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Objective:To examine the expression of core clock genes in the peripheral blood mononuclear cells (PBMCs) and the level of circadian disturbance-related proteins in the serum of chronic pancreatitis (CP) patients with pancreatic exocrine insufficiency (PEI), and explore their potential diagnostic value in clinical practice.Methods:The peripheral blood samples and related clinical data from 68 patients diagnosed with CP in Shanghai General Hospital from Jan 2015 to Jan 2022 were collected. Peripheral blood samples from 30 healthy individuals were used for control. The M-ANNHEIM classification system was used to stratify the clinical stages of patients with CP. The mRNA expression of the core clock genes, including Clock, Bmal1, Per1/2/3 and Cry1/2 in PBMCs was analyzed using realtime qPCR, and the expression of circadian disturbance-related proteins like TrkB, CD 36 and Rbp in serum was measured with ELISA. The receiver operating characteristic curve(ROC) and the area under curve (AUC) was used to test the efficiency for diagnozing PEI. Results:The mRNA expression of Per1 in CP patients was significantly decreased (0.76 vs 1, P<0.05), and the AUC for diagnozing PEI was 0.744 (95% CI 0.628-0.860), with a cut-off value of 0.72; and the sensitivity and specificity was 84.8% and 57.1%, respectively. The protein abundance of serum CD 36 was significantly increased in CP patients (33.85±19.74ng/ml vs 24.71±11.53 ng/ml, P<0.05); the AUC for diagnozing PEI was 0.834 (95% CI 0.735-0.932), with a cut-off value of 29.75 pg/ml; and the sensitivity and specificity was 74.3% and 84.8%, respectively. The expression of CD 36 was increased with the increase of CP clinical stage, and there were statistically significant differences between either two stages (all P value <0.05). The mRNA expression of Per1 in patients with CP in Stage Ⅰ was significantly higher than that in patients with CP in Stage Ⅱ or Ⅲ, and the differences were statistically significant ( P<0.05), but no statistical difference was found between Stage Ⅱ and Stage Ⅲ. Conclusions:The decreased expression of Per1 mRNA in PBMCs and increased level of CD 36 in serum are significantly related to the occurrence of PEI in CP, suggesting that they may have potential value for diagnozing PEI and guiding the clinical practice.
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Objective:To investigate the efficacy and safety of sindilizumab combined with apatinib in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma.Methods:A total of 74 elderly patients with recurrent and metastatic esophageal squamous cell carcinoma who were admitted to Xuancheng City Central Hospital from March 2019 to August 2020 were selected, and they were divided into study group and control group by random number table method, with 37 cases in each group. The control group was treated with apatinib mesylate, and the study group was treated with sindilizumab combined with apatinib mesylate. All patients were treated for 2 cycles and followed up for 1 year. The efficacy, peripheral blood tumor marker levels, adverse reactions and survival were compared between the two groups.Results:The objective response rate and clinical control rate in the study group were higher than those in the control group [35.1% (13/37) vs. 13.5% (5/37), 67.6% (25/37) vs. 43.2% (16/37)], and the differences were statistically significant ( χ2 = 4.70, P = 0.030; χ2 = 4.43, P = 0.035). After treatment, the levels of carcinoembryonic antigen (CEA), squamous cell carcinoma-associated antigen (SCC-Ag) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) in the two groups were all lower than those before treatment (all P < 0.05); the levels of CEA, SCC-Ag and CYFRA21-1 in the study group were lower than those in the control group (all P < 0.05). There were no differences in the incidence rates of fatigue, proteinuria, bone marrow suppression, and hand-foot syndrome between the two groups (all P > 0.05). After 1 year of follow-up, 20 patients in the study group survived, and the 1-year overall survival (OS) rate was 54.1%; 10 patients in the control group survived, and the 1-year OS rate was 28.6%; the difference in OS between the two groups was statistically significant ( χ2 = 4.06, P = 0.044). Conclusions:Sintilimab combined with apatinib has a good efficacy in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma. This regimen can reduce the levels of tumor markers, improve the short-term survival rate of patients, and has good safety.
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Objective:To investigate the effect of AngioJet thrombectomy on proximal iliofemoral vein thrombosis after trauma.Methods:The clinical data of patients with proximal iliofemoral vein thrombosis treated with AngioJet thrombectomy were retrospectively analyzed at Vascular Surgery Department of our hospital in 2019.Results:A total of 76 patients were enrolled. After PMT 20 patients had grade Ⅲ thrombolysis clearance(26.3%), 41 patients (53.9%) had grade Ⅱ clearance, and 15 cases (19.7%) had grade Ⅰ clearance. Thirty four cases (44.7%) of grade Ⅲ were cleared after catheter aspiration or catheter thrombolysis, 35 cases (46.1%) of grade Ⅱ, 7 cases (9.2%) of grade Ⅰ were cleared, thrombus clearance rate increased significantly ( P<0.05). Cerebral hemorrhage occurred in 1 case (1.3%), and thrombosis recurred in 2 cases (2.6%). The patency rate was 91.8% at 3 months follow-up. Conclusions:AngioJet thrombectomy is a safe and effective method for treating post-traumatic proximal iliac femoral vein thrombosis. Intraoperative application of urokinase thrombolysis, catheter aspiration and catheter-directed thrombolysis can increase thrombus clearance effect.
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This paper tried to explore the method of excavation and sorting for local cultural knowledge of traditional Chinese medicine by confirming the research content, setting the eligibility, designing the research method, and implementing the research plan. We pointed out that the trial design, working style, policy support and funding support played an important role for the success of researches.
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The aim of the present research was to investigate and analyze the hunting intentions of medical students for rural grassroots in Gansu and to provide a reference for decision-making on rural health human resource . A questionnaire is the research tool which was used to investigate the views of the senior students from six medical schools , and we studied their employment willingness to rural healthcare institutions .Chi-square test and non-condi-tional logistic regression analyses were used for data analysis .A sample of 600 medical graduates was involved in this investigation.The results of this study show that more than a half (55.6%) of the students would like to work in ru-ral, but only 13.8%of which were “very willing” to work at the rural healthcare institutions .According to the out-comes of this investigation , the number of junior college students who would like to work at the grassroots was 2.3 times the number of the undergraduate students .Medical students whose monthly salary expectations were not high ,with the household registration in rural areas , and having a better understanding of the policy of rural grass-roots em-ployment were more likely to work at the rural healthcare institutions .Based on the findings of this investigation , it can be concluded that the grassroots medical career intention of medical students is not only influenced by its own fac -tors, such as education and household registration , but also the policy of the government , school employment guid-ance and social atmosphere play an important role .The above-mentioned factors should be considered by decision-making and management departments of public healthcare .The departments should introduce a reasonable recruit-ment policy and strengthen the construction of grass-roots medical technology , equipment , and infrastructure , im-prove the grass-roots of employment environment and career development opportunities and strengthen the medical students'employment guidance work to make medical students more willing to work at rural healthcare institutions .
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Objective: To evaluate the relationship between the levels of serum uric acid (SUA) and prevalence of coronary artery disease (CAD) by Meta analysis. Methods: We searched the databases of Pub Med, Elsevier and Web of Science for internationally published cohort study for the relationship between SUA levels and CAD prevalence and conducted a general analysisby using Stata software. Results: A total of 11 cohort study including 463,918 subjects were enrolled in this study. For both male and female genders, increase SUA level was the risk factor for CAD occurrence (RR=1.11, 95% CI 1.00-1.24) and (RR=1.24, 95% CI 1.15-1.34). Dose-response Meta-analysis indicated that by 1 mg/dl SUA elevation, the risk of CAD occurrence would increase 4.8% in male and 12.4% in female, the risk in female gender was higher than male. Conclusion: SUA level has been closely related to CAD prevalence.
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BACKGROUND: Experimental and clinical experiences show that the surface roughness of dental restoration materials directly affects bacterial adhesion; in addition, the material composition and physicochemical properties are also important influencing factors. OBJECTIVE: To compare the bacterial adhesion of zirconia ceramics and nickel chromium al oy as oral materials. METHODS: Zirconia ceramics and nickel chromium al oy were respectively cut into 10 pieces of 3. 0 cm ×3.0 cm×0. 2 cm plate specimens. For each material, five pieces were subjected to surface polishing treatment, and the other five pieces were glazed. Surface roughness value of specimens was detected. Experimental strains of Streptococcus mutans was cultured on the specimen surface at 37 ℃ for 48 hours, and the amount of bacteria adhering to the specimen surface was detected. RESULTS AND CONCLUSION: Surface roughness of four groups of specimens showed no difference. The amount of bacteria that adhered to the polishing specimens of zirconia ceramics was significantly lower than that of nickel chromium al oy (P < 0.05), but no difference was found in the amount of bacteria adhering to the glazing specimens of nickel-chromium al oy and zirconia ceramics. These findings indicate that zirconia ceramics has better ability to inhibit bacterial adhesion than nickel-chromium al oy, especial y after glazing.
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Objective To explore the effect of newly-designed gowns for critical patients. Methods Two hundred critical patients hospitalized for more than 3 days in the intensive care unit of our hospital during February 2013 to February 2015 were divided into the control group and observation group equally according to their odd or even registration number. The control group wore conventional dresses for patients (including a shirt and a pant) and the patients in the latter group were newly-designed gowns. The two groups were compared in terms of comfort, nursing manpower, nursing stuff and security. Result The observation group was significantly superior to the control group in terms of comfort, nursing manpower, nursing stuff and security (P<0.05). Conclusions The newly-designed gowns for critical patients can improve the comfort degree and save nursing manpower and stuff. It allows convenience in treatment and nursing.
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Objective To observe the effect of medicinal wine regimen which is guided by the theory of constitution distinction of TCM.Methods 76 patients were selected from all patients enrolled in wine style health experience from February 2011 to December 2011 in line with the corresponding physical characteristics.Among these 76 patients,23 patients were Yang deficiency constitution,34 were phlegm dampness constitution,and 19 were yin deficiency constitution.All these patients were taken a physical and chemical examination after taking the medicinal wine for a month.Results ①Examination index comparison before and after the treatment in different physical constitution patients:in phlegm dampness constitution patients the pulse were slowed (t=2.122,P＜0.05) after taking the blood fat reducing wine,and physical type of conversion points were lowered (t=4.86,P＜0.01); in Yang constitution patients,the systolic blood pressure (FT4),free thyroxine T4,physical type of conversion points were all significantly decreased [t values were 2.735,3.672,12.93,P＜0.05 or 0.01] after taking Guilu Erxian wine; in Yin deficiency patients,adrenocorticotropic hormone (ACTH),interleukin-1 (IL-1),interleukin-2 (IL-2) were all increased [t values were 2.355,2.645,3.829,P＜0.05 or 0.01] after taking Ziyin-Buxue wine.② Comparison of the clinical curative effect:according to the type of constitution transformation changes,the total effective rate was more than 70％.According to Ridit test,except yin deficiency physique (t=1.85,P＞0.05),patients in both phlegm dampness constitution and yang deficiency constitution groups showed statistical difference after the treatment than before (t=4.86 and 12.93,P ＜0.01).Conclusions Blood fat reducing wine can improve phlegm dampness constitution; Ziyin-Buxue wine can improve Yin deficiency constitution and enhance immune function; Guilu Erxian wine can lower blood pressure and improve Yang deficiency constitution.
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[Objective] Probe the source of Nv’ke Baixiao Quanshu or Obstetrics and Gynecology Pandect compiled by Gong Juzhong in Ming Dynasty, explorate the content and academic idea. [Methods]Through investigating and surveying the different editions, col ating and organizing the contents, probe and analyse the writing motivation, content and main idea of the work. [Results] The most contents of Nu ’ke Baixiao Quanshu are inherited from an-other work named Jiaozhu Furen Liangfang with 8 contents:Regulating the menstrual period, praying for children, antenatal training, previous preparation for delivery, parturition, lying-in, difficult labouring. The rest of the contents is extracted from some other works. This work records disease symptoms and medicine, surgery, gynecology and gravidity in various internal organs. Referring ancient classics on disease causes and researching prescriptions and treatments, the author emphasized naturalizing liver, kidney and spleen in warm. Mr. Gong applied drugs corresponding to syndromes. In the Qiusi and Taihou parts, he discussed rationales of infertility, natural endowment and pre-natal and post-natal care and introduced methodology of pulse feeling to diagnose pregnancy, Yuanfang Chao’s twelve col ateral channels in nourishing and training fetus, medicine conditioning for pregnant women, daily regi-men, medicine prohibition, preparation of ante partum. [Conclusion] Nu ’ke Baixiao Quanshu is created by extracting. Mr gong learned widely from oth-er’s strong points and compiled with distinct academic view, significantly guiding development of clinical medicine in department of gynecology of tradi-tional Chinese medical science and formation of system of reproduction care. Yet, some theories like methodologies of gender-oriented reproduction and gender-shifting reproduction should be discarded.
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Objective To observe the effect of hot spring medicated bath regimen which is guided by the theory of constitution distinction of TCM.Methods According to the standard of Constitution Classification and Decision of TCM which is published by China Association of Chinese Medicine to assess the standard-compliant volunteers,then make the volunteers have physical-chemical indexes checked and hot spring medicated bath taken.At last,re-assess the constitution of the individual and re-check the indexes.Results After the drug bath,the levels of total cholesterol (TCH),low-density lipoprotein (LDL-C),thyroid stimulating factor(TSH),and IL-1 of the patients who were both yang deficiency and phlegm-dampness decreased significantly (t values were 2.093,2.045,2.092,and 2.13,respectively; P＜0.05); the levels of high-density lipoprotein (HDL-C),cortisol,and free thyroxine T4 (fT4) increased significantly (t values were 3.731,2.571,and 3.027,respectively; P＜0.05) ; the pulse rate raised obviously (t=8.323,P＜0.01) ; both of the systolic (t=4.405,P＜0.01) and diastolic (t=2.782,P＜0.01)blood pressure dropped.After the drug bath,the levels of fT4 and IL-1 of the patients who were yang deficiency significantly increased (t values were 3.709 and 3.339,respectively; P＜0.01); the waist circumference reduced (t=2.831,P＜0.01),the pulse rate rised (t=9.605,P＜0.01) ; both of the systolic (t=5.281,P＜0.01)and diastolic (t=6.573,P＜0.01)blood pressure dropped.After the drug bath,the levels of pulse rate and diastolic blood pressure of the patients who are phlegm-dampness changed significantly:the pulse rate raised (t=4.702,P＜0.01),the diastolic blood pressure dropped(t=6.096,P＜ 0.01).As the effect analysis showed,the Ridit data of the criterion group which consists of summation was 0.5.Compared with the criterion group,the total effective rate of the yang deficiency group was 74.1％,which was statistically significant (R=0.55,P＜0.05).The total effective rate of the phiegm-dampness group was 81.8％,which had no statistical significance (R=0.48,P＞0.05).The total effective rate of the both yang deficiency and phlegm-dampness group was 77.4％,which was statistically significant (R=0.46,P＜0.05).Conclusion The Wuyi hot spring medicated bath regiman is helpful to the constitution type of yang deficient and phlegm-dampness,which can help warming yang and benefiting qi,living blood links contact us nourishing the skin,reducing blood fat,lowering blood pressure,improving the immune function and so on.
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<p><b>INTRODUCTION</b>In this study, we have developed and optimised a novel gelatin-chitosan (GC) substrate for use as a cellular carrier for tissue-engineered conjunctival epithelium.</p><p><b>MATERIALS AND METHODS</b>The substrate was fabricated by casting and the mechanical properties of the substrate, including tensile strength and elongation, were measured. Using the MTT, cell proliferation assay with rabbit conjunctival fibroblasts, we optimised the G:C ratio to enhance cytocompatibility. Rabbit conjunctival epithelial cells were immunostained using monoclonal antibodies for keratin 4 and pancytokeratin to investigate the biological effects of the GC substrate on the proliferation and differentiation of epithelial cells.</p><p><b>RESULTS</b>We found that increasing the amount of gelatin resulted in an increase in elasticity (from 1:9 to 1:1 ratio), reaching a maximum (101.89% +/- 7.13%) at a ratio of 1:1. The MTT assay showed that the proliferation of conjunctival fibroblasts significantly increased from 0.068 +/- 0.017 to 0.177 +/- 0.011 (P = 0.014) as the gelatin was increased from 20% (1:4) to 50% (1:1). Additional studies using tissue-cultured conjunctiva explants showed that these explants grew well on the substrate, forming a multilayered epithelium. Cell morphology on this substrate was similar to that of cells grown on culture dishes alone. Positive staining of keratin 4 and pancytokeratin indicated that the substrate supported normal differentiation of conjunctival epithelial cells.</p><p><b>CONCLUSION</b>By enhancing the proportion of gelatin, both the mechanical and biological properties of the chitosan substrate were improved. The results also suggest that this GC biomembrane may be a useful candidate for reconstructive tissue engineering of the conjunctiva.</p>