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Objective:To explore the clinical features of acute diquat (DQ) poisoning, and further improve the awareness of acute DQ poisoning.Methods:A retrospective analysis was performed on the clinical data of patients with acute DQ poisoning diagnosed in the emergency department of the Second Hospital of Hebei Medical University from January 1, 2019 to December 31, 2021. The clinical data included age, gender, exposure routes, presence of pesticides (drugs) mixture poisoning, dosage of poison, the time from taking poisoning to admitting in the emergency department, clinical manifestations, laboratory data, treatment, hospital days, prognosis and survival days.Results:The number of cases who firstly complained of acute DQ poisoning in the past three years were 19 cases in 2019, 28 cases in 2020, and 51 cases in 2021. A total of 12 patients were excluded due to being diagnosed paraquat (PQ) poisoning by toxicology detection. Finally, 86 cases of acute DQ poisoning were included, including 80 cases of oral DQ poisoning, 1 case of intramuscular injection, 1 case of binocular contact and 4 cases of dermal exposure. In 80 cases of oral DQ poisoning, there were 70 cases of diquat poisoning alone (42 cases survived, 28 cases died) and 10 cases of pesticide mixture poisoning (6 cases survived, 4 cases died). The time from oral poisoning to admitting in the emergency department was 0.5-96.0 hours, with an average of (8.6±5.8) hours. The time of intramuscular injection poisoning to admitting in the emergency department was 3 hours. The time of dermal exposure to admitting in the emergency department was relatively long, with an average of 66.1 hours. The time from oral simple DQ poisoning to death was 12.0-108.0 hours, and the time from oral mixed DQ poisoning to death was 24.0-576.0 hours. A total of 70 patients with oral diquat poisoning alone presented various degrees of multiple organ injuries. All patients presented gastrointestinal symptoms such as nausea and vomiting. Renal injury and central nervous system injury were the most significant and closely related to the prognosis.Conclusions:Acute oral DQ poisoning can cause to multiple organ injuries, and the clinical manifestations are related to the dose of the poison. In severe cases, acute renal failure and refractory circulatory failure occur within 24 hours after poisoning, and severe central nervous system injury with disturbance of consciousness as the primary manifestation occurs within 36 hours, followed by multiple organ failure until death.
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Objective:To explore the selection of strategies for early reperfusion therapy and its impact on prognosis in patients with acute ST segment elevation myocardial infarction (STEMI).Methods:The treatment data and 3-year follow-up results of acute myocardial infarction (AMI) patients in 49 hospitals in Hebei Province from January to December 2016 were collected. Patients with STEMI who received either intravenous thrombolytic therapy (ITT) or primary percutaneous coronary intervention (PPCI) within 12 hours of onset were enrolled. Baseline data, the time from the first diagnosis to the start of reperfusion (FMC2N for ITT patients and FMC2B for PPCI patients), vascular recanalization rate, in-hospital mortality, 1-year mortality, and 3-year mortality were compared between ITT and PPCI groups. The efficacy and prognosis of ITT and PPCI at different starting time of reperfusion (FMC2N≤30 minutes, FMC2N > 30 minutes, FMC2B≤120 minutes, FMC2B > 120 minutes) were analyzed.Results:A total of 1 371 STEMI patients treated with ITT or PPCI were selected, including 300 patients in the ITT group and 1 071 patients in the PPCI group. 1 055 patients were actually followed up (205 patients in the ITT group and 850 patients in the PPCI group), with a rate of 79.4%. There were no significant differences in age, gender, and previous history between the two groups. The time from the first diagnosis to the start of reperfusion in the ITT group was shorter than that in the PPCI group [minutes: 63 (38, 95) vs. 95 (60, 150), U = -9.286, P = 0.000], but was significantly longer than the guideline standard. Compared with the ITT group, the vascular recanalization rate in the PPCI group was higher [95.5% (1 023/1 071) vs. 88.3% (265/300), P < 0.01], and in-hospital mortality was lower [2.1% (22/1 071) vs. 6.7% (20/300), P < 0.01], but there were no significant differences in the 1-year mortality and 3-year mortality [5.3% (45/850) vs. 4.4% (9/205), 9.5% (81/850) vs. 9.3% (19/205), both P > 0.05]. Between ITT group and PPCI group with different reperfusion starting time, the FMC2N > 30 minutes group had the lowest vascular recanalization rate and the highest in-hospital mortality. Pairwise comparison showed that the vascular recanalization rate of the FMC2B ≤ 120 minutes group and the FMC2B > 120 minutes group were significantly higher than those of the FMC2N > 30 minutes group [95.5% (654/685), 95.6% (369/386) vs. 88.0% (220/250), both P < 0.008], the in-hospital mortality was significantly lower than that of the FMC2N > 30 minutes group [2.0% (14/685), 2.1% (8/386) vs. 7.6% (19/250), both P < 0.008]. There was no significant difference in 1-year mortality (χ 2 = 2.507, P = 0.443) and 3-year mortality (χ 2 = 2.204, P = 0.522) among the four groups. Conclusions:For STEMI patients within 12 hours of onset, reperfusion therapy should be performed as soon as possible. PPCI showed higher infarct related artery opening rate and lower in-hospital mortality compared with ITT, and had no effect on 1-year and 3-year mortality.
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Objective:To investigate the in-hospital diagnosis and treatment time for patients with acute ischemic stroke in Hebei Province.Methods:The data of in-hospital diagnosis and treatment of acute ischemic stroke in Hebei Province were collected and analyzed, and then compared with the NINDS recommended time. Methods The data of in-hospital diagnosis and treatment of acute ischemic stroke in Hebei Province were collected and analyzed, and then compared with the NINDS recommended time.Results:The median time in hospital diagnosis and treatment was significantly longer than the NINDS recommended time (104 min vs. 60 min, P<0.001). The median time from completing the cranial CT scan to getting the CT report differed significantly to the NINDS recommended time (30 min vs. 20 min, P<0.001). The median time from getting the CT report to obtaining treatment was 43 min, which was significantly longer than the NINDS recommended 15 min ( P<0.001). The median time of in-hospital diagnosis and treatment for emergency service system (EMS) patients was 101 min, which was shorter than that for non-EMS patients (104 min, P=0.01). The median time of in-hospital diagnosis and treatment in Tertiary Hospital was 105 min, which was significantly longer than that in Secondary Hospital 99 min, ( P<0.05). Conclusions:The in-hospital emergency treatment delay in Hebei Province was relatively serious for patients with acute ischemic stroke. The time between obtaining the head CT report to beginning thrombolytic therapy is the most important factor in hospital delay. EMS can shorten in-hospital delay for acute ischemic stroke. Compared with the tertiary hospital, the secondary hospital has shorter in-hospital delay time.
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Objective:To investigate the current situation of emergency medical service (EMS) system and its effect on treatment of the acute stage and short- and long-term prognosis in patients with acute myocardial infarction in Hebei province.Methods:Totally 2 961 patients with acute myocardial infarction who were admitted to major tertiary and some representative secondary hospitals in Hebei province from January 2016 to December 2016 were collected. According to the pattern of arriving hospital, all the patients were divided into the EMS group and self-transport group. The general conditions, time from onset to treatment, treatment methods, in-hospital mortality rate and 3-year mortality rate were compared between the two groups.Results:Of the included 2 961 patients, 33.13% of them were transported through EMS and 66.87% of them by private transport. Patients with a history of hypertension and ST-segment elevation myocardial infarction were more likely to choose EMS, and the difference was statistically significant ( P<0.05). Moreover, patients in the EMS group were more likely to go to tertiary hospitals for treatment (88.58% vs 85.76%, P=0.033). The time from onset to treatment of the EMS group was significantly shorter than that of the self-transport group (160 min vs 185 min, P<0.01), and the proportion of patients in the EMS group from onset-to-door time in <3 h and 3-6 h was higher than that of the self-transport group (55.76% vs 49.14%, 21.41% vs 19.09%, P<0.01). Compared with the self-transport group, the EMS group has a higher rate of reperfusion therapy (67.48% vs 61.67%, P=0.002). Patients in the EMS group had a higher in-hospital mortality rate in the acute stage (7.03% vs 4.44%, P=0.003), but its 3-year mortality rate was lower than that of the self-transport group (17.31% vs 20.77%, P<0.05). Conclusions:EMS can shorten symptom-onset-to-arrival time, increase the rate of reperfusion therapy and improve long-term prognosis of patients with acute myocardial infarction.
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Objective:To understand and compare the online learning effect of students majoring in stomatology and dental technology under the background of COVID-19 epidemic prevention and control, and to analyze the advantages and challenges of online teaching, so as to provide reference for the reform of teaching mode of stomatology education.Methods:A questionnaire survey on online learning was carried out among 267 students majoring in stomatology and 92 students majoring in dental technology in Chongqing Medical University. The results were statistically analyzed by SPSS 21.0, and chi-square test or rank sum test was used to count the data.Results:Computers and mobile phones are the main tools for students to study online. 52.92% of students used computers and 38.72% used smart phones. About 80% of the students said that they could adapt to online learning, and there was no statistical difference between the students of two majors. The online learning time of students majoring in stomatology was mainly 4-6 hours, while that of students majoring in dental technology was 2-4 hours, with statistical significance. However, the latter were more likely to ask questions to teachers than the former, and the proportion of students who often asked questions to teachers was 29.35% and 20.60%, respectively, with statistical significance. A small number of students of both majors failed log on the platform to learn and complete all the teaching materials on time. More than 50% of the students thought that online teaching was not as effective as offline teaching, and offline teaching was more conducive to mastering curriculum knowledge, without statistical differences between the students of two majors. They thought that the unsmooth learning platform, poor network conditions at home, and insufficient teaching materials prepared by teachers were the main reasons that affected the online learning effect.Conclusion:The online teaching is an important and also an advisable way to maintain teaching activities during the epidemic prevention and control of COVID-19. It will be the direction of further research on the education and teaching reform to make full use of information technology, combine the advantages of online teaching and traditional classroom teaching, and actively explore the blended teaching mode from the perspective of specialty and course characteristics.
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Objective:To understand and compare the online learning effect of students majoring in stomatology and dental technology under the background of COVID-19 epidemic prevention and control, and to analyze the advantages and challenges of online teaching, so as to provide reference for the reform of teaching mode of stomatology education.Methods:A questionnaire survey on online learning was carried out among 269 students majoring in stomatology and 92 students majoring in dental technology in Chongqing Medical University. The results were statistically analyzed by SPSS 21.0, and chi-square test or rank sum test was used to count the data.Results:Computers and mobile phones are the main tools for students to study online. 52.92% of students used computers and 38.72% used smart phones. About 80% of the students said that they could adapt to online learning, and there was no statistical difference between the students of two majors. The online learning time of students majoring in stomatology was mainly 4-6 hours, while that of students majoring in dental technology was 2-4 hours, with statistical significance. However, the latter were more likely to ask questions to teachers than the former, and the proportion of students who often asked questions to teachers was 29.35% and 20.60%, respectively, with statistical significance. A small number of students of both majors failed log on the platform to learn and complete all the teaching materials on time. More than 50% of the students thought that online teaching was not as effective as offline teaching, and offline teaching was more conducive to mastering curriculum knowledge, without statistical differences between the students of two majors. They thought that the unsmooth learning platform, poor network conditions at home, and insufficient teaching materials prepared by teachers were the main reasons that affected the online learning effect.Conclusion:The online teaching is an important and also an advisable way to maintain teaching activities during the epidemic prevention and control of COVID-19. It will be the direction of further research on the education and teaching reform to make full use of information technology, combine the advantages of online teaching and traditional classroom teaching, and actively explore the blended teaching mode from the perspective of specialty and course characteristics.
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OBJECTIVE@#To explore the pathogenesis and genetic characteristics of a fetus with a der(X)t(X;Y)(p22.3;q11.2) karyotype.@*METHODS@#G-banding karyotyping analysis, BoBs (BACs-on-Beads) assay, and single nucleotide polymorphism array (SNP-array) were used to delineate the structural chromosomal aberration of the fetus. The parents of the fetus were also subjected to karyotyping analysis.@*RESULTS@#The fetus and its mother were both found to have a karyotype of 46,X,add(X)(p22), while the father was normal. BoBs assay indicated that there was a lack of Xp22 but a gain of Yq11 signal. SNP-array confirmed that the fetus and its mother both had a 7.13 Mb deletion at Xp22.33p22.31 (608 021-7 736 547) and gain of a 12.52 Mb fragment at Yq11.221q11.23 (16 271 151-28 788 643).@*CONCLUSION@#The fetus was determined to have a karyotype of 46,X,der(X)t(X;Y)(p22.3;q11.2)mat. The combined use of various methods has facilitated delineation of the fetal chromosomal aberration and prediction of the risk prediction for subsequent pregnancy.
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Female , Humans , Male , Pregnancy , Chromosome Banding , Chromosome Deletion , Chromosomes, Human, X/genetics , Chromosomes, Human, Y/genetics , Fetus , Karyotyping , Prenatal Diagnosis , Translocation, GeneticABSTRACT
Objective@#To investigate the possible pathogenesis of Staphylococcus aureus (S.aureus) corneal ulcer by analyzing the differentially expressed genes (DEGs) of S.aureus isolated from the patients with corneal ulcer and healthy conjunctival sac.@*Methods@#Ten strains of S.aureus isolates were obtained from January to August 2018 in the clinical laboratory of Qingdao Eye Hospital.Five strains of S.aureus isolated from patients with corneal ulcer and five strains of S.aureus isolated from healthy conjunctival sac were included.The gene expression profiles of 10 strains of S.aureus were sequenced by Illumina high-throughput RNA-sequencing (RNA-Seq). P≤0.05 and fold change≥2 were used as the threshold to determine the statistically DEGs.Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were used to determine the biological functions of DEGs.@*Results@#The genome-wide transcriptional analysis demonstrated that 270 genes were differentially expressed with 138 upregulated genes and 132 downregulated genes in the strains from corneal ulcer.Function analysis of DEGs revealed that genes encoding alpha hemolysin, delta hemolysin, virulence factor EsxA and LysR family transcriptional regulators were significantly upregulated in strains isolated from cornea ulcer.GO enrichment analysis showed that most DEGs was involved in the metabolic process with the biosynthesis, the most significantly related process was the metabolism of inosine monophosphate.The KEGG pathways suggested that a number of metabolic pathways had significant changes, such as S.aureus infection, two-component system and pyruvate metabolism, purine metabolism, which were critical to the pathogenesis of S.aureus corneal ulcer.@*Conclusions@#Identification of the DEGs between corneal ulcer isolates and healthy conjunctival isolates of S.aureus is helpful for further investigations on genes or pathways associated with the pathogenesis and therapeutic targets of S.aureus corneal ulcer.
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Objective@#To investigate the application of emergency medical service (EMS) of Hebei Province and preliminarily analyze its value in the treatment of acute stroke patients.@*Methods@#We collected data of 4 147 acute stroke patients admitted to the Emergency Department between January 2016 and December 2016 in 49 hospitals of Hebei Province. Patients were divided into the EMS group and non-EMS group according to the pattern of arriving hospital. The general data, the onset-to-door time, door-to-treatment time, thrombolytic rate, length of hospital stay and prognosis were compared between the two groups. LSD-t test, Mann-Whitney U or Chi-squared test or Fisher exact test was used for statistical analysis as appropriate.@*Results@#A total of 4 147 acute stroke patients were enrolled, including 589 patients (14.2%) with hemorrhagic stroke and 3 558 patients (85.8%) with ischemic stroke. A total of 750 patients (18.1%) were admitted to the hospital by EMS. The proportion of patients with hemorrhagic stroke who used EMS was higher than that of ischemic stroke (33.4% vs 15.5%, P<0.01). The median onset-to-foor time in the EMS group was less than that in the non-EMS group (1.75 h vs 4.57 h, P<0.01). The median time of onset-to-door time within 1 h in the EMS group was longer than that of the non-EMS group (0.67 h vs 0.53 h, P<0.01). There was no significant difference between the two groups in 1-<2 h period and 2-<3 h period. The median time of onset-to-door time of ≥3 h in the EMS group was shorter than that of the non-EMS group (5.0 h vs 9.47 h, P<0.01). In the EMS group, the proportion of patients with onset-to-door time <3 h was higher than that of the non-EMS group (66.13% vs 57.44%, P<0.01). Compared with the non-EMS group, the time of door-to-treatment time was much shorter in the EMS group (87 min vs 101 min, P<0.01). The length of hospital stay in the EMS group was shorter than that of the non-EMS group [11 (7,14) days vs 12 (6,16) days, P<0.01]. In the EMS group, 15.9% patients received thrombolytic therapy, whereas only 11.0% patients in the non-EMS group received this therapy (P=0.001). In the EMS group, 88.8% patients achieved more favorable outcomes at discharge, which was higher than that in the non-EMS group (85.5%, P=0.02).@*Conclusions@#EMS is considered as effective in shortening onset-to-door time, reducing door-to-treatment time, improving thrombolytic rate, reducing hospitalization days, and enhancing the prognosis of acute stroke patients.
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Objective To investigate the possible pathogenesis of Staphylococcus aureus ( S. aureus) corneal ulcer by analyzing the differentially expressed genes ( DEGs) of S. aureus isolated from the patients with corneal ulcer and healthy conjunctival sac. Methods Ten strains of S. aureus isolates were obtained from January to August 2018 in the clinical laboratory of Qingdao Eye Hospital. Five strains of S. aureus isolated from patients with corneal ulcer and five strains of S. aureus isolated from healthy conjunctival sac were included. The gene expression profiles of 10 strains of S. aureus were sequenced by Illumina high-throughput RNA-sequencing ( RNA-Seq) . P≤0. 05 and fold change≥2 were used as the threshold to determine the statistically DEGs. Gene Ontology ( GO ) and Kyoto Encyclopedia of Genes and Genomes ( KEGG) pathway enrichment analyses were used to determine the biological functions of DEGs. Results The genome-wide transcriptional analysis demonstrated that 270 genes were differentially expressed with 138 upregulated genes and 132 downregulated genes in the strains from corneal ulcer. Function analysis of DEGs revealed that genes encoding alpha hemolysin,delta hemolysin,virulence factor EsxA and LysR family transcriptional regulators were significantly upregulated in strains isolated from cornea ulcer. GO enrichment analysis showed that most DEGs was involved in the metabolic process with the biosynthesis, the most significantly related process was the metabolism of inosine monophosphate. The KEGG pathways suggested that a number of metabolic pathways had significant changes,such as S. aureus infection,two-component system and pyruvate metabolism,purine metabolism, which were critical to the pathogenesis of S. aureus corneal ulcer. Conclusions Identification of the DEGs between corneal ulcer isolates and healthy conjunctival isolates of S. aureus is helpful for further investigations on genes or pathways associated with the pathogenesis and therapeutic targets of S. aureus corneal ulcer.
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Objective To investigate the application of emergency medical service (EMS) of Hebei Province and preliminarily analyze its value in the treatment of acute stroke patients.Methods We collected data of 4 147 acute stroke patients admitted to the Emergency Department between January 2016 and December 2016 in 49 hospitals of Hebei Province.Patients were divided into the EMS group and non-EMS group according to the pattern of arriving hospital.The general data,the onset-to-door time,doorto-treatment time,thrombolytic rate,length of hospital stay and prognosis were compared between the two groups.LSD-t test,Mann-Whitney U or Chi-squared test or Fisher exact test was used for statistical analysis as appropriate.Results A total of 4 147 acute stroke patients were enrolled,including 589 patients (14.2％) with hemorrhagic stroke and 3 558 patients (85.8％) with ischemic stroke.A total of 750 patients (18.1％) were admitted to the hospital by EMS.The proportion of patients with hemorrhagic stroke who used EMS was higher than that of ischemic stroke (33.4％ vs 15.5％,P＜0.01).The median onset-to-foor time in the EMS group was less than that in the non-EMS group (1.75 h vs 4.57 h,P＜0.01).The median time of onset-to-door time within 1 h in the EMS group was longer than that of the non-EMS group (0.67 h vs 0.53 h,P＜0.01).There was no significant difference between the two groups in 1-＜2 h period and 2-＜3 h period.The median time of onset-to-door time of ≥ 3 h in the EMS group was shorter than that of the non-EMS group (5.0 h vs 9.47 h,P＜0.01).In the EMS group,the proportion of patients with onset-to-door time ＜3 h was higher than that of the non-EMS group (66.13％ vs 57.44％,P＜0.01).Compared with the non-EMS group,the time of door-to-treatment time was much shorter in the EMS group (87 min vs 101 min,P＜0.01).The length of hospital stay in the EMS group was shorter than that of the non-EMS group [11 (7,14) days vs 12 (6,16) days,P＜0.01].In the EMS group,15.9％ patients received thrombolytic therapy,whereas only 11.0％ patients in the non-EMS group received this therapy (P=0.001).In the EMS group,88.8％ patients achieved more favorable outcomes at discharge,which was higher than that in the non-EMS group (85.5％,P=0.02).Conclusions EMS is considered as effective in shortening onset-to-door time,reducing door-to-treatment time,improving thrombolytic rate,reducing hospitalization days,and enhancing the prognosis of acute stroke patients.
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<p><b>OBJECTIVE</b>To detect chromosomal imbalance in a fetus with complex congenital heart disease, and to correlate the genotype with the phenotype.</p><p><b>METHODS</b>Routine G-banding was carried out to analyze the karyotypes of the fetus and its parents, and single nucleotide polymorphisms array (SNP-array) was used for delineating fine genomic aberrations. The detected aberrations were confirmed with multiplex ligation-dependent probe amplification (MLPA).</p><p><b>RESULTS</b>The fetus and its parents all showed a normal karyotype, while array-SNP has detected a 13.87 Mb duplication at 4p16.3-p15.33 and a 15.65 Mb deletion at 11q23.3-q25 in the fetus. The results were confirmed by the MLPA assay.</p><p><b>CONCLUSION</b>The partial trisomy 4p (Wolf-Hirschhorn syndrome) and partial monosomy 11q (Jacobsen syndrome) probably underlie the complex heart defects detected in the fetus. Analysis of the karyotypes of its parents offered no help for the determination of the aberrant type and recurrent risk. Compared with routine karyotype analysis, aberrant regions can be identified with array-SNP with greater resolution and accuracy. This has provided useful information for prenatal diagnosis and genetic counseling.</p>
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Adult , Female , Humans , Male , Pregnancy , Asian People , Genetics , China , Chromosomes, Human, Pair 11 , Genetics , Chromosomes, Human, Pair 4 , Genetics , Fetal Diseases , Diagnosis , Genetics , Jacobsen Distal 11q Deletion Syndrome , Embryology , Genetics , Pedigree , Polymorphism, Single Nucleotide , Prenatal Diagnosis , Wolf-Hirschhorn Syndrome , Embryology , GeneticsABSTRACT
Objective To compare the accuracy of cone-beam computed tomography (CBCT ) and periapical radiography in the diagnosis of simulated external apical root resorption (EARR) .Methods The study sample comprised 160 single-rooted premolars for simulating 4 degrees of EARR :no(intact teeth) ,mild(cavity of 1 .0 mm in diameter and depth in root surface) ,moderate(1 .0 mm root shortening) ,and severe(3 .0 mm root shortening) .Two sets of radiographic images were acquired with CBCT and periapi-cal radiography .The severity for all resorption lesions were evaluated blindly by one calibrated examiner .The percentages of correct classification of each degree of EARR were compared between the two imaging techniques using McNemar test .Results With CBCT method ,the percentages of correct classification of no ,mild ,moderate ,severe and all EARR were 95 .0% ,97 .5% ,42 .5% , 87 .5% and 80 .6% ,respectively ;with periapical radiography method ,the percentages were 85 .0% ,42 .5% ,70 .0% ,92 .5% and 72 .5% ,respectively .Significant differences were found between the two imaging techniques for evaluating mild ,moderate ,and all-EARR(P<0 .05) .Conclusion CBCT imaging is more reliable than periapical radiography for detecting EARR ,whereas it is not sensitive to moderate root shortening .In orthodontic practices ,CBCT could be applied to the early diagnosis of EARR ,in order to help make the decision on continuation and modification of orthodontic treatment .
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Objective To investigate dynamic changes and clinical significance of the high-sensitive Creactive protein(hs-CRP) level in acute cerebral infarction patients with different etiological types.Methods 136 patients with acute cerebral infarction were recruited.These patients were classified into five subtypes based on Trial of Org 10172 in Acute Stroke Treatment(TOAST) criteria.Serum hs-CRP levels on the 1st,3rd,5th,7th,14th day after onset from patients and 42 healthy controls were measured with immunoturbidimetry.The neurologic impairmentscore was determined with NIHSS.Results Serum hs-CRP levels is higher on the 1th,3rd,5th,7th,14th day than that of the control group ( (4.26 ± 1.31 ),( 12.57 ± 6.29 ),( 10.23 ± 4.49 ),(7.54 ± 2.33 ),(4.25 ± 1.77) mg/Land (2.56 ± 0.86) mg/L,t = 7.89,10.26,10.99,13.55,5.97,P ＜ 0.05 ).Among 5 subtypes,serum hs-CRP was the highest in large-artery atherosclerosis group after acute ischemic stroke,and cardioembolism group was the next.Serum hs-CRP reached the highest on three or five days after disease onset and decreased slowly.High levels of hs-CRP in large-artery atherosclerosis group indicated severe neurologic functional impairment and worsen prognosis.Conclusions ACI is closely related to serum hs-CRP level,which can be used as an subjective index for severity and prognosis with the lasting,high levels of hs-CRP levels predict poor prognosis.
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Objective To study the effectrve approach of the nutrition support in burn patients. Methods The means of immuno-precipitation-deduction,ELISA and fluore-photometion were used to test the change of activities,protein expression of the 19S regulator and the rate of protein degradation in skeletal muscle in scard rats with enteral feeding or parenteral nutrition. Results Compared with parenteral nutrition , enteral feeding could markedly reduce the activity and protein expression of the 19S regulator ,and the digeneration of skeletal muscle was also lower. Conclusions The early enteral feeding can distinctly inhibit the system of 26S proteasome , thereby reduce the protein degradation of skeletal muscle in scald rats,which may be benefical to the metabolic modulation of the burned patients.
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Objective To explore the clinical efficacy of modified corneal ulcer debridement combining with anti-fungal agents in the treatment of keratomycosis(fungal corneal ulcer).Design Prospective case series.Participants Criteria for inclusion:1)fungal corneal ulcer was diagnosed under direct 10% KOH wet film microscopic examination;2)corneal ulcer located away from the center with superficial infiltration,or located in the center but in small size;3)depth of corneal infiltration was uncertain.From January,2007 to December,2009,141 cases of fungal corneal ulcer patients in Shandong Eye Institute affiliated to Qingdao Eye Hospital were recruited into this study.Methods All patients received modified corneal ulcer debridement including stripping off ulcer lesion as well as infiltrated tissue,and repairing ulcer fringe.For postoperative treatment,0.25% amphotercin B or 5% natamycin and 0.5% fluconazol eye drops were topically administrated with high frequency to the diseased eye.In the meantime,itraconalzole was orally taken as systematic treatment.Clinical efficacy of the above therapy was evaluated at last.Main Outcome Measurs Corneal ulcer infiltration,corneal epithelium reparation and recovery of vision acuity were closely observed following surgery.Results 10% KOH wet film examination showed that hypha was found in all of the 141 cases.The average time for postoperative follow-up was 29 days(from 14 to 60 days).All 141 cases of fungal corneal ulcer were completely healed,of which 127 cases were healed by taking corneal ulcer debridement surgery and anti-fungal medication,and the other 14 cases had to take penetrating keratoplasty(10 cases) or lameller keratoplasty(4 cases) due to uncontrolled infection.No recurrence was found during follow-up.The average time for healing in the 127 cases was 8.5 days,and among these cases,29 cases had a preoperative visual acuity below 0.05,80 cases between 0.05 and 0.3,and 32 cases between 0.3 and 1.0.Postoperative evaluation showed that 6 cases had a visual acuity below 0.05,42 cases between 0.05 and 0.3,93 cases(65.96%) between 0.3 and 1.0,and among 93 cases,81 cases(57.45%) had a visual acuity between 0.5 and 1.0.Conclusions The modified corneal ulcer debridement combining with anti-fungal agents has proved to be an effective treatment for fungal corneal ulcer.It greatly improves patient's visual acuity and shortens the disease duration.For cases of superficial or uncertain infiltration,corneal ulcer debridement enables better ulcer observation and provides guidance for further treatment.
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Full thickness scalding of 37% TBSA was inflicted io rats. Three days later, the liver of the animals was isolated and the changes of the protein metabolism in the liver and the effects of insulin on the changes were evaluated.It was found that the protein and DMA levels of the liver showed no obvious changes after scalding, but the RNA content increased by 24% and the rate of leucine incorporation by 31%. After the addition of insulin, the leucine content increased by 23.% and 25.8% in the controls and the injured animals respectively. The results indicate that the rate of protein synthesis in the liver of the scalded animals increases, which is likely to be related to the increase of RNA content, and the liver protein synthesis remains to be sensitive to insulin.
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This paper is to report the changes of the protein metabolism in the rat soleus muscle in vitro after 37% TBSA full-thickness burns covering one hindlimb and the effects of leucine and insulin on the burned muscle.It was found that there werea significant decreases of the protein content and marked exaggeration of the rates of tyrosine incorporation,tyrosine release and tyrosine net release in the burned muscle.No changes of the above-mentioned parameters could be revealed in the muscle of the unburned limb and the controls.Elevation of leucine concentration in the medium could not improve the protein metabolism of the burned muscle.0.1u/ml of insulin could significantly stimulate the tyrosine incorporation in the muscle of the unburned limb and the controls,but no similar effect was observed on the burned muscle.The results indicate that increased protein degradation of the local burned muscle is responsible for the postburn negative nitrogen balance;administration of leucine alone cannot improve the protein metabolism in the local burned muscle;and the sensivity of the burned muscle to insulin is suppressed.
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Objective To explore the mechanism of negative nitrogen balance in the treatment after burns. Methods The means of immuno precipitation deduction and ELISA were used to test the activities and contents of 26S proteasome and 19S regulator in skeletal muscle of rats inflicted with 30%TBSAⅢ burns. Results TNF? markedly raised the activities and contents of 26S proteasome and 19S regulator in skeletal muscle after scalding. Conclusion TNF? activates the 26S proteasome system in skeletal muscle, thus it enhances the degradation of protein, which is associated with the development of negative nitrogen balance following scalding.