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Objective:To explore the construction and application of an evidence-based practice plan for early postoperative activity in postoperative patients with large area cerebral infarction.Methods:Ninety-six postoperative patients with large area cerebral infarction admitted to Wenzhou Central Hospital from July 2021 to April 2023 were selected as the study subjects for a Clinical trial. They were divided into the control group (48 cases) and the observation group (48 cases) by random number table method. The control group received routine postoperative care for neurosurgery, while the observation group received evidence-based systematic early activity training. Both groups were followed up until 1 month after the patient was discharged from the hospital. The time of postoperative hospitalization, hospitalization expenses, vital signs and pain investigation 48 h after surgery, daily living ability before intervention and 7 d, 1 month after discharge, neurological function before intervention and 7 d and 1 month after surgery, and complications during follow-up between the two groups were compared.Results:In the control group, there were 29 males and 19 females, with an average age of 43-67(56.87 ± 1.76) years. In the observation group, there were 31 males and 17 females, with an average age of 43-68 (57.02 ± 1.82) years. The postoperative hospital stay in the observation group was (6.87 ± 0.65) d, in the control group was (9.06 ± 0.72) d, the difference between them was significant ( t=15.64, P<0.05). 48 hours after surgery, the heart rate, breathing rate and mean arterial pressure in the observation group were (71.65 ± 0, 45) times/min, (14.76 ± 0.36) times/min and (76.98 ± 5.65) mmHg(1 mmHg=0.133 kPa), which were different with those in the control group, (82.76 ± 2.65) times/min, (18.76 ± 2.87) times/min and (93.76 ± 5.93) mmHg ( t=28.64, 9.58 and 14.19, all P<0.05). Seven days after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (84.65 ± 2.45) and (23.65 ± 2.65), which were different than the (79.76 ± 1.97) and (28.54 ± 2.73) in the control group ( t=10.26, 8.91, both P<0.05). A month after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (95.45 ± 1.43) and (18.65 ± 1.98), while in the control group were (87.87 ± 1.39) and (21.54 ± 2.76), the difference between them were significant ( t=26.33, 5.90, both P<0.05). The total incidence of complications such as postoperative bleeding, postoperative infection and hypoxemia in the observation group was 20.83% (10/48), which was significant lower than the 68.75% (33/48) in the control group ( χ2=22.28, P<0.05). Conclusions:Evidence-based systematic early activity training could significantly alleviate postoperative pain in patients with large area cerebral infarction after surgery, improve their daily living ability and neurological function, further effectively shorten their hospitalization time, and reduce the occurrence of complications.
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Objective:To evaluate the effects of different doses of esketamine on patient status index (PSI) under propofol-remifentanil-based anesthesia.Methods:One hundred patients of either sex, aged 22-62 yr, with body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ, were divided into 5 groups ( n=20 each) using a random number table method: normal saline group (group NS) and different doses of esketamine groups (E1-4 groups). Anesthesia was induced and maintained by target-controlled intravenous infusion of propofol and remifentanil.When the depth of anesthesia was stable (PSI value 25-50 ) for 5 min after tracheal intubation and no surgical stimulation was given, esketamine 0.1, 0.2, 0.3 and 0.4 mg/kg were intravenously injected over 60 s in E1-4 groups respectively, and normal saline 10 ml was intravenously injected in NS group. PSI values were recorded at 1-min intervals (1-15 min, T 1-T 15) immediately before anesthesia induction (T 0) and after esketamine administration. PSI values>50, bradycardia and hypotension were recorded during the test. Results:Compared with NS group, no significant change was found in PSI values at each time point in E1 group ( P>0.05), PSI value was significantly increased at T 5-T 10 in E2 group, PSI value was increased at T 5-T 12 in E3 group, PSI value was increased at T 1-T 15 in E4 group, and the incidence of PSI value >50 was increased in E2, E3 and E4 groups ( P<0.05). The incidence of PSI value >50 was significantly higher in E3 and E4 groups than in E2 group ( P<0.05). There was no significant difference in the incidence of PSI value >50 between group E3 and group E4 ( P>0.05). There was no significant difference in the incidence of hypotension and bradycardia among the five groups ( P>0.05). Conclusions:Esketamine ≥ 0.2 mg/kg increases the patient′s PSI value when combined with propofol-remifentanil anesthesia.
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@#Diabetic kidney disease (DKD) is one of the main complications of diabetes, and also the leading cause of the end-stage renal disease (ESRD).The main clinical manifestations are albuminuria and decreased glomerular filtration rate.DKD seriously affects the quality of life of sufferers and places a huge financial burden on them. Traditional Chinese medicine (TCM) has accumulated rich experience in treating DKD.This paper analyzed and summarized the recent treatment of DKD with traditional Chinese medicine from three aspects: active ingredients of TCM, TCM pairs and TCM prescriptions, so as to provide new ideas for the majority of researchers in experimental research.
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BACKGROUND AND OBJECTIVE: Securing the airway in the surgery of maxillofacial disorders and traumas is fundamental during the operation. The present study aims to investigate the beneficial sedative effects of dexmedetomidine (DEX) in patients who underwent maxillofacial surgery with regional anesthesia compared to general anesthesia. METHODS: Fifty patients, aged 20-45 years old were randomly divided into two groups of regional anesthesia (RA) and general anesthesia (GA) (each n=25). The group RA received regional block with sedation (DEX: 1 µg/kg infused over 10 min followed by the maintenance dose of 0.5 µg/kg/h) and the group GA underwent general anesthesia (DEX: 0.1 µg/kg/min over 10 min followed by 0.4-0.7 µg/kg/h). Postoperative pain scores, anesthesia outcomes, hemodynamic parameters, the time of the post-anesthesia care unit (PACU) discharge and intra and postoperative complications were comparatively assessed in both groups. RESULTS: The baseline characteristics of the patients (age, gender, BMI, and ASA physical status) showed no differences between the two groups (P>0.05). Although the duration of surgery and recovery time showed no differences between the groups, the duration of anesthesia and extubation time was remarkably lower in the RA group than in the GA group (P<0.01). Administration of nerve blocks demonstrated less pain and longer sleep time in the postoperative phase as compared to the GA group. Heart rate and mean arterial blood pressure were significantly less in the RA group at the end of the loading dose of DEX and incision time (P<0.05). SpO2, respiration rate and Ramsay sedation scale did not exhibit any significant differences between the two groups at all-time points (P>0.05). No significant differences were observed with regard to the adverse events between the two groups (P>0.05). CONCLUSIONS: Although our findings revealed that both methods are suitable and safe methods for maxillofacial surgery, the outcomes of anesthesia with regional block and sedation include less pain in the postoperative phase, shorter extubation time and earlier discharge from the PACU demonstrated that this method is more reliable for maxillofacial surgery. Further controlled studies are needed to compare the effectiveness and safety profiles of two RA and GA techniques and also to compare DEX with other anesthetic agents to achieve optimum outcomes in maxillofacial surgeries.
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Anesthesia, Conduction , Dexmedetomidine , Surgery, Oral , Humans , Young Adult , Adult , Middle Aged , Dexmedetomidine/therapeutic use , Dexmedetomidine/adverse effects , Anesthesia, General/methods , PainABSTRACT
Objective:To explore the effect of empathy nursing intervention on negative emotion, sleep quality and health literacy of patients with pulmonary tuberculosis.Methods:A total of 77 patients in Department of Infectious Diseases of People′s Hospital of Leshan from June 2019 to September 2020 were divided into intervention group ( n=39) and control group ( n=38) by random digits table method. The patients in the control group were given routine nursing, and the patients in the intervention group were given empathy nursing intervention on the basis of routine nursing. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI) and Health Literacy Management Scale (HeLMS) were used before and 12 weeks after intervention to evaluate the effects. Results:There was no significant difference in the total scores of HAMD, HAMA, PSQI and HeLMS between the two groups before intervention ( P>0.05), but after intervention, the scores of HAMD and HAMA in the intervention group were 10.64 ± 1.86, 12.64 ± 2.12, lower than those in the control group (14.63 ± 2.19, 15.11 ± 2.71). The differences were statistically significant ( t=-8.63, -4.46, P<0.05). The total score of PSQI and the scores of daytime dysfunction, use of hypnotic drugs, time of falling asleep, time of sleep, sleep quality, sleep disorder and sleep efficiency in the intervention group were 10.26 ± 1.65, 1.22 ± 0.22, 1.48 ± 0.23, 1.51 ± 0.27, 1.45 ± 0.26, 1.57 ± 0.22, 1.54 ± 0.21,1.49 ± 0.24, lower than those in the control group (13.07 ± 2.14, 1.92 ± 0.31, 1.75 ± 0.34, 1.95 ± 0.29, 2.02 ± 0.33, 1.84 ± 0.31, 1.72 ± 0.27, 1.87 ± 0.29). The differences were statistically significant ( t values were -11.45--3.27, all P<0.05). The total score of HeLMS and the scores of information acquisition, communication and interaction, and health improvement intention in the intervention group were 96.12 ± 14.71, 37.87 ± 5.83, 35.91 ± 5.13, 16.21 ± 2.53, higher than those in the control group (86.35 ± 14.12, 33.17 ± 5.27, 32.87 ± 5.42, 14.16 ± 2.19). The differences were statistically significant ( t values were 2.53-3.80, all P<0.05). Conclusions:Empathy nursing intervention can effectively alleviate the negative emotions of pulmonary tuberculosis patients, improve their sleep quality, and improve their health literacy level.
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Objective:The risk factors and survival conditions of cardiomyopathy in childhood septic shock were retrospectively analyzed.Methods:Children with septic shock admitted to the PICU at Children′s Hospital of Chongqing Medical University from January 2015 to March 2021 were collected.The case group included children with septic shock and cardiomyopathy.The propensity score matching method was used to match children with septic shock without cardiomyopathy in a 1∶2 ratio as the control group.Basic clinical data, myocardial biomarkers, cardiac ultrasound indicators, organ function indicators and clinical outcome indicators were collected from two groups.Results:Forty-six patients were included in the case group and 92 patients in the control group.There were no significant differences in age, sex, pediatric critical care score, and basic disease between two groups.Moreover, left ventricular ejection fraction[51.0%(43.0%, 62.0%) vs.65.5%(60.6%, 69.0%)], left ventricle short-axis shortening rate (FS)[26%(21%, 33%) vs.35%(32%, 38%)], and oxygenation index(PaO 2/FiO 2)[324.0(234.3, 400.0) mmHg vs.400.0(265.8, 445.0)mmHg] in case group were lower than those in control group, while the incidence of the ST segment changes of the ECG index (21.7% vs.3.3%), lactate[3.20(1.20, 5.87)mmol/L vs.1.80(1.20, 3.40)mmol/L], and vasoactive drug score[25.14(14.84, 42.70)points vs.15.04(10.00, 26.70) points] in case group were higher than those in control group, the differences were all statistically significant (all P<0.05). The differences of PICU mortality (15.2% vs.14.1%) and 28 d mortality (29.1% vs.29.3%) between two groups were not significant ( P>0.05). The Logistic regression analysis showed that the FS was associated with cardiomyopathy occurring in septic shock[ OR (95% CI): 0.795 (0.714~0.870), P<0.001]. Children with septic shock with elevated cardiac troponin I had an increased risk of death. Conclusion:FS is an independent risk factor for cardiomyopathy in septic shock.There is no difference in survival between septic shock with and without cardiomyopathy.Cardiac troponin I is associated with the prognosis of septic shock in children.
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Objective:The risk factors and survival conditions of cardiomyopathy in childhood septic shock were retrospectively analyzed.Methods:Children with septic shock admitted to the PICU at Children′s Hospital of Chongqing Medical University from January 2015 to March 2021 were collected.The case group included children with septic shock and cardiomyopathy.The propensity score matching method was used to match children with septic shock without cardiomyopathy in a 1∶2 ratio as the control group.Basic clinical data, myocardial biomarkers, cardiac ultrasound indicators, organ function indicators and clinical outcome indicators were collected from two groups.Results:Forty-six patients were included in the case group and 92 patients in the control group.There were no significant differences in age, sex, pediatric critical care score, and basic disease between two groups.Moreover, left ventricular ejection fraction[51.0%(43.0%, 62.0%) vs.65.5%(60.6%, 69.0%)], left ventricle short-axis shortening rate (FS)[26%(21%, 33%) vs.35%(32%, 38%)], and oxygenation index(PaO 2/FiO 2)[324.0(234.3, 400.0) mmHg vs.400.0(265.8, 445.0)mmHg] in case group were lower than those in control group, while the incidence of the ST segment changes of the ECG index (21.7% vs.3.3%), lactate[3.20(1.20, 5.87)mmol/L vs.1.80(1.20, 3.40)mmol/L], and vasoactive drug score[25.14(14.84, 42.70)points vs.15.04(10.00, 26.70) points] in case group were higher than those in control group, the differences were all statistically significant (all P<0.05). The differences of PICU mortality (15.2% vs.14.1%) and 28 d mortality (29.1% vs.29.3%) between two groups were not significant ( P>0.05). The Logistic regression analysis showed that the FS was associated with cardiomyopathy occurring in septic shock[ OR (95% CI): 0.795 (0.714~0.870), P<0.001]. Children with septic shock with elevated cardiac troponin I had an increased risk of death. Conclusion:FS is an independent risk factor for cardiomyopathy in septic shock.There is no difference in survival between septic shock with and without cardiomyopathy.Cardiac troponin I is associated with the prognosis of septic shock in children.
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OBJECTIVE@#To explore the genetic basis of three children with unexplained developmental delay/intellectual disability (DD/ID).@*METHODS@#Peripheral blood samples were collected from the patients and subjected to chromosomal microarray analysis (CMA).@*RESULTS@#Patient 1 was found to harbor a 190 kb deletion at 9q34.3, which encompassed most of EHMT1 (OMIM 607001), the key gene for Kleefstra syndrome (OMIM 610253). Patients 2 and 3 were siblings. CMA showed that they have shared four chromosomal copy number variations (CNVs) including a deletion at 9q34.3 which spanned 154 kb and 149 kb, respectively, and encompassed the EHMT1 and CACNA1B (OMIM 601012) genes. The remaining 3 CNVs were predicted to be with no clinical significance.@*CONCLUSION@#Microdeletions at 9q33.4 probably underlay the pathogenesis of DD/ID in the three children, for which EHMT1 may be the key gene.
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Child , Humans , Chromosome Deletion , Chromosomes, Human, Pair 9 , Craniofacial Abnormalities/genetics , DNA Copy Number Variations , Developmental Disabilities/genetics , Heart Defects, Congenital , Intellectual Disability/geneticsABSTRACT
Objective To evaluate the efficacy of biofeedback combined with swallowing function training at different times on post-stroke dysphagia. Methods 124 patients with post-stroke dysphagia were randomly divided into observation group and control group. The observation group was given biofeedback combined with swallowing function training for 2 weeks and 4 weeks of treatment. The control group was given routine swallowing function training for 2 weeks and 4 weeks of treatment. Kubota drinking water test was used to evaluate the swallowing function before treatment, 2 weeks and 4 weeks after treatment in both groups. Results There was no statistically significant difference in the scores of swallowing function between the two groups before treatment (P=0. 401). After 2 weeks of treatment, there was also no statistically significant difference in the evaluation of swallowing function between the observation group and the control group (P=0. 138). After 4 weeks of treatment, the evaluation of swallowing function in the observation group was significantly better than that in the control group(P=0. 003). Conclusion Biofeedback combined with swallowing function training is better than the routine swallowing function training. After 4 weeks of treatment, the efficacy of biofeedback combined with swallowing function training is better than the biofeedback combined with swallowing function training after 2 weeks, indicating that there is a correlation between the treatment effect and the length of treatment time.
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Objective To study the interaction mechanism of anti-cancer drug docetaxel (DTX) andβ-tubulin, to determine the binding sites and the involved amino acids between the β-tubulin and docetaxel, and to analyze the dynamic combination process. Methods The docking binding energy and interaction sites of DTX molecules withβ-tubulin on the potential energy surface were calculated by molecular docking method. The dynamic interaction process of the low binding energy DTX with β-tubulin was simulated by molecular dynamics method. Results The results of molecular docking showed that there are three interaction sites, including N1, N2 and N3, between DTX and β-tubulin. The DTX molecules with structure of No.1, 2 and 4, which have excellent docking energy, were chose for molecular dynamics simulation. As a result, the dynamic change processes of the system complexes from non-equilibrium to equilibrium were obtained. The simulation results showed that the hydrogen bonds formed by the DTX with structure No.1 were significantly higher than those with structures No. 2 and 4. The solvent accessibility surface area of the DTX with structures No.1, 2 and 4 was higher than that of paclitaxel. Conclusion The model of DTX binding toβ-tubulin was established, which could provide theoretical guidance for the design and development of novel paclitaxel anticancer drugs.
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Objective To evaluate the clinical effectiveness of early-stage keep warm intervention on improving low temperature risk children treated with blood purification (BP). Methods Ninety children were randomized into observation group (46 cases) and control group of (44 cases) from July 2013 to September 2015. Control group were nursed with conventional BP standard operation process, while the observation group were nursed additionally with heat insulation blanket before 30 min of booting machine, and recorded the central body temperature of 0 min,30 min,60 min,90 min,120 min for each 60 min 1 time in the future. Until the end of the blood purification 60 min. Low temperature complications were recorded and judged between the two groups. Results In the observation group, 107 cases of low body temperature occurred during the course of 7 cases of blood purification, occurrence rate of 6.5% (7/107). The control group was 15.8% (16/101). The difference between the 2 groups was statistically significant (χ2=4.569,P<0.05);In the continuous blood purification group, observation group 10.6% (5/47), The incidence rate of control group was 29.3% (12/41), he difference between the 2 groups was statistically significant (χ2=4.876,P<0.05). Conclusions Application of heat insulation blanket at the early-stage may effectively reduce the risk of hypothermia complications in the children treated with blood purification. The continuous blood purification effect is more significant.
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OBJECTIVE: To evaluate the colorectal cancer incidence among compliers and non-compliers in the population of colorectal cancer screening area, and to provide scientific basis for health economic evaluation of cancer screening. METHODS: By screening different years build queue, to retrospectively compare the data of colorectal cancer screening from January 1, 2008 to December 31, 2013 and the data of cancer registration, and to analyze the colorectal cancer incidence rates among screening compliers and non-compliers, and to compare the average intervals between the end of screening and clinical cancer diagnosis using SPSS 19 statistical software. Mantel-Haenszel test was performed with a statistical significance level of α = 0.05. RESULTS: The non-compliance rate was 38.24% among males and 28.49% among females (P < 0.001). The non-compliance rate was highest in the 40-44 and 70-74 years age groups and lowest in the 50-59 years age group. The compliers of the screening were followed up for 476,049 person-years, and there were 51 cases of colorectal cancer, with an incidence rate of 10.71/100,000. The non-compliers of the screening were followed up for 259 183 person-years, and there were 66 cases of colorectal cancer, with an incidence rate of 25.46/100,000, which was 1.38 times higher than that of the compliance group (χ2 = 21.699, P < 0.001). The incidence rate of colorectal cancer among subjects who were positive in initial screening but refused to receive an electronic colonoscopy was as high as 164.40/100,000, and the average delay time was 20.8 ± 16.8 months. CONCLUSIONS: The colorectal cancer screening adherence among women is better than among men, and that of 50-54 years and 55-59 years age groups is better than in other age groups. The subsequent incidence rate of colorectal cancer in the non-compliance group is significantly higher than that of the compliance population.
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Colorectal Neoplasms/epidemiology , Mass Screening/statistics & numerical data , Adult , Age Factors , Aged , China/epidemiology , Cohort Studies , Colonoscopy , Colorectal Neoplasms/diagnosis , Early Detection of Cancer , Female , Humans , Incidence , Male , Middle Aged , Patient Compliance/statistics & numerical data , Retrospective Studies , Sex FactorsABSTRACT
<p><b>OBJECTIVE</b>To compare the safety of haemophilus influenzae type b (Hib) vaccine vaccination on vastus lateralis muscle and deltoid muscle of infant.</p><p><b>METHODS</b>A total of 408 3-4 months old infants were divided into vastus lateralis muscle group and deltoid muscle group in Beijing, 2014. They were divided into the vastus lateralis muscle group (204) and deltoid muscle group (204) by extracting random number. Each observation object was given 3 doses of Hib vaccine according to the program. Collected systemic and local reactions after vaccination and calculated the incidence of adverse reactions.</p><p><b>RESULTS</b>A total of 61 infants were quitted during the study, 1 132 doses were observed. The total reactions incidence of Vastus lateralis muscle group and Deltoid muscle group were 33.0% (186/564) and 27.6% (157/568) with no statistical differences (χ² = 3.818, P = 0.059). The two groups incidence at the same day of vaccination (day 0) which the highest were 23.2% (131/564) and 20.6% (117/568), then declined with time (linear trend test vastus lateralis muscle group χ² = 36.600, P < 0.001,deltoid muscle group χ² = 29.947, P < 0.001), day 1 were 20.4% (115/564) and 17.6% (100/568), day 2 were 16.0% (90/564) and 13.4% (76/568), day 3 were 10.3% (58/564) and 10.6% (60/568), day 4-7 were 11.2% (63/564) and 11.3% (64/568). No serious adverse events (SAE) were reported during the study. The local reactions incidence of two groups were 7.1% (40/564) and 7.7% (44/568)with no statistical differences (χ² = 0.176, P = 0.675). The systemic reactions incidence of two groups were 25.9% (146/564) and 20.6% (117/568) with obvious statistical differences (χ² = 4.437, P = 0.035). The fever incidence of vastus lateralis muscle group (11.5% (65/564)) was higher than Deltoid muscle group (4.4% (25/568)) with obvious statistical differences (χ² = 4.868, P = 0.027). The 1st dose incidence of fever and abnormal crying of vastus lateralis muscle group (fever 11.3% (23/204), abnormal crying 19.1% (39/204)) was higher than deltoid muscle group (fever 4.4% (9/204), abnormal crying 11.8% (24/204)) and the 2nd dose of diarrhea of deltoid muscle group (11.6% (22/190)) was higher than vastus lateralis muscle group (5.9% (11/187)) with obvious statistical differences (fever χ² = 15.288, P < 0.001, abnormal crying χ² = 4.224, P = 0.040, diarrhea χ² = 3.829, P = 0.046).</p><p><b>CONCLUSION</b>Both vastus lateralis muscle group and deltoid muscle group had lower incidence of adverse reactions after vaccination. No serious adverse events were associated with vaccination. Vastus lateralis muscle vaccination as well as deltoid muscle vaccination demonstrated safe.</p>
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Humans , Infant , Bacterial Capsules , China , Deltoid Muscle , Fever , Haemophilus Vaccines , Haemophilus influenzae type b , Incidence , Quadriceps Muscle , VaccinationABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of exogenous hydrogen sulfide (H2S) on β-site APP cleaving enzyme 1 (BACE-1) and β-amyloid peptide (Aβ) metabolism in primary culture of neurons under high-glucose condition.</p><p><b>METHODS</b>The cortical neurons in primary culture under normal and high glucose (60 mmol/L) conditions for 24 h were exposed to 25, 50 and 100 µmol/L NaHS. Aβ1-42 concentration in the cell culture was measured by ELISA, and BACE-1 mRNA and protein levels were detected by fluorescent quantitative real-time PCR and Western blotting, respectively.</p><p><b>RESULTS</b>Compared with the neurons cultured in normal glucose, the neurons exposed to high glucose showed significantly increased Aβ1-42 concentration and BACE-1 mRNA and protein expressions (P<0.05). Exposure to 25, 50 and 100 µmol/L NaHS significantly decreased Aβ1-42 concentration and BACE-1 mRNA and protein expressions in the high-glucose cell culture (P<0.05).</p><p><b>CONCLUSION</b>Neurons exposed to high glucose exhibit increased Aβ1-42 levels and BACE-1 mRNA and protein expressions, which can be concentration-dependently decreased by NaHS.</p>
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Animals , Rats , Amyloid Precursor Protein Secretases , Metabolism , Amyloid beta-Peptides , Metabolism , Aspartic Acid Endopeptidases , Metabolism , Cells, Cultured , Culture Media , Chemistry , Glucose , Chemistry , Hydrogen Sulfide , Pharmacology , Neurons , Metabolism , Peptide Fragments , Metabolism , Rats, Sprague-DawleyABSTRACT
Objective To evaluate the effect of isoflurane preconditioning on inflammatory responses during spinal cord injury (SCI ) in rats .Methods Sixty adult male Sprague-Dawley rats ,weighing 250-300 g , were randomly divided into 3 groups ( n= 20 each ) using a random number table :sham operation group (S group) , SCI group , and isoflurane preconditioning group (I group ) . The animals were anesthetized with intraperitoneal pentobarbital sodium 40 mg/kg .SCI was produced by a weight-drop contusion at the T10 level .The rats inhaled 2% isoflurane for 2 h ,and the model was established at 24 h after the end of isoflurane inhalation in I group . Neurological function was assessed and scored by using the the Basso , Beattie , Bresnahan (BBB ) Locomotor Rating Scale on 7 days after SCI .Five rats in each group were then chosen and spinal cord specimens were obtained and cut into sections which were stained with haematoxylin and eosin for determination of the viable neuron count .Fifteen rats in each group were sacrificed and the spinal cord was removed for detection of nuclear factor kappaB (NF-κB ) and interleukin-1β (IL-1β) expression (by Western blot ) .Results Compared with S group ,BBB score and the number of viable neurons were significantly decreased ,and the expression of NF-κB and IL-1βprotein was up-regulated in SCI group ( P<0.05) .Compared with SCI group ,BBB score and the number of viable neurons were significantly increased ,and the expression of NF-κB and IL-1βprotein was down-regulated in group I ( P<0.05 ) .Conclusion The mechanism by which isoflurane preconditioning protects the spinal cord is related to inhibition of inflammatory responses in rats .
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Objective To explore the relationship between serum reproductive hormone levels and premenopausal and postmenopausal breast cancer patients.Methods We recruited healthy women and breast cancer patients who came to our hospital from September 2007 to February 2012 for routine physical examination or surgery and divided them into premenopausal healthy group Ⅰ and breast cancer group Ⅰ ;Postmenopausal healthy group Ⅱ and breast cancer group Ⅱ,with 175 cases in each group.Reproductive hormone levels was measured in all cases.Results There were significant differences among the four groups on estradiol (E2),testosterone (T),progesterone (P),luteotropic hormone (LH),follicle-stimulating hormone (FSH),and prolactin (PRL) (F =76.459,57.224,82.932,161.047,74.801 and 15.246 respectively,P ＜ 0.05).In premenopausal cases:There were significant statistical difference on the levels of E2 [(61.5 ±32.2) ng/L vs.(74.1 ±41.6) ng/L],T [(48.1 ±22.2) μg/L vs.(80.1 ±41.8) μg/L],P [(2.9±1.6) μg/Lvs.(3.5 ±1.3) μg/L],LH [(1.3 ±0.9) U/L vs.(3.5 ±1.4) U/L],FSH [(14.8 ±8.9) U/L vs.(25.1 ±23.3) U/L],PRL [(15.8 ±6.7) μg/L vs.(39.4 ±27.4) μg/L] between the healthy Ⅰ group and the breast cancer Ⅰ group (P ＜ 0.05).In postmenopausal cases:There were significant statistical difference on the E2 [(18.8 ± 8.3) ng/L vs.(55.9±34.1) ng/L],T [(34.1 ±16.2) μg/L vs.(84.7 ±66.4) μg/L],P [(1.3 ±0.9) μg/L vs.(3.5 ±1.4) μg/L],LH [(38.1 ±33.7) U/L vs.(45.6 ± 31.2) U/L] in healthy group Ⅱand the breast cancer Ⅱ group (P ＜ 0.05).The difference was statistically significant on the E2 [(74.1 ± 41.6) ng/L vs.(55.9±34.1) ng/L],LH [(3.5 ±1.4) U/L vs.(45.6 ±31.2) U/L],FSH [(25.1 ±23.3) U/L vs.(70.5±58.2) U/L],PRL [(39.4 ±27.4) μg/L vs.(15.9 ±15.5) μg/L] between the breast group of premenopausal and postmenopausal (P ＜ 0.05).Conclusion Reproductive hormone levels has important clinical significance for the onset and development of breast cancer and provides a reference point for the treatment of menopausal and post-menopausal breast cancer.
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Objective To study the relationship between interleukin(IL)-4,IL-12 and IL-18 and intrauterine infection of hepatitis B virus (HBV),in order to provide the basis for prevention and treatment.Methods Forty pregnant women with positive HBsAg and intrauterine infection of HBV were selected as study group,and 80 pregnant women with positive HBsAg and non-intrauterine infection of HBV were selected as control group.The levels of IL-4,IL-12,IL-18 were compared.Results The level of IL-4 was (51.56 ± 7.86) ng/L in study group,which was higher than that in control group [(31.67 ± 8.64) ng/L],and there was significant difference between two groups (P ＜0.01).The leveh ofIL-12 and IL-18 were (803.45 ± 132.64),(627.87 ± 134.38) ng/L in study group,which werelower than that in control group [(904.87 ± 231.86),(734.78 ± 165.67) ng/L],and there were significant differences between two groups (P ＜ 0.01).Conclusions The levels of IL-4,IL-12,IL-18 are correlated with intrauterine infection of HBV.The increase of IL-4 and the decrease of IL-18,IL-12 may lead to positive HBsAg pregnant women happening intrauterine HBV infection.
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Objective To compare clinical efficacy between improved vaginal hysterectomy (IVH)and traditional vaginal hysterectomy (TVH) and its influences on blood glucose and serum corticosteroid levels.Methods One hundred patients undergoing hysterectomy were divided into using IVH (treatment group,50 patients) and TVH (control group,50 patients).Clinical efficacy,blood glucose and serum corticosteroid levels were compared between two groups.Results There was no significant difference in operation time between two groups (P＞ 0.05).The amount of intraoperative bleeding,postoperative exhaust time and postoperative vaginal bleeding time in treatment group were significantly less than those in control group [(86.7 ± 5.7) ml vs.(131.2 ± 14.5) ml,(24.8 ± 12.9) h vs.(42.8 ± 17.7) h,(16.5 ± 2.9) d vs.(24.3 ±6.7) d,P ＜ 0.05],and the time of blood glucose and serum corticosteroid levels returned to normal levels in treatment group were much earlier than those in control group.Conclusion The clinical efficacy of IVH is preonunced,and postoperative stress reaction is mild.
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Objective To explore the effect of laparoscopic ovarian drilling technique in the treatment of polycystic ovarian syndrome.Methods 60 patients with polycystic ovarian syndrome were randomly devided into observation group( 30 cases) and the control group(30 cases).The effect of the two groups was observed.Results LH and T of all the patients were significantly improved after the treatments( t =27.2158,20.4752,9.7169,0.4551,all P ＜0.05);The ovulation rate and the pregnancy rate of observation group(86.7％ and 86.7％ ) was significantly higher than those of the control group( x2 =5.4545,9.3496,all P ＜ 0.05 ),and the OHSS rate of observation group was 0,significantly lower than that of the control group ( 16.7％ ) ( x2 =5.4545,P ＜ 0.05 ).Conclusion Laparoscopic ovarian drilling technique was effective and safe in treating polycystic ovarian syndrome.
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Background: Anal fissure is one of the most common anal-rectum diseases, and approximately 10 percent patients with chronic anal fissure ultimately receive surgery. Relieving postoperative pain and protecting functions of the sphincter are central issues for coloproctologists. Objective: To evaluate the efficacy and safety of anoplasty in the treatment of chronic anal fissures. Design, setting, participants and interventions: In this prospective, multicenter, randomized controlled trial, 120 adult patients with chronic anal fissure were referred from Department of Coloproctology of Yueyang Hospital of Integrated Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Municipal Hospital of Traditional Chinese Medicine. The patients were enrolled from January 2009 to April 2010 and randomly divided into study (mucosa advancement flap anoplasty, abbreviated as anoplasty) group and control (fissurectomy) group. The two groups were assessed separately, and the main outcome measures were observed for 2 weeks, with a short-term follow-up for 6 weeks. Main outcome measures: Degree of pain, haemorrhage and anal canal pressure were observed and recorded preoperatively, and on the third day, the fourteenth day and the sixth week postoperatively. The wound healing time was also recorded. Surgical complications of the two groups were recorded and compared on the third day and the sixth week postoperatively. The curative effects associated with the surgery were analyzed on the fourteenth day and the sixth week after surgery and the therapeutic results were evaluated. Results: Three patients were dropped out due to the early discharge from hospital and losing connection (1 in study group and 2 in control group). Overall the surgery showed that the anoplasty group had better results than the fissurectomy group in the curative effect on the sixth week after operation (P0.05). There were no significant differences in relieving the anal canal pressure (P>0.05) and the surgical complications (dysuria, edema of anal margin, fever, infection, anal incontinence and anal deformation) between the two groups (P>0.05). None of the patients suffered postoperative complications by the sixth week after operation. Furthermore, there was no recurrence in either of the two groups at six weeks after operation. Conclusion: The results indicate that anoplasty for chronic anal fissures has advantages such as better therapeutic effects, less postoperative pain, a shorter healing time and no incidence of anal incontinence.