Analysis of changes in cardiac structure and function in 363 patients with maintenance hemodialysis / 中国医师杂志

Objective:To investigate the characteristics of cardiac structure and function changes in maintenance hemodialysis (MHD) patients.Methods:The information of 363 MHD patients with dialysis age ≥3 months who were registered in Huadu District People′s Hospital of Guangzhou City before January 2020 was collected, and the echocardiographic screening was performed to analyze the changes in cardiac structure and function.Results:The most common abnormal changes of heart structure and function in MHD patients were valve regentation (69.7%), left ventricular hypertrophy (LVH) (51.8%), left ventricular diastolic dysfunction (29.8%), valve calcification (11.6%), and left ventricular systolic dysfunction (10.2%). With the increase of age, the left ventricular ejection fraction of MHD patients decreased, and the proportion of left ventricular diastolic dysfunction, left atrial enlargement and pulmonary hypertension increased (all P<0.05). Among 363 MHD patients, 188(51.8%) had LVH. It was found that LVH patients had higher average single ultrafiltration volume, higher brain natriuretic peptide (BNP) level, more type 2 diabetes, lower left ventricular ejection fraction (all P<0.05), and were more prone to chest tightness, chest pain, post activity shortness of breath, heart failure and other symptoms compared with the non-LVH patients (all P<0.05). Conclusions:Most MHD patients have different degrees of cardiac structural changes. Early intervention, reduction of single ultrafiltration volume and control of blood glucose are beneficial to improve the dialysis quality of MHD patients and reduce the occurrence of cardiovascular events.

The incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis / 中国医师杂志

Objective:To analyze the incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis.Methods:Clinical data of 627 hemodialysis patients in Huadu District People′s Hospital of Guangzhou who met the inclusion criteria and exclusion criteria from January 2015 to December 2020 were retrospectively collected. Clinical characteristic of patients with malignant tumors was summarized. Multivariate logistics regression analysis was performed to explore the related factors of malignant tumors.Results:Among the 627 patients, 19(3.03%) developed malignant tumors. There were 14 males and 5 females with a mean age of (65.7±13.7)years. Their mean dialysis duration was (45.16±38.18)months. Gastrointestinal tumor was the most common tumor type (9/19). Univariate analysis showed that the age of the patients combined with malignant tumors was significantly higher, and the serum prealbumin was significantly lower than those patients without malignant tumors (all P<0.05). Logistic regression analysis showed that age was the independent risk factor of developing cancers after adjusting dialysis age, hemoglobin, albumin and parathyroid hormone ( P<0.05). Conclusions:The incidence of malignant tumor is significantly higher in maintenance hemodialysis patients than that in the general population. Age is the risk independent risk factor. Therefore, we should strengthen the monitoring of elderly hemodialysis patients, discover the disease in time, and take measures to improve the prognosis.

Clinical features and treatment of breast intraductal papilloma / 中华普通外科杂志

Objective:To investigate the clinicopathologic features and diagnostic methods of intraductal papillary(IP)lesions of the breast.Methods:The clinical data of 1 679 patients who had been pathologically diagnosed as having IP were analyzed retrospectively.Results:Nipple discharge is the most common clinical symptom of IP. According to the postoperative pathological results, IP patients were divided into solitary IP group and multiple IP group . Nipple discharge was more common in solitary IP group ( P<0.05). Bloody discharge and duct nipple discharge and discharge in unilateral breast were the most common clinical symptom of IP, though the difference was not significant ( P>0.05). The accuracy of diagnosing IP by fiberoptic ductoscopy(FDS) was 88.66% which was significantly higher than that of breast ultrasound and mammography. Solitary IP patients with nipple discharge undergoing FDS before surgery and lesions were more often detected located in general or level Ⅰ-Ⅱ duct system ( P<0.05). Postoperative follow-up did not show malignant transformation in solitary IP group, while there were 4 cases in the multiple IP group of malignant transformation and higher recurrence rate of IP ( P<0.05). Conclusions:Bloody discharge, single duct nipple discharge and unilateral breast involving 1esion and 1esions located in the general or level Ⅰ-Ⅱ duct system are common clinical features of IP. FDS has advantages in the diagnosis of IP with nipple discharge. For fear of recurrence , and malignant transformation in multiple IP, active postoperative follow-up should be carried out.

Efficacy of allogeneic platelet-rich on healing and regeneration of diabetic foot wounds / 中国输血杂志

【Objective】 To investigate the effect of allogeneic platelet-rich on the healing and regeneration of diabetic foot wounds. 【Methods】 A total of 86 patients with diabetic foot ulcer treated in our hospital from January 2019 to June 2020 were selected for this study. They were divided into 2 groups by the random number table method, with 43 patients in each group. The control group was given conventional treatment according to the Guidelines for the Diagnosis and Treatment of Diabetic Foot in China, and the observation group was further treated with platelet-rich gel (APG) from the allogeneic blood bank.The clinical efficacy, general conditions, wound conditions, inflammatory factors, serum levels of transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF) and hyaluronic acid (HA) were compared between the two groups. 【Results】 The total effective rate of patients in the observation group was 93.02%, higher than 76.73% in the control group (P0.05). After treatment, hsCRP (2.35±0.50 vs 2.83±0.44) mg/L, TNF-α(3.15±0.82 vs 4.02±1.07) μ g/L and IL-6 (50.82±18.54 vs 72.93±20.25) mg/L in the observation group were lower than those in the control group (P 0.05). After treatment, the levels of TGF-β 1 (17.29±4.09 vs 14.03±3.72) ng/L, VEGF (43.03±14.17 vs 37.04±11.05) and ha (177.96±39.08 vs 151.94±36.17) in the observation group were higher than those in the control group (P<0.05). 【Conclusion】 On the basis of conventional treatment, allogeneic blood bank concentrated platelet APG can effectively improve the curative effect of diabetic foot wound and shorten the wound healing time and hospitalization time. The mechanism may be related to reducing the level of inflammatory factors and increasing TGF-β 1, VEGF and HA.

High-throughput screening identifies established drugs as SARS-CoV-2 PLpro inhibitors

A new coronavirus (SARS-CoV-2) has been identified as the etiologic agent for the COVID-19 outbreak. Currently, effective treatment options remain very limited for this disease; therefore, there is an urgent need to identify new anti-COVID-19 agents. In this study, we screened over 6,000 compounds that included approved drugs, drug candidates in clinical trials, and pharmacologically active compounds to identify leads that target the SARS-CoV-2 papain-like protease (PLpro). Together with main protease (M

Significance of serum levels of uric acid and sphingosine 1-phosphate in patients with intermediate coronary artery lesions / 中华全科医师杂志

A total of 120 patients with intermediate coronary artery disease who were admitted to Ankang Hospital of Traditional Chinese Medicine from October 2017 to October 2019 were enrolled in the study (study group), and 120 patients who had ischemic changes on ECG, but no definite angiographic stenosis served as the control group. The SUA and S1P levels were measured, and Gensini scores were evaluated. Coronary blood flow reserve fraction (FFR)≤0.8 was used as the gold standard for diagnosis of functional myocardial ischemia. Patients in the observation group with functional myocardial ischemia and no-functional myocardial ischemia were evaluated. The correlation between variables was analyzed using the Pearson method. The levels of SUA [(492.52±35.47)μmol/L], S1P [(386.42±46.19)nmol/L] and Gensini score (69.42±7.81) in the study group were significantly higher than those in the control group ( t=51.218, 35.227, 60.237; P<0.05).In the study group, patients with functional myocardial ischemia had higher SUA[(678.23±54.21)μmol/L], SIP[(483.45±34.64)nmol/L] and Gensini score[(83.22±5.34) points], and higher incidence of drinking, hypertension, diabetes, and hyperlipidemia compared with no-functional myocardial ischemia patients ( t=24.764, 18.858, 17.888, respectively; χ 2=55.883, 53.684, 27.819, 71.070, 31.111, respectively; P<0.05). Pearson analysis showed that levels of SUA and S1P in patients with coronary artery lesions were positively correlated with Gensini score ( r=0.653, 0.715; P<0.01). The levels of SUA and S1P in patients with intermediate coronary artery lesions are correlated with the severity of coronary stenosis, the combination of the two indicators has better efficacy in predicting functional myocardial ischemia.

Application of RALE score in children with hematonosis/hematological malignancies complicated with acute respiratory distress syndrome / 解放军医学杂志

Objective: To explore the prognostic capacity of RALE scoring system in children with hematologic malignancies complicated with acute respiratory distress syndrome (ARDS). Methods: The clinical data were retrospectively analyzed of 57 ARDS child patients complicated with hematologic malignancies in pediatric intensive care unit (PICU) from Jan. 2014 to Jun. 2018. According to the therapeutic outcome within 28 days, they were divided into survival group (n=23) and non-survival group (n=34). The clinical features of the two groups were compared, and the relativity between RALE score and oxygenation index (P/F value) and the prognostic capacity of RALE score for ARDS were analyzed. Results: For the 57 child patients, the D1 P/F value was lower in non-survival group [116.0(70.0, 192.0)] than in the survival group [189.5(136.5, 251.3)], while the D1 pedicatic risk of mortality score (PRISM) HI, D1 RALE score and D3-D1 RALE score were higher in non-survival group [10.0(8.0, 16.0), 27.0(25.0, 37.0) and 5(0, 8), respectively] than in the survival group [7.6(4.0, 13.4), 24.0(13.8, 35.3) and -3.5(-7, 1), respectively]. The D1 RALE score was negatively correlated with the D1 P/F value (r=-0.831, P<0.001). A larger value of D3-D1 RALE score was an independent risk factor for 28 day mortality. The survival rate was higher in children when D1 RALE score ≤23 and the D3-D1 RALE score ≤-3 at D28. Conclusion: The RALE score can reflect the oxygenation status of ARDS, which is helpful for risk stratification and screening the high-risk patients.

Analysis of Drug Utilization in Obstetric Patients of Our Hospital during Pregnancy / 中国药房

OBJECTIVE： To analyze the characteristics of pregnancy medication in obstetric patients of our hospital， and to provide reference for promoting rational drug use in obstetric department. METHODS： Using hospital information system， 30 prescriptions of women who produced in our hospital were randomly selected monthly from Jan. 2015 to 30th， 2017. The modes of production and pregnancy outcomes were recorded. The drugs used during pregnancy in our hospital were summarized. Statistical analysis was made on the number of cases， varieties and frequency of drug use in neonatal outcomes and different stages of pregnancy. The rationality of drug use in different stages of pregnancy was evaluated. RESULTS： Totally 1 076 valid prescriptions were collected， including 528， 343 and 205 cases aged 21-30， 31-34， 35 and above， 462 cases with cesarean and 614 patients with spontaneous labor， 1 041 cases with single fetus and 35 cases with twins， 1 089 neonates with APGAR score of 8-10，20 neonates with 4-7，and 2 neonates with 0-3， 96 neonates with low birth weight and 4 neonates with abnormal. The rate of drug use during pregnancy was as high as 96.65％ （1 040/1 076）. The utilization rate of drugs were 55.19％ （574/1 040）， 99.42％ （1 034/  1 040） and 57.98％ （603/1 040） in the first， second and third trimesters of pregnancy， involving 137 drugs. Classification of top 3 drugs in the list of frequency were drugs for digestive tract and metabolic diseases for Fuzheng agent （Chinese patent medicine） and for sex hormones and regulators of reproductive system in the first trimesters of pregnancy， and for digestive tract and metabolism， urinary and reproductive system and cardiovascular system in the second trimesters， for digestive tract and metabolism， blood and hematopoietic organs and systemic hormones except sex hormones and insulin in the third trimesters. There were unreasonable use of drugs in the first trimester and there were also abnormalities outcomes of birth， but the correlation between abnormalities and drugs used during pregnancy could not be determined in the study. CONCLUSIONS： The rate of drugs used during pregnancy was high， and the value of DDDs was highest in the second trimester； the types of drugs used in different periods basically accord with the epidemiological characteristics of pregnancy. However， there are some unreasonable medication problems and potential safety hazards in medication during pregnancy， which need to be further rectified. The correlation between adverse pregnancy outcomes and drugs used during pregnancy has not been determined， and needs to be studied with large sample data.

Analysis on risk factors for deep venous thrombosis of lower extremities after hip fracture / 中华创伤杂志

Objective@#To investigate the risk factors of deep venous thrombosis (DVT) of lower extremities after hip fracture and provide reference for the prevention of DVT.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 167 patients with hip fracture admitted to Daping Hospital of Army Medical University from January 2016 to December 2016, including 75 males and 92 females, aged 18.7-90.3 years [(70.4±17.7)years]. Using the positive results of ultrasound as the standard for confirming the diagnosis of DVT, 79 patients (47.3%) were assigned to the DVT group, and 88 patients (52.7%) to the non-DVT group. Patients' age, gender, body mass index (BMI), smoking history, D-dimer level, osteoporosis, venous thrombosis risk stratification score (RAPT), coronary heart disease, hypertension, diabetes history, anesthesia method (general anesthesia or nerve blocking), type of surgery (joint replacement or internal fixation), operation time were included in the analysis. The correlation between DVT and the above indices was explored through univariate analysis, followed by logistic regression analysis to determine the risk factors of lower extremities DVT after hip fracture.@*Results@#The univariate analysis showed that smoking history, D-dimer level, BMI, RAPT score, hypertension, diabetes, coronary heart disease, anesthesia method and operation time were significantly associated with lower extremities DVT after hip fracture. According to the logistics regression analysis, smoking (OR=9.403, P<0.05). D-dimer (OR=0.999, P<0.01), BMI(OR=0.603, P<0.01), RAPT score (OR=0.499, P<0.05), hypertension (OR=28.965, P<0.01), diabetes(OR=6.948, P<0.05), coronary heart disease (OR=17.185, P<0.01), operation time (OR=36.830, P<0.01) were significantly correlated with newly formed lower extremities DVT after hip fracture.@*Conclusions@#Smoking, D-dimer level, obesity (BMI≥25 kg/m2), RAPT score, hypertension, diabetes, coronary heart disease and operation time (≥150 minutes) are independent risk factors for lower extremities DVT after hip fracture. D-dimer level detection shows early diagnostic value for hip fracture with DVT. RAPT score can effectively evaluate DVT in trauma patients, thus guiding and preventing the occurrence of DVT.

Research progress of positive ALK fusion gene non-small cell lung cancer / 解放军医学杂志

Lung cancer is the highest incidence of malignant tumor in the world, and is the leading cause of cancer death; 80%-85% of lung cancer is non-small cell lung cancer (NSCLC) and the positive rate of anaplastic lymphoma kinase (ALK) fusion gene in NSCLC patients is about 3%-7%. In recent years, targeted therapeutic drugs for ALK fusion gene have developed rapidly. The clinical use of ALK inhibitors such as clozotinib, aletinib and loratinib has significantly improved the survival of patients with ALK positive advanced NSCLC. However, the effect of ALK fusion gene positive on the prognosis of early NSCLC patients is not clear, and whether it can benefit from ALK inhibitor treatment is still unknown. The action mechanism of ALK fusion gene, the clinicopathologic features, the method of detection, the effect of ALK fusion gene positive on the prognosis of NSCLC patients and the recent progress of the ALK inhibitor are briefly described in present paper with a view to having a certain reference to the clinical work.

Clinical effect of 595 nm tunable pulsed pulsed dye laser treatment of fresh trauma scars / 中国医师杂志

Objective To investigate the clinical effect of 595 nm tunable pulsed dye laser (PDL) in treating fresh trauma scars.Methods 85 patients had been selected,of which,117 sites were treated with a 595 nm tunable PDL one time or two times at a fluence of 7-15 J/cm2 and pulse widths of 1.5-3 ms,7 mm spot size.Nursing skill of burn wound was also used on treatment area after laser treatment.Scars were evaluated for melanin,height,vascularity and pliability using the Vancouver Scar Scale (VSS) before treatment and after the last treatment 8weeks.Results Total score of 117 sites decreased from (8.30 ± 2.63) to (2.70 ± 1.25),melanin decreased from (1.60 ± 0.84) to (0.60 ± 0.97),height decreased from (1.30 ± 0.82) to (0.40 ± 0.51),vascularity decreased from (2.40 ± 0.52) to (0.40 ±0.52),pliability decreased from (2.80 ± 1.32) to (1.30 ±0.48),with statistical significance between before treatment and after treatment (P ＜ 0.05).Conclusions 595 nm tunable pulsed dye laser appears to have a beneficial clinical effect on patient's fresh trauma scar.

Analysis on risk factors for deep venous thrombosis of lower extremities after hip fracture / 中华创伤杂志

Objective To investigate the risk factors of deep venous thrombosis ( DVT) of lower extremities after hip fracture and provide reference for the prevention of DVT. Methods A retrospective case-control study was conducted to analyze the clinical data of 167 patients with hip fracture admitted to Daping Hospital of Army Medical University from January 2016 to December 2016, including 75 males and 92 females, aged 18. 7-90. 3 years [(70. 4 ± 17. 7)years]. Using the positive results of ultrasound as the standard for confirming the diagnosis of DVT, 79 patients (47. 3％) were assigned to the DVT group, and 88 patients (52. 7％) to the non-DVT group. Patients' age, gender, body mass index ( BMI), smoking history, D-dimer level, osteoporosis, venous thrombosis risk stratification score ( RAPT ) , coronary heart disease, hypertension, diabetes history, anesthesia method ( general anesthesia or nerve blocking), type of surgery (joint replacement or internal fixation), operation time were included in the analysis. The correlation between DVT and the above indices was explored through univariate analysis, followed by logistic regression analysis to determine the risk factors of lower extremities DVT after hip fracture. Results The univariate analysis showed that smoking history, D-dimer level, BMI, RAPT score, hypertension, diabetes, coronary heart disease, anesthesia method and operation time were significantly associated with lower extremities DVT after hip fracture. According to the logistics regression analysis, smoking (OR=9. 403, P<0. 05). D-dimer (OR=0. 999, P<0. 01), BMI(OR=0. 603, P<0. 01), RAPT score (OR=0. 499, P<0. 05), hypertension (OR=28. 965, P<0. 01), diabetes (OR=6. 948, P<0. 05), coronary heart disease (OR=17. 185, P<0. 01), operation time (OR=36. 830, P<0. 01) were significantly correlated with newly formed lower extremities DVT after hip fracture. Conclusions Smoking, D-dimer level, obesity ( BMI≥25 kg/m2 ) , RAPT score, hypertension, diabetes, coronary heart disease and operation time (≥150 minutes) are independent risk factors for lower extremities DVT after hip fracture. D-dimer level detection shows early diagnostic value for hip fracture with DVT. RAPT score can effectively evaluate DVT in trauma patients, thus guiding and preventing the occurrence of DVT.

Effect of bitter gourd saponins on the expression of ET-1 in renal tissues of rats with renal damage induced by salt-sensitive hypertension / 中国基层医药

Objective To investigate the effect of bitter gourd saponins on the salt -sensitive hypertension caused kidney damage in rats ,and analyze the mechanism of its therapeutic effect .Methods 50 SD rats were fed for 10 days with normal diet ,and then based on random number method ,the rats were randomly divided into 5 groups:the normal control group,model control group and the low total saponins bitter,medium and high dose treatment group,10 rats in each group.Then,the rats in the normal control group and the model control group were given 1mL· kg-1 · d-1 normal saline,and the rats in bitter gourd saponins groups were given high salt diet 8 weeks to establish the model .After 4 weeks,the total saponins of bitter gourd treatment groups were given 10,20 and 40mg· kg-1· d-1.8 weeks later, the rats were sacrificed and the renal pathology was detected by HE staining .The changes of blood pressure , heart rate,urinary function and blood renal function were also analyzed .At last,Western blot and semi -quantitative PCR were used to detect the endothelin -1 (ET-1) in renal tissue.Results For the systolic blood pressure,in whole of treatment,the normal control group maintained at about 120 mmHg, while the model control group maintained at 170mmHg,which of the bitter gourd saponins three doses groups compared to the model control group was significantly lower (t=1.765,1.982,2.126,all P<0.05),further improved.And the heart rate had no statistically significant difference among the groups(all P>0.05).Compared with the normal control group,the blood urea nitrogen (BUN), creatinine (Cr),uric acid (UA),urine volume,urinary protein and N -acetyl beta -D-Glucosaminidase (NAG) levels in the model control group were significantly increased (t=28.703,33.932,29.298,4.695,10.989,10.871, all P<0.05),which in the bitter gourd saponins treatment groups were significantly decreased (all P<0.05).HE staining showed that the rats in the normal group were normal ,and the model control group had obvious glomerular sclerosis and renal interstitial fibrosis , after bitter gourd saponins treatment , the condition was significantly improved .Immu-nohistochemistry,Western blot and semi-quantitative PCR showed that normal control group had almost a little expression of ET-1,and compared with the normal control group ,which of the model control group was significantly increased ( t=14.650,11.387,all P<0.05),and the ET-1 expression in the bitter gourd saponins treatment groups significantly decreased.Conclusion The bitter gourd saponins can significantly improve the symptoms of hypertension and renal damage induced by high salt diet in rats ,which may be related with regulation of ET -1 expression in renal tissue .

A comparative study on children's basic medical insurance system and policies in four municipalities in China / 上海交通大学学报（医学版）

Objective·To analyze the basic medical insurance policies for children in Shanghai in 2011 and 2017, and compare with those of the other three municipalities to understand the basic medical security status of children in four municipalities in China and analyze the existing problems. Methods?·?The current effective children's basic medical insurance policies and child critical illness insurance policies and related insurance systems in four municipalities were collected systematically. The types of basic medical insurance for children in various municipalities and their funding standards, their own expenses and the proportion of government subsidies, the proportion of outpatient emergency payoff lines and reimbursement at all levels of medical institutions, and the coverage and coverage of major illness insurance reimbursement were collected and compared mainly. Results?·?The basic medical insurance for children in Shanghai is a "double insurance" system, which contained children's hospitalization fund and basic medical insurance for urban and rural residents. The basic medical insurance for children in other municipalities mainly consisted of basic medical insurance for urban (rural) residents. Compared with 2011, the level of financing and the reimbursement of the basic medical insurance for urban and rural residents and of the children's hospitalization fund in Shanghai in 2017 was increased. In 2017, the level of financing of basic medical insurance for urban and rural residents in Shanghai was 1?100 yuan, which was slightly lower than that of Beijing medical insurance for urban residents and new rural cooperative medical insurance and was higher than that of basic medical insurance for urban and rural residents in Tianjin and Chongqing, and the individual payment level of Shanghai was the lowest. The hospitalization payoff lines in Shanghai were lower than those of other municipalities. Shanghai's outpatient and inpatient reimbursement levels were higher those of than other municipalities. There wasn't a capping line in Shanghai. There were capping lines in other municipalities. There was a great difference in the insurance policy of the major diseases in four municipalities. Conclusion?·?According to their own actual conditions, models for children's medical care systems that suited each municipalities’ social and economic development have been established. Shanghai children's basic medical insurance basically meets the needs of children's growth but needs improvement in terms of the type and level of medical security for major illnesses.

Tissue culture of callus and establishment of regeneration system of Tussilago farfara petiole / 中国中药杂志

Young petiole of Tussilago farfara was used as the material to investigate the plant growth regulators which could influence in vitro culture and plant regeneration and to establish rapid propagation technique. The ideal sterilization method was that young petiole of T. farfara was sterilized with 75% ethanol for 30 s, and then transferred to saturated bleaching power supernatant for 15 min. The suitable medium for callus induction was MS+6-BA 3.0 mg•L⁻¹+2,4-D 2.0 mg•L⁻¹ with 96.2% induction rate. The seedlings had better differentiation with 91% differentiation rate and 8.26 buds on the medium containing MS+ZT 2.0 mg•L⁻¹+NAA 0.3 mg•L⁻¹. The preferred enrichment medium of adventitious bud was MS+KT 1.0 mg•L⁻¹+IBA 0.3 mg•L⁻¹ with 11.81 enrichment times and 4.9 cm seedling height. The rooting medium included 1/2MS+IBA 0.2 mg•L⁻¹ with the average number of rooting was 5.86 and the rooting rate was above 95.22%. The container seedlings can grow well and the survival rate was more than 90% when they were transplanted on the medium added with river sand and organic fertilizer with the ratio of 3∶1. The field experiments indicated that significant differences in increment and yield of pollen grains among the tissue-culture, cultivation and wild type of T. farfara under the same cultivation conditions. The cultivated plants were relatively high on the increment and yield of pollen grains. The active ingredient content of the tissue culture and the wild materials was basically the same.

Histological changes of the dermal-epidermal junction of superficial scarin rabbit ears induced by ultrapulse CO2 fractional laser / 中华医学美学美容杂志

Objective To explore the effects of wound healing and histological changes by utilizing ultrapulse CO2 fractional laser for the treatment of superficial scar in dermal-epidermal junction (DEJ) in rabbit ears.Methods We adopted traditional iodophor treatment and moist exposed burn ointment treatment repairing the wound and utilizing ultra pulse CO2 fractional laser for the treatment of rabbit ears superficial scar.The superficial scars in rabbit ear were induced with ultra pulse CO2 fractional laser.In 1,2,4,8 weeks tissue samples would be taken.Using electron microscopy we observed DEJ ultrastructure and light microscopy to observe the histological changes of the dermal papilla and PAS staining for epidermis basement membrane.Results The wound healing time of moist exposed burn ointment group was shorter than that of iodophor group (P＜0.05).The number of hemidesmosomes and anchoring fibers in the moist exposed burn ointment group on the 8th week was more than the 1th week,The number of hemidesmosomes and anchoring fibers in the iodophor group on 8th week was more than 1th week (P ＜0.05).The number of hemidesmosomes and anchoring fibers in the iodophor group was less than the moist exposed burn ointment group (P＜0.05).Conclusions U1trapulse CO2 fractional laser can cause ultra structural changes in scarring dermal-epidermal junction area,wet wound healing environment promotes the reconstruction of DEJ district organization,and rebuilding the function of the scar skin has the positive significance.

Application of time-spatial labeling inversion pulse in renal corticomedullary differentiation and time parameter optimization / 中国医学影像技术

Objective To investigate the application value of time-spatial labeling inversion pulse (T-SLIP) in renal corticomedullary differentiaton and the best black blood inversion time (BBTI) value.Methods Totally 60 volunteers were included,who underwent abdominal MR scan with noncontrast-enhanced SSFP sequence combined with T-SLIP.All subjects were scanned with different BBTI (800,1 000,1 200,1 400,1 600,1 800 ms) using coronary T-SLIP SSFP sequence.The images quality was evaluated using a four-point scale method.The region of renal cortex and medulla was devised automatically based on the image training algorithm.The signal intensity ratio with the different BBTI was calculated through measuring the signal intensity of the renal cortex and medulla.And the best BBTI values were analyzed.Results When BBTI was 1 200 ms,the image score was the highest.The signal intensity ratio (SIR) had statistical difference among different BBTI groups (all P＜0.05),when BBTI was 1 200 ms,the SIR was the highest,and the contrast between the renal cortex and medulla was obvious.Conclusion T-SLIP technology can improve the visibility of renal corticomedullary without contrast agents.The optimal BBTI for the best corticomedullary differentiation is 1 200 ms.

Effects of different follow-up methods on quality of life of patients with Heroin Spongiform Lekoencepha-lopathy / 实用医学杂志

Objective To explore the effects of different follow-up methods on the quality of life of pa-tients with Heroin Spongiform Lekoencephalopathy(HSLE)in 6 months after discharge. Methods A total of 59 HSLE patients were assigned to control group(n = 29)and experimental group(n = 30). Control group received regular telephone interview,and experimental group the follow-up from an interdisciplinary cooperation team in 6 months after discharge. Social support rate and the quality of life in 2 groups were compared using the Social Sup-port Rating Scale(SSRS)and the Quality of life for Drug Addicts(QOL-DA)for 6 months after discharge. Re-sults After the intervention,the scores of SSRS and the QOL-DA of experimental group indicated a marked im-provement compared with those of control group. The score of QOL-DA of two groups was all improved and intra-group comparison had statistical differences(P<0.05). Conclusions Follow-up can improve social support rate and the quality of life of HSLE patients,and the effect of follow-up from a multidisciplinary team is better than that of regular telephone interview.

Epidemiology of acute kidney injury in Chinese critical patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the epidemiological profile of acute kidney injury (AKI) in the Chinese critical patients.</p><p><b>METHODS</b>The hospitalization data and serum creatinine data of critically ill adult patients were collected from 9 regional central hospitals across China in 2013. Kidney Disease Improving Global Outcomes (KDIGO 2012) criteria was used to define and stage AKI. The demographic characteristics of the patients, comorbidities, stage of AKI, in-hospital outcomes and risk factors were retrospectively analyzed.</p><p><b>RESULTS</b>Of the total of 14 305 critically ill patients included in the study, 4298 (30.04%) were identified to have AKI, including 2240 (52.1%) in stage 1, 845 (19.7%) in stage 2, and 1213 (28.2%) in stage 3. The in-hospital mortality rate was 16.7% (716/4298) and the odds ratio for death was 7.59 (95%CI 6.54-8.79, P<0.001). The length of hospital stay, daily cost, and mortality rate were associated with the stage of AKI. Multivariate analysis identified chronic kidney disease (OR=5.45, 95%CI: 4.71-6.32, P<0.001), extra-renal organ failure (OR=12.57, 95%CI: 11.24-14.07, P<0.001), shock (OR=2.44, 95%CI: 2.01-2.96, P<0.001) and cardiac surgery (OR=5.96, 95%CI: 5.16-6.87, P<0.001) as the independent risk factors for AKI. Only 5.4% of the AKI patients whose serum creatinine change met the KDIGO criteria during hospitalization received the diagnosis of AKI upon discharge.</p><p><b>CONCLUSION</b>AKI is common in critically ill patients and associated with high mortality rates and poor outcomes. The stage of AKI is related with the in-hospital outcomes of the patients. Chronic kidney disease, extra-renal organ failure, shock and cardiac surgery are the major risk factors for AKI in these patients. Missed diagnosis occurs in most of the AKI cases, which urges more awareness of the condition in the critically ill patients during hospitalization.</p>

The Role of Hydrogen Sulfide in Acute Liver Injury Induced by Traumatic Stress in Rats / 法医学杂志

OBJECTIVE@#To explore the role of hydrogen sulfide (H2S) in acute liver injury induced by crushing hind limbs of rats.@*METHODS@#The rats were randomly divided into the following groups: control, crushing, H2S donor sodium hydrosulfide (NaHS) + crushing, H2S inhibitor propargylglycine (PAG) + crushing group. The acute liver injury model was established by 'crushing the hind limbs of rats with standard weight. Rats were sacrificed at 30 min and 120 min after the crush. The activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured by colorimetric method, and the content of H2S in plasma and the contents of malondialdehyde (MDA), protein carbonyl, glutathione (GSH) in the liver and the activity of H2S generating enzyme (cystathionine y-lyase, CSE) were determined by chemical method. The expression of CSE mRNA in liver was detected by RT-PCR.@*RESULTS@#For crush injury group, the levels of AST and ALT in serum, MDA and protein carbonyl in liver increased. The levels of GSH, CSE, CSE mRNA in liver and H2S in serum decreased. The administration of NaHS before limbs crush could attenuate the changes of liver injury, but the pre-treatment with PAG could exacerbate the changes.@*CONCLUSION@#The decrease of H2S production could involve in mediating the acute liver injury induced by traumatic stress in rats.