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Resumo Fundamento: A fração de ejeção (FE) tem sido utilizada em análises fenotípicas e na tomada de decisões sobre o tratamento de insuficiência cardíaca (IC). Assim, a FE tornou-se parte fundamental da prática clínica diária. Objetivo: Este estudo tem como objetivo investigar características, preditores e desfechos associados a alterações da FE em pacientes com diferentes tipos de IC grave. Métodos: Foram incluídos neste estudo 626 pacientes com IC grave e classe III-IV da New York Heart Association (NYHA). Os pacientes foram classificados em três grupos de acordo com as alterações da FE, ou seja, FE aumentada (FE-A), definida como aumento da FE ≥10%, FE diminuída (FE-D), definida como diminuição da FE ≥10%, e FE estável (FE-E), definida como alteração da FE <10%. Valores p inferiores a 0,05 foram considerados significativos. Resultados: Dos 377 pacientes com IC grave, 23,3% apresentaram FE-A, 59,5% apresentaram FE-E e 17,2% apresentaram FE-D. Os resultados mostraram ainda 68,2% de insuficiência cardíaca com fração de ejeção reduzida (ICFEr) no grupo FE-A e 64,6% de insuficiência cardíaca com fração de ejeção preservada (ICFEp) no grupo FE-D. Os preditores de FE-A identificados foram faixa etária mais jovem, ausência de diabetes e fração de ejeção do ventrículo esquerdo (FEVE) menor. Já os preditores de FE-D encontrados foram ausência de fibrilação atrial, baixos níveis de ácido úrico e maior FEVE. Em um seguimento mediano de 40 meses, 44,8% dos pacientes foram vítimas de morte por todas as causas. Conclusão: Na IC grave, a ICFEr apresentou maior percentual no grupo FE-A e a ICFEp foi mais comum no grupo FE-D.
Abstract Background: Ejection fraction (EF) has been used in phenotype analyses and to make treatment decisions regarding heart failure (HF). Thus, EF has become a fundamental part of daily clinical practice. Objective: This study aims to investigate the characteristics, predictors, and outcomes associated with EF changes in patients with different types of severe HF. Methods: A total of 626 severe HF patients with New York Heart Association (NYHA) class III-IV were enrolled in this study. The patients were classified into three groups according to EF changes, namely, increased EF (EF-I), defined as an EF increase ≥10%, decreased EF (EF-D), defined as an EF decrease ≥10%, and stable EF (EF-S), defined as an EF change <10%. A p-value lower than 0.05 was considered significant. Results: Out of 377 severe HF patients, 23.3% presented EF-I, 59.5% presented EF-S, and 17.2% presented EF-D. The results further showed 68.2% of heart failure with reduced ejection fraction (HFrEF) in the EF-I group and 64.6% of heart failure with preserved ejection fraction (HFpEF) in the EF-D group. The predictors of EF-I included younger age, absence of diabetes, and lower left ventricular ejection fraction (LVEF). The predictors of EF-D were absence of atrial fibrillation, lower uric acid level, and higher LVEF. Within a median follow-up of 40 months, 44.8% of patients suffered from all-cause death. Conclusion: In severe HF, HFrEF presented the highest percentage in the EF-I group, and HFpEF was most common in the EF-D group.
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Humans , Heart Failure/drug therapy , Prognosis , Stroke Volume , Ventricular Function, Left , Heart VentriclesABSTRACT
OBJECTIVE@#To observe the effect of umbilical moxibustion on phlegm damp constitution and intestinal flora, and explore the mechanism of umbilical moxibustion in improving phlegm damp constitution.@*METHODS@#A total of 60 subjects with phlegm damp constitution were randomly divided into an observation group and a control group, 30 cases in each group. The control group was given TCM health guidance, such as diet and exercise; on the basis of the control group, umbilical moxibustion was applied in the observation group, 7 moxa cones each time, 2 times a week for 8 weeks. Before and after intervention, the indexes (transformation score of phlegm damp constitution, body mass, body mass index [BMI], waist circumference, hip circumference, heart rate and blood pressure) related to phlegm damp constitution were recorded in the two groups. The intestinal flora was detected with 16S rDNA sequencing technology in the two groups.@*RESULTS@#After intervention, the transformation score of phlegm damp constitution, body mass, BMI, waist circumference and hip circumference were decreased compared before intervention in the observation group (@*CONCLUSION@#Umbilical moxibustion may reshape the intestinal flora by up-regulating the relative abundance of
Subject(s)
Humans , Acupuncture Points , Gastrointestinal Microbiome , Moxibustion , MucusABSTRACT
Following radiotherapy, patients have decreased bone mass and increased risk of fragility fractures. Diabetes mellitus (DM) is also reported to have detrimental effects on bone architecture and quality. However, no clinical or experimental study has systematically characterized the bone phenotype of the diabetic patients following radiotherapy. After one month of streptozotocin injection, three-month-old male rats were subjected to focal radiotherapy (8 Gy, twice, at days 1 and 3), and then bone mass, microarchitecture, and turnover as well as bone cell activities were evaluated at 2 months post-irradiation. Micro-computed tomography results demonstrated that DM rats exhibited greater deterioration in trabecular bone mass and microarchitecture following irradiation compared with the damage to bone structure induced by DM or radiotherapy. The serum biochemical, bone histomorphometric, and gene expression assays revealed that DM combined with radiotherapy showed lower bone formation rate, osteoblast number on bone surface, and expression of osteoblast-related markers (ALP, Runx2, Osx, and Col-1) compared with DM or irradiation alone. DM plus irradiation also caused higher bone resorption rate, osteoclast number on bone surface, and expression of osteoclast-specific markers (TRAP, cathepsin K, and calcitonin receptor) than DM or irradiation treatment alone. Moreover, lower osteocyte survival and higher expression of Sost and DKK1 genes (two negative modulators of Wnt signaling) were observed in rats with combined DM and radiotherapy. Together, these findings revealed a higher deterioration of the diabetic skeleton following radiotherapy, and emphasized the clinical importance of health maintenance.
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A strain was isolated from tobacco phylloplane and preliminarily identified as Pseudomonas fluorescens TL-1, which had the visible inhibition against ten plant pathogenic fungi, viz., Curvularia lunata, Bipolaris maydis, Valsa mali, Rhizoctonia solani, Colletotrichum gloeosporioides, Sclerotinia sclerotiorum, Botrytis cinerea, Alternaria alternate, Fusarium oxysporum and Verticillium dahlia in dual culture experiments. The ethyl acetate extract of nutrient broth seeded with Pseudomonas fluorescens TL-1 suspension was separated into fifty-nine fractions by the Sephadex LH-20 column and the antifungal activity of each fraction was tested with paper disc diffusion method against Curvularia lunata. The results showed that fraction 1 to 3 had the strongest inhibitory effects on Curvularia lunata. Furthermore, GC/MS analysis of the constituents of fraction 1 to 59 confirmed that phenol, 2, 4-bis (1, 1-dimethylethyl) was the active compound for the antifungal activity from Pseudomonas fluorescens TL-1.
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Objective To observe the differences between Nested-polymerase chain reaction(N-PCR) and virus isolation methods used for detection of respiratory syncytial virus(RSV),and to reveal the potential clinical features of them.Methods From Jan.2010 to Aug.2012,nasopharyngeal aspirates (NPAs) were collected from the children with respiratory infection in the Department of Respiratory,the Children's Hospital of Chongqing Medical University.Both N-PCR and virus isolation were applied to detect RSV,and clinical data were collected for statistical analysis.Results A total of 1143 specimens were used for RSV detection by N-PCR and virus isolation.The male-female ratio was 2.16 vs 1.00.The age of patients was ranged from 1 month to 165 months(median:7 months).The most common diagnoses were as follows:bronchopneumonia [478 cases (41.8％)],chronic fibrous pneumonia [223 cases (19.5％)],bron-chiolitis [221 cases (19.3％)],bronchitis [71 cases (6.2％)] and upper respiratory infection [21 cases(1.8％)].For N-PCR,458 cases were RSV positive (total positive rate was 40.1％ ; 31.7％ for RSV-A,7.7％ for RSV-B,0.7％ for both RSV-A and RSV-B).With virus isolation method,204 cases were positive (17.8％).Comparison result of N-PCR and virus isolation showed:165 cases were positive (P+ I+) and 646 cases were negative (P-I-) by both methods (identity was 70.1％),and the most difference was N-PCR positive but virus isolation negative group (P+ I-) (293 cases,25.6％).When compared to P-I-group,the clinical features of P+ I-group were as follows:younger,longer hospital stays,remarkable season distribution (with peak in winter and lowest in summer),lower percentage of fever,higher percentage of cough,wheezing,dyspnea,severe pneumonia and respiratory failure,all these differences were statistically significant(all P ＜ 0.05),the ma-nifestations matched the clinical features of RSV infection.When compared to P + I + group,the symptoms in the P + I-group had longer duration before they were admitted to hospital (P =0.005) and lower percentage of wheezing (P =0.009).Conclusions The differences between N-PCR and virus isolation for the detection of RSV existed in duration of symptoms prior to hospitalization.Both the sensibility and specificity of N-PCR are desirable for RSV detection.
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Objective To explore the causative factors of children with respiratory tract infection and their clinical features.Methods Nasopharyngeal aspirate (NPA) was collected from 1746 children with acute respiratory infections (ARIs),aged from 37 days to 3 years,who were admitted to Children's Hospital of Chongqing Medical University between Jun.2009 and May 2011.Fourteen respiratory viruses in NPA were investigated using polymerase chain reactions (PCR) after nucleic acids extracted from the samples and then synthesized cDNA.Sequence analysis was performed to verify the results of each virus from random positive samples.A total of 23 cases were identified with twice or more admissions to hospital.Individual factors,virus detection and clinical characte-ristics were compared between patients with and without repeated hospitalization.Risk factors for repeated hospitalization were investigated.Then these factors were compared in patients with repeated hospitalization between first time and second time.Results The median age was 7 months in patients with repeated hospitalization and 8 months in patients without repeated hospitalization,there were significantly different difference (P ＜ 0.0001).There was no significant difference in virus detection including influenza type A,parainfluenza,respiratory syncytial virus (RSV),adenovirus and human bocavirus between patients with and without repeated hospitalization in the same age group.By comparing clinical features between patients with and without repeated hospitalizatin in the same age group,(69.6％ vs 47.4％,P =O.037) and diarrhea (52.2％vs 29.0％,P =0.017) were found more often in patients with repeated hospitalization.There was no connection between respiratory virus detection and presence of fever,wheeze,cough and diarrhea in patients with repeated hospitalization for the first time of hospitalization.RSV was the most frequently appeared virus in twice hospitalizations,presenting 52.2％ and 30.4％,respectively.One case had twice positive for RSV.In the first hospitalization,there were 16 viruspositive cases and 16 wheeze cases,while in the second hospitalization,there were 12 virus-positive cases (75.0％)and 11 wheeze cases (68.8％),respectively.Conclusions Children with respiratory tract infections suffered repeated hospitalization,mainly occur in children less than 3 years old.Wheeze is an important clinical feature in children with repeated hospitalization.Although causative viruses for patients in each infection are different,RSV is the most common detected viral agent.Virus-positive cases in the first hospitalization present higher viral detection rate during the second hospitalization,with similar trend for wheeze.
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BACKGROUND:Acute poisoning is frequently encountered at emergency department. This study was to investigate the epidemiology and characteristics of patients with acute poisoning who were treated at the Emergency Center, Fujian Provincial Hospital, China. METHODS:We retrospectively analyzed the gender, age, causes of poisoning, types of poisons, poisoning route, emergency diagnoses, outcomes, and prognoses of these patients. RESULTS:Altogether 2867 patients with acute poisoning were treated from January 2004 to December 2009. The ratio of male to female was 1:1.04, and their average age was 33.8 years. Of the 2867 patients, 76.39％ were between 18 and 40 years old. The incidence of acute poisoning was as high as 11.33％ in January each year. The incidence of poisoning was in a descending order:alcohol poisoning (54.55％), medication poisoning (25.95％), pesticide poisoning (5.65％), and drug poisoning (4.88％). Most (56.44％) of the patients with drug poisoning were under 25 years and their mean age was significantly lower than that of patients with medication poisoning or alcohol poisoning (P < 0.01). Approximately 69.54％ of the patients were followed up after emergency treatment, 30.39％ were hospitalized, and four patients died. CONCLUSIONS:Acute poisoning is largely alcohol poisoning and medication poisoning in a city. The emergency green channel "pre-hospital emergency care-emergency department-hospital treatment"can significantly improve the survival rate of patients with acute poisoning.
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<p><b>OBJECTIVE</b>To compare the clinical effects between electroacupuncture at Zusanli (ST 36) combined with intravenous drip of Granisetron and intravenous drip of Granisetron only for treatment of nausea and vomiting caused by the chemotherapy of the malignant tumor.</p><p><b>METHODS</b>The methods of multicentral, randomized controlled trial were used, the observation group (127 cases) was treated with electroacupuncture at Zusanli (ST 36) combined with intravenous drip of Granisetron, and the control group (119 cases) was treated with intravenous drip of Granisetron only.</p><p><b>RESULTS</b>The total effective rate of 90.5% in observation group was superior to that of 84.0% in control group (P < 0.01); the nausea and vomiting scores of two groups were obviously decreased after treatment (both P < 0.001), and the decreased degree of the observation group was superior to that of control group (P < 0.001).</p><p><b>CONCLUSION</b>Electroacupuncture at Zusanli (ST 36) can significantly alleviate the symptoms such as nausea and vomiting caused by the chemotherapy of the patients.</p>