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Objective:To investigate the level of self-management and daily physical activity in patients with type 2 diabetes mellitus (T2DM) of Zang and Han nationalities in Tibetan, China, and to compare the difference in daily management between T2DM patients of Zang and Han nationalities, to develop reasonable and effective chronic disease management strategies for long-term out-of-hospital management of T2DM patients of Zang nationalities.Methods:A total of 265 T2DM patients with glycosylated hemoglobin (HbA1c) ≥ 7% who were admitted to the Endocrinology Ward of the Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from November 2020 to April 2021 and who were from different regions of Tibet were included in this study according to inclusion and exclusion criteria. The general data of all included patients were collected. Glucose and lipid metabolism-related indicators were determined. The Generalized Diabetes Self-Management Efficacy Scale and International Physical Activity Questionnaires (IPAQ) were used to evaluate patients' levels of self-management and daily physical activity.Results:The hemoglobin level in T2DM patients of Zang nationality was (154.09 ± 24.11) g/L, which was significantly higher than that in T2DM patients of Han nationality ( P < 0.05). The total cholesterol, fasting blood glucose, and low-density lipoprotein in T2DM patients of Zang nationality were (4.63 ± 1.41) mmol/L, (7.94 ± 2.19) mmol/L, and (2.75 ± 1.11) mmol/L, respectively, which significantly higher compared with T2DM patients of Han nationality (all P < 0.05). Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality had lower self-management scores (81.40 ± 15.44) points, diet control scores (17.26 ± 4.97) points, physical exercise scores (11.67 ± 4.42) points, prevention and treatment of high and low blood sugar score (12.21 ± 5.72) points. The differences were statistically significant (all P < 0.05). Moderate-intensity physical activity was a significant difference between T2DM patients of Zang and Han nationalities ( P < 0.05). Conclusion:Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality have lower overall self-management levels, including diet control, physical exercise, prevention and management of high and low blood glucose, and moderate-intensity physical activity. Targeted individualized education should be carried out according to the Tibetan cultural characteristics, to further develop an intervention method and an out-of-hospital management strategy for chronic disease, which are suitable for T2DM patients of Zang nationality.
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Objective:To observe the correlation between homocysteine (Hcy) and serum uric acid (SUA) and retinopathy in type 2 diabetes mellitus (T2DM), preliminary study on its predictive value.Methods:A retrospective study. From January 2020 to March 2021, a total of 324 T2DM patients hospitalized in Department of Endocrinology, Cangzhou Central Hospital of Hebei Province were included. Fasting blood glucose (FBG), glycated hemoglobin (HbA1C), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), serum creatinine (Scr), blood urea nitrogen (BUN), Hcy, SUA, peripheral blood endothelial progenitor cells (EPC), circulating endothelial cells (CEC) were counted and homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. According to the absence or presence of diabetic retinopathy (DR), the patients were divided into non DR (NDR) group and DR group with 100 and 214 cases, respectively. Clinical data and laboratory biochemical indexes of the two groups were compared and observed. The logistic regression was used to analyze the independent risk factors for DR in T2DM patients. Smooth curve fitting was used to analyze the curve relationship between Hcy, SUA and DR, and ROC area (AUC) of Hcy, SUA; their combined prediction of DR in T2DM patients was calculated by receiver operating characteristic curve (ROC curve), and the predictive value of Hcy and SUA for DR in T2DM patients was evaluated.Results:Diabetic course ( t=5.380), systolic blood pressure ( t=2.935), hypertension ( χ2=10.248), diabetic nephropathy ( χ2=9.515), diabetic peripheral neuropathy ( χ2=24.501), FBG ( t=3.945), HbA1C ( t=3.336) and TG in DR Group ( t=2.898), LDL-C ( t=3.986), Scr ( t=2.139), SUA ( t=7.138), HOMA-IR ( t=3.237), BUN ( t=3.609), Hcy ( t=2.363) and CEC ( t=19.396) were significantly higher than those in NDR group. The difference was statistically significant ( P<0.05). EPC ( t=9.563) and CPC ( t=7.684) levels were significantly lower than those of NDR group, and the difference was statistically significant ( P<0.05). Logistic regression analysis showed that diabetes course, SBP, hypertension, FBG, HbA1C, LDL-C, SUA, Hcy, EPC, CPC and CEC were all independent risk factors for developing DR in T2DM patients ( P<0.05). The smooth curve fitting analysis showed that Hcy and SUA were positively correlated with the occurrence of DR. After adjusting for confounding factors, when Hcy≥15 μmol/L, the risk of DR Increased by 14% for every 1 μmol/L increase in Hcy [odds ratio ( OR)=0.92, 95% confidence interval ( CI) 0.88-0.98, P<0.05]. When Hcy <15 μmol/L, there was no significant difference ( OR=0.96, 95% CI 0.92-1.08, P>0.05). When SUA≥304 μmol/L, the risk of DR increased by 17%, every 20 μmol/L SUA increased ( OR=0.80, 95% CI 0.68-0.94, P<0.05). When SUA <304 μmol/L, the difference was not statistically significant ( OR=0.83, 95% CI 0.72-0.95, P>0.05). ROC curve analysis results showed that the AUC values of Hcy, SUA and Hcy combined with SUA in predicting the occurrence of DR in T2DM patients were 0.775 (95% CI 0.713-0.837, P<0.001), 0.757 (95% CI 0.680-0.834, P<0.001) and 0.827 (95% CI 0.786-0.868, P<0.001). Hcy combined with SUA showed better predictive efficiency. Conclusions:The abnormal increase of Hcy and SUA levels in T2DM patients are closely related to the occurrence of DR, they are independent risk factors for the occurrence of DR. Hcy combined with SUA has high predictive value for the occurrence of DR.
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Objective To study the characteristics of immune function,Epstein-Barr virus(EBV) antibodies and EBV-DNA in children with different clinical types of EBV infection,which provide basis for prevention and treatment of EBV infection.Methods Clinical data of 103 patients suffering from EBV infection were retrospectively analyzed in Xijing Hospital of the Fourth Military Medical University.A total of 103 children were divided into infectious mononualeosis(IM) group(n=68),chronic active Epstein-Barr virus infection(CAEBV) group(n=13) and Epstein-Barr virus-related hemophagocytic lymphohistiocytosis(EBV-HLH) group(n=22).The changes of EBV antibodies,EBV-DNA,immunoglobulin levels,lymphocyte subpopulation and complement series were detected and compared among the three groups.A total of 26 healthy children at the same stage were enrolled as a control group,immunoglobulin levels,lymphocyte subpopulation and complement series were detected in control group,then compared with the rest of the three groups.Results The levels of C3 and C4 in CAEBV group and EBV-HLH group were significantly decreased than those in the control group(P0.05).CD8+T cells in IM group significantly increased than those in the rest of the three groups(P<0.05,respectively).T cells,CD8+T cells,CD4+ T cells,CD4+/CD8+ ratios,NK cells,B cells of EBV-HLH group significantly decreased than those in the rest of the three groups(P<0.05).The positive rates of EBV antibodies in CAEBV group and IM group were significantly higher than those in EBV-HLH group(P<0.05).EBV-DNA in EBV-HLH group were significantly higher than those of CAEBV group and IM group(P<0.05).Conclusion EBV-DNA levels in the serum are positively correlated with disease types and severity,the pathogenesis of IM,CAEBV and EBV-HLH induced by EBV infection are associated with immune dysfunction.Dynamic monitoring of EBV load and cell immune function can reflect disease status and progress risk.
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Objective:To research the curative effect of liuwei dihuang pill and metformin on the serum levels of apolipoprotein of patients with type 2 diabetes.Methods:106 cases with type 2 diabetes were selected and randomly divided into the control group and the observation group,with 53 cases in each group.The patients in the control group were treated with metformin,and the patients in the observation group were treated with liuwei dihuang capsules on the basis of the control group.Then the serum levels of apolipoprotein A and B (ApoA,ApoB),ApoA/ApoB,fasting plasma glucose (FPG),2 h postprandial blood glucose (2 HPG),fasting insulin (FINS),in sulin resistance index (HOMA IR),interleukin 6 (IL-6),hypersensitive c-reactive protein (hs-CRP),endothelin-1 (ET-1) and nitric oxide (NO),the curative effect and safety in the two groups were observed and compared before and after the treatment.Results:After treatment,the serum levels of ApoA,ApoA/ApoB and NO of the both groups were higher than those before,treatment,which were higher in the observation group than those of the control group (P＜0.05).After treatment,the serum levels ofFPG,2hPG,FINS,HOMA IR,IL-6,hs CRP and ET-1 of both groups were lower than before treatment,which were lower in the observation group than those of the control group(P＜0.05).The total effective rate of observation group was higher than that of the control group(P＜0.05).There was no statistically significant difference in the drug safety between the two groups (P＞0.05).Conclusion:Liuwei dihuang capsules and metformin had reliable curative effect on the treatment type 2 diabetes,which could regulate the serum levels of apolipoprotein,and improve the blood glucose,inflammatory factors and endothelial function.
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Objective To study the clinical characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV.Methods Clinical data,laboratory serology,pathological examination,treatment and follow-up results of 10 cases with CAEBV infection who were treated in Xijing Hospital of the Fourth Military Medical University from January 2008 to January 2016 were analyzed retrospectively.Results CAEBV major manifestations were continuous or intermittent fever,hepatomegaly,splenomegaly and lymphadenopathy,and others,including general fatigue,cough,hematemesis,diarrhea,skin rash,jaundice,sore throat,muscle joint pain,and so on.And with liver dysfunction,hematologic abnormality,and so on.All patients in anti-EB virus capsid antigen IgG (EBVCA-IgG)antibodies and EBEA-IgG antibodies had positive,while all patients in EBVCA-IgM antibodies had negative.The median load of EBV-DNA detected by real-time polymerase chain reaction(PCR) in the peripheral blood was 7.15× 105 copies/ml.Six of 10 cases CAEBV patients presented a poor clinical course,1 case died from intracranial hemorrhage,2 cases from respiratory failure,1 case from gastrointestinal bleeding,1 case from liver failure,1 case from severe multiple pathogens infection,rest 3 cases showed an improvement and 1 cases had a recurrence.Conclusion CAEBV infection has varieties of clinical features,with poor prognosis and high mortality.If the patients had unexplained fever,hepatomegaly,splenomegaly and lymphadenectasis,we should be timely detect virology and histopathological to diagnosis as early as possible.
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Objective The chief aim of the present work is to investigate features of sternum of Chinese adults and to establish the sex determination method to evaluate its effect based on 3D recombinant morphology indicators. Methods Based on chest spiral CT scans, 2D images of multi-level recombination and 3D model of volume rendering, the experiment concludes an sex determination equation from 8 measurement indicators of the sternum and 3 ratio indicators. The 8 measurement indicators include full-length, handle length, body length, maximum width of the handle, maximum width of the body, maximum thickness of the handle, maximum thickness of the body, and thickness of the upper body. Results According to the 11 indicators of sex differences in statistics (P<0.05), especially indicators of the full-length, body length, maximum width of the handle and maximum thickness of the body, the body's sex is easier to be determined. All indicators equations, length indicators discriminant equations and stepwise discriminant equations have higher reliable rate (88.6%) which was consistent with the recent foreign research reports. Conclusion The method of sex determination based on multislice spiral CT 3D recombinant techniques is practicable and has an relatively high accuracy. It is expected to be applied to researches in age estimation by sternum and other virtual bones.
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OBJECTIVE:To provide scientific reference for rational,effective and economical drug use in pediatric depart-ment. METHODS:A total of 9771 prescriptions were randomly selected from children's branch of our hospital during May 2012-Apr. 2016. Those prescriptions were analyzed statistically in respects of drug type,prescription cost,utilization rate of injec-tion,utilization rate of essential medicine,clinical diagnosis,irrational drug use,use of antibiotics,etc. RESULTS:Among 9771 prescriptions,2.91 types of drugs were used in each prescription,and each prescription expended 77.10 yuan;utilization rate of in-jection was 57.11％,and that of national essential medicine was 67.80％. Respiratory tract disease was main disease (84.17％). There were 284 irrational prescriptions(2.91％),including 156 non-standard prescriptions,165 unsuitable prescriptions and 65 ex-traordinary prescriptions. Utilization rate of antibiotics was 18.25％,among which that of Cefoxitin sodium injection was the high-est(15.48％),but its utilization index was the lowest(0.58). The detection rate of microorganism isolated from bronchitis patients was in low level(45.10％). CONCLUSIONS:The rate of qualified prescription in the children's branch of our Hospital is higher than the requirement of the former Ministry of Public Health concerning the rate of qualified prescription >95％;utilization rate of antibiotics and injection are both in high level. In the future,it is necessary to strengthen prescription evaluation and promote stan-dard and rational use of drugs so as to guarantee safe,effective and economical use of drugs in clinic.
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Background Studies showed that inflammation is associated with the pathogenesis and development of dry eyes,and tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) are key inflammatory factors.Thymosin β4 (Tβ4) plays a promoting effect on the migration of epithelial cells and anti-inflammatory action.However,the influences of Tβ4 on the repair of ocular surface in dry eyes are unelucidated.Objective This study was to investigate the regulation of Tβ4 to the expressions of TNF-o and IFN-γand its effect on the recovery of ocular surface in rat dry eye models.Methods The dry eye models were induced by topically administered of benzalkonium chloride (BAC) for consecutive 7 days in the left eyes of 50 SPF male SD rats,and 36 successful models were used in the experiment.Tβ4 solution (9 μg/ml),recombinant human epithelial growth factor (rhEGF)and sterile PBS at 5 μl was topically administered three times for consecutive 7 days in the Tβ4 group,rhEGF group and PBS group,and no drug was used in the model control group.The normal right eyes of rats served as the normal control group.The break-up time of tear film (BUT),corneal fluorescein staining score and Schirmer Ⅰ test (S I t)were examined and evaluated in the rats on the seventh day after administration of drugs.Then the rats were sacrificed by excessive anesthesia and the sections of the ocular surface were prepared.The morphology of the specimens was examined by hematoxylin and eosin staining,and the number of conjunctival gobelt cells was counted by periodic acidschiff staining.The ultrastructure of the corneal and conjunctival cells was examined under the transmission electron microscope.The expressions of TNF-α mRNA and IFN-γ mRNA and their proteins in conjunctiva tissue were quantified by quantitative real-time PCR and Western blot,respectively.The use and care of the animals followed by Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The BUT was (10.42±0.66),(7.46±0.49),(8.71±0.50),(9.59±0.35) and (8.63± 0.68) seconds in the normal control group,model control group,rhEGF group,Tβ4 group and BUT group,showing a significant difference among the groups (F =5.65,P =0.00),and the BUT was evidently shortened in the model control group compared with the normal control group,while the BUT was significantly extended in the rhEGF group and Tβ4 group in comparison with the model control group (all at P＜0.05).No significant differences were found in the corneal fluorescence score and S I t among the groups (F =0.42,P =0.79;F =136.77,P =0.00).The corneal and conjunctival epithelium defect and corneal stromal edema were seen in the model control group,and the proliferation of the epithelial cells were found in the rhEGF group and Tβ4 group,with the irregulated arrangement of the cells.A considerable difference was seen in the number of conjunetival goblet cells among the groups (F=3.16,P =0.04),and the number of eonjunctival goblet cells in the rhEGF group and model control group was significantly less than that in the normal control group (all at P＜0.05),and no statistically significant difference was seen between Tβ4 group and normal control group (P ＞ 0.05).The swelling,mergence,crispation,rupture and decrease of the microvilli and micro fold were found in the model control group,and the repair of the cell microvilli was seen in the Tβ4 group.The expressions of the TNF-α mRNA,IFN-γ mRNA and their proteins in the conjunctiva were significantly different among the groups (F =43.08,371.69,34.27,43.52,all at P =0.00),the expressions of the inflammatory factors were significantly higher in the model control group compared with the normal control group,and these expressions were evidently lower in the Tβ4 group in comparison with the model control group and rhEGF group (all at P＜0.05).Conclusions The topical administration of Tβ4 solution can promote the repair of ocular surface by down-regulating the expression of TNF-α and IFN-γ in conjunctiva and stablize the tear film in rat dry eyes.
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Objective To investigate the clinical characteristics of childhood purulent meningitis (PM)and the risk factors for its adverse outcome.Methods One hundred and nine children with PM were retrospective ana-lyzed,who were admitted to pediatric department in Xijing Hospital of the Fourth Military Medical University from Ja-nuary 2008 to July 201 6.They were divided into 5 age groups,the clinical features were compared among the different age groups.According to Glasgow prognostic score,all cases were then divided into 2 groups,the favorable outcome group and the adverse outcome group.All factors including normal information,disease history,clinical manifestations and laboratory examinations were compared between 2 groups.Results There were 72.5% (79 /1 09 cases)of the pa-tients younger than 3 years old.PMwas prone to spring and winter,and most children with PMhad preceding infection. The major clinical manifestations of PM were fever,convulsions and intracranial hypertension.The clinical manifesta-tions of PMwere different in different age groups,and convulsions were more commonly seen in less than 3 years old children,while headache,vomiting and meningeal stimulation had higher proportion in more than 3 years old children. The single factor analysis showed that there were repeated convulsions after admission (≥3 times),the cerebrospinal fluid (CSF)glucose(≤1 .5 mmol/L),CSF protein(≥1 g/L),CSF /blood glucose ratio and complications were signifi-cantly different between 2 groups(all P 500 ×1 06 /L,blood and CSF cultivate positive rate, co -infection,brain CT/MRI abnormality,electroencephalogram abnormality,treatment and duration of seizure more than 5 minutes were not significantly different(all P >0.05).Multivariate analysis showed that there were repeated convulsions after admission (≥3 times)(OR =27.84,P =0.048),CSF protein(≥1 g/L)(OR =28.44,P =0.027) and low CSF /blood glucose ratio (OR =22.1 5,P =0.041 )were independent risk factors for poor prognosis of PM. Conclusion PMhappens mostly in infantile period,with different clinical manifestations at different ages.The inde-pendent risk factors for poor prognosis were repeated convulsions after admission (≥3 times),CSF protein(≥1 g/L) and low CSF /blood glucose ratio.It indicates that if the high risk factors could be identified early,and then intervened immediately and followed up timely,it will be beneficial to improve the long -term prognosis.
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Objective To evaluate the rat model of dry eye induced by topical administration of benzalkonium chloride and compare the morphological characteristics of corneal and conjunctival tissues of the normal and model rats . Methods Topical administration of benzalkonium chloride (0.3%) twice per day for seven days to induce the rat model of dry eye.Pathology with HE and periodic acid-Schiff staining and transmission electron microscopy were performed to evaluate the corneal and conjunctival changes .Results The corneal and conjunctival epithelial cells were sloughed off , the number of goblet cells was decreased in the dry eye model .Microvilli were obviously lost in the surface epithelial cells of the dry eye rat cornea and conjunctiva compared with the normal rats , as indicated by the amount and size of microvilli . Conclusions The changes in the corneal and conjunctival epithelia of BAC-induced rat dry eye are similar to the changes in human dry eye .This rat model may play an essential role for dry eye studies in the future .
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Objective To evaluate the early clinical outcome of one‐stage posterior approach operation for rigid scoliosis caused by lumbosacral hemivertebra in adolescencts .Methods Eighteen adolescencts with rigid scoliosis caused by lumbosacral hemivertebra were surgically treated by the posterior hemivertebral resection and long segment fixation .Hemivertebrae were sited in L5 (14 cases) ,S1 (4 cases) .There were 12 cases of full‐segmented hemivertebrae and 5 cases of semi‐segmented hemivertebrae and 1 case of wedge vertebral body ,10 patients had coronal trunk imbalance .Results The patients were successfully completed sur‐gery .The operation time was 4 .5-8 .5 h ,averaged 6 .3 h ;and the perioperative bleeding was 600-2 800 mL ,averaged 1 180 mL . 2 patient suffered from nerve root injury who received neuro nutrition drugs and Prednisolone after operation and recovered com ‐pletely after one weeks .All cases were follow ed up for 12-38 months ,averaged 21 .6 months .The coronal Cobb angles of lumbo‐sacral curve and proximal lumbar after one week of operations and at the time of the last follow‐up were much better than those be‐fore the operations ,the differences were statistically significant (P<0 .05) .Postoperative radiography demonstrated that no implant failure was observed .Coronal trunk shift was improved in 17 patients after surgery ,1 patient had coronal trunk decompensation . Conclusion The posterior surgery with hemivertebrae resection and long segment fixation is an effective procedure in the treatment of rigid scoliosis caused by lumbosacral hemivertebra in adolescencts .The reconstruction of the coronal plane is the key to the oper‐ation .
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Objective To investigate expression and role of tissue factor pathway inhibitor -2(TFPI -2)in normal cervix,cervical intraepithelial neoplasia(CIN)and cervical squamous cell carcinoma.Methods From Janu-ary 2011 to December 2012,114 patients with cervical resection in our hospital were selected,among them,42 patients with cervical squamous cell carcinoma,27 cases with CIN,45 cases of normal cervix.Immunohistochemical method was used to detect the expression of TFPI -2 protein in cervical tissues.Results The expression of TFPI -2 in cer-vical cancer tissues was significantly lower than that in other cervical tissues,the difference was statistically significant (cervical cancer tissues vs.normal cervical tissues χ2 =59.670,P 0.05).There was no significant difference in TFPI -2 expression in cervical cancer tissues with different differentiation levels(χ2 =4.633,P >0.05).Figo Ⅰcervical cancer TFPI -2 expression was significantly higher than Figo Ⅱ cervical cancer,the difference was statistically significant(χ2 =6.509,P <0.05).The expression of TFPI -2 in cervical cancer tissues without lymph node metastasis was significantly higher than that in cervical cancer tissues with lymph node metastasis,the difference was statistically significant (χ2 =10.916,P <0.05).Conclusion The reduction of TFPI -2 expression may be involved in the development of cervi-cal cancer,and the expression of TFPI -2 is associated with the prognosis of cervical cancer.
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Perinatal glucocorticoid therapy has been proved to be effective on promoting fetal/neonatal lung maturity and has contributed to a dramatic improvement in the mortality and morbidity associated with neonatal respiratory distress syndrome.The underlying mechanisms studies are aimed primarily at accelerating the development of alveoli and pulmonary surfactant system.Meanwhile,a growing number of investigations focus on the side effects of perinatal glucocorticoid therapy on fetal/neonatal.Whether the repeat antenatal glucocorticoid and early postnatal glucocorticoid by intravenous injection is safe remains unclear.More studies are needed on the different route of giving glucocorticoid,the effect of different doses and their machanisms.This review presents the relevant information surrounding perinatal glucocorticoid therapy to enhance fetal/neonatal lung maturity,including clinical and animal studies over the last decades.
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Objective To study the psychosocial behavior reaction,psychosocial needs,anxiety and depression among colostomy patients prior to discharge and to explore the relationship between them.Methods Totally 67 colostomy patients from 2 hospitals in Guangzhou were recruited and investigated by demographic questionnaire,Ostomy Psychosocial Behavior Reaction Questionnaire,Ostomy Psychosocial Needs Questionnaire,Hospital Anxiety and Depression Scale 1-2 days prior to discharge.Results The psychosocial behavior reaction among coIostomy patients was in the moderate level with the mean score 2.15±0.27.The psychosocial needs were in medium to high level with the mean score 2.09±0.41.About 37.3％ of colostomy patients showed anxiety,while 20.9％ patients showed depression.Significant positive correlation was shown between psychosocial behavior reaction and psychosocial needs(r=0.565,P＜0.01),while significant positive correlation was also shown between psychosocial behavior reaction and anxiety-depression(r=-0.472,-0.319,P＜0.01).Psychosocial needs and anxiety could predict psychosocial behavior reaction positively(β=0.486,-0.375,P＜0.01).Conclusion The positive acknowledgement and reconstruction are the main psychosocial behavior reactions prior to discharge in colostomy patients.Patients with more psychosocial needs,severe anxiety show more psychosocial behavior reaction.
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Objective To explore Diagnostic value of combined detection of alpha fetoprotein(AFP) ,carcino‐embryonic antigen (CEA) ,carbohydrate antigen 125(CA125) ,neurone specific enolase(NSE) and carbohydrate antigen 724(CA724) in malignant hy‐drothorax and hydroperitoneum .Methods According to the pathological diagnosis as gold standard ,receiver operating characteristic (ROC) curve was used to analyzed the cut‐off value for the diagnosis of malignant hydrothorax and hydroperitoneum in 291 pa‐tients ,and 135 patients with benign malignant hydrothorax and hydroperitoneum were enrolled as controls .Diagnostic value of sin‐gle and combined detection of tumor markers was analyzed .Results Area under the ROC curve of CEA and CA724 were higher than 0 .7 ,indicating that CEA and CA724 were with high diagnostic value .Among CEA ,CA724 ,NSE and CA125 ,used for single detection ,CEA was with high sensitivity(81 .7% ) ,Jorden index(0 .64) ,negative predictive value(67 .7% ) ,positive predictive value (90 .8% ) ,and NSE(82 .9% ) was with high specificity .Combined detection of tumor markers could increase diagnostic sensitivity , Jorden index and negative predictive value .Conclusion CEA could be with high diagnostic value of malignant hydrothorax and hydro‐peritoneum .Combined detection of tumor markers could increase diagnostic sensitivity ,Jorden index and negative predictive value .
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Objective To investigate the cause of stoma chassis leakage (SCL) and summarize the nursing experience. Method The clinical data of 20 patients with SCL were retrospectively analyzed on the colostomy outpatients. Result The causes of SCL in those stoma patients included insufficient skills of stoma care, peridermal depression, poorly fitting stoma chassis, weight gain, poor positioning and retraction of the stoma. Conclusion Such nursing measures as enhanced awareness of SCL causes, careful reselection of a suitable stoma chassis, addition of ointment patches or heightening of the convex chassis can be effective in prevention of SCL leakage, enhancement of patient′s confidence and improvement of their quality of life.
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OBJECTIVE@#To study the expression of trefoil factor 3 (TFF3)with stromal cell-derived factor (SDF-1) and its receptor (CXCR4) in papillary thyroid carcinoma(PTC), and investigate the function of TFF3, SDF-1/ CXCR4 and the relationship among them during the tumor genesis,development and outcome of PTC.@*METHOD@#Detecting the expression of TFF3 and SDF-1/CXCR4 by immunohistochemical method (SP) in 92 cases of PTC and para-carcinoma tissue. Semiquantitative analysis of the results of immunohistochemistry was conducted by image analysis software.@*RESULT@#(1) TFF3 protein was expressed in the cytoplasm of cancer cells,while TFF3 was negative or weakly positive in follicular cells of para-carcinoma tissue. The positive expression rate of TFF3 was 92.39%, of which the strong positive rate of clinical stage III-IV accounted for 71.79% (42/59) and that of clinical stage I-II was 33.33% (11/33) (P < 0.01). The positive rate of TFF3 was significantly higher in the cases with lymph node metastasis than those without lymph node metastasis (100.00% vs 86.27%, P < 0.05). The AOD value of TFF3 was higher in PTC than in para-carcinoma tissue, that in cases with lymph node metastasis was higher than those without lymph node metastasis, and that in stage III-IV was higher than those in I-II (P < 0.05 or P < 0.05). (2) There was high expression of SDF-1 in the cytoplasm of malignant tissues. The para-carcinoma tissue was weakly positive or negative to SDF 1 and metastatic lymph nodes was weakly positive to SDF 1. The positive rates and AOD values of SDF-1 protein were similar to those of TFF3 in PTC,that is to say the positive rate and AOD values were higher in PTC than in para-carcinoma tissue, those in cases with lymph node metastasis were higher than those without lymph node metastasis, those in stage III-IV were higher than those in I-II, and those in patients older than 45 years old was obviously higher than those in patients under 45 years old (P < 0.05 or P < 0.01); CXCR4 was also mainly expressed in cytoplasm with few expression in nuclei, while negative or weakly positive in para-carcinoma. The positive rate and AOD values of CXCR4 in PTC were similar to SDF-1, meaning that they were higher in PTC than in para-carcinoma tissue and associated with the clinical stage, lymph node metastasis and age (P < 0.05 or P < 0.01). (3) There was positive relationship between TFF3 and SDF-1 as well as between SDF-1 and CXCR4 in PTC (r = 0.971, P < 0.01).@*CONCLUSION@#The high expression of TFF3, SDF-1 and CXCR4 in PTC are correlated with carcinogenesis and progression, and may play a significant role in evaluating the malignancy degree and progression of PTC.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Carcinoma , Metabolism , Pathology , Carcinoma, Papillary , Chemokine CXCL12 , Metabolism , Lymphatic Metastasis , Neoplasm Staging , Peptides , Metabolism , Receptors, CXCR4 , Metabolism , Signal Transduction , Thyroid Cancer, Papillary , Thyroid Neoplasms , Metabolism , Pathology , Trefoil Factor-2ABSTRACT
Objective To determine the efficacy of berberine in the treatment of non-alcoholic steatohepatitis ( NASH) , and to investigate the regulating effect on macrophage phenotype transformation in hepatic tissue on methionine -choline deficiency (MCD) diet induced NASH mice.Methods Fourty male C57BL/6 mice were randomly divided into 4 groups (10 mice per group): the normal group (fed with normal diet), the NASH model group (fed with MCD diet), rosiglitazone treatment group (30mg/kg) and berberine treatment group (150mg/kg).Drugs were adopted in the preventive intervention method for 2 weeks.The hepatic histopathological method was adopted to evaluate the drug therapeutic effect.The serum levels of tumor necrosis factor-α(TNF-α), interleukin(IL)-6, and IL-10 were examined with ELISA method.M1 and M2 phenotype were detected by flow cytometry .Results The results showed berberine improved the degree of hepatic histopathology .Berberine not only reduced the level of TNF-α, but also increased the level of IL-10 in serum on NASH mice significantly ( P <0.05 ) . Flow cytometry data indicated that berberine decreased M 1 type macrophages and increased M 2 type macrophages in liver tissue .The ratio of M1/M2 was significantly decreased in berberine and rosiglitazone treated group ( P <0.01 ) .Conclusion Berberine may improve the hepatic pathological process in MCD diet induced NASH model possibly through modulating macrophage phenotype transformation , i.e.The ratio of M2 type is more than M1 type in hepatic tissue , and increasing anti-inflammatory cytokines .
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Objective To study the effect of the ultrasound scalpel and electric knife in axillary lymph node dissection in modified radical mastectomy for breast cancer.Methods The clinical data of 429 patients with modified radical mastectomy for breast cancer were analyzed retrospectively.The axillary lymph node dissection in 178 cases were performed with the ultrasound scalpel (ultrasound scalpel group) and 251 cases were done with the electric knife(electric knife group).The blood loss,operative time,extubation time,the total amount of drainage,the incidence of seroma were compared.Results Two groups were successfully operated,no axillary vessels and long thoracic nerve,chest nerve injury.The blood loss,operative time,extubation time,the total amount of drainage in ultrasound scalpel group were significantly better than those in electric knife group [(98.0 ± 10.2) ml vs.(152.0 ± 11.5) ml,(125.0 ±9.6) min vs.(155.0 ± 12.3) min,(6.0 ± 2.1) d vs.(9.0 ± 4.3) d,(227.0 ± 10.6) ml vs.(319.0 ± 15.8) ml,P＜ 0.05 or ＜ 0.01].The incidence of seroma was no significant difference between two groups (P ＞ 0.05).Conclusions Using ultrasound scalpel in axillary lymph node dissection for breast cancer can significantly reduce operative time,and is consistent with less blood loss,less extubation time and the total amount of drainage.
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Objective To observe the effect of recombinant human mannose-binding lectin (RhMBL)on the expression of Bcl-2 and p53 gene in thyroid cancer cell lines.Methods Two kinds of thyroid cancer cell lines( K1 cells and FTC-133 cells) were dealed with different concentrations of rhMBL( control group:0 mg/L;experimental group:1 mg/L),then total protein was extracted to detect the expression of Bcl-2 and p53 by Western Blot.Results The expression level of p53 and Bcl-2 were observed to be obviously down-regulated after incubation with RhMBL.( 1 ) K1 cells:There was significant difference on the expression of p53 and Bcl-2 between control group and experimental group [ p53:( 1.51 ± 0.29) vs (0.74 ±0.07),t =7.63 ; P =0.040;Bcl-2:( 1.20 ± 0.07 ) vs ( 0.59 ± 0.04 ),t =6.28,P =0.001 ] ; ( 2 ) FTC-133 cells:there was also significant difference on the expression of p53 and Bcl-2 between control group and experimental group [ p53:( 0.88 ±0.14) vs(0.35 ±0.08),t =3.29,P=0.003; Bcl-2:(1.07±0.11) vs (0.33 ±0.06),t =5.73,P=0.000 ].Conclusion Bcl-2 and p53 may play an important role on the induction of thyroid cancer cell apoptosis and inhibition its proliferation by RhMBL.