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As intelligent outpatient service comes into being, it is significant to enable the elderlies to leverage such benefits and improve their outpatient experience. A hospital explored an " Orange" heart-to-heart service mode for the elderlies in its outpatient clinics since November 2020. Covering the whole process of elderly outpatients visits in the mode, the following measures were taken, namely the age-appropriate transformation of outpatient self-service equipments, a one-stop medical center for the elderlies to optimize the outpatient flow, and a smart outpatient service station for the elderlies to help them immediately complete or gradually learn related operations on mobile phones and self-service machines. The " Orange" elderly assistance school provides elderlies with popular science education on disease knowledge, and how to use information equipment and medical procedures, effectively improving the experience of elderly outpatients.For example, their waiting time was shortened from(22.56±5.25) minutes before to(13.66±3.65) minutes after, and their overall satisfaction scoring for outpatient experience rose from 3.63 to 4.32 points, and satisfaction rate increased from 78.00% to 93.00%. It can provide reference for improving the outpatient experience of elderlies in the context of smart outpatient visits.
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The constitutive androstane receptor (CAR, NR3I1) belongs to nuclear receptor superfamily. It was reported that CAR agonist TCPOBOP induces hepatomegaly but the underlying mechanism remains largely unknown. Yes-associated protein (YAP) is a potent regulator of organ size. The aim of this study is to explore the role of YAP in CAR activation-induced hepatomegaly and liver regeneration. TCPOBOP-induced CAR activation on hepatomegaly and liver regeneration was evaluated in wild-type (WT) mice, liver-specific YAP-deficient mice, and partial hepatectomy (PHx) mice. The results demonstrate that TCPOBOP can increase the liver-to-body weight ratio in wild-type mice and PHx mice. Hepatocytes enlargement around central vein (CV) area was observed, meanwhile hepatocytes proliferation was promoted as evidenced by the increased number of KI67
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Acetaminophen (APAP) overdose is the leading cause of drug-induced liver injury, and its prognosis depends on the balance between hepatocyte death and regeneration. Sirtuin 6 (SIRT6) has been reported to protect against oxidative stress-associated DNA damage. But whether SIRT6 regulates APAP-induced hepatotoxicity remains unclear. In this study, the protein expression of nuclear and total SIRT6 was up-regulated in mice liver at 6 and 48 h following APAP treatment, respectively.
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Objective To observe the abnormality of lipid metabolism and renal function change in elderly patients with hypertension,and to evaluate the relationship between atherogenic index of plasma(AIP) and glomerular filtration rate(GFR).Methods From July 2015 to June 2017,in Quzhou People's Hospital,182 elderly patients with hypertension were selected as observation group,and 192 elderly healthy people with normal blood pressure were selected as control group.The total cholesterol(TC),triglyeride(TG),high density lipoprotein cholesterol (HDL-C) were detected,and the AIP =1og [TG/HDL-C] was calculated.The GFR was estimated by Cockcroft-Gault equation.The relationship between the estimated GFR (eGFR) and the blood lipid parameters was analyzed.Results The eGFR of the observation group and control group were (84.94 ± 19.49) mL · min-1 · (1.73m2)-1,(154.91 ± 20.44) mL· min-1 · (1.73m2)-1,respectively,the difference between the two groups was statistically significant (t =11.27,P ＜ 0.01).The AIP of the observation group and control group were (0.68 ± 0.03),(-0.22 ± 0.02),respectively,the difference between the two groups was statistically significant (t =3.43,P ＜ 0.01).There was a negative correlation between AIP and eGFR in the elderly patients with hypertension (r =-0.845,P ＜ 0.01).Conclusion The fact shows that abnormality of lipid metabolism in the elderly patients with hypertension is present.AIP can be used as a plasma marker of atherosclerosis and could be used as a useful and important parameter for clinical observation in the elderly hypertensive patients with renal impairment.
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Objective To study effect of bufalin on invasion and metastasis of gastric cancer cells and related mechanism.Methods AGS human gastric cancer cell line was used for in vitro experiments.Cultured cells were treated by negative control group,bufalin group and oxaliplatin group.Cell proliferation was determined by MTT.Invasion and metastasis were observed by Wound-Healing Assay and Transwell Assay.Expression levels of E-cadherin,matrix metalloproteinases (MMP)-2,MMP-9 were detected by Western blotting.Results Bufalin was found to significantly inhibit the proliferation of AGS cells in a dose and time dependent manner.Wound-Healing Assay and Transwell Assay showed that as compared with the blank control group,bufalin inhibited invasion and metastasis of AGS cells (P＜ 0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P＞0.05).Western blotting showed the expression of E-cadherin was increased in bufalin group as compared with the blank control group while the expression levels of MMP-9 and MMP-2 were down-regulated (P＜0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P＞ 0.05).Conclusion Bufalin has anti-cancer activity on gastric cancer cells,and it has the ability of inhibiting cancer cell invasion and metastasis,and regulating the expression of some related gene.
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Objective To investigate the therapeutic effect of Jianpi Yiqi, Bushen Fenjing combined with oxaliplatin+CF/5-FU on colorectal cancer.MethodsEighty patients with colorectal cancer who were treated in our hospital from January 2014 to December 2015 were randomly divided into observation group(40cases) and control group (40cases).The control group was given oxaliplatin+CF/5-FU treatment, the observation group in the control group based on the application of Spleen Qi, Bushen fill essence treatment, observed before and after treatment of two groups of serum tumor markers, clinical symptoms and living conditions, changes, record adverse reactions.ResultsThe observation effect of 82.50% was significantly higher than that of the control group (62.50%).The QOL score (37.8±5.6) was significantly higher than that of the control group (33.5±3.1) and the adverse reaction rate was 30.00% (P<0.05).The difference between the two groups was significant (P<0.05).ConclusionThe effect of invigorating spleen qi and tonifying siren solution combined with oxaliplatin+CF/5-FU on colorectal cancer can improve the clinical symptoms and improve the quality of life of patients.
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Alcohol abuse leads to alcoholic liver disease and no effective therapy is currently available. Wuzhi Tablet (WZ), a preparation of extract fromthat is a traditional hepato-protective herb, exerted a significant protective effect against acetaminophen-induced liver injury in our recent studies, but whether WZ can alleviate alcohol-induced toxicity remains unclear. This study aimed to investigate the contribution of WZ to alcohol-induced liver injury by using chronic-binge and acute models of alcohol feeding. The activities of ALT and AST in serum were assessed as well as the level of GSH and the activity of SOD in the liver. The expression of CYP2E1 and proteins in the NRF2-ARE signaling pathway including NRF2, GCLC, GCLM, HO-1 were measured, and the effect of WZ on NRF2 transcriptional activity was determined. We found that both models resulted in liver steatosis accompanied by increased transaminase activities, but that liver injury was significantly attenuated by WZ. WZ administration also inhibited CYP2E1 expression induced by alcohol, and elevated the level of GSH and the activity of SOD in the liver. Moreover, the NRF2-ARE signaling pathway was activated by WZ and the target genes were all upregulated. Furthermore, WZ significantly activated NRF2 transcriptional activity. Collectively, our study demonstrates that WZ protected against alcohol-induced liver injury by reducing oxidative stress and improving antioxidant defense, possibly by activating the NRF2-ARE pathway.
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Objective To investigate the clinical efficacy of electroacupuncture in treating mild and moderate female stress incontinence.Methods One hundred and eighty female patients with mild or moderate stress incontinence were randomly allocated to treatment and control groups, 90 cases each. The treatment group received electroacupuncture and the control group took midodrine hydrochloride tablets. The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) score was recorded and 1-hour pad test leakage was measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the ICIQ-UI SF score and pad test leakage in both groups (P<0.01). There were statistically significant post-treatment differences in the ICIQ-UI SF score and pad test leakage between the treatment and control groups (P<0.01). The total efficacy rate was 86.7% in the treatment group and 68.9% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusions Electroacupuncture is an effective way to treat mild and moderate female stress incontinence. It can improve urinary continence and reduce urine leakage in the patients.
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Objective To investigate the effects ofZhenqi-Fuzheng capsule combined with highly active antiretroviral therapy (HAART) the Thl/Th2, Tcl/Tc2, and CD4+ T lymphocytes in patients with advanced AIDS.Methods A total of 70 patients with advanced AIDS were randomly divided into a treatment group and a control group, with 35 patients in each group. The treatment group was treated withZhenqi-Fuzheng capsule combined with HAART, while the control group was treated with HAART only. The patients in both groups were treated for 24 weeks. The Thl, Th2, Tcl, Tc2 and CD4+ T lymphocytes in peripheral blood were detected by flow cytometer.Results After treatment, the ratios of Th1/Th2 (6.27 ± 0.70vs. 5.39 ± 0.64;P<0.05) and Tcl/Tc2 (10.70 ± 0.68vs. 10.16 ± 0.85;P<0.05) in the treatment group showed significantly higher than those in the control group. The CD4+T lymphocytes after the treatment in both groups showed significantly increased than that before the treatment (treatment group: 289.2 ± 101.5/mlvs. 121.1 ± 77.5/ml,P<0.01; control group: 231.6 ± 97.6/mlvs. 118.9 ± 76.2/ml,P<0.01). The CD4+T lymphocytes in the treatment group showed significantly increased than that in the control group after the treatment (P<0.05).ConclusionsZhenqi-Fuzhengcapsule combined with HAART may regulate the Thl/Th2 and Tcl/Tc2, and increase the CD4+ T lymphocytes in patients with advanced AIDS.
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<p><b>OBJECTIVE</b>To investigate the risk factors on initial surgery in Crohn's disease.</p><p><b>METHODS</b>The clinical data of 173 patients with Crohn's disease who were treated during 2010 and 2014 years in the Second Affiliated Hospital of Sun Yat-Sen University, were analyzed retrospectively. The patients who had received intestinal resection or whose initial symptoms occurred at least 5 years at the end of the follow-up were recruited. Montreal classification was used to evaluate lesion location and disease behavior. The risk factors of the initial surgery were analyzed by using Logistic regression model.</p><p><b>RESULTS</b>Eighty-five patients (49.1%) received intestinal resection in 5 years after the onset of symptoms. The result of univariate analysis showed that the probability of surgical treatment is high in patients who were male and those older than 40 years at diagnosis (P<0.05). Lesions involving upper digestive tract, stenosis and penetrating lesions were also the risk factors on initial surgery in Crohn's disease (P<0.05). The result of multivariate analysis showed the relative risk of initial surgery was increased in male gender (OR=2.02, 95%CI:1.04-3.92) and in those who were older than 40 years at diagnosis (OR=2.34,95%CI:1.05-5.22). However, in patients with Crohn's disease involving colon alone, the relative risk of initial surgery was decreased (OR=0.35, 95%CI:0.13-0.97).</p><p><b>CONCLUSION</b>Abdominal pain is the most common clinical presentation in Crohn's disease. Disease behavior and operation is closely related. Older than 40 years at diagnosis and male gender is high risk factor for surgery while colonic lesion alone is protective factor.</p>
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Humans , Male , Abdominal Pain , Colon , Constriction, Pathologic , Crohn Disease , Follow-Up Studies , Logistic Models , Protective Factors , Retrospective Studies , Risk FactorsABSTRACT
Objective To evaluate the efficacy and safety of de novo combination of tenofovir (TDF) plus lamivudine (LAM) based highly active antiretroviral therapy (HAART) for HBV-HIV coinfected patients.Methods Sixty patients with HBV-HIV co-infections admitted to Wuxi Fifth People's Hospital and Shanghai Public Health Clinical Center during January 2009 and December 2012 were enrolled.The patients were randomly divided into TDF + LAM based HAART group (TDF + LAM group,n =30) and LAM based HAART group (LAM group,n =30).All patients were treated for 72 weeks.SPSS 17.0 was used to compare the ALT normalization rate,HBV DNA negative conversion rate,serological response,HIV RNA negative conversion rate and CD4 + lymphocyte counts elevation rate between two groups at 24-,24-,48-and 72-week.Drug resistance and adverse reaction were observed.Results ALT normalization rates in TDF + LAM group at 24-,48-and 72-week were 83.3％,90.0％ and 93.3％,respectively,which were higher than those in LAM group (x2 =5.079,4.812 and 5.455,P ＜0.05).After 48 weeks of treatment,there were 28 patients (93.3％) in TDF + LAM group with the elevation of CD4 + lymphocyte counts ≥ 150 cells/μL,the rate was higher than that in LAM group (21/30,70.0％) (x2 =5.455,P ＜ 0.05).HBV DNA negative conversion rates in TDF + LAM group at 12-,24-,48-and 72-week were 60.0％,90.0％,93.3％ and 96.7％,respectively,which were higher than those in LAM group (x2 =4.800,5.963,5.455 and 9.017,P ＜0.05).No drug resistance and severe adverse reaction was observed in TDF + LAM group.Conclusion TDF + LAM based HAART is better in HBV viral suppression and liver function normalization,and has lower HBV resistance and higher CD4 + T lymphoeyte counts elevation rate than LAM based HAART for HBV-HIV co-infected patients.
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Objective To investigate the expressions of platelet activation-dependent granule membrane protein and platelet-derived growth factor receptor-αB, and the ultra-microstructure changes of platelets in patients with acute ST-segment elevation myocardial infarction(STEMI). Method The expressions of platelet activationdependent granule of glycoprotein (CD62P)and platelet derived growth factor receptor αβ subtype (PDGFR-αβ)of platelets in peripheral blood in 36 patients with acute ST-segment elevation myocardial infarction(STEMI) hospitalized and another 34 healthy subjects over the same period (control group) were investigated by flow cytometry and data were analyzed. The changes of ultra microstructure and activity of blood platelets in those patients and control group were observed under the scanning electron microscope. Results The expressions of CD62P and PDGFR-αβin patients with STEMI group before treatment were (3.65 ± 1.87) % and (0.43 ± 0.39) %, respectively, and those after treatment were (0.96 ± 0.79) % and (0.28 ± 0. 24) %, respectively, whereas those in control group were (0.67 ± 0.35) % and (0.27 ± 0.22) %, respectively, which were much lower in control than those in patients with STEMI before treatment (P ＜ 0.01 or P ＜ 0.05) respectively. There were statistically significant differences in the expressions of CD62P and PDGFR-αβ in patients group between pre-treatment and posttreatment (P ＜0.01 or P ＜0.05), respectively. Obvious ultra-microstructure changes of platelet surface in patients with STEMI group were observed. Conclusions Due to platelet activation in AMI, the expressions of CD62P can be used as effective indicators for monitoring coronary heart disease, and the PDGFR-αβ can be used as a reference indicator. The platelet surface ultra-microstructure changes during platelet activation in patients with AMI can be found by scanning electron microscopy.
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Objective To investigate the influence of nebulized Pulmieort respules inhalation after endoscopic sinus surgery (ESS)on the expression of epithelial Na~+ channel(ENaC)protein in nasal mucosa. Methods Forty-four patients with nasal polyps undergoing ESS were randomly divided into Pulmieort respules treatment group(n=21,nebulized Pulmieort respules inhalation for 10 d after ESS)and Rhinocort control group(n=23,Rhinoeort aqueous nasal spray for 10 d after ESS).All the patients were performed biopsy of membrane on the residual middle turbinate 14 d after ESS,eosinophils (Eos)and neutrophils(Neu)per hundred inflammation cells were counted under microscope during ESS and after ESS,and the expression of ENaC protein was detected by immunofluorescence assay. Results The percentages of Eos and Neu decreased in two groups after treatment,and the percentage of Neu in Pulmieort respules treatment group was significantly lower than that in Rhinoeort control group(P<0.05).The expression of ENaC protein after treatment in Pulmieort respules treatment group was significantly lower than that in Rhinoeort control group(P<0.01). Conclusion Application of pulmieort respules after ESS can decrease Neu infiltration and inhibit expression of ENaC protein,which can relieve acute inflammation and edema of nasal mucosa.
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OBJECTIVE@#To explore the role in the pathogenesis of nasal polyp (NP) by comparison of eosinophil major basic protein (MBP), and neutrophil elastase (NE) in nasal polyps (NP) epithelium, stroma and the secretion of expression.@*METHOD@#Immunohistochemical detection of 30 cases of patients with chronic sinusitis (CRS) NP epithelium NE stroma and the expression and secretion of MBP.@*RESULT@#1. There were significant differences of the expression of NE and MBP in epithelial tissue, stroma and secretion compared with the control group (P 0.05), while there was significant difference between epithelial tissue and the secretion (P < 0.05); 3. There were significant differences of the average positive expression of MBP and NE among epithelial tissue, stroma and secretion (P < 0.05); 4. MBP and NE were usually degranulated in secretion, while usually located in eosinophils (Eos) and neutrophils (Neu) in epithelial and mesenchymal; 5. There were abundant expression of MBP and NE in epithelial shedding regional, while small amounts of expression in stroma and integrated epithelial; 6. Electron microscopy could show the characteristics of electron density of MBP and NE particles.@*CONCLUSION@#MBP and NE collaborated to cause pathological effects on the occurrence of NP.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Blood Proteins , Metabolism , Bodily Secretions , Metabolism , Eosinophil Major Basic Protein , Eosinophils , Metabolism , Leukocyte Count , Leukocyte Elastase , Metabolism , Nasal Polyps , Metabolism , Pathology , Proteoglycans , Metabolism , Sinusitis , Metabolism , PathologyABSTRACT
OBJECTIVE@#To evaluate the recent clinical efficiency of nebulized Pulmicort respimat after FESS.@*METHOD@#Forty-four patients with chronic sinusitis who received FESS, 21 cases were treated with aerosol therapy: Pulmicort respimat , the other 23 cases were treated with Budesonide aqueous nasal spray. All the patients were asked for return at the day 14. Efficacy was evaluated by measurement of nasal symptom scores and sign scores at day 2 and day 14, the biopsy of the membrane on the gap of sinus maxillary were taken to count the eosinophil cell and neutrophil cell in per hundred inflammation cells under microscope and analyze the statistic of the symptom scores, sign scores, efficiency, percentage of the eosinophil cell and the neutrophil cell between two groups at day 14.@*RESULT@#There was no significant differences on the total score between two groups at the day 2, while the therapy group was remarkably lower than that in the control group at the day 14 (P 0.05). The percentage of the eosinophil was no significant differences between two groups (P > 0.05), while the percentage of the neutrophil was lower in the therapy group (P < 0.01).@*CONCLUSION@#Pulmicort respimat and Budesonide are the same type hormones, butPulmicort respimat is a fine granule mixed liquid, with PARI SINUS nasal spray, it can arrive at the whole cavity of the sinus maxillary and be absorbed faster and in a larger space. We consider that nebulized Pulmicort respimat after FESS can relieve the acute inflammation and oedema, it can also reduce the complication of the surgery. The recent clinical efficiency of the Pulmicort respimat is much better than other aqueous nasal spray.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Administration, Inhalation , Administration, Intranasal , Budesonide , Chronic Disease , Endoscopy , Methods , Intraoperative Period , Nasal Sprays , Sinusitis , General SurgeryABSTRACT
Objective To investigate the relationship between continuous hyperglycemia and the progression of early acute pancreatitis (AP) Methods Five hundred and twelve AP patients were included in this study, in which 418 patients were mild acute pancreatitis (MAP) and 94 were severe acute pancretitis (SAP) Fasting blood sugar was determined and APACHE Ⅱ score was calculated on admission, 2nd and 3rd day of hospitalization respectively Serum tumor necrosis factor (TNF?) and C reaction protein (CRP) levels were determined on the 2nd day of hospitalization Results The incidence of hyperglycemia was higher in SAP patients than that in MAP patients (74 5% vs 25 8%, P =0 001) In SAP, APACHE Ⅱ score in continuous hyperglycemia group (CHG) was significantly higher than that of non continuous hyperglycemia group (NCHG) on admission, 2nd and 3rd day of hospitalization respectively (13?4 vs 11?3, P =0 017; 13?4 vs 11?3, P =0 010; 14?4 vs 10?4, P =0 010, respectively) Continuous hyperglycemia was related to the severity of SAP ( ? 2=7 77, P =0 005) Moreover, serum TNF? and CRP levels of the CHG were also markedly higher than that of NCHG (20?14 vs 14?11, P =0 019; 123?81 vs 93?55, P =0 036, respectively) Conclusion Continuous hyperglycemia might be a risk factor for the aggravation of early acute pancreatitis