ABSTRACT
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. METHODS: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. RESULTS: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. CONCLUSION: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.
Subject(s)
Humans , Asian People , Body Mass Index , Costs and Cost Analysis , Cough , Delivery of Health Care , Dyspnea , Health Expenditures , Hospitalization , Linear Models , Pulmonary Disease, Chronic Obstructive , Respiratory Function Tests , Smoke , Smoking , SputumABSTRACT
Objective To investigate the relationship between proportion of Tumor infiltrating lymphocytes (TILs) in the prostate tumor mass and postoperative recurrence of prostate carcinoma in order to offer the theoretic as well as experimental basis for the prevention of postoperative recurrence in the prostate carcinoma.Methods The proportion of CD3+, CD8+, CD3+CD4+, CD3+CD8+ TILs cells of 81 PCa specimens underwent Radical prostatectomy were analyzed. The proportion of CD3+CD8+TILs in patients with recurrence of PCa within3 years after surgery (group A), within 35 years (group B) and without recurrence after 5 years (group C) was compared. Results The proportion of CD3+CD8+TILs was significantly lower in group A than that of in group B and C (P＜0.05), meanwhile, the proportion of CD3+CD8+TILs were significantly higher in group C than that in group A and B (P＜0.05), while the proportion of CD3+, CD8+, CD3+CD4+ in three groups had no significant difference (P＞0.05). Conclusion The proportion of CD3+CD8+TILs presented in the PCa specimen mass is relative to the postoperative recurrence of prostate cancer, which might be a biomarker for the surveillance of postoperative recurrence of PCa.
ABSTRACT
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a serious adverse drug reaction, characterized with rash, fever, lymphadenectasis, eosinophilia and visceral involvement. This article describes the clinical case of a patient with renal insufficiency after receiving sensitizing drugs,which resulted in limb weakness and cognitive impairment of center nervous system characterized by vasculitis imaging and responded well to glucocorticoid treatment-DRESS syndrome.
ABSTRACT
Objective To understand the risk situation of imported schistosomiasis and its main influencing factors in Shang-hai City from 2005 to 2015. Methods A retrospective survey was performed,and the database was established based on the da-ta collection of imported schistosomiasis,Oncomelania hupensis snail situation and mobile population in Shanghai City from 2005 to 2015. Results From 2005 to 2015,the mobile population in Shanghai City increased by 123.92％,which reached about 9816500,and 54.70％of them were located in the inner suburban districts. The accumulated areas with snails of 7.13 hm2 were found in 16 towns of 4 outer suburbs(excluding Chongming District). A total of 23 cases of imported schistosomiasis were found in Shanghai City,and the number of the imported schistosomiasis cases was on the downward trend(rs=-0.782,P=0.004). From 2005 to 2009,11 out of 13 imported schistosomiasis cases(84.62％)were distributed in the inner suburban dis-tricts where no O. hupensis snails were found at the same time. From 2010 to 2015,9 out of 10 imported schistosomiasis cases (90％)were distributed in the outer suburban districts where O. hupensis snails were found at the same time. Conclusion The number of imported schistosomiasis cases in Shanghai is on the downward trend. However,the threat of imported schistosomiasis to the prevention and control of schistosomiasis in Shanghai City should not be ignored.
ABSTRACT
Objective:To explore influence of metoprolol combined lisinopril on cardiac function and serological mark-ers in patients with chronic heart failure(CHF).Methods:A total of 120 CHF patients treated in our hospital from May 2014 to May 2016 were enrolled.They were randomly and equally divided into lisinopril group and combined treatment group(received metoprolol combined lisinopril),both groups were treated for six months.Therapeutic effect,incidence rate of adverse reactions,levels of cardiac function indexes,C reactive protein(CRP),tumor nec-rosis factor α(TNF-α),N terminal pro B type natriuretic peptide(NT-proBNP),cystatin C(CysC)and neutrophil gelatinase associated lipocalin(NGAL)before and after treatment were compared between two groups.Results:Compared with before treatment,after six-month treatment,there were significant reductions in left ventricular end-diastolic dimension(LVEDd),left ventricular end-systolic dimension(LVESd),levels of CRP,TNF-α,NT-proBNP,CysC and NGAL,and significant rise in left ventricular ejection fraction(LVEF)in both groups,P=0.001 all.Compared with lisinopril group after six-month treatment,there were significant rise in total effective rate(73.33% vs.90.00%),P=0.018,and LVEF[(44.91 ± 2.45)% vs.(48.82 ± 3.55)%],P=0.001;and sig-nificant reductions in LVEDd[(50.34 ± 3.11)mm vs.(45.92 ± 3.04)mm],LVESd[(41.34 ± 3.33)mm vs.(35.53 ± 2.34)mm],levels of CRP[(14.47 ± 2.77)ng/L vs.(10.32 ± 3.01)ng/L],TNF-α[(157.78 ± 43.21)ng/L vs.(110.22 ± 29.01)ng/L],NT-proBNP[(932.43 ± 46.45)pg/ml vs.(464.21 ± 39.78)pg/ml],CysC[(1.34 ± 0.36) mg/L vs.(0.97 ± 0.22)mg/L]and NGAL[(117.69 ± 16.51)μg/L vs.(75.58 ± 10.22)μg/L]in combined treat-ment group,P=0.001 all.No adverse drug reaction was found in two groups.Conclusion:Compared with alone lisi-nopril,metoprolol combined lisinopril can effectively improve cardiac function,inhibit inflammation,relieve body injury,improve cardiac structure and effectively improve prognosis more in CHF patients,which is worth extending.
ABSTRACT
Objective To explore the application value of DOSE index score in the peitients with chronic obstructive pulmonary disease.Methods 122 cases of plateau COPD patients were followed up for 12 months,and we recorded and analyzed the patient's health and life.We also recorde FEV 1 and DOSE scores of the patients with COPD,and record the COPD risk events,including the number of respiratory failure and death,and the times of hospitalization,total such confinement,outpatient expenses,hospitalization expenses,mMRC,and scored in the number of exacerbations,etc.Results The DOSE index score was negatively correlated with FEV1％ pred (r=0.73,P ＜ 0.05) for 122 COPD patients,and were positively correlated with mMRC (r=085,P ＜ 0.01),the annual number of exacerbations (r=0.71,P ＜ 0.01),respiratory failure (r=0.65,P ＜ 0.01),heart failure (r=0.50,P ＜ 0.01),number of outpatient service (r=0.12,P＜0.01),hospitalization time (r=0.70,P＜0.01),the totalsuchconfinement (r=0.66,P＜0.01),outpatient expenses (r=0.13,P＞ 0.13),hospitalization expenses (r=0.65,P＜0.01).ROC curve was used to analyzed the cut-off point and curve area of COPD DOSE index.Conclusion The DOSE index is a simple COPD assessment tools,and is closely related to the prognosis of patients and health.
ABSTRACT
<p><b>BACKGROUND</b>Serum testosterone levels have been found lower in acute ischemic stroke male patients. However, the exact mechanism remains unclear. In the present study, we measured serum testosterone levels, steroidogenesis- related genes and Leydig cells number in experimental transient cerebral ischemia male rats to elucidate the mechanism.</p><p><b>METHODS</b>The middle cerebral arteries of adult male Sprague-Dawley rats were sutured for 120 minutes and then sacrificed after 24 hours. Blood was collected for measurement of serum testosterone, follicular stimulating hormone and estradiol levels, and testes were collected for measurement of steroidogenesis-related gene mRNA levels and number of Leydig cells.</p><p><b>RESULTS</b>Serum testosterone levels in rats after cerebral ischemia were significantly lower (0.53 ± 0.16) ng/ml, n = 7, mean ± SE) compared with control ((2.33 ± 0.60) ng/ml, n = 7), while serum estradiol and follicular stimulating hormone levels did not change. The mRNA levels for luteinizing hormone receptor (Lhcgr), scavenger receptor class B member 1 (Scarb1), steroidogenic acute regulatory protein (StAR), cholesterol side chain cleavage enzyme (Cyp11a1), 3β-hydroxysteroid dehydrogenase 1 (HSD3β1), 17α-hydroxylase/20-lyase (Cyp17a1) and membrane receptor c-kit (kit) were significantly downregulated by cerebral ischemia, while luteinizing hormone, Kit ligand (KitL), 17β-hydrosteroid dehydrogenase 3 (HSD17β3) and 5α-reductase (Srd5a1) were not affected. We also observed that, relative to control, the Leydig cell number did not change.</p><p><b>CONCLUSIONS</b>These results indicate that transient cerebral ischemia in the brain results in lower expression levels of steroidogenesis-related genes and thus lower serum testosterone level. Transient cerebral ischemia did not lower the number of Leydig cells.</p>