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ABSTRACT Purpose: Neovascular age-related macular degeneration is the leading cause of vision loss in the elderly. We aimed to identify baseline predictors of visual prognosis after intravitreal conbercept injection for neovascular age-related macular degeneration. Methods: We conducted a retrospective review of 58 patients with neovascular age-related macular degeneration who were treated with intravitreal injections of conbercept 0.5 mg in routine clinical practice. Basic information such as age, sex, intraocular pressure, and disease course was collected. Best-corrected visual acuity, mean retinal sensitivity, and optical coherence tomography findings were recorded at baseline and 6 months after treatment. Logistic regression analysis was used to identify independent predictors of best-corrected visual acuity at 6 months after treatment. Results: After the 6-month treatment, the mean best-corrected visual acuity improved from 1.10 ± 0.42 logarithm of the minimum angle of resolution (logMAR) to 0.41 ± 0.18 logMAR, the mean retinal sensitivity increased from 5.13 ± 0.86 dB to 7.32 ± 1.21 dB, the mean central retinal thickness decreased from 440.38 ± 61.05 μm to 260.01 ± 24.86 μm, and the total number of hyperreflective dots and the number of hyperreflective dots in each retina layer were significantly reduced as compared with those before treatment (all p<0.05). Twenty-two patients showed improved vision, and 36 had unimproved vision. Multivariate analyses revealed that the number of subretinal hyperreflective dots, the state of external limiting membrane, baseline best-corrected visual acuity, and age were independent predictors of best-corrected visual acuity (all p<0.05). Conclusion: Poor recovery of patients after intravitreal conbercept injection may be related to the number of subretinal hyperreflective dots, the state of external limiting membrane, baseline best-corrected visual acuity, and age, which may be used as predictors of short-term visual outcomes and should be fully evaluated before operation.
RESUMO Objetivo: A degeneração macular neovascular relacionada à idade é a principal causa de perda de visão em idosos. O objetivo deste estudo foi identificar os preditores iniciais que afetam o prognóstico visual após a injeção intravítrea de combercepte para degeneração macular neovascular relacionada à idade. Métodos: Esta é uma revisão retrospectiva de 58 pacientes com degeneração macular neovascular relacionada à idade que foram tratados com injeções intravítreas de 0,5 mg de combercepte na prática clínica de rotina. Foram coletadas informações básicas, tais como idade, sexo, pressão intraocular e evolução da doença. A melhor acuidade visual corrigida, as sensibilidades retinianas médias e varreduras de tomografia de coerência óptica foram registradas no início do estudo e 6 meses após o tratamento. Foi efetuada uma análise de regressão logística para determinar os preditores independentes da melhor acuidade visual corrigida 6 meses após o tratamento. Resultados: Após 6 meses de tratamento, a média da acuidade visual melhor corrigida melhorou de 1,10 ± 0,42 para 0,41 ± 0,18 logMAR; as sensibilidades retinianas médias aumentaram de 5,13 ± 0,86 para 7,32 ± 1,21 dB; a espessura retiniana central média diminuiu de 440,38 ± 61,05 para 260,01 ± 24,86 μm; e os pontos hiper-reflexivos, tanto em números totais quanto em cada camada de retina, foram significativamente reduzidos em comparação com os valores de antes do tratamento (todos com p<0,05). Houve 22 pacientes com visão melhorada e 36 pacientes com visão não melhorada. As análises multivariadas mostraram que o número de pontos hiper-reflexivos sub-retinianos, o estado da membrana limitante externa, a melhor acuidade visual corrigida inicial e a idade foram preditores independentes para a melhor acuidade visual corrigida (todos com p<0,05). Conclusão: A má recuperação de pacientes após a injeção de combercepte intravítreo pode estar relacionada ao número de pontos hiper-reflexivos sub-retinianos, ao estado da membrana limitante externa, à acuidade visual corrigida inicial e à idade, parâmetros que podem ser usados como preditores de resultados visuais de curto prazo e devem ser totalmente avaliados antes da cirurgia.
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INTRODUCTION@#In this study, we aimed to identify the differences in sociodemographic variables and reasons for termination of pregnancy (TOP) between married women and single/divorced women. We hope that this study can guide future policies and interventions to reduce the incidence of unsupported pregnancies in this profile group of women.@*METHODS@#We retrospectively evaluated the sociodemographic data of 802 women who underwent an abortion for social reasons at our institution in Singapore from January 2016 to September 2018. We compared the sociodemographic variables, reasons for and methods of TOP between married and single/divorced women.@*RESULTS@#We analysed data from 524 married women (65.3%) and 278 single/divorced women (34.7%). Married women were more likely to be of older age (29.5 years vs. 24.5 years, P < 0.001), had more living children and higher educational qualifications. The top two cited reason for abortions among married women were having enough children (42.0%) and the inability to afford another child (18.7%). Multivariate analysis showed that women aged >19 years and having more living children were independently associated with recurrent TOPs. Having a tertiary education was noted to be associated with less recurrent TOPs.@*CONCLUSION@#The most common reasons married women cited for having TOP include having enough children and the lack of financial capacity to afford another child. Recommendations to support women ought to be personalised and comprehensive in addressing their needs rather than offering a standardised support method. Greater emphasis should be placed on post-TOP family planning counselling to reduce repeated TOP.
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Pregnancy , Child , Female , Humans , Retrospective Studies , Singapore/epidemiology , Abortion, Induced , Hospitals, University , Educational StatusABSTRACT
Objective:To analyze the exercise and rehabilitation training programs for children's balance ability using scoping review. Methods:The literatures about children's balance ability, exercise and rehabilitation training were retrieved from CNKI, VIP, PubMed and Web of Science, until 2021-03-17. The authors, published time, countries, objects and their ages, study tools, interventions and the time, and outcomes were extracted. Results:A total of 2679 literatures were returned, 34 of which were enrolled, which came from 13 countries, and were almost published in journals of medicine, sports science, and rehabilitation and disabilities. The literatures were mainly published after 2010, investigate with measurements and scales. The measurements mainly included foot pressure system, force platform, Biodex balancer, etc.; and the scales mainly included Berg Balance Scale, Pediatric Balance Scale, Gross Motor Function Measure, Pediatric Evaluation of Disability Inventory, and Bruininks-Oseretsky Test of Motor Proficiency, etc. There were four typies of program: balance training, interactive computer games, virtual reality and sports events. Interventions for sick children included strength training, whole-body vibration training, Wii-Fit balance games and virtual reality treadmill training, etc. Sports for healthy children mainly included skating, Taiji Quan and gymnastics, etc. Conclusion:There are differences in the researches for children's balance ability at home and abroad. The abroad researches focus on the children with various diseases, in a larger age range, using more evaluation tools and more intervention methods. However, Chinese researches are usually for a longer intervention time, more subjects, and focusing more on healthy children. It is needed to pay more attention on children with diseases before three years old, for early diagnosis and treatment. Long-term effects should be observed other than immediateness after intervention.
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Dendrobium huoshanense is a precious medicinal plant belonging to Dendrobium of Orchidaceae. It is a special medicinal material and extremely scarce in Huoshan county, Anhui province. At present, D. huoshanense has been greatly protected, which also makes it possible to industrialize relying on tissue culture and artificial cultivation technology. Three main planting methods were utilized for cultivating D. huoshanense including facility cultivation, under forest cultivation and simulative habitat cultivation. Firstly, the three cultivation modes and technical characteristics of D. huoshanense were compared and analyzed, and it was found that the ecological environment of D. huoshanense cultivated in the simulated environment was closer to that of wild D. huoshanense. Secondly, based on comparing the characters and quality of three cultivation modes, the results showed that the shape of D. huoshanense cultivated in simulated environment was more similar to that of "grasshopper thigh" recorded in Bencao Jing Jizhu, and its quality was better than that of facilities and under forest cultivation. The comprehensive benefit comparison of three modes showed that the simulated cultivation had high income, the lowest input-output ratio and significant economic benefit. The quality of cultivated D. huoshanense was further evaluated from four aspects of "excellent environment" "excellent shape" "high quality" "excellent effect", which summarized the comprehensive advantages of simulative habitat cultivation of D. huoshanense as follows: the original habitat and site environment of simulated wild D. huoshanense, the closer shape to the wild, the more content of main medicinal components, and higher economic benefit and better efficacy. The quality of D. huoshanense was improved by the use of simulative habitat cultivation, which has practical significance to guide its large-scale cultivation.
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Dendrobium , Ecosystem , Forests , Plants, MedicinalABSTRACT
OBJECTIVES@#To evaluate the characteristics of Bletilla striata microspheres (BSMs) and its effects as an embolic agent in a rabbit model.@*METHODS@#BSMs were prepared with an emulsification-cool condensation-chemical cross-linking method. The characteristics of BSMs in vitro were observed. Embolization experiments were performed in renal artery of rabbit and in a rabbit liver VX2 carcinoma model. Seventy-two New Zealand rabbits were divided into 2 groups, and the right renal artery was embolized with BSMs (200 μm in diameter) in the experimental group and with polyvinyl alcohol (PVA) of the same size in the control group. The pathological findings were examined with hematoxylin-eosin and Masson stainings. Liver and renal functions were tested before and after embolization. VX2 tumor was transplanted in 15 New Zealand rabbits, which were randomly divided into 3 groups (n=5). Group A were treated with saline, group B with a mixture of doxorubicin and lipiodol, and group C with hepatic arterial infusion of BSMs (200 μm in diameter). Tumor growth rate was evaluated by magnetic resonance imaging scan. Apoptosis-related factors (bax, bcl-2) and tumor vascular endothelial cell growth factor (VEGF) were evaluated through immunohistochemical staining.@*RESULTS@#The characteristics of BSMs in vitro were in full compliance with the requirements for use in interventional procedures. In the renal artery embolization experiment, after BSMs intervention, it was more difficult to form collateral circulation than that with PVAs, and the kidney manifested atrophy and calcification. There were no significant difference of liver and renal functions in rabbits between groups. In the liver VX2 carcinoma embolization experiment, compared with group A, the growth rate of VX2 liver tumor and Bcl-2 levels was reduced, while apoptosis index, Bax, and VEGF were increased in group B (P0.05).@*CONCLUSIONS@#The characteristics of BSMs in vitro and in vivo meet the requirements for its use as an embolic agent in interventional approaches.
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OBJECTIVE@#To investigate the mechanism of inflflammatory-mediated toll-like receptor 4 (TLR4)-p38 mitogen-activated protein kinase (p38 MAPK) pathway in Kupffer cells (KCs) of non-alcoholic steatohepatitis (NASH) rats and the intervention effect of soothing Gan (Liver) and invigorating Pi (Spleen) recipes on this pathway.@*METHODS@#After 1 week of acclimatization, 120 Sprague-Dawley male rats were randomly divided into 8 groups using a random number table (n=15 per group): normal group, model group, low-dose Chaihu Shugan Powder (, CHSG) group (3.2 g/kg), high-dose CHSG group (9.6 g/kg), low-dose Shenling Baizhu Powder (, SLBZ) group (10 g/kg), high-dose SLBZ (30 g/kg) group, and low- and highdose integrated recipe (L-IR, H-IR) groups. All rats in the model and treatment groups were fed with a high-fat diet (HFD). The treatments were administrated by gastrogavage once daily and lasted for 26 weeks. The liver tissues were detected with hematoxylin-eosin (HE) and oil red O staining. Levels of liver lipids, serum lipids and transaminases were measured. KCs were isolated from the livers of rats to evaluate the mRNA expressions of TLR4 and p38 MAPK by real-time flfluorescence quantitative polymerase chain reaction, and proteins expressions of TLR4, p-p38 MAPK and p38 MAPK by Western blot. Levels of inflammatory cytokines including tumor necrosis factor α (TNF-α), interleukin (IL)-1 and IL-6 in KCs were measured by enzyme-linked immunosorbent assay.@*RESULTS@#After 26 weeks of HFD feeding, HE and oil red O staining showed that the NASH model rats successfully reproduced typical pathogenesis and histopathological features. Compared with the normal group, the model group exhibited significant increases in body weight, liver weight, liver index, serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol, and aspartate aminotransferase as well as TC and TG levels in liver tissues, and significant decrease in serum level of high-density lipoprotein cholesterol (Plt;0.05 or Plt;0.01), while those indices were significantly ameliorated in the H-IR group (Plt;0.05 or Plt;0.01). Higher levels of TNF-α, IL-1 and IL-6 in KCs were observed in the model group compared with the normal group (Plt;0.01). Significant decreases in TNF-α, IL-1 and IL-6 were observed in the H-SLBZ, H-IR and L-IR groups compared with the model group (Plt;0.05 or Plt;0.01). The mRNA expressions of TLR4 and p38 MAPK and protein expressions of TLR4, p38 MAPK and p-p38 MAPK in KCs in the model group were significantly higher than the normal group (Plt;0.01), while those expression levels in the L-IR and H-IR groups were significantly lower than the model group (Plt;0.05 or Plt;0.01).@*CONCLUSION@#Inflflammation in KCs might play an important role in the pathogenesis of NASH in rats. The data demonstrated the importance of TLR4-p38MAPK signaling pathway in KCs for the anti-inflflammatory effect of soothing Gan and invigorating Pi recipes.
Subject(s)
Animals , Male , Rats , Drugs, Chinese Herbal , Pharmacology , Kupffer Cells , Physiology , MAP Kinase Signaling System , Medicine, Chinese Traditional , Non-alcoholic Fatty Liver Disease , Drug Therapy , Plant Extracts , Pharmacology , Rats, Sprague-Dawley , Signal Transduction , Toll-Like Receptor 4 , Physiology , p38 Mitogen-Activated Protein Kinases , PhysiologyABSTRACT
In order to explore endophytes diversity and difference in Dendrobium huoshanense,in this paper,the metagenomics method was used to analyze the endophytic bacteria and fungi community of 5 groups include 30 samples in different growth years. The results indicate that 3 540 bacterial OTUs were identified from D. huoshanense,and there are 138 OTUs in 5 groups simultaneously;2 168 fungal OTUs were identified,and 143 OTUs exist in 5 groups simultaneously. The dominate endophytic bacteria community are Sphingomonas sp.,Acinetobacter sp.,Burkholderia sp.,Methylobacterium sp.,Enterococcus sp.,Bacillus sp.,the difference endophytic bacteria community are Oceanobacillusd sp.,Actinomycetospora sp.,Paenibacillus sp.. The dominate endophytic fungi community are Zasmidium sp.,Zymoseptoria sp.,Alternaria sp.,Cladosporium sp.,Fusarium sp.,the difference endophytic fungi community are Cyphellophore sp.,Fusarium sp.. The results of clustering revealed that both the endophytic bacteria and the endophytic fungi,ⅢY2 and ⅢY3 are complete clustered,and ⅡY1 and ⅢY1 are also cluster completely. These enriched the species and resources of endophytic bacteria and fungi in D. huoshanense,and provided a theoretical reference for the reasonable harvest of D. huoshanense.
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Ascomycota , Bacteria , Dendrobium , Endophytes , Fungi , Fusarium , PhylogenyABSTRACT
As a modern dosage form drug with rapid effect, traditional Chinese medicine (TCM) injection has been more and more used in clinical practice. Meanwhile the safety of TCM injection has attracted more and more attention. The retrospective analysis on 74 cases of adverse reaction of TCM injections collected from 2007 to 2016 in the Third Affiliated Hospital of Beijing University of Chinese Medicine showed that the proportion of men and women with adverse reactions was 0.54:1; the average age was 62.5 years old; 21 kinds of TCM injections were involved. Among them, the most reported were blood-regulating agents. The top four kinds of TCM injections with highest adverse drug reactions (ADRs) were Tanreqing injection, Danhong Injection, Shuxuening Injection and Xuesaitong for injection. The top three clinical manifestations of adverse reactions were lesions of skin and its appendages, damage of circulatory system and damage of nervous system. The potential causes of the adverse reactions of TCM injections were analyzed, and it was believed that individual difference, medicine, pharmaceutical excipients, solvent and TCM syndrome differentiation may be the main five causes for the adverse reactions of TCM injections. In order to reduce the adverse reactions of TCM injections, it is suggested that the clinical pharmacists should participate in the application management of TCM injections in the hospital; the production enterprises shall strengthen the whole life cycle management of the drugs; and at the same time, the drug control and administration authorities should improve the drug management methods constantly and encourage the development of TCM injections to the high quality level.
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Female , Humans , Male , Middle Aged , Drugs, Chinese Herbal , Injections , Medicine, Chinese Traditional , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To observe wet cupping therapy (WCT) on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis (NT-CS).</p><p><b>METHODS</b>Fifty-seven NT-CS patients were randomly divided into WCT group and Jiaji acupoint-acupuncture (JA) group according a random number table. WCT group (30 cases) was treated with WCT for 10 min, and JA group (27 cases) was treated with acupuncture for 10 min. The treatment efficacies were evaluated with a Visual Analogue Scale (VAS). Blood perfusion at Dazhui (GV 14) and Jianjing (GB 21) acupoints (affected side) was observed with a laser speckle flowmetry, and its variations before and after treatment in both groups were compared as well.</p><p><b>RESULTS</b>In both groups, the VAS scores significantly decreased after the intervention (P<0.01), while the blood perfusion at the two acupoints significantly increased after intervention (P<0.05); however, the increasement magnitude caused by WCT was obvious compared with JA (P<0.05).</p><p><b>CONCLUSIONS</b>WCT could improve analgesic effects in patients with NT-CS, which might be related to increasing local blood perfusion of acupunct points.</p>
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@#AIM: To study the myopia and influencing factors among primary school students in Haidian, Beijing. <p>METHODS: A total of 801 primary school pupils from grade one to grade three of Beijing were selected according to the cluster stratified sampling method, and 801 questionnaires were collected from the scene, which accorded with 757 people aged 7-10 years old, and 757 valid questionnaires, the prevalence rate of this study was 24.4%. The baseline data of all the subjects were collected through questionnaires. The data of myopia were compared. The Logistic regression equation was used to calculate the factors causing myopia. <p>RESULTS: The main factors leading to myopia in primary school were reading time, electronic product use time, parents' myopia, outdoor activity time, and reading and writing postures. The above difference data was brought into the Logistic regression equation to confirm. <p>CONCLUSION: The myopia rate of primary school students in Beijing has reached a high level. There are many problems in family, daily life and students themselves. It is necessary to prevent and control the occurrence of myopia and promote the vision health of primary school students.
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The mosquito Aedes albopictus is the primary vector for dengue virus transmission in Fujian Province.Despite that active dengue surveillance has been launched in several sites since 2005,the genetic diversity of A.albopictus from these sites remains exclusive.In this study,mosquito pools collected from dengue surveillance sites during 2015-2016 were randomly selected,the full-length mitochondrial cytochrome C oxidase subunit Ⅰ (mtDNA-COⅠ) were amplified and sequenced.Preliminary sequence alignment of 12 amplicons with the reference sequence indicated 99 ％ homology at nucleotide level,due to varia tions at 9 nucleotide sites.Three haplotypes,namely H02,H03 and H08,were determined based on phylogenetic analysis with 72 reference sequences of known haplotypes.These observations facilitate surveillance and control of arboviral diseases in Fujian.
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Objective To develop a high-performance liquid chromatography (HPLC) method for the measurement of lecithin-cholesterol acyltransferase(LCAT) activity and analyze the relationships between LCAT activity and the traditional risk factors of atherosclerotic cardiovascular disease(CVD).Methods The liposome which contained 7-dehydrocholesterol and 1,2-didecanoyl-sn-glycero-3-phosphocholine (10∶0 PC)as the substrate of LCAT and LCAT activating peptide (LAP642)as LCAT activator was mixed with 10 microliters of serum sample(50∶ 1,V/V)in ice-water bath and subsequently incubated at 37 ℃ for 1 h.After extracting with hexane,the lipid was analyzed by HPLC and the LCAT activity was calculated as the ratio of 7-dehydrocholesterol ester to free 7-dehydroeholesterol.LCAT activities of 120 health volunteers were measured and its relationship with traditional risk factors of CVD was analyzed.Results The liposome composed of substrates(7-dehydrocholesterol and 10∶0 PC with ratio of amount 1∶ 8.5)and LAP642 was stable,efficient and easy for preparation.LCAT activity was a linear correction during 8 hours of incubation and was independent of the volume of serum added in the range from 0 to 20 microliters.The averages of intra-and total coefficients of variation(CV)were less than 1.76％ and 3.11％ respectively.The comparison of two methods showed that the results of the HPLC method were highly correlated with LCAT mass measured by commercial ELISA method and LCAT activity measured by endogenous substrate fractional esterification of high density lipoprotein cholesterol (FERHDL)(P ＜ 0.01).LCAT activity positively correlated with body mass index(BMI),triglyceride (TG) (P ＜ 0.05) and negatively correlated with apolipoprotein AI (apoAI) (P ＜ 0.05) and high density lipoprotein cholesterol (HDL-C) (P ＜ 0.01) in the volunteers.Conclusion A simple,precise and reliable HPLC method for determination of LCAT activity using artificial substrate has been established,and the results were not influenced by endogenous cholesterol levels in serum.The newly developed method could be a useful tool in the study of lipid metabolism and the assessment for risk factors of CVD.
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Objective To explore the correlation between maternal serum total bile acid (TBA) of pregnant women with intrahepatic cholestasis of pregnancy (ICP) and varying degrees of neonatal lung injury.Methods A total of 52 cases of pregnant women with ICP and their corresponding newborns were enrolled into the ICP group from March 2014 to December 2015 in the People's Hospital of Shapingba District.Other 52 cases of pregnant women received cesarean delivery whose gestational age and birth weight of newborns were close to the ICP group and their corresponding newborns were selected as the control group.The conditions of neonatal lung injury were recorded,and the correlations of maternal serum level of TBA and exposure time of high serum level of TBA to degrees of lung injury were analyzed as well.Results The incidence rate of neonatal lung injury in the ICP group (67.3 ％) was higher than that in the control group (17.3 ％),there was statistically significant difference (P＜0.05).The degree of lung injury was positively correlated with maternal serum level of TBA and exposure time of high serum level of TBA (r=0.687,P=0.000;r=0.523,P=0.001).Conclusion The probability of neonatal lung injury of corresponding pregnant women with ICP is significantly increased,and the extent of lung injury is positively correlated with concentration of maternal serum TBA and exposure time of high serum level of TBA.
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Objective To study the diagnostic values of X-ray,CT and MRI for the hip joint lesion of the patient with ankylosing spondylitis (AS).Methods Totally 180 AS patients underwent the examinations of X-ray,CT and MRI from January 2014 to December 2015,and the hip joint lesion,clinical features and the efficacies of the three imaging techniques were observed.Results The rates for positive findings were 69.44％,71.11％ and 72.22％ respectively by X-ray,CT and MRI,and more than 90％ patients had the lesions occurred at the bilateral hip joints simultaneously.Hip joint lesion of AS had the imaging features of bone marrow and joint space changes,which related to the disease progress closely.Early positive signs consisted of medial joint space narrowing by X-ray,rear joint space narrowing by CT as well as bone marrow fat deposition (BMFD) and bone marrow edema (BME) by MRI.Conclusion X ray,CT and MRI all gain their advantages when used to diagnose the hip joint lesion of AS.X-ray behaves well in early diagnosis of medial joint space narrowing,while have disadvantages in displaying soft tissues and minute structures when compared with CT and MRI.CT displays the minute structure of hip joint clearly,and is not so good at soft tissue resolution as MRI.MRI gains the highest resolution for displaying soft tissues in the three techniques,and can show BMFD,BME and etc which can not be revealed by X-ray and CT.
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Objective:To explore high-quality of emergency clinical pathway of percutaneous coronary intervention (PCI)in patients with acute ST elevation myocardial infarction (STEAMI),and systematically evaluate its clinical effect.Methods:A total of 627 STEAMI patients,who received successful emergency PCI from Mar 2008 to Sep 2016,were selected.According to hospitalization sequence,they were divided into traditional pathway group (n=298)and high-quality pathway group (n=329,received new clinical pathway strategy formulated by present study). Reperfusion time and level of infarct related artery (IRA),postoperative mortality,the 36-item short-form heath survey (SF-36)score at discharge,NYHA class and left ventricular ejection fraction (LVEF)on one month after PCI were counted and analyzed in two groups.Results:Compared with traditional pathway group,there were signif-icant reductions in door-to-balloon time [(86.3 ± 22.4)min vs.(65.9 ± 17.8)min]and onset-to-balloon time [(189.5±30.2)min vs.(154.6±27.2)min],and significant rise in percentage of TIMI ≥grade I of IRA before PCI (5.0% vs.25.5%)in high-quality pathway group (P <0.01 all),but there was no significant difference in per-centage of TIMI grade III of IRA after PCI between two groups,P =0.393. Compared with traditional pathway group,there were significant rise in total SF-36 score [(66.1±11.2)scores vs.(75.9±12.8)scores]at discharge and LVEF [(49.3±11.2)% vs.(54.1 ±13.6)%]on one month after PCI,and significant reduction in NYHA class [(1.97±0.65)classes vs.(1.68±0.51)classes]on one month after PCI in high-quality pathway group (P <0.05 or <0.01 ).There was no significant difference in postoperative mortality between two groups,P =0.803. Conclusion:High-quality emergency clinical pathway of PCI in STEAMI patients contributes to early reperfusion of IRA,shortens door-to-balloon time,significantly improves their clinical prognosis,which is worth extending.
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Objective: To explore the effect of β-blocker in hypertension patients with different basic heart rate (HR). Methods: A total of 191 hypertension patients without using β-blocker were enrolled. Based on different basic HR, the patients were divided into 3 groups: Group A: HR (70-79) beats/min, n=58, Group B: HR (80-89) beats/min, n=90 and Group C: HR≥90 beats/min, n=43. All patients received metoprolol extended release at 47.5 mg/d for 2 weeks, for those didn't reach the target HR, 23.75 mg/d was added as 71.25 mg/d for 4 weeks, for those still didn't reach target HR, the dose was added to 95 mg/d, total length of medication was 8 weeks. Blood pressure (BP) and HR were measured every 2 weeks in all patients. Results: 62％ patients had basic HR>80 beats/min, 36％ had basic HR>85 beats/min and 20％ had basic HR>90 beats/min. The average dose of metoprolol was (59.7±17.0) mg/d. HR decreased in 3 groups after medication, all P<0.05. The reducing level in Group C was (29.3±7.8) beats/min, in Group B was (18.7±4.9) beats/min and in Group A was (11.0±4.0) beats/min, P<0.05; upon HR elevating 10 beats/minute, metoprolol caused HR reducing may increase 7.9％. BP was similar among 3 groups before and after medication, P>0.05. The average HR decreasing levels in patients with metoprolol 47.5 mg/d, 71.25 mg/d and 95 mg/d were (17.6±8.1) beats/min, (19.5±8.7) beats/min and (22.5±9.2) beats/min respectively; upon dose elevated to 71.25 mg/d and 95 mg/d, metoprolol caused HR reducing may increase10.8％ and 27.8％. 1 patient had sinus bradycardia and 1 had dizziness during medication, the symptoms improved by dose reducing or drug withdrawal.Conclusion: About 2/3 hypertension patients had basic HR>80 beats/min, metoprolol could cause more HR reducing in patients with the faster basic HR. Metoprolol (47.5-95) mg/d was safe and effective in hypertension patients.
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Objective To study the diagnostic values of X-ray,CT and MRI for the hip joint lesion of the patient with ankylosing spondylitis (AS).Methods Totally 180 AS patients underwent the examinations of X-ray,CT and MRI from January 2014 to December 2015,and the hip joint lesion,clinical features and the efficacies of the three imaging techniques were observed.Results The rates for positive findings were 69.44％,71.11％ and 72.22％ respectively by X-ray,CT and MRI,and more than 90％ patients had the lesions occurred at the bilateral hip joints simultaneously.Hip joint lesion of AS had the imaging features of bone marrow and joint space changes,which related to the disease progress closely.Early positive signs consisted of medial joint space narrowing by X-ray,rear joint space narrowing by CT as well as bone marrow fat deposition (BMFD) and bone marrow edema (BME) by MRI.Conclusion X ray,CT and MRI all gain their advantages when used to diagnose the hip joint lesion of AS.X-ray behaves well in early diagnosis of medial joint space narrowing,while have disadvantages in displaying soft tissues and minute structures when compared with CT and MRI.CT displays the minute structure of hip joint clearly,and is not so good at soft tissue resolution as MRI.MRI gains the highest resolution for displaying soft tissues in the three techniques,and can show BMFD,BME and etc which can not be revealed by X-ray and CT.
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To analyze the epidemiology,genetic variation and genetic evolution of coxsackievirus A4 (CVA4) in patients with hand,foot and mouth disease in Fujian,the virus isolates were molecular typed and amplified the whole VP1 region by RT-PCR,then the genetic variation and evolution were studied.The results showed that 33 CVA4 cases (8.1％) were confirmed from the 407 non-EV71 non-CVA16 HFMD cases in Fujian Province during 2011 and 2014,accounting for 31 cases in 2012 and 2 cases in 2014.Compared with common characteristics of the HFMD epidemic,no specificity in the distribution of CVA4 cases was found between gender and age groups.Sequence analysis of VP1 nucleotide sequences of Fujian CVA4 isolates showed that the nucleotide and amino acid sequences similarity were 92.6 ％-100 ％ and 95.7 ％-100 ％ respectively,low similarity with the prototype (83.7％-85.4％,96.1％-99.0％) and abroad isolates (82.1％-89.1％,90.4％-99.6％) both in nucleotide and amino acid sequences,high similarity with domestic isolates both in nucleotide and amino acid sequences,with the similarity of 87.9％ 99.2 ％ and 96.1％-100 ％.The results from phylogenetic tree showed that the genetic distance between Fujian CVA4 isolates and the prototype and abroad strains was far,and the genetic distance was close to domestic isolates in China.The distribution of the phylogenetic trees of Fujian CVA4 strains showed multiple branches.Therefore,CVA4 is the major HFMD associated-pathogen other than EV71,CVA 16,CVA6,and CVA10 in Fujian Province from 2011 to 2014.CVA4 strains from Fujian Province is co-circulating and co-evolving with other domestic isolates.There is existence of multiple closely related CVA4 transmission chains in various regions of Fujian.
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Objective:To explore high-quality of emergency clinical pathway of percutaneous coronary intervention (PCI)in patients with acute ST elevation myocardial infarction (STEAMI),and systematically evaluate its clinical effect.Methods:A total of 627 STEAMI patients,who received successful emergency PCI from Mar 2008 to Sep 2016,were selected.According to hospitalization sequence,they were divided into traditional pathway group (n=298)and high-quality pathway group (n=329,received new clinical pathway strategy formulated by present study). Reperfusion time and level of infarct related artery (IRA),postoperative mortality,the 36-item short-form heath survey (SF-36)score at discharge,NYHA class and left ventricular ejection fraction (LVEF)on one month after PCI were counted and analyzed in two groups.Results:Compared with traditional pathway group,there were signif-icant reductions in door-to-balloon time [(86.3 ± 22.4)min vs.(65.9 ± 17.8)min]and onset-to-balloon time [(189.5±30.2)min vs.(154.6±27.2)min],and significant rise in percentage of TIMI ≥grade I of IRA before PCI (5.0% vs.25.5%)in high-quality pathway group (P <0.01 all),but there was no significant difference in per-centage of TIMI grade III of IRA after PCI between two groups,P =0.393. Compared with traditional pathway group,there were significant rise in total SF-36 score [(66.1±11.2)scores vs.(75.9±12.8)scores]at discharge and LVEF [(49.3±11.2)% vs.(54.1 ±13.6)%]on one month after PCI,and significant reduction in NYHA class [(1.97±0.65)classes vs.(1.68±0.51)classes]on one month after PCI in high-quality pathway group (P <0.05 or <0.01 ).There was no significant difference in postoperative mortality between two groups,P =0.803. Conclusion:High-quality emergency clinical pathway of PCI in STEAMI patients contributes to early reperfusion of IRA,shortens door-to-balloon time,significantly improves their clinical prognosis,which is worth extending.
ABSTRACT
Objective: To explore the effect of β-blocker in hypertension patients with different basic heart rate (HR). Methods: A total of 191 hypertension patients without using β-blocker were enrolled. Based on different basic HR, the patients were divided into 3 groups: Group A: HR (70-79) beats/min, n=58, Group B: HR (80-89) beats/min, n=90 and Group C: HR≥90 beats/min, n=43. All patients received metoprolol extended release at 47.5 mg/d for 2 weeks, for those didn't reach the target HR, 23.75 mg/d was added as 71.25 mg/d for 4 weeks, for those still didn't reach target HR, the dose was added to 95 mg/d, total length of medication was 8 weeks. Blood pressure (BP) and HR were measured every 2 weeks in all patients. Results: 62％ patients had basic HR>80 beats/min, 36％ had basic HR>85 beats/min and 20％ had basic HR>90 beats/min. The average dose of metoprolol was (59.7±17.0) mg/d. HR decreased in 3 groups after medication, all P<0.05. The reducing level in Group C was (29.3±7.8) beats/min, in Group B was (18.7±4.9) beats/min and in Group A was (11.0±4.0) beats/min, P<0.05; upon HR elevating 10 beats/minute, metoprolol caused HR reducing may increase 7.9％. BP was similar among 3 groups before and after medication, P>0.05. The average HR decreasing levels in patients with metoprolol 47.5 mg/d, 71.25 mg/d and 95 mg/d were (17.6±8.1) beats/min, (19.5±8.7) beats/min and (22.5±9.2) beats/min respectively; upon dose elevated to 71.25 mg/d and 95 mg/d, metoprolol caused HR reducing may increase10.8％ and 27.8％. 1 patient had sinus bradycardia and 1 had dizziness during medication, the symptoms improved by dose reducing or drug withdrawal.Conclusion: About 2/3 hypertension patients had basic HR>80 beats/min, metoprolol could cause more HR reducing in patients with the faster basic HR. Metoprolol (47.5-95) mg/d was safe and effective in hypertension patients.