ABSTRACT
Objective To investigate the distribution and density of Culex mosquito populations and the resistance of Culex pipiens pallens to insecticides in Jiangsu Province in 2018 and 2019. Methods During the period from June to October in 2018 and 2019, six counties (districts, cities) were sampled in southern, northern and central Jiangsu Province as surveillance sites. The density of Culex mosquitoes was measured overnight using the light trapping technique. In addition, Culex pipiens pallens mosquitoes were collected from Hai’an of Nantong City and Yandu District of Yancheng City, central Jiangsu Province, and the sensitivity of female first filial generations to dichlorodiphenyltrichloroethane (DDT), malation, proposur, beta cypermethrin and deltamethrin was tested using the standard WHO insecticide susceptibility test assay. Results A total of 104 423 Culex mosquitoes were captured in six surveillance sites of Jiangsu Province in 2018 and 2019, and Culex quinquefasciatus (49.11%), Culex pipiens pallens (28.38%), and Culex tritaeniorhynchus (21.04%) were predominant species. The density of Culex mosquitoes started to increase since early June, peaked in July and tended to be low in late October. Culex pipiens pallens mosquitoes captured from Hai’an was susceptible to malation, while those from Yandu District were moderately resistant to malation. Culex pipiens pallens mosquitoes from both Yandu and Hai’an were moderately resistant to proposur, and were resistant to DDT, beta cypermethrin and deltamethrin. Conclusions Culex quinquefasciatus, Culex pipiens pallens and Culex tritaeniorhynchus are predominant Culex species in Jiangsu Province. Culex pipiens pallens is resistant to DT, beta cypermethrin and deltamethrin in central Jiangsu Province.
ABSTRACT
Objective To analyze the changes of small molecular metabolites in the larvae of a deltamethrin-sensitive strain of Anopheles sinensis following exposure to deltamethrin, so as to provide the scientific basis for investigating the metabolic pathway and screening metabolic markers of deltamethrin in An. sinensis. Methods The 50% and 75% lethal concentrations (LC50 and LC75) of deltamethrin against the larvae of a deltamethrin-sensitive strain of An. sinensis were calculated in laboratory. The type and content of An. sinensis larvae metabolites were detected using high performance liquid chromatography and mass spectrometry (LC-MS/MS) following exposure to deltamethrin at LC50 and LC75 for 30 min and 24 h, and the changes of metabolites were analyzed. Results The LC50 and LC75 values of deltamethrin were 4.36 × 10-3 µg/mL and 1.12 × 10-2 µg/mL against thelarvae of a deltamethrin-sensitive strain of An. sinensis. Following exposure of the larvae of a deltamethrin-sensitive strain of An. sinensis to deltamethrin at LC50 and LC75 for 30 min, the differential metabolites mainly included organic oxygen compounds, carboxylic acid and its derivatives, fatty acyl and pyrimidine nucleotides, with reduced glucose levels. Following exposure for 24 h, the differential metabolites mainly included organic oxygen compounds, carboxylic acid and its derivatives, aliphatic acyl and purine nucleotides, with increased glucose level detected. Conclusion Carbohydrate, carboxylic acid and its derivatives, fatty acyls, amino acids and their derivatives may play important roles in deltamethrin metabolism in the larvae of a deltamethrin-sensitive strain of An. sinensis.
ABSTRACT
Malaria was one of the major infectious diseases in Jiangsu Province, where Anopheles sinensis and An. anthropophagus are main vectors for malaria transmission. Following the concerted efforts for decades, the goal of malaria elimination was achieved in Jiangsu Province in 2019, and the vector control strategy has played a vital role during the progress towards malaria elimination in Jiangsu Province. Hereby, we review the historical distribution and ecological features of An. sinensis and An. anthropophagus and describe vector control strategies at different stages of malaria control in Jiangsu Province. In addition, the advances in the research of vector biology and control in Jiangsu Province are discussed, including vector identification, strain colonization, susceptibility to malaria parasites and insecticide resistance.
ABSTRACT
OBJECTIVE@#To study the expression and diagnostic value of plasma miR-145 and miR-183 in children with lupus nephritis (LN).@*METHODS@#A total of 92 children with LN who were admitted from January 2016 to May 2019 were enrolled as the LN group, among whom 17 had type II LN, 15 had type III LN, 36 had type IV LN, 18 had type V LN, and 6 had type VI LN. Forty healthy children who underwent physical examination were enrolled as the healthy control group. According to Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), the 92 children with LN were further divided into a stable LN group with 34 children (SLEDAI score <10) and an active LN group with 58 children (SLEDAI score ≥10). RT-PCR was used to measure the expression of miR-145 and miR-183 in plasma. The receiver operating characteristic (ROC) curve was used to analyze the value of plasma miR-145, miR-183, and anti-dsDNA antibody in the diagnosis of LN. Pearson correlation analysis was used to investigate the correlation of the expression levels of miR-145 and miR-183 in plasma with laboratory markers.@*RESULTS@#The LN, active LN, and stable LN groups had significantly higher levels of anti-dsDNA antibody, C-reactive protein, serum creatinine (Scr), and blood urea nitrogen (BUN) than the control group (P<0.05). The active LN group had significantly higher SLEDAI score, anti-dsDNA antibody, Scr, and BUN than the stable LN group (P<0.05). The LN, active LN, and stable LN groups had significantly lower levels of complement C3, complement C4, and serum albumin (Alb) than the control group (P<0.05). The active LN group had a significantly lower level of Alb than the stable LN group (P<0.05). The LN, active LN, and stable LN groups had significantly lower plasma levels of miR-145 and miR-183 than the control group (P<0.01). The active LN group had significantly lower plasma levels of miR-145 and miR-183 than the stable LN group (P<0.01). The children with difference types of LN had significantly lower plasma levels of miR-145 and miR-183 than the control group (P<0.01), and the type V-VI group and the type IV group had significantly lower plasma levels of miR-145 and miR-183 than the type II-III group (P<0.01). The ROC curve analysis showed that the optimal cut-off values of plasma miR-145, miR-183, and anti-dsDNA antibody were 1.05, 0.62, and 186.30 IU/mL respectively, in the diagnosis of LN, and the combination of these three indices had the largest area under the ROC curve of 0.896 (95%CI: 0.835-0.955), with a sensitivity of 90.5% and a specificity of 84.2%. In the children with LN, the plasma levels of miR-145 and miR-183 were negatively correlated with SLEDAI score, anti-dsDNA antibody, Scr, and BUN (P<0.05) and were positively correlated with complement C3, complement C4, and Alb (P<0.05).@*CONCLUSIONS@#There are significant reductions in the expression levels of miR-145 and miR-183 in plasma in children with LN, which are correlated with the activity level and pathological typing of LN. Combined measurement of miR-145, miR-183, and anti-dsDNA antibody has a high value in the diagnosis of LN.
Subject(s)
Child , Humans , Biomarkers , Complement C4 , Lupus Nephritis , Genetics , MicroRNAs , Genetics , ROC CurveABSTRACT
This paper reported one acute lymphoblastic leukemia patient who infected with Plasmodium falciparum after blood transfusion. Through the epidemiological investigation on this patient and the related blood donors as well as laboratory detections, the source of infection was ascertained. This blood donor was an overseas student from Africa, whose blood sample was positive in the rapid diagnostic test, and the results of microscopic examination of peripheral blood smear and PCR both suggested P. falciparum positive.
ABSTRACT
Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
ABSTRACT
OBJECTIVE@#To explore the causes and specific conditions of blood donation reaction under the collective emergency unpaid blood donation, and to provide theoretical basis and decision-making reference for drafting the collective emergency unpaid blood donation and blood donation safety.@*METHODS@#Through a combination of prospective and retrospective models, and statistical methods were used to analyze the causes and conditions of the blood donation response of 10401 people participating in collective emergency unpaid blood donation during 2016.1-2018.8.@*RESULTS@#A total of 10401 person-times donated blood in a sitting manner, and a total of 293 blood donation reactions occurred. By improving the blood donation services year by year, the moderate blood donation reaction during the year 2017 and 2018 was significantly lower than that in 2016 (P＜0.05). In the actual blood donation group of≤100, 200, 300 and 400 ml, the incidence of blood donation reaction was statistically significant (P＜0.05); the incidence of blood donation reaction in the blood donors for 1,2,3 and ＞3 drnations was also statistically significant (P＜0.05); the blood donation reactions rate of B antigen containers was significantly different from the donors without B antigen (P＜0.05); the incidence of blood donation reaction with related to the weight of the donor.@*CONCLUSION@#The blood donation reaction of collective emergency unpaid blood donation closely relates with mental factors, blood donation service, blood donation frequency and body weight of the blood donor. The first blood donation is more likely to produce blood donation reaction. The blood donation volum≤ 100 ml from blood donors is resulted mostly from blood donation reactions.
Subject(s)
Humans , Blood Donors , Blood Group Antigens , Prospective Studies , Retrospective StudiesABSTRACT
Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory (PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests (rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P. vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. falciparum and P. ovale mixed-infection. The diagnostic coincidence rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falciparum, P. vivax, P. malariae, and P. ovale were 98.8%, 57.1%, 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%, 85.0%, 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non- P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
ABSTRACT
This paper reported one acute lymphoblastic leukemia patient who infected with Plasmodium falciparum after blood transfusion. Through the epidemiological investigation on this patient and the related blood donors as well as laboratory detections, the source of infection was ascertained. This blood donor was an overseas student from Africa, whose blood sample was positive in the rapid diagnostic test, and the results of microscopic examination of peripheral blood smear and PCR both suggested P. falciparum positive.
ABSTRACT
To analyze the vector surveillance results during the stage of malaria elimination, so as to provide the evidence for assessing the local transmission risk of imported malaria and carrying out the surveillance work after malaria elimination in Jiangsu Province.From 2011 to 2017, the mosquito population was monitored and human biting rates were calculated by the half overnight human baiting trapping method and overnight lamp trapping method in 7 surveillance sites from June to October. The insecticide resistance level was tested by the force contact method recommended by WHO.A total of 5 106 Anopheles mosquitoes were captured by the half over-night human baiting trapping method in the 7 sites from 2011 to 2017, and all the mosquitoes were identified as Anopheles sinensis. The annual human biting rates were 1.075, 0.786, 1.057, 0.787, 0.790, 1.797 and 1.185 mosquitoes/ (human·hour), respectively. Totally 28 186 Anopheles mosquitoes were caught by the overnight lamp trapping method, and all the mosquitoes were An. sinensis. The densities of Anopheles mosquitoes were 57.950, 50.932, 14.800, 4.405, 58.070, 72.406, and 17.145 mosquitoes/ (night·lamp), respectively. In 2012, the resistance indexes of An. sinensis to deltamethrin, DDT and malathion were at R level in Jiangsu Province.The major vector is An. sinensis and no An. anthropophagus is found in Jiangsu Province. An. sinensis has a high level of resistance to deltamethrin, DDT and malathion.
ABSTRACT
There were vivax malaria, falciparum malaria, and malariae malaria epidemic in Jiangsu Province, and vivax malaria was the dominant disease. Anopheles sinensis and An. anthropophagus were malaria-transmitted vectors. Since the founding of People’s Republic of China, there have been two major malaria outbreaks in Jiangsu Province, when the highest annual malaria incidence reached up to 24.95%. According to prevention and control principles of “adjusting measures to local conditions, giving different guidance to different categories and highlighting key points”, during the epidemic outbreak stage, the largescale malaria prevention and control measures were implemented for all the residents who were target population in Jiangsu malaria-endemic areas. During the basic eradication stage, the targeted prevention and control measures had been carried out according to the different epidemic features to gradually consolidate the achievement of prevention and control in Jiangsu Province. In the malaria elimination stage, Jiangsu Province focused on controlling of the source of infection and malaria surveillance. According to the “1-3-7 targeted elimination” work model, the management of infectious sources and investigation and disposal of foci were carried out for each epidemic focus to block the malaria transmission. By the end of 2017, there had been no indigenous malaria cases for the six consecutive years in Jiangsu Province. All the 13 cities have passed the assessment of malaria elimination of Jiangsu Province. Although Jiangsu Province has achieved the goal of malaria elimination, it is urgent and necessary to maintain and improve malaria surveillance capabilities to prevent malaria reintroduction.
ABSTRACT
Objective To explore the expression characteristics of cytochrome P450(CYP)candidate genes(CYP6M3, CYP6Y1,CYP6P5,CYP4H14,CYP4G17,CYP12F16)in Anopheles sinensis.Methods The samples were collected from dif-ferent developmental stages(eggs,larvae,pupae and adult mosquitoes(females and males)),and different tissues(salivary glands,malpighian tubes,midguts,ovaries,and fat bodies)of An.sinensis and the female adult mosquitoes exposed by differ-ent insecticide doses(0,1.25,3.75,6.25,12.5μg/bottle)and time points(0,5,15,30,60 minutes),then the total RNA was extracted. Quantitative reverse transcription PCR(qPCR)assay was used to analyze the relative expressions of six CYP genes in An.sinensis at different developmental stages,tissues and different insecticide exposure doses and time.Results The expressions of CYP6M3 and CYP6Y1 in the male adult mosquitoes were the highest,the expression of CYP6M3 gene in the males was 35.1 times higher than that in the females,the expression of CYP6Y1 in the males was 61.4 times higher than that in the females;the expression level of CYP4H14 in the larvae was the lowest,the expression of CYP4H14 in the females was 22.5 times higher than that in the fourth instar larvae.The expressions of candidate CYP genes in different tissues of An.sinensis were significantly different,the expression of CYP6M3 in the malpighian tubule was 38.9 times higher than that in the ovary,the ex-pression of CYP6Y1 in the fatbody was 9.1 times higher than that in the ovary,the expression of CYP4G17 was 4.6 times higher than that in the ovary,and the expression of CYP12F16 was 4.4 times higher thanthat in the ovary.The exposure to different in-secticide doses and time showed some induction effects in the expressions of candidate CYP genes,which affected the expres-sions of candidate CYP genes in An.sinensis.Conclusion The expression of candidate CYP genes varies significantly in differ-ent developmental stages and various tissues of An.sinensis,and exposure to deltamethrin at various doses and time points af-fects CYP genes expression in An.sinensis.
ABSTRACT
Glucose-6-phosphate dehydrogenase deficiency (G6PD) is one of hereditary diseases sariously influencing the human health. G6PD is characterized by wide distribution, high incidence, inducing the hemolysis, complex mechanism of hemolysis and common occurence in children and so on. The blood transfusion is most effective method for acute ouset of hemolysis, but the risk is more high, thereby it is necessary to guarante the safety of blood transfusion. In addition of the routine managementin blood transfusion and standard procedures, the basic rules and indicators of blood transfusion must be grasped, the blood preparations should be known well, the blood protection must be strengthened, and the measures of personalized psychologic interference must be drawn up carnestly and performed strictily so as to improve the therapeutic efficacy and safe of blood transfusion. Through the promotion and development of social pubbicity, elucation activities, preventive and control measures and medical levels, many patients have been freed from healthy problems as soon as possible. In this review, the research progress on acute hemolysis and safe blood transfusion in G6PD are summarized.
ABSTRACT
Objective To investigate the clinical efficacy of CRRT in the treatment of severe pancreatitis.Methods 120 patients with severe pancreatitis were divided into two groups according to the treatment.All the patients were given basic treatment in all groups.The Pa arterial oxygen pressure (PaO2),oxygenation index (PaO2/FiO2),and C-reactive protein (CRP) in the two groups after 72 hours of treatment were observed.The levels of blood lactate (Lac),APACHEII,tumor necrosis factor α(TNF-α),interleukin-6 (IL-6) and interleukin-1β (IL-1β) were measured before and after treatment 72 hours.A comparison of mortality and hospitalization time was observed in 28 days of treatment.Results After treatment,Lac [the control group (3.32±0.85)mmol/L,the observation group (2.55±0.65)mmol/L],APACHEII score [the control group (13.30±2.80)points,the observation group (12.01±2.60)points],CRP [the control group (24.30±2.80)mg/L,the observation group (12.33±1.60)mg/L] were significantly lower than before treatment [Lac:the control group (4.85±1.05)mmol/L,the observation group (4.90±1.02)mmol/L;APACHEII score:the control group (16.62±2.95)points,the observation group (16.90±3.01)points;CRP:the control group (40.32±3.10)mg/L,the observation group (40.40±3.51)mg/L;the control group:tLac=1.67,P=0.004,tAPACHEII=6.32,P=0.000,tCRP=29.71,P=0.000;the observation group:tLac=15.05,P=0.005,tAPACHEII=9.52,P=0.000,tCRP=56.36,P=0.000].PaO2 [the control group (75.30±4.80)mmHg,the observation group (84.31±4.60)mmHg], PaO2/FiO2 [the control group (225.30±14.83)mmHg,the observation group (256.31±14.65)mmHg] were significantly higher than before treatment [PaO2:the control group (60.32±4.15)mmHg,the observation group (60.40±4.01)mmHg;PaO2/FiO2:the control group (130.39±11.15)mmHg,the observation group (130.90±11.01)mmHg;the control group:tPaO2=18.29,P=0.000,tPaO2/FiO2=39.62,P=0.000;the observation group:tPaO2=30.35,P=0.000,tPaO2/FiO2=53.01,P=0.000].Those in the observation group were significantly improved than the control group (tLac=5.574,P=0.00,tAPACHEII score=2.615,P=0.005,tPaO2=3.646,P=0.0002,tPaO2/FiO2=11.523,P=0.00,tCRP=28.751,P=0.000).After treatment,the TNF-α,IL-6 and IL-1β levels in the two groups [the control group:IL-1β (70.32±6.85)ng/mL,IL-6 (103.30±8.80)ng/mL,TNF-α (89.30±8.80) ng/mL;the observation group:IL-1β(48.55±6.62)ng/mL,IL-6(92.01±8.60)ng/mL,TNF-α(57.31±7.60)ng/mL] were significantly improved than before treatment [the control group:IL-1β(82.85±7.05)ng/mL,IL-6(173.62±9.95)ng/mL,TNF-α (105.32±9.15)ng/mL;the observation group:IL-1β(83.90±7.32)ng/mL,IL-6 (175.90±10.01)ng/mL,TNF-α (106.40±9.01)ng/mL;the control group:tIL-1β=9.66,P=0.000,tIL-6=41.01,P=0.000,tTNF-α=9.77,P=0.000;the observation group:tIL-1β=27.74,P=0.000,tIL-6=49.23,P=0.000,tTNF-α=32.26,P=0.000].And those of the observation group improved more significantly than the control group (tIL-1β=17.702,P=0.00,tIL-6=7.107,P=0.00,tTNF-α=21.311,P=0.000).The mortality rate and hospitalization time of the observation group were 18.33% and (10.97±2.92)days,which were significantly lower than those of the control group [36.67%,(13.63±3.26)days;χ2=5.058,P=0.025;t=4.708,P=0.000).Conclusion The use of CRRT in the treatment of severe pancreatitis can improve the vital signs,reduce the inflammation index,improve the serum levels of inflammatory factors and lactic acid,reduce the mortality and hospital stay.
ABSTRACT
BACKGROUND:Many experiments and clinical studies have reported that venous blood, absorbable colagen sponge and rich fibrin clot, without the use of bone graft material, can al promote new bone formation; therefore, whether only transplanting concentrated growth factor in the maxilary sinus lift could effectively promote bone regeneration? OBJECTIVE: To conduct the maxilary sinus lift with concentrated growth factor as the graft material, and to observe the peri-implant bone level change. METHODS: Totaly 26 patients were involved, including 14 males and 12 females, aged 35-73 years. Maxilary sinus lift was conducted and autologous concentrated growth factor was taken as the graft material. Astra Tech implants were implanted simultaneously. Patients were divided into 6-12 months, 13-18 months and > 18 months groups according to the folow-up time. Patients were divided into≤ 5 mm, 5-7 mm, and≥ 7 mm groups according to the preoperative alveolar bone height. Patients were divided into≤ 2 mm, 2.0-3.0 mm, and≥3 mm groups according to the postoperative maxilary sinus lift height. The survival rate of implants and marginal bone level changes were observed during the folow-up. RESULTS AND CONCLUSION: Totaly 44 implants were implanted, of which 43 implants were considered as successful repair during the 6-18 months of postoperative folow-up. The survival rate of implants was 98%. There were no significant differences in the changes of mesial, distal and middle marginal bone levels between different folow-up time groups. The maxilary sinus lift with transplantation of concentrated growth factor resulted in a good osseointegration within 6-18 months post-operation. In addition, no significant differences were found in the changes of mesial, distal and middle marginal bone levels between different residual alveolar bone height groups, as wel as between different maxilary sinus lift height groups. It showed that the residual alveolar bone height and maxilary sinus lifting height had no significant effect on the peri-implant bone formation. Briefly, these findings demonstrate that the maxilary sinus lift with concentrated growth factor transplantation can result in a high survival rate of implants that are simultaneous implanted, and the alveolar bone around the implant is stable. But the long-term effect needs further observation.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical features and prognosis of bone metastases in colorectal cancer patients.</p><p><b>METHODS</b>The clinical data of 104 cases of colorectal cancer with bone metastasis were collected and retrospectively analyzed.</p><p><b>RESULTS</b>Among all the 104 patients included, 45 (43.3%) patients had multiple bone metastases, and 59 (56.7%) patients had single bone metastasis. Pelvis (46.1%) was the most common site, followed by thoracic vertebrae (41.3%), lumbar vertebrae (40.4%), sacral vertebrae (29.8%) and ribs (29.8%). One hundred and two patients (98.1%) were complicated with other organ metastases. The median time from colorectal cancer diagnosis to bone metastasis was 16 months, and the median time from bone metastasis to first skeletal-related events (SREs) was 1 month. The most common skeletal-related events (SREs) were the need for radiotherapy (44.2%), severe bone pain (15.4%) and pathologic fracture (9.6%). The median survival time of patients with bone metastases was 10.0 months, and 8.5 months for patients with SREs. ECOG score, systemic chemotherapy and bisphosphonate therapy were prognostic factors by univariate analysis (all P < 0.05). ECOG score and systemic chemotherapy were independent prognostic factors by Cox multivariate analysis.</p><p><b>CONCLUSIONS</b>Bone metastasis in colorectal cancer patients has a poor prognosis and the use of chemotherapy and bisphosphonates may have a benefit for their survival.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Bone Density Conservation Agents , Therapeutic Uses , Bone Neoplasms , Drug Therapy , Radiotherapy , Colorectal Neoplasms , Drug Therapy , Pathology , Radiotherapy , General Surgery , Diphosphonates , Therapeutic Uses , Follow-Up Studies , Fractures, Bone , Lumbar Vertebrae , Pathology , Pain , Pelvic Bones , Pathology , Prognosis , Retrospective Studies , Ribs , Pathology , Sacrum , Pathology , Spinal Cord Compression , Spinal Neoplasms , Drug Therapy , Radiotherapy , Thoracic Vertebrae , PathologyABSTRACT
<p><b>OBJECTIVE</b>To compare the efficacy difference in the treatment of insomnia between scraping technique of stuck needle and conventional acupuncture at Anmian (Extra).</p><p><b>METHODS</b>One hundred and thirty one cases were randomized into an Anmian group (68 cases) and a conventional acupuncture group (63 cases). In the Anmian group, Anmian (Extra) was selected. After arrival of qi, the stuck needling was adopted by rotating the needle gently in single direction, 2-3 rounds till the needle body was stuck tightly. Afterwards, the needle tail was touched gently with the index finger to fix the needle body and the needle handle was scraped gently with the thumbnail from bottom to up. The needle was retained for 30 min. In the conventional acupuncture group, Sanyinjiao (SP 6), Shenmen (HT 7) and Baihui (GV 20) were selected and stimulated with reducing technique by rotating the needles. The needles were retained for 30 min. The treatment was given once every day, continuously for 2 weeks in both groups. The score of each factor and the total score in Pittsburgh sleep quality index (PSQI) were assessed before and after treatment in the two groups. Additionally, the efficacies of two groups were evaluated.</p><p><b>RESULTS</b>For the patients in the conventional acupuncture group, the sleep quality and time of falling into spleen after treatment were improved as compared with those before treatment (all P < 0.01). The improvement of sleep time, sleep efficiency, sleep disturbance, hypnotic drug and daytime dysfunction, and PSQI total score did not present statistically significant difference as compared with those before treatment (all P > 0.05). After treatment, for the patients in the Anmian group, the factor score and total score in PSQI were apparently improved as compared with those before treatment (P < 0.01, P < 0.05). And the improvements of the above items were superior to the conventional acupuncture group (P < 0.01, P < 0.05). The total effective rate was 91.2% (62/68) in the Anmian group and was 74.6% (47/63) in the conventional acupuncture group. The clinical efficacy in the Anmian group was apparently superior to the conventional acupuncture group.</p><p><b>CONCLUSION</b>The scraping technique of stuck needle at Anmian (Extra) achieves the superior effect on insomnia as compared with the conventional acupuncture.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Acupuncture Therapy , Methods , Needles , Sleep , Sleep Initiation and Maintenance Disorders , Therapeutics , Treatment OutcomeABSTRACT
<p><b>INTRODUCTION</b>Constipation is a common poststroke complication. This study was designed to document the incidence and clinical course of poststroke constipation in a rehabilitation ward, as well as identify the factors independently associated with the condition.</p><p><b>METHODS</b>This retrospective study involved patients who were admitted to the rehabilitation ward of our institute due to an acute stroke between 1 August 2010 and 31 July 2011. The main outcome measured was the incidence of poststroke constipation, defined as the use of laxative after stroke, fulfilment of the Rome II diagnostic criteria for functional constipation and/or stool impaction. The variables examined were basic demographic data, presence of impairment, degree of disability (evaluated using the Barthel index), walking ability, medications taken and medical complications.</p><p><b>RESULTS</b>Out of the 155 patients who met the inclusion criteria, 123 (79.4%) had poststroke constipation. All 123 patients used oral laxatives; 56 received additional rectal medications and 13 discontinued their use of laxatives at discharge. Patients with poststroke constipation were more likely to have major medical complications (p = 0.04). Those who used rectal medications had a higher risk of major medical complications than those who used only oral laxatives (p < 0.01). Infratentorial lesions were an independent predictor of poststroke constipation (p = 0.003). More severe disability increased the severity of constipation, as indicated by the use of rectal medication.</p><p><b>CONCLUSION</b>Poststroke constipation is a common complication during inpatient rehabilitation. Healthcare providers should be aware of the incidence of poststroke constipation. Further studies are required to establish standard guidelines for screening and managing bowel function in patients with stroke.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Age Distribution , Cohort Studies , Constipation , Drug Therapy , Epidemiology , Follow-Up Studies , Incidence , Laxatives , Therapeutic Uses , Rehabilitation Centers , Retrospective Studies , Risk Assessment , Severity of Illness Index , Sex Distribution , Singapore , Stroke , Diagnosis , Stroke Rehabilitation , Treatment OutcomeABSTRACT
We report the effects of intravitreal ranibizumab as salvage therapy in an extremely low-birth-weight [ELBW] infant with rush type retinopathy of prematurity [ROP]. This case was a girl of 23 weeks gestational age weighing 480 g at birth. At a postconceptual age of 33 weeks, she presented with zone 1, stage 3 ROP with plus disease. Despite intravitreal bevazucimab and laser photocoagulation, extraretinal fibrovascular proliferation persisted. Intravitreal 0.25 mg [0.025 ml] ranibizumab was injected OU. After treatment, extraretinal fibrovascular proliferation disappeared. Fundus examination showed flat retinas and normal vasculature in both eyes. She has been followed up for 2 years. Intravitreal ranibizumab injection seems effective and well tolerated as salvage therapy in an ELBW infant with rush type ROP. No short-term ocular or systemic side effects were identified. More cases and longer follow-up are mandatory
Subject(s)
Humans , Female , Infant, Newborn , Ranibizumab , Intravitreal Injections , Salvage Therapy , Infant, Extremely Low Birth WeightABSTRACT
Background and Objectives: Anticoagulation clinics are widely used for anticoagulation management in many countries, but have only recently began to gain acceptance in Taiwan. Our service model is a physician-managed outpatient clinic collaborating with clinical pharmacist and nurse. This study aimed to evaluate the adequacy of anticoagulation and rates of warfarin-related complications before and after referral to our collaborative anticoagulation clinic (CAC). Methods: Stroke patients taking warfarin from the neurology department were identifi ed and referred to the CAC during the 12-month period from February 2009 to January 2010. Quality markers include percentage of international normalized ratio (INR) values in the therapeutic range, frequency of INR monitoring, and frequency of follow-up visits and the mean interval of next INR monitoring after non-therapeutic INRs were compared one year before and after management in the CAC. Using studied patients as self-control, they were included in the analysis if patients had at least 3 months follow-up or 3 INR values both before and after referral. Results: A total of 44 stroke patients were included: mean age of 75.0 ± 9.7 years, with a CHADS2 score of 3.71 ± 0.69. The adequacy of anticoagulation was signifi cantly greater during CAC care compared with the period before referral; the percentage of INR within expanded therapeutic range was 60.9% versus 53.7%, respectively (p=0.049). Reduction in sub-therapeutic INR values from 31.8% to 24.2% (p=0.023) contributed mostly to the improved quality of care. The time interval of next INR monitoring after non-therapeutic INRs ( 4.0 or 1.5) was also signifi cantly shorter. However, there was no signifi cant difference in the rates of thromboembolic and hemorrhagic events which may be attributed to a small sample size. Conclusion: Based on results of our study, a CAC may be the optimal structure for anticoagulation management service in the future.