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ObjectiveTo explore host factors interacting with influenza virus nucleoprotein （NP） and study their effects on influenza virus replication， as well as the mechanism of gardenia jasminoides iridoid glycoside （IGE） in inhibiting influenza virus. MethodA yeast two-hybrid system was utilized to screen host factors that interacted with influenza virus NP. Heterogeneous nuclear ribonucleoprotein D0 （HNRNPD）， glucosamine-6-phosphate deaminase 1 （GNPDA1）， poly（rC）-binding protein 1 （PCBP1）， and protein inhibitor of activated signal transducer and activator of transcription （STAT） protein 1 （PIAS1） were validated by immunoprecipitation assay. The effects of PIAS1 and HNRNPD on influenza virus replication were compared by a dual luciferase assay， and the effects of IGE on influenza virus replication were examined in the presence of transfected ribonucleoprotein （RNP） and knockdown of PIAS1. ICR mice were randomly divided into a normal group， model group， oseltamivir phosphate group， and high， medium， and low dose IGE groups， with 10 mice in each group. In addition to the normal group， each group was infected with the influenza A virus FM1 strain by nasal drip to establish a viral pneumonia model. The high， medium， and low dose IGE groups were given drugs of 50， 25， and 12.5 mg∙kg-1 by gavage， and the oseltamivir phosphate group was given the drug of 27.5 mg∙kg-1 by gavage. Equal amounts of distilled water were instilled in the normal and model groups for four consecutive days. Later， protein expression of PIAS1， NP， phosphorylated （p）-STAT3， STAT3， p-STAT1， and STAT1 were detected in the lung tissue by Western blot. ResultIn yeast two-hybrid assays， 16 potential host targets interacting with influenza virus NP were identified. Immunoprecipitation experiments revealed that HNRNPD and PIAS1 could interact with influenza virus NP. The dual luciferase reporter assays found that both PIAS1 knockdown and overexpression significantly affected IAV RNP activity （P<0.05， P<0.01）， and the effect of HNRNPD on IAV RNP was not significant. Both high and low dose IGE groups reduced influenza virus replication （P<0.05） and reversed the increase in influenza virus replication caused by the knockdown of PIAS1（P<0.05， P<0.01）. The expressions of PIAS1， NP， p-STAT3， p-STAT1， and STAT1 in the lung tissue of infected mice were reduced to different degrees in each IGE group （P<0.05， P<0.01）. ConclusionPIAS1 interacts with influenza virus NP and is able to inhibit influenza virus replication. IGE may exert antiviral effects by inhibiting the activity of IAV RNP through the PIAS1/STAT1 pathway.
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Objective:To evaluate the guiding value of ultrasound-guided selective nerve root block in the surgical treatment of multilevel lumbar degeneration.Methods:Retrospective case-control study was used. Clinical data of 47 patients with multi-level lumbar degeneration who underwent decompression surgery in Honghui Hospital, Xi′an Jiaotong University from January 2019 to December 2021 were retrospectively analyzed. They were divided into nerve root block group ( n=22)and non-nerve root block group( n=25) according to whether ultrasound-guided selective nerve root block was performed before decompression surgery. The operation time, intraoperative blood loss, number of decompression laminae, postoperative drainage volume and length of stay of the two groups were recorded and compared. The visual analogue scale of low back pain, the visual analogue scale (VAS) of leg pain, the Japanese orthopaedic association (JOA) score and Oswestry disability index (ODI) score were all compared before surgery and during follow-up between the two groups. Measurement data with normal distribution were represented as mean±standard deviation( ± s), and the comparison between groups was conducted using the paired t-test. Chi-square test was used for counting data. Results:All 47 patients successfully completed the operation without any serious complications such as neurovascular injury. All patients were followed up for (27.6±7.5)months. In the nerve root block group, the operation time, intraoperative blood loss, number of decompression laminae, postoperative drainage volume and hospital stay were (90.5±12.6) min, (110.5±15.8) mL, 1.2±0.8, (85.6±15.8) mL, (6.2±2.8) d, respectively. In the non-root block group, they were (190.6±25.5) min, (450.5±24.8) mL, 3.8±1.6, (210.5±16.8) mL, (9.5±2.2) d, respectively. The above indexes in the nerve root closure group were less than those in the non-root closure group, and the difference was significant between the two groups ( P< 0.05). The scores of VAS of low back pain and leg pain, JOA and ODI in both groups were significantly improved after surgery and during the follow-up period when compared with those of pre-operation ( P< 0.05). The VAS scores of low back pain on the 3rd day, 6 months after operation and at the last follow-up in the nerve block group were 3.2±1.4, 1.4±0.8, 0.5±0.2, the JOA scores were 15.8±4.3, 21.3±5.6, 25.6±1.4, and the ODI scores were 50.6±10.3, 22.8±7.8, 16.8±4.2, respectively. The VAS scores of low back pain on the 3rd day, 6 months after operation and at the last follow-up in the non-nerve block group were 5.1±1.8, 3.4±1.2, 1.8±0.5, the JOA scores were 14.1±4.8, 20.5±3.2, 24.2±1.8, and the ODI scores were 60.5±9.8, 31.6±8.2 and 21.3±5.5, respectively. The difference between the two groups was statistically significant ( P<0.05). However, there was no statistical difference in the VAS scores of leg pain between the two groups after surgery and during follow-up ( P>0.05). At the last follow-up, the internal fixation position of the two groups was good, no loosening and displacement, and bone graft fusion was good. Conclusion:For patients with multi-level lumbar degeneration, ultrasound-guided selective nerve root block before surgery can identify the responsible segment, and selective decompression and fusion based on this can effectively reduce surgical trauma, while improving patients′ back and leg pain and physical function, which has important surgical guidance value.
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BACKGROUND:Lower limb peri-knee muscle strength training and neuromuscular electrical stimulation are generally safe and effective rehabilitation methods for patellofemoral joint pain,but the mechanism of their intervention is still unclear. OBJECTIVE:To determine the effect of muscle strength training combined with neuromuscular electrical stimulation on pain,lower extremity function and biomechanical characteristics in patients with patellofemoral pain. METHODS:Thirty-seven patients with patellofemoral pain were randomly divided into muscle strength training combined with electrical stimulation group(trial group,n=19)and muscle strength training group(control group,n=18).Both groups underwent intervention training for 6 weeks,three times a week.The visual analog scale and anterior knee pain scale were used to evaluate the pain level and functional level of the knee.Kinematic and kinetics data during running were collected by using an infrared motion capture system and a three-dimensional force platform simultaneously.A two-way analysis of variance with repeated measures(group*time)was applied to analyze the data. RESULTS AND CONCLUSION:(1)After the intervention,the visual analog scale scores of the trial group and the control group were significantly decreased(P<0.001),and the anterior knee pain scale scores were significantly increased(Ptrial group<0.001,Pcontrol group=0.001)in the trial group and control group.The anterior knee pain scale scores of the trial group were significantly higher compared to the control group after the intervention(P=0.001).(2)The peak knee flexion angle(P=0.011),peak knee extension moment(P<0.001),the peak knee internal rotation moment(P=0.008),the peak patellofemoral stress(P<0.001)and the peak patellofemoral contact force(P<0.001)were significantly decreased in the trial and control groups during running after the intervention compared with those before the intervention.(3)In conclusion,both muscle strength training and muscle strength training combined with electrical stimulation training are helpful to improve the subjective pain and lower limb function of patellofemoral pain patients,enhance the movement pattern during running and reduce the stress of the patellofemoral joint.Compared with muscle strength training alone,muscle strength training combined with electrical stimulation can improve lower limb function more significantly.
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Objective:To analyze the hepatitis B vaccine (HepB) vaccination rate and immune level among children aged eight months to 14 years in Dali Bai Autonomous Prefecture, and to evaluate the effect of immune prevention and control.Methods:A stratified and cluster sampling was designed to survey and collect serum samples of the 17 236 cases from 12 counties (cities) in Dali Bai Autonomous Prefecture. The cases were divided into four age groups (eight to 17 months, 18 to 35 months, three to six years, seven to 14 years). Serum levels of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) were detected by enzyme linked immunosorbent assay (ELISA). Statistical analysis was conducted by Spearman rank correlation analysis and chi-square test.Results:The overall HepB vaccination rate, timely vaccination rate, and full course vaccination rate among 17 236 children were 98.78%(17 025/17 236), 84.13%(14 500/17 236) and 97.69%(16 838/17 236), respectively. The positive rates of HBsAg and anti-HBs were 0.28%(49/17 236) and 70.57%(12 164/17 236), respectively. From 2013 to 2020, the trend of the vaccination rate, timely vaccination rate, and full vaccination rate of HepB increased year by year. The timely vaccination rate (88.64%(3 989/4 500)) and the positive rate of anti-HBs (92.78%(4 175/4 500)) were the highest at the age of eight to 17 months. Age was negatively correlated with the positive rate of anti-HBs ( rs=-0.427, P<0.001). The vaccination rate, full course vaccination rate, and positive rate of HBsAg in males were higher than those in females ( χ2=4.41, 6.05 and 0.92, respectively, all P<0.05), while the vaccination rate, timely vaccination rate and full course vaccination rate in rural areas were higher than those in urban areas ( χ2=51.75, 4.81 and 33.20, respectively, all P<0.05). The vaccination rate, full course vaccination rate and the positive rate of anti-HBs in minority nationality were higher than those in Han nationality ( χ2=29.44, 11.83 and 5.04, respectively, all P<0.05). The differences were all statistically significant. The positive rates of anti-HBs in individuals with a history of immunization, timely vaccination, and full vaccination of HepB were higher than those in individuals without a history of HepB immunization, timely vaccination, and full vaccination, and the differences were all statistically significant ( χ2=64.67, 65.46 and 13.39, respectively, all P<0.001). Conclusions:The positive rate of anti-HBs in the older age group has decreased significantly. While continuing carrying out routine immunization work, monitoring, strengthening supplementary immunization should be emphasized, and HepB vaccination in older children should be explored to consolidate the immune barrier.
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Objective:To observe the clinical efficacy of Mahuang Fuzi Xixin Decoction combined with balanced acupuncture in the treatment of migraine with yang deficiency and cold congealing syndrome.Methods:Randomized controlled trial. Totally 91 cases of migraine with yang deficiency and cold congealing syndrome in our hospital from March 2021 to May 2022 were selected and divided into 45 cases in the Western medicine group and 46 cases in the integrated Chinese and Western medicine group according to random number table method. The Western medicine group took flunarizine hydrochloride capsules orally, and the integrated Chinese and Western medicine group combined ephedrine and aconiti asarum decoction + balanced acupuncture treatment on the basis of the Western medicine group. Both groups were treated for 1 month. Traditional Chinese Medicine syndrome score was performed before and after treatment, the degree of headache was assessed by VAS scale, and the impact of headache on life was assessed by Headache Impact Test-6 (HIT-6); the levels of 5-hydroxytryptamine (5-HT) and calcitonin gene related peptide (CGRP) were determined by radioimmunoassay. The adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 82.22% (37/45) in the Western medicine group and 95.65% (44/46) in the integrated Chinese and Western medicine group, with statistical significance ( χ2=4.20, P=0.041). After treatment, the scores of headache, hair, urine and cold limbs in the integrated Chinese and Western medicine group were lower than those in the Western medicine group ( t values were 18.49, 22.29, 21.31, 27.49, P<0.01), and the scores of VAS and HIT-6 were lower than those in the Western medicine group ( t values were 23.20, 9.33, P<0.01). After treatment, the level of 5-HT in the integrated Chinese and Western medicine group [(98.34±6.23) μg/L vs. (85.23±4.21) μg/L, t=11.74] was higher than that of the Western medicine group ( P<0.01); CGRP [(11.24±1.99) ng/L vs. (15.22±2.52) ng/L, t=8.37] was lower than that of the Western medicine group ( P<0.01). During treatment, the incidence of adverse reactions was 2.22% (1/45) in the Western medicine group and 2.17% (1/46) in the integrated Chinese and Western medicine group, without statistical significance ( P>0.05). Conclusion:Mahuang Fuzi Xixin Decoction combined with balanced acupuncture can effectively improve the clinical symptoms and life quality of patients of migraine with yang deficiency and cold congealing, and the clinical efficacy can be promoted.
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Objective:To observe the efficacy of traditional Qigong exercise combined with Tuina(Chinese therapeutic massage)manipulations in treating lower cervical disc herniation(CDH).Methods:A total of 120 CDH patients who met the inclusion criteria were randomly divided into an observation group and a control group,with 60 cases in each group.Patients in both groups were given the same Tuina manipulations.In addition,patients in the observation group practiced traditional Qigong exercise,and those in the control group did conventional neck exercise.After 8 weeks of treatment,the efficacy of the two groups was observed.Follow-up was conducted 3 months after the end of the treatment to record any recurrence.Results:The total effective rate of the observation group was higher than that of the control group(P＜0.05).The improvement in symptom scores was more significant in the observation group than in the control group(P＜0.05).There was inter-group statistical significance in comparing the cross-sectional area and fatty infiltration of certain cervical muscles(P＜0.05).In addition,the recurrence rate in the observation group was lower than that in the control group(P＜0.05).Conclusion:On the basis of the same Tuina manipulation treatment,the efficacy of traditional Qigong exercise in treating CDH is superior to that of conventional neck exercise,with more significant improvements in pain and quality of life and a lower recurrence rate.
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Hepatocellular carcinoma (HCC) is one of the most common tumors of primary hepatic carcinoma, and one of the major causes of cancer related deaths worldwide. HCC has high incidence and mortality, with limited treatment. The prevention and treatment of HCC faces great challenges. At present, interventional therapy combined with immune plus targeted therapy has a synergistic effect and a significant effect in prolonging the survival time of patients and controlling tumors, which brings a brand-new therapeutic hope to patients with advanced HCC. The authors report a case of advanced HCC with lung metastasis who underwent hepatic arterial infusion chemotherapy combined with immune plus targeted therapy, with a result of good clinical effect on tumor controlling in a short time.
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Objective: To investigate the effect and safety of tranexamic acid sequential rivaroxaban on perioperative blood loss and preventing thrombosis for elderly patients during lumbar interbody fusion (LIF) with a prospective randomized controlled study. Methods: Between April and October 2019, the elderly patients with lumbar degenerative diseases requiring LIF were included in the study, among which were 80 patients met the selection criteria. According to the antifibrinolysis and anticoagulation protocols, they were randomly divided into a tranexamic acid sequential rivaroxaban group (trial group) and a simple rivaroxaban group (control group) on average. Finally, 69 patients (35 in the trial group and 34 in the control group) were included for comparison. There was no significant difference in general data ( P>0.05) such as gender, age, body mass index, disease duration, diseased segment, type of disease, and preoperative hemoglobin between the two groups. The operation time, intraoperative blood loss, drainage within 3 days after operation, perioperative total blood loss, and proportion of blood transfusion patients were compared between the two groups, as well as postoperative venous thrombosis of lower extremities, pulmonary embolism, and bleeding-related complications. Results: The operations of the two groups completed successfully, and there was no significant difference in the operation time ( P>0.05); the intraoperative blood loss, drainage within 3 days after operation, and perioperative total blood loss in the trial group were significantly lower than those in the control group ( P<0.05). The proportion of blood transfusion patients in the trial group was 25.71% (9/35), which was significantly lower than that in the control group [52.94% (18/34)] ( χ2=5.368, P=0.021). Postoperative incision bleeding occurred in 4 cases of the trial group and 3 cases of the control group, and there was no significant difference in bleeding-related complications between the two groups ( P=1.000). There was 1 case of venous thrombosis of the lower extremities in each group after operation, and there was no significant difference in the incidence between the two groups ( P=1.000). Besides, no pulmonary embolism occurred in the two groups. Conclusion: Perioperative use of tranexamic acid sequential rivaroxaban in elderly LIF patients can effectively reduce the amount of blood loss and the proportion of blood transfusion patients without increasing the risk of postoperative thrombosis.
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Objective To investigate the effect of muscle function on structural stress in patient with lumbar disc herniation (LDH), by observing the stress changes in LDH lumbar-pelvis finite element model loaded with muscle force. Methods One normal healthy volunteer and one LDH patient were selected. Their CT data were collected to establish two corresponding normal and LDH lumbar-pelvis finite element models, and their gait data were also simultaneously collected to drive the AnyBody musculoskeletal model. The muscle force around the lumbar and pelvis as well as the hip-joint force were obtained as the loading condition. Self-loading of the normal and LDH model as well as the normal model loaded with LDH muscle forces were conducted seperately. Then the stress changes in L4 and L5 intervertebral discs and sacroiliac joints under two above loading conditions were compared. Results The stress curve of normal model loaded with LDH muscle force showed a unimodal stress curve, instead of a bimodal curve, and such trend of stress-time curve was as same as the trend of the LDH model during self-loading. But the stress difference in L4 and L5 intervertebral discs and sacroiliac joint of the normal model loaded with LDH muscle force was smaller than that in the LDH model during self-loading. Conclusions Abnormal muscle function of LDH could lead to abnormal joint stress of the intervertebral discs and sacroiliac joint. Structural imbalance itself could lead to stress imbalance, and muscle as a driving factor was an important cause of anomaly structural dynamic stress, thus leading to abnormal joint motion patterns. Therefore, attention should be paid to assessment of the imbalance of peripheral muscle function in clinical treatment of LDH.
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Objective To evaluate different inflammation markers for predicting the risk of acute kidney injury (AKI) in sepsis patients. Methods A retrospective observational study was conducted. The adult patients with sepsis for more than 24 hours admitted to intensive care unit (ICU) of Beijing Friendship Hospital, Capital Medical University from March 1st, 2010 to November 1st, 2017 were enrolled. Inflammatory markers such as white blood cell count (WBC), erythrocyte sedimentation rata (ESR), neutrophil and lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT), etc. were collected at ICU admission. The patients were divided into different groups according to the 24-hour AKI, and subgroup analysis was conducted according to the criteria of the Global Renal Disease Prognostic Organization (KDIGO)-AKI staging. The receiver operating characteristic curve (ROC) was plotted with statistically significant inflammatory markers to assess the predictive value of AKI for patients with systemic infection. Results A total of 753 patients with sepsis were enrolled. 405 AKI patients were diagnosed within 24 hours, with a prevalence of 53.8%. There were 118 cases (15.7%) in AKI stage 1, 48 cases (6.4%) in stage 2 and 239 cases (31.7%) in stage 3. PCT in AKI group was significantly higher than that in non-AKI group [μg/L: 4.98 (1.51, 32.75) vs. 3.00 (0.37, 11.40), P < 0.01]. PCT of AKI stage 2 group was significantly higher than that of AKI stage 1 and 3 groups [μg/L: 27.86 (4.80, 37.26) vs. 3.00 (0.98, 16.10), 4.98 (1.51, 42.55), both P < 0.01]. Although ESR in AKI group was lower than that of non-AKI group (mm/1 h: 45.25±37.42 vs. 52.28±34.89, P < 0.01), there was no significant difference among the subgroups. CRP in AKI group was slightly higher than the non-AKI group [mg/L: 96.00 (42.20, 160.00) vs. 73.60 (21.01, 157.50)], but the difference was not statistically significant (P > 0.05). There was no significant difference in WBC or NLR between AKI group and non-AKI group. It was shown by ROC curve analysis that the area under ROC curve (AUC) of PCT in predicting the occurrence of septic AKI was 0.619, with the 95% confidence interval (95%CI) of 0.545-0.689 (P < 0.01). When the cut-off value of PCT > 0.4 μg/L, the sensitivity was 94.2%, the specificity was 26.5%, the accuracy was 64.2%, the positive predictive value was 61.6%, and the negative predictive value was 78.6%. Conclusion PCT could be a marker to predict AKI with sepsis patients.
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Objective To identify the threshold of percentage of body fat (BF％) associated with diabetes mellitus,hypertension and dyslipidemia in an elderly Chinese population.Methods An individual was considered as a subject if they exhibited any one of the three cardiovascular disease risk factors:diabetes mellitus,hypertension or dyslipidemia.A total of 1 140 subjects were recruited from the Physical Examination Center of Tianjin Hospital,China (male 511,female 629,aged ≥60 years).Questionnaire interview,physical examination,body composition measurement,blood biochemistry measurement,muscle strength measurement and other measurements were performed for each subject.Receiver operating curves (ROC) were created to determine the optimal percentage of body fat cutoff points,with the presence of diabetes mellitus,hypertension or dyslipidemia as outcome variable.Results The percentage of subjects with at least one of the following conditions (diabetes mellitus,hypertension or dyslipidemia) was 62.8％ for men and 73.9％ for women.Increased percentage of body fat was associated with an increased occurrence of diabetes mellitus,hypertension or dyslipidemia in the elderly,particularly among women.The ROC curve shows that the threshold of fat percentage in men and women was 28.2％ and 36.6％,respectively.Conclusion The risks of diabetes,hypertension and dyslipidemia is closely related to elevated body fat mass in the elderly.The percentage of body fat mass is an important indicator of obesity,threshold of BF ％ can provide reference for clinical obesity intervention in elderly patients.It also can provide reference for the treatment and prevention of cardiovascular disease.
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Objective To explore the biomechanical mechanisms of correlation between lumbar disc degeneration and sacroiliac joint disorder though investigating the biomechanical characteristics of lumbar disc degeneration with sacroiliac joint disorders.Methods One normal healthy volunteer and two patients with lumbar disc herniation and sacroiliac joint disorders (one was with sacrum disorders and the other was with ilium disorders) were selected.Their CT data were collected to establish three corresponding lumbar-pelvis finite-element models,and their gait data were also simultaneously collected to drive the AnyBody musculoskeletal model.The muscle force around the lumbar and pelvis as well as the hip joint force were acquired as loading condition for finite element analysis.The stress changes in L4 and L5 intervertebral discs and sacroiliac joints of the patients and normal volunteer were compared.Results There was no significant difference in the stress of the two sides of L4,L5 disc and two sacroiliac joints in normal model,with a bimodal stress curve.However,in the models of sacrum disorders and ilium disorders,the bimodal stress curve peaks changed,even disappeared.The peak stress differences in left and right side of L4 disc were 0.55 MPa and 0.80 MPa,respectively,the peak stress differences in left and right side of L5 disc were 4.05 MPa and 2.08 MPa,respectively,and the peak stress differences in left and right side of sacroiliac joints were 0.96 MPa and 3.32 MPa,respectively.Conclusions The lumbar disc degeneration with sacroiliac joint disorder leads to the tilt of the body loading line,and sacroiliac joint disorder can aggravate the imbalances of stress on the body sides.The impact of sacroiliac joint dysfunction cannot be ignored in the treatment of lumbar disc herniation.
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OBJECTIVE:To investigate the effects and safety of erythropoietin on nerve function and brainstem auditory evoked potential in the preterm children with brain damage. METHODS:46 preterm children with brain damage were randomly di-vided into treatment group and control group,with 23 cases in each group. Control group received conventional symptomatic treat-ment as respiratory support,nutritional support,vitamin K supplement and ganglioside. Treatment group was additionally given rhE-PO for injection (CHO cell) 500 IU/kg hypodermically,3 times a week,on the basis of control group. Both group received 3-4 weeks of treatment continuously. MDI,PDI,the content of serum nerve injury factor(NSE,S-100β),latent period and peak inter-val of brainstem auditory evoked potential were compared between 2 groups before and after treatment,and the occurrence of ADR was observed in 2 groups. RESULTS:There was no statistical significance in MDI,PDI,the content of serum nerve injury mole-cule,latent period and peak interval of brainstem auditory evoked potential between 2 groups before treatment (P>0.05). After treatment,MDI and PDI of 2 groups increased significantly,while the content of serum nerve injury factor,latent period and peak interval of brainstem auditory evoked potential decreased significantly;the treatment group was better than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Erythropoietin can significantly im-prove intelligence development,protect the damaged nerve cells and auditory nerve pathways with good safety.
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Objective To analyze the differences between CyberKnife radiotherapy with different numbers of gold markers.Methods A total of 424 patients undergoing CyberKnife with gold markers from 2013 to 2014 were enrolled and analyzed.In these patients,330 patients with no less than 3 gold markers were assigned to observation group and 94 patients with less than 3 gold markers were assigned to control group.The setup error and treatment error were recorded and analyzed for each patient.Results The mean setup error and mean treatment error were 0.031 mm and 0.314 mm in the observation group and 0.057 mm and 1.122 mm in the control group,respectively.Conclusion Tracking no less than 3 gold markers can substantially improve the accuracy and quality of treatment.
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Objective To analyze the characteristics of change in plasma cholesterol level in patients with sepsis, and to explore its relationship with prognosis and its clinical significance. Methods A retrospective analysis was conducted. 568 patients with sepsis admitted to Department of Critical Care Medicine of Beijing Friendship Hospital Affiliated to Capital Medical University from August 2013 to August 2015 were enrolled, and 475 patients without sepsis hospitalized in the same period served as the control. The basic clinical data of the two groups were collected, and the results of blood fat and biochemical parameters were compared. The patients with sepsis were divided into death group and survival group, and risk factors influencing the prognosis of patients with sepsis were analyzed with multivariate logistic model regression analysis. Results Compared with non-sepsis patients, the levels of plasma total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) in the patients with sepsis were significantly lower [TC (mmol/L): 2.5±1.2 vs. 3.4±1.4, t = 4.274, P = 0.021; HDL-C (mmol/L): 1.6±0.9 vs. 2.5±0.8, t = 3.413, P = 0.018], and that of low density lipoprotein cholesterol (LDL-C) showed no statistically significant difference (mmol/L: 1.9±0.9 vs. 2.1±0.9, t = 0.749, P = 0.614). In the patients with sepsis, the patients in death group (n = 227) were older than those of the survival group (n = 341, years: 74.3±15.5 vs. 65.5±17.5, t = 4.037, P = 0.012), serum creatinine (SCr) was higher than that of survival group (μmol/L: 251.0±115.6 vs. 167.4±108.7, t = 3.254, P = 0.023), the levels of plasma TC, HDL-C and LDL-C were significantly lower than those of survival group [TC (mmol/L): 2.2±1.6 vs. 2.9±1.1, t = 3.057, P = 0.023; HDL-C (mmol/L): 1.4±0.8 vs. 1.9±0.8, t = 4.692, P = 0.016; LDL-C (mmol/L): 1.7±0.7 vs. 2.0±0.8, t = 2.541, P = 0.038]; there was no significant difference in the proportion of male, body mass index (BMI), based disease, intensive care unit (ICU) hospitalization time, the severity of the disease and other biochemical indexes between two groups. With single factor analysis with indicators of statistical significance as a covariate into binary logistic regression equation, the results show that age was the risk factor of death in patients with sepsis [odds ratio (OR) = 1.024, 95% confidence interval (95%CI) = 1.010-1.048, P = 0.009], and TC was the protective factor on the prognosis of patients with sepsis (OR = 0.747, 95%CI = 0.682-0.811, P = 0.013). Conclusions Plasma cholesterol levels in patients with sepsis were significantly lowered, and the levels in death group was significantly lower than that in the survival group. TC may be used as a clinical indicator to assess the outcome of patients with sepsis.
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Objective To explore the feasibility of using contralateral breast as the donor for immediately breast reconstruction or chest wall defect repair after mastectomy in breast cancer patients. Methods From Jul. 2013 to Mar. 2016, contralateral breast fat flap was used as the donor for 8 breast cancer patients with immediate autologous non-microsurgical breast reconstruction or chest wall defect repair after mastectomy. All participants in this study received preoperative oncological screening with ultrasound, mammography, and magnetic resonance imaging which revealed the absence of pathological abnormalities in the donor breast. Results Among the 8 pa-tients, 4 patients underwent immediate breast reconstruction and 4 received chest wall defect repair. Only 1 pa-tient undergoing breast reconstruction had minor complications with little or no effect on the final outcome. No patient undergoing chest wall defect repair had postoperative complications. The functional and aesthetic out-comes were very satisfactory. Regular follow-ups were from 3 to 34 months with no recurrence found up to the present. Conclusions This article presents the first case for immediately breast reconstruction or chest wall de-fect repair using contralateral breast as the donor. The surgical method has some complications but with good aesthetic outcomes, which can be an option for breast cancer patients with hypertrophic and ptotic breast.
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Objective:To study the health equity and explore the influencing factors of health inequities among those insured in New Rural Cooperative Medical System and to provide theoretical and factual basis for improvement of medical insurance system through .Method:Using concentration index decomposition to explore the sources of inequity in health outcomes and the degree of horizontal inequity in health outcomes .Results:Economical level leads that the concentration indexes of two week prevalence favor the poor , i.e.the worse the health outcome of the rich is.Economical level leads that the concentration indexes of chronic disease prevalence and self -reported health defective rate favor the rich , i.e.the worse the health outcome of the poor is .Conclusion:Economic level is the primary factors affecting two weeks prevalence , age, culture level, the employment situation is the factors al-leviate health outcomes unfair .Increase people′s economic level and cultural level , improve the situation of em-ployment is important to the health equity .
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Objective To investigate the difference of nerve behavior among the different types of fullterm small for gestational age infants(SGA) infants and the reasons.Methods The neonatal behavioral neurological assessment(NBNA) scores were given for 148 full-term SGA infants aged 7,14 and 28 days born in Affiliated Hospital of Hebei University.The comparason analysis was conducted among three types including symmetic,asymmetric and the mixture of them.Results Significant differences (P ＜ 0.05) were found between the NBNA scores for full-term SGA infants and normal infants.The NABA scores of full-term SGA infants were lower than those of normal infants.The NBNA scores for three types of full-term SGA infants followed the order of asymmetric ＞ symmetric ＞ mixture of them,significant difference was found between any two types of three types(P ＜ 0.05).Conclusion Full-term SGA infants show the poorer quality of nerve behavior compared with the nomal infants.The neurodevelopment levels for three types of full-term SGA infants are asymmetric,symmetric,mixture of them in the order.
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Objective To investigate the clinical value of combined detection of H‐FABP with cTnI in the diagnosis of myo‐cardial damage caused by hypoglycemia .Methods Levels of blood H‐FABP and cTnI were examined at 0 to 3 h ,24 h ,48 h after hy‐poglycemia diagnosed ,and were compared with the control group .The levels of H‐FABP and cTnI at 24 h after hypoglycemia diag‐nosed were compared among different groups separated according to the decreasing extent of blood sugar (1 .0 to 2 .1 mmol/L ,0 .05) .The statistic difference of the increasing cTnI levels existed for 24 h (P0 .05) .The increasing extent of H‐FABP and cTnI levels was obvious for group with blood sugar <1 .0 mmol/L ,duration of hypoglycemia ≥24 h and have hypoglycemia symptom ,these data have obvious statistic difference compared with other groups(P<0 .05 ,P<0 .01 ,P<0 .01) .The sensitivity and specificity of H‐FABP methods were higher than those of cTnI ac‐cording to the 0 to 3 h and 24 h detection data ,while the opposite result was found for 48 h .Conclusion Combined detection of H‐FABP with cTnI could be well applied in the diagnosis of myocardial damage caused by hypoglycemia .
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Objective To evaluate intraoperative tracing of sentinel lymph nodes ( SLNs) by fluorescence imaging combined with carbon nanoparticles .Methods 112 breast cancer patients eligible for sentinel lymph node biopsy were randomly assigned to the combination group (56 cases)receiving indocyanine green (ICG)and carbon nanoparticles as the lymphatic mapping tracers and ICG alone group (56 cases).Intraoperative frozen sec-tion was performed , followed by conventional histopathology .Results In the combination group , subcutaneous lymphatic vessels were successfully visualized in 53 patients and the detection rate was 94.6%(53/56).The flu-orescence SLNs were successfully detected in 54 patients and the detection rate was 96.4%(54/56)in ICG alone group.In the combination group , SLNs were successfully identified in 54 patients by fluorescence and 52 patients by black dyed, and the SLNs detection rate was 100%(56/56).While in the ICG alone group, the SLNs were found in 52 patients and the detection rate was 92.9%(52/56)(χ2 =2.3, P>0.050).The average number of detected SLNs was 3.7 ±1.5 ( 205/56 ) in combination group vs 2.5 ±1.4 ( 130/52 ) in ICG alone group ( t =-3.5, P=0.001).17 metastatic SLNs were found in 10 patients in the combination group vs 12 metastatic SLNs in 9 patients in ICG alone group .Conclusion Combination of ICG and carbon nanoparticles for mapping sentinel lymph nodes in breast cancer patients can increase the number of SLNs detected and the detection rate , reducing the rate of misdiagnosis and false negative rate .