Current situation and influencing factors of HPV vaccine hesitancy among parents of primary and secondary school girls in Guangyuan / 公共卫生与预防医学

Objective To investigate HPV vaccine hesitancy and influencing factors among parents of primary and secondary schools in Guangyuan, and to provide scientific countermeasures for reducing the hesitancy rate of HPV vaccine in parents. Methods Using stratified multi-stage cluster random sampling, 1,018 parents of girls in primary and secondary schools in Guangyuan were selected for a questionnaire survey from March to July 2021. The data were analyzed by Chi-square test and multivariate logistic regression model. Results The hesitancy rate of HPV vaccine in parents was 42.95%. Multivariate logistic regression analysis showed that families with low economic income, parents who believed that HPV vaccination would have long-term side effects, and be unsafe and expensive, and parents who concerned with the effect of HPV vaccine on the prevention of cervical cancer and insufficient supply of first doses of vaccine, had positive effects on HPV vaccine hesitancy (OR = 2.02, 1.44, 3.13, 1.53, 3.76, and 2.43, respectively, P < 0.05). Conclusion HPV vaccine hesitancy rate is high among parents of primary and secondary schools in Guangyuan. It is necessary to fully promote school education and increase the publicity of HPV vaccine to improve parents' awareness of HPV vaccine. Government departments need to make an overall plan to reduce vaccine costs and ensure sufficient vaccine quantity, so as to reduce parents' hesitation to vaccinate their children with HPV vaccine.

Drug target inference by mining transcriptional data using a novel graph convolutional network framework

A fundamental challenge that arises in biomedicine is the need to characterize compounds in a relevant cellular context in order to reveal potential on-target or off-target effects. Recently, the fast accumulation of gene transcriptional profiling data provides us an unprecedented opportunity to explore the protein targets of chemical compounds from the perspective of cell transcriptomics and RNA biology. Here, we propose a novel Siamese spectral-based graph convolutional network (SSGCN) model for inferring the protein targets of chemical compounds from gene transcriptional profiles. Although the gene signature of a compound perturbation only provides indirect clues of the interacting targets, and the biological networks under different experiment conditions further complicate the situation, the SSGCN model was successfully trained to learn from known compound-target pairs by uncovering the hidden correlations between compound perturbation profiles and gene knockdown profiles. On a benchmark set and a large time-split validation dataset, the model achieved higher target inference accuracy as compared to previous methods such as Connectivity Map. Further experimental validations of prediction results highlight the practical usefulness of SSGCN in either inferring the interacting targets of compound, or reversely, in finding novel inhibitors of a given target of interest.

Effectiveness of abdominal minimal incision sacrocolpopexy for advanced pelvic organ prolapse / 中华妇产科杂志

Objective:To evaluate the indications, surgical skills and clinic outcomes of abdominal minimal incision sacrocolpopexy (AMISC) for treatment of advanced pelvic organ prolapse (POP).Methods:The retrospective study analyzed 30 women with advanced POP who underwent AMISC between June 2016 and October 2019, including 9 cases of recurrent prolapse and 10 cases of vault prolapse. AMISC was especially applicable to: (1) patients with several medical complications who was unable to tolerate general anesthesia or laparoscopic surgery, but able to tolerate combined spinal-epidural anesthesia and open surgery; (2) other abdominal procedures were indicated to perform with AMISC simultaneously, such as myomectomy, subtotal hysterectomy etc, the specimens were easy to get out of the abdominal cavity and morcellation was avoided; (3) surgeons preferring open surgery to laparoscopic surgery or skilled in open surgery; (4) patients with prior pelvic operations, presenting severe abdominal and pelvic adhesions. Objective outcomes were assessed by pelvic organ prolapse quantification (POP-Q) system. Subjective outcome were assessed by pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire-short form (PFIQ-7) and patient global impression of improvement (PGI-I).Results:All patients with 1-3 medical complications were successfully performed with AMISC without stopping procedure, enlarging the incision or changing to other procedure, the operation duration was (110±19) minutes. The mean time of follow-up was (33.5±12.4) months (range: 8-49 months). The postoperative points of Aa, Ba, C, Ap, Bp reduced significantly and point C improved from (2.33±2.50) cm to (-7.54±1.18) cm after AMISC ( P<0.01). The objective cure rates were both 100% (30/30) in apex and posterior compartment, while 97% (29/30) in anterior compartment. Postoperative scores of PFDI-20 and PFIQ-7 were all significant decreased (all P<0.01). About PGI-I, 29 patients chose “significant improvement”, subjective satisfaction was 97% (29/30). Anterior sacral plexus hemorrhage occurred in 2 cases (7%, 2/30). There was no intestinal obstruction or injury of bladder, bowel and ureter intra- and postoperation. Two cases (7%, 2/30) had mesh exposure. Conclusion:AMISC is a safety, convenient, minimal traumatic and durable procedure for apical prolapse with short learning curve in the most of cases.

Clinical characteristics of congenital nephrogenic diabetes insipidus / 中华内科杂志

The purpose of this study was to improve the ability to visualize and diagnose congenital nephrogenic diabetes insipidus (CNDI). The clinical manifestations, laboratory examination findings, imaging features and treatment outcomes of 22 patients with CNDI admitted to the First Affiliated Hospital of Zhengzhou University from May 2013 to May 2020 were retrospectively analyzed. Among the 22 patients with CNDI, 86.4% (19 cases) were male. The age of the 22 patients ranged from 2 months to 47 years old, in which 20 cases were younger than 30 years old and 2 cases were older than 30 years old. The clinical manifestations were polydipsia and polyuria, accompanied with various degrees of fever, defects in growth and development, and increased serum creatinine in some patients. Fifteen patients (68.2%) had different degrees of bilateral kidney and ureteral hydronephrosis, and increased residual urine volume in the bladder. Pituitary magnetic resonance imaging (MRI) enhanced scan showed that the high signal intensity in the posterior pituitary lobe was not detectable in 5 cases (22.7%), and blurred in 6 cases (27.3%). Seven tested patients were all found AVPR2 gene mutation. For patients with suspected CNDI, water-inhibiting vasopressin test and genetic testing should be performed in time so as to confirm diagnosis and treat as early as possible.

Study of clinical characteristics and related gene mutations in children with hereditary spherocytosis / 中华实用儿科临床杂志

Objective:To analyze the clinical phenotypes and molecular genetic characteristics of hereditary spherocytosis (HS) in children.Methods:The clinical data of children with HS in the Affiliated Children′s Hospital of Zhengzhou University from June 2014 to June 2018 were collected and analyzed retrospectively.The peripheral blood samples of 20 children and their parents were collected and targeted capture or whole exon group sequencing was performed using the second generation sequencing technique, and the suspicious mutation sites were verified by Sanger sequencing.Results:A total of 43 pediatric patients (23 males, 20 female) were included in this study.The median age of onset of 1 year old and 11 months (1 month to 10 years old). Pallor (27/43 cases, 62.79%) was the main symptom.Typical clinical manifestations were anemia (36/43 cases, 83.72%), jaundice (35/43 cases, 81.40%), splenomegaly (33/43 cases, 76.74%), and hepatomegaly (27/43 cases, 62.79%). The proportion of spherical erythrocytes in peripheral blood of 23 cases (23/43 cases, 53.49%)≥ 0.1, and the proportion of spherical erythrocytes in bone marrow smears of 17 cases (39.53%) was ≥ 0.1, and 20 cases were positive in erythrocyte osmotic fragility test (20/43 cases, 46.51%). Comparison of 29 children before and after blood transfusion: post-transfusion hemoglobin (Hb) [(88.69±11.22) g/L vs. (78.24±14.47) g/L], mean corpuscular volume (MCV) [(89.37±7.15) fL vs.(84.08±7.49) fL], mean corpuscular hemoglobin (MCH) [(29.12±2.70) pg vs.(27.36±1.95) pg], mean corpuscular hemoglobin corpuscular (MCHC) [(361.79±32.27) g/L vs.(356.31±31.43 ) g/L] were increased, and the total bilirubin (TB) level was lower after blood transfusion than before blood transfusion [(33.27±16.42) μmol/L vs.(41.58±15.40) μmol/L], the differences were statistically significant ( t=-3.538, -5.187, -5.412, -7.404, 2.527, all P<0.05). Seven children underwent splenectomy: postoperative Hb[(116.00±5.54) g/L vs.(75.71±9.96) g/L], MCH[(29.87±1.62) pg vs.(24.61±1.65) pg], MCHC [(391.14±12.99) g/L vs.(315.14±51.99) g/L] all increased, the difference was statistically significant ( t=-9.234, -4.330, -4.031, all P<0.05). The Hb in the operation group was significantly higher than that in the blood transfusion group, including the treatment effect of operation was more significant ( t=-9.247, P<0.05). Thirteen pathogenic mutations (11 new mutations not reported) were detected in 3 genes ( ANK1, SPTB and SPTA1) in 13 children, 8 of who were mutations in ANK1, 4 cases of which were mutations in SPTB and 1 case of which was mutation in SPTA1.Among the 13 mutations, 12 cases were de novo except one inherited from the mother. Conclusions:Anemia and pallor are the initial symptoms of HS in children.Blood transfusion can temporarily improve the symptoms of anemia and jaundice.Splenectomy is an effective and fundamental treatment.The gene diagnosis of 13 pediatric patients got gene diagnosis, which provided basis for genetic consultation of the next fetus.Eleven new mutations were found in ANK1, SPTB, SPTA1 genes, which exten-ded the gene mutation spectrum of HS.

A five?year analysis of effect on transvaginal high uterosacral ligament suspension with or without native?tissue repair for middle compartment defect / 中华妇产科杂志

Objective To assess the five?year effect of the transvaginal high uterosacral ligament suspension (HUS) with or without additional concomitant native?tissue anterior and (or) posterior repair in women suffering from middle compartment defect. Methods A retrospective review of records identified 79 women who underwent transvaginal HUS with or without additional concomitant native?tissue anterior and (or) posterior repair from January 2007 to January 2018 in Fourth Medical Center, General Hospital of People′s Liberation Army. The middle compartment defects were predominant in these patients with point C no less than point Ba or Bp if accompanied with anterior or posterior vaginal wall prolapse. Follow?up visits were performed 2,6 and 12 months after surgery and then annually. Anatomic results of pelvic organ prolapse (POP) was established by pelvic examination using pelvic organ prolapse quantitation system (POP?Q) staging. Funtional results were obtained by patient global impression of improvement (PGI?I) scale in POP, pelvic floor distress inventory?short form 20 (PFDI?20) and pelvic floor impact questionnaire short form (PFIQ?7). Surgical success required the fulfillment of all 3 criteria: (1) anterior or posterior vaginal wall prolapsed leading edge of 0 cm or less and apex of 1/2 total vaginal length or less; (2) the absence of POP symptoms as reported on the PFDI?20 question No.3 ("Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?"); and (3) no prolapse reoperations or pessary use during the study period. Results Of 79 women, 51(65%, 51/79) women completed the five?year follow?up during the study period. The median follow?up time was 5.2 years (2.8-8.3 years). The overall surgery success rate was 86% (44/51) according to above all 3 criteria. Prolapse recurrence rates were isolated anterior 8% (4/51), isolated apical 0, isolated posterior 2% (1/51) and multiple compartments 4% (2/51). Seven women (14%,7/51) developed anterior or posterior prolapse beyond the hymen with the leading edge≤1 cm. No apical prolapsed occurred. None of recurrent women underwent retreatment,including either surgery or pessary usage at last follow?up. The subjective satisfaction rate was 90% (46/51). There was a 1% (1/79) rate of intraoperative ureteral kinking and 3% (2/79) rate of postoperative morbidity. Conclusions The transvaginal HUS for middle compartment defect offers good long?term anatomical results with excellent vault suspension. With additional concomitant native?tissue anterior and (or) posterior repair, it will be a reconstructive surgery for the majority of moderate?to?severe POP. It is minimal traumatic and worthy of being popularized for clinical application.

Effectiveness of vaginal high uterosacral ligament suspension for treatment of recurrent pelvic organ prolapse / 中华妇产科杂志

Objective To evaluate the indications and clinic outcomes of vaginal high uterosacral ligament suspension (HUS) for treatment of recurrent advanced pelvic organ prolapse (POP). Methods This retrospective study analyzed 42 women with recurrent advanced POP who were referred to Fourth Medical Center of PLA General Hospital and underwent transvaginal HUS between November 2005 and January 2018. Primary surgeries included 30 vaginal colporrhaphy, 5 Manchester operation, 5 transvaginal mesh repair,2 sacrospinous ligament fixation.The median time for recurrence from primary pelvic floor repair surgery was 9 months, including 14 cases (33%, 14/42)≤3 months (median time was 2 months) and 25 cases (67%, 28/42) longer than 3 months (median time was 18 months).The rate of recurrent prolapse in stageⅢorⅣ was 79% (33 cases), 45% (19 cases) and 17%(7 cases) in anterior, apical and posterior compartment respectively. Results Transvaginal high bilateral uterosacral ligaments were identified and used for successful vaginal vault suspension after vaginal hysterectomy and residual cervical resection in all 42 consecutive patients. The cases of transvaginal mesh used in anterior wall and posterior wall were 25 (60%, 25/42) and 3 (7%, 3/42) respectively. There was no major intra-and postoperative complications,such as ureter and other pelvic organ injury. The median time of follow-up was 5.3 years after transvaginal HUS. The points of pelvic organ prolapse quantification system reduced significantly and point C improved from+0.3 cm to-8.2 cm after reoperation (P<0.01). The objective cure rate were 100% (42/42) both in apex and posterior compartment,while 93% (39/42) in anterior compartment. None had reoperation or pessary usage for recurrence of prolapse. Conclusion Transvaginal HUS with vaginal wall repair could be as a safety, cost-effective, minimal traumatic and durable procedure for recurrent POP in the most of cases.

Clinical study of peripheral blood helper T cell 17/regulatory T cell balance and levels of related immune cytokines in children with enterovirus encephalitis / 中国医师进修杂志

Objective To study the peripheral blood helper T cell 17 (Th17)/ regulatory T cell (Treg) balance and levels of related immune cytokines in children with enterovirus encephalitis. Methods One hundred and two children with enterovirus encephalitis from January 2014 to January 2017 were selected as enterovirus encephalitis group, and 100 healthy children who received physical examination during the same period were selected as healthy control group. The peripheral blood expressions of Th17 and Treg were detected by flow cytometry, and the Th17/Treg was calculated. The serum levels of interleukin (IL)-6, IL-17, IL-23, IL-4, IL-10 and transforming growth factor (TGF)-β were detected by enzyme-linked immunosorbent assay. Results The peripheral blood expression of Th17 and Th17/Treg in enterovirus encephalitis group were significantly higher than those in healthy control group (0.032 ± 0.006 vs. 0.024 ± 0.004 and 3.04 ± 0.61 vs. 1.99 ± 0.37), the peripheral blood expression of Treg was significantly lower than that in healthy control group (0.011 ± 0.002 vs. 0.013 ± 0.002), and there were statistical differences (P＜0.05). The serum levels of IL-6, IL-17 and IL-23 in enterovirus encephalitis group were significantly higher than those in healthy control group, the serum levels of IL-4, IL-10 and TGF-β were significantly lower than those in healthy control group, and there were statistical differences (P＜0.05). Conclusions The peripheral blood expression of Th17 is high, and the peripheral blood expression of Treg is low in children with enterovirus encephalitis. There is imbalance of Th17/Treg. The IL-17, IL-23, IL-4, IL-4, IL-10, TGF-β and other Th17 and Treg related immune cytokines may be involved in the pathogenesis of enterovirus encephalitis.

Comparison of efficacy of lamivudine plus adefovir dipivoxil de novo combination therapy with optimization monotherapy in patients with decompensated hepatitis B cirrhosis / 重庆医学

Objective To compare the efficacy of lamivudine (LAM) plus adefovir dipivoxil (ADV) de novo combination therapy to optimization monotherapy for hepatitis B virus-related compensated cirrhosis,and analyze the prediction factors of early response of antivirus treatment.Methods A total of 158 cases of patients with hepatitis B virus-related compensated cirrhosis were selected and randomly assigned to combined group (n=81) and optimized group (n =77) according to randomized digital table.The patients in the combined group accepted LAM combined ADV.The patients in the optimized group were firstly treated with LAM or ADV,then they were given optimized therapy with ADV or LAM if they had poor response or virological breakthrough at week 24.The clinical efficaeies were compared between the two groups,and the prediction factors of early response were analyzed.Results At week 12,the decline level of HBV DNA in the combined group was higher than that in the optimized group (P＜ 0.05),but no statistically significant difference was found in the negative transformation rate of HBV DNA between the two groups (P＞ 0.418).At week 24,the decline level of HBV DNA,rate of undetectable HBV DNA and rate of complete response were higher than those in the optimized group,and rate of virological breakthrough was lower than that in the optimized group (P＜0.05).At week 48,the decline level and negative transformation rate of HBV DNA,negative transformation rate and seroconversion rate of HBeAg were higher than those in the optimized group,and serum levels of hyaluronic acid and a2-macroglobulin were lower than those in the optimized group (P＜0.05).There was no statistically significant difference in the recover rate of alanine aminotransferase (ALT),rate of complete response and rate of virological breakthrough between the two groups at week 48 (P＞0.05).Logistic regression analysis showed that the complete response at week 24 was correlated with HBV DNA load,expression of HBeAg,level of ALT and initial treatment (P＜0.05).Layered evaluation showed that the rate of early complete response in the combined group was significantly higher than that in the optimized group,regardless of HBV DNA load,expression of HBeAg,and level of ALT (P＜0.05).Conclusion LAM combined with ADV can reduce resistance and improve the rate of early complete response,which has stronger antiviral activity.In addition,it can improve the liver function and partially reverse cirrhosis.

Long-term effectiveness of transvaginal high uterosacral ligament suspension / 中华妇产科杂志

Objective To assess the long-term effectiveness of the transvaginal high uterosacral ligament suspension (HUS) in women suffering from advanced pelvic organ prolapse (POP).Methods A retrospective review of records identified 118 women who underwent transvaginal HUS with or without additional concomitant anterior and (or) posterior repairs from June 2003 to August 2009 in the First Affiliated Hospital,General Hospital of People's Liberation Army.Of 118 women,104 women completed the follow-up during study period;these 104 women were analysed.Follow-up visits were performed 2,6 and 12 months after surgery and then annually.Anatomic results of POP was established by pelvic examination using pelvic organ prolapse quantitation system (POP-Q) staging.Funtional results were obtained by patient global impression of improvement (PGI-I),pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7).Surgical success required the fulfillment of all 3 criteria:(1) prolapse leading edge of 0 cm or less and apex of 1/2 total vaginal length or less;(2) the absence of pelvic organ prolapse symptoms as reported on the PFDI-20 question No.3 (Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?);and (3) no prolapse reoperations or pessary use during the study period.Results The mean follow-up time was (9.1 ± 1.5) years.The overall surgery success rate was 91.3％ (95/104) according to above all 3 criteria.Prolapse recurrence rates were isolated anterior 6.7％ (7/104),isolated apical 0,isolated posterior 2.9％ (3/104) and multiple compartments 1.0％ (1/104).Five women (4.8％,5/104) developed bothersome vaginal bulge symptoms.None of recurrent women underwent retreatment,including either surgery or use of a pessary at last follow-up.The subjective satisfaction rate was 90.4％ (94/104).PFDI-20 and PFIQ-7 scores showed a statistically significant improvement from preoperative 72 and 65 points to postoperative 17 and 9 points respectively (all P＜0.01).There was a 2.9％ (3/104) rate of intraoperative ureteral kinking and 3.8％ (4/104) rate of postoperative morbidity.Conclusions The transvaginal HUS for vault prolapse offers good long-term anatomical results with excellent vault suspension.With additional concomitant anterior and (or) posterior repairs,it will be a reconstructive surgery for the majority of advanced POP.It is minimal traumatic and appropriate for different type of POP,especially for the eldly patients.It is worthy of being popularized for clinical application.

Fu-Fang Ku-Shen Injection in Combination with Modern Medications in Treating Lymphoma: A Real-world Study Based on Association Rules And Apriori Algorithm / 世界科学技术-中医药现代化

This study was aimed to investigate the application rrles of Fu-Fang Ku-Shen (FFKS) injection in combination with modern medicines for the treatment of lymphoma in the real world,in order to provide references for rational clinical application of effective medication.Patients diagnosed as lymphoma and treated with FFKS injection from 22 triple-A hospitals in China were enrolled as research objects.Patients' treatment data were extracted from the hospital information system,which was established by the Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,in order to analyze the frequency distribution characteristics of modern medications combined in the treatment.Association rules and Apriori algorithm were used in the analysis of association characteristics of medication combination.The results showed that 3 674 cases fit the inclusion criteria were searched from the data warehouse.In the clinical practice,FFKS injection was frequently combined with moderu medications,such as antibiotics,glucocorticoids,5-HT receptor antagonists,immunomodulatory drags,proton pump inhibitor,chemotherapeutic drugs,and hepatic protector.Its associated modern medication combination showed special rrles,which was in consistency with the related diagnosis and treatment of lymphoma guideline.It was concluded that FFKS injection combined with modern medicine in the treatment of lymphoma in the real world was basically in consistency with related guidelines.It was focused on reducing the side effects of chemotherapy,prolonging survival time,and improving quality of life.It provided references for rational clinical drag application of lymphoma.

The nursing soft skills constitute elements of higher vocational nursing students: a qualitative study / 中国实用护理杂志

Objective To explore the nursing soft skills constitute elements of higher vocational nursing students and give some suggestions for their education. Methods A qualitative study was used. In-depth individual interviews were conducted with 15 participants including higher vocational nursing educators, nursing managers and clinical nursing teachers. The results were finally coded, described, classified and analyzed. Results The nursing soft skills of higher vocational nursing students are composed of three main dimensions comprising personal attributes, interpersonal skills and conceptual/thinking skills, among which personal attributes include personality and self-management; interpersonal skills include interpersonal communication and teamwork skills; conceptual/thinking skills include problem-solving and critical-thinking skills. Conclusions Personal attributes are the decisive elements for higher vocational nursing students' competencies. Interpersonal skills are the core competency for nursing works. Conceptual/thinking skills ensure higher vocational nursing students to acquire sustained development. A systematic nursing soft skills training model should be constructed.

Clinical Observation of Itopride Combined with Esomeprazole Magnesium in the Treatment of Esophageal Motility Dysfunction-induced Gastroesophageal Reflux Disease / 中国药房

OBJECTIVE:To investigate the clinical efficacy of itopride combined with esomeprazole magnesium in the treat-ment of esophageal motility dysfunction-induced gastroesophageal reflux disease(GERD). METHODS:A total of 100 patients with esophageal motility dysfunction-induced GERD were selected from our hospital during Sept. 2015-Sept. 2016,and then divided into control group and observation group according to random number table,with 50 cases in each group. Control group was given Esomeprazole magnesium enteric-coated tablets 40 mg,po,qd. Observation group was additionally given Itopride hydrochloride tablets 50 mg,po,tid,on the basis of control group. Both groups received treatment for consecutive 6 weeks. Clinical efficacies of 2 groups were observed,and symptom scores,LES resting pressure,liquid and solid swallowing and peristaltic pressure of esopha-geal body were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of obser-vation group was 94.0％,which was significantly higher than 78.0％ of control group,with statistical significance(P<0.05). Be-fore treatment,there was no statistical significance in symptom scores,LES resting pressure,liquid and solid swallowing or peri-staltic pressure of esophageal body between 2 groups(P>0.05). After treatment,symptom scores of 2 groups were decreased sig-nificantly,and observation group was significantly lower than control group,with statistical significance (P<0.05). Compared with before treatment,LES resting pressure of observation group was increased significantly,and significantly higher than that of control group,with statistical significance (P<0.05). Success rate of liquid swallowing increased significantly in 2 groups,and that of observation group was significantly higher than that of control group,with statistical significance(P<0.05). Success rate of solid swallowing,liquid and solid peristaltic pressure of esophageal body(near segment,middle segment and far segment)in con-trol group were higher than before treatment,without statistical significance (P>0.05). Success rate of solid swallowing, liquid and solid peristaltic pressure of esophageal body(near segment,middle segment and far segment)in observation group were signifi-cantly higher than before treatment,and significantly higher than control group at corresponding period,with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:For esophageal motility dysfunction-in-duced GERD,itopride combined with esomeprazole magnesium can significantly improve clinical symptom,effectively increase LES resting pressure,strengthen esophageal motor function,improve success rate of esophageal swallowing and enhance anti-gas-troesophageal reflux ability with good safety.

Comparison of efficacy of lamivudine plus adefovir dipivoxil de novo combination therapy with optimization monotherapy in patients with decompensated hepatitis B cirrhosis / 重庆医学

Objective To compare the efficacy of lamivudine (LAM) plus adefovir dipivoxil (ADV) de novo combination therapy to optimization monotherapy for hepatitis B virus-related compensated cirrhosis,and analyze the prediction factors of early response of antivirus treatment.Methods A total of 158 cases of patients with hepatitis B virus-related compensated cirrhosis were selected and randomly assigned to combined group (n=81) and optimized group (n =77) according to randomized digital table.The patients in the combined group accepted LAM combined ADV.The patients in the optimized group were firstly treated with LAM or ADV,then they were given optimized therapy with ADV or LAM if they had poor response or virological breakthrough at week 24.The clinical efficaeies were compared between the two groups,and the prediction factors of early response were analyzed.Results At week 12,the decline level of HBV DNA in the combined group was higher than that in the optimized group (P＜ 0.05),but no statistically significant difference was found in the negative transformation rate of HBV DNA between the two groups (P＞ 0.418).At week 24,the decline level of HBV DNA,rate of undetectable HBV DNA and rate of complete response were higher than those in the optimized group,and rate of virological breakthrough was lower than that in the optimized group (P＜0.05).At week 48,the decline level and negative transformation rate of HBV DNA,negative transformation rate and seroconversion rate of HBeAg were higher than those in the optimized group,and serum levels of hyaluronic acid and a2-macroglobulin were lower than those in the optimized group (P＜0.05).There was no statistically significant difference in the recover rate of alanine aminotransferase (ALT),rate of complete response and rate of virological breakthrough between the two groups at week 48 (P＞0.05).Logistic regression analysis showed that the complete response at week 24 was correlated with HBV DNA load,expression of HBeAg,level of ALT and initial treatment (P＜0.05).Layered evaluation showed that the rate of early complete response in the combined group was significantly higher than that in the optimized group,regardless of HBV DNA load,expression of HBeAg,and level of ALT (P＜0.05).Conclusion LAM combined with ADV can reduce resistance and improve the rate of early complete response,which has stronger antiviral activity.In addition,it can improve the liver function and partially reverse cirrhosis.

Operation practice of the pain nursing team as main of pain resource nurses / 中国实用护理杂志

Objective To explore the effect of pain management by pain resource nurse (PRN) attending pain nursing group, and to know the patient′s satisfaction. Methods Advanced practice nurse as the lead of the group. The selection of PRN members in the group was made on merit which all have definite responsibility and like pain nursing, established pain management quality control system in group and training,standardized pain management processes and the regulations, educated knowledge and skills of pain management for PRN. Results Patient satisfaction with pain management increased significantly from 82.0%(496/605) to 97.1%(572/589)(P<0.05). Moderate and serious pain rate of patients decreased significantly from 60.0%to 20.0%(P<0.01). The qualified rate of pain assessment increased from 84.9%(514/605) to 95.1%(560/589)(P<0.05). Conclusions The establishment of pain nursing group can not only improve pain management quality and patients satisfaction, but also improve of PRN′s professional behaviors and development of clinical pain nursing .

Predictive value of liver enzymes and alcohol consumption for risk of type 2 diabetes / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To compare the predictive value of liver enzymes and alcohol consumption for determining risk of type 2 diabetes (T2DM).</p><p><b>METHODS</b>A cross-sectional study was conducted in Zhengzhou with a total of 2, 693 men.Participants' height, weight, and histories of smoking and drinking were recorded. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT) and blood glucose, as well as related metabolic indexes were detected.</p><p><b>RESULTS</b>Moderate daily alcohol consumption (more than 35 g ethanol/week and less than 140 g ethanol/week) decreased the risk of type 2 diabetes (OR =0.376, 95% CI:0.306 -0.463, P less than 0.05) but increased risk for higher levels of GGT and ALT (OR GGT =3.012, 95% CI:2.357-3.849, Pless than 0.01; ORALT =1.473, 95% CI:1.043-2.081, Pless than 0.05). In joint analyses of alcohol consumption and liver enzymes, the group of nondrinkers/light drinkers (less than or equal to 35 g ethanol/week) in the fourth quartile of GGT levels had the highest risk for type 2 diabetes (OR =12.219, 95% CI:6.217-24.016, P less than 0.01). The relationship of ALT and daily alcohol consumption with the risk of type 2 diabetes was almost the same as that of GGT (nondrinkers/light drinkers in the fourth quartile of ALT levels (OR =5.357, 95% CI:3.070-9.350, P less than 0.0 1).</p><p><b>CONCLUSION</b>GGT, ALT and daily alcohol consumption were independently associated with risk of type 2 diabetes. Nondrinkers/light drinkers with the highest levels ofGGT orALT were at high risk of type 2 diabetes.</p>

Clinical analyses of 11 cases with pituitary stalk interruption syndrome / 中华全科医师杂志

Eleven male patients with pituitary stalk interruption syndrome (PSIS) at our hospital were retrospectively analyzed with respects to clinical features,endocrine status and imaging characteristics.The clinical manifestations included growth retardation and delayed puberty.All of them were deficient in growth hormone and pituitary gonadotropin secretion.Secondary hypothyroidism and hypocortisolism occurred in 8 patients and one had concurrent central diabetes insipidus.MRI with gadolinium contrast revealed no pituitary stalk or slim and anterior pituitary hypoplasia with ectopic posterior pituitary.The clinical characteristics of PSIS are growth retardation and delayed puberty,partial or complete adenohypophyseal dysfunction.The detection of hypothalamic pituitary region by MRI is an important diagnostic tool.

Efficiency of single incision adjustable mini sling, Ajust, for the treatment of stress urinary incontinence combined with advanced pelvic organ prolapse in eldly women / 中华妇产科杂志

Objective To estimate the efficiency of the single incision adjustable mini sling, Ajust, in the treatment of stress urinary incontinence (SUI) concomitant with advanced pelvic organ prolapse (POP) in eldly women. Methods From Dec. 2013 to Jul. 2014, 58 patients who had been diagnosed as SUI combined with advanced POP underwent both single incision adjustable mini sling and reductive surgery for advanced POP in the First Affiliated Hospital, General Hospital of People′s Liberation Army. Fifty-eight patients were assessed to evaluate the safety and efficiency at 2, 6, 12 months postoperatively. The primary outcomes include objective and subjective cure rate, Ajust sling related complications, ralues of urinary distress inventory (UDI-6), incontinence impact questionnaire short form (IIQ-7) and patient global impression of change (PGI-C). Results There was no case of leakage tested by cough test, so the objective cure rate for anti-incontinence had been achived to 100% (58/58) at a mean 12 months follow-up. There were 91% (53/58) of the patients′ PGI-C score reached 5, and 9% (5/58) of the patients′ PGI-C score reached 4. No case underwent the reoperation. There was no case of hematoma, bladder perforation, urethral injury, groin pain, as well as pain in the puncture point during the perioperative period of time. The values of UDI-6 and IIQ-7 declined significantly postoperatively (P<0.01). Conclusions The single incision mini sling, Ajust, presents satisfactory objective and subjective cure rate in the treatment of mild and moderate SUI combined with severe POP in the eldly womem. The advantages of this mini sling includes mini-invasiveness, simple to use, rare complications and less urinary retention rate. It is a procedure worth recommending in the clinical treatment of mild to moderate SUI.

Association between interleukin-10 gene polymorphisms and susceptibility to Henoch-Schonlein purpura in children / 中华实用儿科临床杂志

Objective To explore the association between interleukin-10 (IL-10) gene polymorphism and susceptibility to Henoch-Schonlein purpura (HSP)in children,and to further explore the pathogenesis of HSP,provide some scientific evidence for the diagnosis,treatment and prognosis of HSP.Methods One hundred and twelve patients with HSP(HSP group),in which 39 cases were HSP nephritis (HSPN group) hospitalized in Zhengzhou Children's Hospital from December of 2012 to April of 2013 and 184 healthy children (healthy control group)were recruited in this study.The distribution of patients and the healthy control group in single nucleotide polymorphisms (SNPs) of IL-10 (rs1800872,rs3024490,rs3790622,rs1518111,rs1554286,rs3024498) was detected and compared by Seque-nom Massarray system analysis and meanwhile the haplotype analysis and linkage disequilibrium test were conducted.Simultaneously,the serum levels of IL-10 between HSP group and healthy control group were detected.Results The concentration of IL-10 in HSP group was higher than that of the healthy control group (P ＜ 0.01).No significant differences were found in gene distribution between HSP group and the healthy control group (P ＞ 0.05).For haplotypes analysis,ATCATA,AGCGCA were the most common haplotypes,followed by CTCATA,CGCGCA and ATTATA haplotypes.By the chi-square test,the levels of AGCGCA,ATCGCA,CTCATA haplotypes in HSP group were significantly higher than those in the healthy control group(P =8.41 e-012,0.003 536,1.30e-011).While the levels of ATCA-TA,CGCGCA haplotypes in HSP group were significantly lower than those in the healthy control group (P =0.003 519,4.94e-005).In the rs3790622,the allele frequency and the genotype frequency of the HSPN group were significantly higher compared with those of the healthy control group (all P =0.01).Conclusions The children with HSP are closely linked to the serum levels of IL-10.No significant associations were found between these variants and the susceptibility to HSP.For haplotypes analysis,the ATCATA,CGCGCA haplotypes may play a protective role in HSP children.In the rs3790622,the T allele and CT genotype may be the protective factor in HSPN.