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Objective:To explore the construction and application of an evidence-based practice plan for early postoperative activity in postoperative patients with large area cerebral infarction.Methods:Ninety-six postoperative patients with large area cerebral infarction admitted to Wenzhou Central Hospital from July 2021 to April 2023 were selected as the study subjects for a Clinical trial. They were divided into the control group (48 cases) and the observation group (48 cases) by random number table method. The control group received routine postoperative care for neurosurgery, while the observation group received evidence-based systematic early activity training. Both groups were followed up until 1 month after the patient was discharged from the hospital. The time of postoperative hospitalization, hospitalization expenses, vital signs and pain investigation 48 h after surgery, daily living ability before intervention and 7 d, 1 month after discharge, neurological function before intervention and 7 d and 1 month after surgery, and complications during follow-up between the two groups were compared.Results:In the control group, there were 29 males and 19 females, with an average age of 43-67(56.87 ± 1.76) years. In the observation group, there were 31 males and 17 females, with an average age of 43-68 (57.02 ± 1.82) years. The postoperative hospital stay in the observation group was (6.87 ± 0.65) d, in the control group was (9.06 ± 0.72) d, the difference between them was significant ( t=15.64, P<0.05). 48 hours after surgery, the heart rate, breathing rate and mean arterial pressure in the observation group were (71.65 ± 0, 45) times/min, (14.76 ± 0.36) times/min and (76.98 ± 5.65) mmHg(1 mmHg=0.133 kPa), which were different with those in the control group, (82.76 ± 2.65) times/min, (18.76 ± 2.87) times/min and (93.76 ± 5.93) mmHg ( t=28.64, 9.58 and 14.19, all P<0.05). Seven days after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (84.65 ± 2.45) and (23.65 ± 2.65), which were different than the (79.76 ± 1.97) and (28.54 ± 2.73) in the control group ( t=10.26, 8.91, both P<0.05). A month after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (95.45 ± 1.43) and (18.65 ± 1.98), while in the control group were (87.87 ± 1.39) and (21.54 ± 2.76), the difference between them were significant ( t=26.33, 5.90, both P<0.05). The total incidence of complications such as postoperative bleeding, postoperative infection and hypoxemia in the observation group was 20.83% (10/48), which was significant lower than the 68.75% (33/48) in the control group ( χ2=22.28, P<0.05). Conclusions:Evidence-based systematic early activity training could significantly alleviate postoperative pain in patients with large area cerebral infarction after surgery, improve their daily living ability and neurological function, further effectively shorten their hospitalization time, and reduce the occurrence of complications.
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Objective:To evaluate the effects of different doses of esketamine on patient status index (PSI) under propofol-remifentanil-based anesthesia.Methods:One hundred patients of either sex, aged 22-62 yr, with body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ, were divided into 5 groups ( n=20 each) using a random number table method: normal saline group (group NS) and different doses of esketamine groups (E1-4 groups). Anesthesia was induced and maintained by target-controlled intravenous infusion of propofol and remifentanil.When the depth of anesthesia was stable (PSI value 25-50 ) for 5 min after tracheal intubation and no surgical stimulation was given, esketamine 0.1, 0.2, 0.3 and 0.4 mg/kg were intravenously injected over 60 s in E1-4 groups respectively, and normal saline 10 ml was intravenously injected in NS group. PSI values were recorded at 1-min intervals (1-15 min, T 1-T 15) immediately before anesthesia induction (T 0) and after esketamine administration. PSI values>50, bradycardia and hypotension were recorded during the test. Results:Compared with NS group, no significant change was found in PSI values at each time point in E1 group ( P>0.05), PSI value was significantly increased at T 5-T 10 in E2 group, PSI value was increased at T 5-T 12 in E3 group, PSI value was increased at T 1-T 15 in E4 group, and the incidence of PSI value >50 was increased in E2, E3 and E4 groups ( P<0.05). The incidence of PSI value >50 was significantly higher in E3 and E4 groups than in E2 group ( P<0.05). There was no significant difference in the incidence of PSI value >50 between group E3 and group E4 ( P>0.05). There was no significant difference in the incidence of hypotension and bradycardia among the five groups ( P>0.05). Conclusions:Esketamine ≥ 0.2 mg/kg increases the patient′s PSI value when combined with propofol-remifentanil anesthesia.
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@#Diabetic kidney disease (DKD) is one of the main complications of diabetes, and also the leading cause of the end-stage renal disease (ESRD).The main clinical manifestations are albuminuria and decreased glomerular filtration rate.DKD seriously affects the quality of life of sufferers and places a huge financial burden on them. Traditional Chinese medicine (TCM) has accumulated rich experience in treating DKD.This paper analyzed and summarized the recent treatment of DKD with traditional Chinese medicine from three aspects: active ingredients of TCM, TCM pairs and TCM prescriptions, so as to provide new ideas for the majority of researchers in experimental research.
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Objective:To explore the effect of empathy nursing intervention on negative emotion, sleep quality and health literacy of patients with pulmonary tuberculosis.Methods:A total of 77 patients in Department of Infectious Diseases of People′s Hospital of Leshan from June 2019 to September 2020 were divided into intervention group ( n=39) and control group ( n=38) by random digits table method. The patients in the control group were given routine nursing, and the patients in the intervention group were given empathy nursing intervention on the basis of routine nursing. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI) and Health Literacy Management Scale (HeLMS) were used before and 12 weeks after intervention to evaluate the effects. Results:There was no significant difference in the total scores of HAMD, HAMA, PSQI and HeLMS between the two groups before intervention ( P>0.05), but after intervention, the scores of HAMD and HAMA in the intervention group were 10.64 ± 1.86, 12.64 ± 2.12, lower than those in the control group (14.63 ± 2.19, 15.11 ± 2.71). The differences were statistically significant ( t=-8.63, -4.46, P<0.05). The total score of PSQI and the scores of daytime dysfunction, use of hypnotic drugs, time of falling asleep, time of sleep, sleep quality, sleep disorder and sleep efficiency in the intervention group were 10.26 ± 1.65, 1.22 ± 0.22, 1.48 ± 0.23, 1.51 ± 0.27, 1.45 ± 0.26, 1.57 ± 0.22, 1.54 ± 0.21,1.49 ± 0.24, lower than those in the control group (13.07 ± 2.14, 1.92 ± 0.31, 1.75 ± 0.34, 1.95 ± 0.29, 2.02 ± 0.33, 1.84 ± 0.31, 1.72 ± 0.27, 1.87 ± 0.29). The differences were statistically significant ( t values were -11.45--3.27, all P<0.05). The total score of HeLMS and the scores of information acquisition, communication and interaction, and health improvement intention in the intervention group were 96.12 ± 14.71, 37.87 ± 5.83, 35.91 ± 5.13, 16.21 ± 2.53, higher than those in the control group (86.35 ± 14.12, 33.17 ± 5.27, 32.87 ± 5.42, 14.16 ± 2.19). The differences were statistically significant ( t values were 2.53-3.80, all P<0.05). Conclusions:Empathy nursing intervention can effectively alleviate the negative emotions of pulmonary tuberculosis patients, improve their sleep quality, and improve their health literacy level.
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Objective:The risk factors and survival conditions of cardiomyopathy in childhood septic shock were retrospectively analyzed.Methods:Children with septic shock admitted to the PICU at Children′s Hospital of Chongqing Medical University from January 2015 to March 2021 were collected.The case group included children with septic shock and cardiomyopathy.The propensity score matching method was used to match children with septic shock without cardiomyopathy in a 1∶2 ratio as the control group.Basic clinical data, myocardial biomarkers, cardiac ultrasound indicators, organ function indicators and clinical outcome indicators were collected from two groups.Results:Forty-six patients were included in the case group and 92 patients in the control group.There were no significant differences in age, sex, pediatric critical care score, and basic disease between two groups.Moreover, left ventricular ejection fraction[51.0%(43.0%, 62.0%) vs.65.5%(60.6%, 69.0%)], left ventricle short-axis shortening rate (FS)[26%(21%, 33%) vs.35%(32%, 38%)], and oxygenation index(PaO 2/FiO 2)[324.0(234.3, 400.0) mmHg vs.400.0(265.8, 445.0)mmHg] in case group were lower than those in control group, while the incidence of the ST segment changes of the ECG index (21.7% vs.3.3%), lactate[3.20(1.20, 5.87)mmol/L vs.1.80(1.20, 3.40)mmol/L], and vasoactive drug score[25.14(14.84, 42.70)points vs.15.04(10.00, 26.70) points] in case group were higher than those in control group, the differences were all statistically significant (all P<0.05). The differences of PICU mortality (15.2% vs.14.1%) and 28 d mortality (29.1% vs.29.3%) between two groups were not significant ( P>0.05). The Logistic regression analysis showed that the FS was associated with cardiomyopathy occurring in septic shock[ OR (95% CI): 0.795 (0.714~0.870), P<0.001]. Children with septic shock with elevated cardiac troponin I had an increased risk of death. Conclusion:FS is an independent risk factor for cardiomyopathy in septic shock.There is no difference in survival between septic shock with and without cardiomyopathy.Cardiac troponin I is associated with the prognosis of septic shock in children.
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Objective:The risk factors and survival conditions of cardiomyopathy in childhood septic shock were retrospectively analyzed.Methods:Children with septic shock admitted to the PICU at Children′s Hospital of Chongqing Medical University from January 2015 to March 2021 were collected.The case group included children with septic shock and cardiomyopathy.The propensity score matching method was used to match children with septic shock without cardiomyopathy in a 1∶2 ratio as the control group.Basic clinical data, myocardial biomarkers, cardiac ultrasound indicators, organ function indicators and clinical outcome indicators were collected from two groups.Results:Forty-six patients were included in the case group and 92 patients in the control group.There were no significant differences in age, sex, pediatric critical care score, and basic disease between two groups.Moreover, left ventricular ejection fraction[51.0%(43.0%, 62.0%) vs.65.5%(60.6%, 69.0%)], left ventricle short-axis shortening rate (FS)[26%(21%, 33%) vs.35%(32%, 38%)], and oxygenation index(PaO 2/FiO 2)[324.0(234.3, 400.0) mmHg vs.400.0(265.8, 445.0)mmHg] in case group were lower than those in control group, while the incidence of the ST segment changes of the ECG index (21.7% vs.3.3%), lactate[3.20(1.20, 5.87)mmol/L vs.1.80(1.20, 3.40)mmol/L], and vasoactive drug score[25.14(14.84, 42.70)points vs.15.04(10.00, 26.70) points] in case group were higher than those in control group, the differences were all statistically significant (all P<0.05). The differences of PICU mortality (15.2% vs.14.1%) and 28 d mortality (29.1% vs.29.3%) between two groups were not significant ( P>0.05). The Logistic regression analysis showed that the FS was associated with cardiomyopathy occurring in septic shock[ OR (95% CI): 0.795 (0.714~0.870), P<0.001]. Children with septic shock with elevated cardiac troponin I had an increased risk of death. Conclusion:FS is an independent risk factor for cardiomyopathy in septic shock.There is no difference in survival between septic shock with and without cardiomyopathy.Cardiac troponin I is associated with the prognosis of septic shock in children.
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OBJECTIVE@#To explore the genetic basis of three children with unexplained developmental delay/intellectual disability (DD/ID).@*METHODS@#Peripheral blood samples were collected from the patients and subjected to chromosomal microarray analysis (CMA).@*RESULTS@#Patient 1 was found to harbor a 190 kb deletion at 9q34.3, which encompassed most of EHMT1 (OMIM 607001), the key gene for Kleefstra syndrome (OMIM 610253). Patients 2 and 3 were siblings. CMA showed that they have shared four chromosomal copy number variations (CNVs) including a deletion at 9q34.3 which spanned 154 kb and 149 kb, respectively, and encompassed the EHMT1 and CACNA1B (OMIM 601012) genes. The remaining 3 CNVs were predicted to be with no clinical significance.@*CONCLUSION@#Microdeletions at 9q33.4 probably underlay the pathogenesis of DD/ID in the three children, for which EHMT1 may be the key gene.
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Child , Humans , Chromosome Deletion , Chromosomes, Human, Pair 9 , Craniofacial Abnormalities/genetics , DNA Copy Number Variations , Developmental Disabilities/genetics , Heart Defects, Congenital , Intellectual Disability/geneticsABSTRACT
Objective To evaluate the efficacy of biofeedback combined with swallowing function training at different times on post-stroke dysphagia. Methods 124 patients with post-stroke dysphagia were randomly divided into observation group and control group. The observation group was given biofeedback combined with swallowing function training for 2 weeks and 4 weeks of treatment. The control group was given routine swallowing function training for 2 weeks and 4 weeks of treatment. Kubota drinking water test was used to evaluate the swallowing function before treatment, 2 weeks and 4 weeks after treatment in both groups. Results There was no statistically significant difference in the scores of swallowing function between the two groups before treatment (P=0. 401). After 2 weeks of treatment, there was also no statistically significant difference in the evaluation of swallowing function between the observation group and the control group (P=0. 138). After 4 weeks of treatment, the evaluation of swallowing function in the observation group was significantly better than that in the control group(P=0. 003). Conclusion Biofeedback combined with swallowing function training is better than the routine swallowing function training. After 4 weeks of treatment, the efficacy of biofeedback combined with swallowing function training is better than the biofeedback combined with swallowing function training after 2 weeks, indicating that there is a correlation between the treatment effect and the length of treatment time.
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Objective To study the interaction mechanism of anti-cancer drug docetaxel (DTX) andβ-tubulin, to determine the binding sites and the involved amino acids between the β-tubulin and docetaxel, and to analyze the dynamic combination process. Methods The docking binding energy and interaction sites of DTX molecules withβ-tubulin on the potential energy surface were calculated by molecular docking method. The dynamic interaction process of the low binding energy DTX with β-tubulin was simulated by molecular dynamics method. Results The results of molecular docking showed that there are three interaction sites, including N1, N2 and N3, between DTX and β-tubulin. The DTX molecules with structure of No.1, 2 and 4, which have excellent docking energy, were chose for molecular dynamics simulation. As a result, the dynamic change processes of the system complexes from non-equilibrium to equilibrium were obtained. The simulation results showed that the hydrogen bonds formed by the DTX with structure No.1 were significantly higher than those with structures No. 2 and 4. The solvent accessibility surface area of the DTX with structures No.1, 2 and 4 was higher than that of paclitaxel. Conclusion The model of DTX binding toβ-tubulin was established, which could provide theoretical guidance for the design and development of novel paclitaxel anticancer drugs.
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Objective To evaluate the clinical effectiveness of early-stage keep warm intervention on improving low temperature risk children treated with blood purification (BP). Methods Ninety children were randomized into observation group (46 cases) and control group of (44 cases) from July 2013 to September 2015. Control group were nursed with conventional BP standard operation process, while the observation group were nursed additionally with heat insulation blanket before 30 min of booting machine, and recorded the central body temperature of 0 min,30 min,60 min,90 min,120 min for each 60 min 1 time in the future. Until the end of the blood purification 60 min. Low temperature complications were recorded and judged between the two groups. Results In the observation group, 107 cases of low body temperature occurred during the course of 7 cases of blood purification, occurrence rate of 6.5% (7/107). The control group was 15.8% (16/101). The difference between the 2 groups was statistically significant (χ2=4.569,P<0.05);In the continuous blood purification group, observation group 10.6% (5/47), The incidence rate of control group was 29.3% (12/41), he difference between the 2 groups was statistically significant (χ2=4.876,P<0.05). Conclusions Application of heat insulation blanket at the early-stage may effectively reduce the risk of hypothermia complications in the children treated with blood purification. The continuous blood purification effect is more significant.
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<p><b>OBJECTIVE</b>To compare the safety of haemophilus influenzae type b (Hib) vaccine vaccination on vastus lateralis muscle and deltoid muscle of infant.</p><p><b>METHODS</b>A total of 408 3-4 months old infants were divided into vastus lateralis muscle group and deltoid muscle group in Beijing, 2014. They were divided into the vastus lateralis muscle group (204) and deltoid muscle group (204) by extracting random number. Each observation object was given 3 doses of Hib vaccine according to the program. Collected systemic and local reactions after vaccination and calculated the incidence of adverse reactions.</p><p><b>RESULTS</b>A total of 61 infants were quitted during the study, 1 132 doses were observed. The total reactions incidence of Vastus lateralis muscle group and Deltoid muscle group were 33.0% (186/564) and 27.6% (157/568) with no statistical differences (χ² = 3.818, P = 0.059). The two groups incidence at the same day of vaccination (day 0) which the highest were 23.2% (131/564) and 20.6% (117/568), then declined with time (linear trend test vastus lateralis muscle group χ² = 36.600, P < 0.001,deltoid muscle group χ² = 29.947, P < 0.001), day 1 were 20.4% (115/564) and 17.6% (100/568), day 2 were 16.0% (90/564) and 13.4% (76/568), day 3 were 10.3% (58/564) and 10.6% (60/568), day 4-7 were 11.2% (63/564) and 11.3% (64/568). No serious adverse events (SAE) were reported during the study. The local reactions incidence of two groups were 7.1% (40/564) and 7.7% (44/568)with no statistical differences (χ² = 0.176, P = 0.675). The systemic reactions incidence of two groups were 25.9% (146/564) and 20.6% (117/568) with obvious statistical differences (χ² = 4.437, P = 0.035). The fever incidence of vastus lateralis muscle group (11.5% (65/564)) was higher than Deltoid muscle group (4.4% (25/568)) with obvious statistical differences (χ² = 4.868, P = 0.027). The 1st dose incidence of fever and abnormal crying of vastus lateralis muscle group (fever 11.3% (23/204), abnormal crying 19.1% (39/204)) was higher than deltoid muscle group (fever 4.4% (9/204), abnormal crying 11.8% (24/204)) and the 2nd dose of diarrhea of deltoid muscle group (11.6% (22/190)) was higher than vastus lateralis muscle group (5.9% (11/187)) with obvious statistical differences (fever χ² = 15.288, P < 0.001, abnormal crying χ² = 4.224, P = 0.040, diarrhea χ² = 3.829, P = 0.046).</p><p><b>CONCLUSION</b>Both vastus lateralis muscle group and deltoid muscle group had lower incidence of adverse reactions after vaccination. No serious adverse events were associated with vaccination. Vastus lateralis muscle vaccination as well as deltoid muscle vaccination demonstrated safe.</p>
Subject(s)
Humans , Infant , Bacterial Capsules , China , Deltoid Muscle , Fever , Haemophilus Vaccines , Haemophilus influenzae type b , Incidence , Quadriceps Muscle , VaccinationABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of exogenous hydrogen sulfide (H2S) on β-site APP cleaving enzyme 1 (BACE-1) and β-amyloid peptide (Aβ) metabolism in primary culture of neurons under high-glucose condition.</p><p><b>METHODS</b>The cortical neurons in primary culture under normal and high glucose (60 mmol/L) conditions for 24 h were exposed to 25, 50 and 100 µmol/L NaHS. Aβ1-42 concentration in the cell culture was measured by ELISA, and BACE-1 mRNA and protein levels were detected by fluorescent quantitative real-time PCR and Western blotting, respectively.</p><p><b>RESULTS</b>Compared with the neurons cultured in normal glucose, the neurons exposed to high glucose showed significantly increased Aβ1-42 concentration and BACE-1 mRNA and protein expressions (P<0.05). Exposure to 25, 50 and 100 µmol/L NaHS significantly decreased Aβ1-42 concentration and BACE-1 mRNA and protein expressions in the high-glucose cell culture (P<0.05).</p><p><b>CONCLUSION</b>Neurons exposed to high glucose exhibit increased Aβ1-42 levels and BACE-1 mRNA and protein expressions, which can be concentration-dependently decreased by NaHS.</p>
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Animals , Rats , Amyloid Precursor Protein Secretases , Metabolism , Amyloid beta-Peptides , Metabolism , Aspartic Acid Endopeptidases , Metabolism , Cells, Cultured , Culture Media , Chemistry , Glucose , Chemistry , Hydrogen Sulfide , Pharmacology , Neurons , Metabolism , Peptide Fragments , Metabolism , Rats, Sprague-DawleyABSTRACT
Objective To evaluate the effect of isoflurane preconditioning on inflammatory responses during spinal cord injury (SCI ) in rats .Methods Sixty adult male Sprague-Dawley rats ,weighing 250-300 g , were randomly divided into 3 groups ( n= 20 each ) using a random number table :sham operation group (S group) , SCI group , and isoflurane preconditioning group (I group ) . The animals were anesthetized with intraperitoneal pentobarbital sodium 40 mg/kg .SCI was produced by a weight-drop contusion at the T10 level .The rats inhaled 2% isoflurane for 2 h ,and the model was established at 24 h after the end of isoflurane inhalation in I group . Neurological function was assessed and scored by using the the Basso , Beattie , Bresnahan (BBB ) Locomotor Rating Scale on 7 days after SCI .Five rats in each group were then chosen and spinal cord specimens were obtained and cut into sections which were stained with haematoxylin and eosin for determination of the viable neuron count .Fifteen rats in each group were sacrificed and the spinal cord was removed for detection of nuclear factor kappaB (NF-κB ) and interleukin-1β (IL-1β) expression (by Western blot ) .Results Compared with S group ,BBB score and the number of viable neurons were significantly decreased ,and the expression of NF-κB and IL-1βprotein was up-regulated in SCI group ( P<0.05) .Compared with SCI group ,BBB score and the number of viable neurons were significantly increased ,and the expression of NF-κB and IL-1βprotein was down-regulated in group I ( P<0.05 ) .Conclusion The mechanism by which isoflurane preconditioning protects the spinal cord is related to inhibition of inflammatory responses in rats .
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Objective To compare clinical efficacy between improved vaginal hysterectomy (IVH)and traditional vaginal hysterectomy (TVH) and its influences on blood glucose and serum corticosteroid levels.Methods One hundred patients undergoing hysterectomy were divided into using IVH (treatment group,50 patients) and TVH (control group,50 patients).Clinical efficacy,blood glucose and serum corticosteroid levels were compared between two groups.Results There was no significant difference in operation time between two groups (P> 0.05).The amount of intraoperative bleeding,postoperative exhaust time and postoperative vaginal bleeding time in treatment group were significantly less than those in control group [(86.7 ± 5.7) ml vs.(131.2 ± 14.5) ml,(24.8 ± 12.9) h vs.(42.8 ± 17.7) h,(16.5 ± 2.9) d vs.(24.3 ±6.7) d,P < 0.05],and the time of blood glucose and serum corticosteroid levels returned to normal levels in treatment group were much earlier than those in control group.Conclusion The clinical efficacy of IVH is preonunced,and postoperative stress reaction is mild.
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Objective To explore the relationship between serum reproductive hormone levels and premenopausal and postmenopausal breast cancer patients.Methods We recruited healthy women and breast cancer patients who came to our hospital from September 2007 to February 2012 for routine physical examination or surgery and divided them into premenopausal healthy group Ⅰ and breast cancer group Ⅰ ;Postmenopausal healthy group Ⅱ and breast cancer group Ⅱ,with 175 cases in each group.Reproductive hormone levels was measured in all cases.Results There were significant differences among the four groups on estradiol (E2),testosterone (T),progesterone (P),luteotropic hormone (LH),follicle-stimulating hormone (FSH),and prolactin (PRL) (F =76.459,57.224,82.932,161.047,74.801 and 15.246 respectively,P < 0.05).In premenopausal cases:There were significant statistical difference on the levels of E2 [(61.5 ±32.2) ng/L vs.(74.1 ±41.6) ng/L],T [(48.1 ±22.2) μg/L vs.(80.1 ±41.8) μg/L],P [(2.9±1.6) μg/Lvs.(3.5 ±1.3) μg/L],LH [(1.3 ±0.9) U/L vs.(3.5 ±1.4) U/L],FSH [(14.8 ±8.9) U/L vs.(25.1 ±23.3) U/L],PRL [(15.8 ±6.7) μg/L vs.(39.4 ±27.4) μg/L] between the healthy Ⅰ group and the breast cancer Ⅰ group (P < 0.05).In postmenopausal cases:There were significant statistical difference on the E2 [(18.8 ± 8.3) ng/L vs.(55.9±34.1) ng/L],T [(34.1 ±16.2) μg/L vs.(84.7 ±66.4) μg/L],P [(1.3 ±0.9) μg/L vs.(3.5 ±1.4) μg/L],LH [(38.1 ±33.7) U/L vs.(45.6 ± 31.2) U/L] in healthy group Ⅱand the breast cancer Ⅱ group (P < 0.05).The difference was statistically significant on the E2 [(74.1 ± 41.6) ng/L vs.(55.9±34.1) ng/L],LH [(3.5 ±1.4) U/L vs.(45.6 ±31.2) U/L],FSH [(25.1 ±23.3) U/L vs.(70.5±58.2) U/L],PRL [(39.4 ±27.4) μg/L vs.(15.9 ±15.5) μg/L] between the breast group of premenopausal and postmenopausal (P < 0.05).Conclusion Reproductive hormone levels has important clinical significance for the onset and development of breast cancer and provides a reference point for the treatment of menopausal and post-menopausal breast cancer.
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Objective To study the relationship between interleukin(IL)-4,IL-12 and IL-18 and intrauterine infection of hepatitis B virus (HBV),in order to provide the basis for prevention and treatment.Methods Forty pregnant women with positive HBsAg and intrauterine infection of HBV were selected as study group,and 80 pregnant women with positive HBsAg and non-intrauterine infection of HBV were selected as control group.The levels of IL-4,IL-12,IL-18 were compared.Results The level of IL-4 was (51.56 ± 7.86) ng/L in study group,which was higher than that in control group [(31.67 ± 8.64) ng/L],and there was significant difference between two groups (P <0.01).The leveh ofIL-12 and IL-18 were (803.45 ± 132.64),(627.87 ± 134.38) ng/L in study group,which werelower than that in control group [(904.87 ± 231.86),(734.78 ± 165.67) ng/L],and there were significant differences between two groups (P < 0.01).Conclusions The levels of IL-4,IL-12,IL-18 are correlated with intrauterine infection of HBV.The increase of IL-4 and the decrease of IL-18,IL-12 may lead to positive HBsAg pregnant women happening intrauterine HBV infection.
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Objective To explore the effect of laparoscopic ovarian drilling technique in the treatment of polycystic ovarian syndrome.Methods 60 patients with polycystic ovarian syndrome were randomly devided into observation group( 30 cases) and the control group(30 cases).The effect of the two groups was observed.Results LH and T of all the patients were significantly improved after the treatments( t =27.2158,20.4752,9.7169,0.4551,all P <0.05);The ovulation rate and the pregnancy rate of observation group(86.7% and 86.7% ) was significantly higher than those of the control group( x2 =5.4545,9.3496,all P < 0.05 ),and the OHSS rate of observation group was 0,significantly lower than that of the control group ( 16.7% ) ( x2 =5.4545,P < 0.05 ).Conclusion Laparoscopic ovarian drilling technique was effective and safe in treating polycystic ovarian syndrome.
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Background: Anal fissure is one of the most common anal-rectum diseases, and approximately 10 percent patients with chronic anal fissure ultimately receive surgery. Relieving postoperative pain and protecting functions of the sphincter are central issues for coloproctologists. Objective: To evaluate the efficacy and safety of anoplasty in the treatment of chronic anal fissures. Design, setting, participants and interventions: In this prospective, multicenter, randomized controlled trial, 120 adult patients with chronic anal fissure were referred from Department of Coloproctology of Yueyang Hospital of Integrated Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Municipal Hospital of Traditional Chinese Medicine. The patients were enrolled from January 2009 to April 2010 and randomly divided into study (mucosa advancement flap anoplasty, abbreviated as anoplasty) group and control (fissurectomy) group. The two groups were assessed separately, and the main outcome measures were observed for 2 weeks, with a short-term follow-up for 6 weeks. Main outcome measures: Degree of pain, haemorrhage and anal canal pressure were observed and recorded preoperatively, and on the third day, the fourteenth day and the sixth week postoperatively. The wound healing time was also recorded. Surgical complications of the two groups were recorded and compared on the third day and the sixth week postoperatively. The curative effects associated with the surgery were analyzed on the fourteenth day and the sixth week after surgery and the therapeutic results were evaluated. Results: Three patients were dropped out due to the early discharge from hospital and losing connection (1 in study group and 2 in control group). Overall the surgery showed that the anoplasty group had better results than the fissurectomy group in the curative effect on the sixth week after operation (P0.05). There were no significant differences in relieving the anal canal pressure (P>0.05) and the surgical complications (dysuria, edema of anal margin, fever, infection, anal incontinence and anal deformation) between the two groups (P>0.05). None of the patients suffered postoperative complications by the sixth week after operation. Furthermore, there was no recurrence in either of the two groups at six weeks after operation. Conclusion: The results indicate that anoplasty for chronic anal fissures has advantages such as better therapeutic effects, less postoperative pain, a shorter healing time and no incidence of anal incontinence.
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The purpose of this study was to construct expression vectors of idiotype (Id) SmIg in patients with B-chronic lymphocytic leukemia and to express them in E.coli to obtain recombinant Id, and to investigate the effect of the protein on the proliferation and secretion of IL-2 and IFN-gamma of stimulated peripheral blood mononuclear cells (PBMC) in vitro. Light chain gene and Fd fragment of heavy chain gene were inserted into fd-tet-DOG2 vector to construct fd-tet-DOG2-Fab. Fab gene was further cloned into expression vector pHEN2 to construct the soluble expression vector pHEN2-Fab. After induction by IPTG, Fab protein was purified by Ni-NTA-chromatography. MTT was used to determine the effects of purified protein on the proliferation of stimulated PBMC in vitro and the concentrations of IL-2 and IFN-gamma in the culture supernatants were detected by ELISA. The results showed that recombinant pHEN2-Fab expression vector was constructed successfully. Fab protein was expressed in positive clone after induced by IPTG and two specific bands at 24-25 kD position were observed by SDS-PAGE electrophoresis. Proliferation of PBMC could be induced by purified Fab and the concentrations of IL-2 and IFN-gamma in culture supernatants were increased significantly after induction. It was suggested that the expression vector of SmIg Fab fragment was constructed successfully, and expressed and secreted from E. coli. The Fab protein could induce proliferation of PBMC and promote secretion of IL-2 and IFN-gamma.
ABSTRACT
The expression vector of SmIg scFv fragment was constructed in patient with B cell chronic lymphocyte leukemia (B-CLL) and expressed in E. coli to obtain scFv fragment, and the effect of the protein on the proliferation of stimulated peripheral blood mononuclear cells (PBMC) was investigated in vitro. Two pairs of primers were designed, and variable region genes of light chain and heavy chain were amplified by PCR respectively from the pGEM-T vectors previously constructed in our laboratory which containing light chain gene or Fd fragment of heavy chain gene. The PCR product was digested, purified and inserted into pHEN2 vector to construct the soluble expression vector pHEN2-scFv. After the induction by IPTG, the scFv protein was identified by SDSPAGE electrophoresis and purified by Ni-NTA-Chromatography. MTT was used to determine the effect of purified protein on the proliferation of stimulated PBMC in vitro. Plasmid PCR and restriction enzyme digestion of pHEN2-scFv revealed the pHEN2-scFv vector was constructed successfully. Id-scFv protein was expressed in positive clone after induced by IPTG. SDS-PAGE analysis showed that the relative molecular weight of fusion protein was about 30 kD (1 kD=0.9921 ku),which was consistent with the theoretically predicted value. Proliferation of PBMC could be induced by purified Id-scFv. It was suggested that the expression vector of SmIg scFv fragment was constructed successfully, and scFv protein was expressed and secreted from E. coli, which could induce proliferation of PBMC. This may lay an experimental foundation for further research of IdHSP complex vaccine for B-CLL.