Compound oleum lithospermi in improving clinical symptoms of mild to moderate diaper dermatitis: a multicenter, open-labeled, randomized controlled clinical study / 中华皮肤科杂志

Objective:To evaluate clinical efficacy and safety of topical compound oleum lithospermi in the treatment of mild to moderate diaper dermatitis.Methods:A multicenter, randomized, positive-drug parallel-controlled clinical trial was conducted in 19 hospitals from July 2019 to August 2020. Children aged 0 - 12 months with mild to moderate diaper dermatitis were enrolled and randomly divided into 2 groups using a random number table: test group topically treated with compound oleum lithospermi, and control group topically treated with zinc oxide cream. The treatment was carried out 6 - 8 times a day for 7 days. Visits were scheduled on days 0 and 7, and total response rate and clinical healing time were evaluated. Changes in the dermatitis family impact (DFI) score were compared between the test group and control group, and adverse events were recorded. Statistical analysis was carried out by using independent-sample t test for normally distributed continuous data, Wilcoxon rank sum test for non-normally distributed continuous data, and chi-square test or Fisher′s exact test for unordered categorical data; survival curves were drawn, and log-rank test was used for comparisons between two groups. Results:A total of 343 children with diaper dermatitis were enrolled in this study. Among them, 31 children violated the protocol, so 312 were included in the per protocol set, including 157 in the test group and 155 in the control group, and all completed the visits on days 0 and 7. The total response rate was significantly higher in the test group (87.26%, 137/157) than in the control group (78.71%, 122/155; χ2 = 4.04, P = 0.044) . The clinical healing time was significantly shorter in the test group (5.33 days) than in the control group (6.13 days; χ2 = 4.67, P = 0.025) . After 7-day treatment, the DFI score significantly decreased in both the 2 groups compared with that before the treatment, but there was no significant difference in the DFI score between the 2 groups (test group: 4.02 ± 6.96, control group: 3.58 ± 5.90, Z = -0.39, P = 0.686) . The incidence of adverse events was 2.92% (5/171) and 5.45% (9/165) in the test group and control group respectively, and there was no significant difference between the 2 groups ( χ2 = 0.03, P = 0.865) . Conclusion:Compound oleum lithospermi can markedly reduce the clinical severity of diaper dermatitis, improve the total response rate, shorten the clinical treatment period, and improve the quality of life of children′s families with a favorable safety profile.

Meta-analysis of the efficacy and safety of tranexamic acid in open spinal surgery / 中国组织工程研究

OBJECTIVE: The perioperative optimization measures of accelerated rehabilitation surgery run through the whole hospitalization period of patients with open spinal surgery. The clinical efficacy and safety of tranexamic acid in open spinal surgery were evaluated using meta-analysis. METHODS: Databases of PubMed, Embase, Ovid, Cochrane Library, CNKI, CBM, Wanfang, and VIP were searched. According to the inclusion and exclusion criteria, ten prospective randomized controlled trials were obtained. Endnote software was utilized to manage the literature. The extracted data were analyzed using Revman 5.3 software for meta-analysis, mainly analyzing the intraoperative blood loss, postoperative blood loss, total perioperative blood loss, postoperative hemoglobin, operation time, length of hospital stay, blood transfusion rate, and thrombotic complications by using tranexamic acid in open spinal surgery. RESULTS: (1) A total of 10 high-quality prospective randomized controlled studies were included in 802 patients. (2) Meta-analysis results showed that tranexamic acid significantly reduced intraoperative blood loss (MD=-210.38, 95%CI:-267.31 to-153.45, P < 0.000 01), postoperative drainage (MD=-113.40, 95%CI:-126.97 to-99.83, P < 0.000 01), total perioperative blood loss (MD=-266.85, 95%CI:-351.18 to-182.52, P < 0.000 01), and postoperative hemoglobin loss (SMD=0.20, 95%CI: 0.02-0.38, P=0.03) compared with the control group, with significant difference. Moreover, the length of hospital stay (MD=-1.09, 95%CI:-1.86 to-0.32, P=0.006) significantly reduced, and blood transfusion rate (RR=0.61, 95%CI: 0.48 to 0.79, P=0.000 1) significantly reduced. Operation time (MD=-7.75, 95%CI:-16.65 to 1.15, P=0.09) did not shorten. (3) There was no significant difference in the incidence of thrombotic complications between the tranexamic acid group and the control group (RR=0.92, 95%CI: 0.47 to 1.82, P=0.81). CONCLUSION: Tranexamic acid can significantly reduce the perioperative blood loss of open spine surgery, shorten hospital stay, lower blood transfusion rate, and is safe and reliable. The use of tranexamic acid in open spinal surgery can promote enhanced recovery of patients after surgery; the initial dose of tranexamic acid is 10-15 mg/kg, maintenance dose 1.0-2.0 mg/kg per hour. It may be the best solution for intravenous tranexamic acid in open spine surgery.

Influence of body shape on the short-term therapeutic effects of laparoscopic distal gastrectomy: a multicentre retrospective study (A report of 506 cases) / 中华消化外科杂志

Objective To investigate the risk factors of perioperative complications of laparoscopic radical distal gastrectomy and influence of body shape on the short-term therapeutic effects.Methods The retrospective case-control study was conducted.The clinicopathological data of 506 patients (328 males and 178 females,average age 60 years with the range of 24-85 years) who underwent laparoscopic radical distal gastrectomy+D2 lymph nodes dissection in the 8 clinical centers between March 2016 and November 2018 were collected,including 143 in the First Affiliated Hospital of Xiamen University,66 in the Affiliated Hospital of Qinghai University,66 in the Second Affiliated Hospital of Wenzhou Medical University,64 in the Zhongshan Hospital of Xiamen University,54 in the Affiliated Hangzhou First people's Hospital of Zhejiang University School of Medicine,48 in the Zhangzhou Affiliated Hospital of Fujian Medical University,35 in the Affiliated Quanzhou First Hospital of Fujian Medical University,30 in the Second Affiliated Hospital of Xiamen Medical College.The maximum thickness of subcutaneous fat at the level of umbilicus (USCF),the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UAPD),the maximum horizontal distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UTD),the maximum verticaldistance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (XAPD),the maximum horizontal distance between the.anterior abdominal skin and the back skin at the level of the xiphoid bone (XTD),the distance between the anterior abdominal skin and the root of celiac artery (CAD) and the maximum horizontal distance at a right angle to CAD (CATD) were measured using preoperative imaging examinations.Observation indicators:(1) intraoperative and postoperative situations;(2) follow-up situations;(3) risk factors analysis of perioperative complications;(4) influence of body shape related indexes on intraoperative situations and postoperative recovery:① Pearson univariate correlation analysis,② liner regression model analysis.Followup using outpatient examination and telephone interview was performed to detect the postoperative survival and tumor recurrence or metastasis up to December 2018.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using the chi-square test.Comparisons of ordinal data were analyzed by Mann-Whitney U nonparametric test.Risk factors of perioperative complications of laparoscopic distal gastrectomy were analyzed by Logistic regression model.Influence of body shape related indexes on intraoperative situations and postoperative recovery was analyzed by Pearson univariate correlation analysis and liner regression model.Results (1) Intraoperative and postoperative situations:all the 506 patients underwent successful laparoscopic distal gastrectomy,including 103 with Billroth Ⅰ anastomosis,140 with Billroth Ⅱ anastomosis,201 with Billroth Ⅱ + Braun anastomosis,62 with Roux-en-Y anastomosis.The operation time,volume of intraoperative blood loss,number of lymph nodes dissected,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake and duration of postoperative hospital stay were (233±44)minutes,(102±86)mL,34±13,(3.6±1.5)days,(5.8±3.3)days,(8.3±3.8)days,(12.2±5.7)days respectively in the 506 patients.Of 506 patients,196 were defined as pathological stage Ⅰ,122 were defined as pathological stage Ⅱ and 188 were defined as pathological stage Ⅲ postoperatively.Of 506 patients,93 had 106 times of perioperative complications,including 33 times of pulmonary and upper respiratory infection,12 times of incisional infection,11 times of anastomotic leakage,11 times of abdominal infection,8 times of intestinal obstruction,8 times of gastroplegia,6 times of abdominal hemorrhage,5 times of bacteremia,3 times of anastomotic hemorrhage,3 times of lymph fluid leakage,2 times of pancreatic leakage,1 time of urinary infection,1 time of anatomotic stenosis,1 time of deep venous thrombosis and 1 time of pulmonary embolism;the same patient can merge multiple complications.Eleven patients were in the Clavien-Dindo classification ≥ Ⅲ.(2) Follow-up situations:465 of 506 patients were followed up for 1-32 months with a median time of 12 months.During the follow-up,451 had postoperative survival and 38 had tumor recurrence or metastasis.(3) Risk factors analysis of perioperative complications.① Results of univariate analysis showed that age,body mass index (BMI),preoperative hemoglobin,preoperative serum albumin and XAPD were related factors affecting perioperative complications of laparoscopic distal gastrectomy (x2 =10.289,7.427,5.269,5.481,4.285,P＜ 0.05).② Results of multivariate analysis showed that age,BMI,preoperative serum albumin were independent related factors affecting perioperative complications of laparoscopic distal gastrectomy (odds ratio =1.033,1.118,0.937,95％ interval confidence:1.011-1.057,1.025-1.219,0.887-0.990,P＜0.05).(4) Influence of body shape related indexes on intraoperative situations and postoperative recovery.① Results of Pearson univariate correlation analysis showed correlations between UAPD,XAPD,CAD,CATD and volume of intraoperative blood loss (r=0.107,0.169,0.179,0.106,P＜0.05),between UAPD,XAPD,CAD and the number of lymph nodes dissected (r=-0.137,-0.143,-0.173,P＜0.05),between USCF,XAPD and time to postoperative anal exsufflation (r =0.122,0.109,P＜0.05),between USCF,XAPD,CAD and time for initial fluid diet intake (r=0.132,0.108,0.132,P＜0.05),between USCF,XAPD and duration of postoperative hospital stay (r=0.116,0.100,P＜0.05).② Results of liner regression model analysis showed a positive correlation between CAD and volume of intraoperative blood loss (r =6.776),a negative correlation between CAD and the number of lymph nodes dissected (r =-0.841),with statistically significant differences (t =2.410,-1.992,P＜ 0.05);a positive correlation between USCF and time to postoperative anal exsufflation (r=0.170),between USCF and time for initial fluid diet intake (r=0.365),between USCF and duration of postoperative hospital stay (r=0.636) respectively,with statisticallysignificant differences (t =2.188,1.981,2.107,P＜ 0.05).Conclusions Abdominal shape can influence intraoperative situations and postoperative recovery of laparoscopic distal gastrectomy,but cannot increase risks ofperioperative complications.Age,BMI and preoperative serum albumin are independent related factors affecting perioperative complications of laparoscopic distal gastrectomy.

Efficacy and safety of 0.03％ tacrolimus ointment in the long-term intermittent maintenance treatment of atopic dermatitis in children: a multicenter randomized controlled clinical trial / 中华皮肤科杂志

Objective To compare the efficacy and safety of the long-term intermittent maintenance treatment with tacrolimus 0.03％ ointment versus traditional treatment in reducing relapses and prolonging the recurrence interval in children with moderate to severe atopic dermatitis (AD).Methods A two-phase randomized,open-labelled,controlled clinical trial was conducted from September 2012 to November 2013.In the first phase,a total of 171 children aged 2-15 years with moderate to severe AD were enrolled from 7 hospitals in China,and received conventional treatment with tacrolimus 0.03％ ointment twice a day for 2-6 weeks.At the end of the treatment,the patients who achieved an investigator's global assessment (IGA) score ≤ 2 (n =125) were randomly classified into 2 groups to receive the second-phase treatment:test group (n =62) receiving intermittent maintenance treatment with tacrolimus 0.03％ ointment twice a week (Monday and Thursday),and control group (n =63) receiving no treatment.If the patients in the 2 groups experienced relapse,they received conventional treatment with tacrolimus 0.03％ ointment twice a day.The overall observation period was 6 months.The primary endpoint was the time to the first relapse,which was defined as the number of days from the end of the first-phase treatment to the first relapse.The secondary endpoints included the number of relapses at the second-phase trial,the disease severity at the time of relapse,the duration of relapse,the pruritus score at the time of relapse,the total amount of tacrolimus ointment used,the total response rate at the second-phase trial,and the incidence of adverse events.Results A total of 125 children with AD were enrolled into the second-phase trial,and 121 of them completed the follow-up.Among the 121 patients,the recurrence rate was significantly lower in the test group (25/60,41.7％) than in the control group (46/61,75.4％;x2 =14.20,P ＜ 0.001).The time to the first relapse was significantly longer in the test group (46.9 ± 37.7 d) than in the control group (28.8 ± 32.3 d;Z =1 093.50,P =0.020).The total number of recurrence was 31 and 86 in the test group and control group respectively,and the mean number of recurrence in each patient was significantly lower in the test group (0.52 ± 0.68) than in the control group (1.41 ± 1.23,t =4.96,P ＜ 0.001).There were no significant differences between the two groups regarding disease severity during relapse (eczema area and severity index:Z =971.50,P =0.39),duration of relapse (Z =747.00,P =0.07),and pruritus score during relapse (Z =894.00,P =0.95).The therapeutic drug was tolerated well in all the children,and no tacrolimus-related serious adverse events occurred.Conclusion The intermittent maintenance treatment with tacrolimus 0.03％ ointment twice a week for 6 months can effectively and safely prevent and reduce relapses,and prolong the recurrence interval in children with moderate to severe AD.

Short-term clinical effects of selecting duodenal transection timing on laparoscopic-assisted distal gastrectomy: a multicentre retrospective study (A report of 239 cases) / 中华消化外科杂志

Objective To investigate the short-term clinical effects of selecting duodenal transection timing on laparoscopic-assisted distal gastrectomy (LADG).Methods The retrospective cohort study was conducted.The clinicopathological data of 239 gastric cancer (GC) patients undergoing LADG in the 5 medical centers between March 2016 and March 2018 were collected,including 104 in the First Affiliated Hospital of Xiamen University,45 in Zhangzhou Affiliated Hospital of Fujian Medical University,35 in Quanzhou Affiliated Hospital of Fujian Medical University,30 in the Second Affiliated Hospital of Xiamen Medical College,25 in Zhongshan Hospital of Xiamen University.Of 239 patients undergoing LADG + D2 lymph node dissection,107 receiving duodenal transection and then lymph node dissection in the upper region of pancreas after lymph node dissection in the lower region of pylorus and 132 receiving lymph node dissection in the upper region of pancreas and then duodenal transection were respectively divided into anterior approach group and posterior approach group.Sixty-four,8,16,14 and 5 patients in the anterior approach group and 40,37,19,16 and 20 patients in the posterior group respectively came from the First Affiliated Hospital of Xiamen University,Zhangzhou Affiliated Hospital of Fujian Medical University,Quanzhou Affiliated Hospital of Fujian Medical University,Second Affiliated Hospital of Xiamen Medical College and Zhongshan Hospital of Xiamen University.Observation indicators:(1) surgical and postoperative situations;(2) postoperative complications;(3) stratified analyses of surgical and postoperative situations in patients with different TNM staging,body mass index (BMI) and maximum tumor dimension;(4) follow-up and survival.Follow-up using outpatient examination and telephone interview was performed to detect postoperative overall survival and tumor recurrence or metastasis up to April 2018.Measurement data with normal distribution were represented as (-x)±s,and comparison between groups was analyzed using the independent-samples t test.Measurement data with skewed distribution were described as M (Q),and comparison between groups was analyzed using the nonparametric test.Comparisons of count data were analyzed using chi-square test or Fisher exact probability.Comparison of ordinal data was done by the rank-sum test.Results (1) Surgical and postoperative situations:all the patients underwent successful operation,without perioperative death.Number of lymph node dissection in the upper region of pylorus in the anterior and posterior approach groups were respectively 3.9±2.6 and 3.0±2.5,with a statistically significant difference between groups (t=2.778,P＜0.05).Cases with Billroth Ⅰ,Billroth Ⅱ,Billroth Ⅱ +Bruan and Roux-en-Y of digestive tract reconstruction,operation time,dissected times of lymph nodes in greater curvature of stomach,lower region of pylorus,upper region of pancreas and lesser curvature of stomach,cases with visible port vein,volume of intraoperative blood loss,number of overall lymph node dissection,numbers of lymph node dissection in greater curvature of stomach,lower region of pylorus,upper region of pancreas and lesser curvature of stomach,time to postoperative anal exsufflation,time for postoperative fluid diet intake,time for postoperative semi-fluid diet intake,intraperitoneal drainage-tube removal time and duration of postoperative hospital stay were respectively 16,32,47,12,(233.0±41.0)minutes,(14.6±5.4)tninutes,(21.9±6.3)nminutes,(32.7±6.8) minutes,(7.4±2.9)minutes,74,(87±73)mL,35.0±10.0,8.5±4.1,4.8±4.2,13.3±5.2,4.3± 3.3,(4.1±2.6)days,(5.4±2.8) days,(7.9± 3.5) days,(8.9± 2.9) days,(11.7± 4.5) days in the anterior approach group and 17,47,61,7,(243.0±44.0) minutes,(15.7±5.2) minutes,(23.1±8.0) minutes,(34.2±7.1) minutes,(7.9±2.8)minutes,79,(93±57)mL,33.0±10.0,8.1±4.8,5.3±4.9,12.5±5.6,3.8±2.4,(3.8±3.3)days,(5.0±3.6)days,(7.5±4.0) days,(8.5±3.8)days,(11.3±5.7) days in the posterior approach group,with no statistically significant difference between groups (x2 =3.431,t =-1.836,-1.546,-1.324,-1.634,-1.228,x2=2.552,t=-0.684,1.630,0.797,-0.871,1.148,1.314,0.954,0.951,0.884,1.065,0.694,P＞0.05).(2) Postoperative complications:cases with overall complications,anastomotic leakage,anastomotic stenosis,anastomotic bleeding,pancreatic fistula,postoperative gastroparesis,intra-abdominal hemorrhage,incision infection,pneumonia,intra-abdominal infection,bacteremia,intestinal obstruction,endolymphatic leakage,Clavien-Dindo grade Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳa of postoperative complications were respectively 15,1,1,1,0,3,1,2,3,0,1,3,0,3,9,1,2,0 in the anterior approach group and 25,3,0,1,2,2,2,5,7,3,2,3,1,6,14,1,2,2 in the posterior approach group,with no statistically significant difference between groups (x2=1.027,0.643,0.022,0.479,0.161,0.765,0.921,0.161,0.063,Z=-1.055,P＞0.05).Patients in 2 groups with complications were cured by symptomatic treatment.(3) Stratified analyses of surgical and postoperative situations in patients with different TNM staging,BMI and maximum tumor dimension:operation time,dissected times of lymph nodes in upper region of pancreas,cases with visible port vein,number of overall lymph node dissection,numbers of lymph node dissection in upper region of pylorus and upper region of pancreas were respectively (236.0±41.0)minutes,(33.9±6.2) minutes,32,36.0±12.0,3.8±3.0,13.4±5.5 in patients of the anterior approach group with Ⅲ stage of TNM staging and (253.0± 45.0) minutes,(36.5 ±7.0) minutes,29,31.0±t9.0,2.5±2.0,11.4±4.6 in patients of the posterior approach group with Ⅲ stage of TNM staging,with statistically significant differences between groups (t =-1.988,-2.066,x2 =4.686,t =2.472,2.757,2.016,P＜0.05).Numbers of overall lymph node dissection and number of lymph node dissection in upper region of pylorus were respectively 37.0± 12.0,3.6±3.1 in patients of the anterior approach group with BMI ≥ 25 kg/m2 and 30.0±7.0,2.0± 1.3 in patients of the posterior approach group with BMI ≥ 25 kg/m2,with statistically significant differences between groups (t =2.211,2.205,P＜0.05).Volume of intraoperative blood loss and number of lymph node dissection in upper region of pylorus were respectively (80±45) mL,4.0±2.6 in patients of the anterior approach group with maximum tumor dimension ≥ 3.3 cm and (110±67)mL,2.8± 1.8 in patients of the posterior approach group with maximum tumor dimension ≥ 3.3 cm,with statistically significant differences between groups (t =-2.320,2.589,P ＜ 0.05).(4) Follow-up and survival:of 239 patients,202 were followed up for 2-24 months,with a median time of 12 months,including 89 in the anterior approach group and 113 in the posterior approach group.During the follow-up,cases with overall survival,tumor recurrence and metastasis were respectively 85,3,8 in the anterior approach group and 109,3,11 in the posterior approach group,with no statistically significant difference between groups (x2=0.032,0.089,0.119,P＞0.05).Conclusions Both of anterior approach and posterior approach are safe and feasible in LADG,with equivalent short-term efficacies.The anterior approach in LADG has an advantage of the lymph node dissection in the upper region of pylorus compared with posterior approach,and it also is better for patients with later tumor staging,higher BMI and bigger tumor.

Effects of lactobacillus complex capsules in patients with acute exacerbation of chronic obstructive pulmonary disease and different degrees anorexia / 实用医学杂志

Objective To observe the effects of lactobacillus complex capsules in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and different degrees anorexia. Methods 100 anorexia score 1 and 100 anorexia score 2-5 AECOPD patients were divided into 4 groups: the therapy group 1 (anorexia score 1,n = 50) and the therapy group 2 (anorexia score 2-5,n = 50) with conventional and lactobacillus complex capsules therapy, the control group 1 (anorexia score 1, n = 50) and the control group 2 (anorexia score 2-5,n = 50) with conventional therapy. Parameters were recorded, which include length of hospital stay , markers of inflammation , arterial blood gases , lung function , clinical symptoms , death rate and side-effects of lactobacillus complex capsules. Results After treatment, WBC, trophil ratio, length of hospital stay in the therapy group 2 were lower than the control group 2(P 0.05). No side-effects like rashes, diarrhea, were observed in the two therapy groups. Conclusion For anorexia patients with AECOPD, oral lactobacillus complex capsules can safely control infection and reduce length of hospital stay.

Effects of lactobacillus complex capsules in patients with acute exacerbation of chronic obstructive pulmonary disease / 实用医学杂志

Objective To observe the effects of lactobacillus complex capsules in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A hundred AECOPD patients were divided into 2 groups: the therapy group(n = 50) with conventional and lactobacillus complex capsules therapy, and the control group with conventional therapy only. Parameters before and after therapy were compared, which included length of hospital stay, arterial blood gases, dyspnea grade, respiratory function test, markers of inflammation, anorexia score, diarrhea, fungi infection, breathing rate, death rate and side-effects of lactobacillus complex capsules. Results After 7 days of treatment, the blood leukocyte count and neutrophil ratio in the therapy group were lower than that of the control group (P 0.05). There were no side-effects, such as skin rash and diarrhea, to be observed in the therapy group. Conclusion Oral lactobacillus complex capsule can be safe, anti-infective and improve appetite in patients with AECOPD.

On the relationship between bone mineral density and bone turnover markers in subjects aged 80 and above / 中华内分泌代谢杂志

Objective To investigate the value of bone turnover markers(BTMs) in forecasting the variance of bone mineral density (BMD) by studying the relationships between BTMs and BMD in persons aged 80 and above.Methods A sample of 1 509 subjects aged 80 and above was recruited.All subjects underwent BMD measurement by dual energy X-ray absorptiometry,and BTMs (C-telopeptide of type 1 collagen,N-terminal propeptide of type 1 procolagen,osteocalcin) measurements.The relationships among all the BTMs,and between BMD and BTMs were analysed.Results In subjects aged 80 and above,the relationships among BTMs were moderately positive(all P＜0.05).In men aged 80 and above,BMDs were inversely associated with BTMs(all P＜0.05),and in women,BMDs were inversely associated with osteocalcin (P＜ 0.05).Conclusions The clinical significance of BTMs in persons aged 80 and above indicates bone resorption when BTMs are raised.In men aged 80 and above any of BTMs may be selected to evaluate bone metabolism ; while in women,osteocalcin should be selected.

Factors associated with onychomadesis in children: analysis of 120 cases / 中华皮肤科杂志

Objective To analyse factors associated with onychomadesis in children,and to evaluate the relationship between onychomadesis and hand-foot-mouth disease (HMFD).Methods A retrospective study was performed.Clinical data were collected from 120 children with onychomadesis (average age,3.19 ± 2.06 years) and 120 sex-and age-matched patients with hemangioma.Viral detection was realized by real-time reverse transcriptionPCR in throat swab specimens.Data were analyzed by chi-square test using the SPSS 16.0 software.Results Of the 120 patients with onychomadesis,85 (70.83％) had a history of HMFD,which was 4 to 8 weeks prior to the occurrence of onychomadesis.Onychomadesis was strongly correlated with HMFD (OR,7.621,95％ CI,4.292-13.531),but uncorrelated with the occurrence and peak of fever,abnormality of serum trace elements,existence of latent diseases,or the use of antipyretic drugs or antimicrobial drugs during the clinical course of HMFD (all P ＞0.05).Several viruses were detected in 39.7％ of 68 throat swab specimens from patients with HMFD accompanied by onychomadesis,which included Coxsackievirus A16 in 9 patients,enterovirus 71 in 3 patients and unidentified enteroviruses in 15 patients.Conclusion Onychomadesis appears to be a complication of HMFD.

Expression and significance of inducible nitric oxide synthase and interstitial cells of Cajal in the small intestine of rats with postoperative ileus / 中华消化外科杂志

Objective To investigate the change and significance of inducible nitric oxide synthase (iNOS) and intersititial cells of Cajal (ICC) in the small intestine of rats with postoperative ileus (POI).Methods Thirty healthy adult Wistar rats were randomly divided into the control group ( 15 rats) and POI group ( 15 rats) according to the random number table.The gastrointestinal transit rates of the 2 groups were detected.The distributions and expressions of iNOS and c-kit in the small intestines of the rats in the 2 groups were detected by immunohistochemical staining,and the mRNA expressions of c-kit and iNOS were examined by quantitative real-time polymerase chain reaction (qRT-PCR).All data were analyzed by the t test.Results Two rats in the POI group died of excessive dosage of anaesthesia or hypothermia,and the remaining 13 rats in the POI group were included in the analysis.The gastrointestinal transit rate was 42％ ± 14％ in the POI group,which was significantly lower than 64％ ± 13％ in the control group ( t =6.56,P ＜ 0.05 ).The results of immunohistochemical staining showed that the number of cells with c-kit positive staining was 8.9 ± 2.9,which was significantly smaller than 14.4 ± 5.0 in the control group ( t =3.97,P ＜ 0.05 ).The number of cells with iNOS immune-positive reaction increased to 13.6 ±4.9,while there was nearly no cells with iNOS immune-positive reaction in the control group.The results of qRT-PCR showed that the relative mRNA expressions of c-kit and iNOS were 1.6 ± 0.8 and 2.2 ± 1.2 in the POI group,and 2.6 ± 1.1,0.5 ± 0.5 in the control group.There were significant differences on the mRNA expressions of c-kit and iNOS between the POI group and the control group ( t =2.86,4.61,P ＜ 0.05).Conclusions ICC reduction and iNOS increase are observed in rats with POI.The change of the 2 factors may plav an important role in the mechanisms of POI.

Clinical therapy of Candesartan plus CSDP on elderly hypertensive patients with renal dysfunction / 中国综合临床

Objective To explore the therapy effect of candesartan plus CSDP on elderly hypertensive patients with renal dysfunction.Methods Eighty elderly patients with essential hypertension and renal dysfunction were selected as our subjects.All subjects were randomly divided into candesartan group and candesartan + CSDP group,every group for 40 subjects.Patients in candesartan group were treated with 4 mg candesartan once per day for 6 months.Patients in candesartan + CSDP group were given CSDP 10 capsules three times / day beside 4 mg candesartan,once per day for 6 months.The levels of Cr,BUN,Ccr changes were measured.Results Two therapy strategies can decrease blood pressure and the decrease rate of blood pressure in candesartan + CSDP group was higher than that of candesartan group.The level of Cr,BUN in patients with candesartan + CSDP group after treatment performing were (104.6 ± 6.5) μmol/L,(6.21 ± 4.80) mmol/L,lower than that in before treatment (196.8 ± 2.6) μ mol/L,(9.84 ± 3.20) mmol/L.And the Ccr increased from (58.1 ± 4.9)ml/min to (117.2 ± 6.4)ml/min.The differences were significant (t =2.213,2.302,2.136,P ＜ 0.05).However the differences between before and after treatment with only candesartan treat weren't significant (P ＜ 0.05).Conclusion Candesartan + CSDP might show a synergistic effect compared with candesartan in term of curing elderly hypertensive patients with renal dysfunction.

The treatment of Candesartan joint CSDP on type 2 diabetic nephropathy with stage Ⅲ / 中国综合临床

Objective To explore the clinical effect of CSDP combined with losartan treatment on type 2 diabetic nephropathy with stage Ⅲ.Methods Sixty patients suffered from type 2 diabetic nephropathy with stage Ⅲ were recruited as our subjects.They were randomly divided into Candesartan group and Candesartan + CSDP group,each for 30 patients.Patient in Candesartan + CSDP group were administrated with candesartan 4 mg,once per day,the CSDP 15 capsules and three times / day for 3 months.Patients in Candesartan group were given:candesartan 4 mg once/day for 3 months.The level of urinary albumin,serum urea nitrogen (BUN) and creatinine (Cr) were measured of subjects before and after treatment.Results The levels of BUN,Cr were lower after any treatment than before treatment in 2 groups.The difference of BUN,Cr in Candesartan + CSDP group were(-14.6 ± 8) mg/L,(-11.9 ± 3.3) μmmol/L,(-0.7 ± 0.2) mmol/L,higher than that of Candesartan group (-7.1 ± 7.8) mg/L,(-8.5 ± 0.8) μmol/L,(-0.4 ± 0.1) mmol/L] (P ＜ 0.01).Conclusion The treatment strategy of Candesartan joint CSDP can be method regarding of reducing urinary albumin and BUN,Cr in patients of type 2 diabetic nephropathy with stage Ⅲ.

The diagnostic value of fibro-optic bronchoscopy examination combined with detection of aberrant p16 promoter methylation in lung cancer / 中华全科医师杂志

Fibro-optic bronchoscopy (FB) examinations were undertaken in 42 cases with lung cancer and 25 cases with benign lung disease; methylation-specific PCR was performed in plasma, sputum and bronchoalveolar lavage fluid (BALF) specimen for detection of p16 gene promoter methylation in all patients.Of the 42 cases of lung cancer, the positive rates of p16 gene promoter methylation were 59.5% in BALF, 52.4% in plasma and 47.6% in sputum, respectively; while p16 gene promoter methylation was detected only in one plasma sample from 25 cases with benign lung disease ( P ＜ 0.05 ).The sensitivity,specificity and overall accuracy of FB were 59.5%, 100.0% and 74.6%, respectively.The sensitivity,specificity and overall accuracy of FB combined with aberrant p16 gene methylation in diagnosis of lung cancer were 92.9%, 96.2% and 94.0%, respectively.The FB examinations combined with detection of aberrant p16 gene methylation can further improve the accuracy to diagnosis of lung cancer.

Ad5-enhanced green fluorescent protein versus rAAV2-enhanced green fluorescent protein transfecting adipose-derived mesenchymal stem cells / 中国组织工程研究

BACKGROUND:There are reports concerning differentiation of adipose-derived mesenchymal stem cells(ADSCs)into chondrocytes using gene transfection technique.However,the transfection of adenovirus and adeno-associated virus into ADSCs is various.It is controversial whether adeno-associated virus(AAV)can transfect ADSCs.OBJECTIVE:To observe the enhanced green fluorescent protein(EGFP)expression following Ad5-EGFP and rAAV2-EGFP transfection into ADSCs,and investigate the cell proliferation ability following transfection.METHODS:ADSCs were isolated from the adipose tissue,which was from 6-month-old New Zealand albino rabbit back and neck by mechanical digestion and enzyme digestion,then ADSCs were cultured and amplified in vitro.ADSCs were infected with Ad5-EGFP and rAAV2-EGFP,and the EGFP expression was observed.A total of 2 μL sodium butyrate(1 mol/L)was added into the medium after rAAV2-EGFP transfection.MTT assay was used to detect the gene transfection effects on reproductive activity of ADSCs.RESULTS AND CONCLUSION:ADSCs isolated and cultured in vitro were flat,long-spindle and amplified stabry.The cell morphology was uniform.Many green fluorescent cells were observed in Ad5-EGFP and rAAV2-EGFP groups.Transfection efficiencies were about 88% and 83%.Adenovirus and adeno-associated virus vector can be transfected with ADSCs,and transfection efficiency is high.Adeno-associated virus needs sodium butyrate to increase its level of gene expression.

Imaging features of rare mastitis / 中华内分泌外科杂志

Objective To summarise the imaging features of rare mastitis and explore the diagnostic value of ultrasound, mammography and MRI for rare mastitis. Methods The record of 24 patients diagnosed as rare mastitis in our hospital from Jan. 2000 to Jun. 2009 was reviewed, including clinical manifestations, pathological results, imaging diagnosis and diagnostic accurate rate. Results Of the 24 patients, 14 patients were ductal ectasia with chronic mastitis, 3 granulomatous mastitis, 6 chronic abscess and 1 mammary tuberculosis. 13 patients underwent ultrasonic scan, 12 patients underwent mammography and 3 patients underwent MRI, with the diagnostic accurate rate 77%, 25% and 100% respectively. Conclusions There are no special imaging manifestations for most rare mastitis, however, some differential characteristics still exist. MRI has a higher accuracy compared to ultrasound and mammography. The combination of multiple imaging methods can improve diagnostic accuracy.

The clinical effect of benazepril combined with amoldipin on cardiac function and urine microalbuminuria in patients with moderate and severe primary hypertensive left ventricular hypertrophy / 中国综合临床

Objective To explore the effect of benazepril combined with amoldipin on cardiac function and urine microalbuminuria in patients with moderate and severe primary hypertensive left ventricular hypertrophy.Methods 90 patients with mild to moderate essential hypertension and left ventficular hypertrophy were randomly divided into three groups(n=30 in each group),who were treated with benazepril,amoldinpin and benazepril com-bined with amoldipin,respectively.Blood pressure was monitored and left ventricular diameter(LVDd),interven-tricular septal thick(IVS),left ventricular posterior wall(LVPW),left ventricular masses index(LVMI)were measured by echocardiography before and after treatment in three groups.Microalbuminuria,serum nitrogen and creatinine were examined at the same time.Results Both SBP and DSP were significantly decreased in three groups after two weeks treatment.E/A ratio and EF were increased at the same time(P<0.01).After treatment,these changes were more significant in Benazepril with Amlodipine group(P<0.05).After 24 week treatment IVS,LVPW and LVMI were significantly dereased(P<0.01),while LVEF and E/A increased(P<0.01).After 4-week treatment,microalbuminuria was decreased in three groups,especially in combined treatment group(P<0.01).With the time of medication in combined treatment group,microalbuminuria was increasingly decreased which was significant in benazepril and amoldipin group after 24 weeks(P<0.01).Conclusion The Benzazepril with am-lodipine are more effective in lowering blood pressure,left ventricular hypertrophy and decrease microalbuminuria.

The clinical effect of benazepril combined with amoldipin on cardiac function and urine microalbuminuria in patients with moderate and severe primary hypertensive left ventricular hypertrophy / 中国综合临床

Objective To explore the effect of benazepril combined with amoldipin on cardiac function and urine microalbuminuria in patients with moderate and severe primary hypertensive left ventricular hypertrophy.Methods 90 patients with mild to moderate essential hypertension and left ventficular hypertrophy were randomly divided into three groups(n=30 in each group),who were treated with benazepril,amoldinpin and benazepril com-bined with amoldipin,respectively.Blood pressure was monitored and left ventricular diameter(LVDd),interven-tricular septal thick(IVS),left ventricular posterior wall(LVPW),left ventricular masses index(LVMI)were measured by echocardiography before and after treatment in three groups.Microalbuminuria,serum nitrogen and creatinine were examined at the same time.Results Both SBP and DSP were significantly decreased in three groups after two weeks treatment.E/A ratio and EF were increased at the same time(P<0.01).After treatment,these changes were more significant in Benazepril with Amlodipine group(P<0.05).After 24 week treatment IVS,LVPW and LVMI were significantly dereased(P<0.01),while LVEF and E/A increased(P<0.01).After 4-week treatment,microalbuminuria was decreased in three groups,especially in combined treatment group(P<0.01).With the time of medication in combined treatment group,microalbuminuria was increasingly decreased which was significant in benazepril and amoldipin group after 24 weeks(P<0.01).Conclusion The Benzazepril with am-lodipine are more effective in lowering blood pressure,left ventricular hypertrophy and decrease microalbuminuria.

Effects of juice of Fructus Zipiphi Jujubae on blood lipid level and body function in mice / 中国组织工程研究

BACKGROUND:Fructus Zipiphi Jujubae,with certain cyclic adenosine monophosphate(cAMP) and cyclic guanosine monophosphate(cGMP),has effects on hypertension,diabetes,cancer and cardiogenic shock.But there has been rare report on the influence of Fructus Zipiphi Jujubae on blood lipid. OBJECTIVE:To study the effects of juice of Fructus Zipiphi Jujubae on body function and blood lipid level in mice. DESIGN:A completely randomized basic study taking experimental animals as the subjects. SETTINGS:Department of bioengineering,school of life science and technology in a university;Department of endocrinology in a university hospital. PARTICIPANTS:The experiment was completed in the Department of Bioengineering,School of Life Science and Technology in Xi'an Jiaotong University from March to May 2003.ICR mice of clean grade, weighing 20 g to 40 g,were provided by the Shaanxi Academy of Traditional Chinese Medicine[Certification No.08-004]. Juice of Fructus Zipiphi Jujubae:The Chinese date was picked, cleaned,heated and fractured moderately,mixed with water of 10 times and pectinase with the quantity percentage of 0.70% ,soaked at 50 ℃ for 6 hours,then the juice was filtered and condensed into 16% soluble solids,then sterilized for use later.Forty-eight mice (24 male and 24 female) were randomly divided into 4 groups according to body mass with 12 in each group:normal control group(group A), normal date juice group(group B),model control group(group C) and model date juice group(group D). INTERVENTIONS:Mice in group A were fed with basic diet,drank water for 24 hours;Mice in group B were fed with basic diet,drank water and date juice for 12 hours respectively;Mice in group C were fed with high-fat diet,drank water for 24 hours;Mice in group D were fed with high-fat diet,drank water and date juice for 12 hours respectively.Changes of body mass,indexes of thymus gland and spleen were measured after treated with date juice for 30 days.High fat mice models were established,and blood lipid indexes were determined. MAIN OUTCOME MEASURES:Food efficiency of mice,index of thymus gland,spleen index,growth index of mice. RESULTS:The food efficiency and the indexes of thymus gland and spleen in group B were(9.93± 0.473) g/100 g,3.27± 0.35 and 2.93± 0.51 respectively,which were all obviously higher than those in group A[(7.56± 0.382) g/100 g,(3.14± 0.54),(2.87± 0.33)](t=2.55,2.37,2.41,P< 0.05).The body mass was obviously higher in group B [(36.73 ± 4.70) g] than in group A[(34.92 ± 5.12) g] (t=2.32,P< 0.05);while those were very significantly higher in group C and group D [(39.83 ± 6.00), (37.63 ± 2.73) g] than in group A and group B[(34.92 ± 5.12), (36.73 ± 4.70) g](t=4.13,2.48,P< 0.01),and that in the group D[(37.63 ± 2.73) g] was obviously lighter than that in the group C[(39.83 ± 6.00)g](t=2.26,P< 0.05).The serum levels of total cholesterol(TC) in the in group C and group D were significantly higher than those in group A and group B(P< 0.01), while that was significantly lower in group D than in group C(P< 0.05). The serum levels of triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C),arteriosclerosis index(AI),high-density lipoprotein-cholesterol(HDL-C) and HDL-C/TC were significantly higher in group C than in group A(P< 0.01,P< 0.05).TC, HDL-C,AI,HDL-C/TC,TG and LDL-C in group D were lower than those in group C(P< 0.05,P< 0.01). CONCLUSION:Juice of Fructus Zipiphi Jujubae can obviously increase the body mass,promoting food efficiency and indexes of thymus gland and spleen of mice, and has the significant effect on the reinforcement of body function in mice.Juice of Fructus Zipiphi Jujubae can decrease the serum levels of TC,TG and LDL-C in mice with hyperlipidemia,and has the remarkable ameliorating effect on hyperlipidemia of mice induced by high-fat feed.

Childhood thyroid carcinoma:a clinical analysis of 60 cases / 中国普通外科杂志

Objective To investigate clinical characteristics, diagnosis, treatment and prognosis of thyroid carcinoma in childhood. Methods Sixty patients under 14 years of age with thyroid carcinoma were retrospectively reviewed. Results Forty-nine suffered from papillary carcinoma, eight were with follicular carcinoma and three with medullary carcinoma. Cervical lymph node metastasis was found in 36 cases (60%). Operations included unilateral total thyroidectomy and isthmectomy in 20 cases (33.3%), unilateral total thyroidectomy and contralateral subtotal thyroidectomy in 36 cases (60%) and total thyroidectomy in 4 cases (6.7%). The follow-up period was 1 to 20 years (mean 10.5 years), and the survival rate of 5 and 10 years were 93% and 87.1% respectively. Conclusions Most thyroid carcinoma in children is well differentiated and the prognosis is good. A proper surgical procedure and postoperative comprehensive therapy are important for good outcome.