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Qinghao Biejiatang， first recorded in the Detailed Analysis of Warm Diseases （《温病条辨》） written by WU Jutong in the Qing Dynasty， is composed of Artemisiae Annuae Herba， Trionycis Carapax， Rehmanniae Radix， Anemarrhenae Rhizoma， and Moutan Cortex. With the effects of nourishing Yin and relieving heat， this prescription is often used to treat the syndrome of Yin deficiency and internal heat. The deficiency of healthy Qi， invasion of pathogenic toxins， loss of lung Yin， and generation of deficiency-heat are pathogenesis of lung cancer， pneumonia and other lung diseases， the treatment of which usually follows the principles of nourishing Yin， reinforcing healthy Qi， clearing lung， and eliminating heat. With the effects basically in accordance with the treatment principles of lung diseases， Qinghao Biejiatang is widely used in the treatment of lung diseases such as lung cancer-associated fever， hemoptysis or combined with bone metastasis， tuberculosis， community-acquired pneumonia， and pneumonia caused by severe acute respiratory syndrome coronavirus 2（SARS-CoV-2）. Basic experiments have shown that Qinghao Biejiatang may exert the therapeutic effects by reducing inflammation， maintaining immune balance， regulating intestinal flora， hormone secretion， lipid metabolism， and inhibiting tumor and oxidative damage. In addition， the main active ingredients of this prescription include artemisinin， luteolin， sitosterol， stigmasterol， polysaccharides， catalpol， paeoniflorin， quercetin， paeonol， gallic acid， timosaponin， and mangiferin， which have anti-tumor， anti-oxidant， anti-virus， inflammation-regulating， and immunomodulatory activities. The paper reviewed the clinical and basic studies of Qinghao Biejiatang in the treatment of lung diseases， aming to provide a theoretical basis for the clinical application.
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ObjectiveTo investigate the changes of endogenous metabolites in serum of ovariectomized rats and the effect of Erxiantang on them based on liquid chromatography-mass spectrometry（LC-MS）. MethodTwenty-four healthy female SD rats were randomly divided into sham-operated group， model group and Erxiantang group（7.5 g·kg-1）， with 8 rats in each group. Bilateral ovarian tissues were excised in the model and Erxiantang groups， and small pieces of adipose tissues were excised in the abdominal cavity of the sham-operated group bilaterally， and gastric administration was started 2 weeks after surgery， and equal volumes of distilled water were gavaged in the sham-operated and model groups. After 12 weeks of administration， blood was collected from abdominal aorta， and non-targeted metabonomics was performed on rat serum by LC-MS， and orthogonal partial least squares-discriminant analysis（OPLS-DA） was used to screen differential metabolites. Metabolic pathway analysis was performed based on Kyoto Encyclopedia of Genes and Genomes（KEGG）， and the levels of key enzymes of metabolic pathways were verified by enzyme-linked immunosorbent assay（ELISA）. ResultThe results of metabonomics showed that 82 differential metabolites between the model group and the sham-operated group were glycerophospholipids， fatty acyls， steroids and steroid derivatives， of which the most significant difference was glycerophospholipids. At the same time， Erxiantang could call back 65 out of 82 differential metabolites， of which 11 were statistically significant， mainly phosphatidylcholine（PC） and lysophosphatidylcholine（LysoPC） in glycerophospholipids， followed by corticosterone and 11-deoxycortisol in steroids and steroid derivatives. Metabolic pathway analysis showed that the pathways of glycerophospholipid metabolism and steroid hormone biosynthesis in model group were changed， and were recovered after the administration of Erxiantang. ELISA results showed that compared with the sham-operated group， serum levels of cholinephosphate cytidylytransferase（CCT）， secretory phospholipase A2（sPLA2） and lysophosphatidylcholine acyltransferase（LPCAT）， which were the key metabolic enzymes of glycerophospholipid metabolite PC and LysoPC， were significantly decreased in the model group（P<0.05， P<0.01）， and choline phosphotransferase 1（CPT1） levels decreased but the difference was not statistically significant， compared with the model group， the levels of CCT， sPLA2 and CPT1 were significantly increased in Erxiantang group（P<0.01）. In addition， compared with the sham-operated group， the levels of cholesterol（TC）， triglyceride（TG） and low density lipoprotein cholesterol（LDL-C） were significantly increased in the model group（P<0.01）， the high density lipoprotein cholesterol（HDL-C） level was decreased（P<0.05）， compared with the model group， the levels of TC， TG and LDL-C were significantly decreased and the level of HDL-C was significantly increased in Erxiantang group（P<0.01）. ConclusionEndogenous metabolites and related metabolic pathways in ovariectomized rats were altered， and Erxiantang can reverse some of the different metabolites and related pathways， such as regulating glycerophospholipid metabolism by regulating metabolic enzymes CCT， sPLA2 and CPT1 to increase the levels of PC and LysoPC， and then improve the pathological changes such as lipid metabolism disorder in ovariectomized rats.
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BACKGROUND@#Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting.@*METHODS@#To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks.@*RESULTS@#A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type with a cumulative reoperation rate >50%, whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment ( P = 0.013). Precise dissection in the His angle area was independently associated with a lower acute leak rate, whereas preservation ≥2 cm distance from the His angle area was an independent risk factor.@*CONCLUSIONS@#Male sex, elevated waist circumference, hypoproteinaemia, and type 2 diabetes are risk factors of gastric leaks after SG. Optimizing surgical techniques, including precise dissection of His angle area and preservation of smaller gastric fundus, should be suggested to prevent acute leaks.
Subject(s)
Humans , Male , Retrospective Studies , Diabetes Mellitus, Type 2/complications , Obesity, Morbid , Anastomotic Leak/epidemiology , Gastrectomy/methods , Reoperation/methods , Registries , Laparoscopy/methods , Treatment OutcomeABSTRACT
@#We reported a 26-year-old male who was diagnosed with apical hypertrophic cardiomyopathy with left ventricular aneurysm. The location of the hypertrophic myocardium and the extent of resection were accurately assessed preoperatively using 3D modeling and printing technology. Myectomy was performed via transapical approach, and the intraoperative exploration was consistent with the description of the preoperative 3D modeling. The patient underwent the surgery successfully without any complications during the hospitalization, and the cardiopulmonary bypass time was 117 min, the aortic cross-clamping time was 57 min, and the hospital stay time was 7 d. The postoperative echocardiography demonstrated left ventricular cavity flow patency. This case provides a reference for the management of patients with apical hypertrophic cardiomyopathy.
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@#Objective To analyze the clinical efficacy and survival outcome of totally thoracoscopic redo mitral valve replacement and evaluate its efficiency and safety. Methods The clinical data of patients with totally thoracoscopic redo mitral valve replacement in Guangdong Provincial People’s Hospital between 2013 and 2019 were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to determine the risk factors for postoperative death. Results There were 48 patients including 29 females and 19 males with a median age of 53 (44, 66) years. All the procedures were performed successfully with no conversion to median sternotomy. A total of 15, 10 and 23 patients received surgeries under non-beating heart, beating heart and ventricular fibrillation, respectively. The in-hospital mortality rate was 6.25% (3/48), and the incidence of early postoperative complications was 18.75% (9/48). Thirty-five (72.92%) patients had their tracheal intubation removed within 24 hours after the operation. The 1- and 6-year survival rates were 89.50% (95%CI 81.30%-98.70%) and 82.90%(95%CI 71.50%-96.20%), respectively. Age>65 years was an independent risk factor for postoperative death (P=0.04). Conclusion Totally thoracoscopic redo mitral valve replacement is safe and reliable, with advantages of rapid recovery, reducing blood transfusion rate, reducing postoperative complications and acceptable long-term survival rate. It is worthy of being widely popularized in the clinic.
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@#An 81-year-old male patient was admitted to Guangdong Provincial People's Hospital due to chest distress and shortness of breath after activity for half a year. Examination after admission revealed severe aortic insufficiency, tricuspid aortic valve and extremely horizontal aorta with an aortic root angulation of 99°. The Society of Thoracic Surgeons score was 7%. And taking the strong demand of the patient and his family into consideration, we decided to perform transapical transcatheter aortic valve replacement after multidisciplinary evaluation. The procedure was successfully performed by means of low deployment land zone and traction of pre-exist Prolene suture. Three-month follow-up confirmed the normal function of aortic prosthetic valve without residual regurgitation. This case provides a reference for the interventional treatment in patients with extremely horizontal aorta.
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@#Objective To determine the clinical efficacy of transapical transcatheter mitral valve-in-valve treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement. Methods The clinical data of 9 patients who underwent transapical transcatheter mitral valve-in-valve implantation after aortic-mitral double valve replacement due to mitral bioprosthesis deterioration from May 2020 to January 2021 in our hospital were retrospectively analyzed, including 4 males and 5 females with a mean age of 72.44±7.57 years. Results Surgeries were performed successfully in all patients with no conversion to median sternotomy. The mean procedural time was 101.33±48.49 min, the mechanical ventilation time was 23.11±26.54 h, the ICU stay was 1.89±1.05 d and the postoperative hospital stay was 6.11±2.02 d. Residual mild mitral regurgitation was only observed in 1 patient. Only 1 patient needed postoperative blood transfusion. No major complications were observed in all patients. There was no death in postoperative 90 days. Conclusion For patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement, transapical transcatheter mitral valve-in-valve implantation achieves good clinical results and effectively improves the hemodynamics without increasing the risk of postoperative left ventricular outflow tract obstruction. The surgery is feasible and effective.
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@#Objective To investigate the effectiveness and safety of totally endoscopic transmitral myectomy (TETM) for hypertrophic obstructive cardiomyopathy (HOCM), comparing with traditional sternotomy modified Morrow procedure (SMMP). Methods Thirty-eight patients with HOCM who needed surgical intervention were selected from our hospital in 2019, including 14 males and 24 females, with an average age of 56 (44-68) years. According to the operation method, they were divided into a TETM group (n=18) and a SMMP group (n=20). Appropriate patients were screened by propensity matching scores. Finally, the clinical data of two matched groups were compared and
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Objective:To investigate the epidemiological and etiological characteristics of hand-feet-mouth disease (HFMD) in Dali Bai Autonomous Prefecture and to provide scientific evidence for the prevention of HFMD.Methods:The HFMD cases during January 2015 to December 2019 in Dali Bai Autonomous Prefecture were collected through the Chinese Information System for Disease Control and Prevention. The demographic data, incidence rate of HFMD and epidemiological characteristics were analysed. Coxsackie virus A16(CoxA16), enterovirus 71(EV71) and other enterovirus nucleic acid in stool samples of HFMD patients were detected by real-time reverse transcription polymerase chain reaction. Chi-square test was used as statistical method.Results:From 2015 to 2019, 30 730 cases of HFMD were reported in Dali Bai Autonomous Prefecture. The annual incidence rate was 171.50/100 000, and the incidence rate was on rise from 2016 to 2019. There were 24(0.08%) severe cases. Yongping County, Binchuan County and Dali City were with the top three average annual incidence rate. The peak incidence was from June to July in summer, 9 168 cases (29.83%) were reported. The peak incidence was from September to October in autumn, 5 988 cases (19.49%) were reported. The epidemic intensity in summer was higher than that in autumn. Among 30 730 cases, there were 17 373 males and 13 357 females. The annual incidence rate of male patients was 120.29/100 000, and that of female was 75.83/100 000. The difference was statistically significant ( χ2=1 637.467, P<0.01). The highest incidence was in infancy (one to <three years old), followed by preschool stage (three to <six years old) and the incidence rate was 4 158.96/100 000 and 1 953.11/100 000, respectively. From infancy, the incidence decreased with age. Severe cases concentrated in infancy with a total of 16 cases, accounting for 66.67% of severe cases. The affected population was mainly scattered children, and a total of 20 516 cases (66.76%) were reported. Among the 1 294 laboratory confirmed cases, 792 (61.21%) were CoxA16 infected cases, 320 (24.73%) were EV71 infected cases, and 182(14.06%) were other enterovirus infected cases. Conclusions:The incidence of HFMD in Dali Bai Autonomous Prefecture has obvious seasonal, age and population characteristics. It is necessary to strengthen the cooperation among departments, health education and strict implementation of prevention and control measures in order to reduce the incidence and improve the ability of early identification and treatment of severe cases.
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Objective:To analyze the causes of puncture wound infections induced by the high pressure resistant injectable PICC catheter in patients undergoing hematopoietic stem cell transplantation and management measures.Methods:linical data of 75 patients undergoing hematopoietic stem cell transplantation who were treated with the high pressure resistant injectable PICC catheter in our hospital from Nov.2017 to Nov.2019 were retrospectively analyzed.According to whether there were puncture wound infections, patients were divided into the infection group(n=26)and the non-infection group(n=49). Bacterial culture results of the infection group were recorded, and the related factors for puncture wound infections caused by the injectable PICC catheter were analyzed.Effective strategies to prevent high-risk factors, treatment frequency, treatment effect and healing time for patients with different degrees of puncture wound infections were discussed.Results:There were 26 patients in the infection group.The proportions of bacteria types associated with PICC catheter-related infections, in descending order, were as follows: Staphylococcus aureus(46.51%), Klebsiella pneumoniae(30.77%), Corynebacterium(15.38%)and others(7.69%). Significant differences were found in materials used, season of tube placement, timing of dressing changes, duration of catheterization, success rate of first tube placement and condition of dressing films between the non-infection and infection groups( t=5.5, 4.9, 5.0, 13.6, 9.4 and 6.2, all P<0.05). Logistic multi-factor analysis showed that non-U-shaped fixation, delay in dressing changes, long duration of tube placement, low success rate of first tube placement, and loose dressing films were the high-risk factors for PICC catheter-related infections( OR=2.78, 2.42, 3.16, 2.66 and 2.32, all P<0.05). Compared with patients with moderate and mild infections, patients with severe infections had a higher frequency of treatment, a lower total effectiveness rate and a longer healing time( F=10.353, 8.775 and 12.341, all P<0.05). Conclusions:Materials, timing of dressing changes, catheterization time, success rate of first tube placement and condition of dressing films are the high-risk factors for puncture wound infections caused by high pressure resistant injectable PICC catheters in patients undergoing hematopoietic stem cell transplantation.Developing effective intervention strategies can help control the incidence of wound infections.
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Objective:To explore the early surgical outcomes of Thoracoscopic Transmitral Myectomy(TTM) on patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods:Preoperative echocardiography and cardiac magnetic resonance were used to evaluate the patient's hypertrophy extent, mitral valve morphology and function. Myocardial resection was performed via the trans-mitral approach under total thoracoscopy, and the surgical methods and early results were analyzed.Results:From April 2019 to October 2019, a total of 15 cases of TTM were performed by a single surgeon in our ward. Preoperative imaging evaluation revealed that 6 patients(40.0%) had predominantly hypertrophic basal septum while another 9 patients(60.0%) had concomitant midventricular septal hypertrophy. Two(13.3%) patients were interrogated ruptured posterior mitral chord by preoperative echocardiogram. After myocardial resection, the mitral valve was treated as follows: 11 patients(73.3%) underwent anterior leaflet enlargement, and 3(20.0%) were directly reattached to mitral valve annulus, and 1(6.7%) underwent bioprosthetic mitral replacement. There was no case of perioperative death, ventricular septal perforation, residual left ventricular outflow tract obstruction and complete atrioventricular block. Median aortic crossclamp time, cardiopulmonary bypass time, postoperative ventilator use time, ICU stay time, and postoperative hospital stay were 129.0min(116.0, 147.0), 184.0 min(158.0, 227.0), 22.0 h(9.0, 26.0), 3 days(2, 7) and 9 days(7, 14) respectively. No patient lost to follow up, the median follow-up time was 4 months(2, 5). One patient(6.7%) underwent mitral angioplasty three months after surgery due to a tear in the A3 area; the ventricular septal thickness and left ventricular outflow tract pressure decreased significantly(preoperative vs follow-up), and were(19.3±3.3)mm vs. (8.9±4.4) mm( P=0.001), (90.8±23.2)mmHg vs. (8.9±4.4) mmHg(1 mmHg = 0.133kPa)( P<0.001) respectively; no residual SAM was observed during follow-up. Patients with moderate-to severe mitral regurgitation were decreased from 12(80.0%) before surgery to 1(6.7%) during follow up( P<0.001). Conclusion:TTM is a safe and effective procedure for HOCM patients with appropriate surgical indications, providing better exposure to septum from basal to apical area, eliminating left ventricular outflow tract obstruction and SAM-related mitral regurgitation. The anterior mitral valve leaflet should be carefully treated during surgery to reduce the occurrence of residual mitral regurgitation resulted in inappropriate selection of patch size and suturing technique.
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Objective To analyze the relationship between onset of myocardial infarction(MI)to bivalent antibiotics therapy and outcome in elderly female MI patients.Methods One hundred and fourteen elderly MI patients admitted to our hospital from January 2016to January 2018were divided intoΔT≤188min group(n=57)andΔT＞188min group(n=57)according to the onset of MI to bivalent antibiotics therapy.The major adverse cardiac events(MACE),arrhythmia,angina pectoris,heart failure and death were compared between the two groups.Results MACE occurred in 44out of the 144MI patients included in this study.Of the 44MI patients,17died,6 were diagnosed with arrhythmia,16were diagnosed with angina pectoris,5were diagnosed with heart failure.The incidence of arrhythmia,heart failure and the mortality were significantly higher while the incidence of angina pectoris was significantly lower inΔT≤188min group than inΔT＞ 188min group(7.0％vs 3.5％,7.0％vs 1.8％,15.8％vs 14.0％,7.0％vs 21.1％,P＜0.05).Age,diabetes,ΔT,hyperlipidemia,hypertension and coronary artery disease were the independent influencing factors for the poor outcome in MI patients(P＜0.05,P＜0.01).Conclusion TheΔT should be shortened,the MI patients should be timely treated,the criminal blood vessels should be opened,and the ischemic myocardium should be saved in order to prevent the occurrence of severe cardiovascular events and reduce the mortality in elderly MI patients.
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Objective To investigate the susceptibility and resistance profile of clinical isolates in Hunan Yongzhou Hospital during 2016 and 2017. Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using KirbyBauer method or automated systems. Results were analyzed according to CLSI 2016 breakpoints. Results A total of 6 354 clinical isolates were collected from January 2016 to December 2017, of which 4 876(76.7％)were gram-negative bacteria, and 1 478(23.3％)were gram-positive bacteria. The top five bacterial species were Escherichia coli(33.0％), Klebsiella(17.0％), Staphylococcus aureus(9.6％), Acinetobacter(8.6％), and Pseudomonas aeruginosa(7.4％). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)was 33.8％, and prevalence of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 76.2％. The resistance rates of methicillin resistant strains(MRSA and MRCNS)to most of the tested drugs were significantly higher than those of methicillin sensitive strains(MSSA and MSCNS). No vancomycin or linezolid resistant staphylococci were identified. The resistance rate of Enterococcus faecium to most antimicrobial agents was significantly lower than that of Enterococcus faecium. No enterococcal isolate was resistant to vancomycin or linezolid. The non-meningitis S. pneumoniae strains isolated from children showed slightly higher resistance rate to penicillin(20.8％)than the strains isolated from adults(13.3％). The prevalence of extended spectrum beta-lactamases(ESBLs)in Escherichia coli and Klebsiella pneumoniae was 48.0％ and 35.7％, respectively. Most Enterobacteriaceae strains were highly sensitive to carbapenem antibiotics, showing lower resistancerate(<4％). The prevalence of carbapenem-resistant Klebsiella pneumoniae was 18.8％, and the prevalence of carbapenem-resistant E. cloacae was 14.5％. The prevalence of Acinetobacter baumannii strain resistant to imipenem and meropenem was 76.4％ and 78.6％, respectively. Conclusions Bacterial resistance is still serious. It is necessary to strengthen the monitoring of bacterial resistance, infection control, and rational use of antibiotics.
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Objective@#To investigate the effectiveness and safety of Huatan-Quzhuo decoction in combination with western medicine for the treatment of carotid atherosclerotic plaques.@*Methods@#A total of 194 patients with carotid atherosclerosis were selected were randomly divided into two groups, 97 in each group. The control group was treated with simvastatin. The observation group was treated with Huatan-Quzhuo decoction on the basis of the control group. The serum levels of interleukin-1 (IL-1), tumor necrosis factor α (TNF-α), malondialdehyde (MDA), and superoxide dismutase (SOD) were observed before and after treatment in the two groups. The Sod, IMT, number of plaques, number of vulnerable plaques and area of plaques, carotid artery intima-media thickness (IMT), number of plaques, number of vulnerable plaques, and area of plaques were detected.@*Results@#After treatment, the levels of TC, TG, and LDL-C in the observation group were significantly lower than those in the control group (t were 4.546, 6.712, 4.872, P<0.01). After treatment, the IMT (0.85 ± 0.11 mm vs. 1.08 ± 0.13 mm, t=13.302), number of plaques (0.74 ± 0.36 vs. 1.02 ± 0.42, t=4.985), number of vulnerable plaques (0.24 ± 0.25 vs. 0.41 ± 0.27, t=4.550), and plaque area (50.06 ± 9.73 mm2 vs. 68.52 ± 11.24 mm2, t=12.230) in the observation group were significantly lower than those in the control group (P<0.01). The levels of IL-1, TNF-α and MDA in the observation group were significantly lower than the control group (t were 13.089, 4.769, 10.442, P<0.01). The level of SOD was observation group was significantly higher than the control group (t=11.636, P<0.01).@*Conclusions@#The combination of Huatan-Quzhuo decoction and western medicine in the treatment of carotid artery atherosclerosis can regulate the level of blood lipids, improve the degree of atherosclerosis, reduce the degree of inflammation and oxidative stress.
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Objective@#To explore the mediating effect of the childbirth self-efficacy between mindfulness level and fear of childbirth in pregnant women.@*Methods@#A total of 285 pregnant women were measured with five facet mindfulness questionnaire(FFMQ), childbirth attitude questionnaire(FOC), and the short form of the Chinese childbirth self-efficacy inventory(CBSEI-C32).@*Results@#The scores of mindfulness level, fear of childbirth, outcome expectancy and self-efficacy expectancy were(127.51±11.12), (31.44±8.84), (109.36±30.52)and(110.02±30.03), respectively.Pearson correlation analysis showed that mindfulness level was positively correlated with outcome expectancy and self-efficacy expectancy(r=0.247, r=0.235, both P<0.01), while negatively correlated with fear of childbirth(r=-0.274, P<0.01). Outcome expectancy and self-efficacy expectancy were negatively correlated with fear of childbirth(r=-0.251, r=-0.233, both P<0.01). The mediating effect of outcome expectancy and self-efficacy expectancy between mindfulness level and fear of childbirth was significant(P<0.01), and the mediating effect sizes were 17.8% and 15.6%, respectively.@*Conclusion@#Childbirth self-efficacy partly mediates mindfulness level and fear of childbirth in pregnant women.
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Objective To explore the mediating effect of the childbirth self-efficacy between mind-fulness level and fear of childbirth in pregnant women. Methods A total of 285 pregnant women were measured with five facet mindfulness questionnaire(FFMQ),childbirth attitude questionnaire(FOC),and the short form of the Chinese childbirth self-efficacy inventory(CBSEI-C32). Results The scores of mindful-ness level, fear of childbirth, outcome expectancy and self-efficacy expectancy were ( 127. 51 ± 11. 12), (31. 44±8. 84),(109. 36±30. 52) and(110. 02±30. 03),respectively. Pearson correlation analysis showed that mindfulness level was positively correlated with outcome expectancy and self-efficacy expectancy ( r=0. 247,r=0. 235,both P<0. 01),while negatively correlated with fear of childbirth(r=-0. 274,P<0. 01). Outcome expectancy and self-efficacy expectancy were negatively correlated with fear of childbirth ( r=-0. 251,r=-0. 233,both P<0. 01). The mediating effect of outcome expectancy and self-efficacy expectancy between mindfulness level and fear of childbirth was significant(P<0. 01),and the mediating effect sizes were 17. 8% and 15. 6%, respectively. Conclusion Childbirth self-efficacy partly mediates mindfulness level and fear of childbirth in pregnant women.
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Objective To investigate the effectiveness and safety of Huatan-Quzhuo decoction in combination with western medicine for the treatment of carotid atherosclerotic plaques. Methods A total of 194 patients with carotid atherosclerosis were selected were randomly divided into two groups, 97 in each group. The control group was treated with simvastatin. The observation group was treated with Huatan-Quzhuo decoction on the basis of the control group. The serum levels of interleukin-1 (IL-1), tumor necrosis factor α (TNF-α), malondialdehyde (MDA), and superoxide dismutase (SOD) were observed before and after treatment in the two groups. The Sod, IMT, number of plaques, number of vulnerable plaques and area of plaques, carotid artery intima-media thickness (IMT), number of plaques, number of vulnerable plaques, and area of plaques were detected. Results After treatment, the levels of TC, TG, and LDL-C in the observation group were significantly lower than those in the control group (t were 4.546, 6.712, 4.872, P<0.01). After treatment, the IMT (0.85 ± 0.11 mm vs. 1.08 ± 0.13 mm, t=13.302), number of plaques (0.74 ± 0.36 vs. 1.02 ± 0.42, t=4.985), number of vulnerable plaques (0.24 ± 0.25 vs. 0.41 ± 0.27, t=4.550), and plaque area (50.06 ± 9.73 mm2 vs. 68.52 ± 11.24 mm2, t=12.230) in the observation group were significantly lower than those in the control group (P<0.01). The levels of IL-1, TNF-α and MDA in the observation group were significantly lower than the control group (t were 13.089, 4.769, 10.442, P<0.01). The level of SOD was observation group was significantly higher than the control group ( t=11.636, P<0.01). Conclusions The combination of Huatan-Quzhuo decoction and western medicine in the treatment of carotid artery atherosclerosis can regulate the level of blood lipids, improve the degree of atherosclerosis, reduce the degree of inflammation and oxidative stress.
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Objective ToinvestigatethevalueofDCEGMRIimagingindifferentiatingmalignanttransformationinvertedpapilloma (IP)frombenignIP.Methods 24casesofIPconfirmedbyoperationandpathologywerecollectedfromJanuary2012toJanuary 2018,including14caseswithbenignIPand10patientswithIP malignanttransformation.Thedynamicenhancementparametersof thetwogroups,theproductoftransferconstant(Ktrans),therefluxrateconstant(Kep),theextravascularextracellularspacevolume fraction (Ve)andthedifferenceoftheareaundertheinitialcurve(iAUC)wereanalyzed.Thesensitivityandspecificityofdifferent parametersintheidentificationofbenignIPandIP malignancytransformationwereevaluated.Results Thereweredifferencesno significantdifferenceinageandsexbetweenbenignIPgroupandIPmalignanttransformationgroup.Therewasasignificantdifference abouttheconvolutedcerebriformpatternbetweenthetwogroups(P＝0.004).Therewasnosignificantdifferenceofstagingbetween thetwogroups(P＝0.136).TheKtransvaluesofbenignIPgroupandIPmalignanttransformationgroupwere0.21±0.53 (min－1), 0.36±0.93 (min－1),andtherewasasignificantdifferencebetweenthetwogroups(P＝0.000).TheiAUCvaluesofbenignIPgroupand IP malignanttransformationgroupwere29.05±5.45,41.14±9.47,respectively,andthedifferenceofiAUCbetweentwogroupswas statisticallysignificant(P＝0.001).TherewasnosignificantdifferenceinKepandVebetweenbenignIPfromIPmalignanttransformation (P＞0.05).Conclusion BenignIPhasatypicalconvolutedcerebriG formpatternandtheabsenceofitindicatesmalignanttransformation. Thestagingoflesioncan’tdifferentiatethebenignIPfromIP malignanttransformation.DCEGMRIexaminationisworthyinthe evaluationbenignIPandIP malignanttransformation,especiallyKtransandiAUCvalues.
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Objective To compare the difference in risks of obstetric complications of singleton pregnancy between women with hyperandrogenic polycystic ovary syndrome (PCOS) and women with normoandrogenic PCOS. Methods Prospective cohort study. This study was a secondary analysis of data collected during a multicenter randomized controlled clinical trial. Women who got clinical singleton pregnancy were grouped according to whether they were diagnosed with hyperandrogenism at baseline. There were 118 women with hyperandrogenism and 366 women without hyperandrogenism. The incidences of obstetric complications and birth weight were compared between the two groups. Results Women with hyperandrogenic PCOS had a significantly higher risk of preterm delivery than women with normoandrogenic PCOS [12.7％ (15/118) versus 3.6％ (13/366); OR=3.94, 95％CI: 1.82-8.56]. After adjustment of age, duration of infertility, body mass index, and fresh or frozen embryo transfer group, hyperandrogenism was still associated with an increased risk of preterm delivery (OR=3.67, 95％CI: 1.67-8.07). Compared with women with normoandrogenic PCOS, women with hyperandrogenic PCOS had similar risks of pregnancy loss, gestational diabetes mellitus, pre-eclampsia, placenta previa, and postpartum hemorrhage (all P>0.05). Birth weight as well as the risks of being small for gestational age and large for gestational age were also comparable between the two groups (all P>0.05). Conclusion In women with PCOS and singleton pregnancy, those with preconceptional hyperandrogenism have a higher risk of preterm delivery than those without hyperandrogenism.
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Objective To investigate the correlation between serum lectin like oxidized low density lipoprotein receptor-1 ( sLOX-1 ) and left ventricular diastolic function in patients with essential hypertension. Methods From January 2016 to July 2017, one hundred and forty-six patients with essential hypertension were selected and divided into two groups according to the ratio of E/ A,the left ventricular diastolic function group (76 cases) and the left ventricular diastolic function group (70 cases),the sLOX-1 level of the patients was detected by ELISA method, and the left ventricular diastolic function was evaluated by echocardiography. The correlation between sLOX-1 and left ventricular diastolic function was analyzed. Results The serum sLOX-1 levels in left ventricular diastolic function group (( 208. 12 ± 13. 48 ) μg/ L ) were significantly higher than those inthe left ventricular diastolic function group ((152. 12 ± 12. 96) μg/ L) . The difference between the two groups was statistically significant (t= 6. 586,P= 0. 000). Logistic regression analysis showed that serum sLOX-1 was a influence factor of left ventricular diastolic function (OR= 2. 42,95%CI 1. 42-2. 82,P = 0. 036) . Conclusion The levels of serum sLOX-1 can be used as a indicator of left ventricular diastolic function.