ABSTRACT
Objective To observe the visual field loss after 577 nm krypton pan-retinal photocoagulation (PRP) in the treatment of diabetic retinopathy (DR).Methods A prospective clinical studies.Forty-six eyes of 26 patients with proliferative DR (PDR) and severe non-proliferative DR (NPDR) diagnosed by clinical examination from No.306 Hospital of PLA during January 2014 and December 2015 were included in this study.Among them,21 eyes of NPDR and 20 eyes of PDR;13 eyes with diabetic macular edema (DME) (DME group) and 28 eyes without DME (non-DME group).All eyes underwent best corrected visual acuity (BCVA),fundus color photography,fundus fluorescein angiography (FFA) and optical coherence tomography (SD-OCT) examinations.The visual field index (VFI) and visual field mean defect (MD) values were recorded by Humphrey-7401 automatic visual field examination (center 30° visual field).The BCVA of DR eyes was 0.81 ± 0.28;the VFI and MD values were (89.8± 8.4)％ and-7.5 ± 3.85 dB,respectively.The BCVA of the eyes in the without DME group and DME group were 0.92±0.20 and 0.57±0.27,the VFI were (90.86±7.86)％ and (87.46± 9.41)％,the MD values were-6.86± 3.43 and 8.87 ± 4.48 dB.PRP was performed on eyes using 577 nm krypton laser.The changes of VFI,MD and BCVA were observed at 1,3,and 6 months after treatment.Results Compared with before treatment,the VFI of DR eyes decreased by 12.0％,12.3％ and 14.8％ (t=7.423,4.549,4.79;P＜0.001);the MD values were increased by-4.55,-4.75,6.07 dB (t=-8.221,-5.313,-5.383;P＜0.001) at 1,3 and 6 months after treatment,the differences were statistically significant.There was no difference on VFI (t=1.090,-0.486;P＞0.05) and MD value (t=-0.560,-0.337;P＞0.05) at different time points after treatment.Compared with before treatment,the BCVA was significantly decreased in DR eyes at 1 month after treatment,the difference was statistically significant (t=2.871,P＜0.05).Before and after treatment,the BCVA of the DME group was lower than that of the non-DME group,the difference were statistically significant (t=4.560,2.848,3.608,5.694;P＜0.001);but there was no differences on the VFI (t=1.209,0.449,0.922,0.271;P＞0.05) and MD values (t=1.582,0.776,0.927,1.098;P＞0.05) between the two groups.Conclusion The range of 30° visual field loss is about 12％-14.8％ after 577 nm krypton laser PRP for DR.VFI and MD can quantitatively analyze the and extent of visual field loss after PRP treatment.
ABSTRACT
Objective To investigate the feasibility of differential expression proteins identification in peripheral blood mononuclear cells (PBMCs) of sepsis patients using Data Independent Acquisition liquid chromatography-mass spectrometry (DIA LC-MS). Methods Prospective studies were employed and targeted at 10 sepsis patients admitted to the Intensive Care Unit (ICU) of Shanghai Fifth People's Hospital Affiliated to Fudan University from April 2016 to July 2016. And 10 patients admitted to the ICU with similar age and sex that were not complicated with sepsis were served as the control group.The proteins from peripheral blood mononuclear cells in 10 sepsis patients and 10 control persons were analyzed using the latest DIA LC-MS technology and the skyline data extraction software; the model of data obtained from the above analysis was further discriminatorily analyzed with principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA) and orthogonal partial least squares discriminant analysis (OPLS-DA); then the differential proteins of peripheral blood mononuclear cells were analyzed by Pathway analysis and GO analysis. The possible markers were identified by preliminary screening according to variable importance in the projection (VIP). The top 3 proteins (VIP > 1, P< 0.05) were verified by ELISA and their ROC curves were analyzed. Results Totally 1062 fragment ions were identified and 119 proteins were obtained. Among them, 31 proteins were up-regulated and 88 proteins down-regulated. Pathway analysis showed that carbon metabolism, platelet activation, bacterial invasion of epithelium, and complement coagulation cascade activation were participated in the development of sepsis. ELISA showed that significant difference of HMGB-1, MMP-8, and LCN2 in the expression of peripheral blood mononuclear cells in the sepsis and control people (P<0.01). The area under the ROC curve is greater than 0.85, which has good sensitivity and specificity. Conclusions DIA-MS is a compelling way for detecting differential expression proteins. PCA, PLSDA and OPLSDA are suitable for pattern recognition. The high expression of HMGB-1, NGAL and MMP-8 in immune cells may be the potential biomarker of the disease, which lays the foundation for research of early diagnosis and treatment of sepsis.
ABSTRACT
Objective To investigate the correlation between recurrent spontaneous abortion and karyotype correlation,and provide reference for clinical diagnosis and treatment of spontaneous abortion.Methods 51 couples peripheral blood lymphocyte were collected and cultured from March 2010 to March 2013 in the region.Karyotype analysis were performed to observe the distribution of the rate of chromosomal abnormalities situation.Meanwhile the correlation between the number of abortions and chromosomes were compared.Results Among the 102 subjects,32 cases(31.37％)of them were found chromosomal abnormalities in RSA.The ratio of polymorphic mutation accounted for 56.25 ％ of the chromosome abnormality.accounting for 17.65 ％ the total.Which was significantly higher than other chromosomal abnormalities(P＜0.05).Among the RSA and chromosomal karyotype cases,females accounted for 68.75 ％,which was significantly higher than males (31.25 ％)(P＜0.05).46XY(Y≥18)has the highest incidence in chromosome polymorphism,accounting for 33.33 ％,while abortions accounting for 30.77 ％.RSA number and incidence of chromosomal abnormalities to miscarriages three times the highest rate of abnormal,accounting for 43.48％.Conclusion Chromosomal abnormalities is an important factor in recurrent spontaneous abortion.Recurrent abortion is not only related to the structure of chromosomes,but also has a certain relationship with the variation of chromosome polymorphism.
ABSTRACT
Objective To investigate the treatment outcome of modified intracytoplasmic sperm injection (ICSI)using zona pellucida(ZP)-bound sperm.Methods 82 patients with less,weak,abnormal sperm disease who were conformed to ICSI,were divided into traditional ICSI group and the group of modified ICSI using ZP-bound sperm according to ICSI case number.The results of normal fertilization rate,cleavage rate,high-quality embryo rate, planting rate,clinical pregnancy rate and early abortion rate were compared.Results The women's age,the sterility year,mature egg rate,normal fertilization rate,cleavage rate in the two groups had no statistically significant differ-ences (all P>0.05).The planting rate and clinical pregnancy rate of the observation group (46.6%,63.3%)were higher than those of the control group(38.5%,53.6%),but there were no statistically significant differences(all P>0.05).The using embryo rate and high-quality embryo rate of the observation group (73.9%,51.0%)were signifi-cantly higher than those of control group(65.8%,38.6%),the differences were statistically significant(χ2 =5.84,χ2 =11.6,all P<0.05).Conclusion Modified ICSI using ZP-bound sperm can effectively improve the embryos quality in ICSI.
ABSTRACT
Objective To investigate the effects of sperm DNA fragmentation (SDF)and sperm morphology on the fertilization and embryo development in ICSI.Methods SDF and sperm morphology were detected in the meanwhile of taking eggs in 1 45 ICSI treatment cycle.On the basis of SDF index (DFI)divided into group A (DFI≤30%)and group B (DFI >30%).According to the normal sperm morphology divided into group C (NMSR≥4%), group D (1 %≤NMSR 30% and NMSR 0.05).(2)The normal fertilization rate was statistically significant in group C,group D,group E (χ2 =34.5,65.8,11 .8,all P 0.05).(3 )The normal fertilization rate,embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate in group F were significantly higher than those in group G,and normal fertilization rate,embryos utilization rate,good quality embryo rate had statistically significant differences (χ2 =37.5,1 1 .0,4.3,all P <0.05). Conclusion Sperm abnormal morphology has negative effect on fertilization,and the high DNA fragments have negative effects on fertilization and embryo development.
ABSTRACT
This study was aimed to establish fingerprints of Citri Sarcodactylis Fructus from different geographical origins,and to use the method of pattern recognition to compare the differences of Citri Sarcodactylis Fructus from different habitats.In this study,high performance liquid chromatography (HPLC) was used to establish fingerprints for 25 batches of Citri Sarcodactylis Fructus from 4 habitats.Furthermore,similarity evaluation,cluster analysis (CA) and principal component analysis (PCA) were performed.The results from established fingerprints showed that a total of 26 common peaks were pointed out and 4 peaks were identified as the common peaks.The CA and PCA can be used to compare Citri Sarcodactylis Fructus from different habitats.It was concluded that Cirri Sarcodactylis Fructus in near geographic origins had a higher similarity,while the different geographic origins had a higher difference.
ABSTRACT
Objective To investigate the effect of linezolid on procalcitonin ( PCT) in the treatment of methicillin resistant staphylococcus ( MRS) infection.Methods 85 cases with MRS infection in our hospital were grouped, control group received vancomycin treatment, study group received linezolid, 2 weeks for 1 courses.Clinical effect were compared to explore the linezolid effect of PCT levels in patients with MRS infection.Results After treatment, defervescence time, bacterial clearance time, bacterial clearance rate and 48 hour mortality rate between two groups of patients had no significant difference.Compared with the control group, ICU treatment time in the study group was significantly lower ( P<0.05 ) .There was no significant difference in total effective rate between two groups.After treatment, the PCT and CRP in study group were lower than control group(P<0.05).Conclusion Linezolid has significant function to reduce the serum PCT level of patients with methicillin-resistant staphylococcus infection procalcitonin, which has better clinical curative effect.
ABSTRACT
Objective:To identify a suitable biomarker for early diagnosis and prognosis of Candida albicans pneumonia ( CAP) ,we investigated the expression of several biomarkers,such as soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1),soluble hemoglobin-haptoglobin scavenger receptor (sCD163),C-reactive protein (CRP),and procalcitonin (PCT),in rabbits with CAP. Methods:A rabbit model was established after immunosuppression of 40 rabbits,randomly divided into 2 groups of 20 each. The experimental group received 1 ml injection of 5×107 cfu/ml C. albicans solution via percutaneous tracheal puncture,while the control group received normal saline. Rabbit blood samples were collected on days 2,3,4,5,6 and 9 post-inoculation and examined for levels of sTREM-1,sCD163,CRP,PCT,interleukin-6 (IL-6),IL-8,IL-10 and tumor necrosis factor-α (TNF-α). Other tests included routine blood examination,arterial blood gas test,chest thin-layer computed tomography on days 3 and 9 post-inoculation,lung tissue biopsy, and blood culture to confirm C. albicans infection. Results:The levels of sTREM-1,SCD163,PCT,and TNF-αwere higher in the exper-imental group as compared to control. Additionally,sTREM-1 and CRP indices showed an upward trend during 9 days of observation period in the experimental group,while others showed a short-term increase after inoculation and then declined gradually. Areas under the receiver operating characteristic curve for CAP diagnosis were calculated as 0. 882,0. 814,0. 685 and 0. 55 for sTREM-1,SCD163, PCT and CRP,respectively. Conclusion: The diagnostic value of biomarkers,sTREM-1 and SCD163,is superior to that of CRP and PCT in the diagnosis of CAP.
ABSTRACT
Objective To investigate, in vitro, the co-infection of Caco-2 cells ( epithelial cells of intestinal mucosa) with Candida albicans and Enterohemorrhagic escherichia coli ( EHEC) .Methods The ability of both species to invade the Caco-2 cells was evaluated by inverted microscopy.Damage to Caco-2 cells was evaluated by measuring lactate dehydrogenase ( LDH ) activity. C. albicans virulence gene expression ( ALS3, PLB1 and SAP4 ) was evaluated by quantitative real-time polymerase chain reaction ( qRT-PCR) .Results Compared to simple infections with C.albicans alone, a co-infection invaded Caco-2 cells more rapidly, and C.albicans tended to proliferate more easily presenting in cluster shape of distribution.In addition, the LDH activity in the co-infection group (group 3) was the highest compared to groups 1, 2, 4 and 5, (F values of 14.48, 5.48, 11.74 and 3.45 respectively;all P <0.05);There was no significant difference in LDH activity found between the secondary fungous infection group ( group 5) and the EHEC infection group (group 2) (F=2.03, P=0.54) or between the secondary bacterial infection group (group 4) and the Candida albicans infection group (group 1) (F=2.74, P=0.11).The LDH activities in groups 2 and 5 were significantly higher than that in groups 1 and 4 ( all P <0.05 ) .In addition, an up-regulation of toxicity-related genes ( PLB1 and SAP4 ) were detected.The expression of PLB1 was higher in group 3 than that in group 1 ( P=0.014 3 ) and SAP4 was higher in groups 3 and 5 than that in group 1 (P=0.027 2, P=0.001 8, respectively).Conclusions Using Caco-2 cells for an infection model, this study demonstrated that co-infecting in vitro enterocytes with C.albicans and EHEC enhanced the invasiveness and tissue damaging effects of C.albicans.
ABSTRACT
Objective To analyze the value of serum procalcitonin (PCT) in patients with community acquired pneumonia (CAP),and to evaluate the role of PCT in the therapeutic effect,severity and prognosis.Methods A retrospective analysis of data and laboratory tests of 50 patients with CAP admitted from November 15,2011 to November 15,2012 in GICU was carried out.Patients with infection of other parts of body,surgical treatment and trauma were ruled out.The level of PCT (ng/mL) before and during treatment,and the relationships between PCT and respiratory failure,mechanical ventilation,treatment results were analyzed respectively.Results According to the occurrence of sepsis,50 patients were divided into sepsis group and non-sepsis group.In the non-sepsis group,the PCT level before treatment,the highest and average PCT levels during the treatment were 0.1125 (0.078,0.269),0.1235 (0.078,0.494),and 0.1355 (0.08,0.245) respectively.Correspondingly,the PCT levels in the sepsis group were 8.92 (2.715,16.33),13.53 (6.305,25.625),and 4.26 (2.1415,8.2455),and there were statistically significant differences in three values of PCT between groups (ZIst =-4.743,PIST ＜ 0.05 ; ZMax =-5.783,PMax ＜ 0.05 ; ZMean =-5.644,PMean ＜ 0.05).According to the emergence of respiratory failure during treatment,average PCT level in the patients with respiratory failure was 1.7375 (0.224,5.092),and that in the patients without respiratory failure was 0.081 ng/mL (0.049,0.146),presenting the statistically significant difference between two groups (Z =4.472,P ＜ 0.05).In case of using mechanical ventilation (MV),the average PCT level of the patients with mechanical ventilation was 1.618 ng/mL (0.224,5.092),and that in the patients without MV was 0.086 ng/mL (0.061,0.465),producing a significant difference between the two groups (Z =-3.788,P ＜ 0.05).Grouped according to the outcome of patients,the mean value of PCT level in death group was 7.4585 ng/mL (2.392,16.25),and that in the survival group was 0.1965 ng/mL (0.885,0.618),showing statistically significant difference between two groups (Z =3.857,P ＜ 0.05).The first PCT level in the GICU within 24 h after admission was used to make the receiver operating characteristic curve (ROC),and the area under the curve (AUC) was 0.9867,cutoff point was 1.25 ng/mL.Conclusions In case of CAP,the PCT level in patients with sepsis is significantly higher than that in patients without sepsis,and PCT can distinguish sepsis from pneumonia precisely.In addition,PCT is an important biomarker to judge the severity and outcomes of CAP at early stage.
ABSTRACT
Objective To investigate the hospital distribution and drug resistance of pathogens of venous catheter-related infec-tion,so as to provide basis for appropriate usage of antibiotics in clinic.Methods The culture and drug susceptibility results of 369 venous catheter were analyzed retrospectively from 2009 January to 2012 December.Results 161 strains of pathogens were detec-ted among 369 venous catheter,the positive rate was 43.6%.There were 83 strains of Gram positive bacteria,accounting for 51.6%,and Staphylococcus epidermidis had the highest positive rate.There were 63 strains of Gram negative bacteria,accounting for 39.1%,and Klebsiella pneumoniae and Bauman Acinetobacter were main isolated bacteria.There were 15 strains of Fungi,ac-counting for 9.3%,and Candida parapsilosis had the highest positive rate.There was none Gram positive bacteria resistant to van-comycin and linezolid.Carbapenems remained high activity against Gram negative bacteria.Conclusion Staphylococcus epidermidis and Klebsiella pneumoniae are mainly detected in venous catheter in the hospital infection.
ABSTRACT
@#Objective To investigate the status of the establishment and service of the rehabilitation departments in comprehensive hospitals in China mainland.Methods A questionnaire survey was conducted in 240 comprehensive hospitals with different grades distributed in the capital city of 31 provinces, autonomous regions, and municipality cities in China mainland in a stratified sampling way. The contents investigated are the settings of rehabilitation departments, the performances of the rehabilitation services, the staffing of the rehabilitation workers and the problems faced in rehabilitation. Then, statistical analysis were done between the developed eastern regions and economically less developed middle-western regions, as well as different grades of comprehensive hospitals. Results In total, 216 valid questionnaires were collected (72 tertiary hospitals, 72 secondary hospitals and 72 primary hospitals), and there are no statistically difference between eastern regions and middle-western regions(P=0.61). About 69% of the hospitals surveyed have built up the rehabilitation departments, and there are no statistically difference between different regions (P=0.30). As far as the performance of the rehabilitation services are concerned, 97.2% of them have carried out rehabilitation service, 60% of them can satisfy the demands of the patients, and there are no difference between the different grades and between the eastern and middle-western regions(P>0.05). In addition, 76.4% of them have rehabilitation doctors, 68.4% have physiotherapists(PT), 52.3% have traditional Chinese medicine doctors, 50.5% have occupational therapists(OT), 36.9% have speech therapists(ST), 17.8% have psychologists, and only 2.3% have social workers. The staff status on PT, OT and ST of the hospitals in eastern regions are significantly better than that in middle-western regions(P<0.01), and the staff status on rehabilitation doctors, PT, OT, ST and psychologists in the tertiary hospitals are significantly better than that in the secondary hospitals and primary hospitals(P<0.01). Finally, the first five problems the rehabilitation department faced are following: short of professional workers(63.9%), lack of training areas(51%), lack of modern rehabilitation service management system (50.5%), out-of-date equipments(49.5%) and low fees of rehabilitation treatment(49.1%). Conclusion Many problems exists in the rehabilitation departments of comprehensive hospitals, such as the development of rehabilitation departments, the professional workers, the quality and width of the service, the efficient use of rehabilitation resources, rehabilitation management and profession permission, the relative policies and regulations, personnel training and so on. Therefore, the government should enhance to put the supported policies into practice, and reinforce investment to the comprehensive hospitals, in particular, enhance the support of the comprehensive hospitals in middle-western regions, as well as the primary hospitals and the secondary hospitals, all of which will play a much more efficient role in rehabilitation for the disabled in the comprehensive hospitals.
ABSTRACT
Objective To explore the morbidity rate and risk factors of proliferative diabetic retinopathy (PDR) in type 2 diabetes. Methods The clinical data of patients, with PDR in 2739 consecutive cases of type 2 diabetes diagnosed in this hospital from 1994 to 2001 were analyed retospectively. The diagnosis of diabetic retinopathy (DR) was confirmed by ophthalmoscopy and fundus fluorescein angiography (FFA). Blood pressure, fasting and postprandial blood sugar, glycosylated haemoglobin(HbA1c), total serum cholesterol, triglyceride, creatinine, and albumin excretion rate were measured. Results The morbidity rate of type 2 DR was 27.8%(761/2739), and the morbidity rate of PDR was 4. 2%(114/2 739) occupying 15% of the patients with DR. The duration, fasting blood sugar, glycosylated haemoglobin, blood pressure and albumin excretion rate were much higher than those in the control ( P
ABSTRACT
@#ObjectiveTo investigate the current situation of the quality of life of aging people living in the rural areas in Hainan province. Methods253 permanent residents at age of 60 and above in Zhongyuan Town were sampled at random, and were investigated face to face at home. Results96.0% of them were independently managing their activities of daily life with 77.5% lived by themselves. In a self evaluation questionnaire on health status, 32.0% perceived good, 50.8% moderate and 17.2% bad,70.75% had history of chronic illnesse, cataract, hypertension, chronic bronchitis, bone and joint diseases and anemia appeared to occupy the previous five positions.41.0% were satisfied with the current medical condition,52.4% moderate and 6.6% un satisfied. 75.1% thought medical costs too expensive. At the degree of satisfaction to life, 20.2% were high, 63.8% moderate and 16.0% low. ConclusionsDue to the huge amount of demand on health services of the rural elderly people, it was suggested that more medical care should be provided to the rural elderly people, with emphasis on the chronic diseases, and the policy of prevention first and combining prevention with treatment should be sticked to.