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Objective:To investigate the clinical efficacy of modified Guipi Decoction combined with omeprazole in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB) with failure of the spleen to control blood vessels syndrome.Methods:Prospective cohort study. A total of 120 patients from January 2018 to December 2021 Taihe County Hospital of Traditional Chinese Medicine with ANVUGIB of failure of the spleen to control blood vessels syndrome were selected, and the patients were divided into observation group and control group according to the random number table method, with 60 cases in each group. The control group was treated with a large dosage of proton pump inhibitor (omeprazole injection was injected intravenously first, and then omeprazole enteric coated tablets were taken); the observation group took Guipi Decoction on the basis of the control group, and both groups were treated for 7 days. TCM syndrome score, Hemoglobin (Hb) and hematocrit (HCT) levels were measured by colorimetry before and after the treatment. BUN was detected by urease glutamate dehydrogenase method. Prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) levels were detected by immunoturbidimetry. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:Two patients in the observation group and two patients in the control group dropped out of the study. After treatment, the scores of main symptoms, secondary symptoms and total scores in the observation group were lower than those in the control group ( t values were respectively 10.73, 4.45, 7.98, P<0.05). After treatment, the levels of HCT [(41.25 ± 5.03)% vs. (38.19 ± 5.26)%, t=2.95], Hb [(81.09 ± 5.23) g/L vs. (78.39 ± 5.37) g/L, t=2.74] in the observation group were higher than those in the control group ( P<0.01), and BUN [(4.38±0.96) mmol/L vs. (5.39 ± 1.13) mmol/L, t=5.19] was lower than that in the control group ( P<0.01); PT [(12.48 ± 0.67) s vs. (13.22 ± 0.73) s, t=5.69], APTT [(24.66 ± 2.29) s vs. (27.78 ± 2.04) s, t=7.75] were lower than those in the control group ( P<0.01), and FIB [(3.68 ± 0.62) g/L vs. (3.41 ± 0.74) g/L, t=2.13] level was higher than that in the control group ( P<0.05). The total effective rate of the observation group was 93.1% (54/58), and that of the control group was 79.3% (46/58), with statistical significance ( χ2=4.64, P=0.031). During the treatment, the incidence of adverse reactions in the control group was 3.4% (2/58), while that in the observation group was 1.7% (1/58), without statistical significance ( χ2=0.34, P=0.559). Conclusion:High-dosage omeprazole treatment with the addition of internal administration of Guipi Decoction can significantly improve coagulation function, correct the signs and symptoms associated with insufficient blood volume in the body circulation, improve hemostatic efficiency, and reduce the risk of bleeding in patients with ANVUGIB, without increasing the risk of patient safety with the drug.
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Objective:To evaluate the clinical efficacy of cannulated screws with sutures in the treatment of patellar transverse fractures.Methods:A retrospective analysis was performed of the data of 70 patients with patellar transverse fracture who had been admitted to Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital from January 2017 to March 2021. According to the construction methods for the tension band, the patients were divided into 3 groups. In group A of 21 cases subjected to fixation with cannulated screws with sutures (Fiber-Tape), there were 8 males and 13 females with a median age of 55.0 (48.0, 65.0) years; in group B of 32 cases subjected to fixation with Kirschner wire tension band, there were 15 males and 17 females with a median age of 52.5 (41.5, 63.0) years; in group C of 17 cases subjected to fixation with Cable-Pin system, there were 5 males and 12 females with a median age of 55.0 (37.0, 65.0) years. The 3 groups were compared in terms of complications, secondary surgery (removal of internal fixation), operation time, intraoperative blood loss and knee function rated by the Lysholm and B?stman scores at the last follow-up.Results:There were no significant differences in the preoperative general data between the 3 groups, showing they were comparable ( P > 0.05). There was no significant difference in the operation time, intraoperative blood transfusion or follow-up time among the 3 groups ( P > 0.05). The incidence of soft tissue irritation [4.8% (1/21)] and the secondary operation rate [4.8% (1/21)] in group A were significantly lower than those in group B [43.8% (14/32) and 37.5% (12/32)] and group C [41.2% (7/17) and 35.3% (6/17)] ( P < 0.05), but there was no statistically significant difference between group B and group C ( P > 0.05). In groups A, B and C, respectively, the Lysholm knee score was 84.0 (69.0, 88.0), 89.0 (71.5, 95.0) and 82.0 (63.0, 90.0), and the B?stman knee score 26.0 (23.0, 28.0), 26.5 (24.0, 27.5) and 26.0 (22.0, 28.0), showing no significant difference ( P > 0.05). There was no significant difference either in the incidence of other complications among the 3 groups ( P > 0.05). Conclusion:In the treatment of patellar transverse fractures, compared with the Kirschner wire tension band and Cable-Pin system, cannulated screws with sutures (Fiber-Tape) may lead to a lower incidence of soft tissue irritation and a lower rate of secondary surgery, but no significant differences in operation time, intraoperative blood loss, other complications or postoperative functional scores.
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BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.
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Adult , Humans , Male , Middle Aged , Blood Pressure/physiology , China/epidemiology , Follow-Up Studies , Hypertension , Risk Factors , StrokeABSTRACT
Arsenic is a systemic poison ubiquitously distributed in the nature. Long-term arsenic exposure can lead to a variety of cancers. Oxidative stress is a well-recognized mechanism underlying arsenic carcinogenesis. Nuclear factor E2-related factor 2 (Nrf2) is a key transcription factor in cellular antioxidant defense. However, accumulating evidences suggest that environmental arsenic exposure may cause and promote arsenic-related cancers through Nrf2-mediated adaptive antioxidant response, which constitutively induces the expression of antioxidant enzymes and detoxification enzymes and confers survival advantage to the cell under stress. Therefore, elucidating the role of Nrf2 and its medicated antioxidant response in arsenic carcinogenesis is vital to prevention and treatment of cancers related to arsenic exposure.
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OBJECTIVE To discuss the best scheme for fungemia detection by analyzing and comparing the ability and performance characteristics of the BACTEC 9120 automated blood culture system and 4 kinds of blood culture bottles in the detection of simulated fungemia.METHODS Simulated blood culture was produced using 65 fungi isolates from clinical specimens and BACTEC Plus Aerobic/F,Plus Anaerobic/F,Peds Plus/F and Myco/F Lytic blood culture bottles and detected by BACTEC 9120 automated blood culture system.The final inoculum densities were 1-5 CFU/ml blood.The(time to detection TTD) of simulated blood culture with different concentrations of suspension produced using 2 kinds of standard strains and 4 kinds of blood culture bottles was compared.RESULTS From the 260 bottles in this study 216 had growth detected by the BACTEC 9120 blood culture system.The positive rates of BACTEC Plus Aerobic/F and Anaerobic/F,which were 90.77%and 41.54%,respectively,were significantly(P
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TraumaistheNo .1causeofdeathinpersonsundertheageof 4 5andtheNo .3causeof alldeaths .Manytraumapatientsdieofmultipleorganfailure(MOF) ,inducedbysystemicinflammatoryre sponsesyndrome(SIRS) .Thispaperreviewstherelationsoftraumaticshockwithsystemicinflammation . [
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AIM:To investigate the role of peripheral blood leukocytes and polymorphonuclear neutrophils (PMNs) on intestinal injury following mesenteric ischemia/reperfusion (IR) in rats. METHODS: Twenty adult, male Sprague-Dawley rats, weighing 200-230 g, were randomly divided into two groups. The control group (CON) consisting of 10 rats was subjected to laparotomy and separation of superior mesenteric artery (SMA) only. The ischemia/reperfusion (IR) group consisting of 10 rats, was subjected to laparotomy, followed by occlusion of the superior mesenteric artery (SMA) by an atraumatic microvascular clamp for 30 min. At the end of ischemic period in IR, the microvascular clamp was removed and the intestinal segment was reperfused for 60 min. The pathological changes of the ileal mucosal tissue were evaluated. The apoptosis of intestinal mucosal epithelial cells was examined by terminal deoxylnucleotidy-l transferase mediated-dUTP nick end-labeling (TUNEL). The enzymatic activity of casapse-3 in mucosal cells was determined using a colorimetric assay. The percentages of apoptotic peripheral blood leukocytes and PMNs were measured by flow cytometry using Annexin-V/PI double staining assay. The numbers of peripheral blood leukocytes in each animal was measured at baseline, 30 min of ischemia, and 30 min and 60 min of reperfusion. RESULTS: (1) Compared to CON group animals, the most severe mucosal injury was observed in IR group under optical microscope. (2) The number of apoptotic mucosal epithelia cells and enzymatic activity of caspase-3 were significantly higher in IR than those in CON group (P
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Objective: To clone human augmenter of liver regeneration (hALR) cDNA, construct the recombinant expression vector, express and purify its product. Methods: The hALR cDNA was obtained by using RT PCR method with total RNA extracted from the fetal hepatic tissue. Then it was cloned into the pGEM T vector, and subcloned into expression vector pGEX 4T 3.After proved to be correct by sequencing, recombinant expression plasmid pGEX 4T 3(hALR) was transformed into E.coli BL21(DE3). The fusion protein GST hALR was produced by IPTG induction, isolated by affinity chromatography glutathione Sepharose 4B and cleaved by Thrombin. Results and Conclusion: Recombinant expression plasmid pGEX 4T 3(hALR) is constructed. The hALR is highly expressed in E.coli . The fusion protein in the plasma is resoluble. The procedure of purification and cleavage of fusion protein is easy and simple.