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ObjectiveTo explore the effect of therapeutic postural placement on postural control and balance in stroke patients with hemiplegia. MethodsFrom January, 2020 to June, 2022, 60 stroke patients in Cangzhou Hospital of Integrated TCM-WM•Hebei were randomly divided into control group (n = 30) and observation group (n = 30). Both groups accepted routine rehabilitation, while the observation group accepted therapeutic postural placement based on the concept of Bobath additionally. Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Postural Assessment Scale for Stroke Patient (PASS) and Pro-kin balance instrument were used to evaluate the postural control and balance function before and four weeks after treatment, while the area of ellipse and length of motion with eyes open and closed were recorded, respectively. ResultsAfter treatment, the scores of FMA-LE, PASS and BBS significantly increased (|t| > 3.856, P < 0.001), and the area of ellipse and length of motion with eyes open and closed decreased in both groups (|t| > 4.083, P < 0.001); all the indexes were better in the observation group than in the control group (|t| > 2.261, P < 0.05). ConclusionThe therapeutic postural placement could effectively improve the postural control ability and balance function in stroke patients.
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Objective:To analyze the characteristics of immune cross-reaction between herpes simplex virus type 1 (HSV-1) and HSV-2 in terms of serology and clinical protection aiming to provide data for the control and prevention of diseases caused by the two viruses.Methods:An attenuated HSV-1 strain M3 was used to immunize BALB/c mice. Specific immune responses indicated by the production of neutralizing antibodies were detected. Wild-type HSV-1 and HSV-2 strains were respectively used to infect the mice through different ways 28 d after the immunization to observe the protective immunity in the M3-immunized mice against HSV-1/2 infection.Results:M3 strain could not induce specific neutralizing antibodies against HSV-2. Therefore, viral loads in tissues of the immunized mice increased significantly following different modes of HSV-2 exposure. However, no obvious abnormal clinical manifestations were found and the histopathological damage was only slight inflammatory reaction. In contrast, HSV-1-specific neutralizing antibodies were elicited in the M3-immunizaed mice with significant protective effects against HSV-1 infection.Conclusions:The immune response induced by attenuated HSV-1 strain M3 in mice exhibited immune-protective effects characterized by production of neutralizing antibodies and inhibition of virus proliferation in vivo against wild-type HSV-1 infection. For HSV-2, instead of neutralizing virus in form of antibodies, it featured by more of clinical cross-immunoprotective abilities to control virus growth.
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Background@#Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. @*Methods@#Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. @*Results@#In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. @*Conclusion@#The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.
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Background@#Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. @*Methods@#Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. @*Results@#In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. @*Conclusion@#The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.
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Objective:To investigate the significance of changes of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in neoadjuvant therapy for rectal cancer.Methods:The data of 86 patients with rectal cancer who received neoadjuvant therapy from November 2013 to January 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed, and the correlations of NLR and PLR changes with the patients' clinicopathological characteristics and therapeutic effects were also analyzed.Results:There were 43 cases of increased NLR and 43 cases of increased PLR after treatment. NLR and PLR changes before and after neoadjuvant therapy in patients with rectal cancer were not associated with age, gender, TNM stage, lymph node metastasis, number of cancer nodules, and tumor diameter (all P > 0.05). The increasing proportion of NLR and PLR after treatment in patients with the distance from the tumor to anus < 6 cm was higher than that in those with the distance≥6 cm [60.00% (30/50) vs. 36. 11% (13/36), χ2 = 4.778, P = 0.029; 64.00% (32/50) vs. 30.56% (11/36), χ2 = 9.364, P = 0.002]. The increasing proportion of NLR and PLR after treatment in patients with the body mass index (BMI) ≥28 kg/m 2 was higher than that in those with BMI < 28 kg/m 2 [81.82% (9/11) vs. 45.33% (34/75), χ2 = 5.108, P = 0.024; 90.91% (10/11) vs. 44.00% (33/75), χ2 = 8.444, P = 0.004]. The remission rate of patients in NLR reduction group after treatment was higher than that in NLR increase group [72.09% (31/43) vs. 51.16% (31/43), χ2 = 3.983, P = 0.046]. PLR changes were not associated with the therapeutic effects of neoadjuvant therapy before and after treatment ( P > 0.05). Conclusion:NLR changes are associated with therapeutic efficacy before and after neoadjuvant therapy for patients with rectal cancer.
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Objective@#To investigate the risk factors affecting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and establish a new scoring model to predict the short-term prognosis of patients.@*Methods@#This study enrolled 222 patients with HBV-ACLF. According to their clinical outcomes during hospitalization and 90 days after discharge, they were divided into survival and death group. Clinical data were collected to calculate the Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), albumin-bilirubin (ALBI), and age-bilirubin-international normalized ratio-creatinine (ABIC) scores for prognosis. Multivariate logistic regression analysis was used to analyze the independent risk factors affecting 90-day mortality in HBV-ACLF patients. Cox regression model was used to establish a new prediction model. Area under the receiver operating characteristic curve was used to calculate short-term prognostic value of the models. K-M survival curve was used to predict the prognosis of patients.@*Results@#CTP and ABIC scores were independent risk factors for 90-day mortality in HBV-ACLF patients, and the risk of death from liver failure had increased with increase of score. Cox regression model established a new predictive model CTP-ABIC = 0.551 × CTP + 0.297 × ABIC. Area under the receiver operating characteristic curve of all three scoring models (CTP, ABIC and CTP-ABIC) were 0.878, 0.829, 0.927, respectively. CTP-ABIC score was superior to the CTP and ABIC score (P value < 0.001). Patients with CTP-ABIC score ≥9.08 had higher mortality rate than patients with CTP-ABIC score < 9.08, and the difference was statistically significant (P < 0.001).@*Conclusion@#All three scoring systems can predict short-term prognosis in patients with HBV-ACLF, but the accuracy of CTP-ABIC is superior.
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Objective To provide a comprehensive reference index for different mouse models of herpes simplex virus 1 (HSV-1) infection by investigating the related clinical manifestations, pathological features and characteristics of viral distribution in tissues and organs of BALB/c mice infected with different HSV-1 strains by using different strategies.Methods Acute infection models were established by challenging BALB/c mice at age three or six weeks with HSV-1 17+ and McKrae strains via intranasal and corneal administrations.Correspondingly, chronic infection models were established with BALB/c mice through subcutaneous and foot pad injections.Results Although all experimental mice showed trichiasis and roachback, there were differences in weight and fatality rate among different groups.Results of the quantitative PCR detection indicated that the proliferation of HSV-1 in the nervous tissues (brain, spinal cord, trigeminal ganglion) varied among different groups.The pathological examination indicated that in the acute infection groups, significant pathological changes only occurred in the brain tissues, while in the chronic infection groups, pathological injuries only occurred in the trigeminal ganglia.Although a key index latency-associated transcript (LAT) was not detected in the trigeminal nerve tissues of mice in the chronic infection groups, co-culturing the tissues with Vero cells resulted in infectious lesions in the cells.Conclusion This study indicates that there are significant differences in weight and fatality rate among different BALB/c mouse models of HSV-1 infection.Varied replication dynamics of HSV-1 were observed in different tissues or organs of the BALB/c mice in different groups.Therefore, different indexes should be adopted to evaluate different HSV-1 infection models.
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Objective@#To investigate lunch supply of public primary school canteens in Zhejiang Province, and to provide a basis for the scientific guidance of school lunch.@*Methods@#During May to Jun. and Sept. to Oct. in 2019, lunch food supply was weighed and recorded and the number of diners in 44 public primary school canteens were summarized. Each investigation lasted for one week.@*Results@#Food was mainly based on the taste of the students (40.91%) in the school canteen. About 45.45% of the schools referred to the Nutrition Guidelines of School Meals for students meals when making recipes in the school canteen. The supplies of cereals, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk, soybean nuts, vegetable oil and salt were 109.05, 118.01, 0, 63.96, 9.25, 11.31, 0, 10.68, 10.47, 2.54 g. The supply of vegetable oil was basically the same as the recommended amount ( P >0.05). The supplies of energy, protein, calcium, iron, zinc, vitamin A, vitamin B 1, vitamin B 2, vitamin C, dietary fiber were 820.84 kcal, 32.79 g, 164.18 mg, 7.84 mg, 4.71 mg, 23.07 μgRAE, 0.41 mg, 0.35 mg, 20.47 mg, 2.34 g, 37.56% of energy from fat and 48.47% of energy from carbohydrate. The supply of vitamin B 1 was basically the same as the recommended amount ( P >0.05). There were no significant differences in all kinds of food and nutrients between urban and rural primary schools ( P >0.05).@*Conclusion@#Lunch supply is not optimistic in public primary school canteens in Zhejiang Province, with unreasonable structure and fails to agree with current nutritional recommendations. It is suggested that the scientific guidance of students meals should be carried out according to the survey results combined with the characteristics of local diet.
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BACKGROUND:Because of the deficiency of researches on connective tissue growth factor associated with orthopedic diseases, very little attention has been paid to the studies on connective tissue growth factor in the intervertebral disc. OBJECTIVE:Through exploring the role and mechanism of connective tissue growth factor in disc degeneration, to provide new evidence for biotherapy of disc degeneration. METHODS: A computer-based search of PubMed and CNKI was performed by the first author to retrieve articles relevant to the effect and mechanism of connective tissue growth factor on degenerative disc and its related tissues published from January 1997 to October 2014. The keywords were “intervertebral disc; CTGF; TGF-β;hypoxia; disc degeneration” in Chinese and English, respectively, which appeared in the title, abstract or keywords. Articles published recently or in authoritative journals were preferred, and finaly 34 articles were included in result analysis. RESULTS AND CONCLUSION:Recentlyin vivo and in vitro studies on the intervertebral disc have clearly demonstrated the anabolic role of connective tissue growth factor in stimulating matrix production from nucleus pulposus cels and revealed that the transforming growth factorβ-connective tissue growth factor axis was of great importance to celular matrix productionviaregulations and stimulations to transforming growth factor β and hypoxia, while the regulation of hypoxia for connective tissue growth factor was another in a specific cel and tissue manner.
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Objective To verify and confirm the optical performance of the Olympus AU5400 Automatic Analyzer is satisfied for the professional requirements.Methods According to the Medical Standard of the People's Republic of China:Automatic chemistry analyzer(YY/T 0654-2008),the Analyzer Modular Ⅰand Ⅱ optical performance were measured to verify the stray light,the ab-sorption accuracy,linear range,stability and repeatability.Results The stray light absorption of tow modular was 4.789 4-5.158 9;The absorption accuracy of potassium dichromate standard solution (1-1)was (-0.002 1--0.024 7),and solution (1-2)was (-0.008 6--0.067 7);The D-value of stability that the highest absorption of standard solution (1-1)minus the lowest was 0.000 5-0.001 5;The CV% of repeatability for standard solution (1-2)was 0.02%-0.04%;Therof absorption linear was 0.999 6-0.999 9. Conclusion The optical performance of Olympus AU5400 Analyzer conforms to the standard of YY/T 0654-2008.
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Objective To investigate the operational timing and manner for the digestive tract reconstruction after Hartmann procedure and the prevention for the postoperative complications in the patients with left colorectal cancer.Methods The data of twenty-four cases with digestive tract reconstruction were analysed retrospectively containing the cause of Hartmann procedure for left colorectal cancer,preoperative evaluation of the digestive tract reconstruction,operation timing,operation manner,postoperative complications and length of hospital stay and so on.Results Three of 24 patients gave up the digestive tract reconstruction due to the results of their distant metastasis detection in the preoperative evaluation.As a commonly manner of digestive tract reconstruction,rectum-sigmoid colon or sigmoid-descending colon end-end anastomosis was used for 17 patients.Meanwhile,ascending colon-sigmoid colon end-side anastomosis was used for 4 patients.The incidence of postoperative complications was 14.29 ％ (3/21),and the mean time of postoperative hospital stay was 10.5 days.Conclusions In patients undergoing Hartmann procedure for left colorectal cancer,adequate assessment of the tumor recurrence and metastasis is necessary.In addition,the optimal timing of surgery should be selected after completion of chemotherapy,and operational manner should be determined by the situation of intraoperative exploration.
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[Objective] To discuss the clinical effect of Jianpi Qingwei Decoction on chronic erosive gastritis(CEG). [Method] Choose the said patients 68 cas-es, randomly divide them into treatment group(n=38) and control one(n=30).The treatment group take the self-made Jianpi Qingwei Decoction for treat-ment;the control one, lansoprazole and col oid pectinBi. Both take 4w as a course;after 1 course, compare their cure effect and side effects;fol ow up the re-currence. [Result] In the treatment group, 22 cases were cured, 13 better, 3 uncured, the total effective rate 92.10%;for the control one, they were respective-ly 13,11,6 and 80.00%;by comparison, their difference had statistical meaning;there ’s no recurrence fol owing up for half year. [Conclusion] Jianpi Qingwei Decoction has marked cure effect and little side effects on CEG, without easy recurrence, worth promotion.
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This paper analyzed and discussed on the importance of doctor-patient communica-tion skills and the differences between foreign countries and China. Meanwhile, it pointed out the drawbacks of doctor-patient communication skills training for medical students in China and proposed some countermeasures including finding out influence factors, searching for reference books, provid-ing guide for doctor-patient communication theory and skills, formulating teaching pattern, building evaluation mechanism, and establishing a communication platform of doctor-patient communication skills for medical students.
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Objective To investigate the cause,therapeutic strategy,methods of treatment and clinical results for the rectovaginal fistulas(RVF)after rectal cancer operations.Methods The clinical data of 14 female patients with RVF after rectal cancer operations were examined retrospectively.According to therapeutic strategy,all patients were divided into two groups,A group and B group,which were seperately performed traditional treatment,and progynova in combination with non-operative treatment.Results Among 10 patients in A group,8 patients were performed feacal diversion stoma,and 7 patients with RVF cured naturally,then performued colostomy reversal and restoration of bowel continuity,the other 2 cases were performed non-operative treatment for refusing feacal diversion stoma.Among 4 patients in B group,3 cases with RVF healed naturally during 1.5 to 2 months,one case secondary to rectal anastomosis was performed feacal diversion stoma for rectovaginal fistula without signs of healing.Conclusion RVF is a rare but serious complication after resection of rectal carcinoma,which is taken by the treatment strategy of progynova in combination with non-operative treatment,not only can promote the natural healing of RVF obviously,but also can shorten the healing time greatly.Feacal diversion stoma can be used while the treatment is failure.
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Objective To investigate the diagnosis,the treatment methods and the prognosis of rectal cancer patients after renal transplantation.Methods Four patients with rectal cancer were found in 1035 renal transplantation recipients.Three of four patients were treated with anterior resection (AR) or abdomenoperineal resection (APR) with total mesorectal excision (TME).The two patients accepted regular adjuvant chemotherapy for six months period after surgery,but one patient rejected to accept any chemotherapy after surgery.Otherwise,one patient was only treated with chemotherapy and best support therapy for diagnosed as rectal cancer with multiple liver metastases.Results Two patients were fine to be followed up,8 months and 21 months after rectal resection respectively.Two other patients eventually died of metastasized cancer 5 months and 31 months respectively after therapy had been initiated.Conclusion Transplantation patients should receive standard oncology treatment,including operation and adjuvant treatment,so long as their general condition and organ graft functions allow to do so,although a higher degree of morbidity might be encountered,and periodical colorectal screening should be performed before and after renal transplantation.
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Objective To analyze basic data and outcomes in Chengdu Stroke Registry.Methods The stroke patients consecutively admitted to Department of Neurology,West China Hospital,Sichuan University since March 1,2002 were prospectively registered.The baseline demographic,risk factors,treatment,and outcome data was recorded with standardized stroke register form by trained specialists.The patients were followed up at seven days,one,three,six months and one year after onset of the stroke for death and disability.Results A total of 3123 consecutive patients were registered between March 1,2002 and August 31,2006,of which 65.5％ came from urban areas and 34.5％ from rural areas.The age was (63.05 ± 17.98) years old and male accounted for 60.3％.Ninety-seven percent (3028/3123) of patients completed CT or MRI scanning during hospitalization.A total of 1804 patients were included between March 2002 and September 2004,of which ischemic stroke accounted for 62.1％ (1120/1804),intracranial hemorrhage 28.4％ (513/1804),subarachnoid hemorrhage 4.0％ (72/1804) and TIA 5.5％ (99/1804).The median NIHSS score on admission was 8(3-15) points in patients with cerebral hemorrhage,and 5(2-10) points in patients with ischemic stroke.Compared with the patients with intracranial hemorrhage,patients with ischemic stroke more frequently had a history of diabetes (OR =2.427,95％ CI 1.811- 3.253,P=0.000),atrial fibrillation (OR=6.121,95％ CI3.535-10.60,P=0.000),coronary heart disease (OR=4.144,95％ CI 2.944-5.832,P =0.000) and TIA (OR=4.342,95％ CI 1.726-10.92,P =0.001 ),and less alcohol consumption ( OR =0.740,95％ CI 0.611-0.896,P =0.002 ).The proportion of in-hospital treatments were thrombolysis 0.9％,anti-platelet therapy 83.0％,mannitol 23.5％,neuroprotective agents (citicoline) 68.1％,and Chinese herbal medicine 89.7％.Case fatality rate was 10.7％ and 13.9％ respectively at 7 days and one month for patients with intracranial hemorrhage,3.0％ and 5.2％ respectively for ischemic stroke.Death or disability was 40.4％,40.3％ and 38.9％ in patients with intracranial hemorrhage and 37.1％,35.0％ and 33.4％ for ischemic stroke at the end of 3,6,12 months respectively.Conclusions Our stroke registry is featured with the largest sample,and the longest period of consecutively registration.It provides an important platform for clinical investigation of stroke.Our study suggested case fatality and disability is lower in this group than in other ethics.Above features should be considered in design of future clinical trials in China.
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Objective To study the safety of enteral nutrition in preoperative bowel preparation for patients with colorectal carcinoma. Methods 68 patients with colorectal carcinoma were randomized into 2 groups.34 patients in the study group were applied with a kind of enteral nutrition in preoperative bowel preparation.34 patients in the control group were applied with the traditional liquid diet. Results In the study group, the change of the total sum of lymphocytes, hemoglobin, the serum total protein, albumin,prealbumin, transferrin and immune parameters CD3+, CD4+, CD8+ and CD4+/CD8+ after operation had no significant difference compared with that before preoperative bowel preparation (P >0.05). But in the control group, the total sum of lymphocytes, hemoglobin and immune parameters CD+3, CD+4, CD+8 after operation had no significant difference compared with that before preoperative bowel preparation, the serum total protein [(65.35±3.02) g/L],albumin [(32.5±1.98) g/L], prealbumin [(221.02±22.45) mg/L], transferrin [(2.12±0.2) g/L] and CD+4/CD+8 (1.14±1.98) were significantly lower after operation than that before preoperative bowel preparation [(69.43±3.21) g/L, (35.43±2.45) g/L, (236.54±18.45) mg/L, (2.31±0.03) g/L, 1.53±2.45] (P ＜0.05). Conclusion Enteral nutrition could be applied to the preoperation bowel preparation and replace the traditional liquid diet. As a simple way, it can make the colon clear, improve the nutrition and immunity status of the patients.
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The complete nucleotide sequence of the measles virus strain IMB-1, which was isolated in China, was determined. As in other measles viruses, its genome is 15,894 nucleotides in length and encodes six proteins. The full-length nucleotide sequence of the IMB-1 isolate differed from vaccine strains (including wild-type Edmonston strain) by 4% -5% at the nucleotide sequence level. This isolate has amino acid variations over the full genome, including in the hemagglutinin and fusion genes. This report is the first to describe the full-length genome of a genotype H 1 strain and provide an overview of the diversity of genetic characteristics of a circulating measles virus.
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The protein HTRP (human transcription regulator protein) is encoded by the differential gene htrp and induced by Herpes simplex virus type 1 (HSV-1) infection in KMB-17 cells. HTRP was found to interact with SAP30 (mSin3A Association Protein), one of the components of co-repressor complex mSin3A, which is part of the deacetylation transfer enzyme HDAC. To reveal the biological significance of the interaction between HTRP and SAP30, real- time PCR and a dual-luciferase detecting system was used. The results indicate that HTRP could inhibit the transcription of a viral promoter, whose interaction with SAP30 synergistically affects transcriptional inhibition of the viral genes, and is related to HDAC enzyme activity. ChIP experiments demonstrate that HTRP could promote HDAC activity by increasing the deacetylation level of lysine 14 and lysine 9 in histone H3.
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The comparative analysis of the biological characterization and the genetic background study of EV71 circulating strains is commonly recognized as basic work necessary for development of an effective EV71 vaccine. In this study, we sequenced five EV71 circulating strains, isolated from Fuyang, Hefei, Kunming and Shenzhen city of China and named them FY-23, FY-22, H44, K9 and S1 respectively. The sequence alignment demonstrated their genotypes be C4. The genetic distance of the VP1 gene from these isolates suggested that they were highly co-related with genetic identity similar to other previously reported EV71 strains in China. Additionally, these strains were identified to display some obvious proliferation dynamics and plaque morphology when propagated in Vero cells. However, a distinctive difference in pathogenic ability in neonatal mice was found. Some differences in cross neutralization test & immunogenic analysis were also found. All these results are related to the biological characterization of circulating EV71 strains in China and aid in the development of an EV71 vaccine in the future.