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Objective To investigate the clinical effect and hearing loss of endolymphatic sac decompression(ESD)combined with one or two semicircular canal obstruction(SCO)in treating the patient with stage Ⅲ or stageⅣ Meniere disease.Methods Forty-three patients with stage Ⅲ or stage Ⅳ Meniere disease,who failed to respond to conventional conservative treatment and had the expectation of preserving residual hearing function,were enrolled in the study.They were divided into three groups according to the operation they underwent:ESD combined with lateral and posterior semicircular canal obstruction(ESD+LPSCO)13 cases,ESD combined with lateral semicircu-lar canal obstruction(ESD+LPSCO)14 cases,and ESD only 16 cases.Data of vertigo,ear fullness and tinnitus be-fore and after operation was collected,analyzed and compared.Hearing function before and after the operation was also evaluated.Results The number of vertigo attacks in the three groups(ESD+LPSCO,ESD+LSCO,and ESD)were all significantly reduced after operation.The vertigo control rate were 92.3%,78.6%and 62.5%re-spectively.Compared with pre-operation,the vertigo severity post-operation in the three groups were also signifi-cantly reduced.And the improvement rate of vertigo severity after ESD+LPSCO and ESD+LSCO were both 100%,which were significantly higher than that of ESD(68.8%).The discomfort of tinnitus and ear fullness in the three groups were significantly improved compared with that of pre-operation.The improvement rates of tinnitus in the three groups were 46.2%,50.0%and 43.8%respectively,with no significant difference.The improvement rate of ear fullness in the three groups were 61.5%,57.1%and 50.0%respectively,with no significant difference either.The proportion of patients with decreased hearing after operation in the three groups was 15.4%,7.1%and 18.8%,respectively,and the differences were insignificant.Conclusion ESD combined with one or two SCO can effectively control vertigo and other symptoms of patients with stage Ⅲ or Ⅳ Meniere's disease who had failure to conventional conservative treatment,and can preserve the residual hearing function in considerable extent.
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Objective:To investigate the clinical characteristics, diagnosis, treatment and prognosis of infective endocarditis(IE)in elderly patients with cerebral infarction as the first presentation.Methods:The clinical data of 5 elderly infective endocarditis patients with cerebral infarction as the first presentation diagnosed and treated in Beijing Shijitan Hospital, Capital Medical University from October 2010 to December 2021 were retrospectively analyzed, and national and international reports from January 1998 to December 2021 on IE in the elderly with cerebral infarction as the first presentation were collected.The clinical characteristics, diagnosis and prognosis were analyzed and summarized.Results:A total of 18 IE cases with cerebral infarction as the first presentation were reviewed, including 5 cases from our hospital.The male to female ratio was 5∶1, and the median age was 70.5 years.IE was diagnosed several hours to 4 months after the onset of cerebral infarction.All the patients had speech impairment symptoms and most of them exhibited hemiparesis.The National Institute of Health Stroke Scale(NIHSS)scores ranged between 2-35.All 18 patients underwent blood culture, and streptococci were the most common pathogens.Most of the lesions were located in the blood supply area of the middle cerebral artery or the junction between the middle cerebral artery and the posterior cerebral artery.Echocardiography showed that mitral valve vegetations were the dominant features, followed by aortic valve vegetations.All 18 patients received antibiotic treatment, 2 underwent valve replacement and removal of vegetations, and 11 underwent intravenous thrombolysis or mechanical thrombectomy.50.0% of patients(9 cases)had a good prognosis and one third(6 cases)died.Conclusions:Cerebral infarction is the first presentation in some elderly IE patients, and misdiagnoses are common, but half of patients can have a good prognosis after timely anti-infection and surgical treatment.
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Objective:To explore the clinical application of distal and proximal bilateral lateral pre-decompression in replant of digit degloving injury.Methods:From March 2012 to May 2021, 14 patients with 29 digits had replantation surgery of degloved soft tissue and severed digits in Section II, Department of Orthopaedics, Changzhou Medical District of 904th Hospital of PLA Joint Logistic Support Force. There were 2 types of injuries: degloving injury of soft tissue but with intact digital tip, and digital tip degloving injury with intact distal phalanx and nail bed. With the technique of distal and proximal bilateral lateral pre-decompression, pre-decompression incisions were made to the subdermal on both sides of the degloved skin over the proper palmar digital arteries. From where, the distal stump of the proper palmar digital arteries and nerves for anastomosis were found and had them anastomosed with the proximal proper palmar digital arteries and proper palmar digital nerves, then anastomosed digital pulp and digital dorsal veins (11 cases were direct anastomosis and 3 cases were bridged anastomosis). Follow-up was carried out by outpatient consultation, telephone and WeChat APP. The appearance of the digit body, the shape of digital pulp, the nails grow and the motions of the digits were observed, and the Evaluation Standard of Replantation of Severed Fingers by the Society of Hand surgery of Chinese Medical Association was used to evaluate the recovery of function.Results:All 29 segments of degloving digit survived. Small necrotic areas was found in 4 digits and healed after the change of dressing. The followed-up time was lasted for 3-36 months. There was no obvious atrophy found in all the digits. Appearances of digit pulp and nails were satisfactory with good sensational recovery for TPD at 6-10 mm, 7 mm in average. Motions of all the repaired digits were good. According to the Evaluation Standard of Replantation of Severed Fingers by the Society of Hand surgery of Chinese Medical Association, 23 digits were in excellent, 4 in good and 2 in poor, with a satisfactory rate at 93.1%.Conclusion:For a distal digit injury with intact distal soft tissue and relatively mild injury of blood vessels and nerves, using the method of distal and proximal bilateral lateral pre-decompression can help to achieve good appearance in survived digital pulp, good sensational recovery and good nail growth. An individualised treatment intra-and-after the surgery could offer an ideal therapeutic effect.
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【Objective】 To explore the factors affecting the off-site vasovagal reactions in whole blood donors, aimed at providing references for formulating interventions. 【Methods】 The off-site vasovagal reactions in whole blood donors in 2019 was investigated in terms of gender, age, frequency of blood donation, weight and season were classified and analyzed. 【Results】 Among the 42 874 donors who donated 400 mL of whole blood, 67 had non-severe off-site vasovagal reaction, accounting for 0.16%, and none developed severe reaction. Single-factor and multi-factor correlation analysis showed that the age (18~25 years old) and weight (< 55 Kg) were the main influencing factors of off-site vasovagal reaction, while gender, blood donation frequency and season showed no statistical significance. 【Conclusion】 We should pay close attention to the factors predicting the off-site vasovagal reaction and formulate corresponding interventions to reduce the reaction rates, so as to improve the quality of blood donation service, and ensure the safety of blood donors.
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Objective@#To understand health literacy and associated factors of freshmen from Jiangsu Province, and to provide reference for youth health education.@*Methods@#From 2017 October to 2018 October, a total of 15 602 college freshman were randomly selected from 20 universities in Jiangsu Province via stratified cluster sampling method. Structural questionnaires were used to investigate the status of health literacy. The χ 2 test and multivariate Logistic regression model were used to analyze the influencing factors of health literacy.@*Results@#The health literacy level of college freshmen from Jiangsu Province was 20.2%, among which the literacy levels of knowledge, behavior and skills were 23.0%, 30.7% and 31.5% respectively. The literacy levels of the six public health issues, including safety and first aid, scientific health attitude, knowledge of prevention and treatment of infectious diseases, health information, basic health care, and prevention and treatment of chronic diseases, from high to low, were 72.8%, 58.7%, 28.5%, 28.2%, 20.3% and 15.9%, respectively. Multivariate Logistic regression analysis has showed that students from undergraduate colleges(OR=2.77, 95%CI=2.47-3.11), urban areas(OR=1.20, 95%CI=1.07-1.34), or southern Jiangsu regions(OR=1.10, 95%CI=1.00-1.22), being the only child(OR=1.13, 95%CI=1.03-1.25), higher maternal education level (OR=1.53, 95%CI=1.30-1.79), having both parents(OR=1.16, 95%CI=1.00-1.34), reported higher level of health literacy.@*Conclusion@#The three aspects and six dimensions of health literacy of college freshmen were unbalanced. Health literacy is a shared function of multiple factors including society, family, and individuals. It is essential to promote health education through more efforts on key issues, in order to effectively elevate the health literacy level of adolescent students.
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Objective:To investigate the short-term efficacy of Shenmai injection combined with FOLFOX chemotherapy in the treatment of advanced gastric cancer and its effects on immune function and tumor markers. Methods:Eighty-two patients with advanced gastric cancer who received treatment in Shengzhou Hospital of Traditional Chinese Medicine, China between June 2018 and June 2020 were included in this study. They were randomly assigned to receive either FOLFOX chemotherapy (control group, n = 41) or Shenmai injection combined with FOLFOX chemotherapy (observation group, n = 41). All patients received three 21-day courses of treatment. Short-term efficacy of chemotherapy and improvement in quality of life were compared between the two groups. Immune function, expression of tumor markers (carcinoembryonic antigen and carbohydrate antigen 724) and adverse reactions were determined before and after three courses of treatment. Results:Total effective rate in the observation group was significantly higher than that in the control group [70.73% (29/41) vs. 46.34% (19/41), χ2 = 5.025, P < 0.05]. The proportion of patients had improved quality of life in the observation group was significantly higher than that in the control group [78.05% (32/41) vs. 56.10% (23/41), χ2 = 4.473, P < 0.05]. After three courses of treatment, the proportion of CD 3+ and CD 4+ cells and the ratio of CD 4+/CD 8+ cells in the observation group were (58.39 ± 3.14)%, (38.79 ± 2.35)% and (1.54 ± 0.17), respectively, which were significantly higher than those in the control group [(48.10 ± 3.01)%, (30.10 ± 1.78)%, (0.92 ± 0.15), t = 15.148, 18.875, 17.511, all P < 0.05]. After three courses of treatment, serum carcinoembryonic antigen and carbohydrate antigen 724 levels in the observation group were (6.98 ± 1.45) μg/L and (7.85 ± 1.76) μg/L, respectively, which were significantly lower than those in the control group [(15.47 ± 3.21) μg/L, (18.97 ± 3.25) μg/L), t = 15.434, 19.265, both P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Shenmai injection combined with FOLFOX chemotherapy in the treatment of advanced gastric cancer exhibits good short-term efficacy, can improve the immune function, and reduce the levels of carcinoembryonic antigen and carbohydrate antigen 724.
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Objective:To compare the safety and immunogenicity of Sabin strain-based inactivated poliovirus vaccine (sIPV) and the liquid form of typeⅠ+ Ⅲ bivalent oral poliovirus vaccine (bOPV) administered to infants aged ≥2 months in different schedules.Methods:A randomized, blinded, single-center, parallel-group controlled trial was conducted in Hangzhou from 2017 to 2018. Healthy infants aged ≥2 months were enrolled and randomized to receive the vaccines on a schedule of 2, 3, 4 months. Group 1sIPV+ 2bOPV was given one dose of sIPV and two doses of bOPV; group 2sIPV+ 1bOPV was administrated two doses of sIPV and one dose of bOPV; group 3sIPV received three doses of sIPV. Adverse events (AEs) following vaccination were recorded. Blood samples were collected from the subjects (excluding the quitters or subjects against the trial plan) 28-35 d after the full-course immunization. A microneutralization assay was performed to detect the geometric mean titers (GMTs) of neutralizing antibodies against polio virus of Ⅰ, Ⅱ and Ⅲ types. The seroconversion rates of neutralizing antibodies were also calculated.Results:The overall incidence of AEs following vaccination was 3.57% in 1sIPV+ 2bOPV group, 3.61% in 2sIPV+ 1bOPV group and 1.19% in 3sIPV group (χ 2=1.190, P=0.552) and no severe AEs were reported. The antibody seroconversion rates in 1sIPV+ 2bOPV, 2sIPV+ 1bOPV and 3sIPV groups were respectively 100% (84/84), 100% (83/83) and 100% (84/84) against type Ⅰ poliovirus, 81% (68/84), 96% (80/83) and 99% (83/84) against type Ⅱ poliovirus(χ 2=21.469, P<0.001), and 100% (84/84), 100% (83/84) and 100% (84/84) against type Ⅲ poliovirus. In 1sIPV+ 2bOPV, 2sIPV+ 1bOPV and 3sIPV groups, the GMTs of antibody were 1 024.00, 1 015.48 and 982.61 against type Ⅰ poliovirus ( F=2.742, P=0.066), 16.81, 107.94 and 218.85 against type Ⅱ poliovirus ( F=33.570, P<0.001), and 990.75, 990.36 and 613.92 against type Ⅲ poliovirus ( F=37.886, P<0.001). Conclusions:sIPV and bOPV administered in different schedules showed good safety and immunogenicity in infants aged≥2 months. The GMT and the seroconversion rate of neutralizing antibody against type Ⅱ poliovirus after vaccination were higher in 2sIPV+ 1bOPV and 3sIPV group than in 1sIPV+ 2bOPV group. Higher GMT of neutralizing antibody against type Ⅲ poliovirus was induced in 1sIPV+ 2bOPV and 2sIPV+ 1bOPV groups than in 3sIPV group.
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Objective@#To describe the epidemiological characteristics of a cluster of COVID-19 cases reported in Baodi district of Tianjin as of 18 February, 2020, which might be associated with the exposure in a local department store, and provide suggestions for prevention and control strategy development.@* Methods@#The basic characteristics, time and area distributions, clinical manifestations, epidemiological history and transmission mode of the COVID-19 cases associated with the department store exposure were analyzed.@* Results@#A total of 40 COVID-19 cases were associated with the department store exposure, accounting for 75.47% of the total confirmed cases (53 cases) reported in Baodi district. The cases were mainly at the age of 60 years or older (35.00%) and farmers (40.00%). The main clinical manifestations included fever (95.00%), cough (35.00%), and diarrhea (15.00%). The proportion of confirmed severe cases was 32.50%. The incidence curve showed that the incidence peak occurred on 31 January, 2020. Among the 40 cases, 6(15.00%) were department store employees, 19(47.50%) were customers and 15(37.50%) were close contacts (secondary cases). The first case occurred on 21 January, 2020, this case was a department store employee who had a purchasing history at whole sale markets in other provinces and cities before the onset, and 3 employees were still on duty after symptom onsets. The median of the incubation period of customer cases was 6 days, and the median of the interval between onset and medical treatment of customer cases was 7 days.@* Conclusion@#This was a cluster epidemic of COVID-19, which might be associated with the exposure in the department store. By now, the current prevention and control measures have achieved satisfied effects.
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Objective To understand the status of depression and anxiety in patients with chronic hepatitis B in Tianjin, and to analyze its influencing factors, so as to provide references for scientific psychological intervention and health education. Methods Chronic hepatitis B cases whose addresses were Tianjin were randomly selected from the report of infectious disease surveillance system from January 2018 to December 2019 as the study subjects. A certain number of healthy people living in Tianjin were selected as the control. A unified mental health questionnaire survey was conducted by telephone follow-up or face-to-face survey. The distribution characteristics of depression and anxiety were described, and influencing factors of depression and anxiety were analyzed by univariate and multivariate logistic regression analysis. Results A total of 825 cases of chronic hepatitis B and 376 cases of healthy people were investigated. The crude SDS and SAS were (35.47±9.34) and (32.33±8.26), respectively, which were higher than those of healthy people ( P <0.05). The rates of depression and anxiety in chronic hepatitis B patients were 25.45% and 20.61%, respectively, which were significantly higher than those in healthy people (15.96% and 11.70%, respectively) (P < 0.001). The analysis of depression influencing factors showed that the OR of high average monthly income was 0.791 ( 95% CI:0.655~0.955 ), the OR of not knowing correct preventive measures was 1.509 (95% CI:1.084~2.102 ), and the OR of feeling discriminated was 1.650 ( 95% CI:1.166~2.335 ). The multifactor analysis of anxiety influencing factors showed that the OR of not knowing correct preventive measures was 1.490 ( 95% CI:1.049~2.117)), while the OR of feeling discriminated was 1.854 ( 95% CI: 1.289~2.666). Conclusion The levels of depression and anxiety of chronic hepatitis B patients were higher than that of general healthy people. Not knowing correct preventive measures and feeling discriminated in daily life were risk factors while high income was a protective factor.
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To study the relationship between acute graft-versus-host disease (aGVHD) and the SIRT1 expression in peripheral blood CD4+T cells from patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: We collected 40 patients who underwent allo-HSCT from human leukocyte antigen (HLA)-identical sibling donors. SIRT1 expression level in CD4+T cells was measured by real-time PCR and Western blot. Acetylation and phosphorylation of STAT3 in CD4+T cells were detected by Western blot. The binding level between SIRT1 and STAT3 in CD4+T cells was analyzed by co-immunoprecipitation and Western blot. Over-expression of SIRT1 in aGVHD CD4+T cells, as well as STAT3 acetylation and phosphorylation were measured by Western blot. The mRNA levels of RORγt, IL-17A, IL-17F related to Th17 were detected by real-time PCR. Results: SIRT1 expression was significantly down-regulated, while STAT3 expression, acetylation and phosphorylation levels were significantly up-regulated in patients with aGVHD compared with patients without aGVHD. The STAT3 acetylation was positively correlated with STAT3 phosphorylation (r=0.69, P<0.01). Less SIRT1-STAT3 complexes were found in CD4+T cells from patients with aGVHD compared with patients without aGVHD. After SIRT1 over-expression in aGVHD CD4+T cells, the STAT3 acetylation and phosphorylation, and the expression of RORγt, IL-17A, and IL-17F related to Th17 were significantly down-regulated (P<0.05). Conclusion: SIRT1 deficiency in CD4+T cells plays a crucial role in up-regulation of STAT3 acetylation and phosphorylation, the increase of Th17 related gene expression, and induction of aGVHD after allogeneic hematopoietic stem cell transplantation.
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Humanos , Doença Aguda , Linfócitos T CD4-Positivos , Metabolismo , Regulação para Baixo , Doença Enxerto-Hospedeiro , Metabolismo , Transplante de Células-Tronco Hematopoéticas , Antígenos de Histocompatibilidade Classe I , Interleucina-17 , Metabolismo , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares , Metabolismo , Fator de Transcrição STAT3 , Metabolismo , Sirtuína 1 , Metabolismo , Transplante Homólogo , Regulação para CimaRESUMO
Objective To investigate the correlation of serum angiotensin Ⅱ level with the severity of depression and anxiety in patients with Parkinson's disease (PD) and its clinical significance.Methods Sixty patients with PD at the Department of Neurology in our hospital and 60 healthy individuals who underwent physical examination were included from January 2014 to December 2016.Depression and anxiety were evaluated by Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA),respectively.The serum ANG Ⅱ level was also assayed and its association with depression and anxiety in PD patients was examined.Results Depression and anxiety in the PD group were more severe than in the healthy group (HAMD score:23.0±5.9 vs.4.7±2.2,t=22.23,P<0.0001;HAMA score:22.3±9.7 vs.5.2±3.3,t=11.71,P<0.01),while serum ANG Ⅱ level of PD patients was significantly lower than in the healthy individuals [343.4 (230.0,470.2) ng/L vs.793.5 (440.9,2 087.1) ng/L,U =701.5,P < 0.01].Spearman's rank correlation analysis suggested that serum ANG Ⅱ level was negatively related with the severity of depression and anxiety (HAMD:r =-0.5468,P < 0.01;HAMA:r =-0.4146,P =0.001) in PD patients.Conclusions The serum ANG Ⅱ level which is significantly associated with the severity of depression and anxiety in PD patients might become a new clinical biomarker in predicting and diagnosing depression and anxiety in PD patients.
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Objective@#To optimize delivery of gadolinium-diethylenetriamine pentaacetic acid(Gd-DTPA) at the posterior upper point on tympanic medial wall and heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery (hT2W-3D-FLAIR) sequence, and to implement the technique of detecting endolymphatic hydrops using gadolinium-enhancement MRI.@*Methods@#Thirteen patients with periphery vertigo, who visited Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital during June and December of 2017, were enrolled in the study.0.10-0.20 ml of Gd-DTPA in various dilutions (10, 20, and 40-fold) were delivered at the posterior upper point on tympanic medial wall using a soft-tipped tympanic suction and drug-spraying needle through an artificially perforated tympanic membrane. Inner ear MRI was performed at 8, 24 h after Gd-DTPA administration using a 3T MR machine in combination with a 20-channel Tim 4G head/neck coil and the sequence of hT2W-3D-FLAIR to detect the gadolinium-enhancement signal within the inner ear and possible endolymphatic hydrops. The scanning time was either 8 min 35 s or 15 min 11 s.@*Results@#Efficient inner ear uptake of Gd-DTPA was detected and induced high signal to noise ratio of MRI in patients receiving targeted delivery of 0.15-0.20 ml of 10-fold diluted contrast agent at the posterior upper point on tympanic medial wall. At 8 h after delivery, significant uptake was detected in the scala tympani and vestibuli of hook region and basal turn of the cochlea, and perilymhatic compartment of the vestibule. At 24 h after delivery, the distribution of Gd-DTPA became homogenous in each turn of the cochlea and perilymphatic compartment of the vestibule. However, obvious individual variance existed in the inner ear uptake when 0.10 ml of 40-fold diluted Gd-DTPA was delivered. Efficient inner ear uptake and high quality images that generated in patients receiving 0.10, 0.15, and 0.20 ml of 20-fold Gd-DTPA demonstrated endolymphatic hydrops with minor individual variance. There was insignificant difference in the enhancement signal of inner ear between 0.15 and 0.10 ml groups when Gd-DTPA was diluted at 20-fold except for the signal of semicircular canal of 0.15 ml group (190.00±53.95 vs 165.50±42.13, t=2.61, P<0.05). There was insignificant difference in the image quality between 8 min 35 s and 15 min 11 s canning time. Various degrees of endolymphatic hydrops were detected in 7 cochleae and 11 vestibule, and both simultaneous cochlear and vestibular endolymphatic hydrops were detected in 4 ears. Cochlear endolymphatic hydrops was detected in all the 3 patients with definite Meniere′s disease, and 2 of them had combined cochlear and vestibular endolymphatic hydrops. Endolymphatic hydrops was not detected in patients with possible Meniere′s disease nor with symptoms of superior semicircular canal dehiscence.@*Conclusion@#Targeted delivery of 0.10 ml with 20-fold diluted Gd-DTPA (total dosage of 5 μmol) at the posterior upper point on tympanic medial wall in combination with 8 min 35 s scanning time hT2W-3D-FLAIR sequence for inner ear MRI in a 3T MR machine is a clinically practical method to detect endolymphatic hydrops, and reduce the requirement for MRI hardware.
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BACKGROUND:The ankle joint is capable of flexion and extension, including plantar flexion and dorsiflexion, to act as a support and a lever. An ankle injury, often accompanied by fracture and ligament injury, seriously threatens the ankle joint function. Previous diagnosis of ankle injury mainly relied on clinical signs and X-ray examination. However, X-ray examination is not accurate enough for ankle injury diagnosis because it cannot clearly diagnose damage to the surrounding ligaments, tendons and other soft tissues except for obvious fractures. Mutlisequence and multiplanar MRI is currently the optimal noninvasive method for high-resolution determination of soft tissue deformations, but little has been reported on the diagnostic accuracy of ankle ligament and tendon injury. OBJECTIVE:To observe the diagnostic value of MRI for ligament and tendon injury of the ankle in its normal position, and during complete plantar flexion and dorsiflexion. METHODS:It is a single-center, prospective, diagnostic trial that wil be completed at the First Hospital of Hebei Medical University, China. Sixty cases were recruited, including 30 cases of normal ankle joint and 30 cases of ankle ligament and tendon injury. MRI scans of the ankle joint in normal position, complete plantar flexion and complete dorsiflexion were performed in al the cases, and the multi-position MRI results were compared. The primary outcome measure is the sensitivity of MRI to ligament and tendon injury of the ankle during complete plantar flexion. The secondary outcomes include the specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of MRI to ligament and tendon injury of the ankle during the complete plantar position as wel as rate of correct diagnosis;specificity and sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in normal position or during the complete dorsiflexion as wel as rate of correct diagnosis;the morphology of the ankle on the multi-position MRI. This study design was registered at ClinicalTrial.gov (03049423) on February 8, 2017. This study protocol has been approved by the Medical Ethics Committee of Qinghai University Affiliated Hospital of China (approval No. 2015076) and wil be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment was obtained from each volunteer. DISCUSSION:This study aims to determine the rate of correct diagnosis of ankle ligament and tendon injury using the MRI, to clarify the diagnostic value of MRI for ankle ligament and tendon injury, and to provide a quantitative MRI diagnostic standard for developing a reasonable surgical treatment.
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Objective To compare and analyze the detection situation of common pathogens in child respiratory tract infection in our hospital and to provide the basis for clinical accurate diagnosis and reasonable treatment .Methods A total of 6 032 specimens were collected from the children patients with acute respiratory tract infection in the Gansu Provincial Maternity and Child Health Care Hospital from January to December 2015 .The immunodot test technology was adopted to detect the 6 kinds of early specific serum antibody IgM of common respiratory pathogens :adenovirus (ADV ) ,influenza virus (IV ) ,parainfluenza (PIV ) ,respiratory syncytial virus (RSV) ,mycoplasma pneumoniae (MP) and chlamydia pneumonia (CP) .The differences in children infection pat‐terns ,different ages ,seasons and genders were analyzed .Results Among 6 032 specimens ,2 279 cases were positive with the posi‐tive rate of 37 .8% .The positive rates of 6 kinds of respiratory pathogens were in turn 12 .2% for ADV ,9 .6% for IV ,7 .9% for CP ,4 .6% for MP ,3 .0% for RSV and 0 .3% for PIV .The detection rate of respiratory tract pathogens was higher in spring and summer ;age groups of 1-3 years old and 4-6 years old had higher positive detection rate .Conclusion The main common patho‐gen of respiratory tract infection in this hospital is ADV ,followed by IV .Their infection has obvious seasonality .The mycoplasma and chlamydia also are the common pathogens of respiratory tract infection ,which are dominated by MP and CP .
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Objective To study the expression of Nuclear factor E2 related factor 2 (Nrf2) ,Superoxide Dis‐mutas 1 (SOD1) ,and Heme Oxygenase- 1( HO -1) factors related to Nrf2 signaling pathway in noise-induced cochlear injury of rats .Methods A total of 30 SD rats were randomly and equally assigned into the following 2 groups :noise group and normal control group .The rats in noise group were exposed to an 115 dB SPL continuous steady white noise for 12 hours ,then 1 day ,3 days ,and 7 days later ,the rats receveid the ABR and DPOAE testing after noise exposure .Both RT -PCR and Peggy Sue trace protein detection techniques were used to detect gene ex‐pression in Nrf2 /Keapl-ARE signaling pathway and the protein levels by cochlear tissue sampling after noise ex‐posure 7 days later .Results The ABR thresholds in the noise group was higher than those of in normal control group after noise exposure 1 ,3 ,and 7 days later (P<0 .05) .The DPOAE values of noise group were significantly lower than those of normal control group (P<0 .05) .The up -regulation of expression of Nrf2 ,SOD1 ,HO -1 mRNA(1 .11 ± 0 .05 ,1 .45 ± 0 .12 ,1 .15 ± 0 .03) in noise group were higher than those of in the normal control group after noise exposure 7 days later (1 .00 ± 0 .02 ,1 .10 ± 0 .12 ,0 .92 ± 0 .08) ,and the differences were statistically sig‐nificant (P<0 .05) .And in Peggy Sue trace detection system ,we also found SOD1 ,HO -1 protein levels in noise group were higher than those of in normal control group .Conclusion After the noise -induced cochlear injury in rat ,Nrf2 expression in the cochlea increased and up-regulatd expression of downstream gene and protein content such as antioxidant enzymes SOD1 and HO-1gene by regulating Nrf2 /Keapl-ARE signaling pathway ,which may be involved in protection against oxidative stress injury in noise-induced cochlear injury of rat .
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Objective To investigate the laboratory examination,diagnosis and treatment of 57 cases of Acute Promyelocytic Leukemia.Methods The clinical manifestation,laboratory morphology-immunology-cytogenetics-molecular (MICM) classification,treatment and follow-up were analyzed retrospectively among 57 newly diagnosed cases of acute pmmyelocytic leukemia (APL) patients from January 2011 to December 2013 in Xiangya Hospital,Central South University.Results In 57 patients,the first symptom was given priority to with bleeding (73.7%),fever (26.3%),and the organ infiltration accounted for 29.8%.The phenotype of CD13 + CD33 + CD34-HLD-RA-was 59.6% in 57 patients,CD13 + CD33 +CD34 + HLD-RA + was 8.8%,and the remaining 18 cases were not classic phenotypes.The positive percentage of PML/RARa was 93.0% by fluorescence in situ hybridization (FISH),and the remaining 4 cases were other rare abnormal.Except one case gave up the treatment,the other 56 cases of APL patients reached 100% complete remission rate under early screening and diagnosis,relatively standardized and effective treatment.Conclusions Hemorrhage is the most common clinical symptoms of M3.MICM classification,especially the FISH technology,is the main laboratory basis for diagnosis of M3.After the treatment of early specifications currently,M3 can almost be cured.
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OBJECTIVE@#To investigate several abnormal genes by the fluorescence in situ hybridization (FISH) in multiple myeloma (MM), monoclonal gammopathy of undetermined significance (MGUS) and reactive plasmacytosis (RP), and to increase the diagnosis and differential diagnosis levels for these common plasma diseases. @*METHODS@#The clinical manifestations, image and laboratory tests and the FISH detection were retrospectively analyzed in 61 cases of newly diagnosed MM, 20 cases of MGUS and 20 cases of RP from August, 2012 to February, 2015 in the Xiangya Hospital of Central South University. @*RESULTS@#Fifty cases among 61 MM patients showed genetic abnormality by FISH technology. The total positive rate was 81.9%. Among them, 19 cases (31.1%) had 1q21 amplification, 18 cases (29.5%) lacked D13S319, 10 cases (16.4%) missed RB1, 10 cases (16.4%) had IGH translocation and 7 cases (11.4%) lacked p53 gene. The positive rate for two or more genes abnormal was 19.8% in 12 cases. However, in 20 cases of MGUS patients, the positive detection rate was 25%, including 4 cases (20%) of 1q21 augmentation and 2 cases (10%) of IGH translocation. There were not two or more abnormal genes in one case. While in RP cases, only 1 case of patients had D13S319 abnormal gene, and the positive rate was only 5%. There was significant difference (P<0.05) among the 3 groups. @*CONCLUSION@#The positive detection rate is 81.9% in MM patients by FISH, which is significantly higher than that in patients with MGUS or RP. FISH technology can detect a variety of abnormal genes in MM. It is useful for the differential diagnosis and prognosis for MM, MGUS and RP.
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Humanos , Hibridização in Situ Fluorescente , Gamopatia Monoclonal de Significância Indeterminada , Mieloma Múltiplo , Paraproteinemias , Estudos Retrospectivos , Translocação GenéticaRESUMO
Objective To investigate the influence of β-lactam antimicrobial drugs on infants′intestinal flora.Methods Infants from 0 to 1 years old were enrolled in the study,who′s feces samples were tested for Bacillus bifidus,lactobacillus,enterococcus and E.coli by using 16S rRNA quantitative PCR technique before using antibiotics,on the third and fifth day duringβ-lactam antibiotics treatment and the seventh day after treatment.Results The numbers of Bacillus bifidus,lactobacillus,E.coli and enterococci detec-ted in usingβ-lactam antibiotics group were not statistically different from those in not using antibiotics group(P >0.05).The num-bers of Bacillus bifidus and lactobacillus increased with the treatment process,the differencies was statistically significant(P <0.05).The recovery of the numbers of intestinal Bacillus bifidus and lactobacillus in not using antibiotics group was significantly faster than using antibiotics group,the difference was statistically significant(P <0.05).Conclusion β-lactam antibiotics have gen-eral killing effect on the intestinal flora in infants,which could recover to normal.The recovery of intestinal flora could be delayed if antibiotics are used,however,reasonable antibiotics treatment would be very helpful in the treatment of primary diseases.
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Objective The research aimed to probe into the complications of the treatment that endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy (ERCP/EST) combined with laparoscopic cholecystectomy (LC) for the patients suffered from gallstone disease combined with common bile duct stones and investigate the nursing methods.Methods One hundred and twenty-four patients suffered from gallstone disease combined with common bile duct stones were included in this retrospective analysis.At first,they underwent the treatment of ERCP/EST,and underwent LC in 1 to 5 days later.All the clinical data were collected and analyzed.Results Of all the patients,104 patients successfully underwent the treatment of ERCP/EST.And of the 104 patients,100 patients successfully underwent LC,the other 4 patients underwent open cholecystectomy.Nineteen complicated with acute pancreatitises,one with hemorrhage and two suffered from infections of bile duct were observed in this study.Conclusions Combination of ERCP/EST with LC is a safe and effective treatment for gallstone disease combined with common bile duct stones.The preoperative psychological counseling,and the surveillance and nursing of complications play significant roles in the successful treatment.
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Objective To explore the association of post stroke depression (PSD) with the scale of stroke deficit and serum brain-derived neurotrophic factor levels in the elderly.Methods A total of 150 elderly stroke patients from the department of neurology of our hospital were recruited from August 2010 to September 2013.Patients were assessed by the Hamilton depression rating scale (HAMD),the National Institutes of Health Stroke Scale (NIHSS),and the Activitics of Daily Living Scale (ADL).In addition,serum BDNF levels were determined by ELISA.Results 42.0% of the 150 elderly patients suffered depression after stroke (63/150).There were significant differences in neurological function impairment and ADL scores between the PSD group and the non-PSD group [(14.72±4.06) vs.(5.51±1.93) and (40.63±17.06) vs.(79.66±29.31),t=18.49 and 9.47,respectively,P<0.0001 for both].HAMD and NIHSS scores showed positive correlations with the degreeof depression (r=0.998 and 0.962,P=0.0012 and 0.0375,respectively).ADL scores and serum BDNF levels decreased as the degree of depression increased,and were negatively correlated with the degree of depression (r=-0.985 and-0.995,P=0.0149 and 0.0049,respectively).Conclusions The degree of post-stoke depression is positively correlated with the scale of neurological dysfunction and negatively correlated with the activities of daily living scale and serum BDNF levels in the elderly.The primary disease should be properly treated,and improvement in brain metabolism and micro circulation should be attempted to alleviate neurological dysfunction.In addition,rehabilitation therapy should be performed early in elderly stroke patients in order to improve physical activity and self-care ability,thus reducing the degree of disability and depression.