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ObjectiveTo obtain content characteristics of inorganic elements in Scutellariae Radix （aged 1-4 years）， and to explore the feasibility of identifying the growth years of Scutellariae Radix based on characteristic spectrum of inorganic elements combined with chemometric models. MethodAfter microwave digestion， the contents of Mn， Zn， Ca， Fe， Mg， Na， K， Cr， Cu， Se， As， Cd， Hg， Pb and Ni in 21 batches of Scutellariae Radix were determined by inductively coupled plasma atomic emission spectrometry （ICP-OES） and inductively coupled plasma mass spectrometry （ICP-MS）. Meanwhile， characteristic spectrum of inorganic elements in samples was drawn. The identification model was constructed to discriminate the growth years of Scutellariae Radix based on the combination of principal component analysis （PCA）， Fisher discriminant function and support vector machine （SVM）. ResultThe contents of Mn （7.79-36.48 μg·g-1）， Zn （10.12-31.43 μg·g-1）， Cu （6.38-17.20 μg·g-1）， K （2.98-13.89 μg·g-1）， Mg （3.45-7.78 μg·g-1） and Ca （2.32-7.09 μg·g-1） in Scutellariae Radix were detected by ICP-OES and ICP-MS， and their contents increased with the prolongation of growth years. PCA results showed that Cu， Ni， Cd， Na， Mg， Fe， Ca， Zn， Mn and Hg were characteristic elements of Scutellariae Radix. Samples with different years could be divided into four categories in the spatial characteristic diagram of Fisher discriminant analysis. The correct rate of SVM model for identifying the growth years of samples was 95.2%. ConclusionThis established method is accurate and rapid for discriminating the growth years of Scutellariae Radix， which can provide reference for the identification of other Chinese medicinal materials. It is suggested that some elements should be considered as indexes in subsequent construction of the quality evaluation system of Scutellariae Radix.
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ObjectiveAlmond， which is bitter in taste， contains traces of toxic substances. For the sake of the safety of prescriptions containing this medicinal material， the processing method of "soaking in boiling water" was selected. Moreover， through literature research and network pharmacology， the characteristic index of this medicinal material was determined. On this basis， a method was established for the determination of amygdalin in Qingfei Paidu Granules （QFPD） and the transfer rate of it in the processing of this prescription was monitored， aiming at improving the quality control system of QFPD. MethodThe high performance liquid chromatography conditions are as follows： YMC Triart C18 column （4.6 mm × 150 mm， 5 µm）， mobile phase of methanol-water with flow of 1.0 mL·min-1， column temperature of 35 ℃， and detection wavelength of 210 nm. ResultThe linear curve fitted well and the average recovery of amygdalin was 97.74% with RSD of 4.3%. The transfer rates of amygdalin from the medicinal material to the extract， from extract to concentrate， and from concentrate to granules were investigated with this method. The result showed that the average transfer rate from the medicinal material to the granules was （60±3.91）%. The comparison of transfer rate between the processes suggesting that the extraction of the medicinal material might be the key part influencing the prescription preparation. ConclusionThe method is simple， sensitive， reproducible， stable， and accurate， and the index is reasonable. Thus， the method can be used for the quality control of QFPD and determination of transfer rate of components in the preparation of QFPD. This study further improves the quality control standard of almond in QFPD， which can serve as a reference for the clinical application of QFPD.
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Objective:To demonstrate whether image quality and measurement accuracy of vessel wall thickening could be improved using a deep learning image reconstruction (DLIR) algorithm in children with Takayasu arteritis.Methods:From September 2019 to April 2020, 32 patients with Takayasu arteritis underwent low-dose contrast-enhanced CT with 100 kVp in Beijing Children′s Hospital were enrolled retrospectively. The raw data were reconstructed at 0.625 mm slice thickness using the filtered back projection (FBP), 50% adaptive statistical iterative reconstruction-V (ASIR-V) at 50% (50%ASIR-V), ASIR-V at 100% (100%ASIR-V) and DLIR. Subjective evaluation including the image quality of vessel wall identification, overall image noise and diagnostic confidence were evaluated using a 5 points scales by 2 observers. Objective evaluation including the thickness and standard deviation of vessel wall were measured, then the coefficient of variation (CV) was calculated. The CT value and noise of aorta were measured to calculate the contrast to noise ratio (CNR) of image. Friedman test was used to compare the differences of subjective scores among the four groups, and the analysis of variance of random blocks was used to compare the differences of objective measurement indices.Results:In terms of subjective score results, there was no significant difference between 100%ASIR-V and DLIR of overall image noise ( P>0.05), and the image scores of the two groups were higher than those of FBP and 50%ASIR-V (all P<0.05). The vessel wall identification and diagnostic confidence of DLIR were higher than those of other images (all P<0.05). The objective measurement results showed that the standard deviation and CV of vessel wall thickness in DLIR were significantly lower than those in other images (all P<0.05). There was no significant difference in vascular noise, muscle noise and CNR between 100%ASIR-V and DLIR (all P>0.05), which were lower than those in FBP and 50%ASIR-V (all P<0.05). Compared with 50%ASIR-V, the CV of DLIR was reduced by 22.9%, and the CNR was increased by 46.8%. Conclusion:DLIR can improve the overall image quality of CECT in children with Takayasu arteritis and the measurement accuracy of vascular wall, making it possible to further reduce the radiation dose.
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Objective:To investigate the clinical efficacy, safety and tolerance of different enteral nutritional therapy in the treatment of moderately severe acute pancreatitis (MSAP).Methods:From January 2018 to January 2019, 65 patients with MSAP who were hospitalized in Beijing Chao-Yang Hospital, Capital Medical University were prospectively enrolled. According to random number table, the patients were divided into the nasogastric tube enteral nutrition (NGEN) group (35 cases) and the nasojejunal tube enteral nutrition (NJEN) group (30 cases). All the patients received enteral nutrition solution through continuously pumping at a constant speed for 24 h. The two groups were compared in the relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, computed tomography severity index (CTSI) score 1 week after enteral nutrition, nutrition status, infection parameters, hospitalization time, hospitalization expenses and complications. Independent sample t test and rank sum test of two independent samples were used for statistical analysis. Results:There were no significant differences in age, gender, body mass index (BMI), CTSI score and Ranson score at admission, relief time of abdominal pain, time from admission to receiving enteral nutrition treatment, time to resume oral feeding, CTSI score one week after enteral nutrition or hospitalization time between NGEN group and NJEN group (all P>0.05), and there was no death in both groups. The cost of hospitalization, catheterization time, cost of catheterization of NGEN group were all lower than those of NJEN group ((40.0±10.0) thousand yuan vs. (40.4±9.0) thousand yuan; 2.00 min (1.50 min, 2.50 min) vs. 11.50 min (9.50 min, 12.75 min); 135.42 yuan (135.42 yuan, 135.42 yuan) vs. 1 313.30 yuan (1231.20 yuan, 1 823.72 yuan)), and the differences were statistically significant ( t=2.342, Z=6.737 and 7.687, all P<0.01). The albumin levels of MSAP patients of the NGEN group at admission and 1 week after enteral nutrition were both higher than those of NJEN group ((43.5±5.1) g/L vs. (41.0±4.0) g/L, (42.1±4.1) g/L vs. (39.5±4.4) g/L), and the differences were statistically significant ( t=2.135 and 2.486, P=0.04 and 0.02), however there was no statistically significant difference in the decrease of albumin level between the two groups ( P>0.05). There were no statistically significant differences in the incidence of nutrition-related complications (abdominal distension, diarrhea, gastric retention and lumen obstruction) or the incidence of severe complications (transient organ failure and pancreatic necrosis complicated with infection) between NGEN group and NJEN group (all P>0.05). Conclusions:The efficacy and safety of NGEN are equivalent to NJEN in MSAP. Moreover, it can reduce the medical expenses of patients, and it is convenient to carry out in primary hospitals because of its easy operation.
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@#Objective To investigate the risk factors for lymph node metastasis (LNM) and prognosis of T1-stage esophageal squamous carcinoma (ESC). Methods Clinical data of 387 patients with T1-stage ESC who underwent surgical treatment in our hospital from March 2013 to March 2018 were collected. There were 281 males and 106 females aged 60 (41-80) years. The patients were divided into a lymph node metastasis group (n=77) and a non-metastasis group (n=310). The risk factors for LNM and prognosis were analyzed. Results Among 387 patients with T1-stage ESC, 77 (19.9%) patients had LNM. The incidence of LNM was 8.4% (8/95) in T1a-stage patients and 23.6% (69/292) in T1b-stage patients. Univariate analysis showed that tumor size, differentiation degree, depth of invasion and vascular tumor thrombus were associated with LNM (P<0.05). Multivariate logistic regression analysis showed that invasion depth of tumor [OR=2.456, 95%CI (1.104, 5.463), P<0.05] and vascular tumor thrombus [OR=15.766, 95%CI (4.880, 50.938), P<0.05] were independent risk factors for LNM. The follow-up time was 41 (12, 66) months. The 1-year, 3-year and 5-year survival rates were 98.71%, 89.67% and 86.82%, respectively. Univariate analysis showed statistically significant differences in tumor invasion depth, vascular tumor thrombus and LNM between the survival group and the death group. Cox analysis showed that LNM [OR=3.794, 95%CI (2.109, 6.824), P<0.05] was an independent risk factor for prognosis. Conclusion T1-stage ESC patients with deeper invasion or vascular tumor thrombus have a higher risk of LNM. The prognosis of T1-stage ESC with LNM is relatively poor.
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Obstructive sleep apnea(OSA) refers to apnea and hypopnea caused by repeated obstruction of upper respiratory tract collapse during sleep, accompanied by snoring and irregular snoring, daytime sleepiness and repeated arousal.Studies have shown that arousal is associated with daytime sleepiness and other symptoms and some complications in OSA patients.Based on literature review, this paper reviews the current research on OSA and arousal.
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Obstructive sleep apnea ( OSA) refers to apnea and hypopnea caused by repeated obstruction of upper respiratory tract collapse during sleep ,accompanied by snoring and irregular snoring ,daytime sleepiness and repeated arousal.Studies have shown that arousal is associated with daytime sleepiness and other symptoms and some complications in OSA patients.Based on literature review,this paper reviews the current research on OSA and arousal.
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Objective To investigate the relationship between vitamin D level and thyroid peroxidase (TPO) level in Qinghai Province.Methods In 2015 and 2016,a stratified cluster sampling method was used to select 1 873 people in 9 regions of Qinghai Province,including 935 males and 938 females,the average age was (52.3 ± 10.9) years old,there were 1 040 Han people and 833 Tibetans.Fasting venous blood samples were collected,and vitamin D and TPO levels were detected by a fully automated chemiluminescence immunoassay system,vitamin D and TPO levels were compared in different gender,ethnic group,and altitude populations.Results The vitamin D level was (16.3 ± 7.5) μg/L,and abnormal rate of vitamin D was 89.2％ (1 670/1 873);the TPO level [median (quartile)] was 23.8 (16.0-35.0) U/ml,and the positive rate of TPO was 26.8％ (502/1 873).The vitamin D levels of males and females were (16.9 ± 7.6) and (15.6 ± 7.6) μg/L,respectively,the difference was statistically significant (t =3.684,P ＜ 0.01);the TPO levels were 23.8 (16.4-31.0) and 23.8 (15.9-37.6) U/ml,respectively,the difference was not statistically significant (Z =-1.084,P ＞ 0.05).The vitamin D levels of the Han people and the Tibetans were (16.2 ± 7.8) and (16.3 ± 7.3) μg/L,respectively,the difference was not statistically significant (t =-0.110,P ＞ 0.05);the TPO levels were 23.5 (15.7-34.8) and 24.0 (16.5-35.1) U/ml,respectively,the difference was not statistically significant (Z =-0.078,P ＞ 0.05).The vitamin D levels of middle-altitude (1 500-3 000 m) and high-altitude (＞ 3 000 m) populations were (16.6 ± 7.7) and (15.8 ± 7.5) μg/L,respectively,and the difference was not statistically significant (t =2.126,P ＞ 0.05);the TPO levels were 23.4 (16.0-33.0) and 24.0 (16.0-36.8) U/ml,respectively,the difference was not statistically significant (Z =-1.296,P ＞ 0.05).There was negative correlations between vitamin D level and TPO level,altitude (r =-0.150,-0.052,P＜ 0.05),and no correlation with ethnic group (r =0.003,P ＞ 0.05).Conclusions The vitamin D level is negatively correlated with TPO level in Qinghai population.The abnormal rate of vitamin D is high,and vitamin D level of males is higher than that of females.
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Objective To investigate the iodine nutritional and thyroid stimulating hormone level of patients with thyroid nodules in different regions of Qinghai Province and analyze the characteristics of changes in different regions.Methods In 2014-2016,thyroid nodules in 9 regions of Qinghai Province (Tibetan areas:Xiewu,Nangqian,Jiegu,Guoluo;non-Tibetan areas:Xining,Huzhu,Menyuan,Minhe,and Ledu) were selected and serum thyroid stimulating hormone (TSH) and urine iodine were measured.Results A total of 553 thyroid nodules,the median urinary iodine (MUIC) was 160.8 μg/L and the median TSH was 2.97 mU/L.The iodine nutritional status was at an appropriate level.Among them,MUIC (206.8 μg/L) in thyroid nodules in the Menyuan area was slightly higher than the appropriate amount,there was a significant difference in MUIC among different region (x2 =47.747,P ＜ 0.05);of TSH in thyroid nudules in the 9 regions,the differences were statistically significant (x2 =34.832,P ＜ 0.05).Non-Tibetan areas were compared with Tibetan areas,there was a significant difference in MUIC (155.6,185.6 μg/L),TSH (2.68,3.45 mU/L,Z =-3.677,-5.410,P ＜ 0.05);Among them,the differences was statistically significant between MUIC (152.8,187.7 μg/L) of women with thyroid nodules (Z =-3.504,P ＜ 0.05);there was a statistically significant difference in TSH levels among men (2.58,3.46 mU/L) and women (2.80,3.44 mU/L) with thyroid nodules (Z =-3.613,-4.040,P ＜ 0.05);there were no significant differences in MUIC levels among thyroid nodules of each age groups (P ＞ 0.05);of the TSH level in 30-and 50-＜ 65 years groups (2.63,3.17;2.25,3.58 mU/L),the differences were statistically significant (Z =-2.892,-3.233,P ＜ 0.05),and other groups were no significant differences (P ＞ 0.05).Conclusion The iodine nutrition of patients with thyroid nodules in these regions of Qinghai Province is generally at an appropriate level,the MUIC and TSH levels in Tibetan areas were lower than those in non-Tibetan areas,and iodine nutrition status and TSH levels should be monitored for key populations.
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Objective To investigate the autophagy level of Ana-1 cells after ingesting melanized Penicillium marneffei (PM),and to explore the feasibility of rapamycin in killing the bacteria by inducing macrophages autophagy.Methods Melanized PM was cultivated and isolated from the medium containing dopamine.The expression of microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) in Ana-1 cells stimulated by conventional or melanized PM was detected by western blot.The expression levels of LC3 Ⅱ protein in Ana-1 cells treated with rapamycin and incubated with melanized PM was detected.Then,the localization of LC3 Ⅱ in Ana-1 cells which contained melanized PM was observed by immunofluorescence staining.Finally,the direct sterilization effect of rapamycin on melanized PM were detected,and the sterilization effect of Ana-1 cells treated with or without rapamycin on melanized PM was measured.Results No significant change was found in the LC3 Ⅱ level of Ana-1 cells after ingesting melanized PM (P＞0.05),while LC3 Ⅱ level in Ana-1 cells treated with rapamycin which contained melanized PM was significantly increased (P=0.009).The colocalization of LC3 Ⅱ with melanized PM in cytoplasm of Ana-1 cells was observed.For Ana-1 cells treated with rapamycin,3 h and 6 h after incubated with melanized PM,the survival rates of melanized PM both were significantly reduced (P=0.026,0.014).No significant sterilization effect of Ana-1 cells or rapamycin was observed under the same conditions.Conclusion Melanized PM can suppress the activation of macrophage autophagy,and rapamycin can improve sterilization effect of Ana-1 cells by inducing the activation of autophagy.
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Objective To investigate the diagnostic parameters,criteria and diagnostic value of pelvic floor ultrasound in female stress urinary incontinence(SUI).Methods Simple factor logistic regression analysis was used to compare the difference of ultrasonic parameters between SUI patients(260 cases) and asymptomatic subjects(60 cases) to find the relevant diagnostic indexes,and to evaluate the diagnostic criteria and diagnostic value by the ROC curve.Results There were significant differences in urethral inclination angle and levator hiatus area in resting and bladder neck position,bladder position,urethral inclination angle,retrovesical angle,levator hiatus area in Valsalva state and urethral rotation angle,bladder neck mobility between the two groups (all P ＜ 0.05).There was no significant difference in age,BMI,bladder neck position,bladder position,retrovesical angle between resting in the two groups (all P ＞0.05).Using the ROC curve analysis,the cut-off points of urethral inclination angle and levator hiatus area in resting,bladder neck and bladder position,urethral inclination angle,retrovesical angle,levator hiatus area in Valsalva,bladder neck mobility and urethra rotation angle to diagnose SUI were 16.5°,13.5 cm2,3.5 mm,0.5 mm,29.5°,139.5°,19.5 cm2,24.5 mm,45.5°,respectively.The sensitivity/specificity were 54.6％/66.7％,49.2％/80.0％,68.1％/95.0％,64.2％/98.3％,67.3％/93.3％,73.5％/50.0％,68.8％/81.7％,70.0％/95.0％,67.2％/85.0％,respectively.The area under the curve were 0.625,0.668,0.855,0.854,0.817,0.622,0.811,0.866,0.817,respectively.Conclusions Pelvic floor ultrasound is a better way to diagnose stress urinary incontinence,and it provides an objective basis for the diagnosis of SUI.
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Objective To compare the diagnostic performance of multi-contrast atherosclerosis characterization (MATCH) and magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for the detection of IPH with histologic analysis as the reference standard.Methods Thirty individuals were collected in this study.They were diagnosed to have carotid stenosis＞50％ by ultrasound and scheduled for carotid endarterectomy from 2014 to 2015.3 T carotid MR examinations using MPRAGE,MATCH and 3D TOF were performed in these patients.Axial images covered all plaques and centered at the bifurcation of the carotid artery.All image data sets were processed on a semi-automatic software (MRI-Plaque View,VPDiagnostics,US) to analyze the component of IPH for vulnerable plaques.The consistency between MATCH and MPRAGE was analyzed by using Cohen Kappa analysis.Comparison of the two sequences to the pathological results was performed in a similar manner.The sensitivity and specificity of the two sequences were obtained.The SNR,CNR and contrast ratio(CR) of the two regions of interest were calculated and Wilcoxon rank sum test was used to compare the difference between the two methods.Results Among 30 patients,a total of 602 available sections and 95 correponding histology specimens were included in the analysis.When all 602 available sections were included in the analysis,MATCH yielded good agreement with MPRAGE(Kappa=0.773) on the detection of IPH.With pathological specimens as the gold standard,moderate to good agreement was shown for both MATCH and MPRAGE (Kappa=0.778,0.685).The sensitivity and specificity for the detection of IPH was 93.2％ (68/73) and 90.9％ (20/22) for MATCH.For MPRAGE,the sensitivity and specificity was 87.7％(64/73) and 90.9％(20/22) respectively.The difference between MATCH and MPRAGE was statistically significant for SNR,CNR and CR.That is to say,SNR and CNR of MPRAGE were higher than those of MATCH(P＜0.05),while CR of MATCH was higher than that of MPRAGE(P＜0.05).Conclusion Compared to the MPRAGE sequence,MATCH technique demonstrates similar diagnostic performance for the detection of IPH.
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Objective To understand the results and characteristics of targeted monitoring of healthcare-associated infection (HAI)in an intensive care unit (ICU)of a tumor hospital,so as to provide scientific basis for formulating measures of prevention and control of HAI.Methods Patients who admitted to an ICU from January to December 2013 were performed targeted monitoring,incidence of HAI was adjusted with an average severity of illness score (ASIS),three types of invasive procedure-related infection,distribution of pathogens,and multidrug-resistant or-ganisms were monitored.Results A total of 455 patients were monitored,the total patient-days were 2 483 days, 52 cases of HAI occurred,incidence of HAI was 11 .43%,incidence of HAI per 1 000 patient-days was 20.94‰,af-ter the adjustment with ASIS,incidence of HAI per 1 000 patient-days was 6.29‰.The main infection site was re-spiratory system(63.46%),followed by urinary system(19.23%);Incidence of ventilator-associated pneumonia per 1 000 ventilation-days,catheter-related bloodstream infection per 1 000 catheter-days,and catheter-associated urinary tract infection per 1 000 urinary catheter days were 12.08‰,0.95‰,and 4.07‰ respectively.A total of 181 path-ogenic isolates were detected,74.59% (n=135)of which were gram-negative bacteria,18.23%(n=33)were gram-positive bacteria,and 7.18%(n=13)were fungi;18.23%(n=33)were multidrug-resistant strains.Conclusion ICU is the high risk department of the occurrence of HAI,the main infection is respiratory tract infection,the major pathogen is gram-negative bacteria.Targeted monitoring can timely reflect the deficiency in infection control practice,is helpful for formula-ting effective prevention and intervention measures,and reducing the occurrence of HAI.
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Objective To explore the four criteria,including bedside index for severity in acute pancreatitis(BISAP),Ranson score,modified CT severity index(MCTSI) and acute physiology and chronic health evaluation scoring system Ⅱ (APACHE Ⅱ) in assessment of severity and prognosis of hyperlipidemic acute pancreatitis.Methods A total of 326 patients with hyperlipidemic acute pancreatitis were studied retrospectively from August 2006 to July 2015.The discrepancy of the four criteria in assessment of severity and prognosis of hyperlipidemic acute pancreatitis was compared with chi-square test and receiver operating characteristic curve.Results The incidences of moderately severe acute pancreatitis and severe acute pancreatitis,local complications and mortality of patients with BISAP score ≥3,Ranson score ≥3,APACHE Ⅱ score≥8 and MCTSI score≥4 were significantly higher than BISAP score ＜ 3,Ranson score ＜ 3,APACHE Ⅱ score ＜ 8 and MCTSI ＜ 4 respectively (all P ＜ 0.05).As far as severity was concerned,the sensitivity and AUC of APACHE Ⅱ were 57％ and 0.814,which were higher than the other systems.The second most sensitive criterion was BISAP.In assessment of local complications,the sensitivity and AUC of MCTSI were 68％ and 0.791,which were higher than the other three.The most sensitive criterion to predict mortality was BISAP with sensitivity 89％ and AUC 0.867,which was followed by APACHE Ⅱ.Conclusions All four criteria can be used to determine the severity,local complications and mortality.Generally,BISAP is simple and easy to practice,and better than the other three.
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Objective To investigate the expression of Caspase-9 and heat-shock protein-90 (HSP 90) in rats after focal cerebral ischemia-reperfusion injury.Methods The male SD rats (200-250 g) were divided into three groups by the random number table: normal group, sham group and cerebral ischemia-reperfusion (CIR) group.Each group was sorted into four subgroups including group 6 h, group 24 h, group 48 h and group 72 h according to the reperfusion time.Suture-occluded method was adopted to prepare focal cerebral ischemia-reperfusion(CIR) injury in rat model.Enzymelinked immunosorbent assay (ELISA) method was used to detect the variations of Caspase-9 and HSP-90 expression in rats.Results The changes in Caspase-9 and HSP 90 expression in the brain cells were observed by ELISA method.The expression of Caspase-9 and HSP-90 was weakly expressed in sham group, and was at peak in CIR group within 24 h-48 h, then began to decline at 72 h after the reperfusion time.The differences in the expression of caspase-9 and HSP-70 between sham group and normal group were not statistically significant.Conclusions Apoptotic cells gradually increase along with reperfusion time and reach the peak at 48 h after cerebral ischemia-reperfusion.In ischemia half dark stripe, the expression of Caspase-9 and HSP 90 is increased in neuronal cells after cerebral ischemia-reperfusion, and the positive cells number is at peak at 48 h after cerebral ischemiareperfusion.Apoptosis of neuronal cells after cerebral ischemia and reperfusion is a dynamic evolutionary process.The expression of Caspase-9 and HSP 90 in nerve cells plays an important role in regulating cell apoptosis.
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BACKGROUND:Elderly hypertensive patients often associated with organ and tissue ischemia. Al kinds of risks are easy to appear in the process of undergoing arthroplasty. To ensure the smooth operation and to improve the safety of the surgery treatment, it is needed to choose an appropriate mode of anesthesia. OBJECTIVE:To explore the application security of epidural combined with smal dose of intravenous anesthesia in total knee arthroplasty in elderly hypertensive patients. METHODS:A total of 64 elderly hypertensive patients with arthroplasty in the Third Hospital of Hebei Medical University from December 2013 to December 2014 were selected and were divided into control group (32 cases) and observation group (32 cases). They were given total intravenous anesthesia and epidural block combined with smal dose of intravenous anesthesia. Systolic blood pressure, diastolic blood pressure, heart rate, blood oxygen saturation and changes in respiratory rate were detected before anesthesia, after anesthesia induction, 10 minutes after anesthesia, 10 minutes after use of bone cement, and at the end of arthroplasty in both groups. The usage of vasoactive drugs (including ephedrine and dopamine) during arthroplasty and adverse events after arthroplasty were recorded. RESULTS AND CONCLUSION:Compared with pre-anesthesia, systolic blood pressure and diastolic blood pressure were significantly reduced and blood oxygen saturation was increased at 10 minutes after anesthesia and 10 minutes after the application of bone cement in both groups (P<0.05). In the end of arthroplasty, systolic blood pressure, diastolic blood pressure and respiratory rate were significantly higher in the control group than in the observation group (P<0.05). A total of 3 cases in the observation group and 15 cases in the control group used vasoactive drugs (including ephedrine and dopamine), and there was a significant difference in its usage (P<0.05). Moreover, five patients in the control group experienced respiratory insufficiency, which was apparently improved after given the short-term ventilator support. These results confirm that compared with the total intravenous anesthesia, epidural block combined with smal dose of intravenous anesthesia showed a high safety during total knee arthroplasty in elderly hypertensive patients.
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Background and purpose:The symptoms of pancreatic neuroendocrine neoplasms (PNENs) are complicated, that might lead to misdiagnosis. This study aimed to detect the expression level of DJ-1 in PNENs and explore the clinical significance of DJ-1 in PNENs.Methods:DJ-1 protien levels in the serum of 16 cases of PNENs patients and 25 cases of healthy persons were detected by ELISA analysis; The expressions of DJ-1 in 78 cases of PNENs tissues were detected by immunohistochemical staining.Results:The DJ-1 level in the serum of PNENs patients was signiifcantly higher than healthy persons (36.19±6.71vs 24.68±5.94 ng/mL;P<0.001);53.8% (42/78) cases of PNENs tissues showed DJ-1 positive staining; DJ-1 expression level in PNENs tissues had signiifcantly positive correlation with lymph node metastasis (P=0.033), distant metastasis (P=0.017), TNM stage (P=0.012), and pathology grade (P=0.049); As a dependent risk factor, DJ-1 expression was signiifcantly associated with shorter OS (P=0.003) and DFS (P=0.018) of PNENs patients.Conclusion:High expression of DJ-1 protein correlated with invasion and metastasis, disease progression, and poor prognosis in PNEN.
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Objective To explore the related factors influencing the prognosis of children with Tourette syndrome ( TS) . Methods We collected 420 outpatient cases of TS children in the department of pediatrics of Guangdong Provincial Hospital of Traditional Chinese Medicine from January of 2007 to October of 2010 as the research objects. Using the unified survey questionnaire, we observed the influencing factors of TS prognosis such as sex, onset age, mother’s pregnancy situation, the perinatal period, partiality for food intake, family relationship, the first symptom, the severity of disease, underlying diseases, comorbidities ( such as attention deficit hyperactivity disorder, anxiety disorder, and obsessive-compulsive disorder) , family history of psychiatric or neurological diseases, trace elements levels, electroencephalogram (EEG), antistreptolycin O (ASO), course of disease, and maintenance treatment. The related factors of prognosis was analyzed with single factor and multiple factors Logistic regression analysis. Results Among the 420 cases of TS children, 396 cases were included into the final analysis, 24 were lost and the follow-up lost rate was 5.7%. The remission rate of TS was 78.3%, and the uncured rate was 21.7%. The results of preliminary screening of the influencing factors by single factor Logistic analysis showed that the related influencing factors for TS prognosis were 12, and they were course of diseases, abnormal birth history, father’s education level, mother’s education level, upbringing methods, family history of psychiatric or neurological diseases, underlying disease history, comorbidities history, abnormal ASO, the severity of disease, the frequency of disease relapse, and the medication history of western medicine (P<0.05) . And then the obtained 12 factors were analyzed by the multiple fac tors Lo gistic regression analysis, the results showed that upbringing methods, comorbidities history, the severity of disease, and the frequency of disease relapse were correlated with TS prognosis ( P < 0.05) . Conclusion TS children will have poor prognosis when their parents spoil, indiscipline, beat and scold, and dictate them, or when the children have severe illness state, frequent recurrence of the disease, and the history of comorbidities ( atten tion deficit hyperactivity disorder, anxiety disorder, obsessive-compulsive disorder, etc.) .
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Objective To understand the dynamic status of schistosomiasis epidemic situation and Oncomelania hupensis snail status before and after the schistosomiasis transmission interrupted in the mountainous areas of Yunnan Province. Methods The data of schistosomiasis epidemic situation and snail status were collected and analyzed statistically in Jianchuan County from 10 years before the schistosomiasis transmission interrupted to 2008. Results The schistosomiasis control began in Jianch-uan County from 1954. In 1976,the criteria of schistosomiasis endemic controlled were reached,and the infection rate of popu-lation was 0.65%and the infection rate of snails was 0.40%. In 1981,the criteria of schistosomiasis transmission controlled were reached,and the infection rate of population was 0.34%and the infection rate of snails was 1.41%. In 1993,the criteria of schis-tosomiasis transmission interrupted were reached,and the infection rate of population was 0 and the infection rate of snails was 0. There was a fluctuation in the schistosomiasis epidemic situation and snail status during the whole control duration ,but the trend was decreasing. Conclusion The time from schistosomiasis endemic controlled to transmission controlled is relatively short,but the time from transmission controlled to transmission interrupted is relatively long. In the original schistosomiasis en-demic areas,there might be some areas where there is no the disease bud there still are snails.