Five patients with 11β-hydroxylase deficiency due to CYP11B1 gene mutation: A case study / 中华内分泌代谢杂志

Objective:To investigate the clinical and molecular characteristics of 11β-hydroxylase deficiency(11β-OHD) to improve the understanding of this disorder.Methods:The clinical manifestation, hormone level, imaging examination, characteristics of gene variation and follow-up of five patients with 11β-OHD diagnosed in Henan Children′s Hospital from 2016 to 2021 were carefully reviewed.Results:Among the 5 children, 3 were male and 2 were female, all without positive family history. The age at diagnosis was 1 year 5 months to 7 years(average 3 years and 9 months), and the bone age was 3 years 6 months to 16 years(average 10 years and 3 months). Two cases were misdiagnosed as 21-hydroxylase deficiency(21-OHD) and treated with long-term mineralocorticoids. Three patients presented with hypertension and one patient had testicular adrenal rest tumor. Adrenal CT showed bilateral adrenal hyperplasia in five patients. ACTH, 17-hydroxyprogesterone, testosterone, and androstenedione levels were increased in 5 children, and hypokalemia occurred in 1 patient. One patient carried homozygous novel missense variant, and four patients had compound heterozygous variants. Four patients carried missence mutations, two patients had deletion and one patient harbored a chimeric CYP11B2 exon1-6/CYP11B1 exon7-9. Three novel CYP11B1 mutations, including c. 1385T>C(p.L462P), c.64C>T(p.Q22*)and c. 1354G>A(p.G452R) were identified. The final height of 2 male children were 164.4 cm and 150.2 cm, respectively, and the related hormone levels of the other 3 children were normal.Conclusion:11β-OHD is easily misdiagnosed, leading to severe impairment of final height. CYP11B1 gene variation is complex and diverse, which requires variety of gene detection methods.

Clinical application of three-dimensional computed tomography bronchography and angiography in thoracoscopic segmentectomy / 中国医师杂志

Objective@#To explore the clinical value of three-dimensional computed tomography bronchography and angiography (3D-CTBA) in thoracoscopic dissection or combined segmentectomy.@*Methods@#The clinical data of 30 patients with isolated or multiple pulmonary nodules from September 2017 to August 2019 were retrospectively analyzed. All cases were treated with 3D-CTBA to locate the nodules accurately before operations, in order to explicit the courses of bronchi and vessels, and to observe the variations. The target bronchi, arteries and veins were resected accurately during the operations, and the intersegmental plane was determined by expansion-collapse method.@*Results@#13 patients underwent segmentectomy and 17 patients underwent combined segmentectomy. The diameter of the nodule was (11.56±3.79)mm; the depth of the nodule (the shortest distance from the visceral pleura) was (13.88±3.96)mm; the operation time was (134.94±18.68)min, and the intraoperative bleeding volume was (94.38±37.94)ml. No cancer metastasis was found by rapid pathological examination of lymph nodes during operations. No conversion to thoracotomy. The indwelling time of thoracic tube was (3.69±1.30)days, and the hospitalization days after operations was (4.81±1.47)days. No serious complications or death during the perioperative period.@*Conclusions@#Preoperative 3D-CTBA has advantages in pulmonary segmentectomy, which is a safe and effective method for accurate segmentectomy.

Application of thematic health education on breast cancer patients with whole course of disease management / 中国实用护理杂志

Objective@#To explore the efficacy of thematic health education on breast cancer patients with whole course of disease management.@*Methods@#According to the order of admission into the hospital, 100 breast cancer patients were randomly divided into two groups: the control group and the observation group. In the control group, clinical nursing pathway was adopted when health education was conducted. In the observation group, thematic health education based on the whole course of disease management was carried out. Mastery of disease knowledge, health-promoting behaviors and degree of anxiety were compared between the two groups.@*Results@#The total score of the survey on the observation group and the scores of Disease Risk Factors, Functional Training and Observation and Protection of Complication (90.00±11.75, 18.05±4.33, 19.01±4.20, 18.68±0.07) were all higher than those of the control group (86.68±9.340, 16.12±2.86, 17.22±2.83, 15.43±6.78); the differences were statistically significant (t=2.641-9.171, P<0.05) .The total score of the observation group in The Healthy Living Style Scale and the scores in different dimensions were all higher than those of the control group; the differences were statistically significant (t=2.347-6.653, P<0.05 or 0.01) .The score of the Self-rating Anxiety Scale of the observation group after completing all the chemotherapy periods (48.20±4.03) was lower than that of the control group after three chemotherapy periods (53.56±2.84) ;the differences were statistically significant (t=7.028, P<0.05) ; in these two tests, the group differences in scores between the two groups are also statistically significant (t=2.050, 11.560, P<0.05 or 0.01) .@*Conclusion@#Conducting thematic health education on the breast cancer patients based on the whole course of disease management can effectively improve the patients′ mastery of disease knowledge, improve their health-promoting behaviors, relieve their anxiety and help them recover physically and mentally.

Clinical application of three-dimensional computed tomography bronchography and angiography in thoracoscopic segmentectomy / 中国医师杂志

Objective To explore the clinical value of three-dimensional computed tomography bronchography and angiography (3D-CTBA) in thoracoscopic dissection or combined segmentectomy.Methods The clinical data of 30 patients with isolated or multiple pulmonary nodules from September 2017 to August 2019 were retrospectively analyzed.All cases were treated with 3D-CTBA to locate the nodules accurately before operations,in order to explicit the courses of bronchi and vessels,and to observe the variations.The target bronchi,arteries and veins were resected accurately during the operations,and the intersegmental plane was determined by expansion-collapse method.Results 13 patients underwent segmentectomy and 17 patients underwent combined segmentectomy.The diameter of the nodule was (11.56 ± 3.79) mm;the depth of the nodule (the shortest distance from the visceral pleura) was (13.88 ± 3.96) mm;the operation time was (134.94 ± 18.68) min,and the intraoperative bleeding volume was (94.38 ± 37.94)ml.No cancer metastasis was found by rapid pathological examination of lymph nodes during operations.No conversion to thoracotomy.The indwelling time of thoracic tube was (3.69 ± 1.30) days,and the hospitalization days after operations was (4.81 ± 1.47)days.No serious complications or death during the perioperative period.Conclusions Preoperative 3D-CTBA has advantages in pulmonary segmentectomy,which is a safe and effective method for accurate segmentectomy.

Analysis on risk factors and clinical significance in patients with pancreatic cancer / 重庆医学

Objective To investigate the risk factors and clinical significances in the patients with pancreatic cancer(PC). Methods The clinical data of 936 patients with PC in the Affiliated Hospital of Chongqing Medical University during the past 10 years were retrospectively analyzed,and contemporaneous 832 age and sex-matched cases of non-complicating tumor and disease of digestive system and metabolic abnormality were collected as the control group.The differences and correlation between the two groups were analyzed retrospectively,including the gender,age,incidence and course of diabetes mellitus(DM),category of hypogly-cemic drugs,body mass index(BMI),history of pancreatitis,family history of PC and family history of diabetes.Results (1)There were more males than females in PC group,moreover the male proportion was much higher than the female proportion with the age growing.In the PC group,251 cases(26.8%)were complicating DM,which was significantly higher than 13.0% of DM occurrence rate in the control group(P<0.01);in the PC group,new onset DM was up to 14.1%(132/936),which was obviously higher than 3.4% in the control group(P<0.01).The family history of PC,history of pancreatitis,family history of diabetes,overweight and obesity were the independent risk factors for PC.The risk of PC in new-onset DM patients was increased by 4.9 times.Metformin could decrease the risk of developing PC.The time from diagnosed DM to PC in the metformin group was longest[(18.86 ± 3.46) months],which in the non-medication group was shortest[(6.44 ± 1.07)months].Conclusion New-onset DM patients with fami-ly history of DM,family history of PC,history of pancreatitis,overweight and obese should be vigilant to develop PC.For the new-onset DM patients,anti-diabetic drugs influence the onset time of PC and metformin may have effect to delay the occurrence and de-velopment of PC.

Exploring the Matching Method of Government Accounting System and Hospital Accounting System / 中国卫生经济

Through analyzing the project relationship and differences of the Government Accounting System and the Hospital Accounting System, it explored a generalized method about the connection between the old and the new subjects of account based on subject comparison table. Based on the subject matching relationship graph, the connecting relationship between the old and the new was found according to the subject classification. A new hospital government accounting subjects system was setup based on the connected relationship between the old and the new subjects of accounts.

Evaluation of the effect of metronome in the new nurse training of cardiopulmonary resuscitation based on Solomon four-group design / 中国实用护理杂志

Objective To evaluate the effect of using"metronome"to guide chest compression in the new nurse training of cardiopulmonary resuscitation(CPR). Methods From 2015 to 2016,385 new nurses were enrolled and randomly by random number table divided into four groups based on Solomon four-group design:control group 1(96 nurses),sudy group 1(89 nurses),control group 2(104 nurses) and study group 2(96 nurses),Control group 1 and control group 2 accepted normal training plus "chest compressions operation formula" training,study group 1 and study group 2 got "metronome" guiding based on the frequency training.Control group 1 and study group 1 took a baseline test before the training started,while control group 2 and study group 2 didn't.Four groups took part in an operational test after the seven days of training. Results There was no statistical difference between the baseline test scores of control group 1 and study group 1(P>0.05).After the training,the score of study group 1 was 93.4±3.5, which was significantly higher than 91.6 ± 4.7 of control group 1(t=-2.870, P<0.01).Through covariance analysis,after removing the impact of the baseline test score,the score of study group was statistically significant higher than that of control group 1 (F=7.33, P=0.007).Furthermore,there was no statistically significant interaction between the baseline test score and training method (P>0.05).Meanwhile,after training,study group 2 scores was 93.5±3.5,which was statistically higher than 92.1±4.0 of control group 2(t=2.670,P=0.008).Control group 1 were combined with control 2 to form control group,as well as study group 1 with study group 2 to form study group.A comparison between these two new groups indicates that the new study group surpasses the new control group with lower error frequencies in the position,depth and frequency of external cardiac compression (t=4.701 8, 12.488 9, 11.993 9, P<0.05).In addition,the study group also showed a better performance, when taking into consideration of the region and skills of compression and the observation of complexion,while there was no statistical difference between the error frequencies in these three aspects of these two new groups(P>0.05). Conclusions In the CPR training of new nurses,using a 100 times/min"metronome"can help new nurses grasp the accurate compression rates and depth, improve the overall quality of this procedure,making it a simple and effective training method,which is worthy of popularization.

Prognostic role of the ABO blood types in Chinese patients with curatively resected non-small cell lung cancer: a retrospective analysis of 1601 cases at a single cancer center / 癌症

<p><b>BACKGROUND</b>A positive association between the ABO blood types and survival has been suggested in several malignancies. The aim of this study was to assess the role of the ABO blood types in predicting the prognosis of Chinese patients with curatively resected non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>We retrospectively analyzed 1601 consecutive Chinese patients who underwent curative surgery for NSCLC between January 1, 2005 and December 31, 2009. The relationship between the ABO blood types and survival was investigated. In addition, univariate and multivariate analyses were performed.</p><p><b>RESULTS</b>Group 1 (patients with the blood type O or B) had significantly prolonged overall survival (OS) compared with group 2 (patients with the blood type A or AB), with a median OS of 74.9 months versus 61.5 months [hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.72-0.96; P = 0.015]. Additionally, group 1 had significantly longer disease-free survival (DFS; HR 0.86; 95% CI 0.76-0.98; P = 0.022) and locoregional relapse-free survival (LRFS; HR 0.79; 95% CI 0.64-0.98; P = 0.024) than group 2. The association was not significantly modified by other risk factors for NSCLC, including smoking status, pathologic tumor-node-metastasis stage, pT category, pN category, and chemotherapy.</p><p><b>CONCLUSIONS</b>There is an association between the ABO blood types and the survival of Chinese patients with resected NSCLC. Patients with the blood type O or B had significantly prolonged OS, DFS, and LRFS compared with those with the blood type A or AB.</p>

Efficacy observation on chrondromalacia patellae treated with fire needling technique at high stress points / 中国针灸

<p><b>OBJECTIVE</b>To compare the clinical efficacy differences between fire needling technique of filiform needle at high stress points and regular acupuncture on chrondromalacia patellae so as to provide the better therapy for the treatment of this disease.</p><p><b>METHODS</b>Sixty cases of chrondromalacia patellae were randomized into a fire needling group (28 cases) and a routine acupuncture group (32 cases). In the fire needling group, 5 to 6 high stress points were localized according to the symptoms, palpation and imaging condition and were stimulated with fire needling technique of filiform needle. The treatment was given once every two days, 5 treatments made one session. In the routine acupuncture group, the regular acupuncture was applied at Dubi (ST 35), Xiguan (LR 7), Yanglingquan (GB 34), Yinlingquan (SP 9), Zusanli (ST 36), etc. The treatment was given once every day, 5 treatments made one session. Lysholm score, VSA score, patella title angle (PTA) and lateral patella angle (LPA) of the affected knees before and after treatment, as well as the clinical efficacy after treatment were observed in the two groups.</p><p><b>RESULTS</b>After treatment, Lysholm score, VSA score, PTA and LPA were all improved apparently in the two groups (all P < 0.01). After the treatments, the improvements in Lysholm score, VSA score, PTA and LPA in the fire needling group were more obvious than those in the routine acupuncture group (all P < 0.05). The effective rate was 92.9% (26/28) in the fire needling group, better than 87.5% (28/32) in the routine acupuncture group (P < 0.01).</p><p><b>CONCLUSION</b>The fire needling technique of filiform needle at the high stress points relieves the clinical symptoms of chrondromalacia patellae and recovers the biodynamical structure of patellae.</p>

Six cases of hypophosphataemic osteomalacia induced by adefovir dipivoxil / 中华内分泌代谢杂志

[Summary] An analysis of clinical data was performed in 6 patients diagnosed as adefovir dipivoxil (ADV)-induced nephropathy in recent 14 months.The results showed that all of six patients suffered from pain over multiple joints after taking ADV 10-20 mg/d for 2-3 years,along with hypophosphatemia,hypouricemia,and raised osteogenesis index.One case had increased serum creatinine,5 cases had hypokalemia,renal glycosuria,and4 cases had albuminuria.Imageological examination showed osteoporosis,osteomalacia,and pseudo fracture.After discontinuance of ADV treatment,joint pain was obviously relieved within 3-6 weeks,blood uric acid level returned to normal within 1-2.5 months,and renal glycosuria and albuminuria disappeared by 1-2 months.The results suggest that after taking ADV for more than two years,attention should be paid to the nephropathy induced by ADV and regular monitoring of renal function,blood electrolyte,and urine should be mandatory.Hypouricemia is a reliable index of diagnosis and treatment in this event.

Molecular characterization of 71 cases of glucose-6-phosphate dehydrogenase deficiency in Hainan province / 中华血液学杂志

<p><b>OBJECTIVE</b>To molecularly analyze in Han and Li individuals of glucose-6-phosphate dehydrogenase deficiency in Hainan, China.</p><p><b>METHODS</b>The amplification refractory mutation system (ARMS) was employed to detect G1376T, G1388A and A95G mutations. The coding regions and flanking intronic regions from the second to the thirteenth exons of G6PD gene was analyzed by DNA sequencing to characterize the gene mutations in samples without G1376T, G1388A and A95G mutations.</p><p><b>RESULTS</b>Among 29 Han cases of G6PD deficiency, 11 had G1376T (37.9%), 2 G1388A (6.9%), 1 G1376T and G1388A (3.4%) and 1 G1376T and A95G (3.4%) were identified. Mutations of G1376T, G1388A, A95G and their complex accounted for 51.7% of G6PD deficiency in the Han individuals. Among 42 Li cases of G6PD deficiency, 25 had G1376T (59.5%), 6 G1388A (14.3%), 2 A95G (4.8%), 4 G1376T and G1388A (9.5%), 1 G1376T and A95G (2.4% )were identified. These mutations accounted for 90.5% of the Li individuals. Gene mutation of 18 cases (14 Han and 4 Li individuals) remained unknown. Sequencing results of the 18 samples indicated that one case had a single base of T deletion at nucleotide 636 or 637 in the 5th intron (IVS-5 636 or 637 T del) and two cases had C1311T with IVS-11 T93C mutation.</p><p><b>CONCLUSION</b>G6PD G1376T and G1388A are the most common mutations in the populations of the Han and Li nationalities in Hainan. The IVS-5 636 or 637 T del mutation is first reported in Chinese, and the complex mutation of G1376T/A95G is first found in the Li nationality.</p>

Effect of electroacupuncture on gastric mucosal intestinal trefoil factor gene expression in the rat of gastric mucosal injury induced by stress / 中国针灸

<p><b>OBJECTIVE</b>To investigate effects of electroacupuncture on gastric mucosal intestinal trefoil factor (ITF) gene expression in the rat of gastric mucosal injury induced by stress.</p><p><b>METHODS</b>Forty rats were randomly divided into 4 groups: blank group, model group, stomach channel group, gallbladder channel group. The normal group did not receive any processing, and the model group were fixed for 7 sessions and both the stomach channel group and the gallbladder channel group received 7 sessions of electro-acupuncture before modeling. The model was made by water restraint stress (WRS) for 10 hours. Index of gastric mucosal injury was detected and then the gastric mucosa tissue in each rat was taken and the expression of ITFmRNA of the tissue was detected by the reverse transcriptase-polymerase chain reaction (RT-PCR) method.</p><p><b>RESULTS</b>There was very significant or significant difference in the gastric mucosal injury as the stomach channel group and the gallbladder channel group compared with the model group (P < 0.05 or P < 0.01); electroacupuncture had a tendency of improving the expression of gastric mucosal ITFmRNA gene; the expression of ITFmRNA in the gallbladder channel group and the stomach channel group was significantly higher than that of the model group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>The special regulation of electroacupuncture on gastric mucosal tissue is related with the release of epidermal growth factor and the expression of intestinal trefoil factor gene.</p>

Mechanism of Study on Gastric Mucosal Lesion Restoration in Rats Treated by Electroacupuncture / 中国中医药信息杂志

Objective Through comparing the similarities and differences between respairing effect on rat’s gastric mucosal lesion by electroacupure (EA) at Meridian of Foot Yangming and Meridian of Foot Shaoyang, to explore the specificity of the correlation between Meridian of Foot and Stomach and the mechanism of the healing effect by EA at meridian of Foot Yangming for curing the gastric lesion. Methods Forty rats were randomly divided into 4 groups:blank group, model group, stomach tunnel group, gallbladder tunnel group. All rats (except normal group) were made model by water restraint stress (WRS). After corresponding experimental process, epidermal growth factor (EGF) and transforming growth factor alpha (TGF-?) of plasma, gastric mucous tissue concentration was detected with radioimmunoassay, and the expression of EGFR mRNA of above tissue was detected by the reverse transcriptase-polymease chain reaction (RT-PCR) method. Results The gastric mucosal lesion index of Foot Yangming group decreased significantly in comparison with that of other groups, while EGF, TGF-? of gastric mucous tissue concentration level of Foot Yangming group was obviously higher than that of model group and gallbladder tunnel group. EA oould up-regulate the expression gastric mucosal EGFRmRNA, and there was a more significant difference in the group by EA at Meridian of Foot Yangming than that in the model group and gallbladder tunnel group. Conclusion The curative effect of EA at points of Meridian of Foot Yangming on the gastric mucosa may be realized by the synthesis, secretion and release of the related EGF family factor, such as EGF, TGF-? and so on. Such special regulation of electroacupuncture on gastric mucosal tissue was related to the gene expression of EGFRmRNA, and that may be further mechanism of the curative effect of EA at points of Meridean of Foot-Yangming on gastric mucosal lesion. There existed corresponding correlation between Meridian of Foot Yangming and Stomach.