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Objective:To observe any effect of fast walking on walking speed, 6-minute walking test (6MWT) time, and on serum levels of growth differentiation factor-8 (GDF-8) and insulin-like growth factor-1 (IGF-1) in patients with sarcopenia.Methods:A total of 61 sarcopenia patients were randomly divided into an observation group ( n=31) and a control group ( n=30). Both groups were given conventional drug therapy. In addition, the observation group underwent 30-minutes of walking at 100-120 steps/min (about 60% of maximum heart rate) three times a week for 12 weeks. The control group also walked, but at 70-90 steps/min (less than 50% of maximum heart rate). Grip strength, walking speed, 6MWT time, skeletal muscle index (ASMI) and serum GDF-8 and IGF-1 were compared before and after the intervention. Results:There were no significant differences in grip strength or ASMI between observation group and control group (comparing males with males and females with females) before the experiment. Afterward, grip strength and ASMI in the observation group had increased significantly on average. Both were then significantly higher than the control groups′ averages, which had not changed significantly. Average walking speed, 6MWT time and serum IGF-1 levels had improved significantly in both groups, but the observation group′s average improvement was significantly greater. A significant decrease the average serum GDF-8 level was observed in the observation group, but not in the control group.Conclusion:Fast walking can improve the walking of persons with sarcopenia, raise serum IGF-1 levels, and significantly reduce serum GDF-8.
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Hyperphosphatemia is one of the common complications in maintenance hemodialysis patients and is closely related to cardiovascular disease and related death events. Therefore, the effective management of blood phosphorus is an important link to improve the prognosis of patients with maintenance hemodialysis. This study on maintenance hemodialysis patients with hyperphosphatemia 3Ds management including diet, along with the progress of dialysis and drug related nursing intervention were summarized, discuss how to reasonable dietary phosphorus limited, improve the efficiency of dialysis, and the correct use of problems still existing in phosphate binder, in order to reduce hyperphosphatemia to provide the reference for clinical nursing practice.
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Objective@#To analyze the epidemiological characteristics of HIV/AIDS infected students in Shandong Province, to provide a basis for the prevention and control of AIDS transmission in the student population.@*Methods@#All 863 HIV/AIDS students cases during 2010-2019 were collected in Shandong Province. Epidemiological characteristics was described and the trends in the 10 years since 2010 was analyzed.@*Results@#These 863 HIV/AIDS students were mainly transmitted through homosexual sex (763 cases, 88.41%), and the samples were mainly from voluntary consultation testing (433 cases, 50.17%). From 2010 to 2019, the proportion of student cases in the total number of cases showed an increasing trend ( χ 2 trend =30.21, P <0.01). Among them, the proportion of homosexual transmission cases increased year by year ( χ 2 trend =6.35, P =0.01), the proportion of cases aged 18-22 years increased year by year ( χ 2 trend =6.10, P =0.01), the proportion of cases with college degree or above increased year by year ( χ 2 trend =4.26, P =0.04). At present, voluntary consultation testing were the main source.There was no significant difference between the years of sample sources ( χ 2 trend =2.97, P =0.09).@*Conclusion@#The report number of students in Shandong Province are on the rise in recent years, especially those infected by same sex transmission, mainly with high education background, which calls for targeted strategies and intervention measures.
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Objective To analyze the relationship between the measured diameters of pituitary gland on MRI and peak-stimulated growth hormone(GH) in children with growth hormone deficiency (GHD).Methods A total of 46 children with GHD were included in this study, and 30 healthy children who were admitted to the hospital for health check-up were acted as the control group during the same period.The measured diameters of pituitary gland on MRI were compared between the two groups and the correlation between the diameters of pituitary gland on MRI and peak-stimulated GH were analyzed.Results ① The coronary and sagittal heights of pituitary gland on MRI were greater in children aged 7-10 years old and older than 10 years in control group and in children older than 10 years in observation group than those in children younger than 6 years (P<0.05).The anteroposterior diameter of pituitary gland on sagittal MRI in the control group was increased (P<0.05).The coronal height, sagittal anteroposterior diameter and sagittal height were lower in the observation group compared with age-and gender-matched controls(P<0.05).②The peak-stimulated growth hormone levels were higher in children aged 7-10 years old and older than 10 years in both groups compared with children younger than 6 years old (P<0.05).The peak-stimulated GH were lower in observation group compared with age-and gender-matched controls(P<0.05).③ The heights of pituitary gland on coronary and sagittal MRI in children with GHD were positively related to the peak-stimulated GH, and coronary height had the highest correlation(P<0.05).Conclusion The heights of pituitary gland on coronary and sagittal MRI in children with GHD are positively related to the peak-stimulated GH.The growth and development of children can be predicted by monitoring the changes of GH levels.
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Ex-RAD (ON01210) is a novel and efficient anti-radiation drug with low toxicity developed by US army and Onconova Pharmaceuticals in recent years. The significant survival advantage and low toxicity of Ex-RAD have contributed to the approval by the FDA as an investigational new drug in December 2008. Meanwhile, the drug is currently in phase I clinical trials in humans. In this paper, the chemical structure, synthesis route, detection method and pharmacological action of Ex-RAD were reviewed, and the appli-cation prospect of Ex-RAD was also explored.
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Objective To evaluate clinical application value of critical flicker frequency (CFF),psychometric hepatic encephalopathy score (PHES) and Stroop test in the diagnosis of covert hepatic encephalopathy (CHE).Methods A total of 110 patients with decompensated liver cirrhosis and 54 individuals without liver diseases were enrolled as control group.According to PHES＜-4 points as reference threshold for CHE,the threshold of CFF and time of Stroop test for CHE diagnosis was caculated.Positive results of at least two of PHES,CFF and Stroop tests was considered as the gold standard for CHE diagnosis,and then the value of these three methods in CHE diagnosis was evaluated.Student's t test and receiver operating characteristic curve (ROC) were used for statistical analysis.Results Among the 110 patients with liver cirrhosis,40 patients had no hepatic encephalopathy (HE0),52 patients had CHE,and 18 patients had grade 2 hepatic encephalopathy (HE2).The CFF value and total time of Stroop test of control group were (43.70±1.92) Hz and (201.17±20.65) s,respectively.The CFF value of HE0 group was (41.40 ± 1.85) Hz,which was higher than that of CHE group ((38.33 ± 2.32) Hz),and the difference was statistically significant (t=-7.116,P＜0.01).The total time of Stroop test of HE0 group was (197.91±26.68) s,which was shorter than that of CHE group ((253.24± 33.33) s),and the difference was statistically significant (t=8.936,P＜0.01).When PHES＜-4 points was considered as a reference threshold of CHE,the threshold of CFF for CHE diagnosis was 39 Hz,the sensitivity was 94.9％ and the specificity was 73.1％,the area under the curve (AUC) was 0.879.The threshold of the total time of Stroop test for CHE diagnosis was 233.80 s,the sensitivity was 83.3 ％ and the specificity was 71.1％,the AUC was 0.803.The completion time of the number connection test (NCT)-A,NCT-B and digit symbol test (DST),which were there of five subtests of PHES,of CHE group were (80.27±36.05) s,(124.18±55.96) s and (25.03±8.23) s,respectively,compared with those of HE0 patients ((56.68±18.82) s,(80.00±25.58) s and (34.68±8.75) s,respectively),the differences were statistically significant (t =3.691,4.108 and-4.780;all P＜0.01).Compared with the results of combined PHES and Stroop test in the diagnosis of HE0,CHE and HE2,the consistency rates of CFF＜39 Hz as threshold for diagnosis were 95.0％,61.5％ and 100.0％,respectively.Conclusions NCT-A,NCT-B and DST three subtests of PHES have higher efficiency in CHE diagnosis.CFF and Stroop test are also reliable screening methods for CHE,with advantage of objectivity and high specificity.
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Objective To investigate the efficacy of the four commonly used diagnostic methods in infection of Helicobacter pylori ( H. pylori ) . Methods The study included 133 patients with upper gastrointestinal symptoms. Three fresh gastric biopsy were extracted from the lesser curvature of antrum when patients accepting gastroscopy,for the rapid urease test( RUT) test strip, RUT gel method, and histological examination, respectively.14C?urease breath test(14C?UBT) was carried out 1 hour after the procedure. The result of histological examination was served as the golden reference.Any two tests positive were served as the relative golden reference. The diagnostic accuracy of the four methods and the consistence with golden reference and relative golden reference was evaluated. Results The positive results were obtained in 111 cases by RUT test strip,76 by RUT gel method, 70 by 14C?UBT,and 62 by Warthin—Starry stain. With Warthin—Starry positive as the golden reference, the finding of RUT test strip was poorly consistent with the result of Warthin—Starry(Kappa=0?295).However, the findings of RUT gel method and 14C?UBT were highly consistent with the result of Warthin—Starry( Kappa=0?672,0?670) . Because of the poor specificity of RUT test strip, any two positive tests from Warthin—Starry,RUT gel method and 14 C?UBT were used as the relative golden reference to evaluate the diagnostic accuracy. The findings of Warthin—Starry and 14 C?UBT were perfectly consistent with the golden reference( Kappa=0?821,0?850) , and the finding of RUT gel method was highly consistent with the golden reference(Kappa=0?763). However, the finding of RUT test strip was poorly consistent with golden reference(Kappa=0?280).When the delta cutoff value for the UBT was calculated as a standard value(DMP≥100),the area under the ROC curve was 0?932 (0?884?0?979) , and the sensitivity, specificity and accuracy of 14 C?UBT were 100?0%, 86?3% and 92?5%, respectively.When the delta cutoff value for the UBT was recalculated as a new value(DMP≥166),the area under the ROC curve increased to 0?949(0?906?0?992).With the golden reference as the evaluation, the sensitivity, specificity and accuracy of UBT test were 96?7%, 93?2% and 94?7%, respectively. Conclusion RUT test strip shows low accuracy; RUT gel method,UBT and histological examination have high accuracy and similar efficacy. When the delta cutoff value for the test is recalculated as DMP≥166, the accuracy of the test can be improved.
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Objective To investigate the diagnostic value of laboratory evaluation of renal injury in early diagnosis index. Methods Eighty-six patients in in-patient and out-patient of the department of urology were tested in serum C (Cys C), serum creatinine (Cr) and serum UREA nitrogen (UREA). According to the diagnostics (sixth edition), we evaluated their values for diagnosis of renal injury by analyzing the characteristics of the work curve (ROC). Results According to the renal function indexes, 3 groups were divided such as group A (normal renal function control Ccr 80 mL/min) or the Cys C, Cr, and UREA in (0.47 ± 0.24) mg/L, (85 ± 14) μmol/L, and (4.55 ± 1.33) mmol/L, group B (a decrease in renal function reserves, and renal insufficiency 20 mL/min or less Ccr Cr > UREA. Their correspounding ROC curve (AUC) were in the area of 0.908, and 0.785 and 0817. Cys C had the highest AUC (0.908), and achieved a good diagnosis effect. Conclusion Renal damage laboratory indexes of in the early diagnosis, Cys C has a higher sensitivity and specificity to be worth of clinical promotion.
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Objective To observe the operation of Nav1.6 voltage-gated sodium channels in rats with acute cerebral injury after electroacupuncture therapy and investigate the mechanism.Methods Male Sprague-Dawley rats were randomly divided into an ischemia control group (IC,n =48),an electroacupuncture group (ET,n =48),a nimodipine therapy group (NT,n =48) and a sham operation group (SO,n =24),and were treated accordingly.A model of acute cerebral ischemia was induced by occlusion of the right middle cerebral artery using the suture method.The expression of Nav1.6,the concentration of Ca2+ and infarct volume were observed at 6 h,1 d,2 d and 3 d after ischemia with the real-time quantitative fluorescence PCR,immunofluorescence and 2,3,5-triphenyl tetrazolium chloride methods,respectively.Results The Joshua score for neural function was zero in the sham operation group,and increased gradually in the three other groups 6 h and1 and 2 d after ischemia.The average Joshua score 3 d after ischemia was significantly lower than 1 d earlier in each group.In the ET group the expression of Nav1.6 was significantly upregulated at first,followed by a significant decrease.The concentration of Ca2+ behaved similarly.However,no significant changes were observed in the infarction volume percentage.At 3 d after ischemia the expression of Nav 1.6,the Joshua grades,the Ca2+ concentrations and the infarction volume percentage were all significantly lower in the ET group compared with the IC,NT and SO groups.Conclusion Electroacupuncture therapy after acute cerebral ischemia can inhibit the expression of Navl.6,reduced Na + inflow and calcium overload,and mitigate acute cerebral ischemic injury,at least in rats.The protective effect may be attributed to inhibiting the expression of Nav 1.6.
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Objective To investigate the influence of miR-106b on Wnt/β-catenin pathway in HCC cells. Methods QGY-7703 and HepG2 cells were transfected with miRNA mimics or inhibitors. TOP/FOP luciferase ratio assay was used to test the Wnt/β-catenin pathway activity. The expression of downstream targeted genes of Wnt/β-catenin pathway were examined by Real-time PCR. The accumulation of β-catenin in nuclears were measured by Western blotting. Results Ectopic expression of miR-106b dramatically increased the average TOP/FOP ratio and the mRNA expression of downstream targeted genes in QGY-7703 and HepG2 cells. Compared with that in control cells , miR-106b over-expression promoted the nuclear β-catenin accumulation in QGY-7703 cells. Clonclusion MiR-106b activated Wnt/β-catenin pathway in HCC cells.
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OBJECTIVE:To research the mechanism of in vitro permeation of phillyrin through blood-brain barrier. METH-ODS:After Madin-Darby canine kidney epithelial cells transfected with colorectal cancer MDR1 gene (MDCK-MDR1) were cul-tured with phillyrin solution of 0(negative control),10,25,50,75 and 100μg/ml for 24 h,cell viability was determined by resa-zurin method and cell survival rate was calculated. After MDCK-MDR1 cells were cultured with phillyrin solution of 10,25,50, 75 and 100 μg/ml for 10 min,the content of phillyrin in the cells was determined,and concentration-uptake rate curve was drawn. Following 3 h culture of MDCK-MDR1 cells with phillyrin solution of 0 (negative control),50 and 100 μg/ml,the structure of cell tight junction protein was observed under the inverted microscope. RESULTS:Compared to the negative control group,after 24 h cell culture with phillyrin solution of 10-100 μg/ml,no obvious change in cell survival rate occurred. MDCK-MDR1 cells cultured with the phillyrin at a mass concentration of 10-100 μg/ml demonstrated a nonlinear relationship with concentration of phillyrin and a gradual saturation trend. After the cells were cultured with phillyrin of 50 and 100 μg/ml for 3 h,cell tight junction protein was intact. CONCLUSIONS:The absorption of phillyrin through the simulated blood-brain barrier may be in the form of passive transportation combined with active transportation,the concertration has effect on cell tight junction protein.
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Objective To develop a blood gas,acid-base imbalance analysis computer software to diagnose systematically,rapidly,accurately and automatically determine acid-base imbalance type,and evaluate the clinical application. Methods Using VBA programming language,a computer aided diagnostic software for the judgment of acid-base balance was developed. The clinical data of 220 patients admitted to the Second Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. The arterial blood gas〔pH value,HCO3-,arterial partial pressure of carbon dioxide(PaCO2)〕and electrolytes included data(Na+and Cl-)were collected. Data were entered into the software for acid-base imbalances judgment. At the same time the data generation was calculated manually by H-H compensation formula for determining the type of acid-base imbalance. The consistency of judgment results from software and manual calculation was evaluated,and the judgment time of two methods was compared. Results The clinical diagnosis of the types of acid-base imbalance for the 220 patients:65 cases were normal,90 cases with simple type,mixed type in 41 cases,and triplex type in 24 cases. The accuracy of the judgment results of the normal and triplex types from computer software compared with which were calculated manually was 100%,the accuracy of the simple type judgment was 98.9% and 78.0% for the mixed type,and the total accuracy was 95.5%. The Kappa value of judgment result from software and manual judgment was 0.935,P=0.000. It was demonstrated that the consistency was very good. The time for software to determine acid-base imbalances was significantly shorter than the manual judgment(seconds:18.14±3.80 vs. 43.79±23.86,t=7.466,P=0.000),so the method of software was much faster than the manual method. Conclusion Software judgment can replace manual judgment with the characteristics of rapid,accurate and convenient,can improve work efficiency and quality of clinical doctors and has great clinical application promotion value.
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Objective To explore the value of combined use of laboratory indicators for diagnosis of early renal functional damage. Methods Eighty-six patients with various kidney diseases were enrolled in the Second Affiliated Hospital of Guangzhou Medical University. On admission,the serum Cystatin C(Cys C),creatinine(Cr), Urea,etc were determined. The value of using combined laboratory indicators in the diagnosis of renal functional damage was obtained through the analysis of the receiver operating characteristic curve(ROC curve);multiple variable indicators were grouped to establish multiple logistic regression models to be compared and evaluated. Results In the early and late renal injury groups(group B of 32 cases and group C of 12 cases),the serum levels of Cys C,Cr, and Urea were significantly higher than those in the normal renal function control group(group A of 42 cases),the elevation in level in group C being the most significant〔Cys C(mg/L):3.47±0.75 vs. 1.59±1.29,Cr(μmol/L):669±466 vs. 214±173,Urea(mmol/L):21.22±13.10 vs. 11.04±8.24,PCys C+Urea>Cys C>Cr+Urea(0.920=0.920>0.911>0.908>0.809). In this sequence,the AUC made by Cys C+Cr+Urea and Cys C+Cr were equal,both 0.920, whose sensitivity was 75.0%,specificity 100.0%,positive predictive value 100.0%,negative predictive value 80.0%and diagnostic accuracy rate 87.5%. So,Cys C + Cr combination could be used to substitute Cys C + Cr + Urea, and the former clinical diagnostic effect was the best,much higher than that by using AUC whose curve was made by Cys C alone. Conclusion The value of using only one laboratory indicator for diagnosis of patients with early renal functional damage is not high,while applying Cys C+Cr combination can improve the diagnostic effect greatly,and its sensitivity and specificity are higher.
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Objective To explore the methods for training the abitity of critical thinking of ICU nurses.Methods ICU nurses were trained in terms of knowledge training, case study, care rounds, self-reflection, case discussion, simulation training and seminars. The Chinese version of the critical thinking disposition inventory(CTDI-CV)was used before and one year after the training.Result The scores on CTDI-CV as well as the items after training were all significantly higher than that before training(P<0.05).Conclusion The knowledge and ability in critical thinking can be improved by knowledge and skills training.
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Objective To investigate whether rosuvastatin has the effects of anti-oxidative stress and attenuates vascular endothelial adhesiveness on the vessel wall in apolipoprotein E(apoE)knockedout mice. Methods Eighty 8-week-old apolipoprotein E-deficient mice and twenty 8-week-old C57BL/6 mice,were fed a normal chow diet for 12 weeks,and were divided into 2 weeks treatment group and 6 weeks treatment group.apoE knocked-out mice were subcutaneously injected with rosuvastatin at a dose of 1, 5, or 20 mg/kg daily for 2 or 6 weeks prior to sacrifice.Blood sample was taken by cardiopuncture and the aorta was obtained at the end of the 2th or 6th weeks. Results Total cholesterol level was significantly decreased after 2 or 6 weeks of 5,or 20 mg/kg rosuvastatin treatment[2 weeks:(480.7±35.3)mmol/L,(371.5±27.1)mmol/L;6 weeks:(400.1±37.6)mmol/L,(305.0±19.3)mmol/L],compared with 0 mg/kg group(20 weeks:(675.0±42.0)mmol/L;6weeks:(660.0±44.3)mmol/L](P＜0.05 or 0.01).But the changes of triglyceride and high-density lipoprotein were not like the above.The endothelial adhesiveness for monocytes was significantly attenuated after 2 weeks in 20 mg/kg group versus 0 mg/kg group[(2.24±0.72)%vs.(3.76 ±2.53)%](P＜0.05),and even more significantly after 6 weeks in 5,20 mg/kg groups[(1.94±0.40)%,(3.95±2.61)%](P＜0.01).In addition,rosuvastatin inhibited vascular expression of p22phox and superoxide production[0 mg/kg for 6 weeks group:(3.22±1.53)%,(4.75±2.62)μg/L;20 mg/kg for 6 weeks group:(1.41±0.72)%,(2.72±0.88)μg/L](all P＜0.05). Conclusions Rosuvastatin has a role of anti-oxidative stress and attenuates vascular endothelial adhesiveness on the vessel wall.
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Objective To contrast between the advantage and disadvantage of CR system and screen-film combination in the hypomastia mammography. Methods 233 cases underwent high frequency mammography unit made in Itlian, screen-film combiation and CR system made in Japan, in addition, the imaging quality was analyzed. Results The image quality of CR system was better than screen-film combination. The rate of photographing again outstandingly declined. The radiation to patient decreased evidently. Conclusion CR system is better than traditional screen-film combination in the hypomastia mammography.