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Elizabethkingia anophelis is one of the most significant pathogens threatening human health.As an important opportunistic pathogen, it is prone to nosocomial infection outbreaks, and can cause neonatal meningitis, especially in prematurity, seriously affecting the safety and quality of life of children.E.anophelis has the characteristic of multi-drug resistance, which brings great challenges to clinical treatment.E.anophelis was commonly misidentified as E. meningosepticum in previous reports.In fact, E.anophelis accounts for a significant proportion of Elizabethkingia infections, which needs more attention.This article reviews the epidemiology of E. anophelis, clinical features of neonatal infection, drug sensitivity, treatment and prevention, in order to provide reference for clinical diagnosis and treatment.
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BACKGROUND@#China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China.@*METHODS@#This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan-Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models.@*RESULTS@#This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06-1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05-1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23-1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34-4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17-3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37-47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59-8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83-57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13-2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36-22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54-25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57-10.14; P = 0.004) were independently associated with the incidence of AF.@*CONCLUSIONS@#The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.
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Humans , Male , Middle Aged , Aged , Atrial Fibrillation/epidemiology , Prospective Studies , Incidence , Atrial Flutter/complications , Risk Factors , China/epidemiology , ElectrocardiographyABSTRACT
Objective:To explore the features of free uroflow(FF) curve patterns in female patients with detrusor underactivity(DU) and their clinical significance.Methods:Data of 275 adult female patients with lower urinary tract symptoms(LUTS) underwent urodynamic studies(UDS) at urology center of our hospital from June 2014 to June 2016 were analyzed retrospectively. The uroflow curve patterns of patients with DU were classified and analyzed in the context of parameters of FF, cystometry (CM), and pressure-flow study(PFS). The prevalence of each abnormal uroflow curve pattern in DU patients were calculated and compared with those in non-DU patients.Results:No bell-shaped curve was found in 141 patients with DU. The abnormal curve patterns can be divided into 5 types: Type Ⅰ (bell-shaped curve with saw tooth) in 20 cases (14.2%), Type Ⅱ (box-like curve) in 34 cases (24.1%), Type Ⅲ (triangle curve with decreasing slop) in 62 cases(43.9%), Type Ⅳ (triangle curve with increasing slop) in 4 cases (4.3%), Type Ⅴ (tide-wave curve)in 19 cases (13.5%). Maximum flow rate of free uroflow(Q max.FF) of type Ⅰ [(28.4±9.7) ml/s] was significantly greater than that of type Ⅱ, Ⅲ and Ⅴ[(17.0±4.1), (15.8±5.4) and (12.9±6.4) ml/s, P<0.05]. Flow time of free uroflow(FT.FF) of type Ⅲ and Ⅴ [(43.7±17.2) and (50.1±28.9)s] were significantly longer than that of type Ⅰ and Ⅱ [(18.5±7.3)s and (27.2±9.7)s, P<0.05]. Post voided residual > 50ml was noted in 19 cases (30.6%) of type Ⅲ, 7 cases (36.8%) of type Ⅴ, 1 case (2.9%) of type Ⅱ and no one in type Ⅰ and Ⅳ. Abnormal manifestations in cystometry mainly included bladder hypersensitivity, detrusor overactivity, and stress urinary incontinence. Detrusor pressure at Q max (Pdet.Q max) of type Ⅴ [(7.4±5.0) cmH 2O] was significantly lower than that of type Ⅰ, Ⅱ, Ⅲ [(11.8±6.7), (12.0±5.3), (12.1±5.0) cmH 2O, P<0.05]. Among 134 cases of non-DU, there were type Ⅰ curves in 88 cases (65.7%), type Ⅱ curves in 4 cases (2.9%), type Ⅲ curves in 15 cases (11.2%), type Ⅳ curves in 1 cases (0.7%), type Ⅴ curves in 7 cases (5.2%). And normal bell-shaped curves in 19 cases(14.2%). The prevalence of type Ⅱ, Ⅲ and Ⅴ in DU patients was significantly higher than that in the non DU patients ( P<0.05). Conclusions:This study reveals that the characteristics of reduced detrusor contractility and duration, prolonged bladder emptying or incomplete emptying can be reflected in the patterns of free uroflow curve in female patients with DU. The abnormalities of these free uroflow curve patterns, especially type Ⅱ, Ⅲ and Ⅴ will be helpful in preliminarily screening DU in females.
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Objective:To investigate the effects of insulin resistance induced by long-term high-fat diet on cognitive function and brain phosphorylated Tau protein in pR5 MAPT Tau transgenic mice.Methods:Eight-week-old female pR5 MAPT transgenic mice were divided into standard diet(STD) group (pR5 STD, n=8) and high-fat diet(HFD) group (pR5 HFD, n=8). Female wild-type C57BL/6 mice fed with STD were used as control group (WT STD, n=8). The experiment was carried out for 30 weeks until the mice were old.During the experiment, the weight of mice was measured once a week and fasting blood glucose was measured once every two weeks.Thirty weeks later, glucose tolerance test and insulin tolerance test were carried out.Forced swimming test and tail suspension test were used to evaluate the depressive behavior of mice, and elevated plus maze test was used to evaluate the anxiety behavior, Morris water maze test was used to evaluate spatial memory behavior.The levels of total Tau protein and phosphorylated Tau proteins H7-tau, p-tau-Ser396 and p-tau-Thr231 were detected by Western blot.SPSS 17.0 software was used for statistical analysis, repeated measurement ANOVA was used for the data of glucose tolerance test and insulin tolerance test, one-way ANOVA was used for multi group comparison, and LSD test was used for further pairwise comparison. Results:After 30 weeks of high-fat diet, there were significant differences in body weight and fasting blood glucose among the three groups ( F=808.31, 1 117.18, both P<0.01). The body weight of mice in pR5 HFD group ((54.35±2.52)g) was higher than those in pR5 STD group ((24.95±1.15) g) and WT STD group ((23.86±1.10) g) (both P<0.01), and the fasting blood glucose of mice in pR5 HFD group ((8.12±0.24) mmol/L) was significantly higher than those in pR5 STD group ((4.64±0.13) mmol/L) and WT STD group ((4.45±0.22) mmol/L) (both P<0.01). Glucose tolerance test showed that within 120 minutes after injection of glucose, there was a significant time and group interaction in the blood glucose value among the three groups ( F=113.30, P<0.01). After glucose injection, the peak value of blood glucose in pR5 HFD group was delayed, suggesting that glucose tolerance in pR5 HFD group was impaired.The insulin tolerance test showed that there was a significant interaction between time and group in the insulin tolerance among the three groups ( F=209.92, P<0.01). After injection of insulin, the blood glucose in pR5 HFD group decreased slowly, reaching the valley value at 60 min, and then the blood glucose increased significantly, suggesting that the sensitivity of pR5 HFD group mice to insulin decreased significantly.There were significant differences in the percentage of forced swimming immobility time and tail suspension immobility time among the three groups ( F=37.05, 59.29, both P<0.01). The two indexes of pR5 STD group and pR5 HFD group were both higher than those of WT STD group (all P<0.01), and those of pR5 HFD group were both higher than those of pR5 STD group (both P<0.01). The results of elevated plus maze showed that there were significant differences in the activity distance and time in open arm among the three groups ( F=7.82, 10.37, both P<0.05) .The activity distance ((0.40±0.21) m) and activity time ((27.38±8.80) s) of pR5 HFD group were significantly lower than those of pR5 STD group ((2.31±1.74) m, (63.56±27.52)s) (both P<0.05). The space exploration test showed that the residence time in the target quadrant of pR5 HFD group ((15.56±1.16)s) was less than that of pR5 STD group((19.18±0.64)s)( P<0.01), and the time of entering the platform area of pR5 HFD group((1.43±0.06)s) was less than that of pR5 STD group((1.66±0.12)s)( P<0.01). Western blot showed that there were significant differences in the levels of total Tau protein, H7-tau, p-tau-Ser396 and p-tau-Thr231 protein among the three groups ( F=101.50, 80.60, 55.47, 30.89, all P<0.05). Further pairwise comparison showed that the levels of the four Tau proteins showed: the levels of the proteins in pR5 STD group and pR5 HFD group were all higher than those of WT STD group (all P<0.01), and those in pR5 HFD group were all higher than those in pR5 STD group (all P<0.05). Conclusion:Long-term high fat diet causes obesity, hyperglycemia and peripheral insulin resistance, and promotes the cognitive impairment of MAPT mice, which is related to the increase of Tau protein phosphorylation in the brains of MAPT mice.
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Purpose@#The goal of this study was to describe the current status of oncology nurses' behaviors toward end of life (EOL) care in China and to explore the factors associated with oncology nurses’ behaviors toward EOL care. @*Methods@#A cross-sectional design was applied and a convenience sample of 1038 oncology nurses from 22 grade A hospitals were recruited into this study. A general social demographic data questionnaire was administered, and the Chinese version of Nurses’ Behaviors of Caring for Dying Patients Scale was used to assess nurse behavior toward EOL care. The total score ranges from 40 to 200 points. Data were analyzed with SPSS 26.0 software. @*Results@#Chinese oncology nurses' average score of holistic EOL care behaviors was 2.97 ± 0.59. Oncology nurses provide physical care most (3.81 ± 0.76), followed by family care (3.02 ± 0.86), and spiritual care (2.37 ± 0.67). Multiple regression analysis showed that a higher frequency of sharing EOL care experience with colleagues, in-service palliative care education, higher level of head nurse support for EOL patient care, more cases of EOL care, higher working position, and nurse's perceived high level of support were positively associated with behavior toward EOL care. These six factors explained 16.2% of the total variance. @*Conclusions@#The results may help provide a basis for converting behavior for EOL care among oncology nurses and design interventions to better improve quality of life for EOL patients with cancer in China.
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Data of 643 patients who underwent endoscopic polypectomy with high-frequency electrotome in 6 hospitals of Sichuan Province between June 2020 and September 2020 were summarized. The rate of complete polypectomy and the incidence of delayed post-polypectomy bleeding (DPPB) and perforation were analyzed. DPPB occurred in 18 cases (2.80%) and postoperative perforation occurred in 1 case (0.16%). All of the 1 828 polyps were completely resected (100.0%). Univariate analysis showed that polyps′ diameter≥10 mm, long peduncle or laterally spreading tumor (LST), adenomatous polyp, endoscopic mucosal resection, mixed cutting mode 1 of electrocoagulation were significantly correlated with DPPB( P<0.05). Multivariate Logistic regression analysis revealed that polyp diameter≥10 mm ( P=0.001, OR=3.575, 95% CI: 1.175-9.955), morphology of long peduncle or LST ( P=0.004, OR=2.981, 95% CI: 1.233-14.858) were independent risk factors for DPPB. Endoscopic colorectal polypectomy with high-frequency electrotome is effective and safe. Polyps′ diameter≥10 mm, polyps with long pedicle or LST are the risk factors for DPPB.
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Testicular/paratesticular mucinous cystadenoma is a rare type of ovarian epithelial tumor. This paper reported a patient with enlarged left testicle , and CT showed a multifocal cystic mass in left testis. Radical left testis orchiectomy was performed, and the pathology showed testicular borderline mucinous cystadenoma. The patient was followed up for 3 years and no recurrence and metastasis was observed.
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Objective To investigate NIMA-related kinase 2 (NEK2) expression in colorectal cancer (CRC) tissues and its effect on the proliferation, migration and invasion of HCT116 cells. Methods Synthesized siRNA targeting NEK2 was transfected into HCT116 cells by lipofectamine method. CCK8 assay, FACS, wound healing assay and Transwell assay were used to detect the effects of NEK2 knockdown on cell proliferation, cell cycle distribution, migration and invasion. Western blot was carried out to detect the expression of E-cadherin, N-cadherin, CDK4 and cyclin D1. Results The expression of NEK2 in CRC tissues was significantly higher than that in adjacent normal tissues (65.0% vs. 35.0%, χ2=14.593, P < 0.01), and its level was closely related to TNM stage, lymph node metastasis and distant metastasis (all P < 0.05). NEK2 protein and mRNA levels in CRC cell lines were also significantly higher than those in normal colorectal mucosal cells (P < 0.01). After NEK2 was knocked down by siRNA, HCT116 cells were arrested in G0/G1 cycle, while cell proliferation, invasion and migration were significantly reduced (P < 0.01). NEK2 interference in HCT-116 cells led to the upregulation of E-cadherin and downregulation of N-cadherin, CDK4 and cyclin D1 at protein levels. Conclusion The high NEK2 expression is correlated with clinicopathological characteristics of CRC patients. NEK2 knockdown by siRNA could effectively inhibit the proliferation, invasion and migration abilities of colorectal cancer cells, suggesting that NEK2 plays an important role in the occurrence and development of colorectal cancer and it can be used as a potential treatment target.
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Objective:To investigate the correlation between blood pressure changes within 24 h after intravenous thrombolysis and the outcome in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke treated with alteplase intravenous thrombolysis in the Department of Neurology, Anhui No. 2 Provincial People's Hospital from June 2018 to September 2020 were enrolled retrospectively. The patients who received antihypertensive therapy before and within 24 h after intravenous thrombolysis were excluded. The blood pressure before intravenous thrombolysis and the blood pressure drop within 24 h after intravenous thrombolysis were recorded. The modified Rankin Scale was used to evaluate the clinical outcome at 90 d after the onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to investigate the independent correlation between blood pressure changes within 24 h after intravenous thrombolysis and the clinical outcomes. Results:A total of 205 patients with acute ischemic stroke were enrolled, including 125 males (60.98%), 80 females (39.02%); aged 63.30±9.63 years; 124 (60.49%) had a good outcome, and 81 (39.51%) had a poor outcome. Univariate analysis showed that the proportion of diabetic patients as well as baseline systolic blood pressure, prethrombolytic blood glucose, baseline National Institutes of Health Stroke Scale score, and the incidence of symptomatic intracranial hemorrhage in the good outcome group were significantly lower than those in the poor outcome group, and the proportion of patients with small vessel occlusion and the decrease in systolic blood pressure within 24 h after thrombolytic therapy were significantly higher than those in the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that higher baseline systolic blood pressure was independently associated with the poor outcome at 90 d after intravenous thrombolysis (odds ratio 0.964, 95% confidence interval 0.942-0.987; P=0.002), and a greater decrease in systolic blood pressure within 24 h after intravenous thrombolysis was independently associated with a good outcome (odds ratio 1.134, 95% confidence interval 1.067-1.206; P<0.001). Conclusion:For patients with acute ischemic stroke who received intravenous thrombolysis, higher baseline blood pressure before intravenous thrombolysis was associated with the poor outcome, and greater decrease in systolic blood pressure within 24 h after intravenous thrombolysis was associated with the good outcome.
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Objective To investigate the role of enteral nutrition (EN) support in the treatment of patients with chronic heart failure. Methods Ninety patients with chronic heart failure (conform to the New York Heart Association (NYHA) cardiac function class Ⅲ-Ⅳ) admitted to Intensive Care Unit (ICU), Cardiology Care Unit (CCU) and Emergency ICU (EICU) of Taizhou First People's Hospital from January 2015 to September 2017 were enrolled, and according to different nutritional methods, they were divided into a control group (rational autonomous diet group) and an observation group (Ruineng enteral nutritional emulsion for EN group), each group 45 cases. Based on the calculation (Harris-Benedict) of individual total energy consumption the control group had a reasonable autonomous diet and Ruineng EN emulsion for EN group. The chang of various nutrition indexes [including body mass index (BMI), serum total protein (TP), albumin (Alb), hemoglobin (Hb), vitamin B12, folic acid, serum iron], inflammatory factors [tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)], and the level of cardiac function index (LVEF) before and after treatment were observed. Results ① Before treatment, vitamin B12 in the observation group was significantly higher than that in the control group (ng/L: 153.3±54.6 vs. 113.4±80.2, P < 0.05), there were no statistical significant differences in other indicators between the two groups (all P > 0.05). ② After treatment, compared with those before treatment, the nutritional indicators and LVEF of both groups were higher, and inflammatory factors were lower, there were statistical significant differences in the other indicators before and after treatment except Hb and IL-6 in the control group and serum iron in the observation group [the control group: BMI (kg/m2) was 20.9±1.8 vs. 19.9±1.2, TP (g/L) was 66.0±2.4 vs. 63.7±1.6, Alb (g/L) was 34.4±3.5 vs. 31.1±2.3, vitamin B12 (ng/L) was 149.5±79.2 vs. 113.4±80.2, folic acid (nmol/L) was 10.0±1.7 vs. 4.6±3.2, serum iron (μmol/L) was 16.5±13.7 vs. 10.4±7.5, TNF-α (ng/L) was 23.8±10.0 vs. 28.3±8.6, LVEF was 0.35±0.14 vs 0.32±0.04; observation group: BMI (kg/m2) was 21.5±1.4 vs. 20.2±1.4, TP (g/L) was 66.5±2.8 vs. 64.3±2.2, Alb (g/L) was 35.8±3.1 vs. 33.3±1.9, Hb (g/L) was 121.4±13.8 vs. 112.9±12.0, vitamin B12 (ng/L) was 201.1±98.6 vs. 153.3±54.6, folic acid (nmol/L) was 15.7±14.4 vs. 8.8±2.8, TNF-α (ng/L) was 20.5±6.3 vs. 25.8±3.0, IL-6 (ng/L) was 209.4±6.5 vs. 220.9±16.9, LVEF was 0.38±0.07 vs. 0.33±0.02, all P < 0.05]. ③ Before and after treatment, the changes of BMI, Hb, vitamin B12, folic acid and IL-6 in the observation group were more significant than those in the control group [BMI (kg/m2): 1.4±0.9 vs. 1.1±0.3, Hb (g/L): 8.6±1.2 vs. 2.7±0.9, vitamin B12 (ng/L): 47.1±1.0 vs. 36.2±0.9, folic acid (nmol/L): 6.8±1.8 vs. 5.5±1.8, IL-6 (ng/L):-10.8±2.3 vs. -1.6±1.0, all P < 0.05]. After treatment, the degree of increase of serum iron in the control group was more significant than that in the observation group (μmol/L: 6.2±0.8 vs. 1.4±0.9, P <0.05), there were no significant differences in the degrees of improvement in TP, Alb and TNF-α between the two groups (all P > 0.05). ④ The difference value of each indicator before and after treatment of the two groups of patients with cardiac grade Ⅲ was more significant than that in the patients with cardiac grade Ⅳ, among the indicators in the control group, Hb, serum iron and IL-6 showed statistical significant differences [Hb (g/L): 3.05±0.42 vs. 2.47±0.84, serum iron (μmol/L): 6.81±0.91 vs. 5.95±1.82, IL-6 (ng/L): -3.87±0.45 vs. -0.53±0.28, all P < 0.05], while in the observation group of patients with cardiac grade Ⅲ and Ⅳ, Alb, Hb, serum iron, IL-6 appeared statistical significant differences [Alb (g/L): 3.41±0.38 vs. 2.27±0.91, Hb (g/L): 9.83±1.44 vs. 8.10±0.98, serum iron (μmol/L): 2.23±0.34 vs. 1.04±0.88, IL-6 (ng/L):-14.11±0.42 vs. -9.45±1.01, all P < 0.05]. Conclusion In the treatment of patients with chronic cardiac failure, simultaneously EN support is given energetically, that can improve the nutrition status of organism, reduce inflammatory reaction and enhance cardiac function; the therapeutic effect of Ruineng EN support is remarkably better than that of the autonomous diet support.
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Objective To compare the efficacy and safety of low-dose and standard-dose alteplase intravenous thrombolytic therapy in patients with acute ischemic stroke and to investigate whether low-dose alteplase is more suitable for patients with acute ischemic stroke in China.Methods Patients with acute ischemic stroke treated with alteplase intravenous thrombolysis from July 2016 to December 2018 in Anhui No.2 Provincial People's Hospital were enrolled retrospectively.According to the dose of alteplase,they were divided into low-dose group (0.6 mg/kg,the total dose not exceeding 60 mg) and standard dose group (0.9 mg/kg,the total dose not exceeding 90 mg).The efficacy endpoint was the clinical outcome at 90 d after onset evaluated by the modified Rankin Scale (mRS).The mRS score 0-2 was defined as self-care in life,and 0-1 was defined as good outcome.The safety endpoints were the incidence of symptomatic intracerebral hemorrhage (sICH) within 24-48 h after thrombolytic therapy and the mortality at 3 months.Results A total of 103 patients were enrolled,including 45 in the low-dose group and 58 in the standard dose group.There were no significant differences in demography,baseline clinical data,as well as self-care and good outcome rates at 90 d between the 2 groups.The incidence of sICH in the low-dose group (National Institute of Neurological Disorders and Stroke criteria:2.22％ vs.17.24％;x2 =4.521,P=0.033) and mortality at 90 d (6.67％ vs.24.14％;x2 =4.417,P =0.036) were significantly lower than those in the standard dose group.Conclusion The efficacy of low-dose alteplase in the treatment of acute ischemic stroke was comparable to that of standard dose,but the incidence of sICH and mortality at 90 d were significantly reduced,which might be more suitable for Chinese patients.
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Objective To investigate the effect of morphine combined with noninvasive positive pressure ventilation in the treatment of patients with acute left heart failure .Methods 80 patients with acute left heart failure were enrolled ,and they were randomly divided into two groups according to the digital table method ,40 cases in each group.The patients in the control group were treated with noninvasive positive pressure mechanical ventilation .The patients in the observation group were treated with morphine sedation on the basis of the treatment of the control gorup.The vital signs test indicators,disease-related parameters,clinical events,cognitive function and quality of life were compared between the the two groups .Results The systolic blood pressure,heart rate,respiratory rate,PaCO2 and myocardial oxygen consumption in the observation group were significantly lower than those in the control group at 30min after treatment,PaO2 and pH in the observation group were significantly higher than those in the control group , the APACHEⅡ,BNP,Hs-cTnl and CK levels in the observation group at 24 h after treatment were significantly lower than those in the control group,the differences were statistically significant (t =8.349,13.127,7.413,17.072, 15.334,2.631,3.088,12.371,8.061,4.784,18.931,6.568,9.464,all P<0.01).The rate of tracheal intubation of the observation group was significantly lower than that of the control group (0.0％vs.20.0％),the rate of withdrawal of the observation group was significantly higher than that of the control group (85.0％ vs.50.0％),the differences were statistically significant (χ2 =6.806,11.168,all P<0.01).The MLHFQ score of the observation group 3 months after treatment was significantly lower than that in the control group [( 24.69 ±5.38)points vs.( 38.24 ± 8.03)points],the difference was statistically significant (t=8.866,P<0.01).There was no statistically significant difference in MoCA score after treatment between the two groups [(24.80 ±2.93)points vs.(25.07 ±2.33)points, t=0.456,P>0.05].Conclusion Morphine has significant influence on the effect of noninvasive positive pressure mechanical ventilation in patients with acute left heart failure .
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Cardiovascular diseases is a kind of circulatory system disease,circulatory system mainly includes the heart and blood vessels,the common disease including myocardial ischemia,cardiomyopathy,heart failure,arrhythmia and sudden cardiac death.With the change of human living environment and habits, cardiovascular diseases has become the leading cause of human death[1].Autophagy is an important regulation method for the steady state of eukaryotic cells,which has been proved to be closely related to various diseases and is a hotspot in the research of human diseases in recent years.Autophagy is closely related to the occurrence of cardiovascular diseases,and plays an important role in the prevention and control of cardiovascular diseases, but the specific mechanism still needs to be further studied.This paper introduces the concept and mechanism of autophagy,and summarizes the mechanism of autophagy in cardiovascular disease.
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Objective: To study the effect of different dissolution media on the dissolution curve of risperidone oral soluble films to provide reference for the quality evaluation of the preparation.
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ObjectiveTo explore the Clinical effect of Tiotropium Bromide combined with seretide in patients with chronic obstructive pulmonary disease at stable period.Methods84 patients with stable COPD from March 2015 to February 2016 in our hospital outpatient respiratory department were randomly divided into control group and treatment group.The control group was treated with Seretide, the treatment group was treated withtiotropium bromide on the basis of control group.Compared the lung function, blood gas analysis, 6-minute walking distance, dyspnea score and quality of life were between the two groups after six months of treatment.ResultsFVC, FEV1and FEV1/ FVC (%) in the treatment group were significantly higher than those in the control group (P<0.05).The score of quality of life and dyspnea in the treatment group were significantly lower than those in the control group (P<0.05).The 6MWD in treatment group was significantly longer than that in control group (P<0.05).PaCO2 was significantly lower in the treatment group than that in the control group, but PaO2 was significantly higher than that in the control group after six months treated(P<0.05).ConclusionThe combination of tiotropium bromide and seretide in patients with chronic obstructive pulmonary disease (COPD) is effective in improving pulmonary function, improving life therapy, and reducing the symptoms of dyspnea.
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Objective To study the assessment of airway inflammation in asthma patients with airway remodeling by high resolution spiral CT(HRCT).Methods Retrospective analysis on 60 cases of chronicity-persistent period asthma patients with induced sputum IL-4 test,airway mucosa biopsy,HRCT scan; while 20 patients only used HRCT scan as control group.To compare the difference of sputum IL-4,HRCT test of airway wall thickness(WT),wall area(WA)and airway wall relative area(WA％)in different degrees of asthma paitents.Results WA,WA％and WT were significantly increased in different degrees of asthma patients when compared to control group(P<0.05),there were significant difference among each group(P<0.05).WA％and WT were positively correlated with induced sputum IL-4.Conclusion HRCT can effectively evaluate the airway inflammation in airway remodeling of asthma patients,which can be used to evaluate the severity of asthma,treatment effect and follow-up observation.
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Objective@#To investigate the dynamic change of paraquant-induced kidney injury in rats and the protective effect of edaravone.@*Methods@#Eighty SD rats were randomly divided into 4 groups: the normal control group, paraquat poisoning group, edaravone treatment group and edaravone control group. The normal control group of 8 rats were given 1 ml of 0.9% sodium chloride through the abdominal cavity, and the same amount of fluid into the abdominal cavity after 30 minutes. The paraquat poisoning group of 24 rats were given 1 ml of paraquat solution (20 mg/kg) through the abdominal cavity to build poisoning models, and the same amount of 0.9% sodium chloride was injected into the abdominal cavity after 30 minutes. The edaravone treatment group of 24 rats were given edaravone (5 mg/kg) through the abdominal cavity after 30 minutes when the poisoning models were set up. The edaravone control group of 24 rats were given 1 ml of 0.9% sodium chloride through the abdominal cavity, and edaravone (5 mg/kg) was injected into the abdominal cavity after 30 minutes. In addition to the normal control group, the other groups processed 1 times a day to mantain 7 d. On 1, 3, 7, 21 d several rats in each group were excuted and the kidney tissue and serum samples were collected, then each pathological changes of the kidney were observed with light microscopy. Serum creatinine, KIM-1, NGAL were measured by ELISA, the expression of HSP70 protein in kidney were observed with immunohistochemical staining.@*Results@#The pathological examination reveald that the damage of kidney tissue in the paraquat group was the most serious on 3 d, and the damage was consistently alleviated in edaravone treatment group at the same time, renal fibrosisn was unseen in each group until 21 d. Compared with normal control group, there was no statistically significant in edaravone control group (P>0.05) . The KIM-1 in blood and kidney in paraquat poisoning group were markedly increased in 1 d (P<0.05) . The NGAL in blood and creatinine were markedly increased in d7 (P<0.05) . The NGAL in kidney increased over time, but had no statistically difference with the control group (P>0.05) .Compared with paraquat poisoning group, the serum creatinine, KIM-1 in blood and kidney, the KIM-1 in kidney had decreased significantly in edaravone treatment group (P<0.05) . The NGAL in kidney has no statistically significant compared with the poisoning group (P>0.05) . HSP70 expression of kidney tissue in edaravone treatment group had significantly increased in d3 compared with the paraquat poisoning group (P<0.05) .@*Conclusion@#Edaravone can prompt a significant rise of HSP70 in kidney tissue, reduce KIM-1 and NGAL levels, and play a protective role in kidney injury of acute paraquat poisoning.
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Objective To investigate the clinical effect of milrinone injection combined therapy in patients with cor pulmonale complicated with respiratory failure and observe the effect of milrinone on blood gas index, blood viscosity and pulmonary arterial pressure.Methods The clinical data of 100 patients with cor pulmonale complicated with respiratory failure were retrospectively analyzed from April 2014 to April 2016.Among them, 50 cases were treated with conventional oxygen therapy, diuretic, asthma and anti-infection treatment.In the control group, 50 cases were treated with milrinone injection as the treatment group.The clinical curative effect and adverse reaction were analyzed.The blood gas analysis index, blood viscosity and pulmonary arterial pressure were measured before and after the treatment.The sputum normal and cyanosis, cough, wet rales and edema time were recorded in the two groups.Results The total effective rate of the treatment group was 92.0%, which was significantly higher than that of the control group 70.0%(P <0.05).After treatment, the hemorheological indexes and blood gas analysis indexes of the two groups improved significantly, However, the improvement of the indicators of the treatment group were significantly better than the control group (P<0.05).The pulmonary arterial pressure in the treatment group was (18.36 ±7.38) mmHg, which was significantly lower than that in the control group (23.79 ±6.14) mmHg (P<0.05); After treatment, the sputum normal and cyanosis in the treatment group, cough, wet rales, edema time were significantly shorter than the control group ( P <0.05 ) .No significant adverse effects were observed in both groups during the treatment.Conclusion The use of milrinone injection comprehensive treatment of pulmonary heart disease with respiratory failure in patients with significant efficacy and safety , but also can help improve blood viscosity and blood gas analysis indicators, reduce pulmonary artery pressure, better promote the rehabilitation of patients.
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<p><b>OBJECTIVE</b>To compare mid-term results of surgical treatment with aortoiliac stenting (AIS) in patients with chronic aortoiliac occlusion.</p><p><b>METHODS</b>A retrospective review of 68 patients treated between January 2005 and December 2010 was performed. Thirty-three patients underwent surgical revascularization (surgical group) and 35 patients underwent AIS (AIS group). Preoperative clinical factors and outcome data including complications, ankle-brachial index and mortality were collected. Kaplan-Meier estimates for survival, limb salvage and patency were analyzed.</p><p><b>RESULTS</b>Preoperative risk factors were similar between the two groups. Surgical group were younger than AIS group ((56±11) years vs. (65±10) years, t=-2.789, P=0.008) with more patients manifesting rest pain (23/33 vs.15/35, χ2=4.963, P=0.026) and relative higher perioperative mortality (3/33 vs. 0/35, P=0.109). Mean ankle-brachial index increased significantly in both groups after operation (Surgical group 0.90±0.15 vs. 0.43±0.20, t=-7.849, P=0.000; AIS group 0.85±0.20 vs. 0.41±0.25, t=-5.379, P=0.000). Postoperative complications occurred, with statistically higher rates of respiratory failure, transient renal dysfunction and multiple organ dysfunction syndrome in surgical group (χ2=6.98, P=0.010; χ2=9.62, P=0.000; P=0.023). The 5-year primary patency in surgical group was 90.2%, compared with 64.2% in AIS group (χ2=3.717, P=0.054). No difference was observed in survival rate, limb salvage and secondary patency between the two groups.</p><p><b>CONCLUSIONS</b>Five-year primary patency of endovascular reconstruction for chronic aortoiliac occlusion is lower than that for traditional open surgery. Open surgery is still the first choice for the patients who can endure the surgery. Endovascular treatment is an option for patients with high risk. However, additional interventional treatment is needed in some cases.</p>
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Adult , Aged , Humans , Middle Aged , Arterial Occlusive Diseases , General Surgery , Limb Salvage , Postoperative Complications , Retrospective Studies , Risk Assessment , Risk Factors , Stents , Survival Rate , Treatment Outcome , Vascular Patency , Vascular Surgical ProceduresABSTRACT
<p><b>OBJECTIVE</b>To explore the feasibility of short-term neoadjuvant chemotherapy (NACT) in patients with advanced gastric cancer (AGC), and to compare clinical efficacy of short-term neoadjuvant chemotherapy with different ways.</p><p><b>METHODS</b>Clinical data of 310 AGC patients treated with one course of NACT using EOF regimen(epirubicin, oxaliplatin and fluorouracil plus calcium folinate) in our hospital from January 2008 to December 2011 were retrospectively analyzes. Efficacy was compared between regional arterial infusion chemotherapy and intravenously chemotherapy.</p><p><b>RESULTS</b>All the 310 AGC patients completed one course of NACT and none was interrupted by adverse events. Postoperative pathological remission rate was 33.9% (105/310) and 5 patients (1.6%) had complete pathological remission. The pathologic response rate in the regional arterial infusion chemotherapy group was higher than that in the intravenously chemotherapy group(42.4% vs. 23.6%, P = 0.001). Multivariate analysis revealed that chemotherapy method(HR=1.827, 95% CI:1.006-3.316, P = 0.048) was associated with significantly higher pathologic response.</p><p><b>CONCLUSIONS</b>Pathological response rate is quite low following short-term NACT. Regional arterial infusion chemotherapy with short-term NACT can improve the pathological response rate of advanced gastric cancer.</p>