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Objective:To investigate the appetite of patients with lymphoma during chemotherapy and its influencing factors.Methods:A total of 103 patients with lymphoma who underwent chemotherapy were sequentially selected in Fujian Medical University Union Hospital from December 2020 to August 2021. The questionnaire survey was carried out by using general information and Karnofsky score was performed. Appetite score was calculated according to Chinese version of the appetite symptom questionnaire for cancer patients. Multiple linear regression analysis was used to analyze the influencing factors of appetite status of lymphoma patients during chemotherapy, and Pearson correlation analysis was used to explore the relationship between Karnofsky score and appetite score of patients.Results:For patients with lymphoma during chemotherapy, Karnofsky score was (75±18) scores and the appetite score was (25.0±5.0) scores. Univariate analysis showed that age, body mass index (BMI), nausea and vomiting, oral mucosa rupture, gum infection, fever, throat infection were influencing factors of appetite score of patients (all P < 0.05). Multivariate analysis showed that patients ' age ( B = -1.118, β = -0.187, P = 0.016), BMI ( B = -2.047, β = -0.271, P = 0.001), nausea and vomiting ( B = -4.352, β = -0.411, P < 0.001) were the independent influencing factors of appetite score. Correlation analysis showed that the Karnofsky score was positively correlated with appetite score ( r = 0.361, P < 0.05). Conclusions:Special attention should be paid to the appetite of elder lymphoma patients with lower BMI during chemotherapy, and nausea and vomiting should be paid more attention; targeted measures of increasing the patients' appetite could improve their nutritional level and prognosis.
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Beh?et′s syndrome is a kind of chronic systemic vasculitis with involvement of multiple organs. Intestinal involvement of Beh?et′s syndrome is presently named as intestinal Beh?et′s syndrome. Recently, there is considering another kind of disease type with only typical intestinal ulcers. Since it is difficult to differentiate intestinal Beh?et′s syndrome from Crohn′s disease, intestinal tuberculosis, intestinal lymphoma, and intestinal manifestations of many other autoimmune diseases, and there is limited evidence for the therapy of intestinal Beh?et′s syndrome, proposing diagnosis and treatment recommendations for intestinal Beh?et′s syndrome through evidence-based judgment will be of great significance for clinical practice.
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Hepatobiliary and pancreatic diseases are common comorbidities of inflammatory bowel disease (IBD), and the presence of such diseases may affect the diagnosis, treatment, and prognosis of IBD and has certain value in identifying the cause of IBD. This article elaborates on the epidemiology of IBD with hepatobiliary and pancreatic diseases, so as to provide new insights for understanding the pathogenesis of IBD and formulating effective clinical treatment regimens.
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Objective@#To evaluate trough serum vancomycin concentrations and identify their influencing factors in critically ill neurosurgical patients.@*Methods@#A retrospective study was conducted. Adult patients who received vancomycin with at least one appropriate monitoring of trough serum vancomycin concentration and admitted to neurosurgical intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from November 2017 to July 2019 were enrolled. General information including gender, age, comorbidities, etc., trough serum vancomycin concentrations, vancomycin dosage, duration of vancomycin therapy, urine output, serum creatinine (SCr), concurrent medications (including mannitol, diuretic, vasopressors, non-steroidal anti-inflammatory drugs, polymyxin, aminoglycosides and contrast medium, etc.) were collected for analysis. Trough serum vancomycin concentrations were evaluated and their influencing factors were analyzed by multiple linear regression method.@*Results@#In total, 81 trough serum vancomycin concentration data sets obtained from 28 patients were evaluated. ① The initial daily dose of vancomycin was 2.00 (2.00, 2.00) g/d. After 4-6 doses, the trough serum vancomycin concentration obtained from initial blood draw was 10.99 (6.98, 16.25) mg/L, of which only 17.9% (5/28) achieving targeted concentrations (15-20 mg/L), 71.4% (20/28) subtherapeutic level and 10.7% (3/28) supratherapeutic level. ② The duration of vancomycin therapy was 8.0 (6.0, 15.0) days. With average daily dose of 2.00 (1.75, 3.00) g/d, targeted trough vancomycin concentrations were achieved in only 30.9% (25/81) of all cases, subtherapeutic concentrations in 49.4% (40/81) and supratherapeutic concentrations in 19.7% (16/81). ③ There were significant differences in age, comorbidities, vancomycin dosage, diuretics use and mannitol dosage, etc. among different vancomycin concentration groups. Multiple linear regression analysis suggested that the trough serum vancomycin concentration increased by 0.14 mg/L [95% confidence interval (95%CI) was 0.06-0.22] for every 1 year increase in age, increased by 7.22 mg/L (95%CI was 2.08-12.36) in patients with multiple comorbidities (concomitant hypertension, diabetes and coronary heart disease) compared with those without comorbidities, increased by 2.78 mg/L (95%CI was 0.20-5.35) in patients treated with diuretics compared with those without diuretics. The effect of other variables was not statistically significant. It suggested that age, multiple comorbidities (concomitant hypertension, diabetes and coronary heart disease), and diuretic usage affected trough serum vancomycin concentrations.@*Conclusions@#Targeted trough serum vancomycin level is not often achieved in neurosurgical ICU patients following standard dosing. Younger patients are associated with lower trough serum vancomycin concentrations, while diuretic usage, combined with multiple comorbidities are associated with higher trough serum vancomycin concentrations.
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To evaluate trough serum vancomycin concentrations and identify their influencing factors in critically ill neurosurgical patients. Methods A retrospective study was conducted. Adult patients who received vancomycin with at least one appropriate monitoring of trough serum vancomycin concentration and admitted to neurosurgical intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from November 2017 to July 2019 were enrolled. General information including gender, age, comorbidities, etc., trough serum vancomycin concentrations, vancomycin dosage, duration of vancomycin therapy, urine output, serum creatinine (SCr), concurrent medications (including mannitol,diuretic, vasopressors, non-steroidal anti-inflammatory drugs, polymyxin, aminoglycosides and contrast medium, etc.) were collected for analysis. Trough serum vancomycin concentrations were evaluated and their influencing factors were analyzed by multiple linear regression method. Results In total, 81 trough serum vancomycin concentration data sets obtained from 28 patients were evaluated. ① The initial daily dose of vancomycin was 2.00 (2.00, 2.00) g/d. After 4-6 doses, the trough serum vancomycin concentration obtained from initial blood draw was 10.99 (6.98, 16.25) mg/L, of which only 17.9% (5/28) achieving targeted concentrations (15-20 mg/L), 71.4% (20/28) subtherapeutic level and 10.7% (3/28) supratherapeutic level. ② The duration of vancomycin therapy was 8.0 (6.0, 15.0) days. With average daily dose of 2.00 (1.75, 3.00) g/d, targeted trough vancomycin concentrations were achieved in only 30.9% (25/81) of all cases, subtherapeutic concentrations in 49.4% (40/81) and supratherapeutic concentrations in 19.7% (16/81). ③ There were significant differences in age, comorbidities, vancomycin dosage, diuretics use and mannitol dosage, etc. among different vancomycin concentration groups. Multiple linear regression analysis suggested that the trough serum vancomycin concentration increased by 0.14 mg/L [95% confidence interval (95%CI) was 0.06-0.22] for every 1 year increase in age, increased by 7.22 mg/L (95%CI was 2.08-12.36) in patients with multiple comorbidities (concomitant hypertension, diabetes and coronary heart disease) compared with those without comorbidities, increased by 2.78 mg/L (95%CI was 0.20-5.35) in patients treated with diuretics compared with those without diuretics. The effect of other variables was not statistically significant. It suggested that age, multiple comorbidities (concomitant hypertension, diabetes and coronary heart disease), and diuretic usage affected trough serum vancomycin concentrations. Conclusions Targeted trough serum vancomycin level is not often achieved in neurosurgical ICU patients following standard dosing. Younger patients are associated with lower trough serum vancomycin concentrations, while diuretic usage, combined with multiple comorbidities are associated with higher trough serum vancomycin concentrations.
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Objective To investigate the dynamic changes in early gastric antrum contraction in patients with craniocerebral injury. Methods The patients with craniocerebral injury admitted to neurosurgery intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from July to November in 2018 were enrolled. The changes in antral contraction frequency (ACF), antral contraction amplitude (ACA) and antral motility index (MI) were dynamically observed at 1-6 days after injury by ultrasonography. According to Glasgow coma score (GCS), the patients were divided into moderate to severe craniocerebral (GCS ≤ 11) and mild craniocerebral injury groups (GCS > 11). The differences in ACF, ACA and MI between the two groups were compared to observe the effect of craniocerebral injury on gastric antral motility. The patients were divided into simple supratentorial and supratentorial combined infratentorial lesion groups according to the lesion location of craniocerebral injury. The differences in ACF, ACA and MI between the two groups were compared to analyze the influence of lesion location on gastric antrum activity. Results A total of 68 patients with craniocerebral injury were screened during the study period, 50 patients were in accorded with the admission criteria, 17 patients were withdrawn from the observation because they could not tolerate the ultrasonography of gastric antrum or discharged from ICU. Finally, 33 patients were enrolled in the analysis. ① The ACF, ACA and MI at 1 day after injury were lower [ACF (times/min): 1.67 (0.00, 2.00), ACA: 42.06 (0.00, 44.45)%, MI: 0.70 (0.00, 0.87)], and then gradually increased, till 6 days after injury, ACF was 1.83 (1.25, 2.79) times/min, ACA was 56.80 (33.25, 60.77)%, and MI was 0.89 (0.50, 1.70), which showed no differences among all time points (all P > 0.05). ② The contractile function of gastric antrum in two groups of patients with different degrees of craniocerebral injury was decreased, especially ACA in patients with moderate to severe craniocerebral injury (n = 22), which showed significant differences at 3 days and 5 days after injury as compared with mild craniocerebral injury [n = 11; 3 days: 35.05 (0.00, 53.69)% vs. 58.51 (49.90, 65.45)%, 5 days: 39.88 (0.00, 77.01)% vs. 56.94 (41.71, 66.66)%, both P < 0.05], indicating that the degree of craniocerebral injury affected the contractive function of gastric antrum. However, there was no significant difference in ACF or MI between the two groups at different time points after injury. ③ The contractile function of gastric antrum was decreased after craniocerebral injury in both groups of patients with different lesion locations of craniocerebral injury. The ACF, ACA, and MI at 3-4 days in patients with supratentorial combined infratentorial lesion (n = 12) were slightly lower than those in patients with simple supratentorial lesion [n = 21; 3 days: ACF (times/min) was 0.83 (0.00, 2.00) vs. 2.25 (0.00, 3.00), ACA was 35.05 (0.00, 53.60)% vs. 49.93 (0.00, 63.44)%, MI was 0.29 (0.00, 1.07) vs. 1.23 (0.00, 1.61); 4 days: ACF (times/min) was 1.42 (0.50, 2.63) vs. 2.00 (1.63, 2.63), ACA was 30.45 (21.69, 60.61)% vs. 43.29 (38.41, 53.35)%, MI was 0.50 (0.15, 1.45) vs. 0.97 (0.66, 1.28)] without statistical differences (all P > 0.05), indicating that the lesion location might not affect the contractive function of gastric antrum. Conclusion In the early stage of craniocerebral injury, the contractile function of gastric antrum was decreased, and the more severe the craniocerebral injury, the worse contractive function of gastric antrum.[Key words] Craniocerebral injury; Antral contraction; Enteral nutrition; Antral ultrasonography
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<p><b>OBJECTIVE</b>To assess the association of programmed cell death 1 (PDCD1) gene polymorphisms with the susceptibility and/or progression of colorectal cancer.</p><p><b>METHODS</b>A hospital-based case-control study was carried out, which recruited 426 colorectal cancer patients and 500 healthy individuals. Five single nucleotide polymorphisms, namely rs36084323, rs11568821, rs2227981, rs2227982 and rs10204525, were selected for the study and genotyped with a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay.</p><p><b>RESULTS</b>The G allele of rs36084323 under a dominant model was associated with increased risk of advanced TNM staging of colorectal cancer progression (OR=1.59, 95%CI=1.02-2.48). Haplotypes G-G-C-T-A and A-G-C-C-G of the rs36084323, rs11568821, rs2227981, rs2227982, and rs10204525 were negatively associated with the occurrence of colorectal cancer.</p><p><b>CONCLUSION</b>The G allele of rs36084323 is associated with increased risk of advanced TNM staging of colorectal cancer. Conversely, the incidence of colorectal cancer is negatively associated with the haplotypes G-G-C-T-A and A-G-C-C-G of rs36084323, rs11568821, rs2227981, rs2227982, and rs10204525.</p>
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Humans , Asian People , Genetics , Case-Control Studies , China , Ethnology , Colorectal Neoplasms , Genetics , Pathology , Genetic Predisposition to Disease , Haplotypes , Neoplasm Staging , Polymorphism, Single Nucleotide , Programmed Cell Death 1 Receptor , GeneticsABSTRACT
Objective To explore the effect of Ginkgo biloba extract (EGb761) on apoptosis of K-ras mutational human colon cancer cells DLD1(DLD1/G13D)and its mechanism. Methods Human colon cancer cell lines DLD1/G13D and DLD1 with K-ras wild type(DLD1/WT)were cultured in vitro,the cell proliferation and apoptosis after 24 h of EGb761 were measured. Proteins involved in related signal pathway were detected by Western blot or ELISA. Results EGb761 reduced cell proliferation and induced cell apoptosis in a concentration-dependent manner in DLD1/WT and DLD1/G13D cells. EGb761 downregulated the expression of RIP1, impaired the phosphorylation of IκB and decreased the level of NF-κB in DLD1/WT and DLD1/G13D cells[DLD1/G13D: (24±4)%, DLD1/WT: (29±9)%(P<0.05). Conclusion EGb761 restrains the proliferation and induces the apoptosis of DLD1/WT and DLD1/G13D cells. The mechanism may be related to the degradation of RIP-1 and inhibition of activation of NF-κB signaling pathway.
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Objective To evaluate the diagnostic value of cerebrospinal lactate for the diagnosis of bacterial meningitis in patients post-neurosurgical operation (PNBM) with blood-contaminated cerebrospinal fluid (CSF). Methods A prospective observational study was conducted. 101 patients underwent neurosurgical operation and clinically suspected PNBM admitted to neurosurgical intensive care unit (NSICU) of the First Affiliated Hospital of Sun Yat-sen University from October 2015 to December 2016 were enrolled. Based on red blood cell quantitative test in CSF, the patients were divided into blood-contaminated and non blood-contaminated CSF groups. According to the PNBM diagnostic criteria of 2008 Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN), all patients were divided into PNBM group and non-PNBM group. The biochemical indexes levels in CSF were compared among the groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of CSF lactate for PNBM in blood-contaminated patients.Results A total of 101 suspected PNBM patients were enrolled. In 77 blood-contaminated CSF patients, 39 patients were diagnosed as PNBM (account for 50.6%); in 24 non-blood-contaminated patients, 12 patients were diagnosed as PNBM (account for 50.0%). ① In non-PNBM patients, the lactate level in blood-contaminated CSF was significantly higher than that of non-blood-contaminated CSF (mmol/L: 3.5±1.3 vs. 2.3±1.1,P 0.05). ② In both blood-contaminated and non blood-contaminated CSF, white blood cell (WBC), protein and lactate levels in PNBM group were significantly higher than those in non-PNBM group [WBC (×106/L): 660.0 (67.5, 1105.0) vs. 41.0 (15.0, 142.5) in blood-contaminated CSF,168.0 (86.5, 269.5) vs. 34.5 (7.0, 83.5) in non-blood-contaminated CSF; protein (mg/L): 4757.8 (2995.2, 10219.8) vs. 1292.8 (924.2, 1936.2) in blood-contaminated CSF, 39247.3 (14900.6, 62552.2) vs. 1441.6 (977.3, 2963.9) in non blood-contaminated CSF; lactate (mmol/L): 6.8±2.1 vs. 3.5±1.3 in blood-contaminated CSF, 6.9±2.5 vs. 2.3±1.1 in non blood-contaminated CSF, allP < 0.05], and glucose and CSF glucose/blood glucose ratio in PNBM group were significantly lower than those in non-PNBM group [glucose (mmol/L): 2.5±1.2 vs. 4.4±1.6 in blood-contaminated CSF, 1.9±1.4 vs. 3.4±0.9 in non blood-contaminated CSF; CSF glucose/blood glucose ratio: 0.28±0.15 vs. 0.46±0.16 in blood-contaminated CSF, 0.24±0.16 vs. 0.45±0.11 in non blood-contaminated CSF, allP < 0.01]. ③ It was shown by ROC curve analysis that CSF lactate level was a good diagnostic parameter for PNBM both in blood-contaminated and non blood-contaminated CSF, and the area under ROC curve (AUC) was 0.91 and 0.97, respectively. When the cutoff value of lactate in non blood-contaminated CSF was 3.35 mmol/L, the sensitivity was 100%, and the specificity was 91.7%. When the cutoff value of lactate in blood-contaminated CSF was 4.15 mmol/L, the sensitivity was 92.3%, and the specificity was 71.1%, and the combination of CSF lactate and glucose achieved better diagnostic specificity (AUC = 0.96, sensitivity was 97.4%, specificity was 84.2%).Conclusions Blood in CSF led to the elevation of CSF lactate as compared with that in non-blood-contaminated CSF of patients with PNBM. CSF lactate was still a good diagnostic parameter for PNBM both in blood-contaminated patients, and the combination of CSF lactate and glucose achieved better diagnostic specificity.
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Objectives To understand the effects of different doses of vitamin D supplementation on serum calcium,phosphorus,alkaline phosphatase and 25-hydroxyvitamin D levels in very low birth weight infants (VLBWI) and to provide guidance for early prevention of metabolic bone disease in VLBWI.Methods A total of 90 VLBWI hospitalized in the Department of Neonatology,Huzhou Maternal and Child Healthcare Hospital between January 2014 and January 2016 were enrolled and randomly divided into two groups:highdose group and low dose group.High-dose group was given vitamin D 900 U/d orally and low-dose group was given 400 U/d since the eighth day after birth.Serum calcium,phosphorus and alkaline phosphatase levels were detected at 1,7,21 and 42 days of age and serum 25-hydroxyvitamin D levels were detected at 7,21and 42 days of age.Two-sample t-test,Chi-square test,one-way analysis of variance and LSD or Dunnett's T3 test were used for statistical analysis.Results No significant differences in serum calcium,phosphorus and alkaline phosphatase levels were found between the two groups at 1 and 7 days of age,nor were found in serum 25-hydroxyvitamin D level at 7 days of age (all P＞0.05).At 21 days of age,high dose group had higher serum calcium,phosphorus and 25-hydroxyvitamin D levels than low-dose group [(2.38 ± 0.09) vs (2.04 ± 0.15) mmol/L,t=2.421;(1.80±0.50) vs (1.71 ±0.60) mmol/L,t-0.637;(45.58± 18.43) vs (42.53± 16.33) nmol/L,t=0.421],but lower alkaline phosphatase level [(505.12± 185.61) vs (588.32± 168.72) U/L,t=5.314] (all P＜0.05).The same trends were found at 42 days of age.In high-dose group,serum calcium level increased at 7,21 and 42 days of age as compared with that at 1 day of age [(2.43±0.13),(2.38±0.09),(2.39±0.08) vs (2.06±0.57) mmol/L];serum phosphorus level at 7 days of age was lower than that at 1,21 and 42 days of age [(1.31 ±0.26) vs (1.89±0.39),(1.80±0.50),(1.98±0.30) mmol/L];serum alkaline phosphatase level at 7,21 and 42 days of age was higher than that at 1 day of age [(475.18± 133.73),(505.12± 185.61),(538.43 ± 168.16) vs (296.15 ± 99.41) U/L] and a significant increase was observed at 42 days of age as compared with that at 7 days of age;serum 25 hydroxyvitamin D level at 21 days of age was higher than that at 7 days of age,and that at 42 days of age was higher than that at 7 and 21 days of age [(73.55±23.65) vs (30.63± 12.66) and (45.58 ± 18.43) nmol/L];the differences were all statistically significant (LSD or Dunnett's T3 test,all P＜0.05).Conclusions Vitamin D supplementation from the eighth day after birth can improve calcium and phosphorus metabolism in VLBWI and the dose of 900 U/d is more effective than 400 U/d.
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Objective To explore the effect of Ginkgo biloba extract (EGb761) on apoptosis of K-ras mutational human colon cancer cells DLD1(DLD1/G13D)and its mechanism. Methods Human colon cancer cell lines DLD1/G13D and DLD1 with K-ras wild type(DLD1/WT)were cultured in vitro,the cell proliferation and apoptosis after 24 h of EGb761 were measured. Proteins involved in related signal pathway were detected by Western blot or ELISA. Results EGb761 reduced cell proliferation and induced cell apoptosis in a concentration-dependent manner in DLD1/WT and DLD1/G13D cells. EGb761 downregulated the expression of RIP1, impaired the phosphorylation of IκB and decreased the level of NF-κB in DLD1/WT and DLD1/G13D cells[DLD1/G13D: (24±4)%, DLD1/WT: (29±9)%(P<0.05). Conclusion EGb761 restrains the proliferation and induces the apoptosis of DLD1/WT and DLD1/G13D cells. The mechanism may be related to the degradation of RIP-1 and inhibition of activation of NF-κB signaling pathway.
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Diarrhea is a common intestinal symptom in macaque.The corresponding intestinal lesions of macaque are mainly described at autopsy but less observed by colonoscopy.The aim of this study was to develop a colonoscopic technique and to obtain endoscopic images of the entire colon in macaques.Eight healthy adult macaques ( 5 males and 3 females) without diarrhea for 2 months, were fed Glauber’ s salt through nasogastric tubes.The colon cleanliness was well matched to the endoscopic observation of macaque colon.The procedure took 10-20 min for each animal.There was no obvious abnormality in the colon of four animals except some slight differences of mucosal structure from that of human beings.Small pieces of erosion and ulcer in the colons were observed in four macaques which presented mild diarrhea for less than 1 day, while a severe stenosis was observed in one of those four macaques.No animal died during and one week after the endoscopic procedure.Colonoscopy may safely performed in macaques.The images taken by colonoscopy may be important to establish diagnosis and treatment of colitis in macaques in time and to evaluate the efficacy of drug intervention as well.This technique is also helpful to provide qualified macaques for scientific researches.
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Objective Accodring to the guideline of Reference Intervals in the Clinical Laboratory(ISO15189) ,to establish the reference range of Cu ,Fe ,Zn ,Ca and Mg in the peripheral blood of preschool children in Suzhou .Methods Using atomic absorp-tion spectrometry to detect the levels of Cu ,Fe ,Zn ,Ca and Mg in peripheral blood of 3 992 Kindergarden children in Suzhou from Apr to May 2014 ,according the age ,the children were divided into three groups ,1 511 cases in 3 to 4 years old group including 750 boys ,761 girls ,1 169 cases in 4 to 5 years old group including 570 boys ,599 girls ,1 312 cases in 5 to 6 years old group inclu-ding 604 boys 708 girls .According to NCCLS's guideline C28 -A2 to define the reference range .Results The concentration of copper ,iron ,zinc ,calcium ,magnesium had no significant differences in different gender and age groups(P>0 .05) ,the reference ranges in peripheral blood of the preschool children in Suzhou were Cu 11 .47-32 .53 umol/L ,Fe 6 .86-9 .80 mmol/L ,Zn 64 .46-133 .02 umol/L ,Ca 1 .47-2 .09 mmol/L ,Mg 1 .21 -1 .75 mmol/L .Conclusion There are regional difference on the levels of Cu ,Fe ,Zn ,Ca ,Mg in children's peripheral blood ,each region should to establish the local reference range follow the guideline .
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Objective To understand the continuous care needs and related services will of the women in puerperium, and analyze the relative factors of the continuity care of those discharged from maternity hospital.Methods A total of 207 delivery women who were discharged from a hospital in Chenghua District Maternal & Child Care Center in Chengdu city from September to December, 2014 were investigated with self-made questionnaires.Results As for newborn babies' continuity care service, what those delivery women care most were newborn babies' common disease prevention and care, and as for their own continuity care service, what they most need were maternal uterine instauration care.Enforcers for continuity of care services were more inclined to obstetricians and pediatricians, and the service forms tended to make telephone calls or do follow-up visits.Time frequency of the follow-up visits was inclined to 7 days once.Delivery women's educational degree (r=-0.216, P＜0.01), place of residence (r=0.208, P＜0.01), whether they would participate in pregnant Women school (r=0.192, P＜0.01), pregnant women school number (r=-0.382, P＜0.01),the newborn's tire(r=0.173, P＜0.05) and maternal type(r=0.161, P＜0.05) were factors that influenced the degree of maternal continued care needs.Conclusions The main factors which influence the continuity care in obstetrics are educational degrees, place of residence and the types of delivery women.As a result, different methods of continuity care service should be established to aim at different groups of people so as to promote the service quality in obstetrics in general to meet the needs of delivery women at all levels.
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Objective To compare the clinical effect of preserving the ascending uterine artery in laparoscopic hysterectomy with traditional laparoscopic hysterectomy.Methods 112 patients with various kinds of uterine benign lesions performed by hysterectomy were randomly divided into the preserving the ascending uterine artery in laparoscopic hysterectomy group(observation group,n =60) and traditional laparoscopic hysterectomy group (control group,n =52),The operation time,the intra operative blood loss,the postoperative complications rate and the perimenopausal symptoms in two groups were compared as well as the levels of blood calcium and the levels of hormone before operation,the first month,the sixth month,the first year,and the third year after operation.Results The opreration time [(95.5 ± 22.8) win] and intraoperative blood soss [(81.3 ± 11.6) ml] of the observation group was more than those of the control group [(68.8 ± 7.2) ml] (t =3.772,4.418,all P ＜ 0.05).The postoperative abnormal uniation and defection (1.7％) and fever incidence (1.7％) of the observation group was lower than those of the control group (11.5 ％,13.5 ％) (x2 =4.623,5.843,all P ＜ 0.05).The estradiol level of the observation group began to fall in 6 months postoperative,and had significant differences compare with those of the control group 6 months,1 year,3 years after operation [(328.4 ± 13.4) pmol/L vs (304.8 ± 15.2) pmol/L,(311.3 ± 12.9) pmol/L vs (248.5 ±13.6)pmol/L,(258.3 ± 11.4)pmol/L vs (138.7 ± 12.7)pmol/L] (t =8.758,25.121,52.688,all P ＜0.05).There was significant difference in the level of follicle stimulating hormone (FSH) and luteinizing hormone (LH) between the two groups 1,3 years after operation(t =-90.540,-123.229,-14.757,-19.845,all P ＜ 0.01).There was significant difference in the level of calcium between the two groups 1,3 years after operation(t =3.261,3.050,all P ＜0.05).The perimenopausal symptoms of the observation group was less than those of the control group(x2 =6.142,3.471,4.976,6.646,4.633,all P ＜ 0.05).Conclusion Laparoscopic hysterectomy of preserving the ascending uterine artery is safe and reliable;the recently ovarian function of the patients with hysterectomy is to maximize the preservation in the treatment,the women's quality of life will be to improved.
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Objective To explore the effect of Jiangzhipailuan decoction in regulating PPARα( belong to the nuclear receptor family of ligand-activated transcription factors ), PGC- 1α ( peroxime proliferator activated releptour)and SREBP-1c( belong to the baichelix-loop-helix-leucine zipper class of transcription factors), SCAP( SREBP cleavage activating protein) related to lipid metabolism in the treatment of polycystic ovarian syndrome. Methods 84 patients suffered polycystic ovary syndrome were randomly divided into 4 groups: one received traditional Chinese medicine treatment, one western medicine treatment, one combination therapy and one as the control group. Traditional Chinese medicine group was treated with Jiangzhipailuan decoction treatment for 3 months, western medicine group was treated with up to Diane-35 ( ethinyl cyproterone tablets) for three cycles, while the combination therapy group was treated with traditional Chinese medicine ,western medicine as well as combined treatment for 3 courses. Results In the combination therapy group the PPARα, PGC-1α and decreased SREBP-1c, SCAP copy number was significantly improved ,and body mass index was significantly lowered. The total improvement rate of menstrual in three groups were 71.42% ,75.00% ,92.86% respectively. Conclusion Jiangzhipailuan decoction played a prominent role in regulating PPARα,PGC-1α and SREBP-1c,SCAP related to lipid metabolism in the treatment of polycystic ovarian syndrome.
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Objective To investigate the clinicopathological characteristics,diagnosis and therapy,as well as the prognosis of accessory breast cancer. Methods Twenty-two cases were diagnosed as accessory breast cancer from Jan 1,1984 to Dec 31,2008, their clinicopatholgical data were analyzed retrospectively.Results Up to Mar. 1, 2010,2 cases had local recurrence;7 cases had long-distance metastasis;6 cases died. In the current study,the 5-year survival rate of accessory breast cancer was 43. 7%. Conclusions Accessory breast cancer is aggressive. The diagnosis was mainly based on clinical characteristics and postoperative pathology. The combined therapies may improve the survival rate.
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Ocean is a unique and excellent resource that provides a diverse array of intriguing natural products. Marine natural products have demonstrated significant and extremely potent biological activities and have captured the attention of natural products chemists in the past few decades. It is increasingly recognized that a wealth of fascinating natural products and novel chemical entities will play a dominant role in the discovery of useful leads for the development of pharmaceutical agents and provide useful probes to lead to breakthroughs in a variety of life-science fields. This article focused on the research progress of chemistry of marine natural products in recent five years.
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Objective To discuss the values of three screening methods for the detection of early breast cancer,and to analyze the features of the screening cancer.Methods The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years.The three screening methods included physical examination with ultrasound and mammography,physical examination with mammography and mammography only.The rate of recall,biopsy,cancer detection of three methods were analyzed and the mammographic findings were reviewed Chi-square test or Fisher's exact test were used for the statistics.Results The recall rates were 4.90% (49/1001),6.90%(166/2407)and 4.48% (85/1899) in three methods respectively,the biopsy rates were 1.60% (16/1001),1.04% (25/2407) and 0.63%(12/1899),the cancer detection rates were 0.50% (5/1001),0.17% (4/2407) and 0 (0/1899).There were statistical differences among the three groups (X2=12.99,6.264,8.764,P < 0.05).Physical examination with ultrasound and mammnography had the highest cancer detection rate,ten breast cancers were detected and 8 were early stage breast cancer.Of seven cancers detected by mammography,only two were found by ultrasound.A cluster of calcifications were found in 2 cases,linear calcifications in 2 cases.One case presented as a asymmetric density,one as a asymmetric density with calcifications,one as multiple nodules with a duster of calcifications.Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review.Conclusion Physical examination with ultrasound and mammography is the best method for breast cancer screening.The breast cancer can be detected by mammography earlier than other methods.
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Objective To study the preventive and therapeutic effects and the mechanism of Chinese traditional compound medicine to subcilincal hepatic encephalopathy(SHE)induced by endotoxin in liver cirrhotic rats.Methods The liver cirrhosis model of rats were made in subcutaneous injection of 40% carbon tetrachloride,the SHE model was made by infused with endotoxin into the tail vein.Treatment group was given low dose or moderate dose or high dose of Chinese traditional compound medicine,Control group was treated with lactulose.The morbidity of SHE,hepatic function,blood ammonium(BA),endotoxin,liver tissue pathology were observed.Results Above indexes were improved by every group of Chinese traditional compound medicine.The curative effect of moderate and high group of Chinese traditional compound medicine to the hepatic function,BA,endotoxin,liver tissue pathology were better than that of lactulose.Conclusions The effects of the Chinese traditional compound medicines(compose of Polygonum cuspidatum,raw hawthornfruit,seed of Zizyphus jujuba Mill,Mongolian Dandelion Herb and Rhizoma Acoori Graminei)in SHE prevention and treatment is significant.Its mechanism might be as follows:① recovering liver function,decreasing inflammatory changes of liver tissue;② preventing the absorption of BA,lowering the content of BA;③ reducing the sensitivity of the body to endotoxin.