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Objective:To systematically review the profile of lymph node dissection (LND) for patients with intrahepatic cholangiocarcinoma (ICC) in China.Methods:Using the key words "intrahepatic cholangiocarcinoma" "intrahepatic cholangiocellular carcinoma" "lymph node dissection" "lymphadenec-tomy" "lymph node metastasis", the databases including China Zhiwang, Wanfang, Weipu, Sinomed, PubMed, Embase, Web of Science, Scopus, Cochrane Library were systematically searched. Cohort studies or randomized controlled clinical trials with intraoperative LND documentation and with analysis on the clinicopathologic characteristics or prognostic influences on patients with ICC were included into this meta-analysis from the date of database creation to April 20, 2022. The risk of bias in non-randomized controlled trials was evaluated using the Newcastle-Ottawa scale. A meta-analysis of preoperative imaging lymph node enlargement rates, LND rates, and pathological lymph node metastasis rates were performed using R software.Results:Thirty-three relevant studies that met the systematic evaluation criteria were included, all of which were retrospective cohort studies. All these publications were of medium to high quality. Patients’ enrollment ranged from 1993 to 2020. Patients were enrolled from 20 provinces/autonomous regions/municipalities with a total of 39 medical centers and 4 278 patients. The meta-analysis indicated that the LND rate, preoperative imaging lymph node enlargement rate, pathological lymph node metastasis rate were 47.8%(95% CI: 41.3%-54.3%), 18.5%(95% CI: 7.5%-29.6%) and 51.2%(95% CI: 43.8%-58.6%), respectively. Subgroup analysis showed the LND rate was 36.0%(95% CI: 27.0%-45.0%) in studies with a median year of enrollment before 2010, 48.3% (95% CI: 38.1%-58.6%) in studies from 2010 to 2017, and 53.3%(95% CI: 43.3%-63.2%) in studies after 2017. The LND rates were statistically different in the studies in the different periods of patient enrollment ( P=0.032). Conclusion:The meta-analysis indicated that the overall LND rate for ICC in China was not high but showed an increasing tendency.
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This study aimed to evaluate the efficacy and safety of Chaihuang Granules in the treatment of upper respiratory tract infection in children. The databases such as CNKI, Wanfang, VIP, SinoMed, Cochrane Library, PubMed, EMbase, Web of Science, Chinese Clinical Trial Registry, and ClinicalTrials.gov were searched for randomized controlled trial(RCT) of Chaihuang Granules for the treatment of upper respiratory tract infection in children, and supplemented by manual searching of gray literature. Two investigators independently screened the literature, extracted data, and assessed the methodological quality. Meta-analysis was performed using RevMan 5.4 software, trial sequential analysis was conducted using TSA 0.9.5.10 Beta software, and evidence quality evaluation was carried out using GRADE profiler 3.6.1 software. Eighteen RCTs involving 2 459 patients(1 262 in the treatment group and 1 197 in the control group) were included. Meta-analysis showed that compared with conventional therapy alone, Chaihuang Granules significantly improved the total effective rate(RR=1.18, 95%CI[1.15, 1.22], P<0.000 01), reduced the disappearance time of symptoms/signs(MD=-1.39, 95%CI[-1.66,-1.12], P<0.000 01), improved cytokine levels(MD=-2.40, 95%CI[-3.80,-1.00], P=0.000 8), improved humoral immune levels(MD=0.75, 95%CI[0.60, 0.90], P<0.000 01), and reduced the recurrence rate(MD=-2.11, 95%CI[-2.98,-1.25], P<0.000 01). However, the incidence of adverse reactions was not increased(RR=0.94, 95%CI[0.59, 1.49], P=0.78). Subgroup analysis showed that:(1) both Chaihuang Granules used alone(RR=1.19, 95%CI[1.11, 1.27], P<0.000 01) and in combination with other therapies(RR=1.18, 95%CI[1.14, 1.22], P<0.000 01) effectively improved the total effective rate.(2) In terms of symptoms/signs disappearance time, Chaihuang Granules effectively reduced the duration of fever(MD=-1.18, 95%CI[-1.78,-0.58], P=0.000 1), cough with sputum(MD=-1.82, 95%CI[-2.38,-1.25], P<0.000 01), cough(MD=-1.31, 95%CI[-1.89,-0.74], P<0.000 01), sore throat(MD=-1.57, 95%CI[-2.25,-0.89], P<0.000 01), and lung rales(MD=-1.49, 95%CI[-2.06,-0.92], P<0.000 01).(3) Regarding cytokine levels, Chaihuang Gra-nules effectively improved the levels of interleukin(IL)-2(MD=-0.94, 95%CI[-1.16,-0.72], P<0.000 01), IL-6(MD=-4.71, 95%CI[-6.39,-3.03], P<0.000 01), and tumor necrosis factor-α(TNF-α)(MD=-2.07, 95%CI[-2.43,-1.71], P<0.000 01).(4) In terms of cellular immune levels, Chaihuang Granules effectively improved the levels of CD3~+(MD=4.11, 95%CI[1.53, 6.69], P=0.002), CD4~+(MD=4.21, 95%CI[1.69, 6.73], P=0.001), CD8~+(MD=-2.65, 95%CI[-3.93,-1.37], P<0.000 1), and CD4~+/CD8~+(MD=0.25, 95%CI[0.14, 0.37], P<0.000 1).(5) In terms of humoral immune levels, Chaihuang Granules effectively improved the levels of IgA(MD=0.44, 95%CI[0.23, 0.64], P<0.000 1), IgM(MD=0.31, 95%CI[0.15, 0.46], P=0.000 1), and IgG(MD=2.02, 95%CI[1.60, 2.43], P<0.000 01). Trial sequential analysis showed that the cumulative Z-curve of the total effective rate crossed the boundary value, further confirming its clinical efficacy. The GRADE evidence quality evaluation showed that the evidence quality of the above outcome indicators was low or very low, and the recommendation strength was weak. Compared to conventional therapy alone, Chaihuang Granules can effectively improve the total effective rate of treatment, alle-viate symptoms and signs of upper respiratory tract infection in children, improve inflammatory conditions, enhance immune function, and reduce the recurrence rate. Due to the limited quality of the included studies, high-quality RCT is still needed to provide evidence support for the above conclusions.
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Child , Humans , Drugs, Chinese Herbal/therapeutic use , Treatment Outcome , Clinical Trials as Topic , Respiratory Tract Infections/drug therapyABSTRACT
This study aims to evaluate the efficacy and safety of Compound Qinlan Oral Liquid in the treatment of acute upper respiratory tract infection. Computer-based online searching of CNKI, VIP, SinoMed, Wanfang, ChiCTR, ClinicalTrials.gov, Cochrane Library, PubMed, EMbase, and Web of Science was performed to retrieve the randomized controlled trial(RCT) regarding Compound Qinlan Oral Liquid in the treatment of acute upper respiratory tract infection. In addition, manual searching of gray literature was conducted. After two evaluators independently selected articles, extracted data, and evaluated the quality of methodology included in the studies, Meta-analysis was carried out in RevMan 5.4 and trial sequential analysis(TSA) in TSA 0.9.5.10 Beta. GRADE profiler 3.6.1 was employed to evaluate the evidence quality. A total of 21 RCTs were included in this study, involving 2 651 patients(1 330 patients in the observation group and 1 321 patients in the control group). Meta-analysis showed that compared with conventional western medicine alone, Compound Qinlan Oral liquid improved the total response rate(RR=1.15, 95%CI[1.12, 1.19], P<0.000 01) without increasing the incidence of adverse reactions(RR=0.77, 95%CI[0.47, 1.25], P=0.16). The results of subgroup analysis are described as follows:(1) Compared with conventional western medicine alone, Compound Qinlan Oral Liquid improved the total response rate(RR=1.10, 95%CI[1.05, 1.14], P<0.000 01) and shortened the time to symptom relief(SMD=-0.76, 95%CI[-1.02,-0.51], P<0.000 01). There was no significant difference in the incidence of adverse reactions between the two groups(RR=1.16, 95%CI[0.54, 2.47], P=0.71).(2) Compared with conventional western medicine alone, Compound Qinlan Oral Liquid + conventional western medicine improved the total response rate(RR=1.20, 95%CI[1.15, 1.25], P<0.000 01), decreased traditional Chinese medicine(TCM) syndrome scores(MD=-0.58, 95%CI[-0.75,-0.41], P<0.000 01), shortened the time to symptom relief(SMD=-2.44, 95%CI[-3.09,-1.80], P<0.000 01) and physical sign improvement(MD=-2.57, 95%CI[-4.11,-1.04], P=0.001), lowered the serum levels of inflammatory cytokines(SMD=-2.16, 95%CI[-2.61,-1.70], P<0.000 01), improved respiratory function indicators(SMD=1.48, 95%CI[1.00, 1.96], P<0.000 01), and enhanced the humoral immunity(MD=0.94, 95%CI[0.69, 1.18], P<0.000 01). There was no significant difference in the incidence of adverse reactions between the two groups(RR=0.57, 95%CI[0.29, 1.09], P=0.09). TSA showed that the cumulative Z curve of total response rate crossed the traditional threshold and TSA threshold, further confirming the clinical efficacy of Compound Qinlan Oral Liquid. The GRADE graded the evidence of the above outcome indicators as low or extremely low, and yielded weak recommendation. Compared with conventional western medicine alone, Compound Qinlan Oral Liquid can improve the total effective rate and reduce the time to symptom relief. The combination of Compound Qinlan Oral Liquid and conventional western medicine can improve the total response rate, mitigate the symptoms and improve the physical signs, reduce inflammation, and improve respiratory function and immunity of the patients with acute upper respiratory tract infection. In view of the limited number and quality of the included studies, the above conclusions still require high-quality RCT to provide evidence support.
Subject(s)
Humans , Drugs, Chinese Herbal/therapeutic use , Inflammation/drug therapy , Medicine, Chinese Traditional , Respiratory Tract Infections/drug therapy , Treatment OutcomeABSTRACT
High level noise can damage cochlear hair cells, auditory nerve and synaptic connections between cochlear hair cells and auditory nerve, resulting in noise-induced hearing loss (NIHL). Recent studies have shown that animal cochleae have circadian rhythm, which makes them different in sensitivity to noise throughout the day. Cochlear circadian rhythm has a certain relationship with brain-derived neurotrophic factor and glucocorticoids, which affects the degree of hearing loss after exposure to noise. In this review, we summarize the research progress of the regulation of cochlear sensitivity to noise by circadian rhythm and prospect the future research direction.
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Animals , Auditory Threshold , Circadian Rhythm , Cochlea , Evoked Potentials, Auditory, Brain Stem/physiology , Hair Cells, Auditory , Hearing Loss, Noise-Induced , Noise/adverse effectsABSTRACT
Astrocytes are a heterogenous group of macroglia present in all regions of the brain and play critical roles in many aspects of brain development, function and disease. Previous studies suggest that the B-cell lymphoma-2 associated X protein (BAX)-dependent apoptosis plays essential roles in regulating neuronal number and achieving optimal excitation/inhibition ratio. The aim of the present paper was to study whether BAX regulates astrocyte distribution in a region-specific manner. Immunofluorescence staining of SOX9 was used to analyze and compare astrocyte density in primary somatosensory cortex, motor cortex, retrosplenial cortex and hippocampus in heterozygous and homozygous BAX knockout mice at age of six weeks when cortical development has finished and glia development has reached a relatively steady state. The results showed that astrocyte density varied significantly among different cortical subdivisions and between cortex and hippocampus. In contrast to the significant increase in GABAergic interneurons, the overall and region-specific astrocyte density remained unchanged in the cortex when BAX was absent. Interestingly, a significant reduction of astrocyte density was observed in the hippocampus of BAX knockout mice. These data suggest that BAX differentially regulates neurons and astrocytes in cortex as well as astrocytes in different brain regions during development. This study provided important information about the regional heterogeneity of astrocyte distribution and the potential contribution of BAX gene during development.
Subject(s)
Animals , Mice , Astrocytes , Hippocampus , Interneurons , Neurons , bcl-2-Associated X Protein/geneticsABSTRACT
Objective:To measure with Zhejiang province as an example the situation of the self-evaluation health management service capability of primary medical staff in county-level medical alliances.Methods:A self-evaluation scale for health management service capability by primary medical staff was customized, covering 5 dimensions of professional attitude, interpersonal communication ability, comprehensive knowledge integration ability, professional practice ability and professional development ability, as well as 29 items. In July-September 2019, medical alliances were selected from three counties/cities based on economic development as the survey targets, and a total of 264 primary medical staff were surveyed. Quantitative data were described in mean and standard deviation, while qualitative data were described in composition ratio, and the differences were compared by Kruskal-Willis test.Results:The self-evaluation scoring of health management service capability of the primary medical staff was (59.75±18.64) points, and the average scoring of the items was (2.06±0.64) points. The scoring of knowledge integration (1.98±0.70)and professional practical ability (2.03±0.67) were lower than the average scoring of the items; gender and occupation type of primary medical staff present statistical significances in the self-evaluation scoring of health management service capability.Conclusions:Given the health management service capabilities of primary medical staff, they still need to upgrade their knowledge integration and professional practice capabilities. County-level medical alliances should enhance their training of health management knowledge and skills, promote doctor-nurse collaboration in health management services to broaden the depth of primary health management services.
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This study analyzed the effect of the Radix Bupleuri-Radix Paeoniae Alba herb pair on endogenous metabolites in rats with chronic unpredictable mild stress (CUMS)-induced depression by using LC-MS liver metabolomics. Rats were randomly divided into 5 groups: a normal control group, a CUMS model group, a venlafaxine-positive group, and a high-low dose group for the Radix Bupleuri-Radix Paeoniae Alba herb pair, with continuous modeling and administration over 28 days. The efficacy of Radix Bupleuri-Radix Paeoniae Alba herb pair was evaluated by measuring traditional pharmacodynamic indicators of depression (body weight, open field test, sucrose preference test and forced swimming test). Animal experimentation was approved by the Committee on the Ethics of Animal Experiments of Shanxi University (SXULL2016036). Liver metabolic profiles were obtained by the UHPLC-Q Exactive Orbitrap-MS metabolomics technique. The results show that the Radix Bupleuri-Radix Paeoniae Alba herb pair can significantly decrease depression-like behavior of rats in the CUMS model group. Increases in 25 depression-related metabolites were identified by LC-MS metabonomics, and the Radix Bupleuri-Radix Paeoniae Alba herb pair could significantly decrease 16 of them. Metabolic pathway analysis showed that D-glutamine and D-glutamate metabolism, arginine and proline metabolism, alanine, aspartate and glutamate metabolism, and glutathione metabolism were the main metabolic pathways altered by this herb pair in CUMS model rats.
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Objective To evaluate the effects of different dosages of rocuronium on abdominal wound closure under general anesthesia.Methods Ninety ASA class I or II patients scheduled for elective abdominal surgery under general anesthesia were randomized into three groups with 30 cases each.Each group received rocuronium 1 time of ED95 (0.3 mg/kg),0.5 time of ED95 (0.15 mg/kg),0.2 time of ED95 (0.06 mg/kg) respectively when closing the abdominal wall.TOF recovered to 25%, 75%, 90%, time of eye-opening on command, time of head-lift for more than 5 seconds,extubation time, the rate of upper airways obstruction after extubation and the satisfaction score for the muscle relaxation to general surgeons were recorded.Results TOF values had no significantly different among the three groups before abdominal wound closure (P>0.05).Compared with group A and group B,time of TOF in group C was significangtly increased after administration of rocuronium (P<0.05) . Time of TOF recovery to 25%, 75%, 90%in group C were significangtly decreased (P<0.01).Compared with group A and group B, time of eye-opening on command ,head-lift for more than 5 seconds and extubation time were significantly shorter in group C.There were 8,4,0 patients undwent upper airways obstruction among each group respectively after extubation (P<0.05).The satisfaction score for muscle relaxation among three groups had no significant difference.Conclusion An additional administration of 0.2 time of ED95 (0.06 mg/kg) rocuronium before abdominal wound closure in abdominal surgery can achieve satisfactory muscle relaxation for surgeons.
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AIM:To compare the efficacy of one initial intravitreal Conbercept injection(IVR) followed by pro re nata(PRN) dosing with that of three initial monthly IVR followed by PRN dosing in patients with macular edema (ME) after branch retinal vein occlusion (BRVO). METHODS: The clinical data of 35 cases were retrospectively analyzed; 20 received one initial IVR injection (1+PRN group) and 15 cases received 3-monthly IVRs (3+PRN). Both groups were followed monthly for 12mo. The best-corrected visual acuity (BCVA) and the macular central retinal thickness (CMT) on optical coherence tomography were evaluated before and after treatment, and the BCVA results were converted to the LogMAR visual acuity. RESULTS: The mean LogMAR BCVA and CMT, respectively,improved from 0.58士0.21 to 0.34士0.18 and from 561士65μ m to 252士69μ m in the"1+PRN冶 group (P<0 05) and from 0.64士0.21 to 0.29士0.13 and from 585士87μ m to 242士56μ m in the"3+PRN冶 group (P>0.05). During the study period, the mean total number of injections was significantly smaller in the"1+PRN冶 group than in the"3+PRN冶 group (2. 3士1. 2 and 4. 1士1. 1, respectively,P<0.05). No serious complications related to the IVB injections developed in either group. CONCLUSION: The two methods are both safe and effective for the treatment of BRVO combined with ME.
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This paper aimed to investigate the anti-influenza virus activity of the genus Paeonia, screen potential anti-influenza virus compounds and predict targets of anti-influenza virus to explore the mechanism of anti-influenza virus activity. First of all, a total of 301 compounds of the genus Paeonia were summarized from the literatures in recent ten years. The candidate active ingredients from the genus Paeonia were identified by database such as PubChem and Chemical Book. The ligands were constructed by ChemDraw, Avogadro and Discovery Studio Visualizer. Secondly, 23 potential anti-influenza virus targets were developed by combining the target database and the literatures. Uniprot database was used to find the anti-influenza virus targets, and RCSB was used to identify targets associated with anti-influenza virus activity as docked receptor proteins. QuickVina 2.0 software was used for molecular docking. Finally, the Cytoscape 3.5.1 software was used to map the potential activity compounds of the genus Paeonia against influenza virus and the anti-influenza virus target network. Uniprot online database was used to analyze the target GO enrichment and KEGG metabolic pathways. The results showed that 74 compounds of the genus Paeonia had anti-influenza virus effect and 18 potential anti-influenza virus targets were screened. GO analysis concluded that the mechanism of the genus Paeonia anti-influenza virus is consistent with the mechanism of NA anti-influenza virus in order to stop the sprouting, dispersion and diffusion of virus and reduce the ability of virus to infect, so that the infection can be restricted so as to achieve the anti-influenza virus effect.
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<p><b>OBJECTIVE</b>To investigate clinical efficacy and experience of total knee arthroplasty in treating knee osteoarthritis patients with Parkinson's disease.</p><p><b>METHODS</b>From January 2011 to January 2014, 19 knee osteoarthritis patients with Parkinson's disease treated with total knee arthroplasty were collected. Among them, including 9 males and 10 females aged from 61 to 83 years old with an average of 71.3 years old. Radiology results were checked before and after operation. VAS score and KSS score were applied to evaluate clinical effects. Patients were classified according to HoehnYahr grade, 3 cases in grade 1, 4 cases in grade 1.5, 2 cases in grade 2, 4 cases in grade 2.5, 2 cases in grade 3 and 1 case in grade 4.</p><p><b>RESULTS</b>Nineteen patients were followed up from 3 to 7 years with an average of 4.3 years. The pain of patients was significantly reduced or disappeared. All incisions were healed at stage I. At the latest follow-up, 3 patients had knee pain, and mild pain in 1 patient, moderate in 1 patient without severe pain. VAS score was reduced from preoperative 8.4±1.3 to the latest follow-up 3.1±1.2, the difference was statistically significant (0.05). KSS score improved from 43.6±7.3 before operation to 91.8±10.6 after operation. The condition of Parkinson's were controlled by medicine. No loosening and subsidence of prosthesis by X-ray examination.</p><p><b>CONCLUSIONS</b>Total knee arthroplasty is a safe and effective method for the treatment of Parkinson's disease and has satisfactory mid-term clinical effect.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Follow-Up Studies , Knee Joint , Knee Prosthesis , Osteoarthritis, Knee , General Surgery , Parkinson Disease , Retrospective Studies , Treatment OutcomeABSTRACT
As traditional Chinese medicinal herbs, Physalis plants have a variety of pharmacological activities, such as anti-inflammatory, anti-oxidant, and anti-cancer effects, and have been used for the treatment of malaria, rheumatism, hepatitis, asthma, and cancer. In addition to the medicinal value, many Physalis species are also the high-grade nutrition health care fruits, can be made canned and candied etc. In the study, the application progress of DNA molecular marker technologies in medicinal Physalis plants in recent years was reviewed, in order to provide an important molecular technical basis for the identification, classification and rational development and protection of medicinal Physalis resources.
Subject(s)
DNA, Plant , Genetics , Genetic Markers , Physalis , Genetics , Plants, Medicinal , GeneticsABSTRACT
Abstract Introduction Currently, there is limited information about the relationship between manganese superoxide dismutase (sod2) c47t polymorphism and susceptibility to noise-induced hearing loss (NIHL). Objective The aim of this meta-analysis was to clarify the association between SOD2 C47T polymorphism and NIHL. Methods A search in PubMed and Web of Science was performed to collect data. All full-text, English-written studies containing sufficient and complete case-and-control data about the relationship between SOD2 C47T polymorphism and NIHL were included. Three eligible studies, comprising 1094 subjects, were identified. pooled odds ratios (ORs) and 95% confidence intervals (CI) were calculated to evaluate the strength of the association between SOD2 C47T polymorphism and NIHL. Results No significant association between C47T polymorphism and risk of NIHL was found with the following combinations: T vs. C (OR = 0.83; 95% CI = 0.63–1.09); TT vs. CC (OR = 0.49; 95% CI = 0.22–1.09); CT vs. CC (OR = 0.54; 95% CI = 0.25–1.17); TT vs. CC + CT (OR = 0.82; 95% CI = 0.50–1.32); CC vs. TT + TC (OR = 0.49; 95% CI = 0.23–1.04). However, in subgroup analysis, a significant association was found for TT vs. CC + CT (OR = 0.77; 95% CI = 0.42–1.41) in the Chinese population. Conclusion The present meta-analysis suggests that SOD2 C47T polymorphism is significantly associated with increased risk of NIHL in the Chinese population. Further large and well-designed studies are needed to confirm this association.
Resumo Introdução Atualmente, são limitadas as informações acerca da relação entre o polimorfismo C47T de superóxido dismutase 2 (SOD2) dependente de manganês e suscetibilidade à perda auditiva induzida pelo ruído (PAIR). Objetivo O objetivo desta metanálise foi esclarecer a associação entre o polimorfismo C47T de SOD2 e PAIR. Método Foram feitas buscas no PubMed e Web of Science para coleta de dados. Foram incluídos todos os estudos no idioma inglês, com dados suficientes e completos de casos e controles sobre a relação entre o polimorfismo C47T de SOD2 e PAIR. Foram identificados três estudos qualificados, que abrangeram 1.094 indivíduos. Foram calculadas as razões das chances (odds ratio, OR) acumuladas e intervalos de confiança (IC) de 95% para que fosse avaliada a potência da associação entre o polimorfismo C47T de SOD2 e PAIR. Resultados Não foi encontrada uma associação significativa entre o polimorfismo C47T de SOD2 e risco de PAIR com as seguintes combinações: T vs. C (OR = 0,83, IC 95% = 0,63-1,09); TT vs. CC (OR = 0,49, IC 95% = 0,22-1,09); CT vs. CC (OR = 0,54, IC 95% = 0,25-1,17); TT vs. CC + CT (OR = 0,82, IC 95% = 0,50-1,32); CC vs. TT + TC (OR = 0,49, IC 95% = 0,23-1,04). Contudo, na análise de subgrupo, foi encontrada uma associação significativa para TT vs. CC + CT (OR = 0,77, 95% CI = 0,42-1.41) na população chinesa. Conclusão A presente metanálise sugere que o polimorfismo C47T de SOD2 demonstra associação significativa com maior risco de PAIR na população chinesa. Há necessidade de novos estudos de grande porte bem concebidos, para confirmação dessa associação.
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Humans , Polymorphism, Genetic/genetics , Superoxide Dismutase/genetics , Genetic Predisposition to Disease/genetics , Hearing Loss, Noise-Induced/geneticsABSTRACT
Objective To investigate the association of residual renal function with intradialysis dialysis hypotension among maintenance hemodialysis patients. Methods Fifty-six patients who had underwent maintenance hemodialysis from March 2014 to November 2015 were enrolled according to researching protocol in this study. Data of baseline and clinical parameter of every hemodialysis session were collected. The patients were divided into two groups by 24 h urine output:urine group (24 h urine output≥100 ml, 22 patients)and no urine group (24 h urine output0.05). Pearson correlation analysis showed that residual glomerular filtration rate (rGFR) had negative correlation with interdialytic weight gain (r =- 0.257, P = 0.001). Kaplan-Meier analysis showed that with the increase of dialysis time, the rate of intradialysis hypotension increased. The comulative rate of intradialysis hypotension in no urine group was higher than that in urine group (log-rank = 14.67, P =0.000). Conclusions Residual renal function is associated with intradialysis hypotension, and it is important for clinician to consider a residual renal function protection schedule for maintenance hemodialysis patients.
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<p><b>OBJECTIVE</b>To retrospectively analyze the clinical data of 17 patients with bone cement leakage after percutaneous kyphoplasty and explore the leakage type and mid-term clinical effects.</p><p><b>METHODS</b>The clinical data of 17 patients with osteoporotic vertebral compression fractures occurred bone cement leakage after percutaneous kyphoplasty from October 2011 to October 2016 were collected. There were 7 males and 10 females, aged from 68 to 87 years old with an average of 78 years. All the patients had the history of low emergy trauma who had normal activity and full self-care for living before trauma, and complained with the lower back pain without signs and symptoms of nerve root injury after trauma. According to the anatomical location by images, the bone cement leakage pathways was confirmed, the preoperative and postoperative vertebral body height and Cobb angle were measured, the improvement of spinal stenosis were recorded. Preoperative and postoperative visual analogue scale (VAS) and Oswestry Disability Index(ODI) were used to evaluate pain and daily activities.</p><p><b>RESULTS</b>All the patients were followed up for 4 to 7 years with an average of 5.1 years. According to anatomical location by images, we found the bone cement leakage pathways of vertebral side type in 6 cases, intervertebral disc type in 3 cases, spinal canal type in 2 cases, vertebral pedicle type in 5 cases and mixed type in 1 case. Vertebral body height from preoperative(27.7±3.5)% restored to (56.4±2.5)% at final follow-up, and the kyphosis was corrected with Cobb angle from preoperative(45.3±4.2)° corrected to(18.3±3.1)° at final follow-up. VAS score decreased from preoperative 7.9±1.5 to 2.1±0.5 at final follow-up. ODI obviously restored from preoperative(49.1±7.5)% to (23.5±3.7)% at final follow-up. The nerve symptoms in lower limbs occurred in 2 cases, and the neurological symptom was disappeared after urgent symptomatic treatment and anaphase trophic nerve treating. Lower back pain occurred in 3 cases, including one case of unbearable pain, and the pain disappeared after symptomatic treatment.</p><p><b>CONCLUSIONS</b>Although the rate of bone cement leakage during percutaneous vertebral kyphoplasty is not low, the bone cement leakage has little influence on PKP surgery. Even if a little leakage occurred within the spinal canal during the surgery, spinal canal decompression will not be needed urgently. The significant clinical symptoms caused by leakage can basically disappear after treatment in mid-term follow-up.</p>
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<p><b>OBJECTIVE</b>To retrospective analysis the mid-term follow-up effect of hip joint replacement in elderly patients with failure of intertrochanteric fractures of the hip joint internal fixation.</p><p><b>METHODS</b>From December 2008 to December 2011, 32 elderly patients underwent arthroplasty after intertrochanteric fracture fixation failure, of which, 4 death cases were excluded from the study, and the remaining 28 cases were in the study group. The age of patients ranged from 69 to 83 years old with a mean of 75 years old. The time from the internal fixation to the hip replacement were 8 to 72 months. Among them, 6 patients were Evans I type, 11 patients were Evans II type, 9 patients were Evans III type, and 2 patients were Evans IV type. Nine cases showed fracture of the lateral plate before operation, while 15 cases were femoral head screw cut-out and 4 cases were screw loosening. Harris score was used to compare the changes of hip function before operation with the final follow-up. Imaging results(X-ray) and erythrocyte sedimentation rate(ESR) were performed during the follow-up.</p><p><b>RESULTS</b>All patients were followed up from 4 to 7 years with an average of 5.3 years. Pain was significantly reduced or disappeared in patients compared with pre-operation. And hip function was significantly improved. Two cases had moderate pain after the physical activity and 4 cases had mild pain after the physical activity. At the final follow-up, 19 patients resumed free walking, 8 patients required walking with walking sticks, and 1 patient needed walking aid. The Harris scores improved from preoperative 34.9±2.4 to 83.4±5.7 at the final follow-up, among them, 15 cases were classified as excellent, 10 as good, 2 as fair, and 1 as poor. X-ray examination showed no prosthesis loosening and sinking fracture.</p><p><b>CONCLUSIONS</b>Salvage THA surgery could improve the hip function and the quality of life for old patients with intertrochanteric fracture fixation failure, and the middle-term follow-up results support that.</p>
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<p><b>OBJECTIVE</b>To explore clinical efficacy of hip replacement for hip-joint diseases with Parkinson disease.</p><p><b>METHODS</b>From December 2011 to December 2016, 18 patients with hip-joint diseases with Parkinson disease treated by hip replacement, including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them, 3 cases were developmental dysplasia of hip, 3 cases were femoral head necrosis and 12 cases were femoral neck fracture. All patients manifested with obvious pain and limitation of stepping ability. Postoperative complications were observed and Harris score were used to compare hip joint function after operation.</p><p><b>RESULTS</b>The incision were healed well, and pain were alleviated or disappeared, and hip joint function were improved. Eighteen patients were followed up from 1 to 3 years with an average of 2.3 years. At the latest follow up, 14 cases recovered freedom-walk, 2 cases could walk with walking stick, 1 case could walk with walking aid and 1 case was died. Among 18 patients, 2 cases were occurred dislocation, and 1 case were died for cardiac disease at 3 months after operation. Four patients were occurred slight pain. There were significant differences in Harris scores among preoperative (41.7±1.4), 6 months after operation(80.1±5.4) and the final follow-up (83.4±2.1), and 10 cases got excellent result, 4 good, 1 fair and 2 poor.</p><p><b>CONCLUSIONS</b>Application of hip replacement for hip-joint diseases with Parkinson disease is a safe and effective clinical therapy, and has advantages of less complications and rapid recovery of hip joint function.</p>
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<p><b>OBJECTIVE</b>This study explored the correlation of longitudinal changes in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels with the incidence of metabolic syndrome (Mets) based on a dynamic health examination cohort.</p><p><b>METHODS</b>A Mets-free dynamic cohort involving 4541 participants who underwent at least three health examinations from 2006 to 2011 was included in the study. Mets was defined according to the Chinese Medical Association Diabetes Branch definition that included hypertension, obesity, hyperlipidemia, and hyperglycemia. Generalized estimating equation (GEE) model was used to analyze multivariate relative risk (RR) of repeated observations of ALT and AST in quartiles for Mets or its components according to gender.</p><p><b>RESULTS</b>In all, 826 Mets cases were reported. Adjustment of relevant parameters indicated that time-varying changes in ALT and AST levels were positively associated with the incidence of Mets in a dose-response manner. Positive association between high ALT levels and fatty liver was much stronger than that between high AST levels and fatty liver, particularly in male participants. These associations were consistently observed in the following subgroups: participants with ALT and AST levels of <40 U/L, participants with of <25 kg/m2, and participants with non-fatty liver. Furthermore, participants with 2 Mets components at baseline showed lower multivariate adjusted RRs of ALT and AST for Mets than participants with 0-1 Mets component.</p><p><b>CONCLUSION</b>These results suggested that elevated serum ALT and AST levels were early biomarkers of Mets or its components.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Alanine Transaminase , Blood , Aspartate Aminotransferases , Blood , Biomarkers , Blood , China , Epidemiology , Cohort Studies , Hepatitis , Epidemiology , Incidence , Liver , Metabolic Syndrome , Diagnosis , EpidemiologyABSTRACT
AIM:To observe the effects and mechanisms of hydroxyethylstarch (HES) 130/0.4 on no-reflow phenomenon after myocardial ischemia-reperfusion in rats.METHODS: SD rats were randomly divided into 4 groups:sham operation group , ischemia-reperfusion ( IR, treated with normal saline ) group, normal saline ischemia-reperfusion (NS-IR, treated with NS) group and HES ischemia-reperfusion (HES-IR, treated with HES) group.Myocardial infarct size and no-reflow range were determined by staining methods , and the activities of myocardial enzymes ( CK-MB, cTnI and MPO) were measured .Meanwhile , cardiac microvascular endothelial cells of the rat were cultured and divided into 4 groups:control group, hypoxia/reoxygenation (H/R) group, NS-H/R group and HES-H/R group.Acute ischemia reper-fusion models were simulated , and the concentration of calcium ions was measured .The relative cell activity was evaluated by CCK-8 assay, and the apoptotic rate was detected by flow cytometry .RESULTS:In HES-IR group, the myocardial in-farct size, the no-reflow zone, CK-MB, cTnI and MPO activity were all significantly lower than those in IR group ( P<0.05).In microvascular endothelial cells , the concentration of calcium ions and the apoptotic rate in HES-H/R group were significantly decreased, while the relative cell activity increased compared with H/R group (P<0.05).CONCLUSION:HES reduces no-reflow in acute myocardial ischemia-reperfusion .The mechanism may be involved in the inhibition of both the infiltration of neutrophils and the calcium overload of endothelial cells .
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Objective To examine the distribution of bacterial species and antimicrobial susceptibility profile of pathogens in febrile neutropenic patients.Methods A total of 355 bacterial strains were isolated from febrile neutropenic patients in Shanghai General Hospital from January 2005 to December 2012. Antimicrobial susceptibility testing was done by Kirby-Bauer method. The susceptibility testing results were analyzed according to CLSI 2014 breakpoints.Results Gram-negative bacteria accounted for 70.4% of the 355 isolates, while gram-positive organisms accounted for 29.6%. The most common bacterial species werePseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Stenotrophomonas maltophiliaand Staphylococcus haemolyticus. Non-fermentative bacteria accounted for 53.2% of all the gram-negative bacterial isolates. All theEnterococcus and Staphylococcus isolates were susceptible to linezolid, vancomycin and teicoplanin. All theStaphylococcus strains were resistant to methicillin.P. aeruginosa isolates were relatively more susceptible to cefoperazone-sulbactam, piperacillin-tazobactam and cefepime (>70%) than imipenem (40.8%) and meropenem (59.2%). All theK. pneumoniae isolates were susceptible to imipenem and meropenem and more than 70% of the isolates were susceptible to cefoperazone-sulbactam, amikacin. More than 80% of theA. baumannii isolates were susceptible to carbapenems, cefoperazone-sulbactam, amikacin, ciprolfoxacin and aminoglycosides. All the E. coli isolates were susceptible to carbapenems and more than 70% were susceptible to cefoperazone-sulbactam and ceftazidime. More than 90% of theS. maltophilia strains were sensitive to levolfoxacin, minocycline, cefoperazone-sulbactam and trimethoprim-sulfamethoxazole.Conclusions Our data suggest that gram-negative bacteria, especiallyEnterobacteriaceae and non-fermentative bacteria, are still the primary pathogens in febrile neutropenic patients. Antimicrobial resistant strains are prevalent. Such data of bacterial species and antimicrobial susceptibility proifle of pathogens in febrile neutropenic patients are useful for empirical antimicrobial therapy of such infections.