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Objective:To investigate the diagnostic and early-warning value of laboratory test indicators for sepsis-induced myocardial injury (SIMD).Methods:The clinical data of 183 patients with sepsis admitted to the Department of Emergency and Critical Care Medicine of Guangdong Provincial People's Hospital from August 2016 to October 2020 were collected. The patient's age, gender, past medical history, vital signs and pathogen culture results were extracted. Cardiac function, blood routine, liver function, renal function, inflammatory factors, coagulation function, APACHE Ⅱ and SOFA scores were recorded at enrollment and 72 h after admission. SIMD was defined as cTnT ≥300 pg/mL and NT-proBNP ≥1243 pg/mL twice in 72 h intervals between enrolled cases, and the early-warning factors of patients with SIMD were analyzed. The differences in various indicators between the two groups were compared, and Logistic regression analysis was used to explore the diagnostic efficacy of cTnT and NT-proBNP combined for SIMD, and the correlation between PCT/PLT ratio and the occurrence of SIMD.Results:Among 250 patients, 67 patients were excluded for lack of the main indicators, and 183 patients (including 62 patients with history of cardiac disease) were enrolled finally. Among 183 patients with sepsis, 105 patients (57.38%) with cTNT ≥300 pg/mL and NT-proBNP ≥1 243 pg/mL, were diagnosed as myocardial injury; after excluding 62 patients with history of cardiac disease, 59 patients (48.76%) with cTNT ≥300 pg/mL and NT-proBNP ≥1 243 pg/mL were diagnosed as myocardial injury. Logistic regression analysis showed that increased PCT/PLT ratio ( OR=1.585, 95% CI: 1.124-2.237, P=0.009) was an independent risk factor for early-warning of SIMD. The PCT/PLT ratio ( OR= 1.850, 95% CI: 1.103-3.102, P=0.020) could stably predict the occurrence of SIMD in patients without previous history of heart disease. ROC curve analysis showed that PCT/PLT ratio could effectively predict the occurrence of SIMD (AUC=0.693, 95% CI: 0.617-0.769, P<0.001), the optimal cut-off value was 0.177 (sensitivity: 65.7%, specificity: 66.7%). The PCT/PLT ratio was still effective in predicting the occurrence of SIMD after excluding patients with previous history of heart disease (AUC=0.733, 95% CI: 0.643-0.823, P<0.001), and the optimal cut-off value was 0.429 (sensitivity: 55.9%, specificity: 83.9%). Conclusions:The combination of cTnT and NT-proBNP has certain diagnostic value for SIMD, and the PCT/PLT ratio could warn the occurrence of SIMD.
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Objective:To explore the change of blood-brain barrier (BBB) permeability in septic rats.Methods:A rat model of sepsis was established by cecal ligation and puncture. Rats were randomly (random number) grouped according to the intervention time: sham-operated group, sepsis 1-day group, sepsis 4-day group, and sepsis 7-day group. Fluorescein sodium was used to test the permeability of the BBB. Western blot and immunofluorescence methods were applied to detect the expression of tight junction proteins including Claudin-5, Occludin and ZO-1.Results:Compared with the sham-operated group, rats in the sepsis group presented quick breath, slow response, decreased intake of food and water, obvious abdominal distension and loose stools. After abdominal anatomy of sepsis rats, we found mesenteric adhesions, dilatation of proximal intestinal, black cecum ligation site with purulent exudate, enlarged liver and diffused bloody exudate. Compared with the sham-operated group, body weight of sepsis rats was reduced remarkably ( P < 0.05). The body weight of rats of sepsis 7-day group was the lowest, which was significantly lower than that of rats of sepsis 4-day group ( P< 0.05) and 1-day group ( P< 0.05). Compared with the sham-operated group, the content of fluorescein sodium in sepsis 1-day rats was increased remarkably ( P< 0.05). The content of fluorescein sodium in rats of sepsis 7-day group was the highest, which was significantly higher than that in rats of sepsis 4-day group ( P< 0.05) and 1-day group ( P< 0.05). Compared with the sham-operated rats, the expression of Claudin-5, Occludin and ZO-1 in sepsis rats were decreased remarkably (all P < 0.05). The expression of Claudin-5, Occludin and ZO-1 were the lowest in rats of the sepsis 7-day group, which were significantly decreased than those of rats in the sepsis 4-day group (all P< 0.05) and rats in sepsis 1-day group (all P < 0.05). Conclusions:Sepsis rats showed increased permeability of the BBB, and the permeability of BBB increased continuously along with the duration of sepsis.
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Objective To compare the clinical evaluation in diagnosis of thyroid nodules between fine needle aspiration(FNA) and core needle biopsy(CNB).Methods 82 cases with thyroid nodules undergoing FNA and 33 cases with thyroid nodules undergoing CNB were selected.Cytology,histopathology,and postoperative results were compared with postoperative pathology as the gold standard.Results The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate,false negative rate of FNA and CNB were 91.5％ vs 87.9％,93.2％ vs 87.5％,87.0％ vs 88.9％,94.8％ vs 95.5％,83.3％ vs 72.7％,13.0％ vs 11.1％,6.8％ vs 12.5％,respectively.There was no significant difference between FNA and CNB (P＞0.05).Conclusion Both of FNA and CNB examination show high accuracy,sensitivity and specificity in diagnosis of benign and malignant thyroid nodules,but FNA is more economical,safe,convenient and thus has more extensive clinical application.For lymphoma or borderline tumor,CNB examination combined with immunohistochemistry is of more advantages.
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Under the guidance of meridian theory, the acupoints heat-sensitive moxibustion is a treatment method which applies moxa stick to perform mild moxibustion at heat-sensitive acupoints, which can arouse the meridian sensation transmission and promote the movement of meridian qi; consequently, the qi can be extended to the diseases. For its many advantages, such as no direct contact on skin, no injuries, no pains, fewer side effects, easy operating and moderate cost, the acupoints heat-sensitive moxibustion is widely accepted in dermatology, male urology disease, rectum and anus diseases and breast diseases. The application and research status of the acupoints heat-sensitive moxibustion in traditional Chinese surgery in recent years is reviewed, and several problems and suggestions in its clinical application and research are proposed, aiming to provide clinical basis for its further development and clinical application in traditional Chinese surgery.
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Humans , Acupuncture Points , Clinical Trials as Topic , General Surgery , Moxibustion , SensationABSTRACT
OBJECTIVE:To systematically review the clinical efficacy of Tibolone tablet in the treatment of senile vaginitis, and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Medline,CJFD,CBM,VIP and Wangfang Database,randomized controlled trials(RCT)about Tibolone tablet in the treatment of senile vaginitis were collct-ed. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation. RESULTS:Totally 10 RCTs were enrolled,involving 909 patients. Results of Meta-analysis showed Tibolone tablet can significantly improve the cure rate of senile vaginitis [RR=1.46,95%CI(1.32,1.61),P<0.001],maturation vaginal cell index score [SMD=1.83,95%CI(1.65, 2.01),P<0.001] and vaginal health score [SMD=1.56,95%CI(1.21,1.92),P<0.001],reduce recurrence rate [RR=0.07,95%CI (0.02,0.18),P<0.001] and vaginitis score [SMD=-1.44,95%CI(-1.79,-1.08),P<0.001]. CONCLUSIONS:Tibolone tablet has good clinical efficacy in the treatment of senile vaginitis,it can improve the vaginal mucosa estrogen and vaginal environment, reduce recurrence rate.
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Objective To study the etiological agent of hand, foot and mouth disease ( HFMD) and the genetic characteristics of coxsackievirus A16 ( CVA16 ) strains isolated from clinical specimens of patients with HFMD in Liaocheng city in 2013.Methods Throat swab and stool specimens were collected from patients with HFMD in the disease surveillance hospitals in Liaocheng city from January to December 2013.Samples pos-itive for CVA16 strains were screened out for the isolation of virus strains with rhabdomyosarcoma ( RD) cells and Vero cells.The entire VP1 coding regions of 9 randomly selected CVA16 isolates were amplified and se-quenced.BioEdit and MEGA4 softwares were used for homology analysis.A phylogenetic tree among the 9 CVA16 isolates and 56 CVA16 representative strains of known genotypes and subgenotypes was constructed.Re-sults The results of PCR analysis showed that 747(77.73%) out of 961 specimens were positive for HFMD and among them, 74 samples (9.91%) were positive for EV71 strains, 130(17.40%) were CVA16 strains and 543(72.69%) were other enterovirus strains.The 9 CVA16 strains clustered into the B2b evolution branch of B genotype with the representative strains, sharing 97.7%to 100%homologies in nucleotide sequences and 99.3%to 100%in amino acid sequences.Conclusion Although EV71 and CVA16 strains were identified, other enteric viruses were the predominant pathogens causing HFMD in Liaocheng city in 2013.The CVA16 iso-lates belonged to B2b subgenotype.The pathogen spectrum of HFMD had already changed.It is necessary to strengthen the surveillance for EV71, CVA16 and other enteric viruses and understand their genetic characteriza-tions, which would be of great significance for the prevention and control of HFMD.
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BACKGROUND:In recent years, many drugs emerge to control tooth movement, and scholars in China begin to investigate Chinese herbs with moderate nature and smal adverse reaction. OBJECTIVE:To observe the relapse after orthodontic tooth movement, osteoprotegerin and osteoclast differentiation factor expression in periodontal tissue after rats were treated with local tanshinone type IIA at different doses. METHODS:A total of 48 male Wistar rats were randomly divided into four groups:control, low dose (tanshinone type IIA 0.36 mg/d), medium dose (tanshinone type IIA 0.72 mg/d), and high dose (tanshinone type IIA 1.44 mg/d) groups. Taking anterior teeth as the anchorage, the maxil ary first molar of rats was tracted to mesial movement. In experimental groups, gingival mucosa of the first molar was local injected with tanshinone type IIA 1 day before the force device was removed, while control group was injected with physiological saline, once a day, for 4 weeks. Immediately, 1 week, and 4 weeks after the force device was removed, the distance between the maxil ary first molar and second molar was measured and body mass was weighted. The animals were kil ed after 4 weeks, osteoprotegerin and osteoclast differentiation factor expression in maxil ary first molar and periodontal tissue were determined using immunohistochemical staining. RESULTS AND CONCLUSION:There was no obvious change in the body weight of rats in each group (P>0.05). In low, medium and high dose groups, recurrent distance of the teeth was shorter than that in control group (P smal er the degree of recurrence was. Osteoprotegerin expression in the periodontal tissue was significantly higher in the experimental groups than the control group (P<0.05), while osteoclast differentiation factor expression was significantly lower than the control group (P<0.05). The ratio of osteoprotegerin/osteoclast differentiation factor in the periodontal tissue was greater than 1 in both control group and experimental groups, and reached the peak in the high dose group. Local delivery of tanshinone type IIA has no impact on body weight of normal rats, and can effectively control the recurrence rate after orthodontic tooth movement. Within a certain range, high dose achieves the most obvious effect. Regulating osteoclast through adjusting the ratio of osteoprotegerin/osteoclast differentiation factor could be the molecular mechanism of tanshinone type IIA accelerating the periodontal tissue rebuilding.
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It is well known that Tn5B1-4(commercially known as the High Five)cell line is highly susceptible to baculovirus and provides superior production of recombinant proteins when compared to other insect cell lines.But the characteristics of the cell line do not always remain stable and may change upon continuous passage.Recently an alphanodavirus,named Tn5 Cell Line Virus(or TNCL Virus),was identified in High Five cells in particular. Therefore,we established a new cell line,QB-Tn9-4s,from Trichoplusia ni,which was determined to be free of TNCL virus by RT-PCR analysis. In this paper,we describe the development of a novel cell clone,QB-CL-B,from a low passage QB-Tn9-4s cell line and report its susceptibility to ACMNPV,and the level of recombinant protein production. This cell clone was similar to its parental cells QB-Tn9-4s and Tn5B 1-4 cells in morphology and growth rate;although it also showed approximately the same responses to AcMNPV infection and production of occlusion bodies,there were higher levels of recombinant protein production in comparison to QB-Tn9-4s(parental cells)and High5 cells.
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Objective Through investigation and analysis of physical and psychological symptoms among the victims of the disaster,to grasp physical and psychological condition of the victims of the disaster in establish place of Nanba town.Methods According to the mechanical random sampling method,11 of 21 pieces of tent community were randomly selected,then all people over 6 years of 1/6 families from each tent community were randomly selected,in total,486 people from 96 families were recruited as the sample of investigation and assessment.According to the designed questionnaire,face-to-face investigation was adopted.Results In 6 body symptoms,positive rate of cough was 1.85%,positive rate of angina was 0.82%,positive rate of tetter was 0.62%,positive rate of fever(≥38 ℃)and positive rate of diarrhea(≥3 times/day)were both 0.21%.No symtom of vomit was found.Among them,only 22.22% of the cough person seek medical advice in time.In 8 psychological symptom,positive rate of insomnia was 4.94%,positive rate of nervous discomfort was 2.88%,positive rate of palpitation was 2.06%,positive rate of discomfort in chest was 1.65%,positive rate of the headache was 1.44%,positive rate of shiver and numb was 0.41%,positive rate of sometimes unconfidence was 0.21%.No victim thinking life hopeless were found.Conclusions The victims of the disaster in Nanba town have good physical condition and psychological state in the recent week after the earthquake.It was attributed to implement of integrated prevention measures(including health and epidemic prevention).77.78% of the persons who had coughs has not sought medical advice in time.We should pay much attention on this facts.
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Objective: To observe the therapeutic effect of acupuncture therapy for treatment of chronic atrophic gastritis. Methods: According to the theory of TCM, 36 cases of chronic atrophic gastritis were differentiated and treated by acupuncture. Gastroscopy and electrogastrograph (EGG) of the body surface, gastric acid and pepsin, blood gastrin, blood prostaglandin E (PGE), gastric mucosal cells and G cells are recorded. Results: Acupuncture therapy had a better effect in improving clinical symptoms, the markedly effective rate was 97.2% and the disappearing rate of clinical manifestations 97.02%;after acupuncture treatment,blood PGE concentration increased; gastric acid secretion increased; gastric dynamics was enhanced and the amplitude of EGG rose; acupuncture could significantly facilitate secretion of gastrin. Conclusion: Acupuncture is a convenient treatment method for atrophic gastritis with quick effect and without side effects.
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Objective To investigate the pathogens inducing a posto perative nosocomial infection. Methods Specimens was collected fro m exudates or air for bacteria culture and identification. Re sults The postoperative infection was induced by staphylococcus x ylosus. Conclusions The relevant factors affecting the po stoperative nosocomial infection include incomplete sterilization of operative r oom and operative tools. Thus strict control measures must be put into effect.
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Objective To investigate the influences of blast wave overpressure created by explosion on rat's blood-brain barrier (BBB),and to provide an experimental evidence for further elucidating the mechanism of craniocerebral blast injury,to help direct the clini- cal therapeutic strategy.Methods Twenty male Sprague-Dawley rats were randomly divided into four groups:15min,12h and 24h post- explosion groups and normal control group with five rats for each group.Rats were injured with blast wave produced by explosion.Evan 's blue(EB)was intravenously injected into the injured rats,and the overpressure-induced leakage of BBB was examined under the fluores- cence microscope and by quantitative observation with opacimeter.Results Extensive impairment of BBB could be seen all over the brain 15 min after the overpressure explosion,and bright red EB fluorescent patches appeared as a method distributing along the capillary vessels. These patches were more distinct near the cerebral cortex,and with the lapse of time,their number decreased gradually from the inner to the outer areas.The changes in EB contents in brain tissue matched with that of the BBB.The EB contents in brain tissues in 15min group were(330.4?53.6)?g/g,and it was much higher compared with that of other groups(P
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As a successful mode of hospital reform, the hospital group offers the key to the solution of some major problems hindering the development of hospitals. The objective of setting up a hospital group is to better realize the strategic goals of the hospitals. While hospital groups have different types and formation patterns, the key to success lies in the operating mechanism and management standards. Organizational and cultural building is of great significance to the long-term development of hospital groups.