Acute Type A Aortic Dissection and Late Pregnancy: What Should We Do?

ABSTRACT Introduction: Acute type A aortic dissection (AAAD) in late pregnancy is a rare but severe disease. Lack of clinical experience is the main cause of high mortality. This study tries to investigate the multidisciplinary therapeutic strategy for these patients. Case presentation: We reported three patients with AAAD in late pregnancy. Sudden chest pain was the main clinical symptom before operation. All three patients and their newborns survived through multidisciplinary approach in diagnosis and treatment. No serious complications occurred during the mid-term follow-up. Conclusion: Multidisciplinary diagnosis and treatment strategy play a crucial role in saving the lives of pregnant women with AAAD.

Medial parapatellar soft tissue overlapping suture in total knee arthroplasty for severe osteoarthritis with permanent patellar dislocation: early and mid-term results / 南方医科大学学报

OBJECTIVE@#To evaluate the early and mid-term clinical results of medial parapatellar soft tissue overlapping suture in total knee arthroplasty for treatment of severe osteoarthritis combined with permanent patellar dislocation.@*METHODS@#We retrospectively analyzed the data of 12 patients (12 knees) diagnosed with severe knee osteoarthritis combined with permanent patellar dislocation undergoing total knee arthroplasty with medial parapatellar soft tissue overlapping suture. Knee Society Score (KSS), University of California Los Angeles (UCLA) activity-level rating, Visual Analog Scale (VAS) pain score, and knee range of motion of the patients were assessed before and 2 years after the surgery. Anteroposterior and lateral radiographs of the knee joint, full-length standing radiographs of the lower limbs and patellar axial radiographs were evaluated.@*RESULTS@#The mean Knee Society Score of the patients increased from 34.2±11.1 before surgery to 73.5±6.3 at two years after the surgery (P < 0.001). The UCLA activity-level rating increased from an average of 3.8 ± 0.8 before surgery to 5.8 ± 0.6 at two years postoperatively (P=0.003). The mean VAS pain score decreased from 42.8±6.0 before surgery to 20.1±3.7 (P < 0.001) and the range of motion of the knee joint increased from 74.6±8.9 degrees to 97.5±4.5 degrees at two years (P < 0.001). The radiographs showed no signs of subluxation or dislocation of the patella in all the patients.@*CONCLUSIONS@#Medial parapatellar soft tissue overlapping suture in total knee arthroplasty can achieve good early and mid-term clinical results for treatment of severe osteoarthritis combined with permanent patellar dislocation.

Empirical analysis and intervention research on the influencing factors of college students' physical health / Análise empírica e investigação da intervenção sobre os fatores que influenciam a saúde física dos estudantes universitários / Análisis empírico e investigación de intervenciones sobre los factores que influyen en la salud física de los estudiantes universitarios

ABSTRACT Since the reform and opening up, China's national living standards have gradually improved, but the current physical health level of college students has not increased with the improvement of living standards. The physical health of college students — as high-quality talents of the country — is related to the future of the country and the nation,. In order to explore the influencing factors of college students' physical health, the analytic hierarchy process (AHP) was used to evaluate the factors affecting students' physical health. This study analyzes the index of students' physical health through the method of literature, then revises the evaluation index through expert analysis and analytic hierarchy process, and verifies it through examples. The results show that the final score of the school students' physical health is 81.55, of which the school factor has the greatest impact on the students' physical health, and the school factor score is far from the expected score. We can promote the development of students' physical exercise and improve the level of students' physical health through the improvement of school sports management. This study provides reference for the healthy development of public sports students in China.

RESUMO Desde a reforma e a abertura, o padrões de vida nacional da China melhorou gradualmente, mas o atual nível de saúde física dos estudantes universitários não aumentou com a melhoria do padrões de vida. A saúde física dos estudantes universitários — como talentos de alta qualidade do país — SU está relacionada com o futuro do país e da nação. A fim de explorar os fatores que influenciam a saúde física dos estudantes universitários, utilizou-se o processo hierárquico analítico (AHP) para avaliar os fatores que afetam a saúde física dos estudantes. Este estudo analisa o índice de saúde física dos estudantes através do método da literatura, e analisa o índice de avaliação sob a ótica de especialistas e pelo processo hierárquico analítico, e verifica o índice por meio de exemplos. Os resultados mostram que a pontuação final da saúde física dos alunos é 81.55, do qual o fator escolar tem o maior impacto sobre a saúde física dos alunos, e a pontuação do fator escolar está longe da contagem esperada. Podemos promover o desenvolvimento do exercício físico dos alunos e melhorar o nível de sua saúde física através da melhoria da gestão do desporto escolar. Este estudo fornece referências para o desenvolvimento saudável de estudantes de esportes públicos na China.

RESUMEN Desde la reforma y la apertura, los niveles de vida nacionales de China han mejorado gradualmente, pero el nivel actual de salud física de los estudiantes universitarios no ha aumentado con la mejora de los niveles de vida. La salud física de los estudiantes universitarios, como talentos de alta calidad del país, está relacionada con el futuro del país y de la nación. Con el fin de explorar los factores que influyen en la salud física de los estudiantes universitarios, se utilizó el proceso de jerarquía analítica (PJA) para evaluar los factores que afectan la salud física de los estudiantes. Este estudio analiza el índice de salud física de los estudiantes a través del método de la literatura, luego revisa el índice de evaluación a través del análisis de expertos y el proceso de jerarquía analítica, y lo verifica mediante ejemplos. Los resultados muestran que el puntaje final de la salud física de los estudiantes de la escuela es 81.55, de los cuales el factor escuela tiene el mayor impacto en la salud física de los estudiantes, y el puntaje del factor escuela está lejos del puntaje esperado. Podemos promover el desarrollo del ejercicio físico de los estudiantes y mejorar el nivel de salud física de los estudiantes mediante la mejora de la gestión deportiva escolar. Este estudio proporciona una referencia para el desarrollo saludable de los estudiantes de deportes públicos en China.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China: results from a national survey / 亚洲男科学杂志(英文版)

This study aimed to propose an operational definition of late-onset hypogonadism (LOH) that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China. A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China. Serum total testosterone (TT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were measured and free testosterone (cFT) was calculated. The Aging Males' Symptoms (AMS) scale was used to evaluate the LOH symptoms. Finally, 5078 men were included in this analysis. The TT levels did not decrease with age (P = 0.59), and had no relationship with AMS symptoms (P = 0.87 for AMS total score, P = 0.74 for ≥ 3 sexual symptoms). The cFT levels decreased significantly with age (P < 0.01) and showed a negative association with the presence of ≥ 3 sexual symptoms (P = 0.03). The overall estimated prevalence of LOH was 7.8% (395/5078) if a cFT level <210 pmol l

A guide to human microbiome research: study design, sample collection, and bioinformatics analysis / 中华医学杂志(英文版)

The purpose of this review is to provide medical researchers, especially those without a bioinformatics background, with an easy-to-understand summary of the concepts and technologies used in microbiome research. First, we define primary concepts such as microbiota, microbiome, and metagenome. Then, we discuss study design schemes, the methods of sample size calculation, and the methods for improving the reliability of research. We emphasize the importance of negative and positive controls in this section. Next, we discuss statistical analysis methods used in microbiome research, focusing on problems with multiple comparisons and ways to compare β-diversity between groups. Finally, we provide step-by-step pipelines for bioinformatics analysis. In summary, the meticulous study design is a key step to obtaining meaningful results, and appropriate statistical methods are important for accurate interpretation of microbiome data. The step-by-step pipelines provide researchers with insights into newly developed bioinformatics analysis methods.

Genetic variations and epidemiological characteristics of influenza B virus in Xinxiang from 2012 to 2019 / 中华疾病控制杂志

Objective To investigate the genetic variation and epidemiological characteristics of influenza B virus in Xinxiang to provide policy basis for local influenza vaccination. Methods The influenza surveillance data in Xinxiang from January 2012 to February 2019 was analyzed. 23 isolated influenza B virus were randomly selected for hemagglutinin (HA) and neuraminidase (NA) gene sequencing. Sequence alignment was conducted by using DNAman software and phylogenetic tree analysis was conducted using Neighbor-Joining method. Results Yamagata (BY) and Victoria (BV) strains of influenza B virus circulated alternately every other year in Xinxiang, mainly among people aged 0-15 years (91.4%). The dominant influenza B lineages from 2015 to 2016 and from 2017 to 2018 did not match the corresponding trivalent vaccine strain of the year. The HA phylogenetic tree revealed that 87.5% (7/8) of BV strains coexisted with the vaccine strain in one branch, while 88.98% (8/9) of BY strains from 2013 to 2015 were not in the same branch as the corresponding vaccine strain, with 5 epitope site mutions N116K, S150L, N165Y, D196N and N202S. No drug-resistant site mutation was identified in the NA gene. A total of 6 intra-lineage reassortants were identified. Conclusions The influenza B lineage in the trivalent vaccine recommended by WHO did not match the dominant circulating B lineage of Xinxiang in some epidemic year. Therefore, quadrivalent vaccines are recommended to use in susceptible population, especially under the age of 15. In addition, there are large variations in HA gene of the epidemic BY strain compared with the corresponding vaccine. Then, a vaccine more sutable for the epidemic strains in China is expected to be developed.

Differences of Matrix Metalloproteinase 2 Expression between Left and Right Ventricles in Response to Nandrolone Decanoate and/or Swimming Training in Mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Matrix metalloproteinase (MMP)-2 plays an important role in the remodeling of left ventricles (LVs) and right ventricles (RVs). We investigated the differences of MMP-2 expression between LV and RV in response to nandrolone decanoate (ND), swimming training (ST), and combined ND and ST (NS) in mice, based on their structural, functional, and biochemical characteristics.</p><p><b>METHODS</b>Totally 28 male C57B1 mice (6 weeks old; 20-23 g) were divided into four groups, including the control (n = 7), ND (n = 6), ST (n = 8), and NS (n = 7) groups. After respective treatments for 8 weeks, echocardiographic examination was used to assess the cardiac structure and function. Van Gieson stain was used to examine the fibrosis of LV and RV in response to different treatments, and Western blotting analysis was performed to explore different MMP-2 expressions between LV and RV in response to ND and/or ST. Analysis of variance was used for comparing the four groups.</p><p><b>RESULTS</b>At 8 weeks, right ventricular dimension/body weight in the ND group was larger than the other three groups (F = 7.12, P < 0.05) according to the echocardiographic examination. Fibrosis induced by ND administration was increased more in RV (2.59%) than that in LV (2.21%). MMP-2 expression of the ND group in RV was significantly greater than the control and NS groups in RV and the corresponding ND group in LV.</p><p><b>CONCLUSION</b>The experimental data support the hypothesis that ND administration induces greater MMP-2 expression increase in RV compared to LV, leading to consequent RV dilation.</p>

Comparison of dabigatran and warfarin anticoagulant therapy during catheter ablation in patients with atrial fibrillation / 心血管康复医学杂志

Objective: To compare therapeutic effect and safety of dabigatran and warfarin anticoagulant therapy during catheter ablation in patients with atrial fibrillation (AF). Methods: Clinical data of 325 AF patients, who received catheter ablation in our hospital from Jan 2011 to Aug 2014, were retrospectively analyzed. According to perioperative anticoagulant therapy plan, patients were divided into dabigatran group (n=187) and warfarin group (n=138). General data, international normalized ratio (INR), activated coagulation time (ACT), success rate of pulmonary vein isolation (PVI), operation time and incidence rate of complications were compared between two groups. Results: Compared with warfarin group, there were significant reductions in percentages of diabetes mellitus (20. 3％ vs. 11. 8％), chronic heart failure (19. 6％ vs. 10. 2％) and left atrial diameter [(47±10) mm vs. (44± 9) mm]in dabigatran group, P＜0. 05 or＜0. 01. INR of dabigatran group was significantly lower than that of warfarin group [(1. 3±0. 3) vs. (2. 4±0. 4), P=0. 001], and there were no significant difference in ACT, success rate of PVI and operation time between two groups (P＞0. 05 all). Incidence rate of main complications in dabigatran group was significantly lower than that of warfarin group (0. 5％ vs. 5. 1％, P=0. 025). Conclusion: Compared with warfarin, there is significant reduction in INR and incidence rate of main complications during catheter ablation in dabigatran group, which is worth extending.

Correlation of serum androgen levels with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou / 中华男科学杂志

<p><b>Objective</b>To investigate the relationship of the levels of serum androgens with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou.</p><p><b>METHODS</b>Using the stratified cluster sampling method, we conducted a questionnaire investigation and physical examinations among 437 men in Zunyi City. We divided the subjects into a middle-aged (40－64 ［53.20 ± 7.41］ years, n = 269) and an elderly group (=≥65 ［70.63 ± 4.66］ years, n = 168) and collected fasting elbow venous blood samples from them for measuring the levels of total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), total cholesterol (TCH), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), calculated free testosterone (cFT), free testosterone index (FTI), and testosterone secretion index (TSI).</p><p><b>RESULTS</b>Compared with the elderly group, the middle-aged males showed significantly lower SHBG, LH, HDL and LDL, and higher cFT, FTI, TSI, TG and TCH (all P < 0.05). TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, while cFT was positively correlated with TCH, and so was FTI with TG, TCH with LDL, and TSI with TCH, HDL and LDL (all P < 0.05), but LH was negatively correlated with TG, TCH and LDL (all P < 0.05). Multivariate linear regression analysis showed that TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, and so was LH with TCH, HDL and LDL (all P < 0.05).</p><p><b>CONCLUSIONS</b>In the middle-aged and elderly men in Zunyi, low concentrations of TT, SHBG and LH were associated with the increased risk of high-TCH and -LDL dyslipidemia, low concentrations of TT and SHBG with that of high-TG dyslipidemia, while high concentrations of TT, SHBG and LH with that of low-HDL dyslipidemia.</p>

Clinical Analysis of 1593 Patients with Infectious Endophthalmitis: A 12-Year Study at a Tertiary Referral Center in Western China / 中华医学杂志(英文版)

<p><b>Background</b>Infectious endophthalmitis is a severe ocular inflammation which can cause devastating visual loss. The aim of the study was to identify the demographic and clinical features of infectious endophthalmitis in Western China for better prophylaxis and treatment of this disease.</p><p><b>Methods</b>A.</p><p><b></b>retrospective, cross-sectional study was conducted based on the medical records of inpatients having infectious endophthalmitis in a tertiary referral center in Western China between 2005 and 2016.</p><p><b>Results</b>The common cause of infectious endophthalmitis was trauma (82.6%), endogenous (7.8%), ophthalmic surgery (6.9%), and corneal ulcer with perforation (2.7%). These four etiological groups differed in age, gender, enucleation rate, visual outcome, etc. The number of cases in the first 6 years accounted for 38.7% of the total collection, which in the second 6 years accounted for 61.3%. The etiology patterns were different between these two periods. Altogether 51.3% of patients received pars plana vitrectomy, 13.9% of patients underwent evisceration, and the remaining 34.8% received other treatments. Of the 670 cases that had culture results, 266 (39.7%) were culture positive and 177 (66.5%) were Gram-positive organisms, 64 (24.1%) were Gram-negative organisms, 11 (4.1%) had fungal infection, and 14 (5.3%) were infected by multiple pathogens.</p><p><b>Conclusions</b>There was an upward trend of the occurrence of infectious endophthalmitis in Western China for the past decade. The demographic and clinical characteristics of infectious endophthalmitis in Western China had its own characteristics and differed from those of developed countries. Here, open globe trauma was the most common cause of endophthalmitis, most traumatic endophthalmitis patients were male, and most of the injuries were work related, implicate that we should strengthen the education and application of ocular safety regulation specifically targeting the workplace.</p>

Influence of trached extubation time on the emergent agitation during the recovery of sevoflurane combined anesthesia in infants / 口腔疾病防治

Objective@#To investigate the influence of trached extubation time on the emergent agitation during the recovery of sevoflurane combined anesthesia in infants. @*Methods@#Sevoflurane, propofol and remifentanil were combined to maintain general anesthesia after intubation. The propofol infusion was stopped 10 minutes before the operation, and the remifentanil infusion was stopped 5 minutes before the end of the operation. The sevoflurane concentration was reduced to 1%, and the oxygen flow was adjusted to 6 L/min when the sevoflurane inhalation was stopped. Ninety infant patients with cleft palate were randomized into 3 groups (n=30): 30 patients in group A were extubated within 5 minutes, 30 patients in group B were extubated between 5 and 10 minutes, and 30 patients in group C were extubated after 10 minutes. A postoperative agitation score was given after extubation and recorded away from the operating room. Propofol was administered when agitation occurred. The recovery time after the operation and time away from the operating room were recorded. @*Results@# The recovery times of group A, group B, and group C were 21.8 ± 2.5 minutes, 21.4 ± 2.1 minutes and 20.9 ± 1.3 minutes, respectively, although the differences were not significant (P > 0.05). The times away from the operating room of group A, group B, and group C were 8.1 ± 1.6 minutes, 5.2 ± 2.0 minutes and 2.1 ± 0.7 minutes, respectively, and the differences were statistically significant (P < 0.05). When endotracheal intubation was removed, the incidence of agitation in group A (26/30) was higher than that in group B (16/30) and group C (5/30), and the differences were statistically significant (P < 0.05). The incidence of agitation in group B was also significantly different from that in group C (P < 0.05). @*Conclusion@#Propofol, which is used to control coughing and prolong the extubation time, can effectively prevent emergent agitation during the recovery period from sevoflurane-based anesthesia in infants. The optimum time of extubation was 15 minutes.

DREAM: a multifunctional transcriptional regulator / 生理学报

DREAM (downstream regulatory element antagonist modulator), Calsenilin and KChIP3 (potassium channel interacting protein 3) belong to the neuronal calcium sensor (NCS) superfamily, which transduces the intracellular calcium signaling into a variety of activities. They are encoded by the same gene locus, but have distinct subcellular locations. DREAM was first found to interact with DRE (downstream regulatory element) site in the vicinity of the promoter of prodynorphin gene to suppress gene transcription. Calcium can disassemble this interaction by binding reversibly to DREAM protein on its four EF-hand motifs. Apart from having calcium dependent DRE site binding, DREAM can also interact with other transcription factors, such as cAMP responsive element binding protein (CREB), CREB-binding protein (CBP) and cAMP responsive element modulator (CREM), by this concerted actions, DREAM extends the gene pool under its control. DREAM is predominantly expressed in central nervous system with its highest level in cerebellum, and accumulating evidence demonstrated that DREAM might play important roles in pain sensitivity. Novel findings have shown that DREAM is also involved in learning and memory processes, Alzheimer's disease and stroke. This mini-review provides a brief introduction of its discovery history and protein structure properties, focusing on the mechanism of DREAM nuclear translocation and gene transcription regulation functions.

Vasectomy has no obvious longterm influence on the levels of serum androgens in aging males / 中华男科学杂志

Objective@#To explore the longterm influence of vasectomy on the levels of serum androgens in aging males.@*METHODS@#Using stratified random sampling, we conducted a questionnaire survey and physical examinations among 437 adult males aged ≥40 years, 232 with and 205 without the history of vasectomy. In addition, we measured the levels of serum total testosterone (TT), sexhormone binding globulin (SHBG), calculated free testosterone (cFT), testosterone secreting index (TSI), free testosterone index (FTI), and luteinizing hormone (LH).@*RESULTS@#Compared with the nonvasectomy group, the vasectomy group showed significantly increased levels of serum TT (［16.01±5.41］ vs ［17.39±6.57］ nmol/L), SHBG (［58.91±36.89］ vs ［70.28±40.90］ nmol/L), and LH (［8.86±6.49］ vs ［10.85±11.73］ IU/L) (all P0.05), nor after adjustment for relevant factors in TT (β: 1.015, 95% CI: －0.180－2.210), SHBG (β: 5.118, 95% CI: －2.069－12.305), cFT (β: 0.003, 95% CI: －0.011－0.018), FTI (β: －0.012, 95% CI: －0.035－0.011), TSI (β: 0.138, 95% CI: －0.131－0.407), and LH (β: 1.011, 95% CI: －0.811－2.834) (all P>0.05).@*CONCLUSIONS@#Vasectomy has no obvious longterm influence on the levels of serum androgens in aging males.

Simultaneous hybrid coronary revascularization versus off-pump coronary artery bypass grafting for diabetic patients with multivessel coronary artery disease / 中国胸心血管外科临床杂志

@#Objective    To compare the in-hospital and midterm outcomes after simultaneous hybrid coronary revascularization (HCR) with off-pump coronary artery bypass grafting (OPCAB) in diabetic patients with multivessel coronary artery disease. Methods    One hundred thirty-two diabetic patients with multivessel coronary artery disease underwent one-stop HCR at Fuwai Hospital from January 2010 to January 2015. These patients were 1∶2 matched with those who underwent OPCAB using propensity score matching. Results    Simultaneous HCR had less chest tube drainage (618 (420, 811) ml vs. 969 (711, 1 213)ml, P<0.001), lower transfusion rate (19.7% vs. 34.1%, P=0.026), shorter mechanical ventilation time (11.6 (8.2, 14.8) h vs. 16.0 (12.1, 18.7) h, P<0.001), and shorter stay in intensive care unit (21.5 (18.8, 42.0)   h vs. 44.6 (23.7, 70.1) h, P<0.001) than OPCAB. During over median 40 months follow-up, simultaneous HCR offered similar major adverse cardiac or cerebrovascular events (MACCE) rate (6.8% vs 9.0%, P=0.826), but lower stroke rate (0%vs 3.0%, P=0.029), compared with OPCAB. Conclusion    For selected patients with diabetes, simultaneous HCR provides a safe and effective revascularization alternative. It decreases perioperative invasiveness and incurred similar and favorable midterm outcomes with OPCAB.

Effect and safety of testosterone undecanoate in the treatment of late-onset hypogonadism: a meta-analysis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of testosterone undecanoate (TU) in the treatment of late-onset hypogonadism (LOH) by meta-analysis.</p><p><b>METHODS</b>We searched Pubmed (until April 1, 2014), Embase (until March 28, 2014), Cochrane Library (until April 17, 2014), CBM (from January 1, 2001 to February 2, 2014), CNKI (from January 1, 2001 to February 2, 2014), Wanfang Database (from January 1, 2000 to February 2, 2014), and VIP Database (from January 1, 2000 to Febru ary 2, 2014) for randomized controlled trials of TU for the treatment of LOH. We evaluated the quality of the identified literature and performed meta-analysis on the included studies using the Rveman5. 2 software.</p><p><b>RESULTS</b>Totally, 14 studies were included after screening, which involved 1 686 cases. Compared with the placebo and blank control groups, TU treatment significantly increased the levels of serum total testosterone (SMD = 6.22, 95% CI 3.99 to 8.45, P < 0.05) and serum free testosterone (SMD = 4.35, 95% CI 1.86 to 6. 85, P < 0.05) but decreased the contents of luteinizing hormone (WMD = -2.23, 95% CI -4.03 to -0.42, P < 0.05), sex hormone binding globulin (WMD = 2.00, 95% CI 1.38 to 2.63, P < 0.05). TU also remarkably reduced the scores of Partial Androgen Deficiency of the Aging Males (WMD = -9.49, 95% CI -12.96 to -6.03, P < 0.05) and Aging Males Symptoms rating scale (WMD = -2.76, 95% CI -4.85 to -0.66, P <0.05) but increased the hemoglobin level (SMD = 2.35, 95% CI 0.29 to 4.41, P < 0.05) and packed-cell volume (SMD = 4.35, 95% CI 1.36 to 7.33, P < 0.05). However, no significant changes were shown in aspertate aminotransferase, alanine transaminase, prostate-specific antigen, or prostate volume after TU treatment (P > 0.05).</p><p><b>CONCLUSION</b>TU could significantly increase the serum testosterone level and improve the clinical symptoms of LOH patients without inducing serious adverse reactions. However, due to the limited number and relatively low quality of the included studies, the above conclusion could be cautiously applied to clinical practice.</p>

Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Malnutrition and tuberculosis (TB) tend to interact with each other. TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions. Nutrition support can promote recovery in the subject being treated for TB. The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy.</p><p><b>METHODS</b>English database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database of CBM, CNKI, VIP, and WANFANG were searched. Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included. Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer. Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RR s) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CI s).</p><p><b>RESULTS</b>A total of 19 studies (3681 participants) were included. In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears- or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and - 5.42 (-7.93, -2.92), respectively, compared with the control group. The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P = 0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group. No systemic adverse events were recorded.</p><p><b>CONCLUSIONS</b>During anti-TB course, nutrition support may be helpful in treatment of TB patients by improving both sputum smears- or culture-negative conversion rate and BMI, shortening the time of sputum conversion negative. Whether it can improve the final clinical effect, there still needs high-level quality studies to confirm in the future.</p>

The comparation on living quality of the empty nest elderly and the non-empty-nest old people in rural area of Guizhou Province / 预防医学

Objective To survey the living quality of the rural empty nest elderly in Guizhou Province,and to provide basic information for further study of how to improve the living conditions of empty nest elderly.Method Using Multi -stage stratified cluster sampling method to extract the 30 villages,which respectively surveyed 10 to 15 people of the elderly subjects who aged over 60,A self-designed questionnaire was used to investigate and collected the relevant's information, the living condition of the empty nest elderly and the non-empty-nest old people was compared,and the related factors which might affect the living quality of the empty nest elderly was analysed.Results Finally 341 rural elderly were recruited,of which empty nest elderly accounted for 63. 05%,In the survey of empty nest elderly,only 22. 33%consider themselves healthy,Lower than the non -empty -nest old people's proportion of 38. 89% (P <0. 05 ).The ratio of children visitation,comfortably fixed for money,and children given pocket money were 85. 58% and 66. 98% and 39. 53%,lower than the non-empty-nest old people 96. 03%and 75. 40%and 55. 56%(P<0. 05);the ratio of timely medical treatment and loneliness among empty-nest old people were 58. 14%and 47. 91%,higher than the non-empty-nest old people were 44. 44% and 35. 71%(P<0. 05).Conclusion The perceived health status among the empty nest elderly in rural area of Guizhou Province was generally poor.The empty nest elderly needed more life care,medical security and emotional assistance.

Predict value of European system for cardiac operative risk evaluation II on 30 days operative mortality in patients with severe coronary artery disease undergoing active treatments / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the predict value of European system for cardiac operative risk evaluation (EuroSCORE) II on early death in patients with severe coronary artery disease undergoing active treatment.</p><p><b>METHODS</b>Consecutive 2 240 patients with three-vessel disease ( with or without left main disease) diagnosed by elevtive coronary angiogram between July 2011 and September 2012 were screened for this study, data from 1 892 patients who underwent active treatments (percutaneous coronary intervention or coronary artery bypass grafting) were analyzed retrospectivly. The predicted 30 days operative mortality calculated with EuroSCORE II was compared with the actual one. The calibration and discrimination of EuroSCORE II were tested with Hosmer-Lemeshow χ2 test and area under receiver operating characteristic (ROC) curve respectively.</p><p><b>RESULTS</b>Age was 61.0 (54.0-68.0) years old and 75.8% (1,435/1,892) were male in this cohort, 58.0% (1,097/1,892) patients received percutaneous coronary intervention and 42.0% (795/1,892) patients received coronary artery bypass grafting. The overall 30 days operative mortality was 0.53% (10/1,892), 30 days operative mortality predicted by EuroSCORE II was 0.85% (95% CI:0. 44%-1.26%). The calibration (χ2 = 3.47 and P > 0.10) and discrimination (area under ROC curve was 0.75) of EuroSCORE II were satisfactory.</p><p><b>CONCLUSION</b>EuroSCORE II could precisely predict 30 days operative mortality for three-vessel disease patients with or without left main disease undergoing active treatments.</p>

Fermentation pretreatment followed by two-phase combination acid hydrolysis for the extraction of diosgenin / 中国药学杂志

OBJECTIVE: To preliminarily establish the technology of fermentation pretreatment followed by two-phase combination acid hydrolysis for the extraction of diosgenin from the dry tubers of Dioscorea zingiberensis C. H. Wright. METHODS: Orthogonal experiment design was used with the yield of diosgenin as the monitoring index to optimize the conditions for fermentation pretreatment and two-phase combination acid hydrolysis. Two types of conventional methods were compared with the newly developed method. RESULTS: Fine powder of the tubers of Dioscorea zingiberensis C. H. Wright was mixed with water and fermented at 30°C for 72 h under stirring at 500 r · min-1, After that, sulfuric acid and methanol were added into the suspension to reach their final concentration of 10%, and petroleum ether was added to form a two-phase immiscible reaction system which was extracted in oil bath at 120°C for 4 h. As a consequence, the average yield of diosgenin achieved 4.28%, significantly higher than the 3.01% and 3.28% of the two conventional methods. CONCLUSION: This newly developed method of fermentation pretreatment followed by two-phase combination acid hydrolysis is proved to be more convenient than the traditional methods with a higher yield.

Effects of low molecular weight heparin on clot rate and activated clotting time: an in vitro study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Due to lack of point-of-care testing, the use of low-molecular-weight heparin (LMWH) therapy in some special patients is restricted. This study was designed to explore the effects of LMWH on clot rate (CR) and activated clotting time (ACT), and to search for an appropriate method for bedside monitoring of anticoagulant activity of LMWH.</p><p><b>METHODS</b>Thirty-two healthy volunteers were selected from the staff of Beijing Tongren Hospital. CR and ACT were measured with different reagents (glass beads, diatomite, kaolin and magnetic bar) on blood samples spiked with increasing concentrations of LMWH (dalteparin, 0.2-1.8 IU/ml). Correlations between concentrations of LMWH and values of CR and ACT were analysed based on the data obtained and regression analysis was performed to establish a regression equation.</p><p><b>RESULTS</b>With the increase in doses of dalteparin, CR values reduced gradually. The values of CR of four reagents (glass beads, diatomite, kaolin and magnetic bar) were 20.4-4.5 IU/min, 27.4-6.9 IU/min, 27.5-7.9 IU/min and 7.8-0.1 IU/min respectively and an linear relationship was observed between the CR values and dalteparin concentrations (P < 0.05). The values of ACT were 173-615 seconds, 130-270 seconds, 123-226 seconds, 337-1411 seconds respectively, which showed a linear regression between the ACT values and dalteparin concentrations (P < 0.01). Differences in slope of the regression curves of ACT were observed with all the reagents tested (glass beads 248.2 s/IU, diatomite 74.8 s/IU, kaolin 58.2 s/IU and magnetic bar 1112.2 s/IU, P < 0.01). While the minimum concentration of dalteparin was 0.2 IU/ml, 0.4 IU/ml, 1.4 IU/ml and 0.2 IU/ml separately, the ACT values of the four coagulants (glass beads, diatomite, kaolin and magnetic bar) were beyond the normal limit and showed a noticeable increase respectively (P < 0.01).</p><p><b>CONCLUSIONS</b>This study showed that there was an excellent linear relationship between the CR and ACT values and dalteparin concentrations for all the four reagents (glass beads, diatomite, kaolin and magnetic bar) in vitro. The sensitivity of different coagulation reagents to LMWH different. Choosing a suitable reagent, both CR and ACT were possible to be used as a convenient bedside test for LMWH.</p>