strong capacity to reactivate latent HIV through classical NF-κB pathway.</p>
Subject(s)
Humans , Euphorbia , Chemistry , Flow Cytometry , HIV , HIV Infections , NF-kappa B , Metabolism , Nitriles , Phorbol Esters , Chemistry , Plant Extracts , Pharmacology , Signal Transduction , Sulfones , Tumor Necrosis Factor-alpha , Virus LatencyABSTRACT
10.3969/j.issn.1007-3969.2013.04.005
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The effect of iodinated contrast on thyroid function and auto-antibodies after a single percutaneous coronary intervention (PCI) was explored.In 96 patients with randomly selected PCI,serum TSH,T3,T4,thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb) were determined preoperatively as well as by 3-6 months postoperatively.After PCI,the level of TSH,T3,T4,showed no significant changes; TgAb,TPOAb which were positive preoperatively,after 3-6 months were statistically increased(P＜0.05).Iodinated contrast in PCI has no significant influence on thyroid function and auto-antibodies after 3-6 months.
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Objective To investigate the association between preoperative serum TSH level and differentiated thyroid cancer (DTC).Methods The relationship between TSH concentration and differentiated thyroid cancer in 400 qualified patients with thyroid nodules was retrospectively analyzed from January 2009 to December2011 in our hospital.Based on the TSH values,the patients were divided into five groups.Results Preoperative serum TSH level in DTC group was higher than that in benign thyroid nodales group [(2.94 ± 1.74 vs1.92 ± 1.45) μ IU/ml,P＜0.01].The risk of DTC increased as serum level of TSH rose in the patients with thyroid nodule.The incidences of DTC were 27.8％,34.0％,40.0％,63.4％,and 70.2％ respectively in groups with TSH＜0.27,0.27-1.44,1.45-2.19,2.20-4.20,and ＞4.20 μIU/ml groups.TSH level in the group with cervical lymph node metastasis was higher than that without metastasis (P＜0.01).Conclusions The likelihood of thyroid cancer increases with increased serum TSH concentration.High TSH level seems to be associated with lymph node metastasis.Preoperative serum TSH level might be a risk predictor for DTC.
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Objective To investigate the rehabilitative effect of low frequency repetitive transcranial magnetic stimulation (rTMS) on convalescing patients with Broca's aphasia. MethodsTwenty-eight patients with Broca's aphasia recovering from cerebral infarction were randomly divided into a stimulation group and a control group with 14 subjects in each.Patients in the control group accepted conventional drugs,speech rehabilitation and sham stimulation,while patients in the stimulation group were in given low frequency rTMS in place of the sham stimulation.Their speech performance was evaluated using the China Rehabilitation Research Center's aphasia examination (CRRCAE) pre-stimulation,post-stimulation and 90 days later. ResultsCompared with before treatment and with the controls,the speaking scores of the stimulation group increased significantly after treatment and also 90 days later. ConclusionLow frequency rTMS can not only improve the speech performance of Broca's aphasia sufferers in the short term,but it also plays a lasting role.It may thus have clinical application for patients with Broca's aphasia.
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We carried out a new unit-based method in the teaching process of epidemiology for improving undergraduate prevention-oriented medical students' comprehensive ability. The new method integrated heuristic teaching and case teaching, and focused reform on the system of teaching and assessment. The results showed new teaching method can significantly improve students' capacity of analysis and oral expression, and contributes to the comprehensive ability.
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Objective To evaluate the relationship between iodine intake and the prevalence of thyroid diseases in Urumqi.Methods A total of 1693 subjects were investigated.Serum thyroid hormones,thyroid autoantibodies,and urinary iodine concentration were determined,and type B ultrasonography of thyroid gland was performed in all participants.Result The urinary iodine level revealed that 9.5％ of the subjects were iodine deficient and 30.0％ iodine excessive.The average median urinary iodine was 254.9 μg/L.Serum total T4 level in the idione adequate and more than adequate groups was significantly higher than the other 2 groups [ ( 9.02±2.63 ) vs (7.69±2.85)、(8.45 ±2.13 ) μg/dl,both P＜0.05 ],and serum TSH level in the idione deficient group was significantly higher than the other 2 groups [ (3.00±1.86) vs (2.37±1.91),(2.27±1.86) mIU/L,both P＜0.01 ].There was no significant statistical difference in positive rates of thyroid autoantibodies,morbidities of thyroid dysfunction and goiter among 3 groups.Conclusion The iodine deficient situation has been corrected in Urumqi.There is no difference in morbidities of thyroid diseases in population with different iodine intakes.
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BACKGROUND:An abroad study repoRed the distribution and expression of augmenter of liver regeneration(ALR)in the central nervous system.There are few literatures on how to prepare and evaluate ALR protein polyclonal antibody in recombinant rats,and how to construct prokaryotic expression vector.There are no repots concerning ALR in the central nervous system in China.OBJECTIVE:TO express ALR fusion protein in E coli BL21 and prepare and identify polyclonal antibody.METHODS:RNA was extracted from the hippocampus of Sprague Dawley rats.The prokaryotic expression plasmid pET28a-ALR was constructed and the positive recombinant plasmid was transformed into BL21.Protein ALR was expressed by inducing transformed BL21 with Isopropyl-β-D-thiogalactopyranoside(IPTG)and purified by Ni~(2+)affinity chromatography column after immune the rabbit for 4 times.the serum of rabbits was extracted from hear as polyclonal antibody.The titer and specificity of the rabbit's antiserum was respectively measured by ELISA and Western blotting The following parameters were measured:construction of prokaryotic expression plasmid pET26a-ALR;pET28a-ALR recombinant enzyme digestion evaluation;results of ELISA and Western-blotting.RESULTS AND CONCLUSION:Expecting bands were obtained by double enzyme digestion electrophoresis,respectively 5.3 kb and 0.4 kb.Nucleotide sequence analysis verified that prokaryotic expression vector pET28a-ALR was successfully constructed.The 19 ku fusion protein was successfuIly expressed.The titer of the antiserum measured by ELlSA could achieve 1:2 000 This indicated that antibody and purified recombinant ALR had a good reaction.and high titer.could meet the experimental require.Western blotting analysis proved that the antibody could identify the prokaryotic expression product of ALR.Prokaryotic expression system expressed ALR fusion protein,prepared and purified polyclonal antibody of ALR protein,and could meet the experimental require of ALR immunoblotting.
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The purpose and meaning of epidemiology curriculum,the current problems existing in the teaching and teaching reforms for different specialties were discussed.
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OBJECTIVE： To study the method of measuring the in vitro dissolubility of lansoprazole enteric－ coated tablets and to find out the difference between the dissolubility of lansoprazole enteric－ coated tablets and that of lansoprazole enteric－ coated capsules.METHODS： To establish a measuring method of the dissolubility of lansoprazole enteric－ coated tablets and compare the dissolubility of lansoprazole enteric－ coated tablets with that of lansoprazole enteric－ coated capsules and to acquire the dissolving parameters for variance analysis.RESULTS： (1)The accumulative dissolving quantity of the both preparations exceeded 80％ in 30 minutes.(2)The comparison of Weibull parameters,T50,Td and m,between each other in group A showed no significant differences(P>0.05).It was the same for those of group B.(3)The parameters,T50 and Td,of group A,in comparison with those of group B,showed significant differences(P<0.001).The times needed for dissoiving 50％ and 63.2％ of quantity in group B were both shorter than those in group A.The m parameters in different groups had no significant differences(P>0.05).There was no significant difference in slope of equation between two groups.CONCLUSION： This measuring method of the in vitro dissolubility of lansoprazole enteric－ coated tablets is simple,convenient,accurate,stable,feasible and good in repetition.It is concluded that there is significant difference between the dissolubility of the two dosage forms of enteric－ coated preparation of lansoprazole.
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Objective: To get the information about freshmen's mental health and it relationship with sex, city and countryside difference, and to provide the reference for effective mental health education and consultation. Methods: The situation of 1351 freshmen's mental health was surveyed by using UPI. Results: ①11.91% of the freshmen had serious mental derangement, 26.15% of them had a little psychological problem. ②The distinct difference existed not only between male and female, but also between city and countryside. The mental health of male students surpassed the female students, the city students surpassed the countryside students. Conclusion: The situation of medical freshmen's mental health should not be neglected, and its influence factors are various. Mental health education and consultation should be pointed to the students.
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0.05).It was the same for those of group B.(3)The parameters,T50 and Td,of group A,in comparison with those of group B,showed significant differences(P0.05).There was no significant difference in slope of equation between two groups.CONCLUSION:This measuring method of the in vitro dissolubility of lansoprazole enteric-coated tablets is simple,convenient,accurate,stable,feasible and good in repetition.It is concluded that there is significant difference between the dissolubility of the two dosage forms of enteric-coated preparation of lansoprazole.