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Objective:To study the influence of serum triggering receptor expressed on myeloid cells 1(TREM-1)level on prognosis in elderly patients with sepsis and acute respiratory distress syndrome(ARDS).Methods:A total of 100 elderly patients with sepsis were selected as the research objects.All the patients with sepsis were divided into sepsis ARDS group and sepsis non-ARDS group.General data and TREM-1 level were compared between the two groups.The patients with sepsis ARDS were divided into death group and survival group according to the survival status during the 28-day follow-up.TREM-1 level, acute physiology and chronic health evaluation(APACHE)Ⅱ score and SOFA score were compared between the two groups.The correlation between serum TREM-1 level and procalcitonin(PCT), APACHE Ⅱ score and SOFA score was analyzed.The survival rate of high TREM-1 level group and low TREM-1 level group was compared.Results:The age, white blood cell(WBC), PCT, APACHE Ⅱ score, SOFA score and TREM-1 level of sepsis ARDS patients were significantly higher than those of non-ARDS patients( t=2.722, 6.088, 11.55, 6.889, 4.661, 6.122, all P<0.05). The incidence of sepsis ARDS patients with chronic obstructive pulmonary disease was significantly higher than that of non-ARDS patients( χ2=7.895, P<0.05). Serum TREM-1 level, APACHE Ⅱ score and SOFA score of ARDS patients in death group were significantly higher than those in survival group( t=3.293, 6.173, 4.255, all P<0.05). Serum TREM-1 level was positively correlated with PCT, APACHE Ⅱ score and SOFA score( t=0.553, 0.602, 0.636, P<0.001). The Kaplan-Meier survival curve showed that the survival rate of high TREM-1 level group was significantly lower than that of low TREM-1 level group( χ2=3.999, P=0.036). Cox regression analysis showed that TREM-1 level was a risk factor for the prognosis of ARDS patients with sepsis( HR=1.893, 95% CI: 1.049-3.414). Conclusions:Serum TREM-1 level is significantly increased in elderly patients with sepsis ARDS, which is closely related to the prognosis and can be used as a potential prognostic biomarker.
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Objective:To compare biomechanical stabilities between screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury by a 3-D finite element analysis.Methods:A 3-D model of a healthy foot was developed from computed tomography images. The 1st and the 2nd dorsal tarsometatarsal ligaments and Lisfranc ligament were cut in the 3-D model of a healthy foot to establish a Lisfranc ligament injury model, in which screw-plate fixation (with 2 locking plates and 8 standard screws and one non-cannulated screw) and non-cannulated screw fixation (with 3 non-cannulated screws) for Lisfranc ligament injury were simulated respectively. Finite element analyses were carried out by Abaqus 6.14 software after loads were added in the 3-D models of screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury. The overall stress-strain nephogram, the stress distribution and displacement of the foot bone, and the stress distribution on the internal fixation system were compared between the 2 kinds of models.Results:Under the same load, the stress of the whole screw-plate fixation was concentrated on the fixators, and the stress of the non-cannulated screws was also greater than that of the bones. In both models, the strain of the whole foot led to arch collapse, especially in the medial column. The maximum stress on the screw holes in the medial and middle columns in the screw-plate fixation model was 39.91 MPa, smaller than that in the non-cannulated screw fixation model (53.13 MPa). The relative displacement of the first metatarsal joint in the screw-plate fixation model was 8.515 × 10 -1 mm, much greater than that in the non-cannulated screw fixation model (3.893 × 10 -1 mm). Stress concentration was observed in both models. The stress of the screw-plate system was concentrated on the fibular side of the middle section of the plate used to fix the first tarsometatarsal joint, decreasing towards both ends. The maximum stress of the non-cannulated screws was located in the middle of the medial column screw for fixation of the first tarsometatarsal joint, significantly greater than those of the both ends. The maximum stress of the screw-plate system was 239.5 MPa, smaller than that of the non-cannulated screws (256.8 MPa). Conclusions:Non-cannulated screw fixation demonstrates a greater biomechanical stability for Lisfranc ligament injury than screw-plate fixation. However, the former may have a higher risk of screw breakage because it bears a greater stress.
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Objective:To evaluate the accuracy of serum concentration of procalcitonin (PCT) in differential diagnosis of the etiology of bloodstream infections (BSI).Methods:Patients hospitalized in ICU of China-Japan Friendship Hospital from January 2015 to June 2020 with BSI and with PCT test simultaneously when blood drawing for blood culture were enrolled. Sequential Organ Failure Assessment (SOFA) were calculated based on parameters on the day of blood culture. Difference of various indicators among different pathogen infections were compared. Receiver Operating Characteristic (ROC) Curve was used to analyze the value of PCT in differential diagnosis of BSI by different pathogens.Results:Among 1 456 patients with BSI,1 261 (86.6%) patients with monobacterial infection, 80 (5.5%) patients with candidiasis and 115 (7.9%) patients with mixed infection. The 28-day mortality was 24.5% (356/1 456) and the 60-day mortality was 30.6% (446/1456). Mortality of both 28-day and 60-day in the mixed group was significantly higher than that in the bacteriacemia group and candidemia group. PCT levels was significantly higher in patients with bacteremia caused by gram-negative bacteria (GNB) than that in gram-positive bacteria (GPB) infected bacteremia and candidemia {3.4 μg/L[95% confidence interval (95% CI) 0.7-17.0 μg/L] vs 1.3 μg/L (95% CI 0.4-7.3 μg/L); 3.4μg/L (95% CI was 0.7-17.0 μg/L) vs 1.1 μg/L (95% CI was 0.4-3.4 μg/L); P<0.01} . ROC curve analysis showed that: ① the optimal cut-off value of PCT in differential diagnosis of monobacterial bacteremia and candidemia was 7.25 μg/L, with specificity of 90.0% and the area under the ROC curve (AUROC) was 0.612 (95% CI 0.533-0.691). When PCT value was greater than 0.51 μg/L, the sensitivity of diagnostic of bacteremia could reach 73.3%. ② the optimal cut-off value of PCT in differential diagnosis of bacteremia caused by GNB infection and candidemia was 7.32 μg/L, with specificity of 90.0% and AUROC was 0.695 (95% CI 0.614-0.776). When PCT value was greater than 0.51 μg/L, the sensitivity of diagnostic of bacteremia caused by GNB infection was 84.9%.③ the optimal cut-off value of PCT in differential diagnosis of bacteremia caused by GNB and GPB infection was 0.52 μg/L, with sensitivity of 84.9% and AUROC was 0.713 (95% CI 0.672-0.755). When PCT value was greater than 7.36 μg/L, the specificity of diagnostic of bacteremia caused by GNB infection could reach 80.1%. Conclusions:PCT can provide additional information about the possible etiology of patients with BSI, especially as high levels often indicate the possibility of GNB bacteremia.
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Objective:To investigate high mobility group protein 1(HMGB1), tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels and their clinical significance in elderly patients with viral pneumonia.Methods:One hundred and sixty elderly patients with viral pneumonia admitted to the Sixth Hospital Affiliated to Anhui Medical University were enrolled as research subjects.In addition, 40 elderly people who underwent regular physical examination were considered as the control group.Patients with viral pneumonia were divided into the low-risk group, middle-risk group and high-risk group according to CURB-65 scores and pneumonia severity index(PSI)scores.HMGB1, TNF-α and IL-6 levels were compared between different groups.The correlations of CURB-65 scores and PSI scores with HMGB1, TNF-α, IL-6 levels were analyzed.Multivariate Logistic regression analysis was used to examine influencing factors for the severity of viral pneumonia in elderly patients.Results:HMGB1, TNF-α and IL-6 levels were higher in research subjects than in the control group.As the severity of viral pneumonia increased, so did HMGB1, TNF-α and IL-6 levels(all P<0.05). HMGB1, TNF-α and IL-6 levels in the severe viral pneumonia group were significantly higher than those in the non-severe viral pneumonia group( P<0.05). HMGB1, TNF-α and IL-6 levels were positively correlated with CURB-65 scores and PSI scores(CURB-65 score: r=0.463, 0.392 and 0.497, P=0.015, 0.003 and 0.025; PSI score: r=0.596, 0.515 and 0.381, P=0.007, 0.011 and 0.009). HMGB1, TNF-α and IL-6 levels were influencing factors for the severity of viral pneumonia in elderly patients( OR=1.344, 1.422 and 1.351, P=0.006, 0.015 and 0.009). Conclusions:HMGB1, TNF-α and IL-6 levels are closely correlated with the severity of viral pneumonia and are helpful for early assessment of viral pneumonia.
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Objective:To explore the effect of multidisciplinary team (MDT) model on prognosis of patients with traumatic amputation.Methods:A retrospective case-control study was conducted to analyze the clinical data of 54 patients with traumatic amputation admitted to Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from July 2014 to June 2019. There were 41 males and 13 females, aged 39-72 years with an average age of 52.7 years. A total of 29 patients treated using MDT model intervention were served as observation group, and 25 patients treated using routine responsibility system holistic nursing as control group. The self rating anxiety scale (SAS) score, self rating depression scale (SDS) score and improved Barthel index were compared between the two groups on the day of admission and at 2 weeks, 4 weeks and 8 weeks after operation.Results:There was no significant difference in SAS, SDS and improved Barthel index between the two groups on the day of admission ( P>0.05). At 2 weeks, 4 weeks and 8 weeks after operation, the SAS score in observation group was respectively (52.5±7.6)points, (48.3±7.1)points and (41.3±6.1)points, lower than those in control group [(58.0±12.0)points, (54.4±10.7)points and (50.4±9.3)points]; the SDS scores in observation group was respectively (52.6±8.8)points, (47.9±7.6)points, (43.8±5.7)points, lower than those in control group [(58.4±12.4)points, (53.2±10.9)points, (49.5±8.7)points]; the Barthel index score in observation group was respectively (57.2±8.9)points, (80.7±7.7)points, (94.7±3.9)points, higher than those in control group [(50.4±11.4)points, (70.9±9.5)points, (85.6±6.8)points] (all P<0.05). Conclusion:For patients with traumatic amputation, MDT model is conducive to reducing anxiety and depression of patients, can improve the quality of life, and is worthy of clinical application.
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Objective@#To investigate serum level changes of heart-type fatty acid-binding protein(H-FABP)and S100 calcium-binding protein B(S-100B)protein in elderly patients with chronic heart failure and their clinical significance.@*Methods@#A total of 160 patients with chronic heart failure treated at our hospital were recruited, and 80 healthy individuals receiving regular check-ups were enrolled as normal controls.Serum levels of H-FABP and S-100B and cardiac function index scores were compared between patients with different cardiac function grades.Correlations of serum H-FABP and S-100B levels with N-terminal pro-B-type natrlure tiepeptide(NT-proBNP)and with cardiac function index scores in heart failure patients were analyzed.The sensitivity, specificity and accuracy of serum H-FABP, S-100B and NT-proBNP for heart failure detection were compared.@*Results@#Serum levels of H-FABP, S-100B and NT-proBNP in elderly patients with chronic heart failure were elevated with increased cardiac function grading(F=9.823, 11.573 and 13.056, P=0.013, 0.000 and 0.000), and serum levels of H-FABP, S-100B and NT-proBNP were higher in elderly patients with heart failure than in the control group(P<0.05). Serum levels of H-FABP and S-100B were positively correlated with serum NT-proBNP levels, cardiac function grading and left ventricular end-diastolic diameter(LVEDd)(r=0.527, 0.510 and 0.487, P=0.008, 0.003 and 0.002; r=0.604, 0.496 and 0.533, P=0.006, 0.005 and 0.003), and were negatively correlated with left ventricular ejection fraction(LVEF)(r=-0.536 and-0.528, P=0.005 and 0.008). The sensitivity, specificity and accuracy of serum H-FABP combined with S-100B for heart failure detection were 93.2%, 91.6% and 95.7%, respectively.@*Conclusions@#Serum levels of H-FABP and S-100B are high in elderly patients with heart failure, and they are correlated with serum NT-proBNP levels, cardiac function grading and LVEDd.H-FABP combined with S-100B has a high positive rate for heart failure detection.
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Objective To investigate serum level changes of heart-type fatty acid-binding protein(H-FABP)and S100 calcium-binding protein B(S-100B)protein in elderly patients with chronic heart failure and their clinical significance.Methods A total of 160 patients with chronic heart failure treated at our hospital were recruited,and 80 healthy individuals receiving regular check-ups were enrolled as normal controls.Serum levels of H-FABP and S-100B and cardiac function index scores were compared between patients with different cardiac function grades.Correlations of serum H-FABP and S-100B levels with N-terminal pro-B-type natrlure tiepeptide(NT-proBNP)and with cardiac function index scores in heart failure patients were analyzed.The sensitivity,specificity and accuracy of serum H-FABP,S-100B and NT-proBNP for heart failure detection were compared.Results Serum levels of H-FABP,S-100B and NT-proBNP in elderly patients with chronic heart failure were elevated with increased cardiac function grading (F =9.823,11.573 and 13.056,P =0.013,0.000 and 0.000),and serum levels of H-FABP,S-100B and NT-proBNP were higher in elderly patients with heart failure than in the control group(P＜0.05).Serum levels of H-FABP and S-100B were positively correlated with serum NT-proBNP levels,cardiac function grading and left ventricular end-diastolic diameter(LVEDd) (r =0.527,0.510 and 0.487,P =0.008,0.003 and 0.002;r =0.604,0.496 and 0.533,P =0.006,0.005 and 0.003),and were negatively correlated with left ventricular ejection fraction(LVEF) (r =-0.536 and-0.528,P =0.005 and 0.008).The sensitivity,specificity and accuracy of serum H-FABP combined with S-100B for heart failure detection were 93.2％,91.6％ and 95.7％,respectively.Conclusions Serum levels of H-FABP and S-100B are high in elderly patients with heart failure,and they are correlated with serum NT-proBNP levels,cardiac function grading and LVEDd.H-FABP combined with S-100B has a high positive rate for heart failure detection.
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Objective To investigate the potential therapeutic effect of luteolin on sepsis-induced ALI and the underlying mechanisms.Methods Total of 50 mice were randomly(random number) divided into five groups:a sham control group,a sepsis-induced ALI group,and three sepsis groups pre-treated with 20,40,and 80 mg/kg body weight luteolin.Mice in the treatment groups were pre-treated with luteolin at the respective oral dose two days before ALI induction.The lungs were isolated for histopathological examinations,and the bronchoalveolar lavage fluid (BALF) was collected for biochemical analyses.Results Luteolin significantly attenuated sepsis-induced ALI.Additionally,luteolin treatment decreased protein and inflammatory cytokine concentration and the number of infiltrated inflammatory cells in BALF compared with that in the non-treated sepsis mice.Pulmonary myeloperoxidase (MPO) activity was lower in the luteolin-pre-treated sepsis groups than in the sepsis group.The mechanism underlying the protective effect of luteolin on sepsis is related to the up-regulation of certain antioxidation genes,including inducible nitric oxide synthase (iNOS),cyclooxygenase-2 (COX-2),superoxide dismutases (SODs),and heme oxygenase 1 (HO-1),and the reduction of inflammatory responses through blockage of the activation of the nuclear factor (NF)-κB pathway.Conclusions Luteolin pre-treatment inhibits sepsis-induced ALI through its anti-inflammatory and antioxidative activity,suggesting that luteolin may be a potential therapeutic agent for sepsis-induced ALI.
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Objective To evaluate the reporting item quality of randomized controlled trials of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer. Methods The terms including Chinese medicine, Chinese herbal medicine, randomized controlled trials, and non-small cell lung cancer were searched in Chinese and English databases by computer systems to collect relevant literatures. Based on the CONSORT 2010 (consolidated standards of reporting trials 2010), the reporting item quality of the abstracts and main text in eligible papers was evaluated. Results Ninety-five eligible studies were identified from 692 potential eligible articles. None reported all of abstract and main text items in CONSORT 2010. Only 4.12％could be identified as the randomized trial in the title. More than 40％of reports showed the scientific background or rationale in the abstract but not in the main text. Three (3.16％) eligible reports defined the primary or secondary outcome measures. None reported complete information of subjects throughout the clinical trial process. Results A total of 95 eligible papers were collected, of which 0 papers reported complete abstracts and text entries according to the CONSORT. The titles of 4.12％papers were identified as randomized trials. More than 40％of the papers only reported the study purpose or hypothesis in the abstract. 3.16％of the papers reported primary and secondary efficacy index entries, and 0 papers reported complete information of subjects from enrollment to included data analysis sets. Conclusion There is a serious problem of items shortage in the literatures of randomized controlled clinical trials on Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer. The randomized controlled clinical trials of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer should be reported based on the CONSORT to improve the quality of trials.
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Objective To estimate the diagnostic value of cytology, DNA-ICM(DNA-image cytometry),cytology combined with DNA-ICM for pancreatic malignancy,and to explore the cut-off value for DNA-ICM. Methods Patients with suspicious pancreatic malignancy were retrospectively identified. In total,145 EUS-FNA specimens acquired from 140 separate patients were examined by cytology and DNA-ICM. Diagnostic values among cytology, DNA-ICM and the combination of the techniques in detecting pancreatic malignancy were compared. Results Compared with cytology, DNA-ICM had a lower sensitivity (63.0% VS 82.4%)and accuracy(69.7% VS 85.5%). After combining the techniques, the diagnostic value for pancreatic malignancy significantly improved compared with that by cytology(0.941 VS 0.912, P=0.007 0)or DNA-ICM only(0.941 VS 0.815, P<0.000 1). By using the Youden index, the cut-off value for DNA-ICM to detect pancreatic malignancy was one cell with DI(DNA index)≥2.5. Notably,with this standard, the sensitivity and accuracy of DNA-ICM significantly increased to 72.3% and 77.2%, and those of the combined techniques increased to 91.6% and 93.1%, respectively. Conclusion Automated DNA-ICM is an objective and effective method for pancreatic malignancy. Although DNA-ICM has a lower diagnostic value than that of conventional cytology, an improved value was obtained after combining the techniques.
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Objective@#To analyze factors influencing antiretroviral therapy (ART) adherence among human immunodeficiency virus (HIV) patients receiving ART at the town level in Ili Kazakh Autonomous Prefecture (Ili) in May 2015 and to document enhanced ART for acquired immunodeficiency syndrome (AIDS) cases.@*Methods@#A cross-sectional survey was conducted using one-on-one interviews and data collection from the system of AIDS follow-up management in three ART services centers at the town level of Ili. The subjects were HIV-infected individuals, aged 18 years or older, who were receiving ART during the survey. The surveys collected demographic characteristics, information related to ART and status of engaging ART, smoking and drinking behavior, depression, and quality of life.@*Results@#A total of 412 participants completed the survey. The age was (41.1±8.0) years (range, 19-67 years). Approximately 60.9% (251) were male and 39.1% (161) were female. The survey showed that 75.0% (309) of participants were in good adherence and the P50 (P25, P75) of quality of life was 56.31 (50.55, 59.42). Females demonstrated better adherence to ART (82.6% (n=133)) than males (70.1% (n=76)) (χ2=8.16, P=0.005). The compliance rate of participants (78.0% (n=54)) with depression was higher than non-depressed participants (63.5% (n=255)) (χ2=7.52, P=0.008). Multivariate logistic regression analyses showed that the probability of good adherence to ART increased with increasing quality of life (OR=1.06, 95%CI:1.02-1.09). Moreover, participants who consumed alcohol or disclosed their HIV infection status to families were less likely to have good adherence to ART (OR=0.26, 95% CI:0.13-0.53 and OR=0.31, 95% CI:0.13-0.72, respectively). Additionally, employed participants were also less likely to have good adherence to ART compared with unemployed participants (OR=0.45, 95% CI:0.21-0.97).@*Conclusion@#HIV/AIDS patients primarily showed good adherence to ART. Factors related to ART adherence included alcohol consumption, informing family of infection, work status, and quality of life.
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Benign anastomotic stenosis after esophagogastrectomy could reduce the patients' quality of life,even resulting in severe malnutrition and death.The endoscopic treatment includes dilatation,stent insertion,locoregional injection,and a relatively new technique radial incision and cutting.This article reviewed the progress in endoscopic treatment of benign anastomotic stenosis after esophagogastrectomy.
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This paper discussed the method and procedure of building a hospital operational data center,and introduced the application of its service with examples.Three aspects discussed in the paper cover the setup of information standard,integration of heterogeneous data resources,and flexible data presentation.Other issues discussed include key challenges and solutions for development of hospital data center systems.Such a platform enables the hospital in a successful standardization and structural management of its clinical data.
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Objective To study the effect of artesunate on inflammatory responses to severe pneumonia by regulating macrophage migration inhibitory factor (MIF) in rats.Methods Total of 100 SD by random (random number) assigned,20 rats were control group,80 SD rats with severe pneumonia were caused by Klebsiella pneumoniae,60 SD rats were treated with different concentrations (20,40,80 mk/kg) of artesunate after modeling.The pathological changes of lung tissue,the level of MIF myeloperoxidase activity and inflammatory cell infiltration in lung tissue of rats were evaluated.Results After treatment with artesunate,the severity of inflammation was significantly alleviated in rats with severe pneumonia evidenced by decrease in myeloperoxidase activity [severe pneumonia:(17.5 ± 1.5) vs.treatment group:(7.5 ±2.0)] and reduction in inflammatory cell infiltration (severe pneumonia:27 × 106 vs.treatment group:12.5 × 106).Similarly,the artesunate also reduced the production of inflammatory cytokines significantly in bronchoalveolar lavage fluid (IL-1 in severe pneumonia group:(1 100 ± 50) pg/ml vs.treatment group:(400 ± 60) pg/ml;IL-6 in severe pneumonia group:(700-± 30) pg/ml vs.treatment group:(200 ±40) pg/ml;IL-10 in severe pneumonia group:(500 ± 70) pg/ml vs.treatment group:(200 ± 40) pg/ml;TNF-αin severe pneumonia group:(500 ± 80) pg/ml vs.treatment group:(150 ± 50) pg/ml.In addition,artesunate inhibited the level and production of MIF,thus inhibiting the inflammatory responses mediated by MIF.Conclusions Artesunate had a protective effect on pneumonia caused by Klebsiella pneumoniae in rats via inhibiting the inflammation responses mediated by MIF.This study provided a molecular basis for newly developed drugs applied to the treatment of pneumonia caused by Klebsiella pneumoniae in rats.
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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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Objective To explore the etiologies and characteristics of esophageal motility in patients with non-obstructive dysphagia by esophageal high-resolution manometry (HRM).Methods From November 2011 to August 2015,233 patients with non-obstructive dysphagia diagnosed by HRM were retrospectively analyzed.All the patients received gastroendoscopy to exclude obstructive dysphagia.Results Among 233 patients with non-obstructive dysphagia,there were 160 cases of achalasia,38 cases of nonspecific esophageal motor disorder (13 cases of low amplitude peristalsis or absent peristalsis,seven cases of synchronous contraction or rapid contraction,three cases of distal esophageal spasm,six cases of increased resting upper esophageal sphincter pressure (UESP),three cases of reduced UESP,six cases of lower esophageal sphincter (LES) incomplete relaxation),five cases of gastroesophageal reflux disease,four cases of scleroderma,two cases of Jackhammer esophagus,and 24 cases with normal esophageal motility.Conclusions Achalasia is the most common cause of non-obstructive dysphagia,followed by nonspecific esophageal motor disorder.Esophageal HRM is an important method for the diagnosis of nonobstructive dysphagia,especially for unexplained dysphagia.
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Objective To investigate the drug effect of children with Dent disease who received therapy of po-tassium citrate and thiazide diuretics and angiotensin -converting enzyme inhibitors(ACEI),and to provide the refe-rence for the clinical treatment.Methods Dent disease patient who were followed -up in Bayi Children′s Hospital Af-filiated to Beijing Military Region General Hospital during the period of July 2006 and March 201 4 were selected.The patients were administered a therapy of potassium citrate associated with thiazide diuretics and ACEI according to the level of proteinuria and calciuria and serum potassium.The underlying changes before and after the treatment were com-pared and analyzed.Results In 1 5 children with Dent disease,they were all male cases,onset age ranged from 3 months to 1 1 years old[(2.62 ±3.1 1 )years old],and the disease duration ranged from 0.50 to 9.50 years old [(2.81 ±2.34)years].The patients were followed up for 0.50 to 7.50 years[(3.61 ±2.62)years].There was a sig-nificantly statistical difference in calcium/creatinine and daily Ca -creat ratio in contrast to before treatment[(0.41 ± 0.1 9)mg/mg vs(0.26 ±0.1 2)mg/mg,t =2.603,P =0.021 ;(6.76 ±2.0)mg/kg vs (4.34 ±1 .97)mg/kg,t =5.265,P =0.000],there was no significantly statistical difference in 24 -hour urinary protein quantity in contrast to before treatment[(0.96 ±0.62)g/24 h vs (0.87 ±0.44)g/24 h,t =1 .01 6,P =0.327].One case with kidney stone and 5 cases with nephrocalcinosis had a negative result of renal ultrasound after treatment.Conclusions Treatment of potassium citrate combination with thiazide diuretics and ACEI can significantly decrease urinary calcium excretion, make a disappearance of kidney stone and nephrocalcinosi,and it may have a role in protecting renal function.Treat-ment of benazepril can not significantly decrease the proteinuria and has no substantial improvement in low molecular weight protein urine.
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<p><b>OBJECTIVE</b>This study aimed to investigate the status of multiple sexual partners and unprotected sexual behaviors and related influencing factors among HIV-positive men who have sex with men (MSM).</p><p><b>METHODS</b>HIV-positive men having sex with men aged 18 years or older, living in Chengdu, Chongqing or Guangzhou were recruited by using the " snowballing" sampling method. Participants completed the questionnaire on computers, after filling in the Informed Consent Form. Content of the study would include social demographic characteristics, number of sexual partners, sexual behaviors, and the symptoms assessment on depression and anxiety.χ(2)-test,t-test and non-conditional Multiple logistic Regression methods were used to examine the risky sexual behaviors with multiple sexual partners among the participants engaged in this project.</p><p><b>RESULTS</b>Mean age of the 501 participants was (30.24±7.70) years old. In the past 6 months, 17.4% (87/501) of them had engaged in unprotected sexual behavior with two or more sexual partners. Factors at risk would include: being married (OR=1.93, 95%CI: 0.77-4.84), divorced or widowed (OR=3.94, 95%CI: 1.66-9.36), having primary male sexual partners (OR=5.04, 95%CI: 1.08-23.54) and casual or commercial male sexual partners (OR=2.54, 95%CI: 1.34-4.80) in the past 6 months, drinking alcohol (OR=3.00, 95%CI: 1.37-6.62) or Rush (alkyl nitrite) (OR=3.53, 95%CI: 1.72-7.23) during sexual acts, sharing their HIV-infection status to their partly primary male sexual partners (OR=1.84, 95%CI:0.78-4.33) or not (OR=2.68, 95% CI: 1.25-5.73), and having high sexual sensation seeking scores (OR=1.09, 95%CI: 1.03-1.15).</p><p><b>CONCLUSIONS</b>Unprotected sexual behaviors with multiple sexual partners among HIV-positive MSM played an important role in expediting the HIV transmission. Development of intervention programs to minimize the risk sexual behaviors and setting up efficient medical and biological measures in controlling the HIV transmission were in urgent need.</p>
Sujets)
Adulte , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Coït , Dépression , Trouble dépressif , Caractéristiques familiales , Homosexualité masculine , Psychologie , Infections , Épidémiologie , Mariage , Risque , Prise de risque , Comportement sexuel , Partenaire sexuel , Enquêtes et questionnaires , Rapports sexuels non protégés , PsychologieRésumé
Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.
Résumé
Objective To investigate the correlation between insulin resistance with female overactive bladder (OAB) .Meth‐ods 96 female patients with OAB were selected as the observation group and contemporaneous 92 women with healthy physical ex‐amination were taken as the control group .The fasting plasma glucose (FPG) ,triglycerides (TG) ,total cholesterol (TC) ,high‐den‐sity lipoprotein (HDL‐C) ,low‐density lipoprotein (LDL‐C) ,fasting insulin (FINS) ,and C reaction protein (CRP) levels were measured in the two groups .The insulin resistance index was calculated by the homeostasis model assessment of insulin resistance (HOMA‐IR) .Results The waist circumference ,body mass ,body mass index (BMI) ,hypertension cases and proportion of meno‐pause cases in the observation group were higher than those in the control group .FPG ,TG ,FINS ,CRP levels and HOMA‐IR in the observation group were significantly higher than those in the control group ,while the HDL‐C level was lower than that in the con‐trol group .In addition ,the differences in TC and LDL‐C levels between the two groups were not statistically significant (P>0 .05) . Conclusion Insulin resistance has no correlation with female OAB .