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ObjectiveTo analyze the mortality data of children under 5 years in Chongming District， Shanghai， and to analyze the main causes of death of children under 5 years， so as to provide scientific basis for reducing the mortality of children under 5 years in Chongming District. MethodsData of children under 5 years in Chongming District from 2011 to 2020 were collected from the Maternal and Child Health Information System of Chongming District， Shanghai. The mortality rate and main causes of death of children under 5 years in Chongming District were analyzed retrospectively. ResultsFrom 2011 to 2020， the average mortality rate of children under 5 years in Chongming District was 6.51‰， and the overall trend was stable. The mortality rate of children under 5 years with non-local household registration （11.44‰） was significantly higher than that of children under 5 years of age with local household registration （4.88‰） （P<0.05）. The main causes of death for children under 5 years were accidental deaths （drowning， accidental asphyxia， traffic accidents）， while the main causes of death for infants were congenital heart disease， premature birth or low birth weight， congenital abnormalities， birth asphyxia and pneumonia. ConclusionIt is necessary to strengthen safety education for children and their guardians and strengthen safety management for children who are not registered in this city. Departments of obstetrics and gynecology and the departments of pediatrics should be expanded， and prenatal examination should be strenthened for high risk or elderly parturient women to further reduce the death rate of children under 5 years old.
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Objective:To investigate the clinical effect of ethinylestradiol cycloproterone combined with metformin in the treatment of polycystic ovary syndrome (PCOS) with insulin resistance.Methods:Ninety PCOS patients with insulin resistance admitted to the First People's Hospital of Taizhou from May 2017 to May 2019 were selected in the study.According to the random number table method, the patients were divided into control group and treatment group, with 45 cases in each group.The control group was treated with ethinylestradiol and cycloprogesterone, while the observation group was treated with ethinylestradiol and cycloprogesterone combined with metformin.The clinical effects of two groups were compared, including estradiol (E 2), testosterone (T), luteinizing hormone (LH), follicle stimulating estrogen (FSH), insulin resistance index (HOMA-IR), fasting plasma glucose (FPG) before and after treatment.Body mass index (BMI) and fasting insulin (FINS) levels were measured.The ovulation, pregnancy, menstrual recovery and adverse reactions of the two groups were analyzed. Results:The total effective rate of the treatment group (97.77%) was significantly higher than that of the control group (77.77%), the difference was statistically significant (χ 2=8.389, P=0.003). Before treatment, there were no statistically significant differences in E 2, T, LH, FSH between the treatment group and the control group (all P>0.05). After treatment, the levels of E 2[(112.90±18.90)pmol/L], T[(1.30±0.78)nmol/L], LH[(8.00±1.50)U/L]and FSH[(1.20±0.39)U/L] in the treatment group were significantly lower than those in the control group[E 2(128.90±19.95) pmol/L, T(2.19±1.00) nmol/L, LH(11.65±1.60)U/L and FSH(1.89±0.50)U/L], the differences were statistically significant( t=3.905, 4.707, 10.871, 7.299, all P<0.05). Before treatment, the levels of HOMA-IR, FPG, BMI and FINS between the two groups had no statistically significant differences(all P>0.05). After treatment, the levels of HOMA-IR (2.19±0.50), FPG[(4.30±1.19)mmol/L], BMI[(22.40±1.89)kg/m 2], FINS[(15.98±5.00)mU/L] in the treatment group were significantly lower than those in the control group[HOMA-IR(3.90±0.58), FPG (6.09±1.20) mmol/L, BMI (24.69±4.60)kg/m 2, FINS (19.00±6.89)mU/L], the differences were statistically significant( t=14.979, 7.105, 3.089, 2.379, all P<0.05). The ovulation, pregnancy and menstrual recovery in the treatment group were significantly higher than those in the control group (χ 2=4.121, 4.285, 10.000, all P<0.05). The incidence of adverse reactions in the treatment group (13.33%) was significantly lower than that in the control group (37.77%), the difference was statistically significant between the two groups (χ 2=7.066, P=0.007). Conclusion:Ethinylestradiol cycloproterone combined with metformin in the treatment of PCOS with insulin resistance has significant clinical efficacy, can alleviate the endocrine metabolic disorders and insulin resistance, it is worthy of clinical application and promotion.
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Objective:To investigate the clinical efficacy of middle-preserving pancreatectomy (MPP).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of two patients who underwent MPP in Fujian Provincial Hospital from July 2019 to October 2019 were collected. Case 1 was a 52-year-old woman with multiple serous cystic neoplasms of the pancreatic head and tail. Case 2 was a 20-year-old man with chronic pancreatitis and multiple pancreatic duct stones. After comprehensive evaluation, two patients were performed laparoscopic pancreatic head tumor resection+ pancreatic tail resection+ splenectomy+ pancreaticojejunostomy and duodenum-preserving pancreatic head resection+ pancreatic tail resection+ lithotomy by longitudinal pancreatic duct incision+ side-to-side pancreaticojejunostomy, respectively. Observation indicators: surgery, operation time, volume of intraoperative blood loss, blood transfusion, postoperative fasting blood glucose, postoperative complications, duration of postoperative hospital stay, postoperative pathological examination, and follow-up. Follow-up was performed using outpatient examination and telephone interview to detect new-onset diabetes mellitus, pancreatic enzyme replacement therapy and disease recurrence up to March 2020.Results:Two patients successfully underwent MPP. The operation time of case 1 and case 2 were 470 minutes and 400 minutes, the volume of intraoperative blood loss were 200 mL and 100 mL, respectively. No blood transfusion was performed in either patient. The postoperative fasting blood glucose fluctuated between 5.4 and 11.8 mmol/L in case 1, and fluctuated between 5.9 and 11.3 mmol/L in case 2. Case 1 developed abdominal infection after operation, and was discharged after anti-infective treatment. Case 2 had good recovery with no complication. No pancreatic fistula or perioperative death occurred in two patients. The duration of postoperative hospital stay were 12 days and 8 days of case 1 and case 2, respectively. The pathological examination of case 1 showed serous cystadenoma of the pancreatic head and pancreatic tail. The pathological examination of case 2 showed that slightly dilated pancreatic ducts of the pancreatic head and tail with multiple stones and chronic inflammatory cells infiltration around the pancreatic ducts. The length of pancreas preserved was 8.5 cm and 8.3 cm of case 1 and case 2 on postoperative computed tomography (CT) reexamination. Two patients were followed up for 5 months and 7 months, respectively. During the follow-up, both patients had no new-onset diabetes and they didn′t require pancreatic enzyme replacement therapy. Both patients underwent upper abdominal CT examination at postoperative 5 months, which showed good blood supply in middle pancreas and no signs of recurrence of cystadenoma or stones.Conclusions:MPP is a safe and feasible procedure for the treatment of multifocal pancreatic lesions. The procedure can eradicate the lesions and ensure good control of blood glucose in patients.
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Objective:To investigate the clinical effect of transcranial direct current stimulation (tDCS) in treating incomplete cervical spinal cord injury, and to explore the possibility of a relationship between the expression of long chain non-coding RNA (LncRNA) and neurological recovery after such injury.Methods:Forty-six patients suffering from incomplete cervical spinal cord injury were randomly divided into a tDCS group and a control group, each of 23. The American Spinal Cord Injury Association (ASIA) standard, a functional independence scale (FIM) and the modified Barthel index (MBI) were used to evaluate functional changes before and after 8 weeks of treatment. The neurophysiological evaluations of the spinal cord injury were in terms of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs). The expression of the LncRNA-MALAT1, MIAT, GPNMB, LILRB4 and SCD1 genes was quantified before and after the intervention. The relationship between the expression of LncRNA and MBI was then further explored.Results:The average central motor conduction time (CMCT) of the MEPs and the average central conduction time (CTT) of SEPs in the tDCS group were significantly lower than those before treatment and significantly faster than those of the control group after the treatment. The relative expression levels of LncRNA-MALAT1 and MIAT in the tDCS group were significantly higher than those before treatment and among the control group after the intervention. However, no significant differences were observed in the average expression of the LncRNA-GPNMB, LILRB4 or SCD1 genes. After tDCS the relative expression levels of LncRNA-MALAT1 and MIAT were positively and significantly correlated with MBI scores.Conclusions:tDCS can promote the recovery of motor and sensory functions after incomplete cervical spinal cord injury. The underlying mechanism may lie in the up-regulation of LncRNA-MALAT1 and MIAT expression.
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Objective@#To study the efficacy of relieving the postoperation pain by using mesh to stuture and fixate tissue during transabdominal preperitoneal hernioplasty (TAPP) in inguinal hernia patients.@*Metholds@#A retrospective analysis of 156 patients with inguinal hernia who underwent TAPP in Nanhai Hospital Affiliated to Southern Medical University from January 2016 to January 2017 was conducted, they were males, the average age was 50.84 years and the age range was from 33 to 62 years. Patients were divided into sacral nail group (n=120) and absorbable line group (n=36) according to the different methods of fixation of the iliac crest. Among them, the patients in the sacral nail group were fixed with iliac screws, and the patients in the absorbable line group were sutured with absorbable sutures. Pain visual analog scale (VAS) was used to compare the extent of postoperative pain in both groups. After the operation, through the outpatient review and telephone follow-up for 1 year, observed the recurrence of inguinal hernia in both groups. Measurement data were expressed as mean ± standard deviation (Mean±SD), t-test was used for comparison between groups; the Chi-square test was used to compare the count data between the two groups.@*Results@#Among them, 19 patients with moderate pain after operation in the nail group had an incidence of 15.8%. Two patients with moderate pain in the absorbable line group had an incidence of 5.6%. The difference between the two groups was statistically significant (χ2=2.511, P=0.013). The pain VAS of the patients in the sacral nail group was (3.08±1.36), and the absorbable line group was (2.50±0.91), the difference between the two groups was statistically significant (t=2.973, P=0.001). All patients had no recurrence after outpatient review and telephone follow-up for 1 year.@*Conclusion@#In TAPP, the application of absorbable suture fixed patch can effectively reduce postoperative pain.
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Objective To study the efficacy of relieving the postoperation pain by using mesh to stuture and fixate tissue during transabdominal preperitoneal hernioplasty (TAPP) in inguinal hernia patients.Metholds A retrospective analysis of 156 patients with inguinal hernia who underwent TAPP in Nanhai Hospital Affiliated to Southern Medical University from January 2016 to January 2017 was conducted,they were males,the average age was 50.84 years and the age range was from 33 to 62 years.Patients were divided into sacral nail group (n =120) and absorbable line group (n =36) according to the different methods of fixation of the iliac crest.Among them,the patients in the sacral nail group were fixed with iliac screws,and the patients in the absorbable line group were sutured with absorbable sutures.Pain visual analog scale (VAS) was used to compare the extent of postoperative pain in both groups.After the operation,through the outpatient review and telephone follow-up for 1 year,observed the recurrence of inguinal hernia in both groups.Measurement data were expressed as mean ± standard deviation (Mean ±-SD),t-test was used for comparison between groups;the Chi-square test was used to compare the count data between the two groups.Results Among them,19 patients with moderate pain after operation in the nail group had an incidence of 15.8％.Two patients with moderate pain in the absorbable line group had an incidence of 5.6％.The difference between the two groups was statistically significant (x2 =2.511,P =0.013).The pain VAS of the patients in the sacral nail group was (3.08-± 1.36),and the absorbable line group was (2.50 ±0.91),the difference between the two groups was statistically significant (t =2.973,P =0.001).All patients had no recurrence after outpatient review and telephone follow-up for 1 year.Conclusion In TAPP,the application of absorbable suture fixed patch can effectively reduce postoperative pain.
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In order to simultaneously remove carbon and nitrogen from organic-rich wastewater, we used an up-flow anaerobic sludge bed/blanket (UASB) reactor that was started up with anammox with high concentration of carbon and nitrogen by gradually raising the organic loading of influent. We optimized the removal of nitrogen and carbon when the chemical oxygen demand (COD) concentration varied from 172 to 620 mg/L. During the entire experiment, the ammonium and total nitrogen removal efficiency was higher than 85%, while the average COD removal efficiency was 56.6%. The high concentration of organic matter did not restrain the activity of anammox bacteria. Based on polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and tapping sequencing analyses, the Planctomycete, Proteobacteria, Chloroflexi, Chlorobi bacteria are detected in the UASB reactor, which indicated complex removal pathway of carbon and nitrogen coexisted in the reactor. However, a part of Planctomycete which referred to anammox bacteria could tolerate a high content of organic carbon, and it provided help for high performance of nitrogen removal in UASB reactor.
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Ammonia , Chemistry , Biological Oxygen Demand Analysis , Bioreactors , Carbon , Chemistry , Nitrogen , Chemistry , Sewage , Waste Disposal, Fluid , Methods , Wastewater , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To evaluate the immunophenotype conversion of fibroblasts and its clinical significance in the process of breast tumor stromal remodeling.</p><p><b>METHODS</b>CD34, FAP-α, p63 and a-SMA were detected by immunohistochemistry in 273 breast biopsies, including 60 normal breast tissues, 46 atypical ductal hyperplasia (ADH), 60 ductal carcinoma in situ (DCIS), 47 DCIS microinvasive carcinoma (DCIS-MI) and 60 invasive ductal carcinoma (IDC).</p><p><b>RESULTS</b>The positive expression rates of CD34, FAP-α and α-SMA in the stromal fibroblasts of normal breast tissues were 93.3%, 6.7% and 18.3%, respectively. Those in the stromal fibroblasts of ADH tissues were 95.7%, 4.3% and 10.9%, respectively. Those in the stromal fibroblasts of DCIS tissues were 95.0%, 8.3% and 15.0%, respectively. Those in the IDC tissues were 35.0%, 85.0% and 93.3%, respectively. The expressions of CD34, α-SMA and FAP-α in the stromal fibroblasts of normal, ASH and DCIS breast tissues did not show significant differences (χ(2) = 1.142, P = 0.896). The main immunophenotype of stromal fibroblasts in the tumor-host interface at the invasive front of ADH and DCIS lesions was CD34(+)α-SMA(+)FAP-α(+). There were statistically significant differences in the expression of CD34, α-SMA and FAP-α between IDC and ADH, DCIS and normal breast tissues (χ(2) = 8.351, P < 0.001). The immunophenotype of stromal fibroblasts in the IDC and DCIS-MI breast tissues was CD34(-) α-SMA(+) FAP-α(+).</p><p><b>CONCLUSIONS</b>Immunophenotype conversion from CD34(+) α-SMA(-) FAP-α(-) to CD34(-) α-SMA(+)FAP-α(+) may be a sensitive indicator to judge whether DCIS has microinvasion. Detection of the immunophenotype conversion of stromal fibroblasts may be helpful to determine the presence of microinvasion, and to improve the diagnostic accuracy rate of DCIS.</p>
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Humans , Breast , Breast Neoplasms , Allergy and Immunology , Pathology , Carcinoma in Situ , Carcinoma, Ductal, Breast , Carcinoma, Intraductal, Noninfiltrating , Fibroblasts , Allergy and Immunology , Gelatinases , Metabolism , Hyperplasia , Immunohistochemistry , Immunophenotyping , Membrane Proteins , Metabolism , Serine Endopeptidases , MetabolismABSTRACT
To study the enrichment regulation of anammox bacteria during the whole start-up process of anammox reaction, two reactors with addition of carries of Spherical Plastic (SP) and Bamboo Charcoal (BC) and one without carrier (CK) were used to start anammox reaction. Then FISH and q-PCR analyses for the growth of all anammox bacteria were conducted during the operational process. The results indicate that the number of anammox bacteria in all reactors increased with time during the whole start-up process, which was consistent with the removal rate of ammonium and nitrite. On day 123 of stable phase, the percent of anammox cells in the sludge of CK, SP and BC accounted for 23.3%, 32.6% and 43.7%, respectively. The number of anammox bacteria 16S rRNA gene copies was (25.64 +/- 2.76) x 10(7), (47.12 +/- 2.76) x 10(7) and (577.99 +/- 27.25) x 10(7) copies g(-1) VSS in the sludge of CK, SP and BC, respectively. Carrier addition could dramatically increase enrichment of anammox bacteria. BC addition significantly increased the anammox bacteria number in the UASB reactor which resulted in the acceleration of the anammox start-up process. In addition, the max specific growth rate and the minimum doubling time were 0.064 d(-1) and 10.8 d in BC reactor. The max specific growth rate of anammox bacteria in BC reactor was 1.78 times and 1.88 times greater than that in CK and SP reactor, respectively. Therefore, the FISH and q-PCR analyses were suitable for determining the enrichment regulation of anammox bacteria during the start-up time, while a bit of differences in results existed between the two analytical methods due to the difference in analysis targets.
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Ammonia , Metabolism , Bacteria , Metabolism , Bioreactors , Industrial Microbiology , Nitrites , Metabolism , Oxidation-Reduction , Sewage , MicrobiologyABSTRACT
Objective To investigate the prevalence of drug-resistant mutations in reverse transcriptase and protease coding regions of HIV-1 in treatment-na(i)ve patients. MethodsPlasma specimens were collected from 88 patients from Zhejiang, Shanghai, Henan and Anhui. The entire protease gene and the first 1-251 amino acids of the reverse transcriptase gene were amplified by RT-PCR from viral RNA and sequenced. The sequences were analyzed with HIV drug resistance algorithm, and phyligenetic analyses were performed by PHYLIP software. SPSS 13.0 was used for statistical analysis, and Fisher' s exact test was performed to compare the proportions of each subtype between the groups. Results79 gene sequences were obtained, subtyping analyses indicated that 68.4％ (54/79) were subtype B, followed by CRF01 _AE 24.8％ (22/79), CRF07_BC2.5％ (2/79),andCRF08_BC1.3％ (1/79). 7 (7/79,8.9％)presented with primary mutations associated with resistance to antiretroviral drugs, mutations conferring primary resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors ( NNRTIs ) were detected in 3 ( 3. 8％ ) and 4 ( 5. 1％ ) cases, respectively. Protease inhibitors (Pls)associated primary resistance mutations were not found.Conclusion Antiretroviral drug resistant mutations have been found in treatment-na(i)ve patients with HIV-1 infections, while the prevalence level is low, which indicates that drug resistance test is not necessary for most HIV-1infected treatment-na(i)ve patients.