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Objective@#To understand anxiety symptoms among medical college students and their relationship with social ecological risk factors, so as to provide reference for mental health promotion among medical students.@*Methods@#From September to October 2021, a convenient cluster sampling method was used to include 1 274 freshmen to senior students of a medical school in Taiyuan City, and the Generalized Anxiety Disorder-7 and adolescent social ecological risk factors assessment questionnaire were used. Multivariate binary Logistic regression was used to analyze the association between anxiety symptoms and social ecological risk factors among medical students.@*Results@#The overall detection rate of anxiety symptoms among medical students was 16.2%. The rate of anxiety varied significantly by grade (freshman: 19.9%, sophomore: 13.0%, junior: 14.0%, senior: 18.9% ) and number of friends (≤2: 22.8%, 3-5: 14.4%, ≥6: 11.8%) ( χ 2=8.70, 16.34, P <0.05). Spearman correlation analysis showed that individual, family, school, community, policy, culture, time, and total score in socio ecological risk factors were positively associated with anxiety symptom scores at different levels of risk ( r=0.33, 0.25, 0.32, 0.16, 0.15, 0.16, 0.16, 0.35, P <0.01). Logistic regression analysis showed that high risk for personal dimension of the socio ecological risk factors was positively associated with rate of anxiety symptoms among medical students ( OR=3.32, 95%CI =1.66-6.61), and remained positively associated ( OR=2.98, 95%CI =1.49-5.94) after adjusting for grade and number of friends ( P <0.01).@*Conclusions@#Exposure to high personal dimensions of socio ecological risk factors increases the risk of developing anxiety symptoms among medical students. A focus should be placed on the personal factors associated with anxiety to promote medical students mental health.
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Objective Explore the key factors and the type of combined role path of medical accident appraisal con-clusion for the medical responsibility,and provide solution countermeasures for the reduction of medical accidents and the construction of a harmonious doctor-patient relationship.Methods Qualitative comparative analysis(QCA)was used to study 125 cases of medical accident appraisal center in a certain province from 2015 to 2019.The fsQCA software was used to detect the necessity of single factor and the configuration path of multiple factors.Results There were three solutions to the configuration of medical liability for medical accidents,with an solution consisten-cy of 0.853 659 and an overall coverage rate of 0.603 448;draw three paths for the conclusion of medical liability,and summarize three types of combined effects:medical institution management vacancy type,medical staff techni-cal negligence type,and comprehensive effect type of both doctors and patients.Conclusion Attaching importance to institutional management is the basis for evading medical liabilities,standardizing medical staff's diagnosis and treatment behavior is the core to reduce medical accidents,and strengthening humanistic concepts and doctor-pa-tient communication are the key to prevent medical accidents.
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Platelets not only have hemostatic function, but can also directly or indirectly recognize pathogenic microorganisms and the signals they produce to capture and destroy them through membrane receptors. They can collaborate with various components of the body's immune system by releasing of intraplatelet particulate matter, cytokines and chemokines to perform bactericidal functions. And it can also play a bactericidal role by swallowing pathogens, releasing antimicrobial proteins and chemokines and activating and enhancing other specialized anti-inflammatory cells bactericidal effect, such as leukocytes and so on. However, the bacteriostatic composition and bacteriostatic mechanism of platelets remain unclear, so attention should be paid to the immune mechanism and bacteriostatic effect of platelets.
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Blood Platelets , Anti-Bacterial Agents/pharmacology , Cytokines , Leukocytes , Particulate MatterABSTRACT
When nanoparticles were introduced into the biological media, the protein corona would be formed, which endowed the nanoparticles with new bio-identities. Thus, controlling protein corona formation is critical to
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OBJECTIVE@#To explore the inhibitory effects of silencing long non-coding RNA (LncRNA) HIF1A-AS2 on epithelialmesenchymal transition (EMT) and tumor stem cell-like phenotype in cervical cancer cells.@*METHODS@#We designed 3 shRNA constructs for silencing HIF1A-AS2 in CaSki cells, and the shRNA with the strongest interference effect was selected for subsequent experiment. CaSki cells were transfected with shRNA-NC or Sh-HIF1A-AS2, and the changes in cell viability, invasion ability, EMT, expressions of EMT-related proteins, formation of cell spheres and expressions of stem cell markers were detected.@*RESULTS@#Transfection with shRNA-NC and Sh-HIF1A-AS2 did not significantly affected the viability of CaSki cells (@*CONCLUSIONS@#Silencing HIF1A-AS2 can inhibit proliferation, invasion and migration of cervical cancer cells
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Female , Humans , Cell Line, Tumor , Cell Movement/genetics , Cell Proliferation/genetics , Epithelial-Mesenchymal Transition/genetics , Gene Expression Regulation, Neoplastic , Hypoxia-Inducible Factor 1, alpha Subunit , RNA, Long Noncoding/genetics , RNA, Small Interfering/genetics , Uterine Cervical Neoplasms/geneticsABSTRACT
Objective@#To study the effects of patient-controlled intravenous analgesia(PCIA) with Dexmedetomidine, Ropivacaine by local incision infiltration and combined analgesia on inflammatory factors and rapid rehabilitation in infants aged 3-6 months after radical resection of megacolon.@*Methods@#From June 2016 to March 2018, 90 infants aged 3-6 months underwent radical resection of megacolon in Henan Provincial Children′s Hospital as the subjects.According to the postoperative analgesia mode applied to the children, they were divided into Dexmedetomidine group, Ropivacaine group and combined group (Dexmedetomidine PCIA combined with local infiltration of Ropivacaine), 30 cases in each group.The serum levels of interleukin(IL)-6 and IL-10 were measured and recorded 2 hours before operation and 24 hours after operation, and the analgesic scores of 4, 8, 12 and 24 hours after operation were recorded.The rapid recovery index of each group, standard and the number of complications were compared.@*Results@#Compared with 2 hours before operation, the serum levels of IL-6 in the Dexmedetomidine group, Ropivacaine group and combined group [(24.61±1.44) ng/L vs.(13.84±0.65) ng/L, (26.39±1.29) ng/L vs.(13.85±0.67) ng/L, (20.58±2.06) ng/L vs.(13.87±0.63) ng/L], IL-10[(27.63±1.52) ng/L vs.(15.79±1.48) ng/L, (28.29±2.34) ng/L vs.(15.41±1.37) ng/L, (23.21±2.71) ng/L vs.(15.47±1.52) ng/L] were significantly higher (all P<0.05), while the levels of IL-6, IL-10 in combined group were lower than those in Dexmedetomidine group and Ropivacaine group (ta=9.172, 9.835; tb=10.221, 11.034, all P<0.05). At 4 h, 8 h, 12 h, 24 h after operation.The analgesic scores in combined group were(1.89±0.23) scores, (1.87±0.15) scores, (1.95±0.17) scores, (2.08±0.18) scores, those of dexmedetomidine group were(2.06±0.24) scores, (2.08±0.18) scores, (2.76±0.29) scores, (2.55±0.31) scores, those of Ropivacaine group were(2.10±0.26) scores, (2.15±0.26) scores, (2.32±0.19) scores, (3.00±0.28) scores, and the analgesic scores in combined group were significantly lower than those in Dexmedetomidine group and Ropivacaine group(ta=8.526, 9.364, 10.287, 9.521; tb=8.729, 9.514, 11.037, 9.184, all P<0.05). In comparison with the first exhaust time, anal extubation time, hospitalization days, hospitalization expenses and antibiotic use time in the three groups, it was found that combined group was significantly better than Dexmedetomidine group and Ropivacaine group(ta=8.315, 8.294, 7.883, 9.261, 10.487; tb=8.582, 8.329, 7.916, 9.348, 10.862, all P<0.05). The incidence of complications in the combined group, Dexmedetomidine group, and Ropivacaine group were not significantly different in 3 groups(χ2=0.577, P=0.749).@*Conclusions@#The continuous anesthesia of Dexmedetomidine combined with local infiltration of Ropivacaine incision can alleviate the postoperative inflammatory reaction and promote the rapid recovery of children.
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Objective To study the effects of patient-controlled intravenous analgesia( PCIA)with Dexme-detomidine,Ropivacaine by local incision infiltration and combined analgesia on inflammatory factors and rapid rehabili-tation in infants aged 3-6 months after radical resection of megacolon. Methods From June 2016 to March 2018,90 infants aged 3-6 months underwent radical resection of megacolon in Henan Provincial Children's Hospital as the sub-jects. According to the postoperative analgesia mode applied to the children,they were divided into Dexmedetomidine group,Ropivacaine group and combined group( Dexmedetomidine PCIA combined with local infiltration of Ropiva-caine),30 cases in each group. The serum levels of interleukin( IL)-6 and IL-10 were measured and recorded 2 hours before operation and 24 hours after operation,and the analgesic scores of 4,8,12 and 24 hours after operation were recorded. The rapid recovery index of each group,standard and the number of complications were compared. Results Compared with 2 hours before operation,the serum levels of IL-6 in the Dexmedetomidine group,Ropiva-caine group and combined group[(24. 61 ± 1. 44)ng/L υs.(13. 84 ± 0. 65)ng/L,(26. 39 ± 1. 29)ng/L υs.(13. 85 ± 0. 67)ng/L,(20. 58 ± 2. 06)ng/L υs.(13. 87 ± 0. 63)ng/L],IL-10[(27. 63 ± 1. 52)ng/L υs.(15. 79 ± 1. 48) ng/L,(28. 29 ± 2. 34)ng/L υs.(15. 41 ± 1. 37)ng/L,(23. 21 ± 2. 71)ng/L υs.(15. 47 ± 1. 52)ng/L]were signifi-cantly higher(all P<0. 05),while the levels of IL-6,IL-10 in combined group were lower than those in Dexmedeto-midine group and Ropivacaine group(ta =9. 172,9. 835;tb =10. 221,11. 034,all P<0. 05). At 4 h,8 h,12 h,24 h after operation. The analgesic scores in combined group were(1. 89 ± 0. 23)scores,(1. 87 ± 0. 15)scores,(1. 95 ± 0. 17)scores,(2. 08 ± 0. 18)scores,those of dexmedetomidine group were(2. 06 ± 0. 24)scores,(2. 08 ± 0. 18) scores,(2. 76 ± 0. 29)scores,(2. 55 ± 0. 31)scores,those of Ropivacaine group were(2. 10 ± 0. 26)scores,(2. 15 ± 0. 26)scores,(2. 32 ± 0. 19)scores,(3. 00 ± 0. 28)scores,and the analgesic scores in combined group were signifi-cantly lower than those in Dexmedetomidine group and Ropivacaine group( ta =8. 526,9. 364,10. 287,9. 521;tb =8. 729,9. 514,11. 037,9. 184,all P<0. 05). In comparison with the first exhaust time,anal extubation time,hospitali-zation days,hospitalization expenses and antibiotic use time in the three groups,it was found that combined group was significantly better than Dexmedetomidine group and Ropivacaine group(ta =8. 315,8. 294,7. 883,9. 261,10. 487;tb =8. 582,8. 329,7. 916,9. 348,10. 862,all P<0. 05). The incidence of complications in the combined group,Dexme-detomidine group,and Ropivacaine group were not significantly different in 3 groups( χ2 = 0. 577,P = 0. 749 ). Conclusions The continuous anesthesia of Dexmedetomidine combined with local infiltration of Ropivacaine incision can alleviate the postoperative inflammatory reaction and promote the rapid recovery of children.
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Objective To investigate the job satisfaction of general practitioners in Beijing Chaoyang District and related influencing factors.Methods Total 500 general practitioners from 35 community health service centcrs in Chaoyang District were invited to join this web-based survey in June 2015,and valid response was obtained from 419 of them.Information on the satisfaction to their career,income and practicing environment were collected.Factors associated with job satisfaction were analyzed using Chi-square test and logistics regression respectively,before and after adjustment of common confounders.Results Among 419 responders,there were 296 females (70.6%) and 123 males (29.4%) with a median age of 38 years old and median working duration of 15 year;297 (70.9%) of them had college degree or above;185 (44.2%) of them saw > 120 patients per week and 227 (54.2%) of them worked >40 hour per week;179 (42.7%) of the responders worked at the outpatient clinics;180 (43.0%) of them were planning for further education in the next 5 years;311 (74.2%) of the responders were satisfied with their career,while only 124 (29.6%) of them were satisfied with their income,and 206 (49.2%) were satisfied with the practice environment.The multivariate logistic regression showed that age >40 year (OR =2.20,95% CI:1.33-3.61),working < 40 hours per week (OR =2.70,95% CI:1.67-4.36),and planning for further education in the next 5 years (OR =2.21,95% CI:1.35-3.63)were positively associated with career satisfaction;> 40 year old (OR =2.03,95% CI:1.28-3.21),working <40 hours per week (OR =1.60,95% CI:1.04-2.46),and planning for further education in the next 5 years (OR =2.03,95% CI:1.28-3.22) were positively associated with satisfaction with the income;education lower than university (OR =2.14,95 % CI:1.37-3.36),seeing < 90 patients per week (OR =1.78,95% CI:1.18-2.69),working < 40 hours per week (OR =1.73,95% CI:1.15-2.59),not working at outpatient clinic (OR =1.54,95% CI:1.02-2.31) and planning for further education in the next 5 years (OR =1.75,95% CI:1.16-2.63) were significantly associated with higher satisfaction with practice environment.Most of the responders thought that there was a shortage of primary care physicians.Conclusion General practitioners are generally satisfied with their careers,but are not satisfied with their income and practice environment in Beijing Chaoyang District.
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Objective@#To investigate statin adherence and influencing factors in hyperlipidemia patients treated in community health centers.@*Method@#This study enrolled hyperlipidemia patients for whom statins were newly prescribed by doctors at 7 community health centers. Baseline and follow-up information was collected by well-trained investigators by telephone. Adherence to statins was evaluated after 3 months of follow-up.@*Results@#We included 104 hyperlipidemia patients for whom statins were newly prescribed between July and December 2017; of these, 48.1% knew about the complications of hyperlipidemia and 84.6% thought it was necessary to take lipid-lowering drugs; however, 63.5% were concerned about the side effects of these drugs. After 3 months of follow-up, 40.4% of patients had stopped taking statins, and 60.5% were nonadherent to the statin prescriptions. The analysis of influencing factors showed that hyperlipidemia history less than 6 months (OR=9.644, 95%CI: 3.214-28.943, P<0.001) and having to take more than 2 pills per day (OR=3.536, 95%CI: 1.254-9.972, P=0.017) were positively associated with cessation of statin use, while thinking it necessary to take lipid-lowering drugs (OR=0.126, 95%CI: 0.018-0.883, P=0.037) was negatively associated with cessation of statin use. Meanwhile, hyperlipidemia history for less than 6 months (OR=3.368, 95%CI: 1.283-8.847, P=0.014) was positively associated with poor statin adherence.@*Conclusion@#Poor statin adherence was observed in patients treated in community health centers. Health knowledge awareness, attitude toward chronic disease treatment, i.e., lipid-lowering treatment, and pill burden might influence statin adherence.
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Objective To evaluate the effect of interventions for improving the management of cardiovascular risk factors in general practitioners. Methods Interventions were conducted in thirty-five community health service centers in Chaoyang District of Beijing using simplified clinical pathways,clinical decision support systems, service quality evaluation index and feedback mechanism, and quality-related motivation system. The research was divided into three periods, which were indicated as before the interventions (2014.1-6), after the first intervention (2014.8-10), and after the second intervention (2014.12-2015.2), according to the community service center outpatient clinic, the computer randomly selected 2 100, 2 089 and 2 052 subjects. With the method of retrospective case review, historical case records of each selected case were extracted, and the changes in KPIs before and after interventions were evaluated.Results After two cycles of intervention,compared with before the interventions,the capability of general practitioners to record hypertension(99.9% vs.70.5%,χ2=708.9),diabetes(99.6% vs.41.5%,χ2=1691.1),hyperlipidemia(99.5% vs.37.0%,χ2=1854.9),coronary atherosclerotic heart disease(CHD)(99.6% vs. 54.3%, χ2=1190.9), and cerebral hemorrhagic stroke (99.4% vs. 39.7%, χ2=1736.2) had significantly increased (P<0.001). Records of other risk factors, for instance, height and weight (81.4% vs. 72.2%, χ2=50.3),smoking(70.0% vs.0.1%,χ2=2 179.2),and health education including recommended physical activity (75.0% vs. 68.2%, χ2=24.0) and weight control (75.4% vs. 16.2%, χ2=1 467.1) significantly increased (P<0.001). The proportion of patients with hypertension who did not use antihypertensive drugs was 31.6% before the intervention;in the first period of intervention,it reduced to 20.2%,and in the second period after the intervention it was 25.8%. Cases of CHD, stroke, diabetes, patients taking aspirin, beta blockers, angiotensin converting enzyme inhibitors(ACEI)or angiotensin receptor blockers(ARB)in proportion to the class of drugs, and statins increased (P<0.05); the coronary atherosclerosis heart disease patients with beta-blockers utility ratio was 20.2% before the intervention, and in the second cycle it was up to 27.9% after the intervention;for patients with diabetes statins utility ratio was 32.1% before the intervention,and in the second cycle it was up to 40.9% after the intervention.Conclusion Adoption and implementation of a series of interventions such as simplified clinical pathways,clinical decision support systems,service quality evaluation index and feedback mechanism, and quality-related motivation system will be beneficial to improve the capability of general practitioners to manage the cardiovascular disease risk factors,which are implied to be effective methods for managing chronic diseases.
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Objective To explore the effects of interest-induced and psychological intervention in pediatric operating room nursing.Methods Totally 150 cases of children undergoing surgery in our hospital were recruited and randomly divided into the experimental group(n=75)and the control group(n=75).The experimental group received routine care as well as interest-induced and psychological intervention in anesthesia induction room.The control group only received routine care.The children's anxiety degree,anesthesia induction cooperation and parent satisfaction were measured.Results The scores of anesthesia induction cooperation and anxiety in the experimental group were significantly lower than those in the control group (P<0.05 for both),and parent satisfaction in the experimental group was significantly higher than that in the control group(P<0.05).Conclusion The interest-induced and psychological intervention in pediatric operating room nursing can effectively alleviate preoperative anxiety,promote anesthesia induction cooperation and increase parent satisfaction.
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OBJECTIVE@#To study the expression of Cyclin D1 in nasopharyngeal carcinoma cells processed by epigallocatechin gallate(EGCG) and it's significance, and revealed the anti-tumor mechanism of EGCG against nasopharyngeal carcinoma.@*METHOD@#CNE-2 cells were treated by EGCG at different concentrations, the morphological changes of CNE-2 cells were observed by inverted microscope; the inhibition ratio of cell proliferation was detected by MTT colorimetric method, flow cytometry was used to analyze the changes of cell cycle. The expression of Cyclin D1 mRNA was detected by RT-PCR.@*RESULT@#After treated by EGCG, the CNE2 cells decreased in amount and density, some of which became roll and small; Floating and dead cells can be seen in the inverted microscopy; cell proliferation was significantly inhibited in a time and dose dependent (P < 0.05). CNE-2 cells were arrested at G1/G0 phase. The expression of Cyclin D1 mRNA was down-regulated by EGCG with concentration and action time dependent (P < 0.05).@*CONCLUSION@#EGCG resisted nasopharyngeal carcinoma by inhibiting the cell proliferation, The down regulation of Cyclin D1 mRNA expression in a time and dose dependent may be the possible mechanisms.
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Humans , Carcinoma , Catechin , Pharmacology , Cell Cycle , Cell Line, Tumor , Cell Proliferation , Cyclin D1 , Metabolism , Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms , Metabolism , PathologyABSTRACT
Objective To investigate prospectively the diagnostic significance of ulnar/median nerve amplitude ratio in motor neuron disorders.Methods Patients referral to our department between May 2009 and February 2012,due to muscle weakness,inflexible,cramps and atrophy,were consecutively enrolled.Conventional nerve conduction studies of 4 extremities (using surface electrodes) and needle electromyography were performed in all patients with fixed examiner.The compound muscle action potentials (CMAP) were recorded from abductor digiti minimi (ADM) and abductor pollicis brevis (APB) with stimulation of ulnar and median nerve at wrist,respectively.Moreover,the ratio of CMAP amplitude between ADM and APB (ADM/APB) was calculated in the patients who met the diagnostic criteria for definite amyotrophic lateral sclerosis (ALS) and Hirayama disease (HD).The patients with Guillain-Barré syndrome (GBS) and other popyneuropathies (PN) were served as case-controls,and 34 healthy volunteers (aged (45.7 ± 16.3) years) as normal-controls.Results (1) There were 78 cases with ALS,25 HD,51 GBS and 140 other PN,with the mean age(years) of 54.7 ± 11.6,17.6 ± 2.2,41.3 ± 18.4 and 57.1 ± 14.3,respectively.(2) ADM/APB in the ALS subgroup was 2.28 ±2.87 (0.12-22.38),HD0.66±0.36 (0.05-1.34),GBS 1.42 ± 1.33 (0.25-9.85),other PN 1.36 ± 1.48 (0.08-14.44) and normal-controls 1.07 ± 0.28 (0.61-1.64,F =6.872,P =0.000),respectively.(3) The areas under receiver operator characteristic curve in patients with ALS was 0.830 (s-x =0.039) and HD 0.691 (sx =0.039,P =0.000) ; the diagnostic sensitivity and specificity for ALS patients were 36.7% and 93.3%,respectively,with cutoff value of ADM/APB =2; and the diagnostic sensitivity and specificity for HD patients were 53.6% and 89.0%,respectively,with cutoff value of ADM/APB =0.7.Conclusions The ulnar/median CMAP amplitude ratio increases in ALS,but decreases in HD,which may be served as a relatively specific electrophysiological index.ADM/APB amplitude ratio > 2.0 is suggested to be a diagnostic parameter for ALS and < 0.7 for HD.
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A total of 100 patients with subacute thyroiditis hospitalized from January 2011 to October 2012 were recruited.Each received glucocorticoid treatment for 8 weeks and there was a 2-month follow-up period after drug withdrawal.After treatment,the short-term recurrence rate was 34% (34/100).If thyroid ultrasound was abnormal,the recurrence rate was 52% (30/58).And it was significantly higher than 10% recurrence rate for those with normal thyroid ultrasound (4/42,x2 =9.67,P < 0.01).The recurrence rate of different erythrocyte sedimentation rate groups of 40-100 mm/1 h and > 100 mm/1 h was 37% (22/60) and 30% (12/40) respectively (P > 0.05).
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ObjectiveTo study the change of serum interferon- γ(IFN- γ ) and interleukin-4(IL-4)level in children suffered from cough variant asthma after montelukast combined with loratadine therapy.MethodsForty-six patients of children cough variant asthma were recruited and accepted montelukast combined with loratadine therapy for 8 weeks.The changes of serum IFN-γ and IL-4 before and after therapy were compared.ResultsCompared with before therapy,the level of serum IFN- γwas decreased [ (59.94 ± 9.43) ng/L vs.(39.94 ± 9.07) ng/L ] and IL-4 was increased[ ( 48.78 ± 22.23 ) ng/L vs.(60.78 ±16.48) ng/L] after therapy,there were significant differences (P <0.05).ConclusionMontelukast combined with loratadine in the treatment of children cough variant asthma can improve the balance of IFN- γ/IL-4,which deserve further study.
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@#To analyze the relationship among ambulatory blood pressure (AMBP), ankle brachial index (ABI) and left ventricular mass index (LVMI) in hypertensive patients. Methods 578 hypertensive inpatients were reviewed. Results The general clinical dataof selected patients, their ABI, LVMI were not different significantly between male and female. The correlation analysis showed that LVMI was positively correlated with the 24-hour average systolic (r=0.245, P=0.000) or diastolic (r=0.158, P=0.000) blood pressure, whereas negatively correlated with percent of systolic (r=-0.104, P=0.012) or diastolic (r=-0.132, P=0.001) blood pressure declining at night. No significant correlation was found between LVMI and BMI. Multiple regression analysis revealed that LVMI was significant independently positive correlated with 24-hour average systolic blood pressure (P=0.000). Conclusion LVMI does not correlate with ABI, but independent positive related with 24-hour average systolic blood pressure.
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Objective To study the postoperative recovery in patients undergoing coronary artery bypass grafting (CABG)with a history of cerebral infarction.Methods From January 2007 to December 2007,112 patients undergoing elective off-pump coronary artery bypass grafting(OPCABG)with a history of cerebral infarction were studied retrospectively.Each of the 112 patients was matched with 1 control patient who had no cerebral infarction history and were undergoing an elective OPCABG either immediately before or immediately after the study patient,in most cases by the same surgeons.Preoperative characteristics,anesthesia time,awakening time,extubation time,ICU stay,hospital stay,reintubation,hospital mortality,postoperative confusion and stroke were compared in the two groups.Results There were no significant differences between the study and control Patients in the most preoperative characteristics,only the incidence of hypertension and diabetes mellitus were higher than those in control group,P<0.05(78 of 112,69.6% versus 61 of 112,54.5%;52 of 112,46.4% versus 26 of 112,23.2%).The study group took longer to awaken,extubate and stay in ICU and hospital than the control group,P<0.01[(6.4±4.0)h versus(4.6±2.7)h,(19.6±9.7)h versus(16.8±5.5)h,(27.3±16.8)h versus(22.1±10.6)h,(23.4±10.0)d versus(19.5±5.6)]d.The incidence of confusion,stroke and reintubation after operation among the study group was higher than those in control group,P<0.05(17 of 112,15.2% versus 4 of 112,6.3%;8 of 112,7.1% versus 1 of 112,0.9%;8 of 112,7.1% versus 1 of 112,0.9%),RR and 95% CI were 4.83(1.57~14.86)、8.54(1.05~69.45)and 8.54(1.05~69.45).There were no significant differences between the study and control patients in the anesthesia time and hospital mortality.Stroke after the operations was found in 8 of 112 study patients and included cerebral infarction in 6 and transient ischemic attack(TIA)in 2.The 8 patients included new stroke in 7 and worsening of old stroke in 1 without new abnomalities on head computed tomography.1 of 8 patients had early stroke(≤24 hours after operation)and others had late stroke(>24 hours).Conclusion The patients with previous cerebral infarction undergoing off-pump coronary artery bypass grafting took longer to awaken,extubate,stay in ICU and hospital.These patients were more likely to have reintubation,confusion and stroke after operation than those patients with no cerebral infarction history.
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Objective To investigate the involvement of posterior auricular muscle (PAM) and the effect of botulinum toxin type A (BTX-A) injection into PAM in patients with hemifacial spasm (HFS)complicated by auricular symptoms.Methods Sixty-three consecutive HFS patients with auricular symptoms such as tinnitus or murmur,"ticking" or a "clicking" sound and discomfort on the same side,referred to our department between July,2009 and January,2010,were enrolled,and the diagnosis of idiopathic HFS was clinically made.The patients were largely randomized into two groups according to the order of referral.One was regular group including 33 cases whose injection sites were routinely at the frontal,orbicularis oculi,zygomaticus and buccinator muscles while another was PAM group including 30 cases,in which 4 units of BTX-A was additionally injected to the PAM.Before and after injection,the test of blink reflex was performed and lateral spread of blink reflex to orbicularis oris(OO)and PAM,I.e.Abnormal muscle response(AMR),were recorded,and the peak-peak amplitude of AMR was measured.The patients were followed up clinically and electrophysiologically at least 4 weeks((29.5±2.5)days) later.Results(1)The patients reported that their auricular symptoms subsided after injection in both groups.The remission rate was 45.5%(15/33)in the regular group and 76.7%(23/30)in the PAM group,respectively,with a higher rate in the PAM group(x2=6.40,P=0.011).(2)In both groups the AMR amplitude decreased significantly after injection.In the regular group,the OO amplitudes (μV) before and after injection were 304.0±30.3 and 129.3±9.6(t =5.820,P =0.000),and PAM amplitudes,298.0±33.3 and 184.7±20.2(t=2.818,P=0.014),respectively.In the PAM group,OO amplitudes were 405.3±66.7 and 116.0±10.0(t=4.214,P=0.001),PAM amplitudes,390.0±53.6 and 72.0±9.7(t=6.011,P=0.000),respectively.(3)The decrease of PAM amplitudes in the PAM group was more significant compared with those in the regular group (t=4.237,P=0.001).Conclusions In HFS patients with auricular symptoms,the electrophysiological studies are helpful for the guidance of treatment;and the auricular symptoms could be better improved after BTX-A injection into PAM in addition to those regular injection sites.
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Objective To investigate the levels of serum retinol-binding protein 4 (RBP4) and high sensitive C reactive protein (hs-CRP) in type 2 diabetic mellitus (T2DM) patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups: normal control group (35subjects), T2DM patients with macrovascular complications group (40 subjects) and simple T2DM patients group (40 subjects). Serum RBP4 and hs-CRP was detected and fasting blood glucose(FBG), glycosylated hemoglobin A1c (HbA1c), triacylglycerol (TG), total cholesterol (TC), high density lipopretein cholesferel (HDL-C), low density lipoprotein cholesferol(LDL-C) and fasting insulin(FINS) were measured. Body mass index (BMI) and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP:(9.12±4.21),(2.01±1.96), (0.98±0.36)mg/L; RBP4:(30.70 ± 5.45), (20.02±5.32),(12.02±3.45)mg/L] (P<0.01). Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group (P<0.01). Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR (r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P<0.05 or <0.01).Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications.
ABSTRACT
Objective To investigate the levels of serum retinol-binding protein 4 (RBP4 )and related factors in type 2 diabetic patients. Methods Eighty type 2 diabetic and patients 30 non-diabetic subjects were recruited into obese-diabetic group [body mass index (BMI) 1525 kg/m~2],normal-weighted diabetic group(BMI < 25 kg/m~2)and control group(BMI < 25 kg/m~2). Serum adiponectin(APN), RBP4 and hemoglobin A_1c (HbA_1c)triacylglycerol (TG),total cholesterol (TC).high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)and were measured on fasting samples. BMI, waist/hips girth ratio (WHR) and insulin resistance index (HOMA-IR) were calculated. The correlation between RBP4 and other factors was analyzed. Results The concentration of RBP4 was significantly increased in obese-diabetic group and normal-weighted diabetic group compared with that in control group [ (30.02 ± 5.32), (20.10 ± 5.45), (12.02 ± 3.45) mg/L] (P < 0.01). The concentration of RBP4 was higher in obese-diabetic group than that in normalweighted diabetic group (P < 0.01). Univariate analysis showed serum RBP4 was positively associated with TG,BMI,FBG, WHR,FINS,HOMA-IR and negatively associated with APN (r = 0.225, 0.697, 0.323,0.557, 0.272, 0.461, -0.398). Conclusions The concentration of RBP4 is significantly higher in type 2 diabetic patients compared with that in normal subjects. RBP4 possibly plays an important role in the insulin resistance and the occurrence and development of type 2 diabetes.