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Objective:To analyze the gene mutation, clinical manifestations and prognosis of children with steroid resistant nephrotic syndrome (SRNS), and to provide reference for the treatment of hereditary SRNS in children.Methods:The clinical data of 29 patients with SRNS and whole exon sequencing (WES) diagnosed in Xi′an Children′s Hospital from January 1, 2018 to December 31, 2020 were retrospectively analyzed.Results:In 29 cases of SRNS with genetic testing, 10 cases (34.5%) were gene mutations, including 2 cases of congenital nephrotic syndrome. The onset age of the patients with gene mutation ranged from 0.1 to 10.7(4.06±3.73)years, and the median age of onset was 3.3 years. The clinical type was mainly nephritis (8/10), and the pathological type was mainly focal segmental glomerulosclerosis (FSGS) (5/7). The main mutant genes were NPHS1 (2 cases), NPHS2 (2 cases), WT1 (2 cases), SMARCAL1 (1 case), COQ8B (1 case), TRPC6 (1 case) and COL4A3 gene (1 case). The main types of genetic variation were missense mutations, and 6 (60%) cases were new mutations that had never been reported in the database containing human pathogenic mutations before. Compared with the non-gene mutation group, 24 hour urinary protein was higher [(177.92±164.59)mg/(kg·24 h) vs (84.99±40.79)mg/(kg·24 h)] in gene mutation group, with statistically significant difference ( P<0.05). In the gene mutation group, there were 2 cases of complete remission, including 1 case of complete remission treated with coenzyme Q10, 1 case of partial remission, and 8 cases of immunosuppression treatment, with an effective rate of 2/8, while in the non-gene mutation group, the effective rate of immunosuppression treatment was 17/19, with statistically significant difference in prognosis between the two groups ( P<0.05). Conclusions:The pathological type of children with hereditary SRNS is mainly FSGS, which are often ineffective to immunosuppressive therapy, poor prognosis and easy to progress to end-stage renal disease. Gene detection is of great significance for etiological diagnosis, treatment and prognosis evaluation in children with SRNS.
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0bjective To analyze the clinical characteristics, pathological types, treatment and prognosis in children with steroid resistant nephrotic syndrome (SRNS) in Northwest China, in order to provide reference for the treatment of SRNS. Methods:The clinical data, renal pathological results, treatment plan and efficacy of 102 children diagnosed with SRNS in the Department of Nephrology, Xi'an Children's Hospital of Shaanxi Province from January 1st, 2018 to December thirty-first, 2020 were analyzed retrospectively. All children were divided into groups according to age, clinical classification, pathological type, treatment scheme and treatment outcome, and the risk factors affecting the prognosis of children with SRNS were discussed. The measurement datas conforming to normal distribution were expressed as xˉ± s, and t test was used for comparison between groups. Measurement datas that did not conform to normal distribution were represented by M ( Q1, Q3), and Kruskall-Wallis test was used for comparison between groups.Enumeration datas were compared by χ 2 test. Risk factors were analyzed by multiple factor Logistic regression analysis. Results:The median age of onset of 102 children with SRNS was 3.0 years. Focal segmental glomerulosclerosis (FSGS) accounted for 36.3% (37/102), minimal lesions accounted for 33.3% (34/102), and mesangial proliferative glomerulonephritis accounted for 23.5% (24/102). The prevalence rates of hypertension (35.1% (13/37)), 24-h urine protein quantification (130.5 (91.5, 159.6) mg/(kg·24 h) and renal insufficiency (21.6% (8/37)) in FSGS group were higher than those in non-FSGS group (13.8% (9/65), 65.8 (51.2,85.5) mg/(kg·24 h), 4.6% (3/65)). The differences between the two groups were statistically significant (statistical values were χ 2=6.32, Z=5.90, χ 2=7.09; P values were 0.012, <0.001, 0.008). Logistic multivariate regression analysis showed that the hypertension ( OR=4.055, 95% CI 1.178-3.962) and 24 hour urinary protein ( OR=1.036, 95% CI 1.020-1.053) were associated with the increased risk of FSGS ( P values were 0.026 and <0.001). ROC curve ananlysis showed that the optimal critical value of 24 hour urinary protein was 85.65 mg/(kg·24 h) in FSGS. After treatment, complete remission was 61.8%(63/102), partial remission was 14.7%(15/102), and no remission was 23.5%(24/102). By the end of follow-up the treatment effective rate in the small lesion group (94.1%(32/34)) was higher than that in the FSGS Group (51.3%(19/37)), and the difference between the two groups was statistically significant (χ 2=16.02, P<0.001). In the initial immunosuppressive treatment, the complete remission rate of hormone combined with calcineurin inhibitor group (77.1%(37/48)) was higher than that of hormone combined with cyclophosphamide Group (11.1%(3/27)). There was significant difference between the two groups ( Z=32.28, P<0.001). Conclusion:The most common pathological type in children with SRNS was FSGS, and the age of onset was generally small. The prognosis of patients with pathological type FSGS was the worst, and the prognosis of small lesions was better. Hypertension and 24-hour urinary protein quantification were the risk factors of FSGS. Calcineurin inhibitors were the first choice for the second-line immunosuppressants of SRNS in children.
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【Objective】 To analyze the changes in demographic profile of voluntary blood donors from 2012 to 2019 in Shandong, so as to provide scientific basis for establishing effective recruitment strategy and promoting sustainable development of voluntary blood donation. 【Methods】 The demographic information of voluntary blood donors was obtained via the Shandong Blood Management Information System. The gender, age, occupation and education level of blood donors were descriptively analyzed. High socioeconomic status (SES) and low SES districts were defined according to GDP per capita, and the demographic characteristics of blood donors in the two districts were compared. 【Results】 The proportion of blood donors with a bachelor degree or above increased from 14.28% in 2012 to 20.81% in 2019, showing a significant increase in education level (P<0.01). The proportion of college students and medical staff increased from 14.82% and 2.36% in 2012 to 19.19% and 3.73% in 2019, respectively (P<0.01); the proportion of blood donors aged 26~35 years decreased by 8.82%, and those aged 46~60 years increased by 10.86% (P<0.01). The proportion of blood donors aged 18~25 years increased from 30.72% to 38.12% in high SES district, and decreased from 22.77% to 13.04% in low SES district. 【Conclusion】 The demographic profile of voluntary blood donors in Shandong showed significant changes during the past 8 years ( from 2012 to 2019), which may also exist in other areas in China. It is necessary to improve the recruitment strategies according to those changes, thus promot the sustainable and healthy development of voluntary blood donation.
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ObjectiveTo investigate the impact of the COVID-19 outbreak on the medical advice seeking of Chinese children with chronic kidney disease (CKD). Materials and MethodsAn anonymous online questionnaire survey was conducted in 17 pediatric nephropathy diagnosis and treatment centers in China. The questions collected basic information on the patients and their parents and data on changes in the approach to medical treatment and their needs in the context of the outbreak etc. This is a Multicenter Cross-section Study. ResultsA total of 735 valid questionnaires were collected. 555 patients (75.5%) and their parents said that the outbreak had a significant influence on their medical treatment: 264 patients (47.6%) said that it would be delayed by 2 to 4 weeks and 199 patients (35.9%) by 4 to 8 weeks. 510 patients (84.16%) hoped to get in touch with specialists through online consultation, and 528 patients (84.5%) hoped that online consultation could be implemented and that medication could be delivered to them.. A total of 458 patients (62.3%) said that their greatest concern was that the CKD would be aggravated or that they would experience a relapse; only 203 patients were infected by 2019-nCoV. A total of 313 patients (42.5%) experienced anxiety and thus required the intervention of psychologists. ConclusionThe COVID-19 outbreak has affected the medical treatment of children with CKD. Online consultation, medication delivery and psychological counselling are the greatest needs reported by patients and their families and could especially provide solutions for the management of low income children with CKD in remote rural areas in the context of the COVID-19 epidemic. Strengths and limitations of this studyThe study is a Multicenter Cross-section Study in the Context of a Public Health Emergency of International Concern. The study can well explore the impact of COVID-19 outbreak on the medical treatment of CKD children in China and the needs of current patients. The study explored ways to meet the medical needs of CKD children in the context of a public health emergency of international concern, which provides a method support for all countries in the world experiencing COVID-19 outbreak. The study is an exploration of the coping strategies for CKD management in China. The limitations of this study is that it is quite simple and descriptive, and many studies need to be further carried out.
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Objective:To investigate the clinical features of children with kidney diseases who developed posterior reversible encephalopathy syndrome (PRES), explore the risk factors of PRES in these children, improve the understanding of the diseases, and help early diagnosis and effective treatment of the diseases.Methods:The clinical manifestations, laboratory inspection results, magnetic resonance imaging(MRI) material as well as the prognosis of 10 children with kidney diseases complicated by PRES who were admitted to the Department of Nephrology, Xi′an Children′s Hospital from November 2016 to August 2018 were analyzed retrospectively.Results:A total of 10 children were recruited, including 1 boy and 9 girls, with the onset age ranging from 4 years and 3 months to 13 years [(8.53±3.09) years]. The diagnosed kidney diseases in these patients were primary nephritic syndrome (6 cases), lupus nephritis (1 case), Hepatitis B-related nephritis (1 case), polyarteritis (1 case) and hemorrhagic fever with renal syndrome (1 case). Eight children received corticosteroids and 4 of them received other immunosuppressants simultaneously.Nine children suffered from the infections.All of them had acute onset, and the main symptoms were hypertension (10/10 cases, 100.0%), headache and dizziness (5/10 cases, 50.0%), nausea and vomiting (5/10 cases, 50.0%), visual disturbance (3/10 cases, 30.0%) and convulsions by the ways of seizures definitely (9/10 cases, 90.0%). There was nothing positive in the examinations of the nervous system and fundus.Computer tomography examinations of 9 cases showed nonspecific low-density foci.The cranial MRI scan showed abnormal signals on the cerebral cortex of frontal lobe, parietal lobe and occipital lobe in all these 10 cases.The hyperintensities were observed on the fluid-attenuated inversion recovery sequences of all the 10 cases.Slight hyperintensities on diffusion-weighted images of 4 cases indicated that PRES progressed from reversible angiogenic edema to irreversible cytotoxic edema, meaning a poor prognosis.After blood purification treatment and reducing intracranial pressure, these 4 cases recovered.After timely treatment upon PRES diagnosis, patients had no recurrence and showed a good outcome.Conclusions:Children with kidney diseases and PRES also suffer from hypertension, and the treatment with immunosuppressive agents may precede the occurrence of PRES.Cranial MRI is important for the diagnosis of PRES.
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Objective@#To study serum zinc level in pregnancy and umbilical cord blood and their association with newborn birth weight.@*Methods@#Pregnant women accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. The follow up was conducted during their first, second and third trimesters of pregnancy and the self-designed questionnaire was used to collect information of social and demographic characteristics. Blood samples in the first, second pregnancy period and umbilical cord blood samples were collected and serum concentrations of zinc were assayed. 3 239 mother-infant entered the final analysis. We divided serum zinc level into low (<P25), medium (P25-P75) and high (>P75) groups according to their exposure concentrations at each trimesters. Non-conditional multivariate logistic regression model was conducted to evaluate the association between serum zinc level in first, second trimesters of pregnancy and umbilical cord blood with small for gestational age (SGA) and large for gestational age (LGA).@*Results@#Serum zinc level in P50 (P25-P75) during the first, second trimesters and cord blood were 1 016.18 (907.09-1 145.60), 813.36 (732.47-897.89) and 903.44 (808.71-1 015.64) μg/L, respectively. The prevalence of zinc deficiency during the first, second trimesters and cord blood were 1.5% (44/2 957), 15.9% (492/3 087) and 6.5% (176/2 707), respectively. The prevalence of total SGA and LGA were 9.7% (313/3 239) and 16.5% (536/3 239), respectively. Compared to high-level serum zinc group, the risk of SGA (OR (95%CI) in low-level serum zinc group during first trimesters was 1.51 (1.05-2.19)). Serum zinc level among second pregnancy period and umbilical cord blood had no statistically significant effect on SGA and LGA (both P values >0.05).@*Conclusion@#Zinc nutritional status of pregnant women in Ma'anshan city was at a good level. The low serum zinc level in first trimester increased the risk of SGA.
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Objective To investigate the relationship of thallium exposure and outcomes of births.Methods A total of 3 236 mothers who had visited in Ma'anshan Maternal and Child Health-Care Hospital between May 2013 and September 2014 were included in this study and their thallium concentrations measured from samples of maternal and umbilical cord blood by inductively coupled plasma mass spectrometry.The results were correlated and evaluated with birth outcomes of the infants,using the multiple linear regression method.Results The median (P25-P75) of thallium levels in first trimester,second trimester and umbilical cord blood were 61.7 (50.8-77.0),60.3 (50.8-75.2) and 38.5 (33.6-44.1) ng/L,respectively.After adjustment for potential confounders,the thallium levels showed an inversely significant association with birth head circumference (unstandardized β coefficient=-0.41,95％ CI:-0.76--0.06) in thc first trimester blood,and associated with reduced birth length (unstandardizedβ coefficient=-0.65,95％ CI:-1.25--0.05) in umbilical cord blood.However,there appeared no significantly associations with birth weight,length and head circumference (P＞0.05) in second trimester.On stratification by sex,in girls but not in boys,the thallium levels were adversely associated with birth head circumference (unstandardized β coefficient=-0.53,95％ CI:-1.05--0.01) in the first trimester and were associated with decreased birth weight (unstandardized β coefficient =-277.08,95％CI:-485.13--69.03) and length (unstandardized β coefficient=-1.39,95％CI:-2.26--0.53) in umbilical cord blood thallium.Conclusions Thallium exposure appeared a gender difference in newborn birth outcomes.In the first trimester,it was negatively associated with the birth head circumference,in the umbilical cord blood,and reduced birth weight and length in girls.
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Objective To investigate the relationship of thallium exposure and outcomes of births.Methods A total of 3 236 mothers who had visited in Ma'anshan Maternal and Child Health-Care Hospital between May 2013 and September 2014 were included in this study and their thallium concentrations measured from samples of maternal and umbilical cord blood by inductively coupled plasma mass spectrometry.The results were correlated and evaluated with birth outcomes of the infants,using the multiple linear regression method.Results The median (P25-P75) of thallium levels in first trimester,second trimester and umbilical cord blood were 61.7 (50.8-77.0),60.3 (50.8-75.2) and 38.5 (33.6-44.1) ng/L,respectively.After adjustment for potential confounders,the thallium levels showed an inversely significant association with birth head circumference (unstandardized β coefficient=-0.41,95％ CI:-0.76--0.06) in thc first trimester blood,and associated with reduced birth length (unstandardizedβ coefficient=-0.65,95％ CI:-1.25--0.05) in umbilical cord blood.However,there appeared no significantly associations with birth weight,length and head circumference (P＞0.05) in second trimester.On stratification by sex,in girls but not in boys,the thallium levels were adversely associated with birth head circumference (unstandardized β coefficient=-0.53,95％ CI:-1.05--0.01) in the first trimester and were associated with decreased birth weight (unstandardized β coefficient =-277.08,95％CI:-485.13--69.03) and length (unstandardized β coefficient=-1.39,95％CI:-2.26--0.53) in umbilical cord blood thallium.Conclusions Thallium exposure appeared a gender difference in newborn birth outcomes.In the first trimester,it was negatively associated with the birth head circumference,in the umbilical cord blood,and reduced birth weight and length in girls.
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Objective To explore the risk factors of Mycoplasma pneumoniae pneumonia ( MPP ) combined with mucous plug in children. Methods A retrospective analysis was carried out on the clinical data of one hundred and forty-nine patients with MMP who received fiber bronchoscope from September 2013 to September 2016. Based on the airway mucosal lesions seen through the bronchoscope,patients were divided into two groups:the mucous plug group( 82 cases) and the control group( 67 cases) . The risk factors of mucous plug in MMP children were analyzed through single factor and multifactor analysis. Area under curve ( AUC ) was calculated according to receiver operator characteristic ( ROC ) curve to evaluate the diagnostic value of independent risk factor. Results The result of univariate analysis showed that,in the mucous plug group,the age was (5.88±2.01)ages,pleural effusion cases was 64.63％,febrile course was (10.65±2.87)d,CRP was (50. 99±20. 23) mg/L,serum LDH was (429. 94±160. 28)U/L,significantly higher than those in the control group ( age(5. 12±2. 15)ages,pleural effusion cases was 28. 36％,febrile course was(8. 97±3. 01)d,CRP was (20. 89±9. 98) mg/L and serum LDH was(300. 12±125. 14)U/L),the differences were statistically significant (P<0. 05) . Multiple factors analysis showed that age of onset, febrile course, CRP, serum LDH were the independent risk factors, the differences were statistically significant ( 95％CI= 2. 054 ～ 18. 305, 1. 539 ～21. 778,1. 159 ～ 24. 565,1. 883 ～ 9. 469,P<0. 05) . . ROC curve analysis indicated that the AUC of CRP and LDH was 0. 897,0. 829,respectively. Conclusion Old age,long febrile course,and high level of CRP and LDH are the independent risk factors for the mucous plug formation in MPP children. The diagnostic value of CRP is higher than that of LDH. Monitoring these factors can help the doctor determine whether the patient need do bronchoscope without delay and prevent the formation of mucous plug and improve the prognosis.
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Objective:To explore the clinical effect of mycophenolate mofetil combined with glucocorticosteroid on the children with anaphylatic purpura nephritis.Methods:70 cases of children treated and diagnosed as anaphylatic purpura nephritis in our hospital from March,2012 to September,2015 were enrolled in this study.They were randomly divided into the observation group and the control group.Conventional therapy was applied to both groups,the observation group was treated by mycophenolate mofetil combined with prednisone,the control group was given cyclophosphamide combined with prednisone.The total effective rate,disappearence time of clinical symptoms,biochemical indicators,immune function as well as the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 94.29％,which was 85.17％ in the control group,no statistical difference was found between two groups(P＞0.05).After therapy,the disappearence time of albuminuria,hematuria in observation group showed no significant difference compared with those of the control group,the level of 24 h urine protein quantitation and CD19+ of both groups were significantly decreased,and the level of CD19+ of observation group was significantly lower than that of the control group (P ＜0.05),the level of albumin,total protein and CD3+,CD3+CD4+ of both groups were significantly increased,and the level of CD3+,CD3+CD4+of observation group were significantly higher than those of the control group (P＜0.05).The incidence of adverse reactions in observation group was significantly lower than that of the control group (P ＜0.05).Conclusion:Mycophenolate mofetil combined with glucocorticosteroid was more effective and safe on the children with anaphylatic purpura nephritis than that of cyclophosphamide combined with prednisone.
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Objective To explore the clinical feature of Kimura disease complicated with nephrotic syndrome in children. Methods The clinical data from 4 children with Kimura disease complicated with nephrotic syndrome were retrospectively analyzed. Results In all of the 4 male children, level of serum IgE was increased but level of eosinophils was not increased in peripheral blood. The renal pathological manifestations were different among them. Two cases had acute tubular injury, one case had pathological changes in repeated renal biopsy, and one case had a little of eosinophils infiltration in renal interstitium. All of them were sensitive to oral hormone treatment. Except that one case had no relapse yet in short follow-up period, the other 3 cases had relapsed and all manifested as positive urinary protein without lymphadenectasis. The 3 cases with recurrence were treated by combined immunosuppressive agents, the palindromia of two cases were reduced which were combined with tacrolimus. Conclusion The Kimura disease complicated with nephrotic syndrome in children has a long course and different renal pathological manifestations. It is sensitive to hormone treatment but easy to relapse, and the treatment should be combined with immunosuppressive therapy. Tacrolimus may have the effect on reducing relapse and delaying the progress of renal pathology.
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Objectives To investigate the effects of phytosterol intensive diet intervention on blood glucose, blood lipid and liver function in patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease(NAFLD). Methods Patients with NAFLD admitted to the department of endocrinology, the Affiliated Hospital of Jiangsu University from January 2016 to June 2016 were recruited.We divided the groups according to the order of patient admission,with patients admitted from January to March who received conventional diabetes mellitus low-fat diet enrolled as control group,and patients admitted from April to June received extra phytosterol intensive diet on the basis of conventional diabetes mellitus diet as treatment group. The changes of blood glucose, blood lipid and liver function between two groups with a follow-up of six months before and after intervention were compared and analyzed. Results After intervention,the levels of fasting blood sugar(FPG)and blood glucose(2hPG), glycosylated hemoglobin (HbA1c), cholesterol (TG), triglyceride (TC), alanine aminotransferase (ALT) of patients in control group(11.13 ± 3.17)mmol/L,(18.65 ± 6.21)mmol/L,(9.82 ± 1.69)%,(2.81 ± 1.43) mmol/L、(5.40 ± 1.14)mmol/L,77.27%(51/66),which were lower than those before intervention((8.51 ± 2.83)mmol/L,(10.39 ± 3.62)mmol/L,(7.78 ± 1.46)%,(2.18 ± 1.13)mmol/L,(4.99 ± 1.04)mmol/L, 90.91%(60/66),P<0.05,and FPG,2 hPG,HbA1c,TG,TC,LDL-C,ALT and aspartate aminotransferase (AST) in the experimental group were(11.32 ± 3.64)mmol/L,(20.09 ± 4.83)mmol/L,(9.70 ± 2.12)%, (2.68 ± 1.74)mmol/L,(5.16 ± 1.10)mmol/L,(3.18 ± 0.92)mmol/L,(70.27)%(52/74),(86.49)%(64/74), which were significantly lower than those before intervention((7.37 ± 2.08)mmol/L,(9.20 ± 3.35)mmol/L, (6.75 ± 0.99)%,(1.86 ± 1.13)mmol/L,(4.69 ± 1.06)mmol/L,(2.67 ± 0.72)mmol/L, 91.89%(68/74), 98.65%(73/74), P<0.05, and the differences was statistically significant(t=4.584,9.329,7.349,2.823, 2.140,χ2=4.587, P<0.01 or 0.05 in control group;t=8.106,15.715, 10.826,3.393,2.651,3.755,P<0.01 in experimental group). The levels of FPG, 2 hPG and HbA1c were significantly lower in the experimental group compared with those in control group after intervention(P<0.05),and the positive-to-negative rate of fatty liver were found to be significantly higher (33.8%,25/74) than that (9.1%,6/66) in controls(P<0.05).There were not significantly differences in the level of TG,TC,high density lipoprotein(HDL-C), LDL-C, ALT and AST between the control group and experimental group(P>0.05). Conclusions Phytosterol intensive diet intervention can effectively reduce LDL-C,AST and the blood glucose level of type 2 diabetes patients with NAFLD, improving the positive-to-negative rate of fatty liver. Phytosterol intensive diet intervention can effectively reduce LDL-C, AST and the blood glucose level of type 2 diabetes patients with NAFLD,improve the positive-to-negative rate of fatty liver.
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Objective To explore the effect of the improved abdominal rotation card method in insulin injection. Methods A total of 100 hospitalized diabetes patients were randomly divided into control group (n=50) and observational group (n=50) according to the random number method. In the control group, insulin was injected to the subcutaneous tissue of abdomen with traditional method annular rotating method. Insulin was injected using improved abdominal rotation card method in the observational group. Compare accuracy and mastery rate of injection site rotation between the two groups. Compare fasting blood glucose (FBG), postprandial 2H blood glucose (PBG), HbA1c, the incidence of hypoglycemia and endermic induration between the two groups after three months. Results The nurses in the observation group had higher accuracy rate of the injection site rotation compared to the control group [98.6%(690/700) vs. 38.6%(270/700),χ2=584.66, P<0.01]. Mastery rate of the injection site rotation for the patients in the observation group were significantly higher than the control group [70.0% (35/50) vs. 20.0% (10/50), χ2=25.74, P < 0.01]. The incidence of endermic induration were significantly lower in observation group compared to the control group [2.0% (1/50) vs.16.0% (8/50), χ2=5.98, P < 0.01]. The incidence of hypoglycemia were significantly lower in observation group compared to the control group [4.0%(2/50) vs. 16.0%(8/50),χ2=4.00, P<0.01]. Conclusions The new abdominal rotation method in insulin injection can be a safe and effective therapy in patients with type 2 diabetes.
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Objective The purpose of this study was to investigate the effect of a dietary modification intervention model applied by ward nurse on change of dietary behavior among patients with type 2 diabetes mellitus (T2DM).Methods A total of 80 participants were divided into intervention patients (n=40) and control subjects (n=40) by random number table.Except lecture-based diabetes educational which was applied for control subjects,a dietary modification intervention model was conducted in intervention patients for a period of two weeks.The intervention program consisted of evaluating an individual's stage of change after being provided dietary information regarding kind of food and portions,discussion with a role model,and keeping a food diary record.Body mass index (BMI),waist-hip ratio (WHR),fasting plasma glucose (FPG),postprandial 2-h plasma glucose (2hPG),glycosylated hemoglobin (HbAlc) and score of healthy eating behavior were measured at initial and six months later.Results Compared with control group,BMI,WHR,FPG,2hPG,HbA1c in intervention group were significantly decreased,P ＜ 0.01 or 0.05.After six months intervention,FPG,2hPG and HbA1c in both groups were significantly decreased compared with baseline levels,P＜ 0.01.Compared with control group,the scores of healthy eating behavior in intervention group were significantly decreased,P＜ 0.05.After six months intervention,the scores of healthy eating behavior in both groups were significantly elevated,P ＜ 0.01,compared with baseline levels.Conclusions This study yielded evidence for the benefits of using the dietary modification intervention model as a framework in healthy eating behavior among patients with T2DM.
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Objective:To study the effect of different dose of persicae semen extract extract(PSE) to barrier function of the intestinal mucous membrane and immunologic function in acute pancreatitis rats.Methods:A total of 48 rats were divided into model control group,low dose,medial dose and high dose PSE groups,and there were 12 rats in each group.Another 12 rats were Sham-operation group.After anesthesia recovery,rats in low dose,medial dose and high dose PSE groups respectively received PSE 0.12 g/kg,0.248 g/kg and 0.36 g/kg,and rats in Sham-operation group and model control group receive isovolumetric distilled water,once per 6 h,4 times in 24 hours.All rats were anesthetized by 10%chloral hydrate after in 24th hour after dosing.Thorax and enterocoelia were opened; 5 ml of blood were respectively drawed to EDTA-anticoagulation tube and un-anticoagulation tube from aorta abdominalis.CD4+, CD8+and Treg cells were determined by direct fluorescent-labelded flow cytometry.IgA, IgG and IgM were determined by immunoturbidimetry.Serum amylase was determined by EPS-G7 substrate,D-lactic acid was determined by enzymology, and serum diamine oxidase was determined by active ration of colorimetry method.Pathological examination of small intestine mucous membrane tissue was taken after HE staining.sIgA in small intestine was determined by radioimmunoassay.mRNA of TLR4 and NF-κBp65 in small intestine tissue was determined by RT-PCR.Results:(1) Serum amylase,D-lactic acid and diamine oxidase in medial dose and high dose PSE groups were significantly decreased ( P<0.01 ) , and sIgA in small intestine was significantly increased ( P<0.01).These indicators were significantly different in medial dose and high dose PSE groups(P<0.01).(2) CD4+and CD4+/CD8+in medial dose and high dose PSE groups were significantly increased(P<0.01),and CD8+,Treg cells were significantly decreased(P<0.01) compared with those in low dose PSE group.These indicators were significantly different in medial dose and high dose PSE groups(P<0.01).(3) IgA,IgG and IgM in medial dose and high dose PSE groups were significantly decreased(P<0.01) compared with those in low dose PSE group.These indicators were significantly different in medial dose and high dose PSE groups(P<0.01).(4) Small intestine mucous membrane tissue in Sham-operation group was not damaged significantly,but that in model control group was damaged significantly.Small intestine mucous membrane tissue in low dose PSE group was similar to that in model control group,and damage in medial dose and high dose PSE groups was decreased significantly.( 5 ) mRNA of TLR4 and NF-κBp65 in small intestine tissue in medial dose and high dose PSE groups were significantly increased ( P<0.01 ) compared with those in low dose PSE group.These indicators were significantly different in medial dose and high dose PSE groups ( P<0.01 ).Conclusion: PSE has protective effect to barrier function of the intestinal mucous membrane,and significantly improve the immunologic function.
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Objective:To describe the epidemiological characteristics of mental disorders in community resi-dents aged 18 years and over in the Chifeng City of Inner Mongolia Autonomous Region.Methods:Six thousand three hundred and seventy six individuals aged 18 years and over were sampled using stratified Probability-Propor-tional-to-Size Sampling in Chifeng City in 2010.All respondents were investigated by face-to-face interview.The Composite International Diagnostic Interview-3.0 Computer Assisted Personal Interview (CIDI-3.0-CAPI)was used to make diagnoses based on the definition and criteria of the Diagnostic and Statistical Manual of Mental Dis-orders,Fourth Edition (DMS-IV).Results:A total of 4528 subjects completed the CIDI-3.0-CAPI.Regarding anxi-ety disorder,mood disorder,substance use disorder,and impulse control disorder,the 30-day adjusted prevalence rates (95%CI)were 2.5%(2.08% -2.99%,0.9%(0.67% -1.23%),0.5%(0.34% -0.76%),and 0.6%(0.41% -0.86%)respectively,and the 12 -month prevalence rates were 4.5% (3.93% -5.15%),2.4%(2.0% -2.90%),1.1% (0.84% -1.45%),and 1.0% (0.74% -1.32%)respectively.The lifetime adjusted prevalence rates were 6.6% (5.92% -7.36%),6.5% (5.81% -7.24%),2.7% (2.26% -3.21%),and 1.4%(1.23% -1.95%)respectively.Conclusion:According to morbidity,anxiety disorders,mood disorder,substance use disorders and impulse control disorders are common in Chifeng City of Inner Mongolia Autonomous Region se-quencely,being a prominent public health problem.
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Objective: To evaluate the post-operative mortality of left ventricular end-diastolic pressure (LVEDP) during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: We retrospectively analyzed 255 patients with new onset of STEMI who received primary PCI in our hospital and all patients received LVEDP measurement before coronary artery opening. According to LVEDP value, the patients were divided into 2 groups: LVEDP≤14 mmHg group,n=155 and LVEDP>14 mmHg group,n=100. The post-operative mortality up to 6 months was observed, and the effect of LVEDP on death rate was studied by Cox regression analysis. Results: Compared with LVEDP≤14 mmHg group, the patients in LVEDP>14 mmHg group had the 6 months mortality at HR=4.26, 95% CI (1.13-16.08),P=0.03. Relevant study presented that LVEDP was slightly related to LVEF (r=-0.267, P=0.001) and BNP (r=-0.154,P=0.041). Multi-regression analysis indicated that with adjusted LVEF and BNP, LVEDP was the independent predictor for post-operative mortality up to 6 months in acute STEMI patients after PCI. Conclusion: The LVEDP value measured during PCI procedure is the independent predictor for mortality after PCI in patients with new onset of STEMI.
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Objective To evaluate the outcome of ST-segment elevation myocardial infarction (STEMI) patients received different reperfusion therapies. Methods The 238 consecutive STEMI patients were enrolled from February 2012 to December 2012. According to the current guideline of PCI and the choice of patients, the patients were divided into the groups of percutaneous coronary intervention (PCI), ifbrinolysis, and conservative medication. The major adverse cardiac events (MACE) was analyzed in a follow up of 6 months. Results (1) The enrolled patients included the 210 patients received PCI (88.2%), 14 patients received fibrinolysis (5.9%) and 14 patients received conservative medication (5.9%).The Median time of D2B was 110minutes.(2) The rate of late stent thrombosis was signiifcant higher in BMS than DES (n=2, 2.8%vs 0, P < 0.05) . (3) The PCI group had a signiifcantly higher incidence of stroke than the ifbrinolysis group and the conservative medication group (1.0%vs 0, P < 0.05;1.0%vs 0, P<0.05). (4) The PCI group had a signiifcantly higher incidence of bleeding compared to the thrombolysis group and the medication group (1.0% vs 0, P < 0.05; 1.0% vs 0%, P < 0.05). Conclusions The majority of STEMI patients received PCI;The D2B time, which was required<90 minutes in guideline of PCI, was found delayed in our study;Compared to ifbrinolysis and conservative medication, PCI showed better clinical outcomes of STEMI patients.
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Objective To investigate the correlation between serum epidermal growth factor,hepatocyte growth factor and acute pancreatitis severity or prognosis,and to provide the basis for acute pancreatitis clinical diagnosis and treatment.Methods A total of 112 patients with acute pancreatitis (AP) were selected,and they were divided into mild acute pancreatitis (MAP) group (n =66) and severe acute pancreatitis (SAP) group (n =46) according to severity.The patients in two groups were treated with conventional therapy.The levels of serum epidermal growth factor (EGF) and hepatocyte growth factor (HGF) in two groups were observed.The correlation analysis was performed with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score.The complications of patients in two groups were compared.Results The levels of serum EGF and HGF in MAP group and SAP group were significantly higher than those in control group,while they in SAP group were significantly higher than those in MAP group (P ＜ 0.01).The APACHE Ⅱ scores of MAP and SAP groups were (5.4 ± 1.6) ％ and (9 ±2.9) ％,and the APACHE Ⅱ score was positively related to serum EGF and HGF levels (P =0.00).The infection,abscess,necrosis,acute lung injury,or the incidence of ARDS in SAP Group were higher than that in MAP group (P ＜ 0.01).Conclusions AP severity and prognosis were related to patient's serum HGF and EGF levels.Therefore,early and timely monitoring changes of HGF,EGF,and HGF had a certain clinical value to assess condition and prognosis,and EGF had a strong tissue repair and regeneration functions,which might provide a new way to clinical treatment.
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Objective To investigate the changes of autonomic nerve function of coronary heart disease (CHD) patients with panic disorder(PD). Methods All the subjects who met with the diagnostic code of CHD and PD were divided into CHD group(n=40) ,PD group(n=36) ,comorbid CHD and PD group(n=27) ,and 40physical examinee were recruited as normal control group. They had a 24 hours Holter ECG monitoring by time and frequency domain analysis of heart rate variability. ANOVA analysis was utilized to statistic the collected data. Results Compared with normal controls,the patients of others groups had every indexs of HRV were reduced. The indexs of HRV of comorbid CHD and PD were lower than the patients of CHD or PD group. The score of time domain SDNN(70.40 ± 14.74)ms,SDANN(91.72 ± 24.46)ms,PNN50(2.83 ±2.07)%, RMSSD( 15.66 ±7.45)ms,frequency domain LF(647.54 ± 129.24)ms2, HF(596. 16± 127.66) ms2 in comorbid CHD and PD. There were significant differences with others groups(P ＜ 0.05 ). Conclusion The autonomic nervous functional of the patients with CHD and PD were in disorder. The autonomic nervous functional disorder of the patients with comorbid CHD and PD was more severe.
