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Objective@#The consistency of 24-hour oropharyngeal Dx-pH monitoring and proton pump inhibitor(PPI) test in the diagnosis of laryngopharyngeal reflux disease (LPRD) was investigated.@*Methods@#Sixty patients with laryngopharyngeal reflux (LPR) related symptoms who had never received PPI treatment were assessed by reflux symptom index (RSI) and reflux finding score (RFS) between October 2017 and October 2018, including 28 males and 38 females, aged from 16 to 72 years, with a medium age of 38 years. Prior to treatment, all patients were evaluated with 24 hours oropharyngeal Dx-pH monitoring(Restech). After empiric therapy with PPI twice-daily for 8 weeks, the efficacy was evaluated according to posttreatment RSI score.The data was analysed with Kruskal-Wallis test, Student Newman Keuls test and consistency check.@*Results@#(1)Among all 60 patients,13 patients (21.7%) had pathologic Ryan score and all resulted responsive to PPI;27 patients (45.0%) with a negative Ryan score were unresponsive to PPI; 20 patients (33.3%) despite a negative Ryan score resulted responsive to PPI therapy. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of Ryan score were 39.4%, 100%, 100% and 57.4% respectively. The Kappa value was 0.369 (P<0.01). (2)Among 34 patients (56.7%) with positive Dx-pH results (24-hour oropharyngeal acid reflux events≥ 3 times), 29 patients were positive and 5 patients were negative in PPI test. Among 26 patients with negative Dx-pH results (24-hour oropharyngeal acid reflux events<3 times), 4 patients were positive and 22 patients were negative in PPI test. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of 24-hour oropharyngeal acid reflux events were 87.9%, 81.5%, 85.3% and 84.6% respectively. The Kappa value was 0.696(P<0.01).@*Conclusions@#There is a positive correlation between 24-hour oropharyngeal Dx-pH monitoring positive results (24-hour oropharyngeal acid reflux events≥3 times) and PPI test in the diagnosis of LPRD. The 24-hour oropharyngeal Dx-pH monitoring can be a promising tool for the diagnosis of suspected LPRD patients, and more sensitive and accurate Dx-pH diagnostic index will be required in the clinic.
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Objective: To study diagnostic and predictive value of levels of high sensitive C reactive protein (hsCRP) and cystatin C (CysC) for acute coronary syndrome (ACS) in aged patients.Methods: A total of 60 ACS patients (ACS group) treated in our hospital and 60 healthy subjects (healthy control group) undergoing physical examination during Dec 2013 to Sep 2015 were randomly selected.Serum levels of hsCRP and CysC, and abnormal rates of hsCRP and CysC were measured and compared between two groups.Results: Compared with healthy control group, there were significant rise in serum levels of hsCRP[(3.02±1.13) mg/L vs.(7.95±2.38) mg/L]and CysC[(0.75±0.11) μg/ml vs.(1.35±0.43) μg/ml], and abnormal rates of hsCRP (0 vs.13.33%) and CysC (0 vs.11.67%) in ACS group, P<0.01 all.Conclusion: Serum hsCRP and CysC level measurements can effectively predict and assess occurrence, development and prognosis of disease in ACS patients, and provide clinical valid evidence for its diagnosis, prevention and treatment.
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<p><b>OBJECTIVE</b>To investigate the onset time and efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in children with house dust mites (HDM)-induced allergic rhinitis (AR).</p><p><b>METHODS</b>One hundred and forty three children with perennial moderate to severe HDM-induced AR were treated by SLIT with standardized Dermatophagoides farinae extract. One hundred children who finally completed two years treatment were divided into two groups according to the age: younger children group (aged 4-8 years, n = 52) and older children group (aged 9-14 years, n = 48). Respectively, Each children was assessed before and after 1st, 2nd, 3rd, 6th, 12th, 24th months of the treatment. Total nasal symptom score (TNSS), total medication score (TMS) and visual analogue scale (VAS) were evaluated at each visit. All clinical data were analyzed retrospectively with the SPSS 19.0 software.</p><p><b>RESULTS</b>TNSS, TMS and VAS of two groups decreased significantly after three months of the treatment compared with before (younger children group: Z value was -3.843, -3.534, -3.940, older children group: Z value was -3.938, -3.405, -3.953, all P < 0.05). TNSS and VAS of younger children group decreased significantly after two months of the treatment compared with before (6.4 ± 1.6, 5.3 ± 1.4 vs 8.6 ± 1.2, 7.9 ± 1.6, Z value was -3.843, -3.940, both P < 0.05). Five children (5%) experienced local adverse events and 2 children (2%) experienced mild systemic adverse events. No severe adverse events happened during the treatment.</p><p><b>CONCLUSIONS</b>SLIT with Dermatophagoides farinae drops is an efficient and safe treatment for children with HDM-induced AR. Its onset of action can be observed as early as 3 months after treatment.</p>
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Adolescent , Animals , Child , Child, Preschool , Humans , Administration, Sublingual , Allergens , Antigens, Dermatophagoides , Dermatophagoides farinae , Retrospective Studies , Rhinitis, Allergic, Perennial , Drug Therapy , Software , Sublingual Immunotherapy , Treatment OutcomeABSTRACT
Objective To investigate curative efficacy of tetramethylpyrazine in combination with chemotherapy in treatment of medium and advanced liver cancer and its effects on level of brain-derived neurotrophic factor ( BDNF).Methods 90 patients of medium and advanced liver cancer who received therapy from January 2011 to June 2012 were selected as research objects.According to therapeutic schemes, those patients were divided into the control group (n=42) and the observation group (n=48).The control group was treated with transcatheter hepatic arterial chemoembolization ( TACE) , while the observation group was treated with tetramethylpyrazine in combination with TACE.Then, the short-term curative efficacy, long-term curative efficacy, level of BDNF and adverse reactions were compared.Results The total short-term therapeutic efficacy ratio in the observation group was statistically higher than that in the control group ( 83.3% vs 64.3%, P <0.05 ).During the three-year follow-up, the one-year and two-year survival rate in the observation group was statistically same with that in the control group respectively (75.0% vs 66.7%, 66.7% vs 59.5%), while the three-year survival rate was statistically higher than that in the control group (52.1%vs 30.9%, P<0.05).After treatment, in comparison with the control group, level of BDNF in the observation group was statistically lower(P<0.05).During treatment, incidences of liver function deterioration, abdo minal pain and diarrhea, nausea and vomiting, fever and headache in two groups were statistically same.Conclusion Tetramethylpyrazine in combination with TACE is effective for medium and advanced liver cancer, which can increase short-term and survival rate to some extent, significantly reduce level of BDNF with not increasing incidence of adverse reactions.
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Objective To observe the clinical efficacy of therapy of soothing liver and clearing heat for the treatment of glucocorticoid-dependent adult chronic idiopathic thrombocytopenic purpura ( CITP) . Methods Thirty-two qualified glucocorticoid-dependent adult CITP patients with the syndrome of interior heat due to liver stagnation and liver failing in storing blood were enrolled into the study. Based on the primary regimen, the patients were additionally given Shugan Qingre Recipe ( mainly composed of Rhizoma Dioscoreae, Radix Bupleuri, Radix Paeoniae Alba, Radix Rehmanniae, Cortex Moutan, Herba Artemisiae Scopariae, Poria, Fructus Corni, Fructus Lycii, Herba Agrimoniae , Radix Rubiae, Radix Glycyrrhizae) for 3 months (12 weeks), 2 doses a day, decocting with water for oral use. Before and after treatment, the changes of Chinese medical syndrome scores and the laboratory indexes were investigated. Results (1) After treatment for 12 weeks, 10 cases were markedly effective, 16 effective , 5 improved, one ineffective, and the total effective rate arrived to 81.25%. ( 2) After treatment for one month, the scores of traditional Chinese medical syndrome were not improved ( P>0.05 compared with those before treatment) . At the end of 2-month and 3-month treatment course, the scores were improved obviously compared with those before treatment, the difference being significant (P<0.05 or P<0.01) . (3) Platelet count rose up from the fourth week of treatment, and the difference was significant compared with that before treatment ( P<0.01) . Conclusion Therapy of soothing liver and clearing heat shows certain ef fect for the treatment of glucocorticoid-dependent adult chronic CITP, and has satisfactory clinical prospect.
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OBJECTIVE@#To retrospectively analyze the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) and to explore pathogenetic mechanism.@*METHOD@#One hundred and seventy-eight cases of the SD in our department were retrospectively analyzed. They were all treated under the guidance of clinical guidelines.@*RESULT@#(1) In all these patient's with SD, there were 31 cases with BPPV secondary to the SD. There were 26 cases of BPPV of posterior semicircular canal and 5 cases of BPPV of lateral BPPV semicircular canal. All patients with BPPV were diagnosed as the same ears as the SD, including 16 cases on left sides and 15 on right sides. (2) The interval between the onset of SD and BPPV was less than one week in 27 cases, between one week and one month in 3 cases, and between one and three months in 1 case. (3) All patients with BPPV secondary to the SD were cured with Epley maneuver or Barbecue roll maneuver.@*CONCLUSION@#The occurrence of BPPV may follow SD, and the major of BPPV secondary to the SD occurs in the posterior semicircular canal. The canalith repositioning is an effective therapy to the secondary BPPV.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Benign Paroxysmal Positional Vertigo , Hearing Loss, Sudden , Diagnosis , Retrospective Studies , Vertigo , DiagnosisABSTRACT
Objective To observe the effects of secoisolariciresinol (SECO) and its metabolites, enterolactone (ENL) and enterodiol (END), on proliferation of MCF-7 cell line and to the probable mechanism. Method Effect of SECO, END, ENL and genistein (GEN) on MCF-7 proliferation was investigated by MTT assay. Cell cycle arrest was measured by flow cytometry (FCM). Cell morphology was observed by optical microscope. The anticarcinogenic mechanism of SECO was analyzed. Results SECO had promotive effect on the cell growth at lower concentration (≤40 ?mol/L) but inhibition effect at higher concentration (100 ?mol/L). ENL and END, however, showed significant inhibition effect at all tested concentrations (10~100?mol/L). The cell cycle progression was arrested at G2/M phase and apoptosis was observed by optical microscope. Conclusion Effect of SECO on the MCF-7 cell proliferation depends on its concentration. Inhibition effect of SECO may relate to its metabolites ENL or END.
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Objective:To study the preventive and therapeutic effects of silk fibroin peptides (SFP) on acute alcoholism in mice. Methods:In first experiment, the mice were randomly divided into four groups, and every group was treated by 56o alcohol (ethanol dosage 7.56 ml/kg bw) via i.g. Eighty mice were fed normal saline (NS) and different dosages of SFP (0.1, 0.5, 2.5 g/kg bw) 30 min later respectively, then the rate of ebriety and time of sobriety were determined. Another 72 mice were also divided into four groups and given NS and SFP similarly. The concentration of ethanol in serum was measured 1 h, 2 h and 4 h later respectively. In second experiment, the mice were also divided into four similar groups, but 56o alcohol was given at 6.16 ml/kg?bw via i.g. NS and SFP were given similarly, 0.5 h before alcohol. Two experiments were performed to observe the effect of SFP on prevention of temulence. Results:The time of sobriety and concentration of ethanol of SFP groups fed 0.5 and 2.5g/kg bw were lower significantly than those of NS group (P