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Objective:To explore the efficacy and safety of adalimumab (ADA) in Chinese Takayasu arteritis (TAK) patients.Methods:This study prospectively included ten refractory active TAK patients. The clinical, laboratory and imaging data of these patients before and after ADA treatment were collected and compared. Statistical analysis was carried out with the statistical product and service solutions (SPSS) program V.24.0. We performed univariate analysis by Wilcoxon-Mann-Whitney test for numerical data according to normality. The P value <0.05 was interpreted as statistically significant. Results:Ten TAK patients recruited in this study were all female, with a median age of 27.5 [25.0, 36.0] years. Fever or fatigue (6/10, 60%), neck pain (6/10, 60%), and limb claudication (4/10, 40%) were the most common clinical manifestations. The most common pattern of vascular involvement was Numano type V (7/10, 70%). The serum erythrocyte sedimentation rate (ESR) [22.0(4.5, 37.5) mm/1 h vs 7.0(4.5, 31.0) mm/1 h, Z=-2.04, P=0.042] and IL-6 level [12.3(3.6, 57.7) ng/L vs 2.8(2.0, 24.0) ng/L, Z=-2.19, P=0.028] reduced significantly after ADA treatment. The thickness of the common carotid artery intima decreased from 2.7(2.2, 4.0) mm to 2.3(1.6, 3.4) mm after ADA treatment ( Z=-1.99, P=0.046). The lumen diameter of the common carotid artery increased from 0.31(0.20, 0.42) cm to 0.37(0.29, 0.43) cm ( Z=-2.02, P=0.043). The glucocorticoid dosage was reduced from [11.2(6.9, 15.0) mg to 10.0(5.0, 13.1) mg, Z=-1.89, P=0.059]. In the 10 patients, 6 patients (60%) reached complete response, 2 patients (20%) reached the partial response, and the total effective rate was 80%(8/10). Pneumonia in one TAK patient was recorded. Conclusion:The results of this study suggest, that ADA can be used for refractory active TAK patients, and is safe.
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Objective To explore the effect of specific labeling method in improving the mixed placing of medical waste in neonatal intensive care unit(NICU).Methods Medical waste classification of 34 trash cans in the NICU of a hospital between July and December 2014 were investigated,July-September was pre-implementation phase of spe-cific labeling,October-December was post-implementation phase,mixed placing of medical waste between pre-and post-implementation phase was compared.Results A total of 504 cases of medical waste classification in NICU were investigated,252 cases respectively in pre-and post-implementation phase,74 cases of mixed placing were found. Mixed placing rates before implementing specific labeling was higher than after implementing (25.40%[64/252]vs 3.97%[10/252],χ2 =46.187,P <0.001 );before implementing specific labeling,57 cases of infectious waste and non-infectious waste were mixed placing,after implementing specific labeling,only 8 cases of infectious waste and non-infectious waste were mixed placing.Mixed placing were mainly performed by trainees for in-service training and interns,accounting for 39.06% before implementing and 50.00% after implementing.Conclusion The specific labeling for standardizing and managing of medical waste can improve the classification of medical waste in NICU, significantly improve the compliance of all kinds of health care workers to the standard handling of medical waste.
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Objective:To investigate the effect on proliferation and apoptosis of T-cell leukemia cells by silencing NRP-1 ( Jurkat cells).Methods:The lentivirus plasmid which expresses NRP1 gene specific shRNA was constructed in our preliminary ex-perimental.We transfected the lentivirus plasmid to human T-cell Lymphoma cells.The proliferation of Jurkat cells different groups and effect on cell proliferation after chemotherapy drug EPI-treated were found by CCK-8 kit.The proliferation level and apoptosis rate of the cells were detected by flow cytometry and Annexin-V-FITC/PI method.Results:The proliferation level of NRP-1 /shRNA interference group was decreased significantly in 48 h,72 h,96 h,which was compared with the control groups.The apoptosis rate of the NRP-1/shRNA interference group was increased compared with control groups.The chemotherapy drug sensitivity of epirubicin ( EPI ) test results showed that EPI concentration was 0.025,0.05,0.1,0.2,0.4 μg/ml,the NRP-1/shRNA interference group of cell growth inhibition rate was increased,the corresponding control group difference had statistical significance(P<0.05).We choose the drug con-centration of the EPI IC50 for next experiments.NRP-1/shRNA interference group cell apoptosis rate increased significantly after induction,compared with the control groups difference was statistically significant ( P<0.05 ).Compared with control group, the expression level of Bcl-2 protein was decreased and the expression level of bax protein was increased significantly after EPI induction.The percentage of cells at G0/G1 phase increased significantly,while those at S phase decreased significantly.Conclusion:Plasmid shRNA-NRP1 inhibited the expression of NRP1 in Jurkat cells and decreased the proliferation level of Jurkat cells and promote their apoptosis and enhance their drug sensitivity;the molecular mechanism may relate to down-regulation of Bcl-2 and up-regulation of Bax.and arrested the cell cycle at G0/G1 phase.
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Objective To investigate the correlation between the transport time of preterm infants with respira-tory failure and the clinical outcome. And to determine the transit time in critically ill premature infants. Methods Premature infants in level Ⅱ neonatal ward in Hunan Province Children's Hospital from January 1 to December 31, 2013,admitted to the Neonatal Intensive Care Unit requiring respiratory support(invasive and noninvasive),were re-viewed. All the patients were classified into non - standardized transport group and regulate transport group according to respiratory support that infants in the level Ⅱ neonatal ward required. Data on general information,the time of ventilator application,the time of exposure to oxygen,morbidity of bronchopulmonary dysplasia(BPD),the cure and improvement rate,length of stay,the total length of stay(length of stay in the local hospital and our hospital),and hospitalization ex-penses were collected. Results Among the 363 infants,there were 107 cases in the non - standardized transport group, and 256 cases in the regulate transport group. The time of ventilator application in the non - standardized transport group was longer than that in regulate transport group[(19. 75 ± 19. 53)d vs(13. 02 ± 12. 64)d,t = 18. 706,P ﹤ 0. 05],the time of exposure to oxygen was longer[(30. 60 ±24. 80)d vs(19. 50 ±19. 24)d,t =6. 883,P ﹤0. 05],the morbidity of BPD was higher[57. 01%(61/ 107 cases)vs 18. 36%(47/ 256 cases),χ2 = 53. 934,P ﹤ 0. 05],but the cure and im-provement rate was lower[70. 10%(75/ 107 cases)vs 83. 20%(213/ 256 cases),χ2 = 7. 912,P ﹤ 0. 05],and the total length of stay was longer[(59. 50 ± 34. 02)d vs(34. 48 ± 23. 69)d,t = 22. 967,P ﹤ 0. 05]than that in the regulate group. But there was no significant difference between the length of stay[(43. 99 ±28. 08)d vs(32. 79 ± 23. 76)d,t =2. 012,P ﹥0. 05]in the non - standardized transport group and regulate transport group,with the hospitalization expenses [(6. 55 ±4. 30)vs(4. 99 ±4. 12)thousands yuan,t =0. 552,P ﹥0. 05]. Conclusions The non - standardized transport group has higher morbidity of BPD,but lower cure or improvement rate,and it has longer length of stay. The 2013 edition of Chinese Neonatal Ward Hierarchical Construction and Management Guide(Proposal)is reasonable,level Ⅱ neonatal ward should be in strict accordance with it to transport regional neonatal.
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Objective]To investigate academic thoughts of Prof. Yan Dexin in spleen and stomach syndrome treatment.[Methods]The paper summarized the academic origin, academic thoughts as well as practical treatment cases of Prof. Yan Dexin ’s spleen and stomach syndrome treatment theory. [Results]The main points of Prof. Yan’s academic thought on spleen and stomach therapy has succeeded and developed the therapy of Menghe physician, which includes an emphasis on spleen Qi rise and stomach Yin drop, Qi of spleen and stomach regulation, special attention on the function of the stomach-yang and spleen-yin, an advocation ofspleen leading four organs, and therapy design from spleen with an ingenious use of atractylodes rhizome, Atractylodes and Zhizhu pill. [Conclusion] Professor Yan Dexin developed his unique theoretical system in spleen-stomach diseases therapy on basis of the experiences of spleen and stomach disease treatment from ancient physicians, which is instructive for later physicians.
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BACKGROUND: At present, studies concerning human umbilical cord blood mesenchymal stem cells (UCB-MSCs) transplantation for repair of rat spinal cord injury, brain tumor, and myocardial infarction have been reported, and studies that human UCB-MSCs were induced differentiation into osteogenic cells under certain conditions have also been reported at home and abroad. But application of UCB-MSCs transplantation in the treatment of osteonecrosis of animals has not yet been reported. OBJECTIVE: To observe the repair results of recombinant lentivirus vector tracing enhanced green fluorescent protein (EGFP)-transfected UCB-MSCs transplantation in treatment of ischemic necrosis of the femoral head in rabbits. METHODS: Bone morphogenetic protein-2 gene plasmid, recombinant lentivirus vector carrying EGFP and UCB-MSCs were co-cultured. Rabbit models of femoral head defects were made and randomly divided into 3 groups. There was no treatment in the normal group, control group with bone defects and experimental bone defects filled with UCB-MSCs tracing transfected by recombinant lentivirus vector carrying EGFP. At 4 and 8 weeks after treatment, the imaging and histological of the femoral head were observed.RESULTS AND CONCLUSION: Imaging and histology results showed that there were osteogenic response and new bone formation in the experimental group at 4 weeks, and the bone defects were basically repaired at 8 weeks after treatment. In the control group, the bone defects filled with fibrous connective tissue fiber connective tissues at 4 weeks, and the osteosclerosis could be found surrounding femoral head, bone defects filled with fibrous connective tissue fibers and bone trabecula distributed disorderly. The recombinant lentivirus vector tracing EGFP-transfected into UCB-MSCs has strong effects bone conduction and can repair ischemic necrosis of the femoral head.
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@#Objective To observe the effects of systems of progressive resistance exercise on lower limb extensors （quadriceps femoris） of stroke patients. Methods 89 stroke patients with weak lower limbs were randomly divided into progressive resistance exercise group (n=46) and control group (n=43), both receiving corresponding treatment for 4 weeks. They were assessed with Manual Muscle Test (MMT), integrated electromyogram (iEMG) and root mean square (RMS) of surface electromyography on quadriceps femoris before and after the treatment. Results The incidence of improvement with MMT was 94.3% in progressive resistance exercise group, and 63.8% in control group （P<0.01）. The iEMG and RMS of the exercise group was significantly higher than that of the control （P<0.01）. Conclusion The systems of progressive resistance exercise could improve the muscle strength of lower limbs extensors of stroke patients more effectively.
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Objective To investigate the efficacy of progressive resistance exercise for improving the lower limb motor function of hemiplegic stroke patients. Methods Eighty-nine hemiplegic patients were randomly divided into a treatment group (n =46) and a control group ( n = 43 ) . Both groups received routine rehabilitation training, while the treatment group also undertook progressive resistance training. The control group received extra quadriceps femoris training. Before and after the treatment, motor function was evaluated with the Fugl-Meyer lower limb assessment, functional ambulation category (FAC) classification and the modified Barthel index (MBI). Results Before intervention, there were no significant differences between the two groups in any of the assessments. Four weeks later, all the assessment scores obtained with the Fugl-Meyer lower limb assessment, FCA classification and MBI in the treatment group were significantly better than those in the control group. Conclusion Progressive resistance training combined with routine rehabilitation treatment can improve motor function in the lower limbs, ambulation and ability in the activities of daily living of hemiplegic patients after stroke.
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To study the implementation of the epidemic prevention by the authorities of the concession and late Qing dynasty through investigation of the prevention and treatment of pestilence in Shanghai from 1872 to 1911, this paper analyzes the issues concerning municipal administration, inspection and disinfection, food sanitation, vaccination, regulatory legislation and health promotion, etc. The experiences are summarized in the study. The lessons drawn from what the concession authority did to prevent pestilence imply that the implementation of health promotion should be carried out according to the variation of the time, location and population, and that traditional Chinese medicine should be involved in the prevention and treatment of pestilence.