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Tuberculous meningitis (TBM) is one of the most serious and lethal diseases in neurology. The early diagnosis and treatment of TBM still faces severe challenges. Acid-fast staining of cerebrospinal fluid and culture of Mycobacteriumtuberculosis are the "gold standard" for the diagnosis of TBM, but lack sensitivity. With the application of metagenomic next-generation sequencing technology, significant advances have been made in the early diagnosis of TBM. The optimal treatment regimen for TBM remains to be further explored and studied. This article intends to provide an overview of the pathogenesis, pathology, clinical manifestations, diagnosis and treatment advancement of TBM, and provide guidance for clinical practice.
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Objective@#To describe bullying victimization of middle school students in Dalian and associated factors, so as to provide scientific basis for campus bullying prevention.@*Methods@#The stratified cluster sampling method was used to select 2 540 middle school students from urban and rural areas in Dalian, who were investigated with campus bullying victimization and related factors.@*Results@#The reported rate of campus bullying victimization among middle school students in Dalian was 25.11%. The rates of physical violence (5.99%, 3.66%) and verbal violence(24.93%, 15.87%) of male students were higher than that of female students( χ 2=6.56, 27.94, P <0.05). The rates of verbal violence (22.84%, 16.25%) and emotional neglect(16.84%, 13.18%) of junior high school students were higher than those of high school students( χ 2=14.21, 5.44, P < 0.05 ). The rates of physical violence(6.07%, 3.55%), verbal violence(24.58%, 16.05%) and emotional neglect(18.88%, 12.06 %) of rural students were higher than those of urban students( χ 2=7.72, 24.81, 19.64, P <0.05). Male students, junior high school students and rural students suffered more severe campus bullying than female students, high school students and urban students( Z =3.46, 3.75, 5.89, P <0.01). The structural equation model showed that academic performance (path coefficient -0.003) and father s education (path coefficient -0.004 ) have a direct negative effect on campus bullying behavior, while mother s education (indirect action coefficient -0.000 8), height(indirect action coefficient -0.000 3), father s education (indirect action coefficient -0.000 3) and weight (indirect action coefficient 0.000 2) indirect effects on campus bullying through academic performance.@*Conclusion@#The prevalence of campus bullying victimization among middle school students in Dalian is relatively high, which worths further attention to. Rural students, junior high school students and boys are more likely to suffer campus bullying. Improving academic performance might be beneficial for campus bullying prevention.
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At present, experimental animals have an irreplaceable important role in scientific research and design, more new drug research and development and surgical technique innovation are carried out in experimental animal models. The preparation of experimental animal models is inseparable from good medical research design. Selecting standardized experimental animals can reduce experimental errors and ensure the reliability, accuracy and repeatability of experimental results. Therefore, this article will summarize the application of experimental animals in medical scientific research design.
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Traditional Chinese medicine industry is an important cultural industry of the Chinese nation. In the historical development, traditional Chinese medicine has played a pivotal role. In recent years, traditional Chinese medicine has attracted more and more attention from the society in regulating children's qi, blood, yin and yang, viscera function, and improving the immune function of the body and so on. But while obtaining many historic new opportunities, traditional Chinese medicine is also facing huge challenges. Therefore, this article will review the development status of traditional Chinese medicine, the physiological characteristics of children, and the role of traditional Chinese medicine in childhood diseases, so as to provide references for clinical and scientific research.
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At present,experimental animals have an irreplaceable important role in scientific research and design,more new drug research and development and surgical technique innovation are carried out in experimental animal models.The preparation of experimental animal models is inseparable from good medical research design.Selecting standardized experimental animals can reduce experimental errors and ensure the reliability,accuracy and repeatability of experimental results.Therefore,this article will summarize the application of experimental animals in medical scientific research design.
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Objective To investigate the clinical features,diagnosis,treatment and prognosis of Dementia with Lewy Body (DLB) in order to improve doctors' understanding and experience.Methods Thirteen cases of clinicall diagnosed DLB were analyzed.The clinical manifestations,neurological examination,laboratory tests,treatment and prognosis were analyzed.Results All of 13 patients had fluctuating dementia.Among them,11 were diagnosed with probable DLB,and 2 were diagnosed with possible DLB.There were 8 cases (8/13) with volatility cognitive impairment,8 cases (8/13) with Parkinson's syndrome,8 casess (8/13) with visual hallucinations,13 cases (13/13) with memory loss,4 patients with limb tremor (4/13),5 cases with delirium (5/13),3 cases with increased sleep (3/ 13),1 case with silence (1/13),9 cases with anxiety and depression (9/13),one case with dizziness (1/13),6 cases with abnormal dysplasia (6/13),and one case with abnormal sensitive to diazepam (1/13).The cognitive function fluctuated,the condition deteriorated and two patients died during the follow-up from 6 months and 5 years.Conclusions Lewy body dementia is an irreversible and progressive neurodegenerative disease.Comprehensive understanding of its clinical features is helpful for the early diagnosis and treatment,which may in turn improve the prognosis.
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Objective To evaluate Roux-en-Y gastric bypass operation on carbohydrate and lipid metabolism in type 2 diabetes mellitus patients with BMI range of 24 -29. Methods Thirty seven cases of type 2 diabetes mellitus patients undergoing Roux-en-Y gastric bypass operation were studied. Body mass index (BMI), glycosylated hemoglobin ( GHbAlc), fasting glucose ( FPG), fasting insulin (FIns) and C-peptide( FC-p), HOMA-IR, oral glucose tolerance (OGTT) including 2 hour insulin (2hIns) and C-peptide (2hC-p) , plasma levels of total cholesterol (TC), triglycerides(TG), high density lipoprotein( HDL-c)and low density lipoprotein ( LDL-c) were measured preoperatively and on 3 months, 6 months, later postoperatively. Result There was no statistically significant difference between BMI values measured preoperatively and postoperatively (P>0. 05 ). Serum levels measured in pre-operative and third and sixth post-operative months were: FPG (8. 8 ± 0. 9, 7. 0 ± 2. 0, 6. 3 ± 0. 6, P<0. 01) ( mmol/L) , GHbAlc (8.2±1.2, 7.0±0.8, 6.2±0.7, P<0.01)(%), FIns(10. 6 ±1. 2, 9.0±0.9, 9.0±0.8, P<0.05)(mU/L), FC-p(1.9±0.5, 1.2 ±0.6, 1.2 ±0.4, P<0. 01) (nmol/L), TG(3.3 ±0.8, 2.7 ±0.9,2.6±0.7, P<0.05)(mmol/L), TC(6.5±1.8, 4.6±0.9, 4.2 + 1.0, P<0. 05) (mmol/L)and LDL-c (3. 6 ±1.2, 2. 8 ±0.8, 2. 7 ±0.2, P<0.01) (mmol/L), 2 hour glucose after OGTT(2hPG) (18. 6 ±3.0, 12.7 ±2.3, 11.4±2.0, P<0. 01) (mmol/L), HOMA-IR(3. 2 ± 1. 7, 2.6±1.6, 2. 5 ±1.3, P<0. 05). Postoperative levels of HDL-c (1. 2 ± 0. 1, 1. 4 ± 0. 4, 1. 4 ± 0. 2, P<0. 01) ( mmol/L) , 2hIns (17. 2 ±3.4, 26. 3 ±4.7, 28. 6 ±4.1, P<0. 01) (mU/L)and 2hC-p(4. 2 ± 1. 0, 6. 3 ± 1. 5, 6. 2 ± 1.4,P<0. 01 ) ( nmol/L) were significantly higher than that of the pre-operative values ( P<0. 01 ).Conclusions Roux-en-Y gastric bypass significantly improves the metabolism of carbohydrate and lipid in type 2 diabetes patients with BMI 24-29, and the effects are not associated with weight loss.
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Objective To observe the effects of Roux-en-Y gastrointestinal reconstruction(RYGR) on carbohydrate and lipid metabolism in non-obese patients with type 2 diabetes and gastric carcinoma.Methods Fifty seven gastric cancer cases who underwent radical distal gastrectomy were studied and among them 35 patients had Roux-en-Y gastrointestinal reconstruction (RYGR group) and 22 had Billroth-Ⅰ gastrointestinal reconstruction (B-I GR group).Both groups were subjected to the measuring of preoperative and postoperative third,sixth months values of body mass index (BMI),glycosylated hemoglobin (GHbA1c),fasting glucose (FPG),fasting insulin (Flns) and C-peptide (FC-P),oral glucose tolerance (OGTT) including 2 hour insulin (2hIns) and C-peptide (2hC-P),plasma levels of total cholesterol (TC),triglycerides (TG),high density lipoprutein (HDL-c) and low density lipoprotein (LDL-c).Result There was no significant difference between the two groups in preoperative values (P＞0.05).There was no statistically significant difference in BMI values measured postoperatively (P ＞ 0.05).In RYGR group,preoperative FPG and that of third and sixth month postoperatively was (9.3±0.9) mmol/L vs.(7.2±2.1) mmol/L vs.(7.1±0.8) mmol/L,P=0.000,GHbAlc was (9.2±1.2)% vs.(7.3±1.2)% vs.(7.2±1.1)%,P=0.000,TG was (3.21±0.88) mmol/L vs.(2.12±0.97) mmol/L vs.(2.02±0.09) mmol/L,P =0.000,TC was (6.4±1.9) mmol/L vs.(4.3±1.0) mmol/L vs.(4.1±1.0) mmol/L,P =0.000 and LDL-c was (3.61±1.05) mmol/L vs.(2.77±0.68) mmol/L vs.(2.71±0.18)mmool/L,P=0.000,2 hour glucose after OGTT(2hPG) was (17.6±2.5) mmol/L vs.(12.1±1.9) mmol/L vs.(11.6±2.3) mmol/L,P = 0.000.Levels of FIns was (98±11) pmol/L vs.(120±9)pmol/L vs.(122±8) pmol/L,P =0.000,FC-P was (0.21±0.08) mmol/L vs.(0.30±0.01) mmol/L vs.(0.30±0.01) mmol/L,P=0.000,HDL-c was (1.08±0.10) mmol/L vs.(1.61±0.34) mmol/L vs.(1.62±0.09) mmol/L,P = 0.000,2 h Ins was (410±19) pmol/L vs.(446±19) pmol/L vs.(459±18) pmol/L,P = 0.000 and 2 h C-P was (0.87±0.17) mmol/L vs.(1.22±0.14) mmol/L vs.(1.19±0.15) mmol/L,P =0.000.In B-I GR group,preoperative and third and sixth postoperative month values of GHbA1c were (9.2±1.2)% vs.(8.4±1.6)% vs.(8.3±1.1)%,P =0.046.Conclusion Roux-en-Y gastric bypass can significantly improve the metabolism of carbohydrate and lipid in non-obese patients with type 2 diabetes and gastric carcinoma,and the effects are not related with postoperative weight loss.
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Objective To explore the optimal storage methods to maintain serum clozapine (CZP) and N-desmethylclozapine (N-CZP) concentration in a long-term stablility. Methods Ten fresh clinical blood samples were collected, and each sample's serum was separated at volume of 0.5 ml into five pieces of 10 ml conic glass cen-trifuge tubes with cocks; then CZP and N-CZP were beth assayed with HPLC in samples collected on sampling day, stored at 4 ℃ and -20 ℃ for 12 weeks and 24 weeks,respectively. Results There was no significant difference in CZP among samples stored at 4 ℃ for 12 weeks[(525.1±124.3) μg/L] ,at -20 ℃ for 12 weeks[ (535.5± 126.7) and 24 weeks[ (532.5±126.7) μg/L] ,as well as collected on sampling day[(542.7±135.0) μg/L] (P>0.05); There was also no significant difference in N-CZP among samples stored at -20 ℃ for 12 weeks [(226.2±50. 7) μg/L] and 24 weeks[ (224.9±44.8) μg/L] and collected on sampling day[(236.9± 66.6) μL] (P>0.05). Conclusion CZP and N-CZP concentration would be maintained stable within 24 weeks under the refrigerated storage temperature of -20 ℃ at a fixed volume.
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Objective To investigate the influence of quetiapine fumarate on the liver function of patients with schizophrenia.Method Liver function change of 63 patients with schizophrenia were compared before treat- ment and at the end of six weeks after treatment with the method of self comparison.Results Patients'ALT in- creased evidently after treatment,A/G decreased(P0.05).Conclusions Quetiapine fumarate induces symptomless abnormal ALT and AST.But it has a great effect of estimation.
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0.05).Conclusion hs-CRP and TCH/HDL-C are closely associated with the stenosis,their combined detection would also be helpful in the evaluation of the severity of coronary artery disease.
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Objective To explore the expression of recombinant adenovirus hypoxia-inducing factor-1? (HIF-1?) and its effects on the angiogenesis in a rat model of acute hindlimb ischemia. Methods (1) Recombinant adenovirus HIF-1?-Al?564 (Ad-H564 for short) was amplified in large scale in HEK293A cells and concentration gradient centrifuged in CsCl, purified by dialysis and then its titer was determined by spectrophotometry. (2) A model of acute ischemia in rats' hind limb was reproduced, and 72 rats were randomly allocated into Ad-LacZ group, Ad-H0 group, Ad-H564 group and control group (18 rats for each group). After the HIF-1? mRNA expression was detected, six rats of control group were intramuscularly injected with normal saline (NS group) to serve as control. Angiography and vascular cast were carried out in another two groups with in each six rats to serve as sham operated controls. In to hind limb skeletal muscles of rats of Ad-LacZ, Ad-H0 and Ad-H564 groups Ad-LacZ, Ad-H0 and Ad-H564 were respectively injected, normal saline was given to the rats of NS group, and nothing was given to the rats in sham group. (3) HIF-1? mRNA expression was determined by RT-PCR on the 1st, 3rd, 5th and 7th day after injection. (4) Selective arteriography and vascular cast were performed to evaluate the vascular density. Results (1) PCR and gene sequencing suggested that correct recombinant adenovirus HIF-1? was obtained after being amplified and purified, and the titer of adenovirus was 1011OPU/ml. (2) RT-PCR showed that the highest expression of HIF-1? mRNA (0.544 7?0.141 2) was seen in Ad-H564 group, and the value was significantly different compared with that of normal group and Ad-LacZ group (P=0.000), but it did not show significant difference compared with that of Ad-H564 group and Ad-H0 group (0.533 0?0.041 6, P=0.368). The expression of HIF-1? mRNA reached the highest value on the 7th day in all the groups. (3) Arteriography on the 28th day after injection showed that the density of the collateral vessels was higher in Ad-H564 group than that in Ad-H0 group, but no significant difference was found. Vascular casts showed denser microvasculature in Ad-H564 group than that in the other groups. Conclusions The present study suggests that single site mutation may enhance the expression of human HIF-1? gene in the local muscles, facilitate angiogenesis in the ischemic tissue, but no significant difference was found between the wild-type and the mutated HIF-1? genes.