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Objective To explore the effect of recombinant human tissue plasminogen activator(rt-PA) intravenous thrombolytic therapy combined with antiplatelet therapy on the recurrence of cardio cerebral vascular adverse events in patients with mild acute ischemic stroke (AIS).Methods From December 2015 to December 2017,74 patients with mild AIS treated in Shaoxing Central Hospital were selected in the research.According to the random number table method,the patients were divided into two groups,with 37 cases in each group.The control group received rt-PA intravenous thrombolysis,and the combined group was treated with antiplatelet therapy on the basis of the control group.The serum creatinine(SCr),alanine transaminase(ALT) and platelet count(PLT) were compared before and after treatment in the two groups,and the scores of the Barthel index scale and the modified Rankin scale were compared between the two groups.The incidence of cardiovascular adverse events in 3 months of the two groups was also recorded.Results There were no statistically significant differences in liver and kidney function indicators between the two groups before and after treatment (t =0.30,0.27,0.20,0.77,0.03,0.64,all P ＞ 0.05).Before treatment,the Barthel index scale scores in the combined group and control group[(74.97 ±4.74)points,(61.95 ± 4.24) points] were significantly increased,and the increasing degree in the combined group was more significant than that in the control group(t =12.45,P ＜ 0.05).The modified Rankin scale scores in the combined group and control group[(1.16 ± 0.37) points,(2.05 ± 0.45) points] were significantly decreased compared with those before treatment,and the reduction degree of the combined group was more significant than that in the control group(t =9.29,P ＜ 0.05).The total incidence rate of bleeding events,cardiovascular events,cerebrovascular events and death events in the combined group(5.41％) was significantly lower than that of the control group(27.03％) (x2 =4.87,P ＜ 0.05).Conclusion rt-PA intravenous thrombolytic therapy combined with antiplatelet therapy can effectively improve the nerve function and daily activity of patients with mild AIS.It can also effectively reduce the incidence of cardiovascular and cerebrovascular adverse events,and thus help to improve the prognosis and improve the quality of life.Therefore,it has good clinical application value.
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Objective To observe the clinical,pathological features and prognosis of IgA nephropathy in children with crescent formation.Methods A total of 38 cases of children with IgA nephropathy diagnosed by renal biopsy at Qilu Hospital of Shandong University were retrospectively analyzed.According to whether there were crescent formation,they were divided into crescents formation group (crescent formation≥10％,n=18) and control group consisting of children with complete clinical data and matching age,gender and course of disease (no crescent formation,n=20).The clinical,pathological features and prognosis of the two groups were compared.Results Fourteen cases (77.78％) of crescents formation group were associated with nausea hematuria,and 12 cases (66.67％) had hypertension,8 patients in control group (40％) had gross hematuria,and 6 cases (30％)had high blood pressure.The differences were statistically significant (P ＜ 0.05).In crescents formation group,Alb and eGFR were significantly lower than those of control group.24 h urine protein and Scr were significantly higher than those of control group and there were significant statistically differences between two groups (P ＜ 0.05).Nephropathological changes in crescent formation group were mainly in grade Ⅱ and grade Ⅲ and were usually combined with tubular interstitial damages.In addition to IgA immunoglobulin deposition,they often accompanied by IgG and IgM immunoglobulin deposition.In control group,nephropathological changes were mainly in grade Ⅰ and grade Ⅱ and tubular interstitial damages were rare.IgA was the main form of deposition in control group.After 12 weeks steroid treatment and (or) immunosuppressive therapy,urinary protein turned negative in 7 cases in crescent formation group,24 h urinary protein level declined by half than before in 7 cases and no obvious change in 4 cases.In control group,urinary protein turned negative in 12 cases,6 cases showed a more than 50％ decline in urinary protein level and 2 cases had no obvious change.During the 1-3 years of follow-up,renal function of 14 cases and 19 cases was normal in the crescent formation group and control group respectively,serum creatinine of 3 cases and 1 case increased mildly in the crescent formation group and control group respectively,1 case needed dialysis treatment in the crescent formation group and the one in the control group who had slightly increasement of Scr did not reach the standard of dialysis treatment.Conclusions The clinical and pathological manifestations of children with IgA nephropathy with crescent formation are more severe and more likely to manifest renal insufficiency,suggesting that crescent formation is one of the indicators of poor prognosis.
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Objective Broth dilution method was used as a reference method to observe the capability of Kirby-Bauer disc diffusion assay(K-B)for correcting automated ampicillin susceptibility detection of He-mophilus influenzae(HI).Methods A total of 228 HI strains isolated were collected,broth dilution assay,K-B and automated microdilution broth test(ATB)were used to determine the susceptibility of HI to ampicillin. Analyze the essential agreements of the three methods and the correction of K-B to the errors of A TB. Results The essential agreement of K-B or ATB with broth dilution method were 77.19%,70.18% respec-tively,combination of K-B and ATB could make the essential agreement increase up to 86.0%,which was sig-nificantly higher than ATB(χ2=16.600,P=0.000).Major error of ATB(42.0%)was higher than that of K-B(10.0%)(χ2=13.306,P=0.001),but very major error and minor error showed no significant difference be-tween the two methods(χ2=1.208,P=0.272;χ2=1.182,P=0.227),meanwhile,76.19% of major error of ATB could be corrected by K-B.For the very major error of ATB,53.57% could be corrected by K-B.Howev-er,the corrective capability of K-B to minor error of ATB was relative low.Conclusion K-B test could correct some errors generated by ATB.For the β-lactamase negative strains which were judged as ampicillin resistance by A TB,K-B test should be used to correct the errors by ATB.Moreover,it is necessary to apply K-B to confirm am-picillin sensitivity of the β-lactamase positive strains which were judged as ampicillin susceptible by ATB.
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Objective To investigate the epidemic strains of biological type, drug resistance, and the basic clinical characteristics of haemophilus influenzae(Hi)isolated from hospitalized adults with lower respiratory tract infection in Chengdu area.Methods A prospective cross-sectional study was conducted to analyze the biological typing,capsular genes detected by PCR technique,and drug resistance tested by drug sensitive test of Hi epidemic strains isolated from the sputum of adults aged above 18 years who were hospitalized in two tertiary hospitals of west Sichuan in China.Results The positive rate of pathogenic bacteria in adults aged above 18 years who were hospitalized in the two hospitals was 46.71%(15 447/33 069)between November 2013 and October 2014.The positive rate of Hi isolated from the sputum of 100 adults with lower respiratory tract infection was 0.31%(101/33 069).The constituent ratio of Hi in lower respiratory tract infection pathogens was 0.65%(101/15 447).The Hi were all undifferentiated type detected by PCR,and the biological typing of Hi were typeⅠ(42.57%),Ⅳ(29.7%),Ⅱ(15.84%),Ⅲ(9.9%),Ⅶ(1.98%), and Ⅵ(0.9%).The diseases of Hi positive were acute phase of chronic obstructive pulmonary disease(59%), pneumonia(35%), and bronchitis(6%), in which community acquired infection was 55%.The rate of β-lactamase enzyme production was 38.61%.The frequencice of β-lactamase -nonproducing-ampicillin-resistant(BLNAR)strains was 2.97%,and of intermediary strains was 4.95%(5/101).The drug resistance rate of amoxicillin and clavulafiate was 2.97%.The drug resistance rate of cefuroxime was 12.87%, and intermediary rate was 12.87%.The drug resistance rate of cefaclor was 29.7%,and intermediary rate was 8.91%.The drug resistance rate of cefotaxime and ofloxacin was 6.93%and 1.99%.There were no obvious statistical differences between the drug resistance rates of the two hospitals.Conclusions The Hi epidemic strains isolated from the sputum of adults with lower respiratory tract infection were all undifferentiated type,and the common biological types were Ⅰ,Ⅳ,Ⅱ, andⅢ in west Sichuan in China.It should pay attention to the BLNAR strains and ofloxacin-resistant strains.
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Objective To investigate the immediate effects of lower limb with open chain weight-adding on joint position sense and gait symmetry in stroke patients. Methods From January, 2016 to January, 2017, 39 stroke patients were included. Their joint position sense and gait symmetry were compared before and after weight-adding. The joint position senses of active reproduction of active positioning (ARAP) and passive reproduction of passive positioning (PRPP) were assessed during lower limb straight leg raise. The gait symmetry was also as-sessed and three indexes were recorded including the symmetry of foot rotation angle, step length and percentage of single leg support phase. Results After weight-adding, the position sense of PRPP did not improve (t=0.832, P=0.832), nor of the symmetry of foot rotation an-gle (t=-0.704, P=0.483) and percentage of single leg support phase (t=0.381, P=0.702);the position sense of ARAP improved (t=3.158, P=0.011), as well as the symmetry of step length (t=2.022, P=0.041). Conclusion The lower limb with open chain weight-adding could im-prove the active joint position sense and symmetry of step length.
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<p><b>OBJECTIVE</b>To understand epidemiological characteristics of Haemophilus influenzae (Hi) infection in hospitalized children with lower respiratory tract infection (LRTI) in west Sichuan China.</p><p><b>METHOD</b>The multicenter prospective cross-sectional design was used; four hospitals in west Sichuan China were chosen as research field, sputum bacterial culture was done and biological typing, PCR identification and drug sensitivity test of Hi epidemic strains were carried out among 0-17y hospitalized patients with LRTI in four hospitals located in west Sichuan China.</p><p><b>RESULT</b>Totally 5 748 cases with LRTI in four hospitals were investigated in west Sichuan from Nov. 2013 to April 2014 and the rate of sputum culture was 46.96% (2,699/5 748). The total pathogenic bacteria positive rate of sputum culture was 43.53% (1,175/2 699), and 279 Haemophilus influenzae (Hi) strain in 272 cases were isolated, the Hi positive rate was 10.08% (272/2 699). All the strains (100%) were non-typeable Haemophilus influenzae (NTHi ) indentified by PCR. The main biotype of 279 strains was type Ⅰ with 39.07% (109/279) and type Ⅳ with 50.90% (142/279) ; 272 cases were enrolled in this survey, 12.50% (34/272) had broncheolitis, the rest of lower respiratory infection was 87.50 % (238/272), and 2.57% (7/272) was neonatal pneumonia, 2.21%(6/272)was pneumonia complicated with sepsis; in four hospitals the overall positive rate of Hi in inpatients with lower respiratory infection was 10.21%, 28.96%, 4.80%, 10.21% (χ(2) = 112.561, P = 0.000) and the positive rate of Hi inpatients with broncheolitis was 11.92%, 20.93%, 4.76%, and 66.67% (Fisher exact probability P = 0.001), with the rest lower respiratory infection was 9.96%, 30.90%, 4.81%, 9.85% (χ(2) =108.876, P = 0.000); 2.87% (8/279) bacterial strains of β-lactamase-nonproducing-ampicillin-intermediary (BLNAI) distributed in four hospitals, and 1.79% (5/279) bacterial strains of β-lactamase-nonproducing-ampicillin-resistant (BLNAR), 0.72% (2/279) bacterial strains of β-lactamase-positive amoxicillin-clavulanate-resistance (BLPACR) were found in two hospitals respectively.</p><p><b>CONCLUSION</b>All the Hi isolated from sputum were non-typeable among 0-17y inpatients with LRTI and the main biotype were type Ⅰ and type Ⅳ in west Sichuan China. Much attention should be paid to BLNAR and BLPACR strains found in the west Sichuan region.</p>
Subject(s)
Child , Humans , Ampicillin , Child, Hospitalized , China , Epidemiology , Cross-Sectional Studies , Drug Resistance, Bacterial , Epidemiologic Studies , Haemophilus Infections , Epidemiology , Haemophilus influenzae , Microbial Sensitivity Tests , Pneumonia, Bacterial , Epidemiology , Polymerase Chain Reaction , Prospective Studies , Respiratory Tract Infections , Epidemiology , Microbiology , Sepsis , Epidemiology , beta-LactamasesABSTRACT
The inter-species differences of estradiol metabolism were investigated in human, Beagle dog and rat liver microsomes by comparing enzyme kinetics of parent drug and the formation of its major metabolites. The incubation systems of estradiol with liver microsomes of the three species were optimized in terms of estradiol concentration, microsomal protein content and incubation time. The concentrations of estradiol and its metabolites were measured by LC-MS/MS method. The t1/2, CLint, CLh, Km and Vmax of estradiol incubated with male human liver microsomes were 40.02 +/- 8.32 min, 41.39 +/- 6.57 mL x min(-1) x kg(-1), 13.81 +/- 12.36 mL x min(-1) x kg(-1), 26.8 +/- 6.99 micromol x L(-1) and 0.75 +/- 0.92 micromol x L(-1) x min(-1), respectively. The corresponding parameters of female human were 44.71 +/- 10.21 min, 29.85 +/- 8.97 mL x min(-1) x kg(-1), 0.01 +/- 0.68 mL x min(-1) x kg(-1), 44.2 +/- 7.73 micromol x L(-1) and 1.27 +/- 4.41 micromol x L(-1) x min(-1), that of male dog were 21 +/- 7.33 min, 165.53 +/- 29.33 mL x min(-1) xkg(-1), 26.01 +/- 8.39 mL x min(-1) x kg(-1), 19.5 +/- 7.34 micromol x L(-1) and 1.6 +/- 0.65 micromol x L(-1) x min(-1), that of female dog were 25.5 +/- 5.32 min, 135.11 +/- 42.34 mL x min(-1) x kg(-1), 0.24 +/- 3.18 mL x min(-1) x kg(-1), 8.33 +/- 6.32 micromol x L(-1) and 0.51 +/- 2.15 micromol x L(-1) x min(-1), that of male rat were 5.11 +/- 3.84 min, 485.63 +/- 36.52 mL x min(-1) x kg(-1), 49.57 +/- 15.29 mL x min(-1) x kg(-1), 62 +/- 13.74 micromol x L(-1) and 19.16 +/- 9.67 micromol x L(-1) x min(-1), and that of female rat were 7.0 +/- 3.69 min, 354.82 +/- 33.33 mL x min(-1) x kg(-1), 8.04 +/- 3.23 mL x min(-1) x kg(-1), 35.38 +/- 7.65 micromol x L(-1) and 8.39 +/- 4.91 micromol x L(-1) min(-1), respectively. There were nine metabolites detected from all the three species, but the relative amounts of the metabolites generated were different in three species. The results indicted that the major phase I metabolic pathway of estradiol was similar in the liver microsomes from all the three species. However, the inter-species differences were found in the view of relative amounts of the metabolites as well as the metabolic characteristics of estradiol in liver microsomal incubation.
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Objective To study the level and structure of intelligence in children with benign epilepsy of childhood with centrotemporal spikes(BECT)and investigate factors affecting their intelligence.Methods Congitive skills such as intelligence quotient(IQ),phonological test and morphological test,were evaluated in 47 children with BECT,and the results were compared to a control group of 30 children matched for gender,age,level of education and family background.The effects of age of onset,disease course,seizure frequency,seizure type,location of spike,and spike and wave index(SWI)on the level and structure of intelligence were also analyzed.Results The total IQ score was slightly lower in children with BECT(104.20±12.34)when compared to the control group of normal children(109.45±15.01),but the difference was not significant.There was no difference in performance IQ scores between BECT and normal children.BECT children had a lower verbal IQ score(90.67±18.40)when compared to the control group(98.17±13.18,t=3.431.P<0.05).Analyses of verbal subtests revealed significant differences between BECT and normal children in vocabulary and similarities(5.97±2.95 vs 8.51±3.67 and 4.85±3.02 vs 6.95±3.07,respectively,t value were 2.365 and 2.096,both P<0.05).The differences between BECT and normal children were also significant in phonological test and morphological test (12.56±2.3 vs 16.78±3.72 and 22.35±3.25 vs 24.15±5.28,respectively,t=2.478 and 2.770,both P<0.05).SWI was negatively correlated with verbal IQ,vocabulary,similarities,phonological test and morphological test(r=-0.305--0.838,P<0.05).Age of onset,disease course and seizure frequency were not correlated with verbal IQ,phonological test and morphological test.The level of intelligence was not different among children with left hemispheric foci,fight hemispheric foci or bilateral foci.The level of intelligence Was similar between children with partial seizures or secondarily generalized seizures.Conclusions Children with BECT have normal level of intelligence,but the structure of intelligence is abnormal with retardation of their language ability.SWI affects the language ability in children with BECT,but age of onset,seizure type and location of spike do not influence their language ability.