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Objective To analyze the changes of CD4+ T cell numbers at different periods of antiviral therapy in HIV-infected and AIDS patients (HIV/AIDS) in Yichang City. Methods The relevant information was retrieved from the National AIDS Comprehensive Prevention Information System-Antiretroviral Treatment Management Database. Changes in the number of CD4+ T cells were analyzed in HIV/AIDS patients who started receiving highly active antiretroviral therapy (HAART) and continued the treatment for 3 years from January 1, 2003 to December 31, 2017 in Yichang. Results The number of CD4+T lymphocytes in 550 HIV/AIDS cases increased significantly at various time points within 3 years after treatment, and increased with the increase of treatment time（F=100.20，P<0.001）. The CD4+T cell counts of different baseline level groups were statistically different before and after treatment（F=8.57，P<0.01）. The CD4+ T cell counts of patients who started treatment at age of 15-30 years old increased faster than those who started treatment at age of over 30 years old（F=1.27，P<0.05）. Conclusion HAART has a significant effect on the increase of CD4+T cells, and the early treatment is more effective. Early detection, diagnosis and treatment should be promoted, and anti-viral treatment should be actively carried out.
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Objective To investigate the epidemiological characteristics of acute myocardial infarction (AMI) in Yichang City in the last 5 years, and to provide a basis for targeted prevention and treatment. Methods The annual estimated percentage was used to evaluate the trend of morbidity and mortality of AMI by using the monitoring data from 2015 to 2019 from the health big data platform of Yichang. Results There were 1 976 new cases of AMI in Yichang from 2015 to 2019, with a crude morbidity of 41.96/100 000, and standardized morbidity of 87.52/100 000. Among them the crude incidence rate in males was 57.69/100 000, and 29.84/100 000 in females. The difference was statistically significant (χ2=15.76, P2=45.65, P<0.001). The morbidity and mortality of males and females were increased with age. Conclusion From 2015 to 2019, the morbidity of AMI in Yichang was at a moderately low level in China, but the mortality was higher than the national average. The morbidity showed an upward trend, with men and elderly people aged ≥60 being more serious. Appropriate intervention measures should be taken for different groups of people to reduce the incidence of AMI.
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Objective To explore the causes of nosocomial infections in ICU as to provide scientific evidence for the corresponding intervention measures.Methods The retrospective survey was used to investigate and analyze the incidence of nosocomial infections in ICU from 2013 to 2014.Results The total of 1225 patients investigated,182 patients suffered from nosocomial infections and the nosocomial infections rate was 14.86％.The etiology of ICU specimen was 95.22％.Gram negative bacilli,Gram positive bacteria and fungi,which accounted for 69.16％,18.22％ and 12.62％ respectively.The main infection site were respiratory tract,blood and urinary tract,which accounted for 70.43％,11.30％ and 4.78％ respectively.Conclusion The hospital infection rate of ICU in our hospital is kept the same level of the hospital in the same area.Etiology specimens rate comply with national standards.Main pathogens are gram negative bacilli,and the main site of infection is respiratory.
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In recent years, remote ischemic preconditioning is found as a novel way to protect the brain, which may be achieved through nerve pathways, humoral factors or nerve-humoral interaction. The molecular mechanisms for the protection might be related to mitochondria ATP-sensitive potassium channel, mitogen-activated protection kinase, mammalian target of rapamycin, including nitric oxide synthase and cannabinoid receptors. The aim of this review is to explain the mechanism of action of remote ischemic preconditioning on brain protection, as well as the possible direction of clinical application.
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Diabetic peripheral neuropathy is a common complication of diabetes mellitus,can occur in some patients with painful diabetic peripheral neuropathy.The occurrence of PDPN is related to many factors,such as long term severe hyperglycemia and metabolic disorders,deficiency of neurotrophic factors, disorder of microcirculation,increase of oxygen free radicals in oxidative stress and disorder of immune func-tion.Mitogen activated protein kinase (MAPK)is a kind of serine /tyrosine protein kinase ,which can widely expressed in cell,and can be involved in the pathophysiological process of stress,inflammation,cell cycle and apoptosis through increased nuclear transcription factors.P38MAPK signaling pathway is an im-portant branch of the MAPK,this overview focuses on the research progress of p38MAPK signaling pathway in the pathogenesis of PDPN.
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Objective To investigate the relationship between obesity and esophageal high resolutionmanometry ,24‐hour pH monitoring and gastroscopic results of patients with gastroesophageal reflux disease (GERD) .Methods A total of 196 patients with GERD(DeMeester score>14 .72) were selected and divided into normal weight group (18 .5 kg/m2 0 .05) .The percent total time pH≤4 of obesity group was 15 .42% (10 .31% to 21 .49% ) ,percent supine time pH≤4 was 14 .21% (5 .75% to 34 .98% ) and percent upright time pH≤4 was 14 .25% (8 .19% to 18 .13% ) .The reflux episodes (106 .50 ,67 .00 to 145 .75) and the longest duration of reflux episodes (28 .10 min ,10 .90 min to 47 .93 min) were more than those of normal group (9 .74% ,5 .35% to 15 .96% ;7 .31% ,3 .25% to 11 .80% ;8 .45% ,5 .43% to 17 .48% ;72 .50 ,53 .00 to 100 .50;15 .80 min ,9 .90 min to 21 .28 min) and overweight group (11 .36% , 6 .74% to 15 .87% ;7 .74% ,2 .36% to 15 .05% ;11 .27% ,3 .37% to 14 .73% ;85 .50 ,58 .75 to 117 .75;21 .40 min ,11 .50 min to 39 .90 min) ,and the differences were statistically significant (Z=7 .054 ,11 .181 , 6 .429 ,6 .452 ,8 .246 ,all P0 .05) .There was no statistically significant difference in the incidence of Barrett′s esophagus among three groups (all P>0 .05) .Conclusions Compared with that of normal weight group and overweight group of patiento with GERD ,abdominal length of LES of obesity group was shorter .With an increase in BMI , acid exposure and the incidences of reflux esophagitis and hiatal hernia also increased .
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Objective To analyze the common symptoms in our gastrointestinal (GI) clinic of a general hospital and the prevalence of gastroesophageal reflux disease (GERD) combined with functional bowel diseases (FBD) was also investigated.Methods Data of out-patients who visited GI clinic from April to June,2011 were collected,including demographic information and chief complaints.A validated Chinese Reflux Disease Questionnaire (RDQ) was used to assess the frequency and severity of typical gastroesophageal reflux (GER) symptoms.Reflux esophagitis (RE) and non-erosive gastroesophageal reflux disease (NERD) werc differentiated according to RDQ scores,endoscopic diagnosis,and response to proton pump inhibitors (PPIs).FBD was diagnosed based on Rome Ⅲ criteria.Results Totally 1074 patients (98.3％) had completed the questionnaires.A total of 107 patients(10％) were diagnosed as GERD among 351 patients(32.7％) who had GER symptoms.A total of 404 cases (37.6％)presented symptoms of chronic abdominal pain/bloating,chronic diarrhea/constipation.Totally 206 cases (19.2％) of FBD were diagnosed,including 63 irritable bowl disease (IBS),40 functional constipation and others.RDQ scores were positively correlated with the prevalence of other atypical GER symptoms,as well as chronic bloating,constipation,the incidence of IBS and functional constipation (FC) (P ＜ 0.05).Further,the incidences of chronic bloating[25.2％ (27/107)],chronic constipation[14.0％ (15/107)],IBS [10.3％ (11/107)] and FC[7.5％ (8/107)] in GERD patients were higher than those in non-GERD patients [16.6％(160/966),7.1％ (69/966),5.4％ (52/966),3.3％ (32/966),all P ＜0.05].Higher rate of NERD than RE overlapping with FBD was found,but without statistic significance.Conclusions GERD frequently represents with chronic bloating and constipation,usually overlaps with IBS and FC.The severity of GERD symptoms is associated with higher rate of overlapping with FBDs.
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Objective To investigate the resistance of Pseudomonas aeruginosa and genotyping of the main β-lactamases in China. Methods A total of 645 Pseudomonas aeruginosa isolates were collected from 28 hospitals in 16 cities in China from July 2006 to July 2007. The susceptibilities to 11 kinds of antimicrobial agents were detected by agar dilution or Kirby-Bauer disk diffusion method. The genotypes of β-lactamases including TEM, SHV, CTX-M and OXA of all the strains were detected by polymerase chain reaction (PCR) and sequence analysis. Results The resistance rates of 645 Pseudomonas aeruginosa isolates to antimicrobial agents were high, except those to amikacin and meropenem were lower than 30 %. Two hundred and seventy-five (42. 64 % ) strains were carbapenem and (or) meropenem-nonsusceptible Pseudomonas aeruginosa. Three hundred and sixty-eight (57.05 %) strains were multidrug-resistant Pseudomonas aeruginosa and 20 (3. 10%) strains were pandrug-resistant. The genotyping results of β-lactamases were as follows: 51 stains produced OXA-10 group β-lactamases, 37 were CARB type, 36 were TEM, 35 were PER, 11 were CTX-M, 9 were VEB, 5 were SHV, 24 were metallo-β-lactamases positive and 1 was GES. None of genotypes of plasmidmediated AmpC enzyme and other carbapenemases were detected. CTX-M-13, CTX-M-14,CTX-M-15, CTX-M-3 of extended spetrum β-lactamese were detected in Pseudomonas aeruginosa.Conclusions The situation of Pseudomonas aeruginosa resistances is severe in China. OXA-10 and PSE-1 are the most common genotypes of β-lactamases. The β-lactamases genotyping is different between carbapenem-nonsusceptible and carbapenem-susceptible strains.
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OBJECTIVE:To analyze the utilization of different dosage forms of essential drugs in the clinical practice in our sanatorium and the tendency of drug use of patients.METHODS:The utilization of essential drug in our sanatorium were analyzed statistically in respect of drug category,constitution ratio of drug use.A questionnaire survey was carried out to survey the tendency of drug use of patients.RESULTS:Tablet was the most common dosage form in the clinic.Antibiotics and drugs for clinical therapy had complete dosage forms.The common dosage forms used patients were tablets and capsule,etc.CONCLUSIONS:Patients of our sanatorium select drugs tendentiously.The tendentious selection of drug is no difference in each age group.
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<p><b>OBJECTIVE</b>To investigate the effects of treatment with ursodeoxycholic acid (UDCA) on intrahepatic cholestasis in rats, and to explore its mechanism.</p><p><b>METHOD</b>Rats suffering from intrahepatic cholestasis were treated with UDCA. Their serum alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), gamma-glutamyl transpeptidase (gamma-GT), total cholesterol (TCH), bile flow, total bile acid excretion, total Na(+) and TCH of bile were measured before and after treatment. In addition, the changes of liver tissue under microscrope were observed and recorded.</p><p><b>RESULTS</b>Compared with the control group, serum ALT, ALP, TBIL, DBIL, gamma-GT and TCH of rats in the treatment group decreased, while bile flow, total bile acid excretion, total Na(+) and TCH decreased significantly. Degeneration of hepatocytes, infiltration of inflamed cells and proliferation of small bile ducts in the treatment group were improved under microscope.</p><p><b>CONCLUSION</b>UDCA may have therapeutic effects on cholestatic hepatitis. The mechanism may involve in its hydrophilicity, choleretic effect and immune modulation.</p>
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Animals , Male , Rats , Cholestasis, Intrahepatic , Drug Therapy , Rats, Sprague-Dawley , Ursodeoxycholic Acid , Therapeutic UsesABSTRACT
OBJECTIVE: To analyze the use situation and trend of cardiovascular and cerebrovascular drugs during 2007～2009 in a military sanatorium, and provide reference for the rational use of cardiovascular and cerebrovascular drugs and its essential medicines. METHODS: Cardiovascular and cerebrovascular drugs in the rehabilitation center during 2007～2009 were analyzed statistically in the respect of category, consumption sum and DDDs. RESULTS: The consumption sum and DDDs of cardiovascular and cerebrovascular drugs were increasing in the past three years. And its essential drugs account for 94.8%.The most widely used drugs were cerebrovascular drug, brain metabolism drug, nootropics and antihypertensive drugs. Oxiracetam and Xueshuantong were widely used cerebrovascular drug, brain metabolism drug and nootropics. Amlodipine were widely used antihypertensive drugs in the clinic. CONCLUSION: Cardiovascular and cerebrovascular drugs and its essential drugs were characterized with complex classification, numerous categories, extensive application and potential market demand, which require rational use of drug should be strengthened.
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OBJECTIVE:To analyze the utilization of drug included in the army of rational medicine directory in a military sanatorium in 2009.METHODS:To extrac convalescent medication data from a military sanatorium "military sanatorium information system",and analyze the drug use situation.RESULTS:The first 6-bit key role of drug consumption was the circulatory system drugs,anti-microbial drugs,a major role in the central nervous system drugs,clinical subjects medication,a major role in the respiratory system drugs,a major role in the digestive system drugs.CONCLUSION:The drug use of the military sanatorium for the convalecents basically matches the spectrum of convalecent disease.