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1.
Chinese Journal of Geriatrics ; (12): 1429-1434, 2021.
Article in Chinese | WPRIM | ID: wpr-911033

ABSTRACT

Objective:To understand the utilization of clinical services provided through hospital-at-home to the elderly in Xuzhou City, and analyze patient satisfaction.Methods:The stratified cluster sampling method was used to select community elderly people aged 60 and above in Xuzhou city to conduct a face-to-face questionnaire survey.Descriptive analysis was used to examine the utilization and evaluation of home-based clinical services for the elderly.Multiple linear regression analysis was used to analyze associated factors for the satisfaction of the elderly in this care setting.Results:A total of 203 elderly people who had received this type of services were investigated.The overall satisfaction of the elderly in Xuzhou City with home-based clinical services was 79.3%(161/203), and the average satisfaction score of the comprehensive evaluation was(4.11±1.03)points.Age( β=-0.011), marital status( β=0.164), informed consent for service( β=0.162), doctors' bed-side services( β=0.146), service fee( β=0.346), and the home hospital bed assembling process( β=0.257)were the influencing factors for satisfaction with family hospital bed services, according to the patients involved in the comprehensive evaluation(all P<0.05). Conclusions:The utilization and evaluation with clinical services by elderly people in the hospital-at-home setting in downtown Xuzhou is relatively good, with relatively high satisfaction.Comprehensive measures should be taken in response to factors related to satisfaction to promote sustainable development of clinical services through hospital-at-home in China.

2.
Article in Chinese | WPRIM | ID: wpr-907851

ABSTRACT

Objective:To explore the value of tidal lung function in distinguishing central and small intrathoracic airway obstructive lesions.Methods:A total of 124 infants with intrathoracic obstructive diseases, including bronchiolitis obliterans (BO), bronchiolitis, airway foreign body, and airway stenosis, were confirmed in Children′s Hospital of Chongqing Medical University from April 2014 to June 2019 and selected as subjects, and 111 normal infants were enrolled as healthy control group.According to the location of lesions, these subjects suffering from intrathoracic obstructive diseases were divided into small airway lesion group(BO, bronchiolitis) and central airway lesion group(airway foreign body, airway stenosis). Lung function was assessed by plethysmography.Results:As for the ratio of time to reach peak tidal expiratory flow to total expiratory time (TPTEF/TE) and the ratio of volume to reach peak tidal expiratory flow to total expiratory volume (VPTEF/VE), all disease groups were lower than that in healthy control group TEF/TE: BO 13.2(10.3, 16.3)%, bronchiolitis 15.9 (13.2, 19.7)%, airway foreign body 24.5 (16.7, 30.7)%, airway stenosis 20.7 (16.1, 29.3)%, healthy control group 30.2(25.6, 36.5)%; VPTEF/VE: BO 18.2(17.8, 22.3)%, bronchiolitis 20.3(17.0, 21.6)%, airway foreign body 26.0(20.5, 30.7)%, airway stenosis 22.9(20.2, 29.1)%, healthy control group 31.5(28.1, 37.0)%]( P<0.05) and the lesion in the small airway lesion group was significantly lower than that in central airway lesion group.Compared with the healthy control group, the functional residual capacity (FRC)was higher in each disease group[BO (501.6±166.5) mL, bronchiolitis (334.6±149.6) mL, airway foreign body (392.2±130.1) mL, airway stenosis (350.1±127.9) mL, healthy control group (191.6±73.8) mL]( P<0.05). The ratio of peak expiratory flow to tidal expiratory flow at 25% remaining expiration(PF/TEF 25) was obviously higher in small airway lesion group than that in central airway lesion and healthy control group [BO 232.7(183.2, 261.2)%, bronchiolitis 186.4 (153.3, 247.7)%, airway foreign body 143.1(126.8, 168.9)%, airway stenosis 140.3(122.9, 186.0)%, healthy control group 132.3 (123.1, 147.8)%] ( P<0.05), while no significant differences were found between central airway lesion group and healthy control group ( P>0.05). There were no significant differences in effective airway resistance among all groups ( P>0.05). The tidal breathing flow volume (TBFV) curve shape of small airway lesion group showed the depression of expiratory phase to the transverse axis, while the slope of descending branch of expiratory phase had no significant increase in central airway lesion group. Conclusions:Combined with the increase in PF/TEF 25, the decrease in TPTEF/TE and VPTEF/VE is the characteristic of small airway obstruction.PF/TEF 25 is a sensitive index reflecting small airway obstruction.Combined with the value of lung function parameters, the shape of TBFV is helpful to distinguish central and small airway obstructive lesions.

3.
Article in Chinese | WPRIM | ID: wpr-880026

ABSTRACT

OBJECTIVE@#To explore the synergistic immunomodulatory mechanism of interferon alpha-1b, interleukin-2 and thalidomide (ITI) regimen on patients with acute myeloid leukemia (AML).@*METHODS@#Sixty eight untreated de novo or relapsed or refractory or maintenance therapy patients with AML admitted in the Affiliated Cancer Hospital of Zhengzhou University and the other 11 medical units from March 2016 to May 2019 were treated with ITI regimen. Peripheral blood specimen per patient was collected into EDTA-K3 anticoagulation vacuum tube before the administration of ITI and 3 months after the treatment; peripheral blood lymphocyte subsets and perforin and Granzyme B expression were analyzed by using flow cytometry; the levels of VEGF, IFN-γ, TNF-α and IL-6 in the plasma were detected by using a cytometric bead array. Thirty-five healthy subjects from the hospital physical examination centre were selected as normal controls.@*RESULTS@#The ratio of CD4@*CONCLUSION@#The ITI regimen can raise the ratio of CD4


Subject(s)
CD8-Positive T-Lymphocytes , Humans , Interferon-alpha , Interleukin-2 , Leukemia, Myeloid, Acute/drug therapy , Perforin , Thalidomide
4.
Article in Chinese | WPRIM | ID: wpr-879086

ABSTRACT

Methotrexate(MTX) is a commonly used antimetabolite, which can be used in the treatment of a variety of diseases. However, hepatotoxicity in the use of MTX severely limits its clinical use. Therefore, how to prevent and treat hepatotoxicity of MTX has become an urgent clinical problem. This paper summarizes and analyzes relevant literatures on the prevention and treatment of hepa-totoxicity caused by MTX with traditional Chinese medicines and natural medicines in recent years. MTX-induced hepatotoxicity mechanisms include folate pathway, oxidative stress damage and adenosine pathway, of which oxidative stress theory is the main research direction. A total of 14 kinds of traditional Chinese medicine and natural medicine extracts including white peony root, and 21 kinds of natural monomer compounds, including berberine, play an anti-MTX-induced hepatotoxic effect by resisting oxidative stress, inhibiting inflammation and regulating signal pathways. According to current studies on the prevention and treatment of hepatotoxicity induced by MTX with traditional Chinese medicines and natural medicines, there are insufficiencies, such as partial and superficial mechanism studies, inadequate combination of experimental research and clinical practice, non-standard experimental design and lack of application of advanced technologies and methods. This paper systematically reviewed the effects and mechanisms of traditional Chinese medicines and natural medicines against hepatotoxicity induced by MTX and defined current studies and deficiencies, in the expectation of proposing new study strategies and directions and providing scientific basis for rational clinical use of MTX and development of new drugs against MTX hepatotoxicity.


Subject(s)
Chemical and Drug Induced Liver Injury/prevention & control , Drug-Related Side Effects and Adverse Reactions , Humans , Liver/metabolism , Medicine, Chinese Traditional , Methotrexate/toxicity , Oxidative Stress
5.
International Eye Science ; (12): 1870-1874, 2021.
Article in Chinese | WPRIM | ID: wpr-887370

ABSTRACT

@#AIM: To observe the control effects of low concentration atropines, orthokeratology, and spectacles on children with myopia in Baotou, and to analyze change rules of myopia-related regulatory parameters for providing bases for myopia preventions and controls.<p>METHODS: We selected 120 children with myopia aged 8-14 years old(240 eyes), treated in Ophthalmology Clinic of the First Affiliated Hospital of Baotou Medical College from June 2018 to December 2018. They were divided into three groups as follows: low concentration atropine group, orthokeratology group, and spectacles group. The accommodative lag, positive relative accommodation, negative relative accommodation, and diopter were followed up at 1, 3, 6, 12mo.<p>RESULTS:During the follow ups of 3, 6, and 12mo. We observed a statistically significant difference in the accommodative lag between the orthokeratology group and low concentration atropine group spectacles group(<i>P</i><0.05). At the 6, 12mo follow up, there was a statistical difference in the accommodative lag between the orthokeratology group and the spectacles group(<i>P</i><0.05). During the follow ups of 3, 6, and 12mo, there was a statistically significant difference in negative relative accommodations among the low concentration atropine group, orthokeratology group, and spectacles group(<i>P</i><0.05). The difference in positive relative accommodations was statistically significant among the orthokeratology group, low concentration atropine group, and spectacles group at each time point during the follow ups(<i>P</i><0.05). During the follow ups of 6, 12mo,the difference of equivalent spherical lens was statistically significant among the low concentration atropine group and spectacles group(<i>P</i><0.05). At the follow up 12mo, the difference between the equivalent spherical lens of the orthokeratology group and the spectacles group was statistically significant(<i>P</i><0.05).<p>CONCLUSION: The effects of three commonly used methods of controlling myopia on the accommodation parameters of myopic children are as follows: orthokeratology can not only solve the problem of hyperopia defocus by reducing accommodation lags but also improve positive relative accommodations, while it should be worn for a prolonged period. Low concentration atropine can improve the negative relative accommodations. However, there may be other ways to control myopia development. Compared to other groups, the spectacles group exerted fewer effects on each adjustment index, and did not demonstrate a significant effect on myopia control.

6.
Article in Chinese | WPRIM | ID: wpr-864286

ABSTRACT

Objective:To explore the value of airway responsiveness measurement by the tidal lung function test combined with the bronchial provocation test (BPT) in the diagnosis of infant cough variant asthma (CVA), and to provide evidence for clinical diagnosis of CVA.Methods:The tidal lung function test and BPT test results of 131 cases of chronic cough (including 70 CVA cases and 61 non-CVA cases) treated in the Asthma Specialist Clinic of Children′s Hospital Affiliated to Chongqing Medical University from January 2018 to September 2018 were retrospectively analyzed.The results between CVA group and non-CVA group were compared.Results:There was no significant difference in the basal tidal lung function detection results between the CVA group and non-CVA group ( P>0.05). The positive rate of BPT in the CVA group was significantly higher than that in the non-CVA group (98.6% vs. 27.9%, χ2=30.757, P<0.01). Among the patients with positive BPT, the proportion of patients with moderate and severe positive reactions in the CVA group was significantly higher than that in the non-CVA group (40.0% vs. 3.3%, 15.7% vs. 0, χ2=24.894, 20.464, all P<0.01). During BPT test process, a significantly greater number of patients showed wheezing and a significant decrease in oxygen saturation(SpO 2) in the CVA group than in the non-CVA group (50.0% vs.0, 91.4% vs.45.9%, χ2=32.169, 36.544, all P<0.01), while the number of patients with severe cough and shortness of breath was similar in both groups (all P>0.05). After the application of bronchodilator or oxygen inhalation, the symptoms of polypnea and wheezing disappeared in all children.The values of the ratio of the time to reach peak tidal expiratory flow to total expiratory time[(TPTEF/TE)%] and the ratio of the volume required to reach peak tidal expiratory flow to total expiratory volume[(VPTEF/VE)%] recovered to more than 80% of the basic values and SpO 2 up to 95%. Conclusions:The tidal lung function test combined with the BPT test is of certain significance for the diagnosis and differential diagnosis of CVA infants.CVA can be better diagnosed based on the degree of BPT and the clinical manifestations during the course of the test.

7.
Article in Chinese | WPRIM | ID: wpr-782452

ABSTRACT

OBJECTIVE@#To study the changes in pulmonary function in infants and young children with Mycoplasma pneumoniae pneumonia (MPP).@*METHODS@#A total of 196 hospitalized children (at age of 0-36 months) who were diagnosed with MPP from January 2014 to June 2018 were enrolled as study subjects. A total of 208 children (at age of 0-36 months) with pneumonia not caused by Mycoplasma pneumoniae infection during the same period of time were enrolled as controls (non-MPP group). A retrospective analysis was performed for their clinical data. The two groups were compared in the pulmonary function on the next day after admission and on the day of discharge. The children with MPP were followed up to observe pulmonary function at weeks 2 and 4 after discharge.@*RESULTS@#Compared with the non-MPP group, the MPP group had significant reductions in the ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE), inspiratory-to-expiratory time ratio, and tidal expiratory flow at 25% remaining expiration on the next day after admission and on the day of discharge (P<0.05). In addition there were significant increases in the ratio of peak tidal expiratory flow to tidal expiratory flow at 25% remaining expiration, respiratory rate, effective airway resistance, and plethysmographic functional residual capacity per kilogram (P<0.05). Compared with the normal reference values of pulmonary function parameters, both groups had reductions in VPTEF/VE and TPTEF/TE on the next day after admission; on the day of discharge, the MPP group still had reductions in VPTEF/VE and TPTEF/TE, while the non-MPP group had normal values. The MPP group had increases in VPTEF/VE and TPTEF/TE from the day of discharge to weeks 2 and 4 after discharge (P<0.05), but TPTEF/TE still did not reach the normal value at week 4 after discharge.@*CONCLUSIONS@#Airway obstruction is observed in infants and young children with acute MPP or non-MPP, and the children with MPP have a higher severity of airway obstruction and a longer time for improvement, with a certain degree of airway limitation in the recovery stage.

8.
Article in English | WPRIM | ID: wpr-880604

ABSTRACT

OBJECTIVES@#To compare the differences in clinical characteristics between Type 1 diabetes mellitus (T1DM) and fulminant Type 1 diabetes mellitus (FT1DM), and to reduce the missed diagnosis, misdiagnosis, and mistreatment of FT1DM by medical staff.@*METHODS@#A total of 101 hospitalized patients with T1DM (including 8 cases of FT1DM) were enrolled in this study from Changsha Central Hospital between June 2012 and December 2018. Clinical characteristics of the 8 FT1DM patients were collected and compared with all T1DM patients.@*RESULTS@#All FT1DM patients were adult with the average age of (30.25±5.28) years old, accompanied by severe diabetic ketoacidosis (DKA) occurred within 1 week after onset. Moreover, pancreatic beta cells in these patients were destroyed and the islet-related antibodies were negative, while the serum pancreatic enzyme levels were increased. Compared with classic T1DM patients, the plasma glucose levels in FT1DM patients were much higher [(41.89±12.54) mmol/L vs (22.57±9.74) mmol/L], but glycosylated hemoglobin (HbA1c) and fasting C peptide levels were significantly lower [(6.08±0.41)% vs (10.87±2.46%)%, @*CONCLUSIONS@#The onset time of FT1DM patients is very urgent via driving DKA. These patients have higher blood glucose concentration than classic T1DM patients, accompanied by electrolyte disturbances, impaired renal function, partially impaired liver function, as well as gastrointestinal symptoms and elevated trypsin. Most FTDM patients are adolescents and adults with no gender difference, especially pregnant women who are at high risk. Lifelong insulin dependence in FT1DM patients should be paid more attention in clinical treatment.


Subject(s)
Adolescent , Adult , Diabetes Mellitus, Type 1/complications , Diabetic Ketoacidosis , Female , Glycated Hemoglobin A/analysis , Humans , Insulin , Pregnancy , Sex Factors , Young Adult
9.
Article in English | WPRIM | ID: wpr-812994

ABSTRACT

OBJECTIVES@#To detemine preventive effects of compound formula Rhizoma Coptidis and Atractylodes on mice with gastric-ulcer.@*METHODS@#The mice were randomly divided into a normal group, a gastric ulcer group, a ranitidine positive drug group, a Rhizoma Coptidis group, an Atractylodes group, and a Rhizoma Coptidis plus Atractylodes group (the ratios of Coptidis to Atractylodes were 9꞉1, 8꞉2, 7꞉3, 6꞉4, 5꞉5, or 4꞉6, respectively). Gastric ulcer models were established by intragastric administration of anhydrous ethanol after 6 days of preventive infusion. The mice were killed 6 days after the treatments. The whole stomach was opened to observe gross morphology of gastric mucosa. The pathological changes of gastric tissue were observed under microscope, and serum samples were collected to detect the contents of superoxide dimutase (SOD), malondialdehyde (MDA), NO, and endothelin-1 (ET-1).@*RESULTS@#The Rhizoma Coptidis and Atractylodes decoction significantly decreased ulcer area (<0.001), and the effects of compound formula are better than those of Coptidis and Atractylodes alone (<0.05, <0.01, or <0.001). The anti-ulcer effect of compound formula (Coptidis꞉Atractylodes=6꞉4) was the best one, and the anti-gastric ulcer effect of the high-dose group was significantly better than that of the ranitidine-positive group (<0.001). The ranitidine positive drug group, the high-dose group of Rhizoma Coptidis, the high-dose group of Atractylodes, and the high-dose group of Rhizoma Coptidis-Atractylodes (6꞉4) significantly reduced MDA, ET-1 (<0.01 or <0.001), and significantly increased SOD, NO in serum (<0.01 or <0.001).@*CONCLUSIONS@#Rhizoma Coptidis and Atractylodes decoction exerts the effect on preventing ethanol-induced gastric ulcer in mice in a ratio-dependent and dose-dependent manner. The mechanism might be related to anti-oxidation and relaxion of blood vessels. The combination of the two drugs shows a synergistic effect.


Subject(s)
Animals , Atractylodes , Drugs, Chinese Herbal , Gastric Mucosa , Mice , Stomach Ulcer
10.
Article in Chinese | WPRIM | ID: wpr-871719

ABSTRACT

Objective:To comparatively analyze for the fundus characteristics of acquired immune deficiency syndrome (AIDS) with cytomegalovirus retinitis (CMVR) between first-visit and non-first-visit in ophthalmology.Methods:A retrospective study was performed for 22 patients (41 eyes) diagnosed as CMVR with AIDS by ophthalmology in the Affiliated Municipal Hospital of Xuzhou Medical University from July 2004 to September 2017. The patients were divided into two groups: one with the first-visit in ophthalmology (FVO) and the other with the first-visit in non-ophthalmology (FVNO). All patients underwent visual acuity, intraocular pressure, slit lamp microscope and indirect ophthalmoscope examinations. Thirty-nine eyes of 21 patients with clear refractive media were examined by color fundus photography, of which 5 patients were examined by FFA. Five patients examined by OCT and B-mode ultrasound. The CMVR were characterized as fulminant type or indolent type. All the 22 patients (41 eyes) except 2 patients (4 eyes) accepted highly active antiroviral therapy, and all patients were treated with ganciclovir intravenously. Nine patients (12 eyes) received intravitreal injection of ganciclovir, 7 patients (10 eyes) underwent vitrectomy because of retinal detachment, 6 patients (7 eyes) gave up surgery because of extensive retinal detachment, and the other 12 eyes did not undergo any eye surgery. All patients were followed for 6-58 months (average 23±39 months). The incidences and fundus characteristics of the patients with fulminant or indolent CMVR were compared and analyzed. Between the two groups, the difference of visual acuity and CD4 +T cell count at the first vist and the last follow-up were analyzed by a t-test, and the macular involvement and spread of the two groups were compared by a chi-square test. Results:Fulminant CMVR showed dense yellow-white necrotic lesions along the great vessels with or without satellite lesions, while indolent CMVR showed sparse yellow-white granular lesions with a little bleeding. The concomitant signs included frost-like dendritic vascular sheath, retinal artery occlusion and optic disc edema. Fourteen eyes of 7 patients in FVO group were fulminant, including 2 patients (2 eyes) with retinal artery occlusion and 1 patient (two eyes) with optic disc edema. In FVNO group, there were 27 eyes of 15 patients, including 21 eyes of 13 cases identified as fulminant type and 6 eyes of 4 patients as indolent type. In the fulminant type, there were 4 patients (6 eyes) with frost-like dendritic vascular sheath, 10 patients (12 eyes) with retinal artery occlusion and 4 patients (4 eyes) with optic disc edema. There was no significant difference in initial visual acuity ( t=-1.534, P=0.133), but there was a significant difference in visual acuity at the last follow-up ( t=-3.420, P=0.001). There was no significant difference in CD4 + T cells between the two groups at the first visit ( t=-0.902, P=0.378). The proportions of macular involvement and 3-4 quadrant involvement in FVO group were significantly higher than those in FVNO group ( χ 2=7.552, 7.865; P=0.006, 0.005). Conclusion:For AIDS patients with CMVR, the first-visit in ophthalmology showed more dense necrotic lesions involving macular and a wider range of lesions than the first-visit in non-ophthalmology.

11.
China Pharmacy ; (12): 1677-1682, 2020.
Article in Chinese | WPRIM | ID: wpr-823042

ABSTRACT

OBJECTIVE:To establish a method for simultaneous determination of the contents of codonopatin ,syringin, atractylenolide Ⅰ,atractylenolide Ⅱ and atractylenolide Ⅲ,and to compare the contents of above 5 components in different varieties and harvesting periods of Codonopsis Radix. METHODS :HPLC method was used. The column was Inertsil ODS- 3 with mobile phase consisted of acetonitrile-water (gradient elution )at the flow rate of 0.8 mL/min. The detection wavelengths were 210 nm (codonopatin),220 nm (syringin,atractylenolide Ⅱ ,atractylenolide Ⅲ),276 nm (atractylenolide Ⅰ). The column temperature was set at 30 ℃ ,and the sample size was 20 μ L. RESULTS:The linear range of codonopatin ,syringin, atractylenolide Ⅰ,atractylenolide Ⅱ and atractylenolide Ⅲ were 44.30-886.00 μg/mL(r=0.999 7),6.50-130.03 μg/mL(r=0.999 6), 4.47-89.46 μg/mL(r=0.999 5),2.53-50.50 μg/mL(r=0.999 4),5.64-112.80 μg/mL(r=0.999 5);the limits of quantification were 2.446 0,0.168 0,0.248 1,0.065 7,0.099 8 μg/mL,and detection limits were 1.352 0,0.067 2,0.005 4,0.006 3,0.007 3 μ g/mL;RSDs of precision ,stability(24 h),repeatability and durability tests were all less than 2%;the recoveries were 98.87%-100.62%(RSD=0.73%,n=6),98.46%-101.54% (RSD=1.15%,n=6),98.32%-101.12%(RSD=1.19%,n= 96.83%-104.16%(RSD=2.62%,n=6),97.87%-100.99% (RSD=1.07%,n=6). The average contents were 33.78-431.82, 0-20.60,0.44-3.68,0-10.83,0.27-73.40 μ g/g. The content of 1271985629@qq.com codonopatin was in descending order was as follows as Codonopsis pilosula >C. tangshen >C. pilosula Nannf. var. modesta (Nannf.) L. T. Shen >ecotypic variety of C.·1677· tangshen. The content of syringin in descending order was C. pilosula >C. pilosula Nannf. var. modesta(Nannf.)L. T. Shen >C. tangshen,but it was not detected in ecotypic variety of C. tangshen . The content of atractylenolide Ⅰ in descending order was C. pilosula Nannf. var. modesta(Namf.)L. T. Shen >ecotypic variety of C. tangshen >C. pilosula >C. tangshen . The content of atractylenolide Ⅱ in C. pilosula was higher than C. pilosula Nannf. var. modesta(Nannf.)L. T. Shen ,but was no detected in C. tangshen and ecotypic variety of C. tangshen . The content of atractylenolide Ⅲ in descending order was C. pilosula >C. pilosula Nannf. var. modesta(Nannf.)L. T. Shen >ecotypic variety of C. tangshen >C. tangshen . In Codonopsis Radix collected from Jul. to Oct. ,the content of codonopatin was the highest ;the content of atractylenolide Ⅰ was lower in sample collected from Jun. to Oct.;atractylenolide Ⅱ was not detected in sample collected in Aug. ;the contents of atractylenolide Ⅰ and atractylenolide Ⅱ were the lower in sample collected in Sept. ,and syringin and atractylenolide Ⅱ were not detected in some samples. CONCLUSIONS : The established HPLC method is simple ,accurate,highly sensitive and reproducible. It can be used to simultaneously determine 5 active ingredients contents of Codonopsis Radix ;there are great difference in contents of 5 active ingredients in different varieties and harvesting periods of Codonopsis Radix.

12.
Article in Chinese | WPRIM | ID: wpr-828895

ABSTRACT

OBJECTIVE@#To explore the value of leukotriene D4 (LTD4) bronchial provocation test (BPT) in detection of airway hyper-responsiveness (AHR) in children.@*METHODS@#A total of 151 children aged 6 to 14 years, including 86 in remission of asthma and 65 with acute bronchitis, who were followed up in our respiratory clinic between November, 2017 and August, 2018. The children were randomly divided into LTD4 group (78 cases) and methacholine (MCH) group (73 cases). In LTD4 group, the 78 children underwent LTD4-BPT, including 46 with asthma and 32 children having re-examination for previous episodes of acute bronchitis; in MCH group, the 73 children underwent MCH-BPT, including 40 with asthma and 33 with acute bronchitis. MCH-BPT was also performed in the asthmatic children in the LTD4 group who had negative responses to LTD4 after an elution period. The major adverse reactions of the children to the two BPT were recorded. The diagnostic values of the two BPT were evaluated using receiver-operating characteristic (ROC) curve.@*RESULTS@#There was no significant difference in the results of basic lung function tests between LTD4 group and MCH group (>0.05). The positive rate of BPT in asthmatic children in the LTD4 group was significantly lower than that in the MCH group (26.1% 72.5%; < 0.05). The positive rate of BPT in children with previous acute bronchitis in the LTD4 group was lower than that in the MCH group (3.1% 15.2%). The positive rate of MCH-BPT in asthmatic children had negative BPT results in LTD4 group was 58.8%, and their asthma was mostly mild. The sensitivity was lower in LTD4 group than in MCH group (0.2609 0.725), but the specificity was slightly higher in LTD4 group (0.9688 vs 0.8485).The area under ROC curvein LTD4 group was lower than that in MCH group (0.635 0.787). In children with asthma in the LTD4 group, the main adverse reactions in BPT included cough (34.8%), shortness of breath (19.6%), chest tightness (15.2%), and wheezing (10.9%). The incidence of these adverse reactions was significantly lower in LTD4 group than in MCH group ( < 0.05). Serious adverse reactions occurred in neither of the two groups.@*CONCLUSIONS@#LTD4-BPT had high safety in clinical application of children and was similar to the specificity of MCH-BPT. However, it had low sensitivity, low diagnostic value, and limited application value in children's AHR detection.


Subject(s)
Adolescent , Asthma , Bronchial Provocation Tests , Child , Humans , Leukotriene D4 , Methacholine Chloride , Respiratory Hypersensitivity
13.
Chinese Journal of Geriatrics ; (12): 1116-1120, 2019.
Article in Chinese | WPRIM | ID: wpr-796864

ABSTRACT

Objective@#To study the current situation and relevant risk factors for disability and dementia among the elderly in urban areas of Jiangsu province.@*Methods@#A stratified cluster sampling method was used to select representative elderly people aged 60 years and over in urban areas in Jiangsu Province, and a face-to-face questionnaire survey was conducted.The activities of daily living(ADL)scale and mini-mental state examination(MMSE)were used to assess the status of disability and dementia.And the relevant risk factors for disability and dementia were analyzed by univariate and multivariate Logistic regression methods.@*Results@#A total of 1 600 elderly people were investigated and 1 514 valid questionnaires were recovered.The effective recovery rate was 94.6%.The rates of disability and dementia were 17.9%(271/1 514)and 8.5%(129/1 514)respectively in the elderly in Jiangsu urban areas.Univariate analysis showed that age, marital status, education level, empty-nest, whether or not to suffer from chronic diseases, health status, medication, and whether or not to have dementia were significantly related with the disability in the elderly(P<0.01). And age, gender, marital status, education level, whether or not to suffer from chronic diseases, health status, medication, and whether or not to have disability were significantly related with the dementia in the elderly(P<0.01). Multivariate analysis showed that the risk factors associating with increasing disability in the elderly were advanced age(OR=16.371), non-marriage(OR=1.917), chronic disease(OR=2.256), poor health condition(OR=23.214), dementia(OR=4.067)and insufficient income(OR=1.607)(P<0.05). And the factors associating with increasing risks for dementia in the elderly were advanced age(OR=2.864), female(OR=1.610), poor health condition(OR=3.097), empty nest(OR=1.607)and disability(OR=4.026)(P<0.05). Therefore, comprehensive measures should be taken for intervention of disability and dementia in the elderly.@*Conclusions@#The incidence of disability and dementia is high among the elderly in urban areas of Jiangsu Province.Disability and dementia are the results of the interaction effect of health, family and social factors.Therefore, comprehensive measures against risk factors should be taken for intervention of disability and dementia in the elderly.

14.
Chinese Journal of Geriatrics ; (12): 1116-1120, 2019.
Article in Chinese | WPRIM | ID: wpr-791647

ABSTRACT

Objective To study the current situation and relevant risk factors for disability and dementia among the elderly in urban areas of Jiangsu province.Methods A stratified cluster sampling method was used to select representative elderly people aged 60 years and over in urban areas in Jiangsu Province,and a face-to-face questionnaire survey was conducted.The activities of daily living (ADL) scale and mini-mental state examination(MMSE) were used to assess the status of disability and dementia.And the relevant risk factors for disability and dementia were analyzed by univariate and multivariate Logistic regression methods.Results A total of 1 600 elderly people were investigated and 1 514 valid questionnaires were recovered.The effective recovery rate was 94.6%.The rates of disability and dementia were 17.9 % (271/1 514) and 8.5 % (129/1 514) respectively in the elderly in Jiangsu urban areas.Univariate analysis showed that age,marital status,education level,empty-nest,whether or not to suffer from chronic diseases,health status,medication,and whether or not to have dementia were significantly related with the disability in the elderly(P <0.01).And age,gender,marital status,education level,whether or not to suffer from chronic diseases,health status,medication,and whether or not to have disability were significantly related with the dementia in the elderly(P < 0.01).Multivariate analysis showed that the risk factors associating with increasing disability in the elderly were advanced age(OR =16.371),non-marriage(OR =1.917),chronic disease (OR =2.256),poor health condition(OR =23.214),dementia (OR =4.067) and insufficient income (OR =1.607)(P<0.05).And the factors associating with increasing risks for dementia in the elderly were advanced age(OR =2.864),female(OR =1.610),poor health condition(OR =3.097),empty nest (OR =1.607) and disability (OR =4.026) (P < 0.05).Therefore,comprehensive measures should be taken for intervention of disability and dementia in the elderly.Conclusions The incidence of disability and dementia is high among the elderly in urban areas of Jiangsu Province.Disability and dementia are the results of the interaction effect of health,family and social factors.Therefore,comprehensive measures against risk factors should be taken for intervention of disability and dementia in the elderly.

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Article in Chinese | WPRIM | ID: wpr-751714

ABSTRACT

Objective To investigate the efficacy,prognosis and safety of weekly paclitaxel with concurrent radiotherapy in nasopharyngeal carcinoma (NPC) patients with multiple liver metastases.Methods A total of 64 NPC patients with multiple liver metastases in First Affiliated Hospital of Hainan Medical University between January 2016 and January 2018 were recruited and randomly divided into experimental group (n =32) and control group (n =32) by the method of random number table.The patients in the two groups were given palliative radiotherapy with a median dose of 30 Gy.The experimental group used weekly paclitaxel (40 mg/m2) concurrent chemotherapy,cisplatin (40 mg/m2) in the control group.Paclitaxel and cisplatin were used weekly until the end of radiotherapy.The clinical efficacy and adverse effects between the two groups were compared.Results During the follow-up,1 patient was lost to follow-up in the experimental group,complete remission (CR) in 6 cases (19.4%),partial remission (PR) in 9 cases (29.0%),stable disease (SD) in 7 cases (22.6%) and progressive disease (PD) in 9 cases (29.0%);2 patients were lost to follow-up in the control group,CRin4 cases (13.4%),PR in 10 cases (33.3%),SD in9 cases (30.0%) and PD in7 cases (23.3%).There was no significant difference between the two groups (Z =-0.060,P =0.952).The effective rates of the experimental group and the control group were 48.4% (15/31) and 46.7% (14/30) respectively,and the difference was not statistically significant (/x2 =0.018,P =0.893);the tumor control rates were 71.0% (22/31) and 76.7% (23/30),with no statistically significant difference (x2 =0.256,P =0.613).The median survival time of the experimental group and the control group were 9.4 months and 8.9 months respectively,and the 1-year survival rates were 14.5% and 10.0%,with no significant difference (x2=1.136,P =0.286).Among the adverse effects,the incidence rates of allergic reaction,neurotoxicity and cardiovascular toxicity in the experimental group were higher than those in the control group [18.8% (6/32) vs.3.1% (1/32),28.1% (9/32) vs.15.6% (5/32),31.3% (10/32) vs.15.6% (5/32)],with no significant differences (x2 =2.566,P=0.109;x2 =1.463,P=0.226;x2 =2.177,P =0.140).The incidence rates of granulocyte decline,platelet decline,red blood cell decline,and impaired liver and kidney function in the experimental group were lower than those in the control group [56.3% (18/32) vs.68.8% (22/32),12.5% (4/32) vs.21.9% (7/32),15.6% (5/32) vs.25.0% (8/32),21.9% (7/32) vs.28.1% (9/32)],with no significant differences (x2 =1.067,P=0.302;x2 =0.988,P =0.320;x2 =0.868,P =0.351;x2 =0.333,P =0.564).The incidence rates of nausea and vomiting was lower than that in the control group [(40.6% (13/32) vs.78.1% (25/32)],with a significant difference (x2 =9.328,P =0.002).Conclusion Weekly paclitaxel with concurrent radiotherapy has equivalent efficacy to cisplatin and the adverse effects can be tolerated.

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Article in Chinese | WPRIM | ID: wpr-743448

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Objective To observe the difference between continuous subcutaneous insulin infusion (CSII) at acupoint and CSII at non-acupoint in treating type 2 diabetes, for providing a novel option in selecting the insulin injection site. Method Sixty-six subjects with type 2 diabetes were randomized into a treatment group of 32 cases and a control group of 34 cases. The treatment group was intervened by CSII at acupoint, while the control group was intervened by CSII at non-acupoint. The body mass index (BMI), fasting plasma glucose (FPG), 2 h-postprandial plasma glucose (P2hPG), bedtime blood sugar, glycated hemoglobin (HbA1c), consumption of insulin, and the score of diabetes symptom grading and quantification of the two groups were compared. Result The blood sugar level, insulin consumption, HbA1c level and symptom score declined significantly after treatment in both groups (P<0.05);the BMI and initial dosage of insulin in the treatment group dropped significantly after treatment in the treatment group (P<0.05); after treatment, the BMI, FPG level, initial dosage of insulin and symptom score in the treatment group were markedly lower than those in the control group (P<0.05); there were no significant differences between the treatment group and the control group in the P2 hBG level, bedtime glucose sugar level, HbA1c level, pre-prandial insulin dose and total effective rate (P>0.05). Conclusion CSII at acupoint and at non-acupoint both can effectively improve the disease condition of type 2 diabetes. The treatment group is superior to the control group in controlling BMI and FPG, reducing the initial level of insulin, and improving the symptoms, and the treatment group presents a higher total effective rate with the increase of treatment duration compared with the control group. It is indicated that insulin infusion at abdominal acupoint has a certain advantage in the treatment of type 2 diabetes.

17.
International Eye Science ; (12): 1901-1907, 2019.
Article in Chinese | WPRIM | ID: wpr-756882

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@#AIM: To systematically evaluate changes in dioptre, keratometry results, uncorrected visual acuity, and ocular axis in teenage patients with myopia using orthokeratology lens for different durations. To understand and determine the duration for using orthokeratology lens more accurately in these patients and to provide correct and reliable treatment guidance for these patients.<p>METHODS: Computerised search was conducted to retrieve studies from PubMed, CBM, WanFang Data, VIP, and CNKI databases, from the establishment of the databases to April 2019. The search yieldedrelevant studies on the use of orthokeratology to control the development of myopia in teenage patients. After two researchers independently conducted literature screening, data extraction, and methodological quality evaluation, a Meta-analysis was performed using RevMan 5.3 software.<p>RESULTS: Finally, 8 relevant studies were selected, which included 1 136 teenage patients with myopia. The Meta-analysis revealed that after wearing orthokeratology lens for 1wk, keratometry results changed without statistical significance \〖1wk: <i>MD</i>=0.91, 95% <i>CI</i>(-0.01-1.83), <i>P</i>=0.05\〗. However, after using orthokeratology lens for 1, 3, 6, and 12mo, keratometry results decreased \〖1mo: <i>MD</i>=0.82, 95% <i>CI</i>(0.12-1.53), <i>P</i>=0.02; 3mo: <i>MD</i>=1.31, 95% <i>CI</i>(0.63-2.00), <i>P</i><0.05; 6mo: <i>MD</i>=1.35, 95% <i>CI</i>(0.62-2.09), <i>P</i><0.05; 12mo: <i>MD</i>=1.41, 95% <i>CI</i>(0.68-2.41), <i>P</i><0.05\〗. Further, after 12mo of using orthokeratology lens, the increase in dioptre was effectively controlled \〖12mo: <i>MD</i>=2.61, 95% <i>CI</i>(1.52-3.71), <i>P</i><0.05\〗, and the uncorrected visual acuity improved \〖12mo: <i>MD</i>=-0.81, 95% <i>CI</i>(-0.84--0.79), <i>P</i><0.05). The ocular axis did not show a statistically significant increase \〖12mo: <i>MD</i>=-0.06, 95% <i>CI</i>(-0.21-0.09), <i>P</i>=0.44\〗. <p>CONCLUSION: The use of orthokeratology lens cannot only reducekeratometry values, but also control the growth of the ocular axis. However, these results can be achieved only after long-term wear.

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Article in Chinese | WPRIM | ID: wpr-697167

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Objective To assess and compare the predicted abilities of PRE- DELIRIC and E-PRE-DELIRIC two delirium prediction models in ICU patients. Methods From January 2017 to April 2017, 265 critically ill patients who met the inclusion criteria were included in this study. The clinical data of all the included patients, respectively calculated the scores with both PRE-DELIRIC and E-PRE-DELIRIC rating software were collected. Forecasting performance of two different models of discrimination and calibration were assessed. 2 medical staff assessed 20 patients with the Chinese version PRE-DELIRIC and E-PRE-DELIRIC,while the intraclass correlation coefficients were accumulated to evaluate the inter-rater reliability. Results The average scores of PRE-DELIRIC were46.41 ± 14.05in delirium group and20.08 ± 9.96 in patients without delirium, the difference between scores was statistically significant (t=14.34, P<0.05). The average scores of E-PRE-DELIRIC were36.23±13.34in delirium group and14.45±9.56 in patients without delirium, the difference between scores was statistically significant (t=14.59, P<0.05). The AUROCC and its 95%CI of the PRE-DELIRIC and E-PRE-DELIRIC for prediction of delirium were 0.928(0.891-0.965) and 0.904(0.861-0.947) respectively in all patients. Discrimination was generally good for two models. The PRE-DELIRIC and E-PRE-DELIRIC sensitivity were 0.841, 0.812, specificity was 0.939, 0.913, the threshold values of PRE-DELIRIC model was 36.5%and E-PRE-DELIRIC model was 30.5%. The Youden′s index of PRE–DELIRIC model was 0.779, which better than 0.725 of E-PRE-PREDIRIC model. Conclusions The PRE-DELIRIC and E-PRE-DELIRIC models both have high accuracy in predicting delirium of patients in intensive care unit. PRE-DELIRIC does better performance than E-PRE-DELIRIC, but has imitation in terms of time. E-PRE-DELIRIC model can be used in ICU patients who develop delirium within 24 h following admission.

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Journal of Modern Laboratory Medicine ; (4): 131-132,136, 2018.
Article in Chinese | WPRIM | ID: wpr-696183

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Objective To investigate the relationship between nuclear factor kappa B(NF-κB) and matrix metalloproteinase-9 (MMP-9) mRNA in human umbilical vein endothelial cells(HUVECs) stimulated by the serum from children with coronary artery lesions of Kawasaki disease (KD).Methods HUVECs were cultured and were divided into 4 groups:normal serum group,general fever group,Non-CALs group and CALs group.Co-Immunoprecipitation (ChIP) was used to detect the relationship between NF-κB and MMP-9,and RT-PCR was used to detect the mRNA level of MMP-9.Results Compared with control groups,NF-κB p65 could bind the promoter of MMP 9 in HUVECs cultured with 10 % serum from KD patients with coronary artery lesions.The mRNA level of MMP 9 was also up-regulated.Conclusion NF-κB p65 can promote the transcription of MMP-9 in HUVECs induced by the serum from KD patients with coronary artery lesions.

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Chinese Journal of Hematology ; (12): 822-827, 2018.
Article in Chinese | WPRIM | ID: wpr-810229

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Objective@#To detect the expression of CRLF2 in adult Ph negative acute B lymphocytic leukemia (B-ALL) in newly diagnosed cases, and to investigate the relationship between CRLF2 and the general clinical characteristics, efficacy and prognosis.@*Methods@#103 cases of newly diagnosed adult B-ALL patients were investigated from Apr 2016 to Dec 2017 in the Department of Hematology, Henan Cancer Hospital. Bone marrow samples was used to detect the expression of CRLF2 in leukemic cells. The expression of CRLF2 ≥20% was defined as CRLF2-high group and <20% was defined as CRLF2-low group. The clinical characteristics and prognosis of the two groups were compared.@*Results@#The Median overall survival (OS) and disease free survial (DFS) in CRLF2-high group were 9.0 months and 4.25 months, respectively. CRLF2-low group were 15.5 months and 10.25 months, respectively. There was a statistically significant difference in median OS and DFS between the two groups (P=0.007, P=0.000) . The 18-month OS and DFS in CRLF2-high group were 38.6% and 25.1%, respectively. CRLF2-low group were 57.8% and 42.3%, respectively. Multivariate analysis showed high expression of CRLF2 was an independent risk factor for OS (HR=2.991, 95% CI 1.429-6.261, P=0.004) and DFS (HR=2.374, 95%CI 1.146-4.960, P=0.041) in patients.@*Conclusion@#Patients with high expression of CRLF2 had poor prognosis.

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