ABSTRACT
Objective:To explore the mechanism of zoledronic acid (ZOL) affects osteogenic differentiation and bone formation through the regulation of sirtuin 3 (SIRT3) / P53 expression.Methods:Bone marrow mesenchymal stem cells (BMSCs) were induced to differentiate into osteogenic cells, the expression of SIRT3 in the cells was detected, and the targeting regulation relationship between SIRT3 and P53 was analyzed. The intracellular expressions of SIRT3 and P53 were intervened and ZOL was used to treat the cells. MTT method, Western blot method and kit were used to detect cell viability, osteogenesis-related genes Osteoprotegerin (OPG), runt-related transcription factor 2 (Runx2) expression, alkaline phosphatase (ALP) activity and alizarin red S (ARS) staining, respectively. Ovariectomy (OVX) was used to construct a rat model and explore the effect of ZOL on the progression of osteoporosis (OP) in vivo.Results:ZOL promoted osteogenic differentiation of BMSCs. The expression of SIRT3 was down-regulated in the serum of OP patients (0.78±0.23) compared with that of healthy subjects (1.00±0.26 vs. 0.78±0.23. t=3.85, P<0.001). During the osteogenic differentiation of BMSCs, the expression level of SIRT3 gradually increased with the prolonged induction of osteogenesis. Compared with the p53 protein expression and BMSCs activity in the control group, SIRT3 knockout could increase the expression level of p53 protein (0.59±0.05 vs. 1.01±0.11. t=6.02, P=0.004) but inhibited the activity of BMSCs (100.00±8.41 vs. 51.26±5.59. t=8.36, P=0.001). After ZOL treatment, the inhibitory effect of SIRT3 on cell viability (49.61±5.11 vs. 87.61±7.31. t=7.38, P=0.002) and osteogenesis was relieved, and the level of P53 was inhibited (1.10±0.10 vs. 0.69±0.04. t=6.59, P=0.003). P53 overexpression partially offseted the effects of ZOL on cell viability (84.61±6.52 vs. 66.54±5.47. t=3.68, P=0.021) and osteogenesis. Compared with the sham surgery group, the OVX group showed inhibition of osteogenesis in rats, and ZOL treatment significantly improved osteogenic inhibition. ZOL treatment increased the expression level of SIRT3 protein in bone tissue of OVX rats, but inhibited the expression level of P53. Conclusion:ZOL promoted osteogenic differentiation and bone formation of BMSCs by promoting the ubiquitination and degradation of P53 by SIRT3.
ABSTRACT
Neck dissection and reconstruction are two important aspects of oral cancer treatment.There are various surgical methods for neck dissection and reconstruction,but all of them are performed by open surgery.This article reports a full endoscopic neck dis-section through the retroauricular hairline approach,the radical resection of the intraoral tumor and the repair of the defect by superfi-cial circumflex iliac artery perforator flap with in situ vascular anastomosis intraorally.The incision is located in the hairline,hidden and invisible,and there is no exposed surgical scar on the neck after surgery.This paper introduces the technique of scarless neck dissection combined with free skin flap repair for the treatment of oral cancer and discusses its advantages and disadvantages.
ABSTRACT
Objective To classify and analyze the existing animal models of vertigo based on the clinical characteristics of Chinese and Western medicines,evaluate the clinical fit of the models,and their advantages and disadvantages,to improve the existing animal models and provide a more intuitive reference for clinical research.Methods The existing animal models of vertigo in the database from January 2000 to March 2023 were searched,and the models were classified by the modeling method combined with the characteristics of Chinese and Western medicine clinical conditions of vertigo and the existing animal model evaluation method,and assigned values to evaluate the clinical fit and the advantages and disadvantages of the models.Results The existing animal models of vertigo were neck surgery,motor stimulation,otogenic stimulation,sclerotherapy injection,flight variation pressure,vertebral artery ligation,and stasis injection models.Among them,the Western medical fit was high for the neck surgery model(65%)and otogenic stimulation model(65%).All models had a moderate Chinese medical fit(50%≤fit<60%)or low(fit<50%)TCM anast omosis.No model had both high Chinese and Western medicines anastomosis.Conclusions The animal models of vertigo are mainly Western medicine disease models,Chinese medicine evidence models are lacking,and few models have a high clinical fit between Chinese and Western medicines,which fail to highlight the characteristics of Chinese medicine.Therefore,the establishment of animal models of vertigo that are closely integrated with the clinical characteristics of Chinese and Western medicines may provide more reasonable and comprehensive experimental support for the development,screening,and clinical evaluation of new anti-vertigo drugs.
ABSTRACT
Various pancreatic diseases can cause dyspepsia due to pancreatic exocrine insufficiency (PEI) caused by pancreatic parenchymal injury and/or pancreatic duct obstruction, which further leads to impaired digestive function and a series of severe clinical outcomes such as malnutrition, weight loss, and shortened survival time. Therefore, pancreatic disease-related dyspepsia should be taken seriously in clinical practice to improve its diagnosis and treatment rates, so as to improve the quality of life of patients with pancreatic diseases and prolong overall survival time.
ABSTRACT
ObjectiveTo investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on the efficacy and cognitive function of adolescents with depression. MethodsA total of sixty adolescent depression patients who met the diagnostic criteria of the International Classification of Diseases, tenth edition (ICD-10) and were admitted to the psychological outpatient clinic of the Affiliated Hospital of North China University of Technology from September 2021 to March 2022 were selected for the study, and the random number table method was used to divide the study group (escitalopram oxalate combined with rTMS treatment) and a control group (escitalopram oxalate combined with rTMS pseudo-stimulation treatment) of 30 cases each, and both groups were treated for 4 weeks. Before treatment and at 1, 2, 3 and 4 weeks of treatment, patients' depressive symptoms were assessed using the scores and subtraction rates of the Hamilton Depression Scale-24 item (HAMD-24), and before treatment and after 4 weeks of treatment, cognitive function was assessed using the Motion Screening Task (MOT), Rule Switch Task (RST) and Delayed Matching-to-Sample (DMS) task of the Zhiyun Neuropsychological Automated Test System assessment. Adverse effects during treatment were recorded in both groups. ResultsRepeated measures ANOVA results showed statistically significant time main effects, group main effects, and the interaction between the two groups for HAMD-24 scores before treatment and after 1, 2, 3 and 4 weeks of treatment in patients (F=522.021, 39.905, 26.412, P<0.05). Individual effect analysis showed statistically significant differences in HAMD-24 scores between the two groups after 2, 3 and 4 weeks of treatment (t=-12.784~-2.776, P<0.01). After 4 weeks of treatment, the total effective rate of treatment in the study group was higher than that in the control group (93.33% vs. 73.33%, χ2=4.320, P<0.05), and the differences in each indicator of RST and DMS between the two groups were statistically significant compared with those before treatment (t=-5.616~9.135, P<0.05 or 0.01), and the differences between the two groups were statistically significant (t=-4.823~5.518, P<0.05 or 0.01). ConclusionrTMS may help improve depressive symptoms as well as cognitive function in adolescents with depression.
ABSTRACT
Objective:To find the preferences of nursing staff when they provide " Internet + nursing service" for elderly patients.Methods:By means of the discrete choice experiment, a questionnaire was designed to investigate the preferences of nursing staff when they provide " Internet + nursing services" for elderly patients. In-service nursing staff from 8 medical and health institutions in Ningbo city and Wenzhou city were selected by random sampling, for an online questionnaire survey conducted from May to June 2022. The preferences of nursing staff on their service income, service content, service distance, service continuity and residence status of elderly patients when providing " Internet + nursing service" were analyzed by mixed logit regression.Results:A total of 420 valid questionnaires were collected. Compared to 50 yuan/order, nursing staff preferred to a price of 150 yuan/order ( β= 1.22, P<0.001) nursing services; Compared to specialized nursing services, nursing staff preferred to the routine care ( β= 0.86, P<0.001) and health promotion ( β= 0.86, P<0.05) service; Compared to<5 km, nursing staff were unwilling to provide nursing services for elderly patients at distances of 5-10 km and 11-15 km ( β=-0.66, P<0.05; β=-0.95, P<0.001) ; Compared to 1-2 visits per month, nursing staff preferred not to provide continuing care services ( β=-0.70, P<0.05); Compared to homestay with the patient family, nursing staff preferred to provide nursing services for elderly patients residing in nursing homes ( β= 1.21, P<0.001) . Conclusions:Considering the preference of nursing staff tend to provide " Internet + nursing service" for the elderly patients with services featuring appropriate price, non-specialist care, close distance, low continuity (moderate intensity used as the reference) and security assurance for practice.
ABSTRACT
The treatment of patients with diabetes mellitus, which is characterized by defective insulin secretion and/or the inability of tissues to respond to insulin, has been studied for decades. Many studies have focused on the use of incretin-based hypoglycemic agents in treating type 2 diabetes mellitus (T2DM). These drugs are classified as GLP-1 receptor agonists, which mimic the function of GLP-1, and DPP-4 inhibitors, which avoid GLP-1 degradation. Many incretin-based hypoglycemic agents have been approved and are widely used, and their physiological disposition and structural characteristics are crucial in the discovery of more effective drugs and provide guidance for clinical treatment of T2DM. Here, we summarize the functional mechanisms and other information of the drugs that are currently approved or under research for T2DM treatment. In addition, their physiological disposition, including metabolism, excretion, and potential drug-drug interactions, is thoroughly reviewed. We also discuss similarities and differences in metabolism and excretion between GLP-1 receptor agonists and DPP-4 inhibitors. This review may facilitate clinical decision making based on patients' physical conditions and the avoidance of drug-drug interactions. Moreover, the identification and development of novel drugs with appropriate physiological dispositions might be inspired.
ABSTRACT
Objective:To investigate the effect of pelvic packing on the control of intractable postpartum hemorrhage after emergency perinatal hysterectomy (EPH).Methods:Eleven cases with complete clinical data of pelvic packing due to failure of hemostasis after EPH were collected to evaluate the outcome, complications, hospital stay of pregnant women, and to analyze the factors affecting the effect of pelvic packing. The cases included patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University after pelvic packing treatment in the other hospital due to continuous bleeding after EPH or who were referred to our hospital for pelvic packing treatment due to continuous bleeding after EPH from January 2014 to August 2021.Results:The median gestational week of 11 pregnant women was 38.3 weeks(38.0-39.9 weeks) , and the methods of termination of pregnancy were cesarean section in 7 cases (7/11) and vaginal delivery in 4 cases (4/11). The median time between postpartum hemorrhage and pelvic tamponade was 10 hours (5-57 hours), the median amount of bleeding was 8 500 ml(4 800-15 600 ml) , the median number of pelvic tamponade was 3 pieces (2-7 pieces), and the median retention time of gauze pad was 6.0 days (3.0-6.0 days). The median frequency of laparotomy in this pregnancy was 3 times (2-3 times), with a maximum of 4 among the 11 cases, the first pelvic packing was successful in hemostasis in 9 cases, and the final successful treatment in all of the 11 cases. All parturients had hemorrhagic shock (11/11) and disseminated intravascular coagulation (11/11) before pelvic packing. Other common complications were multiple organ dysfunction syndrome (9/11), cardiac arrest (4/11), deep vein thrombosis (3/11), septic shock (3/11), and intestinal obstruction (1/11). All parturients took out the gauze after the coagulation function returned to normal and there was no active bleeding. The recovery time of coagulation function in 11 cases was 3 days (3-5 days), the retention time of gauze pad was 6 days (3-6 days), the median length of stay in intensive care unit was 14 days (11-26 days), and the median total length of stay was 22 days (16-49 days).Conclusions:Pelvic packing could be used as a temporary strategy for intractable postpartum hemorrhage after EPH, which provides a key time for injury control resuscitation for patients with unstable vital signs. This technology provides an opportunity for referral to superior medical institutions and further treatment.
ABSTRACT
In recent years, as people's diets have changed and diversified, the incidence of dental arthritis has increased year by year, seriously affecting the quality of life of patients. Therefore, the prevention and treatment of dental arthritis should be emphasized. To further study the pathogenesis of dental arthritis and the development and screening of therapeutic drugs, this paper summarized and analyzed the modeling methods, mechanisms, as well as the advantages and disadvantages of the existing animal models of dental arthritis. The clinical diagnostic criteria of traditional Chinese medicine (TCM) and western medicine was established, and the compatibility of TCM and western medicine anastomosis in animal models was evaluated. The results showed that the gel perfusion model had a good match between TCM and western medicine, with simple operation and short cycle. By combining the pathogenic factors of TCM and western medicine, the models of kidney deficiency and stomach heat with kidney deficiency in TCM were obtained, which fully reflected the clinical syndrome characteristics of TCM and western medicine, thus simulating the pathogenesis of human natural dental arthritis. Besides, ligation line model, as the most commonly-used animal model of dental arthritis with a good match to western medicine, was mature and highly repeatable, and had a high success rate. Ligation line model was widely used in various periodontal disease studies, but it did not involve the pathogenic factors of TCM. The current animal model of dental arthritis is given priority to western medicine disease model, and the combination of disease and model is rare, which cannot meet the requirements of the syndrome characteristics of TCM. Only an animal model of dental arthritis with TCM syndrome that conforms to the clinical syndrome characteristics effectively assists to study the nature of TCM syndrome and develop innovative Chinese medicine. Therefore, the establishment of an accurate and standardized animal model of dental arthritis combined with TCM and western medicine is still the focus of future study on the pathogenesis of dental arthritis. This study is intended to provide a certain basis for the discovery, screening, and evaluation of medicines for the treatment of dental arthritis.
ABSTRACT
Age-related laryngeal dysfunction seriously affects swallowing, speech and respiratory function of the elderly and decreases their quality of life.This review summarizes the methods for assessing swallowing, voice and respiratory function associated with laryngeal dysfunction in the elderly, aiming to improve the standards and systems for laryngeal dysfunction assessment in the elderly and to achieve timely detection and treatment of laryngeal dysfunction in the elderly and reduce its negative effects.
ABSTRACT
Objective:To investigate the current situation of the " Internet plus nursing services" for the elderly in Ningbo, and evaluate the promotion effect of the pilot policy, for reference to further optimize such service policy of China nationwide.Methods:The data came from the orders for " Internet plus nursing services" by elderly users over 60 years on the " cloud hospital" platform in Ningbo from 2016 to 2021. Descriptive analysis was used to study major demographic information, types of service items and number of person-times of the elderly users; The promotion effect of the pilot policy on " Internet plus nursing services" for the elderly in 2019 was analysed by Chow test.Results:The number of elderly users increased from 76 person-times in 2016 to 5 923 person-times in 2021, accumulating up to 12 209 person-times. The number of nursing service items increased from 18 in 2016 to 36 in 2021. The person-times of users of common clinical nursing and specialized nursing service items were 11 850 and 359 respectively. After the pilot policy was issued, the number of service items and the number of users were significantly increased in 2020( P<0.05). Conclusions:The development of " Internet plus nursing services" for the elderly in Ningbo had achieved certain results, especially with the promotion of the pilot policy in 2019, the types of service items and the number of elderly users had increased year by year. In the future, we should continue to focus on the elderly living alone and other special elderly groups with the support of relevant policies, further expand the scale of elderly users, improve the types of service items, and optimize the charging standards to help China′s healthy aging process.
ABSTRACT
@#Objective To investigate the changes of mitochondrial unfolded protein response (mtUPR) in hippocampus of lithium-pilocarpine induced seizures and the effect of mitochondria-targeted antioxidant. Methods Lithium chloride and pilocarpine were used to elicit status epilepticus in rats, and the rats were further treated with mitochondria-targeted antioxidant Mito-TEMPO. Adult male Wistar rats were randomly divided into control group, PILO group, Mito-TEMPO group and PILO +Mito-TEMPO group. Nissl staining was used to observe the damage of hippocampal neurons, electron transmission microscopy was used to observe the ultrastructure of mitochondria, ROS production of mitochondria was detected by reactive oxygen species fluorescent probe (DCFDA), and mitochondrial membrane potential was detected by Rhoda.mine123 staining. The expressions of mitochondrial heat shock protein HSP60, protease LONP1 and mitochondrial protease CLpP were detected by Western blot. Results (1) Compared with CON group, the ultrastructure of hippocampal neuronal mitochondria in PILO group was seriously damaged, mitochondrial ROS production was increased, and mitochondrial membrane potential was decreased. (2) Compared with the CON group, the expressions of HSP60 , Lonp1 and CLpP in the PILO group were increased. (3) Compared with the PILO group, the damage of mitochondrial ultrastructure was alleviated in the PILO+Mito-TEMPO group, the production of mitochondrial ROS was significantly reduced, and the mitochondrial membrane potential was increased. (4) Compared with the PILO group, the expressions of HSP60, LONP1 and CLpP in the hippocampal neurons of the PILO+Mito-TEMPO group were decreased. Conclusion The mtUPR is significantly activated in hippocampal neurons in epilepsy, and Mito-TEMPO may play a protective role in hippocampal mitochondrial injury in epilepsy regulating mtUPR.
ABSTRACT
Objective@#To evaluate the nutritional status, food intake, eating behavior and physical activity level of college students in a medical college in Guangzhou, and to explore its association with dietary behavior.@*Methods@#A total of 263 students selected using stratified random sampling method from a medical college in Guangzhou were investigated by questionnaire from October to December in 2019. Chi square test and Wilcoxon test were used to analyze group differences. Multivariate Logistic regression was used to analyze associated factors with thinness, overweight and obesity.@*Results@#The rate of thinness was 25.5%, and the rate of overweight and obesity was 11.8%. The intake of cereals, fruits, eggs, livestock, fried foods and carbonated drinks varied significantly by gender (U=3 278.00,5 224.50,5 981.00,6 663.00,5 460.00,3 873.00,P<0.05). There was significant difference in total physical activity level in different grades (U=4 239.50,P<0.05). Multivariate analysis showed that egg intake was negatively correlated with emaciation (OR=0.20, P<0.01). Picky eating and partial eating were positively correlated with emaciation (OR=2.96, P<0.01). Eating fast was positively correlated with overweight and obesity (OR=5.35, P<0.05).@*Conclusion@#The detection rate of malnutrition among college students in this college is relatively high, and dietary behavior is associated with thinness, overweight and obesity.
ABSTRACT
Early brain injury (EBI) is a series of pathophysiological changes occurring within 72 h after subarachnoid hemorrhage (SAH) and before cerebral vasospasm, which is a key factor affecting the outcome of SAH. The possible pathological mechanisms include cell metabolism, oxidative stress and immune inflammation, in which inflammatory response plays an important role. As the important immune cells in the central nervous system, microglia undergo M1/M2 polarization after brain injury. On the one hand, microglia secrete proinflammatory cytokines through Toll-like receptor 4 (TLR4), calcium sensing receptor (CaSR) and triggering receptor expressed on myoid cells 1 (TREM-1) mediated signaling pathways, which are involved in neuronal apoptosis, blood-brain barrier damage and brain edema after SAH. On the other hand, microglia play the anti-inflammatory and protective effects through the expression of neuroglobin and heme oxygenase 1. This article reviews the M1/M2 polarization process of microglia in EBI after SAH and its dual mechanisms of action.
ABSTRACT
AL3810, a molecular dual inhibitor of the vascular endothelial growth factor receptor (VEGFR) and fibroblast growth factor receptor (FGFR), has earned the permission of phase II clinical trial for tumor treatment by China FDA. As a reversible ATP-competitive inhibitor, AL3810 targets ATP-binding site on intracellular region of VEGFR and FGFR, whereas, AL3810 lacking interplay with extracellular region of receptors rendered deficient blood-brain tumor barrier (BBTB) recognition, poor brain penetration and unsatisfactory anti-glioma efficacy. Integrin
ABSTRACT
Objective:To observe the differences in clinical efficacy of Jieyu Anshen Decoction combined with auricular points and oral tibolone in the treatment of patients with perimenopausal sleep disorders, and provide effective treatment for patients with contraindications to hormone supplement therapy in clinicalMethods:Using a randomized trial design, from July 2018 to August 2020,102 perimenopausal insomnia patients in International Peace Maternity and Child Health Hospital of China Welfare Institutewith kidney deficiency and liver depression who met the inclusion criteria were randomly divided into a treatment group and a control group with 51 cases each. The treatment group took Jieyu Anshen Recipe. At the same time, unilateral auricular point pressing treatment was given, and the opposite ear was changed in 5 d. The control group was treated with tiburon for a period of 3 months. The changes in the scores of each scale were observed in the two groups after 1 month and 3 months treatment. The scale included Pittsburgh sleep quality index (PSQI), modified Kupperman score (KMI), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire Depression Screening Scale (PHQ-9). Its effectiveness and differences were evaluated and analyzed comprehensively through the above scale.Results:PSQI, KMI, GAD-7, PHQ-9 scores decreased significantly in the control and treatment groups after 1 month and 3 months of treatment, and the difference were statistically significant: PSQI: (8.58 ± 1.94) and (5.81 ± 1.93) scores vs. (13.10 ± 2.53), (9.15 ± 2.59) and (6.33 ± 1.98) scores vs.(13.52 ± 2.27) scores; KMI: (19.92 ± 2.16) and (14.67 ± 4.11) scores vs. (28.54 ± 7.65) scores, (19.02 ± 5.92) and(14.10 ± 4.37) scores vs. (27.42 ± 7.34) scores; GAD-7: (4.54 ± 2.03) and (3.81 ± 1.63) scores vs. (5.69 ± 2.95) scores, (3.71 ± 2.48) and (3.32 ± 1.73) scores vs. (4.90 ± 3.17) scores; PHQ-9:(6.90 ± 2.52) and (4.98 ± 1.96) scores vs. (9.83 ± 3.71) scores, (6.15 ± 2.62) and (4.44 ± 1.81) scores vs. (9.02 ± 3.73) scores ( P<0.01). PSQI, KMI, PHQ-9, and GAD-7 scores declined between the two groups, but there were no significant differences between the two groups ( P>0.05). After 1 month and 3 months of treatment, using PSQI scale and KMI score, the total efficiency of patients in the control group was slightly higher than that of the treatment group, but the difference was not statistically significant ( P>0.05); after 1 month and 3 months of treatment, using PHQ-9 score and GAD-7 score, the total efficiency of patients in the treatment group was slightly higher than that of the control group, but the difference was not statistically significant ( P>0.05). Conclusions:Traditional Chinese medicine combined with ear acupoint pressing has similar effects to tibolone in treating perimenopausal insomnia with kidney deficiency and liver depression. It can significantly improve the quality of sleep and quality of life of patients, and has good safety. For patients who are not suitable for hormone, Chinese medicine can be used as an alternative. The therapies are worthy of clinical application.
ABSTRACT
The causal mechanisms and treatment for the negative symptoms and cognitive dysfunction in schizophrenia are the main issues attracting the attention of psychiatrists over the last decade. The first part of this review summarizes the pathogenesis of schizophrenia, especially the negative symptoms and cognitive dysfunction from the perspectives of genetics and epigenetics. The second part describes the novel medications and several advanced physical therapies (e.g., transcranial magnetic stimulation and transcranial direct current stimulation) for the negative symptoms and cognitive dysfunction that will optimize the therapeutic strategy for patients with schizophrenia in future.
ABSTRACT
The causal mechanisms and treatment for the negative symptoms and cognitive dysfunction in schizophrenia are the main issues attracting the attention of psychiatrists over the last decade. The first part of this review summarizes the pathogenesis of schizophrenia, especially the negative symptoms and cognitive dysfunction from the perspectives of genetics and epigenetics. The second part describes the novel medications and several advanced physical therapies (e.g., transcranial magnetic stimulation and transcranial direct current stimulation) for the negative symptoms and cognitive dysfunction that will optimize the therapeutic strategy for patients with schizophrenia in future.
Subject(s)
Humans , Cognitive Dysfunction , Schizophrenia/therapy , Transcranial Direct Current Stimulation , Transcranial Magnetic StimulationABSTRACT
Objective:To evaluate the reliability and validity of Short-form health survey-36 (SF-36) during the first trimester of pregnancy.Methods:From January 2020 to January 2021, pregnant women aged 18―40 during the first trimester visit were admitted to the Obstetric Department of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Split-half reliability and Cronbach′s α coefficients were used to evaluate the reliability. The convergent and discriminative validity were evaluated by using AMOS 24.0 and the criterion-rated validity was evaluated with correlation analysis and non-parameter test. Exploratory factor analysis and confirmatory factor analysis based on structural equation modeling were used in the evaluation of contract validity.Results:SF-36 scale had good reliability (split-half reliability: R=0.901, Cronbach′s α coefficients=0.878), convergent validity, discriminate validity and the criterion-rated validity ( r=0.907). Second-order confirmatory factor analysis model was not well-fitted ( RMSEA=0.070, χ 2/dF=3.566, GFI=0.813, CFI=0.814, TLI=0.792, NFI=0.761), indicating that the construct validity was poor. Conclusions:The reliability, consolidation validity, discrimination validity and criterion-related validity of Sf-36 scale are good, while the construct validity is poor. Improvement is needed when the scale is used for pregnant women.
ABSTRACT
Objective:To explore the clinical characteristics of liver function of patients with autoimmune liver disease (AILD) complicated with gallbladder stone (GS), so as to guide clinical practice.Methods:From November 2009 to October 2018, at General Hospital of Tianjin Medical University, the clinical data of 386 patients with AILD were retrospectively analyzed. According to the relevant diagnostic criteria, 208 cases of autoimmune hepatitis (AIH), 129 cases of primary biliary cholangitis (PBC) and 49 cases of PBC-AIH overlap syndrome were screened out. The incidence, clinical characteristics and the changes of laboratory indicators including albumin, alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT) of AILD patients complicated with GS were analyzed. Chi-square test, t test and rank sum test were performed for statistical analysis. Results:There was no significant difference in the incidence between AILD, AIH, PBC and PBC-AIH overlap syndrome patients complicated with GS (32.9%, 127/386; 28.8%, 60/208; 36.4%, 47/129 and 40.8%, 20/49; respectively; P>0.05). Gallstones of AILD patients complicated with GS mostly were multiple and small stones with maximum diameter <1 cm (45.7%, 58/127 and 57.7%, 60/104, respectively). The age of initial diagnosis, the proportion of liver cirrhosis at inital diagnosis and the levels of ALP and GGT were higher in AILD patients complicated with GS than those of AILD patients without GS ((60.5±11.5) years vs. (57.6±11.5) years; 53.5%, 68/127 vs. 42.1%, 109/259; 154.00 U/L (89.00 U/L, 257.00 U/L) vs. 125.00 U/L (86.00 U/L, 212.00 U/L); 169.00 U/L (79.00 U/L, 343.00 U/L) vs. 128.60 U/L (48.00 U/L, 284.00 U/L); respectively); however the albumin level was lower than that of AILD patients without GS ((36.46±7.30) g/L vs. (38.34±7.58) g/L), and the differences were statistically significant ( t=-2.361, χ2=4.506, Z=-2.192, -2.443, t=2.322; all P<0.05). The incidence of GS in AILD patients≥60 years old was higher than that AILD patients<60 years old (37.6%, 73/194 vs. 28.1%, 54/192), and the difference was statistically significant ( χ2=3.948, P=0.047). The incidence of GS in AILD patients and AIH patients complicated with liver cirrhosis was higher than that in patients without liver cirrhosis (38.4%, 68/177 vs. 28.2%, 59/209; 35.7%, 35/98 vs. 22.7%, 25/110; respectively), and the differences were statistically significant ( χ2=4.506 and 4.259, P=0.034 and 0.039). Conclusions:AILD patients complicated with GS are common, most are multiple and small stones. When complicated with GS, the initial diagnosis may be delayed and the rate of liver cirrhosis at initial diagnosis may increase. The incidence of GS is high in AILD patients with older age and liver cirrhosis.