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1.
Article in English | WPRIM | ID: wpr-874365

ABSTRACT

Purpose@#Systemic inflammatory response is a critical factor that promotes the initiation and metastasis of malignancies including pancreatic cancer (PC). This study was designed to determine and compare the prognostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and fibrinogen-to-albumin ratio (FAR) in resectable PC and locally advanced or metastatic PC. @*Materials and Methods@#Three hundred fifty-three patients with resectable PC and 807 patients with locally advan-ced or metastatic PC were recruited in this study. These patients were classified into a training set (n=758) and a validation set (n=402). Kaplan-Meier survival plots and Cox proportional hazards regression models were used to analyze prognosis. @*Results@#Overall survival (OS) was significantly better for patients with resectable PC with low preoperative PLR (p=0.048) and MLR (p=0.027). Low FAR, MLR, NLR (p < 0.001), and PLR (p=0.003) were significantly associated with decreased risk of death for locally advanced or metastatic PC patients. FAR (hazard ratio [HR], 1.522; 95% confidential interval [CI], 1.261 to 1.837; p < 0.001) and MLR (HR, 1.248; 95% CI, 1.017 to 1.532; p=0.034) were independent prognostic factors for locally advanced or metastatic PC. @*Conclusion@#The prognostic roles of FAR, MLR, NLR, and PLR in resectable PC and locally advanced or metastatic PC were different. FAR showed the most prognostic power in locally advanced or metastatic PC. Low FAR was positively correlated with OS in locally advanced or metastatic PC, which could be used to predict the prognosis.

2.
Article in Chinese | WPRIM | ID: wpr-879819

ABSTRACT

OBJECTIVE@#To study the clinical effect of continuous subcutaneous insulin infusion (CSⅡ) versus multiple daily injection (MDI) on blood glucose control in children with type 1 diabetes mellitus (T1DM).@*METHODS@#A retrospective analysis was performed on the medical data of 91 children with T1DM who were treated with CSⅡ for more than 1 year and 75 children with T1DM who were treated with MDI. The two groups were compared in terms of glycosylated hemoglobin (HbA1C) and the recurrence of diabetic ketoacidosis (DKA) to evaluate the difference in the efficacy during the 3-year follow-up. A survey was conducted for the children in the CSⅡ group and their family members to investigate the degree of satisfaction with insulin pump.@*RESULTS@#There was no significant difference in age, sex, and course of diabetes between the CSⅡ and MDI groups at disease onset and in the first year, the second year, and the third year of follow-up (@*CONCLUSIONS@#Children with T1DM treated with CSⅡ have a better control of blood glucose than those treated with MDI, and children and their family members are satisfied with CSⅡ treatment. Therefore, it holds promise for clinical application.


Subject(s)
Child , Diabetes Mellitus, Type 1/drug therapy , Diabetic Ketoacidosis , Follow-Up Studies , Humans , Insulins , Retrospective Studies
3.
Article in Chinese | WPRIM | ID: wpr-911441

ABSTRACT

Objective:To investigate the long-term safety of digoxin in patients with coronary artery disease (CAD) and atrial fibrillation (AF).Methods:This was a prospective study, in which 25 512 AF patients were enrolled from China Atrial Fibrillation Registry Study. After exclusion of patients receiving ablation therapy at the enrollment, 1 810 CAD patients [age: (71.5±9.3)years] with AF were included. The subjects were grouped into the digoxin group and non-digoxin group, and were followed up for a period of 80 months. Long-term outcomes were compared between the groups and an adjusted Cox regression analysis was applied to evaluate the risk of digoxin on the long-term outcomes. The primary endpoint was all-cause mortality.Results:The patients were followed up for a median period of 3.05 years. After multivariable adjustment, the Cox regression analysis showed that digoxin significantly increased the risk of all-cause mortality ( HR=1.28, 95% CI 1.01-1.61, P=0.038), cardiovascular mortality ( HR=1.48,95% CI 1.10-2.00, P=0.010), cardiovascular hospitalization ( HR=1.67,95% CI 1.35-2.07, P=0.008) and the composite endpoints ( HR=2.02,95% CI 1.71-2.38, P<0.001). In the subgroup of patients with heart failure (HF), digoxin was not associated with the risk of all-cause mortality, but was still associated with the increased risk of cardiovascular mortality ( HR=1.44,95% CI 1.05-1.98, P=0.025), cardiovascular hospitalization ( HR=1.44,95% CI 1.09-1.90, P=0.010) and the composite endpoints ( HR=1.37, 95% CI 1.01-1.70, P=0.004). However, in the subgroup of patients without HF, digoxin was only associated with all-cause mortality ( HR=2.56,95% CI 1.44-4.54, P=0.001). Conclusion:Digoxin significantly increased the risk of all-cause mortality in CAD patients with AF, especially in patients without HF.

4.
International Journal of Surgery ; (12): 308-314,f3, 2020.
Article in Chinese | WPRIM | ID: wpr-863326

ABSTRACT

Objective:Assessing the prognosis of patients with bladder urothelial carcinoma by using multiple molecular markers [epithelial-cadherin (E-cadherin), fibroblast growth factor receptor 3 (FGFR3), Jagged2, Survivin and stromal antigen 2 (STAG2)] in combination method, and compared it with the traditional method of evaluating prognosis by clinical pathological parameters.Methods:Retrospective analysis of 128 cases of bladder urothelial carcinoma patients admitted to Beijing Friendship Hospital, Capital Medical University from January 2010 to December 2016, including 102 males and 26 females; the median age was 70.5 years, ranged from 41 to 93 years. E-cadherin, FGFR3, Jagged2, Survivin and STAG2 alterations by immunohistochemistry during the first surgical treatment. The Kaplan-Meier survival curve was used to evaluate the relationship between the above markers and overall survival (OS), recurrence-free survival (RFS), progression-free survival (PFS), and clinicopathological indicators of tumors. Use Cox regression model to find the most suitable molecular markers for judging the prognosis of bladder urothelial carcinoma, and compare it with the traditional clinical staging + pathological grading method to evaluate OS to detect its sensitivity and specificity.Results:After 36.4 months of follow-up, it was found that the expressions of E-cadherin, FGFR3, Jagged2 and Survivin were all related to the OS, RFS and PFS of bladder urothelial carcinoma (all P<0.05). The expression of STAG2 was related to the TMN stage of bladder urothelial carcinoma ( P=0.047) and pathological grade ( P=0.015). Cox regression analysis showed that Survivin ( P=0.001) and Jagged2 ( P=0.037) were independent risk factors for evaluating the OS of bladder urothelial carcinoma, and Survivin ( P<0.001) and Jagged2 ( P=0.006) were independent risk factors for RFS, Survivin ( P=0.001) was also an independent risk factor for PFS. Multivariate analysis of the above molecular markers showed that the prognosis of patients with more than 3 molecular markers was better than that of independent application or the use of two of them to evaluate the prognosis ( P<0.001). The combined application of Survivin and Jagged2 to evaluate the 5-year survival rate was not less sensitive and specific than the clinical and pathological indicators (93.5% vs 77.2%, 84.7% vs 81.3%). Conclusions:Five molecular markers of E-cadherin, FGFR3, Jagged2, Survivin and STAG2 have an evaluation effect on the prognosis of bladder urothelial carcinoma, and some can independently predict the OS and RFS of patients with bladder urothelial carcinoma, however, the combined application is better than the single molecular marker to evaluate the prognosis. Compared with the traditional method of evaluating the prognosis by clinical pathological parameters, the combined application of Jagged2 and Survivin may be a better choice for evaluating the prognosis of patients with bladder urothelial carcinoma.

5.
Article in Chinese | WPRIM | ID: wpr-876208

ABSTRACT

Objective To determine the relationship between chronic diseases and cognitive function in elderly patients, for the purpose of preventing and alleviating cognitive malfunction. Methods A total of 100 retired high intellectuals with age older than 65 years were enrolled.They were hospitalized in Zhongshan Hospital and were requested to complete a conventional questionnaire.Cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) Scale.Their chronic diseases including hypertension, coronary artery disease, diabetes mellitus were recorded and compared among subjects with different cognitive function levels. Results Based on MoCA Scale, 34 cases were sorted as having normal cognitive function, 50 cases as mild cognitive impairment, and 16 cases as moderate cognitive impairment.Patients with moderate cognitive impairment showed a significantly higher percentage of hypertension (93.8%), coronary artery disease (75.0%), stroke (56.3%), diabetes mellitus (56.3%) while the patients with normal cognitive function exhibited relatively lower percentage of the above-mentioned diseases (61.8%, 41.2%, 17.6%, 20.6%, respectively, P < 0.05).However such difference was not observed for respiratory disease and neoplastic disease among patients with different cognitive conditions (P>0.05).In addition, cardiovascular and metabolic diseases were found to be important risk factors of mild-to-moderate cognitive impairment (P=0.002). Conclusion Prevention and treatment of cardiovascular and metabolic diseases could be imperative to alleviate the process of cognitive impairment.

6.
Journal of Medical Postgraduates ; (12): 820-825, 2020.
Article in Chinese | WPRIM | ID: wpr-823275

ABSTRACT

ObjectiveA good invasion ability of extravilloustrophoblas (EVTs) is the prerequisite for successful placental colonization and effective remodeling of the uterine spiral artery. This article aims to simulate the pathophysiological process of oxidative stress inducing trophoblasts to pyroptosis in vitro, exploring the correlation between trophoblasts pyroptosis and the pathogenesis of preeclampsia.MethodsTwenty-five patients with preeclampsia were selected from the Department of Obstetrics and Gynecology, Zhongda Hospital affiliated to Southeast University from September 2017 to January 2019. Among them, early-onset preeclampsia (gestational weeks<34) was early-onset group (n=17), late-onset preeclampsia (gestational weeks≥34) was late-onset group (n=8), and full-term pregnant women with normal blood pressure (39<gestational weeks>42) were selected as normal group (n=10). Human trophoblasts were cultured with HTR-8/SVneo for 12 hours, and then treated with H2O2 (100, 150, 200, 250μmol/L) (2, 4, 6, 12 h), to induce human trophoblast HTR-8/SVneo pyrolysis model; the control group was normal cultured cells of 1640+10% fetal bovine serum + 1% antibiotics. Placental specimens from 7 patients with preeclampsia were randomly selected, including 3 cases in early onset group, 4 cases in late onset group and 1 case in normal group. The total proteins of cells and placenta were extracted respectively, and the expression of scorch death-related molecular proteins was detected. The mRNA levels of pyroptosis related molecules in cells was detected by RT-qPCR, and the morphological changes of cells were observed by inverted phase contrast microscope.ResultsThe Western blot results showed that the activation of the key molecular activation form of the cell pyrogenesis pathway, Cleaved caspase1, could be detected in the placenta. When H2O2 was 150 mol/L for 2h, the mRNA levels of NLRP3 and IL-1, the key molecules of the upstream activation signal, were significantly up-regulated (8.680±0.481, 14.136±0.244) compared with the control group (1.00±0.00) (P<0.000). At 4h, mRNA levels of key molecule GSDMD and downstream inflammatory factor IL-18 (1.639±0.354 and 1.794±0.043) in the pyrogenesis pathway were significantly higher than those in the control group (1.00±0.00), with statistically significant differences (P<0.05). By reverse validation of the mRNA levels of the molecules associated with pyroptosis, the optimal conditions of the model induced by H2O2 were 150 mol/L and 4h, and the typical changes, such as cell swelling, fragmentation and plasma membrane bubble formation, could be seen under the light microscope.ConclusionThe pyroptosis model of trophoblast cells was successfully established, and the physiological process of oxidative stress inducing trophoblasts to pyroptosis in vitro was successfully simulated, providing new ideas and directions for the diagnosis and treatment of preeclampsia and the development of new drugs.

7.
Journal of Medical Postgraduates ; (12): 225-229, 2019.
Article in Chinese | WPRIM | ID: wpr-818217

ABSTRACT

Coronary computed tomography (CCTA) has become an important modality in the evaluation of coronary artery disease (CAD). CCTA is able to evaluate beyond the lumen in characterizing and quantifying atherosclerotic plaques, including features of calcification and fat around lesions. Although CCTA has high negative predictive value to exclude obstructive CAD, it has low specificity in the diagnosis of ischemia-inducing lesions. Recent advances in CT technology have resulted in the development of multiple functional CT techniques to provide hemodynamic information, such as coronary transluminal attenuation gradient (TAG), CT-derived fractional flow reserve (CT-FFR), computational fluid dynamics (CFD) and CT perfusion (CTP). In this article, we provide a perspective on these cardiac CT techniques in the evaluation of CAD.

8.
Article in English | WPRIM | ID: wpr-777109

ABSTRACT

OBJECTIVE@#To observe the effects of electroacupuncture (EA) on reproductive outcomes in women with Shen (Kidndy) deficiency syndrome after in vitro fertilization-embryo transfer (IVF-ET), and explore the underlying molecular mechanism.@*METHODS@#Sixty-six infertile patients with Shen deficiency syndrome undergoing IVF-ET were divided into EA or control groups according to a random table, 33 cases in each group. Before undergoing IVF, patients in the EA and control groups received EA therapy and placebo needle puncture, respectively, for 3 menstrual cycles. Shen deficiency syndrome scores were assessed. Other outcome measures included the number of retrieved oocytes and fertilization, high-quality embryo and clinical pregnancy rates. Follicular fluid was collected on the day of oocyte retrieval, and granulosa cell expression of phosphatidylinositide 3-kinases (PI3K), serine-threonine kinase (Akt) and forkhead box O3 (Foxo3a) mRNA were measured by reverse transcribed and quantitative real-time polymerase chain reaction.@*RESULTS@#Syndrome scores for pre- versus post-treatments decreased significantly (16.53±1.75 to 8.67±1.61) in the EA group (P<0.05), but showed no significant change in the control group (17.18±1.58 to 14.74±1.58). A significant difference in score change was found between the EA and control groups (P<0.05). High-quality embryo and clinical pregnancy rates were both increased in the EA group compared with the control group [69.15% (195/282) vs. 60.27% (176/292) and 66.67% (22/33) vs. 42.42% (14/33), respectively, P<0.05]. The fertilization rate was equivalent in EA and control groups. No difference was found in the number of retrieved oocytes between the two groups. Granulosa cell expression levels of PI3K and Akt mRNA were significantly increased in the EA group compared with the control group, while the expression of Foxo3a was reduced (all P<0.05).@*CONCLUSIONS@#For infertile patients with Shen deficiency syndrome undergoing IVF, EA for tonifying Shen as an adjunct treatment may alleviate clinical symptoms and improve the high-quality embryo rate. The EA-induced mechanism may involve regulation of PI3K/Akt/Foxo3a expression in granulosa cells to improve the developmental microenvironment of oocytes and inhibit granulosa cell apoptosis, possibly contributing to the improved clinical pregnancy rate (Registration No. ChiCTR 1800016217).

9.
Article in Chinese | WPRIM | ID: wpr-802198

ABSTRACT

Objective:To observe effect of long-term administration of rhein on the kidney toxicity of mice, and explore its possible toxic mechanism, in order to provide some basis for rational clinical drug use and further research. Method:The 30 Kunming mice (half male and half female) were randomly divided into 3 groups:control group, low-dose rhein group and high-dose rhein group (0.175,0.35 g·kg-1), with 10 mice in each group. The intragastric administration lasted for 60 days. During administration, general situations of the mice were observed and recorded. Serum urea nitrogen (BUN), creatinine (SCr), malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected after drug withdrawal. Kidney index was calculated, and glutathione peroxidase (GSH-Px) and reduced glutathione/oxidized glutathione (GSH/GSSG) ratio were measured. The kidneys were collected and histopathologically examined, and the protein expressions of transforming growth factor beta (TGF-β1) and cysteine aspartic acid specific protease-3 (Caspase-3) were detected by immunohistochemistry. Result:Compared with the control group of the same sex, BUN and SCr of the administration group increased significantly(PPPPα and Caspase-3 increased significantly(PPPPβ1 was increased(PConclusion:The toxicity of rhein in the kidney of mice was obvious at the dose of 0.35 g·kg-1·d-1, and the toxicity in male organism is more obvious. The mechanism of its potential toxicity may cause the imbalance of glutathione antioxidant system, induce excessive oxidation, trigger inflammatory reaction, activate the expression of Caspase-3, and then induce apoptosis.

10.
Article in Chinese | WPRIM | ID: wpr-802197

ABSTRACT

Objective:To study nephrotoxicity induced by long-term administration of different doses of aloe-emodin in mice, and explore its mechanism. Method:A total of 30 male and female Kunming mice were randomly divided into normal control group, and low-dose aloe-emodin group,high-dose aloe-emodin group (0.8,1.6 g·kg-1). Every dose of group was administered intragastrically for 11 weeks,twice daily. effect of serum urea nitrogen (BUN),creatinine (SCr),superoxide dismutase (SOD),malondialdehyde (MDA),Glutathione (GSH/GSSG) and Glutathione Peroxidase (GSH-Px) levels were detected by biochemical kits according to manufacturer's instruction. Enzyme-linked immune assay was used to determine serum tumor necrosis factor (TNF)-α and interleukins(IL)-6 levels. Hematoxylin eosin (HE) staining was used to detect renal pathological changes in kidney tissues, and cysteine aspartic acid specific protease(Caspase)-3 and transforming growth factor(TGF)-β1 proteins were determined by immunohistochemistry. Result:According to results,compared with normal control group,the levels of BUN and SCr in serum with high-dose aloe-emodin were increased. The renal tubules in low-dose group were mildly injured,while renal tubules and glomeruli of high-dose group were moderately damaged. Compared with normal control group,the level of SOD was significant decreased (PPPPα and IL-6 were increased,the expression of TGF-β1 protein in kidneys was increased in low-dose and high-dose groups (PConclusion:results show that 1.6 g·kg-1 aloe-emodin was administered intragastrically for 11 weeks,which had toxic effects on kidney in mice. The mechanism may be related to oxidative stress,apoptosis and TGF-β1 protein expression.

11.
Article in Chinese | WPRIM | ID: wpr-802196

ABSTRACT

Objective:To observe the effect of long-term administration of emodin on the kidney toxicity of mice, explore its possible toxic mechanism, and provide some basis for clinical rational drug use and further research. Method:The 30 Kunming mice, half male and half female, were randomly divided into 3 groups:control group, emodin low dose group and emodin high dose groups (0.8, 1.6 g·kg-1), 10 mice in each group. Continuous intragastric administration was given for 11 weeks. During administration, the general situation of the mice was observed and recorded. After treatment, the serum urea nitrogen (BUN), creatinine (SCr), malondialdehyde (MDA), superoxide dismutase (SOD) tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were detected. Kidney index was calculated and glutathione peroxidase (GSH-Px) and reduced glutathione/oxidized glutathione (GSH/GSSG) ratio were measured. The kidneys were taken for histopathological examination and the protein expression levels of transforming growth factor-β1(TGF-β1) and cysteine aspartic acid specific protease-3 (Caspase-3) were then detected by immunohistochemistry assay. Result:As compared with control group of the same sex, the weight of mice in the administration groups was decreased significantly, renal index was decreased while BUN and SCr levels were increased significantly (PPPPα was increased significantly (PP PPConclusion:The long-term administration of emodin at a large dose would show toxicity effect on mice kidney, and the toxicity was obvious at the dose of 1.6 g·kg-1·d-1, but there was no significant difference between the sexes. The mechanism of its potential toxicity may be related to the disorder of oxidation system, the injury of oxidative stress, the triggering of inflammatory reaction, and the apoptosis of cells.

12.
Article in Chinese | WPRIM | ID: wpr-732804

ABSTRACT

Objective To evaluate the expression of 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) in adenoid cystic carcinoma and the effects of PFKFB3 on the proliferation,migration,invasion and tumorigenesis in vivo of adenoid cystic carcinoma cells.Methods Immunohistochemistry and Westem blotting were applied to detect the expression of PFKFB3 in 29 cases of adenoid cystic carcinoma tissues and 10 cases of para-carcinoma normal salivary gland tissues.PFKFB3 in adenoid cystic carcinoma ACC-2 cells was silenced by adenovirus vector.The effects of PFKFB3 silence on cell proliferation,migration,invasion and tumorigenesis in vivo and distant metastasis of adenoid cystic carcinoma cells were evaluated by cell proliferation assay,wound healing assay,Transwell assay,xenografted mice model and lung metastasis mice model.Results The results of immunohistochemical staining showed that the positive expression rate of PFKFB3 in adenoid cystic carcinoma tissues was 93.1% (27/29),and the positive expression rate of PFKFB3 in normal salivary gland tissues was 20.0% (2/10),with a significant difference (x2 =20.84,P < 0.001).The results of methyl thiasolyl tetrazolium (MTT) assay showed that,compared with ACC-2 group,the proliferation activity of cancer cells with silence of PFKFB3 (PFKFB3--ACC-2) was significantly suppressed for 72 h (1.8 ± 0.2 vs.4.7 ± 0.8,t =3.582,P =0.001).The results of wound healing assay showed that after scraping cells away for 24 h,the number of cells in the scratch area was 99.8 ± 13.2 in the PFKFB3--ACC-2 group,which was significantly less than that in the ACC-2 group (263.0 ± 97.4,t =2.868,P =0.029).Transwell results indicated that the number of cells passing through matrigel was 17.6 ± 2.1 in the PFKFB3--ACC-2 group,which was less than that in the ACC-2 group (28.6 ± 3.8,t =4.452,P =0.004).The tumor volume in the PFKFB3--ACC-2 [(623.5 ± 134.1) mm3] was smaller than that in the ACC-2 group [(1 621.0 ±278.1) mm3,t =4.213,P =0.001].More pulmonary metastases were found in the ACC-2 group thanPFKFB3--ACC-2group(18.1±3.2vs.4.1±2.2,t=6.322,P=0.001).Condusion The expression of PFKFB3 is higher in adenoid cystic carcinoma tissue than normal salivary gland tissue,and the highly expressed PFKFB3 plays a driving role in the proliferation,migration,invasion and metastasis in adenoid cystic carcinoma.

13.
Acta Pharmaceutica Sinica ; (12): 111-120, 2018.
Article in Chinese | WPRIM | ID: wpr-779853

ABSTRACT

The Chinese herbal Sophora alopecuroides is widely used to clean intestine and eliminate dampness, and it has good therapeutic effects on treating bacillary dysentery and inflammatory bowel disease, etc. in clinics. However, the mechanism of treatment is not yet well understood. The present study was aimed to explore the mechanism of Sophora alopecuroides treatment of large intestine dampness-heat syndrome (LIDHS). The LIDHS model was performed by the comprehensive factors, including high temperature and humidity environment, high-sugar and high-fat diet, and intraperitoneal injection of Escherichia coli. The blood routine, serum proinflammatory cytokine levels and histopathological changes of intestine were detected and observed. Meanwhile, the serum metabolomic approach was conducted using the method of ultra performance liquid chromatography coupled to quadrupole time-of-flight mass/mass spectrometry (UHPLC-Q/TOF-MS/MS). The results showed that Sophora alopecuroides has good therapeutic effects on the LIDHS rat models. After treatment with Sophora alopecuroides, the abnormality of blood routine indexes as well as proinflammatory cytokines, including IL-1β, IL-2, IL-6 and TNF-α in vivo, tended to be normal, and the histopathological changes of intestine were improved. Through metabolic profiling and protocol analysis, 9 potential metabolic markers may be closely related with the treatment mechanism of Sophora alopecuroides on this disease, including taurine, L-tryptophan, LysoPE, LysoPC, LPA, DG, chenodeoxycholic acid disulfate, traumatic acid and 7-ketodeoxycholic acid, which were involved in taurine and hypotaurine metabolism, glycerophospholipid metabolism, glycerolipid metabolism, tryptophan metabolism and primary bile acid biosynthesis etc. The serum metabolomic approach can be applied to clarify the therapeutic mechanism of Sophora alopecuroides on LIDHS, and provide the theoretical basis for Sophora alopecuroides in clinical practice.

14.
Article in Chinese | WPRIM | ID: wpr-753861

ABSTRACT

Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in the First Affiliated Hospital of Bengbu Medical College in 2017. Methods Antimicrobial susceptibility testing was carried out by automated systems or Kirby-Bauer method. The data were interpreted according to CLSI 2017 breakpoints and analyzed by WHONET 5.6 software. Results A total of 4 295 strains of bacteria were isolated in 2017, including 1 196 (27.8%) strains of gram-positive bacteria, and 3 099 (72.2%) strains of gram-negative organisms. Methicillin-resistant Staphyloccus aureus and methicillin-resistant coagulasenegative Staphylococcus isolates accounted for 54.7% and 77.4%, respectively. The resistance rates of methicillin-resistant strains to most of antibiotics tested (except trimethoprim-sulfamethoxazole) were significantly higher than those of methicillinsusceptible strains. None strains were found resistant to linezolid or vancomycin. E. faecium and E. faecalis were the major isolatesin Enterococcus. The resistance rates of E. faecalis to most antibiotics (except tetracyclines and linezolid) were much lower than those of E. faecium. A few Enterococcus strains were resistant to linezolid and vancomycin. A few strains of penicillin-resistant Streptococcus pneumoniae were identified. ESBLs-producing strains accounted for 66.0% in E. coli and 22.7% in K. pneumoniae. The resistance rate of Enterobacteriaceae to carbapenems was increasing. Theresistance rates of Klebsiella pneumoniae, Enterobacteriaceae and Citrobacter to imipenem and ertapenem were higher than 10%. The resistance rates of P. aeruginosa to imipenem was 43.3%, but lower than 30% to ceftazidime, cefepime, piperacillin-tazobactam, and levofloxacin. The resistance rates of A. baumannii to all the antibiotics tested except amikacin were higher than 70%, and the resistance rate to imipenem was 87.5%. The prevalence of extensively drug-resistant strains in P. aeruginosa, K. pneumoniae and A. baumannii was 15.8%, 28.4%, and 46.7%, respectively. Conclusions Antimicrobial resistance was serious in this hospital in 2017. Especially, carbapenem-resistant Enterobacteriaceae and extensively drug-resistant K. pneumoniae were increasing. Therefore, more attention should be paid to rational use of antibiotics and antibiotic resistance surveillance.

15.
Chinese Medical Journal ; (24): 1898-1903, 2018.
Article in English | WPRIM | ID: wpr-773952

ABSTRACT

Background@#Obstructive sleep apnea syndrome (OSAS) is prevalent in obesity and is associated with many metabolic abnormalities. The relationship between OSAS and bone metabolism is still unclear. The aim of this study was to investigate the relationship between the severity of OSAS and bone metabolic markers.@*Methods@#A total of 119 obese males were enrolled in this study in spring months from 2015 to 2017. All candidates underwent polysomnography, and their bone mineral density (BMD) and the serum levels of total procollagen type 1 N-terminal propeptide (t-P1NP), N-terminal midfragment of osteocalcin (N-MID), β-C-terminal telopeptide of type 1 collagen (β-CTX), vitamin D (VD), and parathyroid hormone (PTH) were measured. The analysis of variance and Pearson correlation analysis were performed for data analyses.@*Results@#No significant differences in the mean values of BMD were observed among the obesity, mild-to-moderate OSAS, and severe OSAS groups; and the serum levels of t-P1NP and β-CTX in the severe OSAS group were significantly higher than those in the obesity group (48.42 ± 23.78 ng/ml vs. 31.98 ± 9.85 ng/ml, P < 0.001; 0.53 ± 0.24 ng/ml vs. 0.41 ± 0.13 ng/ml, P = 0.011, respectively). The serum level of VD in the obesity group was significantly higher than those in the mild-to-moderate and severe OSAS groups (both P < 0.001), and decreased as the severity of OSAS increased (P < 0.001). The serum level of PTH in the severe OSAS group was significantly higher than those in the obesity and mild-to-moderate OSAS groups (both P < 0.001). The results of correlation analysis indicated that the level of apnea-hypopnea index (AHI) was correlated with the levels of t-P1NP (r = 0.396, P < 0.001), VD (r = -0.404, P < 0.001), and PTH (r = 0.400, P < 0.001), whereas the level of minimum Osaturation (SaOmin) was correlated with the levels of VD (r = 0.258, P = 0.016) and PTH (r = -0.376, P < 0.001).@*Conclusions@#The levels of bone resorption and formation markers in patients with severe OSAS were significantly increased compared to obese men, and the severity of OSAS was correlated with the serum levels of t-P1NP, VD, and PTH.


Subject(s)
Biomarkers , Blood , Bone Density , Bone and Bones , Metabolism , Humans , Male , Middle Aged , Obesity , Parathyroid Hormone , Polysomnography , Sleep Apnea, Obstructive
16.
China Journal of Endoscopy ; (12): 105-107, 2018.
Article in Chinese | WPRIM | ID: wpr-702916

ABSTRACT

Objective To evaluate the clinical efficacy of laparoscopy and short poly FURS in treatment of UPJO combined with renal stones. Methods From May 2014 to November 2016, 20 patients with ureteropelvic junction stricture in our hospital were treated with Laparoscopy and short poly FURS lithotripsy, the clinical data of the patients before and after operation were retrospectively analyzed. Results The patients in this group were successfully operated in stage I, and the hemoglobin descent rate did not change significantly before and after operation. No need of blood transfusion, the first day after the review of urinary tract plain film observed DJ tube position, postoperative back to hospital in March pulled out of DJ tube, postoperative follow-up 6 months to 1 year, the patient recovered well, no long-term complications. Conclusion Laparoscopy and short poly FURS lithotripsy, has satisfactory effects and no significant complications which should be promoted.

17.
Article in Chinese | WPRIM | ID: wpr-694938

ABSTRACT

Objective To compare the effectiveness between ultrasound-guided brachial plexus block via costoclavicular approach and ultrasound-guided infraclavicular brachial plexus block via cora-coid approach.Methods Fifty-eight patients scheduled for forearm or hand surgery,33 males and 25 females,aged 18-70 years,ASA physical status Ⅰ-Ⅲ,were selected in this study.The patients were equally randomized into two groups:the group of brachial plexus block via costoclavicular approach (group A)and group of infraclavicular brachial plexus block via coracoid approach (group B).0.5 % ropivacaine 20 ml was used for local anesthetic.The anatomic depth of brachial plexus nerve,nerve block operation time,sensory and motor blockade situation were recorded.Results Ultrasonic ima-ging showed the brachial plexus was shallower in group A (2.0±1.2)cm than in group B (3.5± 1.8)cm (P<0.05).Nerve block operation time in group A (2.0±1.5)min was less than that in group B (4.0 ± 1.5 )min (P <0.05 ).After 5 minutes and 10 minutes of the local anesthetic inj ection,the sensory blockade rate of the median nerve,the ulnar nerve,the radial nerve and the muscle cutaneous nerve in group A was higher than in group B (P<0.05).After 10 minutes of the inj ection,the motor blockade rate for the ulnar nerve,the radial nerve and the muscle cutaneous nerve was higher in group A than in group B (P<0.05).There were no dyspnea,nausea,vomiting,tinni-tus and other adverse reactions in the two groups.Conclusion The ultrasound-guided costoclaviculari brachial plexus block is more shallower than the subclavicular plexus block in the anatomic depth,and the nerve-blocked-operating time is shorter;at the same time,the former’s sensory and motor block effects is faster than the later.

18.
Chinese Medical Journal ; (24): 2210-2215, 2018.
Article in English | WPRIM | ID: wpr-690243

ABSTRACT

<p><b>Background</b>Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features.</p><p><b>Methods</b>One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t- test was obtained to analyze continuous variable.</p><p><b>Results</b>No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P > 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ = 40.34, P < 0.001; OR = 39.87).</p><p><b>Conclusions</b>Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.</p>


Subject(s)
Adolescent , Adult , Cross-Sectional Studies , Cryptococcosis , Allergy and Immunology , Pathology , Humans , Lung Diseases , Allergy and Immunology , Pathology , Male , Retrospective Studies
19.
Article in English | WPRIM | ID: wpr-311360

ABSTRACT

The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service (CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor-patient relationships, information and support, organization of care, and accessibility (P < 0.001). One or more factors such as gender and self-perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy.


Subject(s)
Adolescent , Adult , China , Community Health Services , Data Collection , Female , Humans , Male , Middle Aged , Patient Satisfaction , Young Adult
20.
China Journal of Endoscopy ; (12): 97-100, 2017.
Article in Chinese | WPRIM | ID: wpr-668213

ABSTRACT

Objective To observe the clinical application of all seeing needle system system in diagnosis and treatment of patients with hematospermia. Methods From May 2015 to September 2016, 22 patients with hemospermia were treated with seminal vesiculoscopy and seminal vesicle lithotripsy by using a all seeing needle system instead of traditional seminal vesicle. Results All the patients were successfully found the seminal vesicle gland and successfully entered the seminal vesicle gland, 16 cases had chronic inflammation of the seminal vesicle, dilute iodine rinse, 6 cases of seminal vesicle, holmium laser lithotripsy, stone basket to remove. The average operation time was (15.7 ± 6.2) min. The catheterization was performed the next day after operation. The average hospital stay was 2 d. After follow-up for 3 to 6 months, 20 patients had disappeared (90.9%). No complication was found Disease and long-term complications. Conclusion The all seeing needle system can replace the traditional seminal vesicle for the operation of seminal vesicle. The puncture system is short, directional and maneuverable. It has advantages of short operation time, simple operation, easy to master and no complications.

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