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OBJECTIVE To explore the effects of intensive pharmaceutical intervention led by clinical pharmacists on hypertension patients with medium and high risk of ischemic stroke. METHODS The hypertension outpatients with medium and high risk of ischemic stroke， who were assessed by the modified Framingham stroke scale in Zhengzhou People’s Hospital from Oct. 2019 to Apr. 2020， were randomly divided into control group and intervention group， with 200 cases in each group. Patients in the control group received conventional treatment without pharmaceutical intervention； on the basis of conventional treatment， patients in the intervention group received 12-month intensive pharmaceutical intervention （grading management of compliance+ regular follow-up， involving medication education and guidance， blood glucose， blood pressure， blood lipid management and healthy life guidance） provided by clinical pharmacists. The blood glucose indexes， blood lipid indexes， blood pressure compliance rate， medication compliance， 10-year stroke risk and stroke incidence were compared between two groups at baseline and 12 months after enrollment. RESULTS After 12 months of enrollment， the level of low-density lipoprotein cholesterol （LDL-C） in intervention group was significantly lower than that in the same group at baseline， and the levels of fasting blood glucose， glycosylated hemoglobin， total cholesterol and LDL-C in intervention group were significantly lower than those in control group at the same time points （P＜0.05 or P＜0.01）. The compliance rate of blood pressure and medication compliance in intervention group were significantly higher or better than those in control group （P＜0.01）. There were 12 and 15 patients in control group and intervention group turned into low-risk ones respectively， and the proportion of high-risk patients in intervention group was significantly lower than that in control group（P＜0.01）， while the proportion of medium-risk patients was significantly higher than that in control group（P＜0.05）； the incidence of stroke in intervention group was significantly lower than that in control group （1.0% vs. 4.5%， P＜0.05）. CONCLUSIONS The pharmaceutical intensive intervention led by clinical pharmacists can reduce blood glucose and blood lipid levels of hypertensive outpatients， improve their blood pressure compliance rate and medication compliance， and help reduce the risk of stroke.
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The syndrome of dampness stagnancy due to spleen deficiency (DSSD) is relatively common globally. Although the pathogenesis of DSSD remains unclear, evidence has suggested that the gut microbiota might play a significant role. Radix Astragali, used as both medicine and food, exerts the effects of tonifying spleen and qi. Astragalus polysaccharide (APS) comprises a macromolecule substance extracted from the dried root of Radix Astragali, which has many pharmacological functions. However, whether APS mitigates the immune disorders underlying the DSSD syndrome via regulating gut microbiota and the relevant mechanism remains unknown. Here, we used DSSD rats induced by high-fat and low-protein (HFLP) diet plus exhaustive swimming, and found that APS of moderate molecular weight increased the body weight gain and immune organ indexes, decreased the levels of interleukin-1β (IL-1β), IL-6, and endotoxin, and suppressed the Toll-like receptor 4/nuclear factor-κB (TLR4/NF-κB) pathway. Moreover, a total of 27 critical genera were significantly enriched according to the linear discriminant analysis effect size (LEfSe). APS increased the diversity of the gut microbiota and changed its composition, such as reducing the relative abundance of Pseudoflavonifractor and Paraprevotella, and increasing that of Parasutterella, Parabacteroides, Clostridium XIVb, Oscillibacter, Butyricicoccus, and Dorea. APS also elevated the contents of short-chain fatty acids (SCFAs). Furthermore, the correlation analysis indicated that 12 critical bacteria were related to the body weight gain and immune organ indexes. In general, our study demonstrated that APS ameliorated the immune disorders in DSSD rats via modulating their gut microbiota, especially for some bacteria involving immune and inflammatory response and SCFA production, as well as the TLR4/NF-κB pathway. This study provides an insight into the function of APS as a unique potential prebiotic through exerting systemic activities in treating DSSD.
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Rats , Animals , NF-kappa B/metabolism , Spleen , Gastrointestinal Microbiome , Toll-Like Receptor 4 , Polysaccharides/pharmacology , Astragalus Plant/metabolism , Immune System Diseases/drug therapy , Body WeightABSTRACT
The contents of general practice discipline construction comprise of orientation, team development, personnel training, scientific research, teaching base establishment and management of the discipline, etc. At present, the weakness in above aspects of general practice discipline construction is still the major challenges in most of the primary healthcare institutions. Our experiences in last 10 years shows that the application of Leicester Assessment Package can effectively promote the general practice discipline development for primary care institutions.
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Based on the self-assembly process occurring in the human body all the time, self-assembled nanomaterials were designed by the researchers. The self-assembled nanomaterials have controllability, biocompatibility and functional advantages in vivo. The self-assembled nanomaterials constructed in situ under a physiological environment display various biological characteristics which can be used for imaging, therapy, and broad clinical applications. In situ self-assembled nanomaterials can boost drug function, reduce toxic and side effects, prolong imaging time and enlarge signal-to-noise ratio. By using pathological conditions to trigger specific responses in vivo, well-ordered nanoaggregates can be spontaneously formed by multiple weak bonding interactions. The assembly shows higher accumulation and longer retention in situ. Endogenous triggers for in situ assembly, such as enzymes, pH, reactive oxygen species and ligand receptor interaction, can be used to transform the materials into a variety of controllable nanostructures including nanoparticles, nanofibers and gels through bioactivated in vivo assembly (BIVA) strategies. BIVA strategies can be applied for treatment, imaging or participate in the physiological activities of cells at the lesion site. This review summarized and prospected the design of self-assembled peptide materials based on BIVA technology and their biomedical applications. The nanostructures of the self-assembly enable some beneficial biological effects, such as assembly induced retention (AIR) effect, enhanced targeting effect, multivalent bond effect, and membrane disturbance. Thus, the BIVA nanotechnology is promising for efficient drug delivery, enhancement of targeting and treatment, as well as optimization of the biological distribution of drugs.
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Humans , Drug Delivery Systems , Nanofibers/chemistry , Nanoparticles , Nanostructures/chemistry , PeptidesABSTRACT
Objective:To evaluate the effectiveness of mentorship-Leichester assessment package (LAP) model in general practice teaching.Methods:Sixty five-year Traditional Chinese Medicine (TCM) students undergoing general medicine internship from July 2020 to December 2020 were divided into study group and control group with 30 students in each group. Students in study group undertook general practice internship in Fangzhuang Community Health Service Center with the mentorship-LAP model, including group-based teaching, weekly LAP case discussion and mentor-intern individualized LAP clinical practice teaching; students in control group undertook general practice internship in other community teaching bases with the traditional clinical practice training methods. After one month, students were evaluated with LAP score sheet and the evaluation results were compared between two groups.Results:After one month of training, the scores of medical history collection, physical examination, problem solving, patient management, doctor-patient relationship, expected care and medical records in both groups increased compared with pre-training (the control group: t=4.23, 5.06, 8.94, 4.85, 3.99, 1.04, 5.13, study group: t=1.86, 2.85, 12.42, 13.61, 6.29, 4.83, 5.63, all P<0.05). The scores of medical history collection, physical examination, problem solving, patient management, doctor-patient relationship, and expected care after training in the study group were higher than those in the control group ( t=5.66, 2.83, 5.67, 8.13, 2.76, 2.52, all P<0.05). After the training, in the medical history collection items, the scores of patient-centered communication, RICE recognition, and physical-psychological-social factors in study group were higher than those in the control group ( t=5.66, 7.35 and 2.66, all P<0.05); in the problem-solving items, the scores of clinical data application, comprehensive analysis ability and personal ability limitation in study group were higher than those in the control group ( t=4.32, 3.38 and 2.26, all P<0.05); in the patient management items, the scores of overall management plans, doctor-patient collaboration, dispelling doubts, subsequent visits/follow-up, and the degree of patient understanding the management plan in the study group were higher than those in the control group ( t=3.03, 2.07, 2.43, 3.15 and 2.17, all P<0.05). Conclusion:The mentorship-LAP teaching model is helpful to improve the effectiveness of general practice internship for medicine students.
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Objective:To investigate the complications and prevention strategies of Dynesys stabilization in the treatment of lumbar degenerative disease.Methods:Two hundred and forty-three patients underwent lumbar spine stabilization with Dynesys owing to lumbar degenerative disease were retrospectively analyzed from July 2008 to December 2016. The mean follow-up time was 5.6 years (48-148 months). There were 152 patients with lumbar disc herniation and 91 patients with lumbar spinal stenosis. 167 cases underwent single-level operation, 71 cases underwent two-level operation, and 5 cases underwent three-level operation. All patients had low back pain, radiating pain in the lower extremities, and/or intermittent claudication. Clinical outcomes were evaluated using Oswestry disability index (ODI) and visual analogue scale (VAS). The occurrence of perioperative complications (with in 3 months) and postoperative complications (after 3 months) after the operation were recorded and analyzed. Radiographic adjacent segment degeneration (ASD) was evaluate dusing University of California at Los Angeles Grading Scale (UCLA).Results:All patients underwent surgery successfully. ODI score of patients improved from 55.1%±16.8% preoperatively to 15.6%±5.8% at the final follow-up, the difference was statistically significant ( t=34.6, P<0.01). VAS score decreased from 6.4±2.3 preoperatively to 1.1±0.4 at the final follow-up, the difference was also statistically significant ( t=35.4, P<0.01). There were 25 cases (10.29%) with complications, and 3 cases (1.23%) underwent secondary operation. Perioperative complications occurred in 13 patients (5.35%), including 5 cases of cerebros pinal fluid leakage, 5 cases of poor wound healing (2.06%), and 3 cases of deep wound infection (1.23%). Twelve patients (4.94%) had long-term postoperative complications, including 6 patients (2.47%) of unilateral screw loosening at the 5-year follow-up, 3 patients (1.23%) of screw fracture, and 3 patients (1.23%) of symptomatic ASD, among whom 2 patients underwent secondary operation, and 1 patient underwent conservative treatment. There was no recurrence at the operated segments in all patients. At the final follow-up, 41 patients (16.87%) had radiographic ASD. The UCLA score atthe final follow-up was significantly different from that preoperatively ( Z=2.60, P=0.01). Conclusion:Dynesys dynamic system combined with decompression in the treatment of degenerative lumbar spine diseases can achieve good long-term clinical outcome, with low incidence of complications and ASD.
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Objective:To summarize the best evidence for extubation management of adult patients with mechanical ventilation in the intensive care unit (ICU), which will provide practical guidelines for medical staffs.Methods:BMJ best clinical practice, UpToDate clinical consultants, Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Medlive guide, Cochrane Library, JBI evidence-based Health Care Center Database, Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ebsco, SinoMed, CNKI, Wanfang Database, etc., were systematically searched. Clinical guidelines, systematic reviews, expert consensus, and randomized controlled trial (RCT) studies were searched from the above database unit August 31st, 2020. Literature quality was evaluated using Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREEⅡ), JBI quality evaluation tools, and Cochrane risk bias assessment. Two researchers evaluated the quality of the included literature respectively, and then the best evidence of endotracheal intubation and extubation management in ICU adult patients with mechanical ventilation was extracted and summarized.Results:A total of 12 articles were collected, including 2 guidelines, 5 systematic reviews, 2 expert consensus, and 3 RCTs. This paper summarizes 17 best evidences on extubation management of adult patients with mechanical ventilation in ICU, including accurate pre-extubation assessment, personnel and equipment, medication, posture, oxygen therapy, airway management, and post-extubation monitoring.Conclusion:Medical staff should choose the best evidence that meets the requirements of the clinical settings and standardize the management of patients after extubation to reduce the incidence of complications and re-intubation rate to ensure the safety of patients, which will be very important for the management of ICU adult patients with mechanical ventilation after extubation.
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Objective:To explore the levels of vitamin A(VA) and vitamin D(VD) in blood of children with tic disorder (Tic disorder, TD) and their associations with tic symptoms severity and clinical types, so as to provide evidence for better prevention and treatment of TD.Methods:A total of 245 children with TD from September 2018 to April 2019 in the department of child Health care, affiliated hospital of qingdao university were enrolled as the case group and 63 healthy children who underwent routine physical examination at the same time as the control group. The levels of VA and VD were measured and their relationship with the severity of tic symptoms and clinical types were analyzed.Results:(1)The VD level of the case group was significantly lower than that of the control group ((23.72±8.87) μg/L , (26.61±7.59) μg/L, t=-2.24, P=0.03), and the proportion of insufficiency or even lack (37.31%, 75/201) was higher than the control group (15.79%, 9/57) (χ 2=9.37, P=0.002). (2)According to the Yale global tic severity scale(YGTSS), the children in the case group were divided into mild TD group, and moderate-to-severe TD group. ①There were significant differences in serum VA and VD levels in mild TD group, moderate-to-severe TD group and the control group ( F=29.79, P<0.01; F=10.90, P<0.01). Among them, the content of VA and VD in moderate-to-severe TD group were lower than those in mild TD group and control group (VA: (0.29±0.06)mg/L, (0.35±0.06)mg/L, (0.34±0.06)mg/L; VD: (21.01±8.30)μg/L, (25.84±8.76)μg/L, (26.61±7.59)μg/L). ②VA and VD levels of children with TD were negatively correlated with the severity of symptoms ( r=-0.325; P<0.01; r=-0.228; P=0.001). (3)According to DSM-V classification criteria, TD children were divided into PTD group, CTD group and TS group. ①There was no significant difference in serum VA level among different clinical types of TD children ( F=0.87, P=0.46). ②The levels of serum VD were different among the four groups ( F=4.13, P=0.007). Among them, the VD level in TS group was the lowest, and its content was significantly lower than that in control group ((21.83±7.60)μg/L, (26.61±7.59)μg/L, P<0.05)). The prevalence of insufficient or even lack of serum VD in children with different subtypes of TD was higher than that in the control group (χ 2=10.88, P=0.01). Conclusion:Vitamin D deficiency exists in children with TD. The level of vitamin A and vitamin D in serum of children with TD is related with the severity of tic symptoms.The VD level is related with clinical type of TD.
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Objective@#To investigate the clinicopathological features, diagnosis, differential diagnosis, treatment and prognosis of pediatric alveolar rhabdomyosarcoma (ARMS).@*Methods@#The clinical and pathological data of 25 pediatric ARMS from 2008 to 2018 in Children′s Hospital of Fudan University were collected. This histomorphology was assessed, and FOXO1 gene rearrangement was detected with FISH. The treatment details and outcome were analyzed.@*Results@#There were 13 males and 12 females, with ages range from 19 days to 14 years (median 6 years, mean 6.2 years). The ARMS were located in the limbs (13 cases), head and neck (4 cases), trunk (3 cases), abdominal cavity (3 cases), scrotum (1 case) and perianal region (1 case). The ARMS were classified histologically as classic group (18 cases), solid group (5 cases) and embryonic-alveolar mixed group (2 cases). The typical pathological characteristics were small dark round cells arranged in solid, glandular and papillary patterns. The tumor cells expressed ALK (D5F3) (21/25, 84.0%), muscle origin DES (23/25, 92.0%), myogenin (22/25, 88.0%), MYOD1 (19/25, 76.0%), and in some cases they also expressed neurogenic marker Syn (6/25, 24.0%). FOXO1 gene rearrangement was detected by FISH in 24/25 cases (96.0%).@*Conclusion@#Pediatric ARMS is rare and has unique clinicopathological characteristics, and needs to be differentiated from other common small round cell malignancies in children. ALK, DES, myogenin, MYOD1 immunohistochemistry and FOXO1 gene rearrangement are valuable aid in the diagnosis of ARMS.
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Objective We aimed to evaluate the diagnostic value of anti-carbamylate protein antibody (anti-CarP antibody) for rheumatoid arthritis (RA).Methods All domestic and foreign database were searched by computerized and manual methods,including PubMed database,Embase database,Cochrane library.All studies about anti-CarP antibody on the diagnostic value of RA were included.The deadline of the search was March 15,2018.Studies that did not meet the population and threshold to select criteria requirements were excluded.Results Manager 5.2,Meta-disc 1.4 and Stata12.0 software were used for literature quality evaluation and statistical analysis.Results A total of 8 papers were included.The heterogeneity test showed that there was heterogeneity caused by nonthreslold effects among the studies,and random effects model was used for Meta analysis.The sensitivity,specificity,positive and negative likelihood ratios of antiCarP antibody for the diagnosis of RA were [45％,95％CI(43％,48％)]、[97％,95％CI(95％,98％)]、[12.65,95％ CI (8.87,18.05)]、[0.56,95％ CI (0.53,0.6)].DOR was [23.97,95％ CI (16.33,35.17)] respectively,and the AUC was 0.777 5.Conclusion Anti-CarP antibody is highly specific for the diagnosis of RA,but its sensitivity is poor.
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Foodborne disease is one of the most important public health issues worldwide. China faces various and unprecedented challenges in all aspects of the food chain. Data from laboratory-based foodborne disease surveillance systems from 2013 to 2016, as well as different regions and ages, can be found along with differences in the patterns of pathogens detected with diverse characteristics. Vibrio parahaemolyticus has been the leading cause of infectious diarrhea in China, especially among adults in coastal regions. Salmonella has been a serious and widely distributed pathogen responsible for substantial socioeconomic burden. Shigella was mostly identified in Northwest China and the inland province (Henan) with less-developed regions among children under 5 years. Data from foodborne disease outbreak reporting system from 2011 to 2016 showed that poisonous animals and plant factors responsible for most deaths were poisonous mushrooms (54.7%) in remote districts in southwest regions. The biological hazard that caused most cases reported (42.3%) was attributed to V. parahaemolyticus, the leading cause of foodborne outbreaks. In this review, we summarize the recent monitoring approach to foodborne diseases in China and compare the results with those in developed countries.
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Humans , Bacteria , Classification , China , Epidemiology , Disease Outbreaks , Food Microbiology , Foodborne Diseases , Epidemiology , Microbiology , Forecasting , Laboratories , Mushroom Poisoning , Epidemiology , Population Surveillance , Public HealthABSTRACT
Objectives To explore the clinical features of allergic colitis and the expression of eosinophil cationic protein (ECP) in intestinal mucosa in infant and young children. Methods The clinical data of 24 cases of allergic colitis treated from September 2011 to February 2014 were analyzed retrospectively. Immunohistochemical staining was used to detect expressions of ECP in intestinal mucosa in 24 cases of allergic colitis, gastric and duodenal mucosa in 16 cases of helicobacter pylori infection and proximal normal intestinal mucosa in 18 cases of postoperative resection of congenital megacolon, and the results were compared. Results In the 24 subjects (15 males and 8 females) with allergic colitis,. they were infants except for 1 subject, and 20 subjects were <6 months old. All of them had bloody stool, in which there were 15 cases of diarrhea, 1 case of eczema and 3 cases of drug allergy. The endoscopic lesions were mainly showed in the sigmoid colon (12 cases) and the rectum (11 cases). The most common manifestations were mucosal erythema (21 cases), pox like nodules (18 cases), erosions (3 cases), and ulcers (3 cases). Histopathological findings were eosinophilic infiltration of the mucosa. The number of eosinophils in intestinal mucosa was 42(30~60)in patients with allergic colitis whose ECP was positive,18(15~23)in patients with Helicobacter pylori infection and 25.5 (14~35) in patients with congenital megacolon children, and the differences are statistically significant mong three groups (H=28.14,P<0.001). Conclusions Allergic colitis is more common in infants and young children. The main endoscopic findings are mucosal erythema and eruption like nodules. In addition, the increase of ECP positive eosinophils in intestinal mucosa is the characteristic manifestation of allergic colitis.
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Objective: To explore the role of clinical pharmacists in the treatment of artial fibrillation complicated with digoxin poisoning and the entry points of pharmaceutical care.Methods: Clinical pharmacists participated in the therapy for a patient with atrial fibrillation and digoxin poisoning, monitored the blood concentration of digoxin combined with the characteristics of the patient, analyzed the causes of digoxin poisoning in terms of the underlying diseases, renal function and combined medication, and performed beneficial pharmaceutical care.Results: The suggestions of clinical pharmacists were adopted by doctors, digoxin was withdrawn timely and the drug poisoning was corrected.
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An iceberg model for better understanding the patients was developed.In this model the seeking for consultation is visible part of illness behavior,but the thoughts,concerns and expectations toward his or her illness are the hidden parts.Through detailed history taking,using appropriate language skill (Leichester Assessment Package) and nonverbal communication skill (space distance,eye contact,listening,pronunciation,appropriate silence),physicians can acquaint comprehensive knowledge about the hidden thoughts,concern and expectation of patients about their illness.This model would help general practitioners to raise communication and consultation ability and skills in their practice.
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Objective To assess the efficacy and safety of tacrolimus (TAC) combined with methotrexate (MTX) for the treatment of refractory rheumatoid arthritis (RA),and to compare it with cyclophosphamide (CTX) added to MTX for the treatment of refractory RA.Methods Thirty-six cases of refractory RA patients were divided into the observation group and the control group.TAC+MTX were used in the observation group,and CTX+MTX were used in the control group.We used repeated measures to analyze the variance and Fisher exact probability method to analyze the efficacy at 8 weeks and 24 weeks.Results The effective rate of the observation group in 8 weeks,24 weeks were 77.8％(14 cases) and 100％(18 cases) respectively,while those of the control group were 11.1％ (2 cases) and 44.4％(8 cases),it showed that both TAC+MTX and CTX+MTX in the treatment of refractory RA were effective,but the efficacy of TAC+MTX was better than CTX+MTX,the difference of C reactive protein (CRP) and disease activity score (DAS)28 was statistically significant (P＜0.05),and it could significantly improve the clinical symptoms and laboratory indexes.Conclusion TAC+MTX is effective and safe in treating refractory RA,and is worth of spreading.
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AIM:To observe the effects of liraglutide on the level of microRNA-33 (miR-33) and the expres-sion of AMP-activated protein kinase ( AMPK ) and apoptosis-related proteins in mice with type 2 diabetes mellitus (T2DM), and to explore its possible mechanism .METHODS:High-fat diet and intraperitoneal injection of streptozocin were used to establish the type 2 diabetic model in C57BL/6 mice.The mice were randomly divided into 4 groups ( n=15 ):in control group , the normal mice were subcutaneously injected with equivalent volume of saline ;in model group , the T2DM mice were subcutaneously injected with equivalent volume of saline ; in low-and high-dose liraglutide treatment groups, the T2DM mice were subcutaneously injected with 100 and 200 μg? kg -1? d-1, respectively.After 4 weeks of administration, the levels of FBG, TG, TC, HDL-C, LDL-C, ALT and AST were determined.HE staining was used to ob-serve the pathological changes of the liver tissues .The protein level of cleaved caspase-3 in the liver tissue was detected by the technique of immunofluorescence .The protein levels of p-AMPK/AMPK and apoptosis-related proteins were detected by Western blot .The expression of miR-33 in the liver tissues was detected by real-time PCR.RESULTS: Compared with model group, the contents of FBG, TG, TC, LDL-C, ALT and AST were decreased significantly , while the content of HDL-C was increased significantly in low-dose liraglutide group and high-dose liraglutide group ( P<0.05 ) .The protein levels of phosphorylated AMPK and Bcl-2 were up-regulated significantly , and the expression of cleaved caspase-3 was down-regulated significantly (P<0.05).The level of miR-33 was decreased significantly (P<0.01).CONCLUSION:Liraglutide alleviates liver injury in type 2 diabetic mice , and the mechanism may be associated with reducing the level of miR-33 and increasing the phosphorylation of AMPK in the liver tissues , thereby inhibiting hepatocyte apoptosis .
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Objective To study the relevance of 1iver fibrosis at Kasai procedure with age, degree of pathological changes of liver tissue, header bile ductuler proliferation and pathological feature of portal fibrous tissue in biliary atresia patients. Methods From January 2013 to June 2016, 48 biliary atresia patients accepted Kasai procedure, and liver tissue biopsy and portal fibrous tissue excision was done. Level of liver fibrosis was evaluated under microscope using Masson trichrome staining and HE staining, and extent of ductular reaction was evaluated using CKl9 immunohistochemistry staining with image analysis technology. Based on classification of Okamoto severity degree of liver fibrosis, forty eight patients were divided into two groups:low-grade liver fibrosis group (23 patients)and severe liver fibrosis group (25 patients). The relevance of age at Kasai procedure, liver pathological changes, header bile ductuler proliferation, portal fibrous tissue in volume and bile ductuler proliferation, inflammation reaction with severity degree of liver fibrosis was analyzed with SPSSl6.0 software statistically. Results Age of severe 1iver fibrosis group at Kasai procedure were 38- 89 d, and the mean age was (62.64 ± 14.92) d. Age of low-grade 1iver fibrosis group were 18- 92 d, and the mean age was (53.13 ± 16.89) d. There was significant difference (t=2.071, P=0.044). Mean number of patients with header bile ductuler proliferation at Kasai procedure in severe 1iver fibrosis group and low-grade 1iver fibrosis group were (17.28 ± 4.31) cases and (11.39 ± 4.00) cases, and there was significant difference (t=4.900, P=0.000). There was significant difference in degree of hepatocellular pathological changes at Kasai procedure between groups (χ2 =4.691, P=0.030). There were no significant differences in the volume of portal fibrous tissue in volume (t=0.276, P=0.784), portal bile ducts proliferation (t=0.53, P=0.60) and inflammation reaction (χ2=3.074, P=0.080) between groups. Conclusions There is significant relevance between the degree of 1iver fibrosis in biliary atresia patients at Kasai procedure and age, level of hepatocellular pathological change and degree of header bile ductuler proliferation , The more older the age, the more sever the hepatocellular pathological change and the bile ductuler proliferation, the more sever the liver fibrous.
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Objectives To explore the clinical features of allergic colitis and the expression of eosinophil cationic protein (ECP) in intestinal mucosa in infant and young children. Methods The clinical data of 24 cases of allergic colitis treated from September 2011 to February 2014 were analyzed retrospectively. Immunohistochemical staining was used to detect expressions of ECP in intestinal mucosa in 24 cases of allergic colitis, gastric and duodenal mucosa in 16 cases of helicobacter pylori infection and proximal normal intestinal mucosa in 18 cases of postoperative resection of congenital megacolon, and the results were compared. Results In the 24 subjects (15 males and 8 females) with allergic colitis,. they were infants except for 1 subject, and 20 subjects were <6 months old. All of them had bloody stool, in which there were 15 cases of diarrhea, 1 case of eczema and 3 cases of drug allergy. The endoscopic lesions were mainly showed in the sigmoid colon (12 cases) and the rectum (11 cases). The most common manifestations were mucosal erythema (21 cases), pox like nodules (18 cases), erosions (3 cases), and ulcers (3 cases). Histopathological findings were eosinophilic infiltration of the mucosa. The number of eosinophils in intestinal mucosa was 42(30~60)in patients with allergic colitis whose ECP was positive,18(15~23)in patients with Helicobacter pylori infection and 25.5 (14~35) in patients with congenital megacolon children, and the differences are statistically significant mong three groups (H=28.14,P<0.001). Conclusions Allergic colitis is more common in infants and young children. The main endoscopic findings are mucosal erythema and eruption like nodules. In addition, the increase of ECP positive eosinophils in intestinal mucosa is the characteristic manifestation of allergic colitis.
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Objective To detect the serum levels of angiopoietin-like protein 2 (ANGPTL 2) and vascular endothelial growth factor (VEGF) in patients with rheumatoid arthritis (RA),and to analyze their value in the differential diagnosis of RA in order to clarify whether they are synergetic in the pathogenesis of RA.Methods Seventy-seven patients with RA and 25 subjects for heath check-up in the same period were selected.According to the relevant clinical information,the RA patients were divided into three subgroups:high disease activity group [(DAS28)＞5.1],moderate disease activity group (3.2＜DAS28 ≤5.1),low disease activity group (DAS28 ≤3.2).Enzyme-linked immunosorbent assay (ELISA) was used to masure the levls of ANGPTL2 and VEGF of those groups.The data were analyzed by t test,Mann-Whitney U test,Kruskal-Wallis H test and Speraman correlation analysis.Results ① The serum levels of ANGPTL2 and VEGF in RA patients were significantly higher than those in control group [(5.3±1.1) ng/ml vs (3.3±0.9) ng/ml,Z=-6.644;(106±30) pg/ml vs (93±12) pg/ml,Z=-4.4115,P＜0.05].② Serum level of ANGPTL2 in RA patients with high disease activity was higher than low disease group and healthy control group {[5.7(1.3)] ng/ml vs [4.5(0.3)]ng/ml,H=4.257,P＜0.05;[5.7 (1.3)] ng/ml vs [3.3 (0.9)] ng/ml,H=7.639,P＜0.05}.Serum level of VEGF in RA patients with high disease activity was higher than low disease group and healthy control group {[116(37)]pg/ml vs [96(8)] pg/ml,H=3.579,P＜0.05;[116(37)] pg/ml vs [92.90(12.24)] pg/ml,H=5.698,P＜0.05].③ There was a positive correlation between the serum level of ANGPTL2 and DAS28 score,erythrocyte sedimentation rate,swollen joint count and tender joint count (rDAS28=0.703,rESR=0.311,rSJC=0.503,rTJC=0.670,P＜0.05),so was VEGF (rDAS28=0.553,rESR=0.260,rSJC=0.399,rTJC=0.538,P＜0.05).④ In RA patients,there was a positive correlation between ANGPTL2 and VEGF (r=0.853,P＜0.05).Conclusion ANGPTL2 might coordinate with VEGF and be involved in the immune process of RA,and it might be regarded as one of the reference indexes of RA activity,so that it may contribute to access and monitor the condition of RA.
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BACKGROUND:Failure rate is higher in patients with osteonecrosis of femoral head than in osteoarthritis patients after primary total hip arthroplasty, especial y acetabular prosthesis. Bone mineral density around the prosthesis is a key factor for quality of life of the prosthesis. OBJECTIVE:To observe the difference in periprosthetic bone mineral density between patients with osteonecrosis of the femoral head and osteoarthritis patients and the exact location of differences after primary total hip arthroplasty. METHODS:Fifty patients with osteonecrosis of femoral head and fifty osteoarthritis patients were enrol ed in this study. Dual energy X-ray absorptiometry examination was used to compare bone mineral density 5 years after total hip arthroplasty. In accordance with De Lee’s and Charnley’s methods, images of acetabulum were divided. The bone mineral density of different areas of the acetabulum was compared between the two groups. RESULTS AND CONCLUSION:(1) Periprosthetic bone mineral density:Bone mineral density in the lower part and upper part of the acetabulum was significantly lower in the osteonecrosis group than in the osteoarthritis group (P<0.05). No significant difference in bone mineral density in the middle of the acetabulum was detected between the two groups. (2) Results confirmed that the bone mineral density in the lower and the upper parts of the acetabular component was significantly lower in patients with osteonecrosis of femoral head than in patients with osteoarthritis.