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Objective:To analyze the relationship between early-life famine exposure and the risk of metabolic syndrome in Chinese population.Methods:Relevant literature on the relationship between early-life famine exposure and the risk of metabolic syndrome in the Chinese population was retrieved from databases such as CNKI, Wanfang, VIP, CBM, Web of Science, and PubMed. The search was conducted from the inception of the databases up to October 2022. Two researchers independently extracted and systematically evaluated the data from the literature, and meta-analysis was performed using Stata 16.0 software. Results:A total of 12 publications met the inclusion criteria, including 71 470 study subjects. Meta-analysis results showed that early-life famine exposure increased the risk of metabolic syndrome in the Chinese population( OR=1.28, 95% CI 1.16-1.40). Subgroup analysis showed that both fetal famine exposure( OR=1.25, 95% CI 1.03-1.52) and childhood famine exposure( OR=1.29, 95% CI 1.15-1.45) increased the risk of developing metabolic syndrome compared to the non-exposed group, and this significant association was only found in the female population. Conclusion:Early-life exposure to famine may increase the risk of developing metabolic syndrome in adulthood in the Chinese population, particularly among females.
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Objective:To evaluate the clinical efficacy of Yangxue-Qingnao granule combined with ligustrazine injection in the treatment of wind-phlegm entering collaterals syndrome of cerebral infarction. Methods:A total of 96 patients with cerebral infarction and wind-phlegm entering collaterals syndrome to Suixi County Hospital of Traditional Chinese Medicine from January 2019 to December 2019 were selected and randomly divided into two groups by random number table method, with 48 in each group. The control group was given intravenous ligustrazine injection, and the observation group was given Yangxue-Qingnao granule on the basis of the treatment of the control group. Both groups were treated continuously for 2 weeks. TCM syndrome scores were performed before and after treatment, the National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment, and the Activity of Daily Living Scale (ADL) was evaluated. To evaluate the patient's quality of life, to detect the high-shear viscosity, low-shear viscosity and plasma viscosity of whole blood with an automatic hemorheology instrument. Results:The total effective rate of the observation group was 95.8% (46/48) and that of the control group was 70.8% (34/48). The difference between the two groups was statistically significant ( χ2=9.08, P<0.01). After treatment, the TCM syndrome score of the observation group was significantly lower than that of the control group ( t=3.51, P<0.01), the NIHSS score was significantly lower than that of the control group ( t=34.41, P<0.001), and the ADL score was significantly higher than that of the control group ( t=57.88, P<0.01). After treatment, the observation group's whole blood high shear viscosity [(5.04 ± 0.93)mPa?s vs. (5.64 ± 1.13)mPa?s, t=2.84], whole blood low shear viscosity [(11.32 ± 1.74)mPa?s vs. (13.39 ± 2.23)mPa?s, t=5.07] and plasma viscosity [(1.51 ± 0.33)mPa?s vs. (1.73 ± 0.47)mPa?s, t=2.65] of the observation group were significantly lower than those in the control group ( P<0.05 or P<0.01). Conclusion:Yangxue-Qingnao granule combined with ligustrazine injection can improve the neurological status and quality of life of patients with cerebral infarction syndrome of wind-phlegm entering the collaterals, and improve the clinical efficacy.
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Objective:To explore the significance of plasma homocysteine (Hcy) as a new biomarker for the differential diagnosis of postural tachycardia syndrome (POTS) and suspected myocarditis in children.Methods:A total of 24 children diagnosed with POTS and 21 children diagnosed with suspected myocarditis treated in the Pediatrics Department of the Peking University First Hospital from July to December 2016 were included in the study.Plasma Hcy levels were measured in each subject and compared between children with POTS and suspected myocarditis.The receiver operating characteristic (ROC) curves were depicted for assessing the diagnostic potential of Hcy in distinguishing POTS from suspected myocarditis.Results:Plasma Hcy level in the POTS group was significantly higher than that in the suspected myocarditis group [(14.25±8.09) μmol/L vs.(8.99±3.19) μmol/L], which was also significantly higher than that of the mean levels in Beijing children [(8.82±5.58) μmol/L] (all P<0.05). When the cut-off was 9.36 μmol/L, the area under the ROC curve was 0.76, and the sensitivity and specificity for distinguishing POTS from suspected myocarditis were 71% and 68%, respectively. Conclusions:Plasma Hcy levels are helpful in the differential diagnosis of POTS and suspected myocarditis in children.
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ObjectiveTo investigate the features of liver injury and related influencing factors in adolescents and adults with infectious mononucleosis (IM). MethodsA retrospective analysis was performed to investigate the features of liver injury in adolescents and adults with IM who were hospitalized in Peking University First Hospital from January 2005 to December 31 2018, and the patients were divided into subgroups based on age, Epstein-Barr virus (EBV) DNA level, and presence or absence of jaundice or infection with cytomegalovirus or hepatitis E virus (HEV). The t-test was used for comparison of continuous data meeting analytical conditions between two groups, and the Mann-Whitney U test was used for comparison of continuous data which did not meet analytical conditions between two groups; the chi-square test was used for comparison of categorical data between two groups, and the Fisher’s exact test was used for comparison of categorical data which did not meet the analytical conditions of the chi-square test. A logistic regression analysis was used for multivariate analysis. ResultsA total of 274 patients were enrolled, with 154 male patients (56.2%) and 120 female patients (43.8%), and the mean age of onset was 22.3±67 years. The incidence rate of liver injury ［defined as alanine aminotransferase (ALT) ＞50 U/L and/or aspartate aminotransferase (AST)＞40 U/L］ was 97.4% (267/274), and that of jaundice was 27.6% (74/268). The patients, aged ≥20 years, tended to have a higher level of gamma-glutamyl transpeptidase (GGT) (Z=2.070, P=0.038). Serum EBV DNA was measured for 167 patients, among whom 90 had positive results and 77 had negative results. The positive serum EBV DNA group had significantly higher levels of GGT (Z=3.005, P=0.003) and lactate dehydrogenase (Z=2.162, P=0.031) than the negative serum EBV DNA group. The patients with cytomegalovirus infection tended to have a higher level of alkaline phosphatase (Z=2.351, P=0.019), and the patients with HEV infection presented with a higher level of GGT (Z=1.988, P=0.047). AST (odds ratio ［OR］=1.006, 95% confidence interval ［CI］: 1.002-1.010, P=0.005) and ALP (OR=1.012, 95%CI: 1.005-1.020, P=0.001) were independent risk factors for jaundice. ConclusionThere is a high incidence rate of liver injury in adolescents and adults with IM, and the patients with an older age or positive serum EBV DNA tend to have more severe liver injury.
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Objective@#Meta-analysis was conducted on the tetanus antibody protection rate of healthy population born after 1978 in China (data from Hong Kong, Macao and Taiwan was excluded, the same below).@*Methods@#Search the data on China′s tetanus antibody level which were published in China National Knowledge Infrastructure, Wanfang data, VIP, SinoMed database, PubMed and the Cochrane Library. The Chinese search keywords were "Tetanus Antitoxin", "Tetanus Antibody", "Healthy Population" and "Mainland China". English search terms include "tetanus antitoxin", "tetanus vaccine", "tetanus vaccine", "general population" and "mainland of China". The time limit for inclusion in literature research was 2010-2019. Stata software was used to conduct meta-analysis on the protection rate of tetanus antibody.@*Results@#A total of 24 articles were included. There was no obvious publication bias in the included articles. The total number of respondents was 23 530, the antibody protection rate was 49.5%-99.0%. A total of 20 817 people got effective antibody protection, which meant the antibody level reached and exceeded 0.1 IU/ml, and the combined protection rate was 78.6% (95%CI: 75.0%-88.2%). The combined protection rates of antibody in 0-7 years old and 8-15 years old groups were 88.9% (95%CI: 86.9%-91.0%) and 79.3% (95%CI: 72.9%-86.2%) respectively. The combined protection rates of antibodies in 16-20 years old, 21-30 years old and 31-40 years old groups were 58.9% (95%CI: 46.5%-71.2%), 47.7% (95%CI: 16.8%-78.7%) and 63.8% (95%CI:32.6%-95.1%) respectively. The combined protection rate of tetanus antibody for 0-15 years old people was 85.6% (95%CI: 83.1%-88.1%), and the combined protection rate of antibody for 16-40 years old people was 52.9% (95%CI: 39.3%-66.6%).@*Conclusion@#With the increase of age, the protection rate of tetanus antibody among the healthy population aged 16-40 years in our country decreases. An individualized vaccination plan should be formulated according to the previous tetanus vaccination history and the tetanus antibody level when necessary.
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Objective@#To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7+ in AML patients with wild-type (WT) or mutant-type (MT) CEBPA.@*Methods@#The clinical data of 298 newly diagnosed non-M3 AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7+ and CD7- patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7+ group by Kaplan-Meier method.@*Results@#In CD7+ group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7- group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7+ group comparing to those of CD7- group in AML patients with wild type CEBPA. There were no statistical difference between CD7+ group and CD7- group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7+ group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7+-CEBPA MT group, CD7- and CD7+-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) .@*Conclusion@#The CEBPA mutation rate was higher in CD7+ AML patients then that of CD7- patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.
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Objective@#To understand the status of dietary behaviors among urban primary school children, to explore the relationship with the family environment in order to provide a basis for adopting the intervention measures and reducing the occurrence of child dietary behavior problems.@*Methods@#A questionnaire survey was conducted among 507 children of grade 5 randomized selected through dustering method from 4 in primary schools in Haidian district，as well as their parents.@*Results@#About 80.3% of the surveyed children reported the rate of frequency consumptions of vegetables 6-7 days per week. The frequency of consumption of fruits was lower than that of vegetables（67.8%）. The frequency of consumption of meat, eggs, milk and beans was lower（the rate of 6-7 days per week was 57.5%,45.3%,60.0%,17.3%, respectively）, and the number of children who did not eat beans was the highest(9.9%). The multiple linear regression revealed that parents’ dietary behaviors（β=0.21）, parents’ restrictions on snacks（β=0.21）, family cohesion（β=0.15）, and family monthly income（β=0.13） were promoting factors for children’s good dietary behaviors. The stock of snacks was a risk factor for children’s good dietary behaviors (β=-0.11)(P<0.05).@*Conclusion@#Dietary behavior of primary school children in urban area was influenced by family environment factors, especially dietary environment in family. Family environment factors could promote children’s dietary behaviors through parental support and modelling. Giving the parents intervention on nutrition and healthy diet, normalizing the family dietary environment are conducive to children’s dietary behaviors.
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Objective:To compare the effects of phenoxybenzamine and doxazosin on intraoperative hemodynamics in patients with normotensive pheochromocytoma.Methods:Perioperative data of patients who underwent surgery for normotensive pheochromocytoma in Peking University First Hospital from January 1, 2004 to December 31, 2017 were collected.Patients were divided into phenoxybenzamine group and doxazosin group according to the type of preoperative α-blockade.The primary endpoint was intraoperative hemodynamic fluctuations.Secondary endpoints included postoperative circulatory support, complications, mortality, and etc.Results:Sixty-one patients were included in the study, with 24 cases in phenoxybenzamine group and 37 cases in doxazosin group.There was no significant difference in the area under the curve of intraoperative blood pressure fluctuation between the two groups ( P>0.05). The area under the curve of intraoperative heart rate >110 bpm was significantly greater in phenoxybenzamine group than in doxazosin group ( P<0.05). There was no significant difference in the secondary endpoints between the two groups ( P>0.05). Conclusion:The effect of preoperative administration of doxazosin or phenoxybenzamine on blood pressure fluctuation has no significantly statistical difference in patients with normotensive pheochromocytoma, and the patients took phenoxybenzamine preoperatively have an increased risk of intraoperative tachycardia.
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Objective:To understand the 10-year risk of ischemic cardiovascular disease (ICVD) in hypertensive patients in communities in Shenzhen, and to provide baseline data for the comprehensive implementation of community-based hypertension health management measures based on ICVD risk assessment.Methods:From July 2017 to June 2018, 200 community health service centers in 10 districts of Shenzhen were selected by multi-stage random sampling to investigate hypertensive patients in communities aged≥35. After the patients who met the inclusion criteria signed the informed consent form, the demographic characteristics, physical examination, and laboratory tests were conducted. The absolute risk of ICVD in 10 years was evaluated by using the ICVD risk assessment module from the Shenzhen community health service information system. According to the China 10-year risk for ICVD score tables, recommended by the Chinese cardiovascular disease prevention guidelines, the risk grade of ICVD was estimated and analyzed. In addition, the relative risk was used to eliminate the influence of gender and age, and the single sample t-test was used for comparisons with the larger population. Results:30 015 hypertensive patients from communities were investigated, including 16 165 (53.86%) males and 13 850 (46.14%) females, aged 35-102 years, with a median age of 59.0. 6 405 (21.34%), 5 771 (19.23%) and 17 839 (59.43%) were at high, medium and low risk of ICVD, respectively. The absolute risk was 3.77%, 95% CI (3.72%-3.82%). The risk grades of ICVD in 10 years was different as per gender, age, marital status, population type， smoking, family history of hypertension, history of diabetes mellitus, systolic blood pressure, body mass index, and total cholesterol level, P values were all<0.001. The risk grades of ICVD in males, married patients, floating populations, having a total cholesterol <5.20 mmol/L, non-smokers, non-diabetics, and having a family history of hypertension were lower than that of other characteristics, and increased with age, systolic blood pressure, and body mass index. Further analysis of 15 652 patients aged 35-59 years old showed that the 10-year risk of ICVD in patients with hypertension in communities was slightly higher than that of the larger population, and the relative risk was 1.27, 95% CI (1.25-1.28), t=37.648, P<0.001. In males, relative risk was 0.94, 95% CI (0.93-0.95), t= 9.906, P<0.001, and there were no significant trend changes among age groups. In females, relative risk was 2.05, 95% CI (2.01-2.09), t=72.207, P<0.001, and increased with age. Conclusion:The 10-year risk of ICVD in hypertensive patients is often at a high level in Shenzhen, so it is necessary to carry out the risk assessment of ICVD in the community. The effect of community hypertension health management on reducing the risk of ICVD may vary between genders. The risk of ICVD in male patients is lower than that of males in the larger population, but in female patients it is still much higher.
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Objective@#To explore the potential mechanism of pimecrolimus in airway remodeling of atopic dermatitis (AD) and asthma mice.@*Methods@#Female BALB/c mice were randomly divided into three groups: control group, atopic dermatitis group and pimecrolimus treatment group. The cell in bronchoalveolar lavage fluid (BALF) was calculated by Ray-Jimsa staining. The structural changes in lung tissue and skin tissue were observed by hematoxylin-eosin (HE) staining, and the level of interleukin (IL)-33, IL-5, IL-13 in serum was detected by enzyme-linked immunosorbent assay (ELISA). The expressions of type 1 collagen (Col1) in the airway of mice were detected by RT-PCR and Western blotting. And western blotting was also used to determine the activation of mitogen-activated protein kinase P38 (P38MAPK) and mitogen-and stress-activated protein kinase 1 (MSK1) in the lungs of mice.@*Results@#Compared with those in the control group, the total number of leukocytes in bronchoalveolar lavage fluid (BALF) and the expression levels of IL-33, IL-13 and IL-5 in serum of atopic dermatitis group were significantly higher, and the difference was statistically significant (P < 0.05). In the atopic dermatitis group, the phosphorylation of P38MAPK and MSK1 protein was increased (1.50 ± 0.43 vs. 0.80 ± 0.43, 1.39 ± 0.08 vs. 0.62 ± 0.08) and the expression of Col1 protein and protein (1 vs. 3.20 ± 0.59, 1.40 ± 0.12 vs. 0.13 ± 0.16) was increased, and the difference was statistically significant (P < 0.05). After pimecrolimus treatment, the number of leukocytes in BALF, the levels of IL-33, IL-5 and IL-13 in serum (213.13 ± 11.89, 657.97 ± 86.47, 143.82 ± 33.02), the phosphorylation of P38MAPK and MSK1 protein in lung tissue (0.10 ± 0.04, 0.85 ± 0.05), and the expression of Col1 mRNA and Col1 protein were decreased (0.61 ± 0.22, 0.48 ± 0.08), and the difference was statistically significant (P < 0.05). The edema of lung and skin tissue and the infiltration of inflammatory cells were alleviated.@*Conclusions@#Pimecrolimus can alleviate the inflammation and airway remodeling in mice by inhibiting the activation of IL-33 related pathways, thereby reducing the incidence of asthma.
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OBJECTIVE： To prepare Ursolic acid （UA）/Pluronic F127 （PF127）/TPGS-doxorubicin （DOX） mixed nanomicelles， and to characterize it and study its in vitro release behavior. METHODS： UA/PF127/TPGS nanomicelles were prepared by thin film hydration method. Using encapsulation efficiency of UA as index， combined with the results of single factor tests， L9（34） orthogonal test was used to optimize drug dosage of UA， molar ratio of PF127 to TPGS， hydration temperature and hydration volume， validation test was performed. On the basis of succinylated TPGS， TPGS-DOX was synthesized and mixed with UA/PF127/TPGS to prepare UA/PF127/TPGS-DOX mixed nanomicelles， the appearance， particle size and critical micelle concentration （PF127/TPGS） were investigated. The drug release behavior was examined by dialysis bag diffusion method. RESULTS： The optimal preparation technology of UA/PF127/TPGS nanomicelles was as follows as drug dosage of UA 8 mg， molar ratio of PF127 to TPGS 3 ∶ 7， hydration temperature 50 ℃， hydration volume 4 mL. Average encapsulation efficiency of UA in nanomicelles was 89.00％ （RSD＝0.43％， n＝3）. The prepared UA/PF127/TPGS-DOX mixed nanomicelles solution was clear with opalescence. The nanomicelles were spherical and uniform in size； average particle size was （115.00±9.42） nm； critical micelle concentration of PF127/TPGS （molecular ratio 3 ∶ 7） was 0.001 3％. The in vitro drug release of UA and DOX in the mixed nanomicelles was significantly slowed down， compared with raw materials or substance control. The drug release process of the two drugs in the nanomicelles conformed to Weibull equation. CONCLUSIONS： UA/PF127/TPGS-DOX mixed nanomicelles are successfully prepared with uniform particle size， good stability and good sustained-release effect.
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PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
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Humans , Asian People , B-Lymphocytes , Cyclophosphamide , Disease-Free Survival , Doxorubicin , Follow-Up Studies , Lymphoma, B-Cell , Prednisone , Prognosis , Rituximab , VincristineABSTRACT
OBJECTIVE We used Al lergic Rhinitis Control Test (ARCT) questionnaire to evaluate the control level of allergic rhinitis, in order to get the data of prevalence rate, epidemiological characters and risk factors of uncontrolled allergic rhinitis. METHODS Patients with AR were recruited from our department and the treatment based on the Allergic Rhinitis and Its Impact on Asthma(ARIA) guidelines. Telephone interview will be taken after 2 weeks in these patients, compared to symptoms, impact on quality of life, ARCT value before and after treatment. RESULTS Among 134 patients enrolled, moderate/severe AR account for 95％. After 2 weeks of treatment, both symptom and quality of life were marked improvement(P <0.001). Patients with uncontrolled AR(26.1％) at day 15 more frequently presented higher height and weight(P <0.001), history of ear, nose, and throat(ENT) infection or antibiotics intake for respiratory infection in the last 12 months (40.4％ versus 62.9％, P =0.022), smoking (4.0％ versus 17.1％, P =0.02), and smell disturbance (10.1％ versus 25.7％, P =0.044). CONCLUSION Most of AR patients have remarkable improvements in symptom and quality of life after treatment, but 26.1％ of patients still remain uncontrolled. Smoking and nose infection are risk factors of uncontrolled AR.
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Objective To apply real-time transperineal ultrasound ( TPUS) to monitor the intra-fractional prostate motion,collect and analyze the data of the prostate motion,aiming to provide evidence for the optimization of the target area and plan of radiotherapy for prostate cancer. Methods TPUS is a non-invasive monitoring technique that utilizes an automatic scanning ultrasound probe to dynamically monitor and correct the motion of organs during radiotherapy. In this study, TPUS was utilized to collect 1588 intra-fractional data of 70 patients with prostate cancer. Prior to each cycle of radiotherapy,CBCT was adopted to correct the errors between intra-factional data by using VMAT. During radiotherapy, real-time ( once per second) ultrasound images were acquired to monitor the 3D motion of the prostate on the x (left+,right-),y (cranial+, caudal-), and z ( abdominal+, dorsal-) axes, emphasizing the analysis of 4D motion of the prostate. Results All patients successfully completed the treatment and data collection. The median time of effective monitoring per faction was 179 seconds (132-286 seconds). During 95% of the monitoring time,the distance of prostate motion was 2. 22 mm in the left direction,2. 17 mm in the right,2. 08 mm in the cranial, 1. 98 mm in the caudal,2. 44 mm in the abdominal and 2. 97 mm in the dorsal direction,respectively. In the x,y and z axes,the percentage of time in which the distance of prostate motion less than 1 mm among the total time was 83. 07%,85. 46% and 78. 27%,respectively,whereas 97. 70%,97. 87% and 96. 45% for＜3 mm, respectively. Conclusions TPUS is a non-invasive real-time monitoring technique,which can detect the 4D motion of the prostate during radiotherapy. By using VMAT,the range of prostate motion is relatively small, and the motion range is less than 3 mm in each direction within 95% of the time.
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Objective To investigate the value of strong ion gap (SIG),anion gap (AG),and the anionic gap corrected by albumin (ACAG) and lactate in evaluating the prognosis of severe pneumonia in children. Methods Pediatric patients with severe pneumonia hospitalized in the Affiliated Hospital of North Sichuan Medical College from June 2014 to June 2017 were selected as study subjects. A total of 20 death pa-tients (death group) and 59 survivors (survival group) were analyzed respectively according to their progno-sis. The data of Na + ,K + ,Cl - ,HCO -3 ,Mg2 + ,Ca2 + ,pH,PaCO2 ,P,albumin and lactate were obtained from blood gas analysis and blood biochemistry. Based on these data,ACAG was calculated by the Henderson-hasselbalach formula and SIG was calculated by the Stewart-Figge formula. Results There were significant differences in ACAG,SIG,and lactate levels between death group and survival group(P < 0. 05). The area under the ROC curve of ACAG was 0. 756,and the area under the ROC curve of SIG was 0. 936,which were larger than the area under the diagnostic reference line (P < 0. 05),the results were statistically significant. The sensitivity and specificity of ACAG was 79. 7％ and 70. 0％ respectively,and the cut off was 12. 7. The sensitivity and specificity of SIG was 81. 4％ and 95. 5％ respectively,and the cut off was 2. 7. Conclusion SIG,ACAG and lactate have the guiding value in assessing the prognosis of children with severe pneumonia. Meanwhile,SIG has a greater guiding significance for the assessment of the prognosis of children with severe pneumonia.
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Objective To investigate whether preset epidural catheter and individualized onset time could improve the effect of epidural labor analgesia.Methods This was an open-label,random-ized,controlled trial.The nulliparae aged from 18 to 35 years,with single cephalic term pregnancy, were randomized into two groups.In the individualized group,epidural catheterization was performed at the beginning of labor (emergence of regular contractions and nearly disappearance of cervix),and epidural analgesia was initiated when asked by parturients and the numeric rating scale (NRS,a verbal rating score from 0 to 10 for pain,in which 0 represented no pain and 10 the worst pain imagi-nable)pain score ≥ 5 .In the control group,epidural analgesia was initiated at cervical dilation of≥ 1 cm.The primary outcome measures were the most severe NRS pain score during labor and the pro-portion of the most severe NRS pain score ≥ 7 evaluated at 24 hours after delivery.Results A total of 194 parturients completed the study,among whom 97 were in the individualized group and 97 in the control group.The most severe labor pain score during labor [median 9 (IQR 8-10)in the individ-ualized group vs 9 (8-10)in the control group,P=0.201]and the proportion having the most severe pain score ≥ 7 [94 cases (96.9%)in the individualized group vs 89 cases (91.8%)in the control group,P=0.1 2 1 ]did not differ significantly between the two groups.There were no significant differences of adverse events between the two groups.Conclusion For the nulliparae with single ce-phalic term pregnancy suitable for vaginal delivery, the effects of individualized epidural labor analgesia are comparable to that of traditional analgesia (beginning at cervical dilation of ≥ 1 cm). The individualized analgesia is safe.
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Objective To investigate the synergistic effects of tannic acid(TA) and cis-dichlorodiamine platinum(CDDP) on hepatocellular carcinoma HepG2 cells and its activation situation of endoplasmic reticulum stress(ERS) pathway.Methods Human hepatocellular carcinoma HepG2 cells were divided into the control group,TA group,CDDP group and TA+CDDP group,and were cultured in vitro for 24 h.The growth inhibitory effect of medication on HepG2 cells was detected by MTT assay.The pharmacodynamics synergistic effect between the two drugs was analyzed by the drug interaction index,drug dose reduction index and equivalent graphical method.The nucleus changes were observed by DAPI staining.Real time fluorescent quantitative PCR(q-RT-PCR) and Western blot were used to detect the levels of ERS markers glucose regulated protein (GRP)78 and GRP94.Results TA and CDDP had dose-dependent growth inhibition effect on HepG2 cells,their median effective concentrations(IC50) were 360.00 μmol/L and 1.80 μg/mL respectively.The combination treatment of 180.00 μmol/L TA and 0.90 μg/mL CDDP on HepG2 cells could enhance the inhibitory effect on cell growth.Ta and CDDP had synergistic effect for inhibiting hepatocellular carcinoma cells growth.Compared with the TA group and CDDP group,cell shrinkage and rounding were accelerated in the combined group,apoptotic cells were increased,nuclear had pyknosis,irregular edge and dense staining,nuclear fragmentations were increased and the expressions of GRP78 and GRP94 were up-regulated.Conclusion TA can enhance the effect of CDDP on anti-hepatic carcinoma HepG2 cells,and the synergy mechanism may be related to the activation of ERS pathway.
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Objective To analyze the therapeutic effect of combined administration of pilocarpine and timolol eye drops in the treatment of glaucoma, and to summarize the rational administration of the two drugs.Methods The study was conducted by animal experiment.The study was conducted from January 2016 to February 2016.Fifty New Zealand white rabbits were randomly divided into 5 groups: pilocarpine group, timolol group, conventional administration group, pilocarpine+timolol group, timolol group and pilocarpine group.each group had 10 New Zealand white rabbits, according to different modes of administration,,the changes in intraocular pressure after 10, 20, 30, 40, 60, 90, 120, 150, 180 and 240 min after the first administration were compared.Results Intraocular pressure changes with time points after administration of different administration methods, There was no significant difference of IOP changes in pilocarpine group and timolol group single drug.pilocarpine+timolol timolol group changes with time continuing to reduce intraocular pressure of rabbits, compared with the conventional dose group, pilocarpine+timolol group and timolol pilocarpine+group alkali group of intraocular pressure, intraocular pressure and good control effect,the difference was statistically significant (P<0.05).There was no significant difference between in the adverse reactions between pilocarpine group, timolol group, routine administration group, pilocarpine+timolol group, timolol group and pilocarpine group.ConclusionThe treatment of glaucoma can be treated with pilocarpine and timolol eye drops, pilocarpine+timolol compared with pilocarpine, timolol simple treatment, conventional administration of several modes of administration, from the continuous reduction of intraocular pressure time Point of view, lowering the intraocular pressure longer, fewer adverse reactions, with high therapeutic safety, worthy of clinical promotion and application.
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Objective The purpose of this study was to assess the value of prenatal ultrasound diagnosis for fetal ear auricle malformations.Methods The coronal and sagittal planes of fetuses ears were obtained prospectively in 6239 singleton fetuses in the First Affiliated Hospital of Shantou University Medical College for the period from 2012 February to 2015 December,the ultrasound images and pregnancy outcomes were analyzed in 11 cases of fetuses ear auricle malformations diagnosed prenatally.Results Eleven Cases of fetuses ear auricle malformations include with 7 cases of microtia,3 cases of low-set ears and 1 case of anotia.Eleven cases were combined with other structural malformations were as followings,3cases with craniocerebral congenital malformation,5 cases with dentofacial deformity,5 cases with malformation of heart,3 cases with limb deformity.Cordocentesis was performed in 7 cases among which 6 with abnormal karyotype,including 2 cases of trisomy 21,2 cases of trisomy 13,2 cases of trisomy 18,1 case of 22ql 1 abnormalities.Compared with the postpartum facial examination,prenatal ultrasound correctly diagnosed 10 cases of fetal ear auricle malformations,missed diagnosis 1 case of microtia.Conlusions Fetus with ear auricle abnormalities have characteristic prenatal ultrasound imaging;prenatal ultrasonography can provide reliable information in the diagnosis of this disease.This study suggests that antenatal ear auricle length measurements might be a promising sonographic screening method for the detection of abnormal karyotype in pregnancy.
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Objective@#To explore the relationship between venous blood routine test parameters and syncopal recurrence of children with vasovagal syncope (VVS).@*Method@#Sixty-three children (male 32, female 31) diagnosed as VVS in Department of Pediatrics, Peking University First Hospital from November 2010 to October 2015 were included in a case observational study.Their mean age was (11.2±2.7) years and basic treatment such as predisposing causes avoiding, standing training, autonomic nervous function exercise and oral rehydration salts were advised to them.The clinical data were obtained by out-patient visit and over telephone from December 2015 to January 2016, with a median follow-up period of 10 (4, 26) months. The effects of baseline venous blood routine test parameters, gender, age, and body mass index (BMI) on syncopal recurrence were studied via univariate and multivariate Cox regression analysis.Kaplan-Meier curve was used to evaluate the long-term prognosis.@*Result@#Among the 63 VVS children in this study, 31 cases were diagnosed as VVS vasodepressor type, 4 cases as VVS cardioinhibitory type and 28 cases as VVS mixed type, 16 cases (25%) had experienced recurrence of syncope while 47 cases (75%) had not.The result of univariate analysis of Cox regression showed that baseline platelet count (PLT) (HR=1.012, 95%CI: 1.003-1.022) had a marked impact on the survival rate.And the result of multivariate analysis of Cox regression showed that baseline hemoglobin concentration (HGB) (HR=1.055, 95%CI: 1.007-1.105), mean corpuscular hemoglobin (MCH) (HR=0.612, 95%CI: 0.423-0.884) and PLT(HR=1.015, 95%CI: 1.006-1.024) had significant effects on survival rate of VVS children.In this study, the one-year, two-year, and three-year survival rate were 83% (52/63), 79% (50/63) and 75% (47/63), respectively.@*Conclusion@#The baseline venous blood routine test parameters HGB, MCH and PLT might be the influencing factors of the syncopal recurrence of VVS children.