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Objectives: To explore the effect of percutaneous transluminal angioplasty (PTA) combining thrombolysis on ankle brachial index (ABI) in patients with aortoiliac stenosis or occlusive disease (ASOD). Methods: A total of 100 ASOD patients treated in our hospital from 2012-06 to 2015-06 were enrolled. According to treatment method, the patients were divided into 2 groups: Traditional surgery group and PTA combining thrombolysis group. 50 in each group. Results: Compared with Traditional surgery group, PTA combining thrombolysis group had the less intra-operative bleeding, shorter bed time, hospital stay time and the lower complication rate. ABI, walking distance were improved after the operation in both groups and they were better in PTA combining thrombolysis group than Traditional surgery group, P<0.001. The 1, 2, 3 years total patency rates and limb salvage rates were similar between 2 groups, P>0.05. Conclusions: PTA combining thrombolysis method had good short- and long-term efficacy for treating ASOD; it may reduce surgical trauma and complications, should be beneficial to future recovery in relevant patients.
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Objectives: To compare the changes in effectiveness of cross-institutional collaboration before and after intervention and non-intervention from medical personnel in order to empirically support promoting cross-institu-tional communication, coordination and cooperation modes for chronic diseases services. Methods: The typical sam-pling and multistage random sampling were used to conduct a questionnaire survey among medical personnel at villa-ges, townships and county levels. The Propensity ( Tendency) Scores were used to match the samples of the baseline and the following year of intervention, and the results were statistically analyzed. Results: After one-year of interven-tion, the county-level hospital doctors manifested higher participation while the sense of identity in work decreased;township medical personnel offered patient-centered provision of chronic disease services at higher level, but they re-ceived limited benefits from training attendance; and village medical institutions benefited a lot from the improved health care services and improved the clinic capability from cross-institutional collaboration on chronic diseases serv-ices. Suggestions: At the level of cross-institutional collaboration model policy development, attention should be paid on the work needs of county-level hospital doctors. It is also necessary to improve incentive mechanism and to work out definite and clear procedures and standards of promotion, establish a sound cross-institutional training mechanism and put knowledge into practice thereby encouraging individual development. For ultimate stand-straight, the roles and responsibilities of multi-level institutions in cross-institutional cooperation should be explored from the perspective of continuous chronic disease services.
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Objectives:This study aims to analyze the current status of the collaboration of medical staff among county,township,and village with comprehensive prevention and control of chronic diseases based on nine dimen-sions of DMIC integrated medical service development model,with a view to providing medical services collaboration on chronic diseases across the organization to provide direction for improvement. Methods:278 health workers sam-pled by the combination of typical sampling and multi-stage random sampling method received a questionnaire and the results were analyzed statistically. Results:According to the findings of this study,village doctors show higher partic-ipation in chronic care collaboration,but they are faced with the aging population and most of them are poorly educat-ed;the multi-institutional collaboration is of low efficiency in practice although it is well accepted by all health work-ers;there is no existing shared health information system among county,township and village. Conclusion:These re-sults suggest that the government should strengthen its leadership and promote primary health care management through medical staff collaboration;initiatives of health workers should be stimulated to promote the continuity of medical serv-ices;the shared health information system should be set up to facilitate the health workers' collaboration.
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Objective: To study the secondary metabolites of endophytic fungus Chaetomium sp. Methods: The compounds were isolated and purified by chromatographic methods on silica gel, Sephadex-LH20 columns, and semi-prep HPLC. The structures were established on the basis of spectroscopic data interpretation. Results: Ten compounds were isolated and identified as chetoseminudin B (1), gonytolide C (2), chaetone D (3), 1H-indole-3-carbaldehyde (4), 1H-indole-3-carboxylic acid (5), indole-3-methylethanoate (6), 3R*,4R*-dihydroxy-3-methylpentan-2-one (7), emodin (8), 3β,5α,9α-trihydroxy-(22E,24R)-ergosta-7,22-dien-6-one (9), and (3β,5α, 6β,22E)-6-methoxyergosta-7,22-diene-3,5-diol (10). Conclusion: All compounds are isolated from Chaetomium sp. for the first time.
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OBJECTIVE: To study the chemical constituents of Sapium sebiferum leaves. METHODS: The chemical constituents in the petroleum ether and n-butyl alcohol parts of the 95% ethanol extract of Sapium sebiferum leaves were isolated and purified by chromatographic methods. Their structures were elucidated by spectral data and physicochemical properties. RESULTS: Twelve compounds were purified and identified as squalene(1), 3β-hydroxyglutin-5-ene(2), fraxetin(3), friedelin(4), β-sitosterol(5), gallic acid ethyl ester (6), quercetin (7), 5-hydroxymethylfurfural (8), blumenol C glucoside (9), kaempferol-3-O-β-D-glucopyranoside (10), 1'-O-benzyl-α-L-rhamnopyranosyl-(1″-6') -β-D-glucopyranoside(11), and shikimic acid(12). CONCLUSION: Compounds 1-3, and 8-12 are isolated for the first time from this plant.
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<p><b>OBJECTIVE</b>To observe serum uric acid (UA) level distribution and explore risk factors of hyperuricemia (HUA) in a large cohort of active and retired employees underwent physical examination.</p><p><b>METHODS</b>Physical examination was arranged for 21 700 active and retired employees from May 2010 to September 2011, 16 416 employees were examined and complete examination data were obtained in 14 044 subjects. The distribution characteristics of UA level and correlations of UA level and HUA prevalence rate with gender, age, body mass index (BMI), systolic pressure (SBP), diastolic pressure (DBP), fasting blood-glucose (FPG), serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were analyzed.</p><p><b>RESULTS</b>HUA prevalence rate was 11.2% in this cohort, which was significantly higher in males (15.8%) than in females (4.1%, P < 0.05). The UA level and the HUA prevalence rate presented a "J" curve relationship with aging and positively correlated with BMI, SBP, DBP, TG, LDL-C, TC and FPG while negatively correlated with HDL-C. Multiple linear regression analysis showed that SBP, BMI, FPG, TG, and LDL-C were independent risk factors while HDL-C and female gender were the protective factors of HUA(all P < 0.01). Aging and high DBP were independent risk factors of HUA for females (all P < 0.05) and LDL-C was risk factor of HUA for males (P < 0.05).</p><p><b>CONCLUSIONS</b>Serum UA level presents a "J" wave relationship with aging. The risk factors of HUA are increased SBP, BMI, FPG, TG, LDL-C while the protective factors of HUA are female gender and high HDL-C.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Hyperuricemia , Epidemiology , Physical Examination , Prevalence , Risk Factors , Uric Acid , BloodABSTRACT
This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1 st), interval between W1 and W2 (1 st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the WI, W2, NA, and (lst-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with WI, W2, NA,(lst-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.
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<p><b>OBJECTIVE</b>To establish a reverse remodeling heart model in rats and observe collagen and TGF-β expression and relevant microRNAs changes during reverse remodeling.</p><p><b>METHODS</b>Lewis rats were divided into four groups including sham (NL, n = 10), abdominal aortic constriction (AAC, n = 10), heterotopic transplantation of abdominal aortic constriction (AAC-HT, n = 9) and heterotopic transplantation of normal heart (HT, n = 8). Left ventricular wall thickness and LV cavity were measured by echocardiography. The cardiomyocyte cross-sectional area (CSA) was determined on HE stained sections. Immunohistochemical and qRT-PCR were used to detect collagen and TGF-β expressions. miRNAs were detected by MicroRNA microarray.</p><p><b>RESULTS</b>Heart weight, left ventricular wall thickness and CSA were significantly increased in AAC hearts compared to those in the NL and AAC-HT hearts. The collagen and TGF-β were increased in AAC hearts and further increased in AAC-HT hearts. miRNA microarray evidenced more than two folds changes on 82 miRNAs compared to NL (10 in AAC, 32 in AAC-HT and 40 in HT).</p><p><b>CONCLUSION</b>Rat abdominal aortic constriction and heterotopic transplantation could be used as a reverse remodeling heart model and significant collagen and TGF-β as well microRNA expression changes were evidenced in this model.</p>
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Animals , Male , Rats , Collagen , Metabolism , Heart Ventricles , Metabolism , MicroRNAs , Metabolism , Myocytes, Cardiac , Metabolism , Rats, Inbred Lew , Transforming Growth Factor beta , Metabolism , Ventricular RemodelingABSTRACT
This study evaluated the change in regional left ventricular myocardial function in rats following acute occlusion of the left anterior descending coronary artery (LAD) by using two-dimensional speckle tracking imaging (2D-STI). Sixty Wistar rats were randomly divided into two groups,a myocardial infarction (MI) group,in which 50 rats were subjected to LAD occlusion for 30-45 min,and a sham-operated (SHAM) group that contained 10 rats serving as control. Echocardiography was performed at baseline and 1,4 and 8 week(s) after the operation. High frequency two-dimensional images of left ventricular short axis at papillary muscle level were recorded. Peak systolic radial strain (PRS) and circumferential strain (PCS) were measured in the mid-ventricle in short-axis view by using EchoPAC workstation. Left ventrieular internal diameter at diastole (LVIDd)and systole (LVIDs),fractional shortening (FS),ejection fraction (EF) and left ventricular mass (LVM)were measured by anatomical M-model echocardiography. Infarct size was measured using triphenyl tetrazolium chloride (TTC) staining 1 week and 8 weeks after the operation. Fibrosis of left ventricular myocardium was displayed using Van Gieson staining 1 week after the infarction. In terms of the TTC staining results,the left ventricle fell into three categories:infarcted,peri-infarcted and remote myocardial regions. Compared with those at baseline and in the SHAM group,(1) PRS and PCS in the infarcted,peri-infarcted and remote myocardial regions were significantly decreased in the MI group within 1 week after the operation (P＜0.05) and the low levels lasted 8 weeks;(2) Compared with those at baseline,LVIDd,LVIDs,FS,EF and LVM in the MI group showed no significant difference 1 week after the operation (P＞0.05). However,LVIDd,LVIDs and LVM were increased significantly 4 and 8 weeks after the operation (P＜0.05),and FS and EF were decreased substantially (P＜0.05). Van Gieson staining showed that fibrosis developed in all the three myocardial regions to varying degrees. It is concluded that 2D-STI is non-invasive and can be used to assess regional function of myoeardium with different blood supply in rats following acute occlusion of the LAD,and can be used as a sensitive and reliable means to follow up the process of left ventricular remodeling.
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<p><b>OBJECTIVE</b>To explore risk factors and infection characteristics of secondary pancreatic infection in severe acute pancreatitis (SAP).</p><p><b>METHODS</b>A clinical data of 49 patients with secondary pancreatic infection in severe acute pancreatitis (SPI group)were matched with 49 patients without infection in severe acute pancreatitis (NSPI group) between January 2003 and December 2005. The two groups were analyzed by a case-control study. Conditional Logistic regression model univariate and multivariate were used to screen out risk factors. The types of infection, the peak infection and the bacteria spectrum were analyzed in SPI group.</p><p><b>RESULTS</b>(1) In univariate Logistic regression analysis, 7 factors including continuous hypoalbuminemia, prolonged time of central venous catheter, usage of hormone, high APACHE II scores, multi-antibiotics, intestine dysfunction and continuous hyperglycemia were selected out. Moreover, the first three were statistically significant in multivariate Logistic regression analysis. (2) Pancreatic abscess ranked first in SPI group. Of all the pancreatic infection, 22.5% occurred within two weeks and 71.4% occurred in the 4th week or later. (3) In SPI group, 81 strains of microorganisms were cultured, including 45 strains of gram-negative bacteria (55.6%), 22 strains of gram-positive bacteria (27.2%), and 14 strains of fungi (17.3%). The common gram-negative bacteria were Escherichia coli, and the common gram-positive bacteria were Staphylococci and Enterococci. The fungi included Monilia and Yeastoid fungus. Further study revealed that 35 strains of all the microorganisms were intestinal bacteria (43.2%).</p><p><b>CONCLUSIONS</b>Continuous hypoalbuminemia, prolonged time of central venous catheter and usage of hormone were independent risk factors of SPI. The main type of infection was pancreatic abscess. Gram-negative bacteria, were the common bacteria causing secondary pancreatic infection.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bacterial Infections , Microbiology , Case-Control Studies , Logistic Models , Pancreatitis , Microbiology , Pancreatitis, Acute Necrotizing , Retrospective Studies , Risk FactorsABSTRACT
Background and purpose:The pain is not only the chief symptom of cancer but also the main factor of survival quality for the cancer patient.So it is the most difficult for how to control the pain of moderate to severe late-stage cancer and reduce the rate of side effects.We observed the analgesia effects of micro-dosage ketamine associating morphine patient control skin analgesia(PCSA) for latter cancer pain patients.Methods:52 cases middle, latter cancer pain patients were divided two groups randomly,the first group used the morphine PCSA and the second group used micro-dosage ketamine associating morphine PCSA.The VAS(Visual Analogue Scale) was used to evaluate the pain level,then statistic the side effects rate of two groups.Results:Two groups patients'pain all alleviated fundamentally,the VAS of every period have not statistic difference,but the PCSA pressing times in the first group was more than in the second group.The second group patients'life satisfactory rate was higher obviously than the first group patients';Side effects:the incidence of nausea,vomiting,indulge in sleep and skin titillation in the first group was higher than in the second group;the incidence of respiration depression and hallucination had not difference between two groups.Conclusion:Micro-dosage ketamine associating morphine patient control skin analgesia(PCSA)approach appears to provide patient with safe and effective pain relief and reduce side-effect for moderate to severe late-phase cancer pain,easy to perform and have no process complication to used in clinic.