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Objective:To evaluate the role of brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) signaling pathway in 17β estradiol-induced reduction of long-term cognitive impairment induced by multiple propofol anesthesia in developing rats.Methods:Eighty 7-day-old clean-grade healthy newborn Sprague-Dawley rats of both sexes, weighing 11-17 g, were divided into 4 groups ( n=20 each) using a random number table method: control group (group C), propofol group (group P), 17β estradiol plus propofol group (EP group) and 17β estradiol plus propofol plus BDNF/TrkB signaling pathway blocker K252a group (K group). Propofol 80 mg/kg was intraperitoneally injected every day for 5 days in P, EP and K groups.The equal volume of fat emulsion was given instead in group C. In EP and K groups, 17β estradiol 600 μg/kg was subcutaneously injected at 30 min before propofol injection.BDNF/TrkB signaling pathway blocker K252a 100 μg/kg was intraperitoneally injected in group K. Morris water maze test was performed on days 30-34 after birth to assess the cognitive function.The rats were sacrificed after the end of Morris water maze test, and the hippocampal tissues were removed for determination of the apoptosis rate of hippocampal neurons (by flow cytometry), expression of BDNF, p-Trkb and cleaved caspase-3 (by Western blot and immunofluorescence), and expression of Bcl-2 and Bax mRNA (by real-time polymerase chain reaction) and for microscopic examination of the pathological changes in hippocampal CA1 region (with a light microscope). Bax mRNA/Bcl-2 mRNA ratio was calculated. Results:Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the expression of BDNF and p-TrkB was down-regulated, the expression of cleaved caspase-3 was up-regulated, the apoptosis rate of hippocampal neurons and Bax mRNA/Bcl-2 mRNA ratio were increased ( P<0.05), and the pathological changes in hippocampal CA1 region were accentuated in group P. Compared with group P, the escape latency was significantly shortened, the number of crossing the original platform was increased, the expression of BDNF and p-TrkB was up-regulated, the expression of cleaved caspase-3 was down-regulated, the apoptosis rate of hippocampal neurons and Bax mRNA/Bcl-2 mRNA ratio were decreased( P<0.05), and the pathological changes in hippocampal CA1 region were attenuated in group EP.Compared with group EP, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the expression of BDNF and p-TrkB was down-regulated, the expression of cleaved caspase-3 was up-regulated, the apoptosis rate of hippocampal neurons and Bax mRNA/Bcl-2 mRNA ratio were increased( P<0.05), and the pathological changes in hippocampal CA1 region were accentuated in group K. Conclusions:BDNF/TrkB signaling pathway is involved in 17β estradiol-induced reduction of long-term cognitive impairment induced by multiple propofol anesthesia in developing rats.
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Objective:To investigate the perioperative situation and recent effect of pelvic exenteration for patients with locally recurrent cervical cancer.Methods:A total of 17 patients with locally recurrent cervical cancer who underwent pelvic exenteration in Peking University People's Hospital from October 2015 to May 2018 were retrospectively analyzed for their clinical and pathological characteristics, surgical conditions, hospitalization costs, postoperative complications, and survival situation.Results:(1) The median age of 17 patients with locally recurrent cervical cancer was 51 years (range 27-64 years). Pathological type: 13 cases of squamous cell carcinoma, 2 cases of adenocarcinoma, and 2 cases of adenosquamous carcinoma. Thirteen patients received radiotherapy during the initial treatment and 4 patients did not receive radiotherapy. (2) Pelvic exenteration was performed in 17 patients with locally recurrent cervical cancer, of which 9 cases were performed with total pelvic exenteration (operation range including radical cystectomy, partial urethrectomy rectectomy and partial vaginalectomy), and 8 cases with anterior pelvic exenteration operation (operation range including: radical cystectomy, part of urethrectomy and part of vaginalectomy). Of the 17 patients successfully completed the operation. The median operation time was 450 minutes (range 240-760 minutes), the median intraoperative blood loss was 2 200 ml (range 200- 8 400 ml), the median postoperative hospital stay was 17 days (range 9-55 days), the median hospital cost was 83 857 yuan (range 41 588-296 354 yuan). (3) Of the 17 patients underwent pelvic exenteration, 16 of them had early complications, the most common one was fever (14 cases). Fourteen of them had late complications, and the most common one was a urinary system infection (12 cases). (4) The median overall survival time was 26.0 months (range 3-44 months), the median progression-free survival (PFS) time was 9.0 months (range 2-44 months). Among them, 13 patients received radiation therapy during the initial treatment, the median PFS time was 9.0 months (range 2-30 months); 4 patients did not receive radiation therapy in the initial treatment, the median PFS time was 10.5 months (range 2-44 months).Eleven patients received adjuvant therapy after pelvic exenteration, the median PFS time was 12.0 months (range 2-44 months); 6 patients did not receive adjuvant therapy, the median PFS time was 5.0 months (range 2-9 months).Conclusions:Pelvic exenteration has a wide range of operations, many postoperative complications, and high hospitalization costs. Adjuvant treatment after pelvic exenteration could improve the PFS time for some patients. Its clinical value and health economic value need to be further explored.
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Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coro-navirus (MERS-CoV) in the twenty-first century. In this minireview, we provide a brief introduction of the general features of SARS-CoV-2 and discuss current knowledge of molecular immune pathogenesis, diagnosis and treatment of COVID-19 on the base of the present understanding of SARS-CoV and MERS-CoV infections, which may be helpful in offering novel insights and potential therapeutic targets for combating the SARS-CoV-2 infection.
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Objective To study perioperative period conditions of total and partial colpocleisis with severe pelvic organ prolapse(POP)in elderly patients. Methods From Jan. 2014 to Oct. 2017286 severe POP elderly patients underwent total or partial colpocleisis. The mean age was(76.0±5.1)years(60-90 years). Of which,220 patients(76.9％, 220/286)presented more than one kind of medical disease. The operative time, intraoperative blood loss, hospital stay after surgery, postoperative complications, preoperative urinary dysuria symptoms of total and partial colpocleisis in treatment of 286 patients were analyzed. Results In 286 patients, 172 patients(60.1％)underwent total colpocleisis and 114 patients(39.9％) underwent partial colpocleisis. Totally 48 patients(16.8％)in 286 patients underwent anti-urinary incontinence procedure. The mean operating time of 286 patients was(67 ± 22)minutes, the mean blood loss was(52 ±57)ml, the mean hospital stay after surgery was(5.9 ± 1.9)days(2-16 days). The rate of postoperative complications was 8.7％(25/286). Those complications including 1 case of bladder injury during operation, 3 cases of postoperative pelvic hematoma, 1 case of intestinal obstruction, 5 cases of atrial fibrillation, 10 cases of postoperative morbidity, 3 cases of pulmonary embolism, 1 case of lower limb thrombosis, 1 case of urinary retention underwent electrical stimulation treatment because of ineffective application of urinary retention catheter. The mean operating time was(67±22)minutes in total colpocleisis and(68±20) minutes in partial colpocleisis(P>0.05), the mean blood loss was(58±62)ml in total colpocleisis and(41± 45)ml in partial colpocleisis(P>0.05), the mean hospital stay after surgery was(5.9 ± 1.9)days in total colpocleisis and(6.0 ± 1.8)days in partial colpocleisis(P>0.05), the rate of post operative complications was 8.1％(14/172) in total colpocleisis and 9.6％(11/114)in partial colpocleisis(P>0.05), respectively;those four of comparisons showed no significant difference. There were 129 patients(45.1％, 129/286)with voiding difficulty before surgery;the mean postvoid residual volumes of the above two operation types of people after operation were(35 ± 43)and(34 ± 41)ml, which showed no significant difference(P>0.05). Conclusions Colpocleisis is a safe and effective management in selected elderly patients with severe POP, who no longer desire to maintain vaginal coital function. There is no significant difference in the perioperative period conditions between total and partial colpocleisis. The choice of surgical procedure is based on factors such as the presence or absence of malignancy in the uterus, age and willingness of the patient, and general condition.
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Aortoiliac occlusive disease is a common and frequently-occurring disease of vascular surgery,and atherosclerosis is the main cause of its disease.Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC Ⅱ) D type of aortoiliac occlusive disease due to complex lesions,the preferred treatment method is aortobifemoral bypass.With the change of treatment concept,in-depth study of kiss stent,and the introduction of reconstruction of aortic bifurcation and integrated stent technology,endovascular therapies has achieved satisfactory short-term and long-term patency rates.At present,endovascular therapies has become the preferred treatment for TASC Ⅱ D aortoiliac occlusive disease.This article reviews the recent advances in endovascular therapies of TASC ⅡD aortoiliac occlusive disease.
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Objective To investigate the clinical efficacy of capecitabine metronomic chemotherapy in the maintenance of elderly patients with metastatic breast cancer. Methods Fifty-six patients with metastatic breast cancer treated in Jiangsu Shengze Hospital from April 2014 to April 2017 were randomly divided into two groups according to random number table method: metronomic chemotherapy group (n = 28) and conventional chemotherapy group (n = 28). The patients in the metronomic chemotherapy group were treated with capecitabine 500 mg, 2 times/d and continuous oral administration. The conventional chemotherapy group received capecitabine 1 250 mg, 2 times/d for 14 days, rested for 7 days, 21 days was a course of treatment.After two courses,the clinical efficacy,toxicity and quality of life were evaluated. Results There were no significant differences in RR and DCR between the metronomic chemotherapy group and conventional chemotherapy group (RR: 39.3 % vs. 42.8 %, DCR: 89.3 % vs. 85.7 %, both P > 0.05). The median progression-free survival (PFS) time in the metronomic chemotherapy group was 5.8 months (95 % CI 3.23-7.44, P= 0.764) and median overall survival (OS) time was 7.9 months (95 % CI 4.15-7.95, P=0.519). The median PFS time in the conventional chemotherapy group was 7.2 months (95 % CI 3.32-6.33, P=0.835), median OS time was 10.3 months (95 % CI 4.08-7.37, P=0.463). There was no significant difference between the two groups (both P> 0.05). The incidences of hand-foot syndrome, myelosuppression and digestive tract reaction in conventional chemotherapy group were higher than those in metronomic chemotherapy group, there were significant differences between the two groups (all P < 0.05). No Ⅲ-Ⅳ level adverse reactions were found in the metronomic chemotherapy group. The overall rate of improvement of the quality of life in the metronomic chemotherapy group was significantly higher than that in the conventional chemotherapy group (92.9 % vs. 78.8 %, χ 2= 7.629, P < 0.05). Conclusion The clinical efficacy of capecitabine metronomic chemotherapy in the maintenance of elderly patients with metastatic breast cancer is similar to conventional dose maintenance therapy,but it can not only reduce the side effects, but also improve the quality of life of patients.
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Objective To investigate the status and influencing factors of pleasant events among community-dwelling dementia patients. Methods Totally 266 community-dwelling dementia patients were recruited from Bei-jing,Guangzhou and Tianjin,and were investigated with the Chinese-version Pleasant Events Schedule-AD(PES-AD). Results The overall score of PES-AD was (14.0±6.7). The factor scores from high to low were sensory stimulation activities(0.9±0.5),family activities(0.8±0.5),emotional stimulation activities(0.8±0.4) and autonomy activities(0.6± 0.5). Multiple linear regression showed that the severity of disease,without chronic disease,educational level of de-mentia patients and their caregivers were significant influencing factors of pleasant events,which explained 41.1% of the total variance. Conclusion Sensory stimulation activities of community-dwelling dementia patients were relatively satisfactory,followed by family activities and emotional stimulation activities,but autonomy activities were relatively unsatisfactory. It is suggested to choose appropriate pleasant activities according to the severity of disease for de-mentia patients to improve their quality of life.
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Objective To investigate the mechanism of Guiqiyiyuan Ointment (GO) for preventing and treating 12C6+ beam radiation induced lung and kidney bystander effect to provide a new strategy for prevention and treatment of clinical radiation injury. Methods Sixty healthy male Wistar rats were randomly and equally divided into 3 groups: NC group, SR group (simple radiation 2ml/kg), GO group(GO 2ml/kg intragastric administration for 7 days). The right side of the lung was modeled by 12C6+beam radiation. After modeling, the rats were killed at 48h. The left lung, left and right kidney tissues were taken from the rats. The DNA methylation rate was detected by ELISA assay, pathological changes were observed by HE staining, and the expressions of Dnmt1, Dnmt3a and Dnmt3b were detected by immunohistochemistry. Results Compared with the NC group, the level of DNA methylation was decreased significantly (P<0.01), the left lung showed inflammation, no abnormal finding was seen in the left and right kidneys, and the expressions of Dnmt1, Dnmt3a and Dnmt3b were significantly increased in the SR group (P<0.01). Compared with the SR group, the level of DNA methylation was increased significantly (P<0.01), the left lung inflammation became better, and the expressions of Dnmt1, Dnmt3a and Dnmt3b were significantly decreased in the GO group (P<0.01). Dnmt1, Dnmt3a and Dnmt3b proteins were expressed in the cytoplasms of bronchial and renal tubular epithelial cells in all the groups. The NC group presented as light brown-brown staining, showing a weak positive expression, the SR group as brown-brown staining, showing astrong positive expression, and the GO group as light brown-brown staining, showing a moderate positive expression. Conclusion The GO can reduce the bystander effect caused by 12C6+ beam radiation, and its mechanism is related to improving the level of DNA methylation.
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Objective@#To evaluate the effect of breast massage at different time in the early period on maternal lactation after cesarean section.@*Methods@#80 women delivered by cesarean section were randomly selected from maternity ward of a hospital in Shandong province during Jan. 2013 to Jan. 2015; which were divided into four groups, with 20 patients in each. Three groups received 3 times of breast massage every 24 hoursbeginning from 2, 12 and 24 h after cesarean section, respectively. The control group didn't receive any breast massage. The starting time and status of lactation were observed and recorded after cesarean section. 5 ml venous blood sample was drawn from each patient respectively at 2 h before cesarean, 6, 12, 24, 48 and 72 h after cesarean to test the level of serum prolactin. The lactation status of each group was compared.@*Results@#The P50 (P25-P75) of starting time of lactation of the three massage groups and control group were 3 (2-6) h, 4 (2-8) h, 4 (3-12) h and 4 (2-12) h, respectively, whose differences showed no statistical significance (H=3.32, P=0.345).The number of delivered women with adequate lactation 24 hours after cesarean was 10 in the group who received massage beginning from 2 h after cesarean; while the number was only 2 in the control group. The number of delivered women with adequate lactation 48 hours after cesarean was 18 in the group who received massage beginning from 2 h after cesarean; while the number was 8 in the control group. The differences showed statistical significances (P values were 0.021 and 0.008, respectively). The serum prolactin level in the group of delivered women who received massage from 2 h after cesarean was separately (195.9±78.5), (176.0±96.5), (216.4±110.0), (190.0±56.8) and (184.8±69.6) μg/L at 2, 12, 24, 48 and 72 h after cesarean, which were significantly higher than those in the control group (which were (128.8±40.6), (127.3±66.8), (162.2±58.8), (145.1±64.7) and (141.7±49.3) μg/L, respectively) (P=0.007).@*Conclusion@#Breast massage beginning from 2 hours after cesarean section can effectively improve the lactation status of delivered women.
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Objective To investigate the prevalence of metabolic syndrome (MS) among adults in rural areas of Ningxia Hui autonomous region.Methods A cross-sectional study was conducted in 10 639 adults enrolled with a multistage method from Jingyuan County.The MS was identified according to Chinese type 2 diabetes prevention guide (2013).Results Among all the subjects, 17.4% of them met the MS definition with the standardized prevalence of 14.7% after adjustment of sex and age.The prevalence and standardized rate of MS in men were 19.9% and 17.3%, and in women were 15.3% and 13.5%.The prevalence of MS in men was higher than that in women(P<0.001) and increased with aging in both genders.The prevalence and standardized rate of abdominal obesity,hyperglycemia,hypertension,high triglycerides,and low HDL-C were 19.5% and 16.7%, 15.0% and 12.9%, 42.0% and 37.1%, 25.8% and 23.1%, 28.5% and 27.7%,respectively.The rate of abdominal obesity was higher in women than in men (20.5% vs 18.2%, P=0.004), whereas the rate of hypertension, high triglycerides, and low HDL-C were higher in men than in women (all P<0.01).The prevalence of having one parameter of the MS was 68.4%.Conclusion The prevalence of MS is higher in rural areas of Ningxia Hui autonomous region, suggesting that a series of comprehensive prevention measures should be carried out to prevent and control the MS so as to improve the public health conditions in rural areas.
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AIM To determine the contents of polymethoxylated flavones in Citri Reticulatae Pericarpium from eleven cultivar origins.METHODS HPLC was applied to screening extraction solvents (methanol,anhydrous ethanol,95％ ethanol,ethyl acetate and petroleum ether).Ultraviolet-visible spectrophotometry was adopted in the content determination of polymethoxylated flavones in eighteen batches of samples,nobiletin was taken as a reference substance,and the detection wavelength was set at 330 nm.RESULTS Ethyl acetate exhibited the best extraction effect,so it was selected as extraction solvent.Nobiletin showed a good linear relationship within the range of 3.024-13.104 μg/mL (R2 =0.999 8),whose average recovery was 101.37％ with the RSD of 1.34％.The contents of polymethoxylated flavones had obvious differences among samples from different cultivar origins,which were relatively high from Citrus reticulata ‘ Chachi’,Citrus reticulata ‘ Dahongpao’,Citrus reticulata ‘ Tangerina’,Citrus reticulata ‘ Ponkan’,Citrus reticulata ‘ Kinokuni’and Citrus reticulata ‘ Shiyueju’(more than 0.4％).CONCLUSION This simple and accurate method can effectively eliminate the interference of another flavonoids,which is suitable for the content determination of polymethoxylated flavones in Citri Reticulatae Pericarpium.
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With the example analysis method, this paper discussed the feasibility of flipped class to permeate the medical ethics education into medical English teaching. Practice has proved that consciously combining lan-guage teaching with the medical ethics education on various modern networks teaching platform enabled students to foster a correct view of medical ethics and to be qualified medical workers.
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Objective To investigate the clinical characteristics and angiographic findings of cardiogenic shock(CS)following acute myocardial infarction(AMI) in elderly patients.Methods Between January 2015 and April 2016,we carried out a retrospective observational analysis of consecutive elderly patients in Tianjin Chest Hospital,who suffered CS-complicating AMI.Emergency angiography and percutaneous coronary intervention(PCI) were performed after admission.All selected patients were divided into CS and non-CS groups according to whether CS occurred.Electrocardiograph (ECG),cardiac enzyme testing,and ultrasound cardiography were performed after admission to monitor the occurrence of CS.Results The incidence of CS-complicating AMI was 8.33％ (34/408) in elderly patients.Among all CS patients enrolled,the aged patients accounted for 91.89 ％ (3 4/3 7).In-hospital mortality rate was 2 9.41 ％ (10/3 4).There were significant differences between two groups in WBC,H s-CRP,blood glucose,CR and ALT (t =2.403,4.596,6.778,6.109,each P＜0.05).The NT-Pro BNP level,the time of FMC,the frequency of left main and multivessel disease were higher in the CS group than in the non-CS group (each P ＜ 0.05).Conclusions Elderly patients are bearing high risk of CS following AMI.Prolonged FMC time and the presence of left main and/or multivessel lesion are independent risk factors for the development of CS.The optimal revascularisation strategy can improve the clinical outcome of patients with CS.
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OBJECTIVE: The purposes of this study were to measure the orthodontic forces generated by thermoplastic aligners and investigate the possible influences of different activations for lingual bodily movements on orthodontic forces, and their attenuation. METHODS: Thermoplastic material of 1.0-mm in thickness was used to manufacture aligners for 0.2, 0.3, 0.4, 0.5, and 0.6 mm activations for lingual bodily movements of the maxillary central incisor. The orthodontic force in the lingual direction delivered by the thermoplastic aligners was measured using a micro-stress sensor system for the invisible orthodontic technique, and was monitored for 2 weeks. RESULTS: Orthodontic force increased with the amount of activation of the aligner in the initial measurements. The attenuation speed in the 0.6 mm group was faster than that of the other groups (p < 0.05). All aligners demonstrated rapid relaxation in the first 8 hours, which then decreased slowly and plateaued on day 4 or 5. CONCLUSIONS: The amount of activation had a substantial influence on the orthodontic force imparted by the aligners. The results suggest that the activation of lingual bodily movement of the maxillary central incisor should not exceed 0.5 mm. The initial 4 or 5 days is important with respect to orthodontic treatment incorporating an aligner.
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Incisor , RelaxationABSTRACT
Objective To sum up the experience in the treatment on delayed graft function (DGF) complicated with severe pulmonary infection. Methods Clinical data of 15 patients undergoing renal transplantation and suffering delayed graft function (DGF)complicated with severe pulmonary infection in Chengdu Military General Hospital from January 2008 to November 2014 were retrospectively studied.The treatment course and prognosis were studied.Results Continuous renal replacement therapy was adopted and dosage regimen was adjusted according to the dosage adjustment table for continuous veno-venous hemofiltration.Antibiotic de-escalation therapy was adopted.Immunosuppressive agents were adjusted and low-dose adrenocortical hormone and other comprehensive treatment were applied.Of the 15 patients,8 cases underwent tracheal intubation,2 cases underwent mechanical ventilation after tracheotomy and 5 cases underwent noninvasive ventilator-assisted breathing.Through positive rescue treatment,11 patients were cured and 4 patients died.The cure rate was 73% and the fatality rate was 27%.All died patients were complicated with acute respiratory distress syndrome.Conclusions DGF complicated with severe pulmonary infection after renal transplantation is characterized by severe condition and fast progression. Once cases confirmed, continuous renal replacement therapy shall be ‘fully’applied ‘as early as possible’,and dosage regimen shall be adjusted according to the dosage adjustment table for continuous veno-venous hemofiltration.And other comprehensive treatments shall be combined in order to improve the cure rate.
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Growth year is one of the important factors for the quality of Polygala tenufolia. In this study, primary metabolites and secondary metabolites were compared in 1, 2 and 3 years old P. tenufolia cultivated in Shaanxi Heyang. The samples were subjected to ultra-high performance liquid chromatography (UPLC)-quadrupole time-of-flight mass spectrometry (Q-TOF MS) and nuclear magnetic resonance (NMR) analysis, and the obtained data were analyzed using principal component analysis (PCA) and other statistical analysis methods. In addition, content and correlation of different metabolites were also calculated. The results showed no significance between main component contents in 2 year-old and 3 year-old P. Tenufolia, but 1 year-old was statistically different. The contents of primary metabolites, such as fructose, sucrose, and choline increased as time goes on, while glycine and raffinose decreased. The contents of secondary metabolites, such as onjisaponin Fg, polygalasaponin XXVIII, polygalasaponin XXXII increased, while polygalaxanthone III and parts of oligosaccharide multi-ester including tenuifoliose A, tenuifoliose C, tenuifoliose C2 and tenuifoliose H decreased with the extension of the growth years. Growth years has important impact on the quality of P. tenuifolia and the existing growing years of commodity P. tenuifolia have its scientific evidence. This study supplied a new method for the quality evaluation of Chinese medicinal materials.
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BACKGROUND:Although the renal transplantation technology has been quite mature, vascular complications during and after transplantation inevitably occur. OBJECTIVE: To investigate the diagnosis and management of vascular complications during and after renal transplantation. METHODS: A retrospective analysis was performed in 11 patients suffering from vascular complications during and after renal transplantation. During the transplantation, there were two cases of arterial anastomotic stenosis, one case of renal vain transverse, three cases of atherosclerosis plaque of the external iliac artery blocking the transplant renal artery, one case of twisted renal vein. After transplantation, there were two cases of extra renal pseudoaneurysm, one case of arterial anastomotic stenosis, and one case of renal artery obstruction. RESULTS AND CONCLUSION: Two cases of arterial anastomotic stenosis during operation had good recovery, and renal alograft dysfunction occurred after 6 and 11 years, respectively. In the case of renal vain transverse, the renal alograft functioned for 12 years. Among the three cases of atherosclerosis plaque of external iliac artery blocking the transplant renal artery, 1 case presented with renal alograft dysfunction immediately, the other two patients,renal function recovered wel during the folow-up of 6 and 2 years respectively. In the case of twisted renal vein, delayed graft function occurred, and the patient died of severe pulmonary infection 1 month later. The renal alograft dysfunction occurred in the two cases of post-transplantation extra renal pseudoaneurysm. The case of post-transplantation arterial anastomotic stenosis was treated by baloon angioplasty and metalic stent placement via femoralartery, and the renal function became normal during 18 months of folow-up. The case of post-transplantation renal artery obstruction appeared to have delayed graft function, and died of severe pulmonary infection 3 weeks later. These findings indicate that patients with vascular complications during and after renal transplantation can obtain satisfactory outcomes if receiving accurate diagnosis and timely treatment.
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This paper expounds the connotation of doctor-patient communication and its importance in medical prac-tice, and points out the problems existing in the doctor-patient communication in practice. Based on this, advances the ESP teaching ideas, reform mainly from the following several aspects: first, the increase in oral English course arrange-ment class, small class teaching;secondly, on the oral English teaching mode reform, with school, learning, is unified. Once again, to reform on English spoken language teaching material use, both medical professional knowledge and English language skills. Finally, the reform on oral English teaching staff, improve English teachers' team.
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<p><b>OBJECTIVE</b>To study long-term effect on renal function exposed to environmental cadmium.</p><p><b>METHODS</b>Stratified random sampling and cluster sampling method of epidemiological investigations were carried out in northern Guangdong province between April, 2011 and August, 2012. A total of 167 residents who lived in high cadmium exposure area for more than 15 years, aged above 40 were selected in exposed group. Moreover, A total of 145 residents who had similar living and economic conditions and lived in local for more than 15 years, aged above 40 were selected in control group. We used health questionnaires and medical examinations in order to acquire their health status. Home-harvested rice and vegetables were collected using quartering method for detection of cadmium level. Urine specimens of residents were collected for detection of cadmium level and creatinine as well as renal dysfunction biomarkers, namely, N-acetyl-beta-D-glucosamidase (NAG), β2-microglobulin (β2-MG), and retinol binding protein(RBP), respectively. The analysis of spearman rank correlation and multiple regression were used to investigate the relationships between age, urinary cadmium levels and renal injury biomarkers.</p><p><b>RESULTS</b>The cadmium levels in rice and vegetables of exposed group were 0.75 and 0.10 mg/kg, both were significantly higher than 0.07 and 0.01 mg/kg in the control group (Z values were -6.32 and -7.84, all P values < 0.001). The urinary cadmium level of exposed group was 8.29 µg/g · cr, which was higher than that of the control group 2.03 µg/g · cr with significant difference (Z value was -11.39, P < 0.001). After stratified the total population by age, the urinary cadmium level in 40-49 years, 50-59 years and ≥ 60 years subgroups were 7.22, 8.71, and 13.10 µg/g · cr, which both were significantly higher than 1.80, 2.04, and 2.05 µg/g · cr in the control group (Z values were -5.22, -7.41, and -7.14, all P values < 0.001). After stratified the total population by gender, the urinary cadmium level of male and female were 5.12 and 12.36 µg/g · cr, which both were significantly higher than 1.79 and 2.16 µg/g · cr in the control group (Z values were -7.68 and -9.03, all P values < 0.001). Comparing the differences of renal dysfunction biomarkers (NAG, β2-MG, RBP) between two groups. The level of urinary β2-MG and RBP of exposed group were 0.21 and 0.04 µg/g · cr, which were higher than 0.05 and 0.00 µg/g · cr of the control group with significant difference (Z value was -7.08 and -9.65, all P values < 0.001). Pearson correlation analysis showed that NAG, β2-MG and RBP were positively correlated with urinary cadmium and age, the correlation coefficients were 0.57, 0.49, 0.21 and 0.22, 0.26, 0.23 respectively (all P values < 0.001). After adjusting the effect of age, it was appeared that urinary cadmium levels contributed most to the alteration of NAG, β2-MG and RBP, the standardized regression coefficients were 0.57, 0.49 and 0.20 (all P values < 0.001), and suggested that the cadmium body burden was one of the most important factors for renal dysfunction.</p><p><b>CONCLUSION</b>Residents, who had cadmium contaminated rice and vegetables for a long time, would take the risk of increasing body burden of cadmium and urinary early biomarkers of renal tubular injury that referred to occurrence of renal dysfunction.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Cadmium , Creatinine , Environmental Exposure , Epidemiologic Studies , Food Contamination , Kidney Diseases , Multivariate Analysis , Oryza , Risk , Time , VegetablesABSTRACT
<p><b>OBJECTIVE</b>To measure the orthodontic forces exerted on the upper right central incisor with the increase of the distance of tooth movement and the thickness of the aligner.</p><p><b>METHODS</b>The labial movement of upper right central incisor at various distances (0.3, 0.6, 0.9, 1.2, 1.5, 1.8 mm) was designed and the stereolithography model (2 times bigger than the original model) was created with 3-D scanning and tomography output. These models were used to fabricate the aligners with different thicknesses (0.8, 1.0, 1.5 and 2.0 mm) of the thermoplastic materials (6 samples for various distances of tooth movement and thicknesses). Orthodontic forces exerted on the upper right central incisor were measured with the micro-stress sensor measurement system.</p><p><b>RESULTS</b>The orthodontic forces increased with the increase of the thickness of the aligner at the same distance of tooth movement (P < 0.05). The orthodontic force was (1.237 ± 0.082), (1.543 ± 0.059), (3.602 ± 0.102), (6.734 ± 0.063) N when the labial movement of upper right central incisor was 0.3 mm with the aligner of 0.8, 1.0, 1.5, 2.0 mm. The orthodontic forces also increased with the increase of the distance of the tooth movement at the same thickness of the aligner(P < 0.05). The orthodontic force of the aligner of 0.8 mm were (1.354 ± 0.039), (1.288 ± 0.037), (1.479 ± 0.031), (1.799 ± 0.039) N when the upper right central tooth labial movement at 0.6, 0.9, 1.2, 1.5 mm.</p><p><b>CONCLUSIONS</b>The orthodontic forces increased with the increase of the distance of tooth movement and the thickness of the aligner.</p>