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ObjectiveTo observe the clinical effectiveness and safety of She medicine （畲药） Diren Zishen Formula（地稔滋肾方） combined with acupuncture as adjunctive treatment for primary biliary cholangitis with liver and kidney yin deficiency syndrome. MethodsSeventy patients of primary biliary cholangitis with liver and kidney yin deficiency syndrome were randomly divided into a control group and a treatment group， with 35 patients in each group. The control group received oral ursodeoxycholic acid capsules （250 mg per dose， three times daily）. The treatment group received She medicine Diren Zishen Formula oral decoction （one dose daily， 200 ml per dose in the morning and evening， served warm） and acupuncture ［bilateral Sanyingjiao （SP6）， Taichong （LR3）， Ganshu （BL18）， Zusanli （ST36）， Fenglong （ST17）， once daily， 5 consecutive days per week］ in addition to the same treatment as the control group. The treatment duration was three months for both groups. Comparisons were made between the two groups before and after treatment for the following parameters， which were four traditional Chinese medicine （TCM） symptoms scores （skin itching， fatigue， jaundice， and flank pain）， TCM syndrome scores， liver function indicators including aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， gamma-glutamyl transferase （GGT） and total bilirubin （TBiL）， liver fibrosis markers including serum laminin （LN）， serum hyaluronic acid （HA）， serum type Ⅳ collagen （Ⅳ-C） and serum type Ⅲ procollagen （PC-Ⅲ）， and inflammatory factor indicators including serum interleukin-6 （IL-6） and tumor necrosis factor-alpha （TNF-α）. The effectiveness of TCM syndrome between the two groups was compared and safety evaluations were also conducted after treatment. ResultsA total of 32 cases were finally analyzed in the treatment group， while the control group had 31 cases. The total effective rate of TCM syndrome in the treatment group （87.50%， 28/32） was higher than that in the control group （67.74%， 20/31） （P＜0.05）. After treatment， the TCM symptom scores， syndrome scores， liver function， and liver fibrosis markers in both groups signi-ficantly decreased， while in the treatment group， the inflammatory factor indicators decreased after treatment， and more decreases were found than those in the control group （P＜0.05 or P＜0.01）. Both groups had good safety， and no adverse reactions were observed. ConclusionThe combination of She medicine Diren Zishen Formula and acupuncture as an adjunctive treatment for primary biliary cholangitis can significantly improve the clinical effectiveness， improve liver function， reduce inflammatory response， and alleviate liver fibrosis， with good safety.
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Objective:To evaluate the protective effect of foam dressing in preventing intraoperative acquired pressure injury (IAPI), and to provide reference basis for prevention and treatment of IAPI during clinical operation.Methods:The clinical data of 455 surgical patients admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2020 to January 2021 were retrospectively collected. According to whether foam dressing was used at the compression site during operation, the patients were divided into dressing group (101 cases) and control group (354 cases). The two groups were matched with age, body mass index, preoperative Braden and cerebrovascular disease as covariates, and were finally divided into 89 patients in the dressing group and 162 patients in the control group. Logistic regression analysis and stratified analysis were used to comprehensively evaluate the actual effect of foam dressing on the occurrence of IAPI in the surgical patients.Results:Among the 251 patients, there were 14 (15.7%) cases with IAPI in the dressing group and 13 (8.0%) cases in the control group, and the difference was not statistically significant ( χ2=3.41, P>0.05). Among the patients in the prone position, compared to the control group, the dressing group can effectively reduce the risk of IAPI in surgical patients by 77% ( OR=0.23, 95% CI 0.05-0.98, P<0.05). There was no interaction between foam dressing and intraoperative surgical characteristics ( P>0.05). Conclusions:Foam dressing plays a protective role in preventing the occurrence of IAPI in patients undergoing surgery in the prone position. There was no significant protective effect of intraoperative foam dressing in patients with other surgical characteristics.
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This article started from the definition of unavoidable stress injury, analyzed the mechanism of occurrence and the current development of unavoidable pressure injury assessment methods and assessment tools, discussed the limitations of the current differential assessment of unavoidable stress injury, and putted forward relevant suggestions to provide reference for the research on the assessment and prevention strategies of unavoidable pressure injury in China.
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Echinococcosis is mainly prevalent in the agricultural and pastoral areas in the northwest of China, but it is relatively rare in Hunan Province. Here, we reported the clinical data of a case of echinococcosis in Hunan Province. The patient was an 11-year-old male, who sought treatment at the Second Xiangya Hospital of Central South University due to abdominal mass. According to the symptoms, signs, and laboratory examinations, he was initially diagnosed as "intra-abdominal mass" and "spleen cyst". Subsequently, he underwent abdominal massive occupying resection and splenectomy. Postoperative pathological examination revealed the cuticle and germinal layer of hydatid and protoscolex, which was consistent with characteristics of echinococcosis. In addition, the serological examination showed that the specific anti-hydatid IgG antibody was positive. Combined with the patient's condition, he was given praziquantel treatment. After a month of follow-up, the patient was asymptomatic.
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Animals , Child , Humans , Male , China , Echinococcosis/surgery , Echinococcus granulosus , SplenectomyABSTRACT
Objective:To understand the level of discharge preparation of parents of premature infants in intensive care unit, and investigate the status of discharge preparation of parents of premature infants and its influencing factors.Methods:Convenient sampling was used to recruit the 202 parents of preterm infants who stayed in the neonatal intensive care unit in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May to December 2018. The characteristics questionnaire and the Chinese version of Readiness for Hospital Discharge Scale-Parent Form were used to collect data.Results:The total score of parents' readiness for discharge of premature infants ranged from 111 to 290 (222.28±34.81). Multiple linear stepwise regression analysis showed that birth gestational age, birth weight, parity, parents' gender, annual family income were the influencing factors of premature parents' discharge readiness( P<0.05). Conclusions:The parents of premature infants in NICU are not well prepared for discharge. Medical staff should pay more attention to premature infants with low birth age and weight, first-born parents and low-income parents, so as to improve the discharge guidance content, help them prepare for discharge in all aspects and improve their care ability after discharge.
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Objective:To summarize the treatments and outcomes of patients with chronic granulomatous disease (CGD), so as to improve the management of the disease and improve the quality of life of the patients.Methods:Clinical data of 82 children with CGD hospitalized at Children′s Hospital of Chongqing Medical University and born between January 1999 and December 2016 were collected.Patients were divided into the survival group and the death group.The general information, infectious events and inflammatory complications, as well as treatments and survival situations were analyzed.Results:Among the 82 cases, 55 cases (67.1%) were in the survival group and 27 cases (32.9%) were in the death group.Forty-nine (59.8%) cases developed manifestations in the neonatal period.Specifically, there was a statistically significant difference ( P<0.05) in the proportion of patients who deve-loped manifestations in the neonatal period between the death group (81.5%) and the survival group (49.1%). Fifty-eight (70.7%) cases started to receive Compound Sulfamethoxazole since diagnosis, with an average duration of 36.8 months.Fifty-two (63.4%) cases received Voriconazole or Itraconazole to prevent fungal infection, with an average duration of 34.3 months.There were 288 hospitalizations due to infections in total.The detection rate of bacteria, fungi and mycobacterium tuberculosis was 41.3%, and the rate in the death group (51.8%) was higher than that in the survival group (36.9%)( P<0.05). Klebsiella pneumoniae, Staphylococcus aureus, Burkholderia onion and Escherichia coli were the most frequent bacteria detected, among which Klebsiella pneumoniae and Escherichia coli were all exten-ded-spectrum β-lactamases positive.The use of advanced-antibiotics in the death group (70.4%) was higher than that in the survival group (40.0%) ( P<0.05). Seventeen (20.7%) cases developed inflammatory complications, mainly including interstitial lung disease or pulmonary fibrosis, inflammatory bowel disease and incomplete Kawasaki disease.Thirty-two (39.0%) cases received hematopoietic stem cell transplantation (HSCT), of which 25 patients (78.1%) were transplanted in Children′s Hospital of Chongqing Medical University, with a success rate of 96.0% (24/25 cases). The Kaplan-Meier survival curves showed a worse prognosis in those who developed manifestations in neonates, rely on advanced-antibiotics, and did not receive transplantations. Conclusions:The earlier the clinical manifestations appear, and the higher the utilization rate of advanced-antibiotics used, the more serious the condition is.Conservative treatment with drugs is still insufficient, and the emergence of drug-resistant bacteria increases the difficulty of managements.The recognition and treatments of inflammatory complications needs more explorations.HSCT is so far the only curative therapy for CGD in China.
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Objective@#To investigate the incidence of abnormal spinal curvature and related factors in primary and secondary school students in the Hongkou District of Shanghai, so as to provide evidence for abnormal spinal curvature prevention and treatment.@*Methods@#Using a stratified cluster random sampling method, 1 884 students of grade 4 to grade 12 from seven schools were investigated via questionnaires for abnormal spinal curvature in Hongkou District.@*Results@#The detectable rate of abnormal spinal curvature was 7.2%, The detectable rate of abnormal spinal curvature increased with increasing age(P<0.01): senior high school (15.7%) > vocational high school (8.1%) > junior high school (3.4%) > primary school(1.8%)(χ 2=91.24, P<0.01). The detectable rate of spinal curvature among female students was 8.6%, which was higher than that among male students(5.9%), and the difference was significant(χ 2=5.27, P<0.05). Multivariate Logistic regression analysis showed that the factors influencing abnormal spinal curvature included phase of studying, nutritional status and time spent engaged in outdoor activities every day(P<0.05).@*Conclusion@#Abnormal spinal curvature is one of the common conditions that endangers the health of children and adolescents. The collaboration of the school, students and parents is required to strengthen screening and prevention.
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Objective: to develop an integrative learning program for people with dementia. Method: a methodological study was conducted using Delphi technique to develop the learning program, followed by a feasibility test. An expert panel was invited to develop the integrative learning program based on the neuroplasticity and learning framework. A feasibility test was conducted to evaluate the implementation of the program in two centers after the training of personnel who run the program. Verbatim transcripts of case conferences were coded, analyzed, and collapsed into themes and sub-themes by consensus. Results: there was no indication for content modification during the period of program implementation. Qualitatively, the participating older adults showed improvement in communications, emotions, connectedness with self and others, and well-being. Conclusion: the integrative learning program was uneventfully implemented with promising results. The program is ready for full-scale research on its efficacy in multiple centers to obtain more robust evidence.
Objetivo: desarrollar un programa de aprendizaje integrador para personas con demencia. Método: se realizó un estudio metodológico empleando la técnica Delphi para desarrollar el programa de aprendizaje, seguida de una prueba de viabilidad. Se invitó a un panel de expertos a que desarrollara el programa de aprendizaje integrador sobre la base del marco de la neuroplasticidad y el aprendizaje. Se realizó una prueba de viabilidad para evaluar la implementación del programa en dos centros después de haber capacitado al personal que dirige el programa. Las transcripciones literales de los debates de casos se codificaron, analizaron y resumieron en temas y subtemas por medio de consenso. Resultados: no hubo ninguna indicación para modificar el contenido durante el período de implementación del programa. En forma cualitativa, los adultos mayores que participaron del programa evidenciaron mejoras en la comunicación, las emociones, la capacidad de conexión con ellos mismos y con los demás y el bienestar. Conclusión: el programa de aprendizaje integrador se implementó sin inconvenientes con resultados prometedores. El programa es apto para ser sometido a una investigación a gran escala con respecto a su eficacia en varios centros para obtener evidencia más sólida.
Objetivo: desenvolver um programa de aprendizagem integrativa para pessoas com demência. Método: foi realizado um estudo metodológico com a técnica Delphi para desenvolver o programa de aprendizagem, seguido de um teste de viabilidade. Um grupo de especialistas foi convidado para desenvolver o programa de aprendizagem integrativa com base no framework da neuroplasticidade e da aprendizagem. Um teste de viabilidade foi realizado para avaliar a implementação do programa em dois centros após treinamento do pessoal que dirige o programa. Transcrições literais de conferências de casos foram codificadas, analisadas e agrupadas em temas e subtemas por consenso. Resultados: não houve indicação de modificação de conteúdo durante o período de implementação do programa. Qualitativamente, os idosos participantes apresentaram melhora nas comunicações, emoções, conexão consigo e com os outros e bem-estar. Conclusão: o programa de aprendizagem integrativa foi implementado sem intercorrências com resultados promissores. O programa está adequado para ser submetido a pesquisas em grande escala relacionadas com sua eficácia em vários centros a fim de obter evidências mais robustas.
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Psychiatric Nursing , Nursing Methodology Research , Delphi Technique , Communication , Community Health Services , Dementia , Learning , Neuronal PlasticityABSTRACT
Objective To explore the differential diagnostic value of CEUS in salivary malignant and benign lesions. Methods Totally 87 lesions (including 74 benign lesions and 13 malignant lesions) underwent CEUS, then the degree of homogeneous, enhancement type, margin, rim and enlarged area were observed and analyzed respectively. In addition, the enhancement degree, type of enter-in and wash-out were analyzed according to the time-intensity curves of lesions and surrounding glands. The differences between benign and malignant lesions were compared. Results The enhancement degree, enhancement type, degree of homogeneous, type of wash-in and wash-out had no statistically significant differences between benign and malignant lesions (all P≥0.05), while the enhancement margin, rim and enlarged enhancement area showed statistically significant differences between them (all P<0.01). Combining the latter three features, the differential diagnostic sensitivity, specificity and accuracy was 84.62% (11/13), 95.95% (71/74) and 94.25% (82/87), respectively. Conclusion The absent enhancement rim, ill-defined margin and enlarged enhancement area are features of salivary malignant lesions, and combining all of them has the great differentiated diagnostic efficacy to salivary malignant lesions.
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Objective To observe the effect of enteral nutrition emulsion (fresubin diabetes) on inflammatory factors and prognosis in patients with diabetes and mechanical ventilation (MV). Methods Sixty-six patients with diabetes and MV admitted to Lishui Hospital of Traditional Chinese Medicine from June 2014 to December 2016 were enrolled, and they were divided into an observation group and a control group according to random number table, 33 cases in each group. Active treatment of the primary disease, maintenance of water and electrolyte balance, active control of infection, protamine biosynthesis of human insulin injection to control blood glucose and other treatment were given to both groups. After 24 hours of MV, enteral nutrition suspension (nutrison fibre) was evenly dripped into the control group through a nasogastric tube, and fresubin diabetes was evenly dripped with the same method as above into the observation group. After treatment for 2 weeks, the average values of daily blood glucose, of blood glucose fluctuation and daily total insulin dosage of two groups were calculated; the differences in procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and serum albumin (ALB), prealbumin (PA) and transferrin (TF) were compared before and after treatment in the two groups; the duration of MV, stay time in ICU, and 2-week MV withdrawal rate were observed in the two groups. Results During nutritional therapy, there was no significant difference in the average daily blood glucose level between observation group and control group (mmol/L: 8.62±2.65 vs. 9.70±3.43, P > 0.05), however, in the observation group, the average daily blood glucose fluctuation value (mmol/L: 3.13±1.09 vs. 5.68±1.40), and the daily total insulin dosage (U/d: 31.93±4.93 vs. 43.50±5.31) were significantly lower than those of the control group (both P < 0.05). After treatment, PCT and hs-CRP in both groups were significantly lower than those before treatment, and the degrees of decrease in observation group were more significant than those in the control group [PCT (μg/L):2.81±1.03 vs. 5.95±1.57, hs-CRP (mg/L): 4.41±2.01 vs. 11.46±4.05, all P < 0.05]. After treatment, the levels of ALB, PA and TF were significantly higher than those before treatment [ALB (g/L): the control group was 37.98±3.49 vs. 30.50±3.44, the observation group was 37.88±3.47 vs. 30.48±3.34; PA (mg/L): the control group was 188.60±12.66 vs. 130.22±11.33, the observation group was 184.42±12.95 and 133.50±11.91; TF (mg/L): the control group was 2.71±1.01 vs. 2.07±0.86, the observation group was 2.69±1.02 vs. 2.08±0.90, all P < 0.05]; however, there were no statistical significant differences between the two groups (all P > 0.05). The MV time (days: 7.29±3.65 vs. 10.70±4.43) and ICU stay (days: 11.13±3.09 vs. 15.48±4.40) in the observation group were significantly lower than those in the control group (both P < 0.05), and 2-week MV withdrawal rate was significantly higher than that of the control group [69.70% (23/33) vs. 39.39% (13/33), P < 0.05]. Conclusion Fresubin diabetes can meet the nutritional needs of diabetic patients with MV, in the aspects of controlling blood sugar, maintaining stable blood sugar levels and reducing inflammation, the therapeutic effect of fresubin diabetes is better than that of nutrison fibre, thus fresubin diabetes may better improve the prognosis of patients with diabetes.
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Objective To investigate the factors influencing hepatitis B virus (HBV) reactivation in patients with HBV-related liver cancer after receiving transarterial chemoembolization (TACE) in order to prevent HBV reactivation and liver function damage, and to improve the clinical ways and means of TACE to provide reliable basis for the further improvement of curative effect. Methods A total of 80 patients with HBV-related liver cancer, who were admitted to authors' hospital during the period from January 2015 to August 2016, were collected. The gender, age, preoperative liver function classification, preoperative HBV DNA load, portal vein tumor thrombus, number of tumor lesions, the amount of used gelatin sponge, the amount of used microsphere, and the amount of lipiodol used in operation, etc. were recorded, and the results were statistically analyzed. Results Single factor analysis showed that higher preoperative HBV DNA load, the large amount of lipiodol used in operation and the presence of portal vein tumor thrombus were significantly related to the reactivation of HBV, but other factors had no significant relationship with the reactivation of HBV. Multivariate analysis indicated that higher preoperative HBV DNA load and the used dosage of lipiodol in operation >10 ml were the greatest risk factors for reactivation of HBV. Conclusion Reactivation of HBV in patients with HBV-related liver cancer can be induced by TACE, especially in the patients who have higher preoperative HBV DNA load and portal vein tumor thrombus, and also in whom the dosage of lipiodol used in operation is larger. Therefore, in order to prevent HBV reactivation and liver function injury the indications and contraindications of TACE should be strictly observed, the active antiviral therapy should be adopted before and after TACE, and the amount of lipiodol should be strictly controlled during the operation.
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Objective To investigate the characteristics and risk factors of pressure injuries in patients admitted to the pediatric intensive care unit(PICU).Methods Totally 302 PICU patients were recruited from five tertiary general hospitals from December 2016 to April 2017.Data about the characteristics of the patients(demographic and clinical data),the assessment and characteristics of pressure injuries were collected and analyzed.Results The prevalence of pressure injuries in pediatric patients was 16.23％,in which 40.82％ were related to medical devices,and 81.63％ of the patients had grade 1 injury.The most commonly affected site was head and face(64.40％),followed by sacrococcygeal region(10.17％),heels(8.47％) and ankles(8.47％).The prevalence of pressure injuries was different among different diseases.Patients with pressure injuries were usually accompanied by serious condition,disturbance of consciousness,mechanical ventilation,surgical procedure,frequent use of medical devices and with low Braden Q scores.Conclusion Patients in PICU are high risk group,the key to prevent pressure injuries is early identification of risk factors and timely intervention.Clinical nurses should identify its characteristics timely and take corresponding protective measures.
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Aim To explore the effect of Cx43 over-expression on proliferation of C6 cells and its mechanisms by transfecting pCMV-Cx43cDNA plasmid into C6 cells.Methods pCMV-Cx43cDNA plasmid was transfected into C6 cells by liposome to up-regulate the expression of Cx43, and C6 cells with over-expression of Cx43 was stably cloned by using G418.Determination of cell doubling time and soft agar colony formation assay to detect the degree of cell proliferation.The cells were treated with ERK1/2 specific blocker PD98059(30 μmol·L-1) and p38MAPK specific blocker SB202190(10 μmol·L-1)respectively, the expression of Cx43, p-Cx43, p-ERK1/2 and p-p38MAPK of each group were detected by Western blot, and the activity of each group was detected by MTT Assay.Results pCMV-Cx43cDNA plasmid was transfected into C6 cells successfully.Cell lines with over-expression Cx43(C6-Cx43) or empty vector (C6-pCMV) were stably selected by using G418.Determination of cell doubling time and soft agar colony formation experiments showed that the proliferative rate and the colony number of C6-Cx43 group were significantly decreased, compared with that of C6 group and C6-pCMV group(P<0.01);ERK1/2, p38MAPK specific blockers were treated with each group,Western blot showed that the expression of Cx43 protein was increased(P<0.01), while p-Cx43 protein was decreased (P<0.05) in C6-Cx43+PD98059 group and C6-Cx43+SB202190 group,compared with that of C6-Cx43 group.Conclusion Cx43 may decrease the proliferation of glioma cells through ERK1/2, p38MAPK pathways.
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Objective To analyze the influence factors of maintenance dialysis patients with carotid plaque and explore its relationship with cardiovascular disease(CVD). Methods 52 patients on peritoneal dialy-sis and 46 patients on maintenance hemodialysis were involved in this study. Bilateral carotid intima-media thick-ness(IMT)and plaque,the related clinical indicators and CVD were recorded. According to the mode of dialysis, carotid plaque,CVD respectively,we divided our population into two groups,and statistical analyses were made between the two groups. Results Age,percentage of male,the number of hypertension and diabetes,blood uric acid ,blood glucose ,the incidence of cardiovascular disease are higher ,but the level of albumin is lower in the carotid plaque group. Binary Logistic Regression analysis showed that hypertension ,albumin and uric acid signifi-cantly influenced carotid plaque formation (P < 0.05). CVD is closely related to the carotid plaque (r = 0.415 , P = 0.000). Left and right IMT value are higher in the patients with CVD (P < 0.01);carotid plaque mainly distributed in the common carotid artery(CCA)and carotid artery bifurcation(BIF),and with the larger number in the patients with CVD(P<0.01). Conclusions Carotid plaque formation is closely related with the occurrence of CVD in maintenance dialysis patients. Hypertension ,albumin and uric acid are risk factors for the formation of carotid plaque,so dialysis patients in addition to maintain the blood pressure and improve nutrition,are also very important to control the level of uric acid.
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Objective To study the effect of acupuncture on the ratio of CD4+ CD25+ regulatory T cells and expression of transcription factor Foxp3 in patients with septic shock.Methods Sixty-four patients with septic shock were randomly divided into two groups by using the random number table method.Acupuncture group (34 cases) was treated with both western medicine and acupuncture,and control group(30 cases) was treated with western medicine.The period of treatment was 7 days.After treatment,the ratio of CD4+ CD25+ T cells in peripheral blood was determined by flow cytometry.And the expression of Foxp3 mRNA in peripheral blood was detected by quantitative real time PCR.Results After treating for 7 days,the ratios of CD4+ CD25+ Treg cells and CD4+ CD25+ Foxp3 + Treg cells were (20.23 ± 1.12) ％ and (78.70 ± 7.65) ％ respectively in peripheral blood of the control group,which in the acupuncture groupwere (17.32 ± 0.78) ％ and (68.53 ± 8.01) ％,the differences were statistically significant between the two groups(t =2.587,2.749,all P ＜ 0.05).The levels of Foxp3 mRNA in peripheral blood were (1.21 ±0.02) and (1.02 ± 0.04) in the control group and acupuncture group,the difference was statistically significant(t =2.119,P ＜ 0.05).Conclusion Acupuncture can adjust immune status of patients with septic shock by reducing the ratio of CD4+ CD25+ Treg cells and down-regulating the expression of Foxp3 mRNA.
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AIM:To explore the role of Bcl-2 and PCNA expression in the injury of rat myoblasts induced by hydrogen peroxide (H2O2).METHODS:Rat myoblasts at growth phase were divided into 4 groups based on basic fibroblast growth factor (bFGF) and H2O2 levels:normal control group, bFGF group, model group (H2O2 group) and treatment group (bFGF+H2O2 group).The expression of Bcl-2 and Bax was observed by immunohistochemistry and fluorescence methods.The protein levels of Bax, Bcl-2 and PCNA were determined by Western blot.RESULTS:Compared with model group, both immunofuorescence and fluorescence in treatment group showed enhanced Bcl-2 and low expression of Bax.Furthermore, the results of Western blot showed up-regulated PCNA and Bcl-2 protein and decreased Bax expression in treatment group.CONCLUSION:Oxidative stress results in the pathologic changes of myoblasts, and the up-regulation of Bcl-2 and PCNA may attenuate myoblast injury.
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Objective To analyze the clinical feature of X-linked chronic granulomatous disease (X-CGD) and gene mutation of CYBB. Method The clinical data of X-CGD in one child and the results of CYBB gene detection in his family were reviewed. Results This boy had onset in the neonatal period and presented with recurrent severe pulmonary infection as his main manifestation. Results of nitroblue tetrazolium test (NBT) in both non-stimulation group and LPS stimulation group in the child were 0, and neutrophil oxidation index (NOI) was 1.15. Gene analysis showed a deletion mutation in exon 6 of CYBB gene in the child (579-582delATTA), which resulted in frameshift mutation started from coding sequence of 189—isoleucine (I) and stop codon occured in advance in the 212th amino acid (I189fsX212). Both the child's mother and grandmother were carriers of the mutated gene. The same deletion mutation was not found in the CYBB gene in the amniocyte from the mother's next child. Conclusion One case of X-CGD patient with CYBB gene mutation and his families were diagnosed by gene detection. Prenatal diagnosis can avoid the birth of children with X-CGD.
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Objective To get the information about the geriatric syndromes in the elderly with different age and gender so as to provide the basis for management of the geriatric syndromes.Methods A questionnaire survey was used to investigate and analyze the geriatric syndromes in 2 778 older subjects aged 60 years and above from Zhejiang and Jiangsu province.Results Among all 2 778 old adults,(3.4 ± 1.8)geriatric syndromes in average were found.The difference in geriatric syndromes number between different age groups showed a statistical significance(F =145.135,P＜ 0.001),but a significant difference in geriatric syndromes number between male and female group was not found(t=0.817,P=0.414).On the top incidence rate of geriatric syndromes were daily life ability defects 2 199 cases(79.2％),falls 1 828 cases(65.8％),urinary incontinence 1 356 cases(48.8％),sleeping disorder 1 023 cases(36.8 ％),cognitive impairment 908 cases (32.7 ％) and visual impairment 896 cases (32.3 ％).Among above six geriatric syndromes,the incidence of daily life ability defects,falls,urinary incontinence,sleeping disorder and cognitive impairment seemed to increase with ageing (P＜0.001).The incidence of daily life ability defects,falls and urinary incontinence was higher in males than in females (P＜ 0.05).The incidence of sleeping disorder and cognitive impairment was higher in females than in males(P＜0.05).The elderly patients with 3 or more geriatric syndromes exceeded about 66.4 ％.The most common clusters of geriatric syndromes were daily life ability defects combined with falls and urinary incontinence,which seemed to significantly increase along with ageing (x2=202.523,P＜0.001).Conclusions Geriatric syndromes are common in the elderly,medical care workers should pay attention to the management of the geriatric syndromes,and promote the development of the elderly healthcare.
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To adapt to the new challenge of nutrition and food safety as well as to cultivate talents with capacity of innovation and practical application, Dalian Medical University starts to explore a wide range of experimental teaching system:expanding classical confirmatory experiment, offering comprehensive and designing experiment , encouraging students to participate in scientific research , building Internet teaching platform, and initiating community practice service projects. Multiple dimensional and teaching patterns contribute to strengthen basic skills, interest in scientific research, innovation consciousness and practical ability of undergraduate students, which greatly improves their consciousness of social service and responsibility and helps to cultivate the practical professional talents.
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Objective To explore the effect of chromofungin (CHR), a chromogranin A (CGA) derived peptide CGA47-66, on hyper-permeability of blood brain barrier in septic mice. Methods 120 healthy male C57BL/6 mice were randomly divided into groups, with 12 mice in each group. Seventy-two mice were used for dynamic observation of the contents of water and Evan blue (EB) in brain tissue after being treated with lipopolysaccharide (LPS). Another 48 mice were divided into normal saline control group (NS group), LPS induced sepsis model group (LPS group), low-dose CHR pretreatment group (CL+LPS group), and high-dose CHR pretreatment group (CH+LPS group). The septic model was reproduced by intraperitoneal injection of 10 mg/kg LPS 0.1 mL, and the mice in NS group was given equal volume of normal saline. The mice in CL+LPS group and CH+LPS group were intraperitoneally injected with 15.5 μg/kg and 77.5 μg/kg CHR 10 minutes before LPS injection. Six hours after LPS injection, 4 mL/kg of 2% EB was injected via caudal vein, the contents of water and EB in brain tissue were determined, and EB immune fluorescence in brain tissue was determined to assess the changes in permeability of blood brain barrier. Brain pathology was observed with hematoxylin and eosin (HE) staining. Results With the extension of time after LPS injection, the contents of water and EB in brain tissue were gradually increased, and the time of difference with statistical significance appeared earlier when compared with that of control group in the contents of water than that in EB contents (3 hours and 6 hours, respectively). The contents of water and EB in brain tissue in LPS group were significantly increased as compared with NS group [water content: (79.77±0.62)% vs. (78.28±0.44)%, P < 0.01; EB content (μg/g): 13.87±4.50 vs. 7.13±1.76, P < 0.05]. CHR pretreatment with either of two dosages could reverse the increase in water and EB contents in brain tissue induced by LPS, and the effect was more significant in CH+LPS group [water content: (78.15±0.73)% vs. (79.77±0.62)%, EB (μg/g): 7.09±2.59 vs. 13.87±4.50, both P < 0.05]. It was shown by EB fluorescence observation that the fluorescence signal displayed only in the meninges in NS group, and EB fluorescence was widely distributed in brain parenchyma in LPS group, indicating that the EB leakage in LPS group was more marked than that of NS group. In CHR pretreatment groups, EB fluorescence was decreased in brain parenchyma, indicating that EB leakage was significantly less marked, while it was more obvious in high dose CHR group. It was shown by HE staining that cerebral blood vessel structure was intact in NS group, and the gap around blood vessel was not significant increased. On the other hand, brain structure in LPS group appeared loose, with widening of small perivascular spaces and obvious edema. Brain edema in CHR pretreatment groups was improved as compared with that of the LPS group, and it was more apparent in high dose CHR group. Conclusions LPS induced change in blood brain barrier permeability in mice in a time-dependent manner. Exogenous CGA derived peptides CHR can inhibit LPS induced hyper-permeability of blood brain barrier in septic mice, thus reduces brain edema, protects the brain tissue, and the effect is more obvious with a high dose of CHR (77.5 μg/kg).