Risk factor analysis on 180 cases of ectopic pregnancy / 上海预防医学

[Objective] To explore risk factors for ectopic pregnancy to provide basis for its prevention.[Methods] A case-control study was done on 180 cases of ectopic pregnancy treated in Deqing Chinese medicine hospital from January 2012 to December 2016 and another 180 cases of intrauterine pregnancy were as control who received artificial abortion in outpatient clinic during the same period. The data on the factors that might bring about ectopic pregnancy were analyzed by single-factorial and multi-factorial logistic regression. [Results] The multi-factorial analysis confirmed that the risk factors associated with ectopic pregnancy were prior abortion history, pelvic inflammation, ectopic pregnancy history, fallopian tube surgery history and others. [Conclusion] Ectopic pregnancy is associated with multiple factors, whose occurrence should be prevented and reduced by taking corresponding measures against it.

An application of Delphi method in the establishment of evaluation index system for health promotion in hospital / 预防医学

Objective To establish a reasonable and practical evaluation indicator system for health promoting hospital. Methods According to the importance recognized by the experts,two round Delphi consultation was conducted to set up the indicator system of health promoting.Results A total of 20 experts participated in this study,with the average age of 42.75 ±5.20 years.The average years of work was 15.15 ±6.85 years.All of experts had bachelor degree and above,and 80.00% had senior technical titles.Questionnaire response rates of two round Delphi consultation were both 100.00%. The average coefficients of experts'authorities (Cr)was 0.93 ±0.10.There was statistically difference between the Kendall coefficients of two round consultations (P <0.05).The evaluation indicator system was finally established including 5 first-class indexes (organization construction, environment construction, patient health education, employee health promotion,and out -hospital health education),14 second -class indexes and 25 third -class indexes.The average scores of important degree among each index involved was 4.30 -5.00,with standard deviation 0.00 -0.83,and the coefficient of variation was 0.000 - 0.182,which met the design requirements.Conclusion The Delphi expert consultation method in this study have good representative,authoritative and coordination.

Protection and Mechanism of Qingyuan Shenghua Decoction on Multiple Organs of Sepsis Patients after Bone Trauma / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the protection of Qingyuan Shenghua Decoction (QSD) on multiple organs of sepsis patients after bone trauma, and to preliminarily explore its mechanism.</p><p><b>METHODS</b>Totally 60 sepsis patients after bone trauma were randomly assigned to the treatment group and the control group according to random digit table, 30 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took QSD or were nasally fed with QSD, one dose per day for 1 week. Changes of WBC, oxygenation index (PaO2/FiO2), serum creatinine (SCr), total bilirubin (TBIL), aspartate aminotransferase (AST), fibrinogen (FIB), D-dimer (DD), activated partial thromboplastin time (APTT), pro-calcitonin (PCT), C-reactive protein (CRP), heart rate (HR), mean arterial pressure (MAP), intra-abdominal pressure, scores for Acute Physiology and Chronic Health Evaluation II (APACHE II), sequential organ failure assessment (SOFA) scores were observed before treatment and on day 1, 3 and 7 after treatment.</p><p><b>RESULTS</b>Compared with the control group at the same time point, MAP increased at post-treatment day 1 and 3; CRP, APTT, HR, SCr, TBIL, AST, intra-abdominal pressure at post-treatment day 3 obviously decreased in the treatment group (P < 0.05, P < 0.01). WBC, SOFA scores, PCT, CRP, APACHE II, APTT, D-D, HR, SCr, TBIL, AST and intra-abdominal pressure significantly decreased; FIB, MAP and PaO2/FiO2 obviously increased at post-treatment day 7 (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>QSD had good protective effect on multiple organ function in sepsis patients after bone trauma, and its mechanism might be related with effectively clearing endotoxin, alleviating inflammatory reactions, and fighting against coagulation dysfunction.</p>

Goal-directed Fluid Therapy May Improve Hemodynamic Stability of Parturient with Hypertensive Disorders of Pregnancy Under Combined Spinal Epidural Anesthesia for Cesarean Delivery and the Well-being of Newborns / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy (HDP) can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress. The aim of this study was to investigate whether the goal-directed fluid therapy (GDFT) with LiDCO rapid system can improve well-being of both HDP parturient and their babies.</p><p><b>METHODS</b>Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited. After loading with 10 ml/kg lactated Ringer's solution (LR), parturient were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was guided by increase in stroke volume (ΔSV) provided via LiDCO rapid system. The control group received the routine fluid therapy. The primary endpoints included maternal hypotension and the doses of vasopressors administered prior to fetal delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events.</p><p><b>RESULTS</b>The severity of HDP was similar between two groups. The total LR infusion (P < 0.01) and urine output (P < 0.05) were higher in the GDFT group than in the control group. Following twice fluid challenge tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group. The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group (P < 0.01). There were no differences in the Apgar scores between two groups. In the control group, the mean values of pH in umbilical artery/vein were remarkably decreased (P < 0.05), and the incidences of neonatal hypercapnia and hypoxemia were statistically increased (P < 0.05) than in the GDFT group.</p><p><b>CONCLUSIONS</b>Dynamic responsiveness guided fluid therapy with the LiDCO rapid system may provide potential benefits to stable HDP parturient and their babies.</p>

Expression and clinical significance of serum high-mobility group protein box 1 in children with Henoch-Schönlein purpura / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To determine the expression of high-mobility group protein box 1 (HMGB1), high-sensitivity C-reactive protein (hs-CRP), and D-dimer (D-D) in the peripheral blood of children with Henoch-Schönlein purpura (HSP) and to investigate the clinical significance of HMGB1 in children with HSP.</p><p><b>METHODS</b>A total of 40 children with HSP (HSP group) and 30 healthy children (control group) were involved in the study. The level of serum HMGB1 was determined using enzyme-linked immunosorbent assay, and the levels of serum hs-CRP and plasma D-D were determined using automatic biochemical analyzer and automatic blood coagulation analyzer, respectively.</p><p><b>RESULTS</b>The levels of HMGB1, hs-CRP, and D-D in the peripheral blood of the HSP group in the acute phase were significantly higher than in the control group (P<0.05). The levels of the three indicators were significantly higher in HSP children with renal damage than in those without renal damage (P<0.05). In children with HSP, the expression of HMGB1 was positively correlated with the expression of hs-CRP and D-D (r=0.878, P<0.001; r=0.625, P<0.001).</p><p><b>CONCLUSIONS</b>The expression of HMGB1 is related to the inflammatory response and hypercoagulability in children with HSP. HMGB1 may be involved in the development of HSP and associated renal damage in children.</p>

Effect of Tongfu Jinghua Decoction on hemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsis shock / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of Tongfu Jinghua Decoction (TJD) on hemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsis shock.</p><p><b>METHODS</b>Totally 60 patients were randomly assigned to the treatment group and the control group, 30 in each group. Patients in the treatment group took TJD or were administered with TJD by nasal feeding in combined with conventional Western medical treatment, while patients in the control group only received conventional Western medical treatment. Changes of each index in hemodynamics and tissue oxygen metabolism were observed before treatment, and at 6, 12, 24, and 48 h after treatment.</p><p><b>RESULTS</b>Compared with before treatment in the same group, hemodynamic changes were significantly improved at each time point in the two groups. All indices of tissue oxygen metabolism at each time point of the two groups were significantly improved, except changes of O2 extraction ratio (ER) after treatment in the control group (P < 0.05, P < 0.01). Compared with the control group in the same period, heart rate (HR), systemic vascular resist- ance (SVR), and cardiac output (CO) were significantly improved with statistical difference (P < 0.05, P < 0.01). Mean arterial pressure (MAP), central venous pressure (CVP), and cardiac index (CI) were significantly improved at 6, 12, and 24 h after treatment with statistical difference (P < 0.05, P < 0.01). Each index of tissue oxygen metabolism in the treatment group were all improved at each time point with statistical difference (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>TJD combined with conventional Western medical treatment could quickly improve hemodynamics and tissue oxygen metabolism disorder in patients with septic shock, and its curative effect was superior to that of conventional Western medical treatment alone.</p>

Hair roots induction and culture of Withania somnifera and its withanolide A synthesis / 中国中药杂志

Withanolide A is a biologically active secondary metabolite occuring in roots and leaves of Withania somnifera. In the present study, adventitious roots from leaf explants of W. somnifera were induced for the production of withanolide-A by Agrobacterium tumefaciens strain C58C1 to obtain hair roots. Hair roots induction rate reached 30%. The withanolide A was determined by HPLC in different hair roots lines and different parts of W. somnifera. The average content of withanolide A in all hair roots lines were 1.96 times as high as that in wild-plant, the concentration of withanolide A in hair roots (1.783 mg x g(-1) dry weight) were 1.51 times as high as the roots of wild W. somnifera (1.180 mg x g(-1) dry weight), respectively. It is possible to obtain withanolide A from hair roots culture of W. somnifera.

Effects of methyl jasmonate on accumulation and release of main tropane alkaloids in liquid cultures of Datura stramonium hairy root / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effects of methyl jasmonate (MJ) on the accumulation and release of main secondary metabolites i. e. scopolamine and hyoscyamine in liquid cultures of Datura stramonium hairy roots.</p><p><b>METHOD</b>After 18 days liquid culture of D. stramonium hairy roots induced by agrobacterium rhizogenes C58C1, the chemical elicitor methyl jasmonate was added into 1/2 MS liquid cultures and scopolamine and hyoscyamine on the day 0, 3, 6, 9 and 12, after dealing with MJ, was determined by HPLC.</p><p><b>RESULT</b>After dealing with MJ on the day 3, 6, 9 and 12,the concentration of scopolamine reached to 0.419, 0.439, 0.431, 0.374 mg x g(-1), respectively, the increase of scopolamine were 1.36, 1.42, 1.17 and 1.12 fold higher than that of the control, respectively. And hyoscyamine reached 1.493, 0.817, 0.723 and 0.698 mg x g(-1), respectively, the increase of hyoscyamine were 2.28, 1.11, 0.63 and 0.70 fold higher than that of the control, respectively.</p><p><b>CONCLUSION</b>MJ could stimulate the accumulation of scopolamine and hyoscyamine (3,6 d) in D. stramonium hairy root and have released them into the culture medium.</p>

Scopolamine and hyoscyamine synthesis in hair roots culture of Datura metel / 中国中药杂志

<p><b>OBJECTIVE</b>To establish the hair roots culture system of Datura metel and study the hair roots growth and biosynthesis of scopolamine and hyoscyamine in hair roots culturing system.</p><p><b>METHOD</b>Direct degermed cotyledon of wild D. metel was infected by Agrobacterium tumefaciens strain C58C1 to obtain hair roots. Growth curves and scopolamine and hyoscyamine biosynthesis curves were determined. The scopolamine and hyoscyamine from different hair roots lines were examined by HPLC.</p><p><b>RESULT</b>Hair roots induction rate reached 70%. After 25 days cultured in 1/2 MS liquid nutrient medium, the hair roots weight, content of scopolamine and hyoscyamine reached maximum, tow high efficient accumulation hyoscyamine and scopolamine hair roots lines M1 and M2 were obtained. The medial accumulation coefficient of hyoscyamine and scopolamine were 2.53 times and 5.37 times compared with the leaves of wild D. metel respectively.</p><p><b>CONCLUSION</b>The established hair roots induction and culture system of D. metel provided a foundation for further obtaining scopolamine and hyoscyamine.</p>

Analysis of the Epidemioiogical Characteristics of Bacillary Dysentery in Jinhua from 1993 to 2007 / 预防医学

Objective To analyze the epidemiological characteristics of bacillary dysentery in Jinhua from 1993 to 2007, then to provide scientific evidence for making strategies and measures of disease control. Methods Method of descriptive epidemiology was used to analyze cases of bacillary dysentery. Results The reported number of cases of bacillary dysentery was 42963, with an average annual incidence of 62.26 per 100 thousands, accounting for 18.08% of the number of category A and B infectious diseases reported on the contemporaneous, showing a downward trend year by year. The top three areas with the highest average annual incidence were Wucheng District, Dongyang City and Wuyi County with the incidence of 100.97 per 100 thousands, 93.75 per 100 thousands and 75.28 per 100 thousands, respectively. The incidence of bacillary dysentery was higher from July to October than that in others. Majority patients were boys who were under 10 years old and students. It was reported that the outbreak occurred 14 cases, mainly in primary and secondary schools (57.14%). Conclusion The incidence of bacillary dysentery was decreasing year by year in Jinhua, but school outbreak occurred from time to time. The children under 10 years old and students are the high risk population.

Effects of dexamethasone on CTLA-4 expression and apoptosis in lymphocytes obtained from children with mesangial proliferative nephritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The pathogenesis of mesangial proliferative glomerulonephritis (MsPGN) and mechanisms of glucocorticoid (GC) resistance have not been fully identified. Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is an important inhibitor of T-lymphocyte activation. The objective of the study is to investigate the CTLA-4 expression and apoptosis in lymphocytes of children with MsPGN and the effects of dexamethasone (Dex) on the CTLA-4 expression and apoptosis.</p><p><b>METHODS</b>Blood samples were collected from 36 children with MsPGN and 30 healthy children. CTLA-4 expression in in vitro cultured lymphocytes with or without Dex treatment was measured by flow cytometry following direct immune fluorescene. The rate of apoptosis in the lymphocytes was evaluated by annexin V-FITC and propidium iodide staining.</p><p><b>RESULTS</b>The CTLA-4 expression and apoptosis in lymphocytes from children with MsPGN were significantly lower than those in the healthy control children in the absence or presence of Dex treatment (p<0.05). There was a positive correlation between CTLA-4 expression and apoptosis in lymphocytes (p<0.05).</p><p><b>CONCLUSIONS</b>Abnormal CTLA-4 expression may participate in the pathogenesis of MsPGN and be one of mechanisms of GC resistance.</p>

Epidemiologie investigation on murine typhus in Hongta areas of Yuxi city, Yunnan province of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To identify epidemic status of murine typhus in Hongta areas of Yuxi city and to provide evidence for control and prevention of the disease.</p><p><b>METHODS</b>Serologic survey was conducted among residents and rodents. Isolation of Rickettsia moseri was performed.</p><p><b>RESULTS</b>The overall infection rate among general population was 28.92% (96/332) with geometric meantiter (GMT) as 10.83 and there was no difference between males and females (26.71%, 43/161 vs. 30.99%, 53/171, P > 0.05). Significant differences were found between age groups (P < 0.05) with positive rates of 29.63% (8/27), 18.06% (13/72), 39.62% (42/106), 27.50% (22/80) and 23.40% (11/47) among age groups 0-6, 7-18, 19-39, 40-59 and over 60, respectively. The overall rate of infection in mouse was 44.95% (89/198) with GMT as 30.30. Five isolates of R. moseri from mouse specimen, three from fleas plus one case of murine typhus were diagnosed. Rattus norvegicus and Rattus flavipectus were the predominant species of rodent animals (99.49%, 197/198) and Xenopsylla cheopis was the major species of vector (74.26%, 303/408). Flea index and mouse density were 2.06 and 11.13% respectively.</p><p><b>CONCLUSION</b>High infection rates on R. moseri were demonstrated in rodents and residents as well as high risk of murine typhus outbreak might occur in these areas.</p>

Effect of hypoxic radiosensitizer sodium glycididazole on long-term result of radiotherapy for nasopharyngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the long-term effect of sodium glycididazole (CMNa) as a hypoxic radiosensitizer on the radiotherapy for nasopharyngeal carcinoma.</p><p><b>METHODS</b>Between May 1999 and May 2002, 211 patients with pathologically confirmed nasopharyngeal carcinoma were randomized into group-A treated by radiotherapy plus CMNa or group-B by radiotherapy alone. The staging was determined according to 92' Fuzhou staging systerm. The type, procession and dosage of radiotherapy were identical in both groups. The early adverse effect grade was assessed based on the CTC2.0 criteria and the late adverse effects were evaluated according to the RTOG/EORTC criteria. The median follow-up time was 52 months. All the data was analyzed by the SPSS 13.0 software. Characteristics and adverse events of these patients were compared between the two groups using t-test and the Wilcoxin rank sum test. Time-to-event curves were estimated using the Kaplan-Meier method. The prognostic parameters were analyzed using univariate analysis and the Cox multivariate regression analysis.</p><p><b>RESULTS</b>The clinical data of the two groups were comparable. The 3-year survival was 88.4% in group-A, while 75.2% in group-B, with a statistically significant difference between two groups (P = 0.010). Univariate analysis showed that the 3-year survival was statistically correlated with N-staging ((N0-1, 86.9%, N2-3 73.8%, P < 0.001), T-staging (T1-2 85.6%, T3-4 79.3%, P = 0.014), TNM staging (P = 0.039), and whether using CMNa or not during rediotherapy (Group-A 88.4%, Group-B 75.2%, P = 0.010). The 5-year recurrence-free survival, 5-year metastasis-free survival and 5-year overall survival were 75.8%, 74.9% and 77.7% in Group-A, while 63.0%, 63.0% and 62.4% in Group-B with a statistically significant difference between two groups (0.013, 0.022 and 0.010, respectively). If stratified in the subgroups, the overall survival of stage III - IV patients was statistically different between group A and B (P = 0.009), however, not of stage I - II patients (P = 0.502). Cox multivariate regression analysis showed that the independent prognostic parameters for survival were N-stage (RR = 3.288) , T-stage (RR = 2.147) and use of CMNa during rediotherapy (RR = 0.407). However, there was no statistically significant difference between two groups in acute or late adverse effects on nervous system or heart, which suggested that use of CMNa during radiotherapy would not aggravate the toxicity caused by radiotherapy.</p><p><b>CONCLUSION</b>Sodium glycididazole is well tolerable effective as a hypoxic radiosensitizer, which can improve the efficacy of radiotherapy and the long-term result of nasopharyngeal carcinom a patients, especially for the stage III - IV patients.</p>

Polymorphism at Position - 318 in Promoter of Cytotoxic T Lymphocyte Associated Antigen 4 Gene in Children with Primary Nephrotic Syndrome / 实用儿科临床杂志

Objective To investigate the correlation between cytotoxic T lymphocyte associated antigen 4 (CTLA - 4 ) and primary nephrotic sysdrome(PNS) with the pathologic type of mesangial proliferative glomerulonephritis(MsPGN) of glucocorticoid(GC) resistance. Methods The polymerase chain reaction - restriction fragment length polymorphism( PCR - RFLP) analysis was used to investigate the genotype of position - 318 promoter of CTLA- 4 gene of 36 patient children and 30 healthy controls. Results The frequences of genotypes at position - 318 promoter of CTLA- 4 gene in patients were 38.9% for CC,61.1 % for TC and 0% for TT. The frequences of alleles at this position were 69.4% for C allele and 30.6% for T allele. The frequences of genotypes and alleles in children were not significantly different from those in controls. Conclusion CTLA-4 promoter ( -318)C/T dimorphism was not associated with PNS- MsPGN of GC resistance, which hinted that the polymorphism may be not inlolved in pathogenensis of PNS-MsPGN and the mechanism of GC resistance.

Effects of breast milk and some infant foods on the adhesion of entero-pathogenic Escherichia coli (EPEC) to Hela cells and intestinal mucosa / 第三军医大学学报

Objective　To investigate the effect of breast milk and some other kinds of infant foods on the adhesion of EPEC to Hela cells and intestinal mucosa so as to understand the possible protective mechanism of breast-feeding in the intestine of infants. Methods　The adhesion of EPEC to Hela cells and intestinal mucosa were examined by cell culture, bacterial adherence test, light and electron microscopy in the mediums that contain breast milk, cow's milk and formula milk or contain ecal filtrate of the infants fed by breast milk and formula milk respectively. Results　Adhesive index for EPEC to Hela cells was significantly lower in the medium containing breast milk than in control and so did in the fecal medium containing breast fed infants than artificial feeding infants. Conclusion　Breast milk may inhibit the adhesion of EPEC to infant intestine.

Effects of breast milk and some infant foods on the adhesion of entero-pathogenic Escherichia coli (EPEC) to Hela cells and intestinal mucosa / 第三军医大学学报

Objective　To investigate the effect of breast milk and some other kinds of infant foods on the adhesion of EPEC to Hela cells and intestinal mucosa so as to understand the possible protective mechanism of breast-feeding in the intestine of infants. Methods　The adhesion of EPEC to Hela cells and intestinal mucosa were examined by cell culture, bacterial adherence test, light and electron microscopy in the mediums that contain breast milk, cow's milk and formula milk or contain ecal filtrate of the infants fed by breast milk and formula milk respectively. Results　Adhesive index for EPEC to Hela cells was significantly lower in the medium containing breast milk than in control and so did in the fecal medium containing breast fed infants than artificial feeding infants. Conclusion　Breast milk may inhibit the adhesion of EPEC to infant intestine.