ObjectiveTo investigate the role of recombinant human growth hormone (rhGH) in the treatment of patients with multiple organ dysfunction syndrome (MODS). MethodsThirty-eight patients with MODS routinely treated with antibiotics and nutrition support were divided into two groups: the rhGH group and control group. The rhGH group was treated by subcutaneous injection of 5 U rhGH for two weeks. ResultsOn the 7th day of treatment, the score of APACHE Ⅱ in the rhGH group was much higher than the control group, the levels of ALT, AST, BUN and Cre did not change much compared with the control group. The level of albumin in the rhGH group increased (P＜0.05). The stay in ICU, time of mechanical ventilation and hospital stay decreased compared with the control group (P＜0.05). ConclusionrhGH can effectively improve the pathophysiology of critically ill patients and has no side effects on the function of liver and kidney, meanwhile it can shorten hospital stay and decrease mortality.
Objective To guide blood glucose management during pregnancy and reduce the incidence of long-term complications of the fetus by exploring the long-term growth condition of offspring of pregnant women with gestational diabetes mellitus. Methods A total of 180 cases full-term newborns of pregnant women with gestational diabetes mellitus from December 25th, 2011 to December 25th, 2012 were selected as the diabetes group. Another 200 newborns of pregnant women without any complications were randomly collected as the control group. Birth weight, gestational age, sex, blood glucose, and 24-, 48-, 72- and 120-hour transcutaneous bilirubin value after the birth of the newborns were recorded; weight, height, body mass index (BMI), triglycerides, total cholesterol, high density lipoprotein (HDL), low density lipoprotein, blood pressure and fasting plasma glucose quota between the two groups were contrasted when the children were three years old. Results There were no significant difference in the birth weight, gestational age and sex between the diabetic and the control group. The blood glucose levels of the newborns in the diabetic group was significantly lower than that in the control group (P<0.05). The 24-, 48-, 72- and 120-hour transcutaneous bilirubin values of the newborns in the diabetic group were significantly higher than those of the control group (P<0.05). The weight, height and BMI of the three years old offspring in the diabetic group were significantly higher than those in the control group (P<0.05). There were no significant difference in triglycerides, total cholesterol, HDL, Low density lipoprotein, fasting plasma glucose quota, and systolic blood pressure between the diabetic group and the control group (P>0.05), but the diastolic blood pressure in the diabetic group was much higher than that in the control group (P<0.05). Conclusion The impact of gestational diabetes mellitus on offspring of pregnant women was not only in the fetus and newborn period, but also in the future, which should be timely intervened.
Objective To explore the tumor suppressive effect of superantigen staphylococcal enterotoxin B (SEB) for mice beared by Lewis lung cancer cell (LLCC). Methods SEB gene expressive plasmid PCDH-SEB-GFP was constructed and transfected into LLCC and it was detected by Western blot. Tumor-bearing mice model was established by subcutaneous injection of LLCC and SEB expressive plasmid PCDH-SEB-GFP was successfully injected into the tumor to observe its suppressive effect on the growth of Lewis lung cancer in mice. Results SEB expression was detected after transfection of LLCC with SEB gene plasmid PCDH-SEB-GFP. Intratumoral injection of plasmid PCDH-SEB-GFP could significantly inhibit the growth of Lewis lung cancer in tumor-bearing mice. Conclusions Intratumoral injection of superantigen SEB expressive plasmid can inhibit the growth of Lewis lung cancer in mice. It deserves a further study that SEB gene can work as an exogenous antigen gene in immune gene therapy for lung cancer.
ObjectiveTo explore the related risk factors of polypoid lesions of gallbladder (PLG) in civil aviation flight cadets and the health management measures for the risk factors. MethodsRetrospective analysis of the 2022 flight annual medical students, according to the B ultrasound examination results have PLG, divided into PLG group (n=128) and non-PLG group (n=150), collect the basic data of the students, and establish a multivariate logistic regression equation model to analyze the related risk factors of gallbladder polypoid lesions. ResultsThe results of univariate analysis showed that there was no significant difference between groups with hypertension, hyperlipidemia and hyperglycemia (P>0.05), but with age and body mass index, high total bilirubin in serum and hyperuricemia, regular schedule and diet, and sufficient exercise (P<0.05). The results of multivariate logistic regression equation model analysis showed that age, high serum total bilirubin, hyperuricemia, irregular sleep and rest, irregular diet and lack of exercise were independent risk factors for PLG. ConclusionsAge, high serum total bilirubin, hyperuricemia, irregular work and rest, irregular diet and lack of exercise are the main reasons for PLG in civil aviation flight cadets. Intervention and prevention of risk factors can effectively ensure their health and flight safety.
【摘要】 目的 评价中药复方（益气养阴、清热活血方Yiqi Yangyin Qingre Huoxue decoction，YYQHD）联合放射疗法治疗鼻咽癌在减毒增效方面的疗效。 方法 采用Cochrane系统评价方法，电子检索Cochrane图书馆临床对照试验资料库（Cochrane Central Register of Controlled Trials，CENTRAL）、PubMed、EMBASE、中国生物医学文献数据库（CBM）、中文科技期刊全文数据库（CNKI）和中国期刊全文数据库（VIP）以及万方数据库等数据库2010年3月前所发表的相关文献。同时互联网检索Current Controlled Trial、Clinical Trials和中国临床试验注册网。手工检索部分肿瘤类核心期刊。采用Cochrane协作网推荐的 “偏倚风险评估”工具，评估纳入研究的质量，使用RevMan 5.0.23.0软件对纳入的研究进行定量系统评价。 结果 最终纳入符合标准的中文文献9篇共795例患者。定量分析结果显示:与单纯常规放射治疗相比较，中药复方（YYQHD）联合常规放射治疗能显著提高肿瘤近期疗效、生存率，并且能显著减少放射治疗常见毒副反应的发生，从而提高放射治疗按时完成率确保放射治疗疗效、改善患者生存质量。 结论 虽现有研究尚不能得出可以将中药复方（YYQHD）作为标准治疗手段辅助放射治疗的结论，但提示益气养阴、清热活血类中药联合放射治疗治疗鼻咽癌是值得继续探索的研究方向，期待设计科学合理、高质量的多中心、大样本、双盲、随机对照临床试验以进一步验证其疗效。【Abstract】 Objective To compare the efficacy of traditional Chinese medicine (TCM) plus radiotherapy (RT) with RT alone on nasopharyngeal carcinoma (NPC) by Yiqi Yangyin Qingre Huoxue decoction (YYQHD) through a meta-analysis of all available randomized controlled trials. Methods Literature retrieval was conducted using the Cochrane Library, PubMed, EMBASE, CBMdisk, CNKI, VIP, and Wanfang Database electronically. Relevant journals and conference proceedings were also hand-searched until March 31, 2010. The quality of included studies was assessed according to the criteria recommended by the Cochrane handbook, and the Meta-analysis was performed for homogeneous studies using RevMan 5.0.23.0 Software. Results Basing on our search criteria, we found nine trials (795 patients) which all published in Chinese. Our results showed that TCM (YYQHD) plus RT compared with RT alone, improved immediate tumor response, survival, completion rate of RT, quality of life, and alleviation of adverse effect of patients with NPC. Conclusions Considering the limitations related to this Meta-analysis, it nevertheless presents credible evidence that TCM (YYQHD) plus RT is worthy of additional study. Therefore, further large-scale, muti-center, randomized, and double-blind trials are warranted.
Objective To decrease the operative difficulty, with the purpose of looking for an orthotopic liver autotransplantation model which not only materializes the liver transplantation but also possesses higher survival rate. Methods This model was established via portal vein perfusion in thirty rats, and from which the result of the liver after perfusion, the operative time and the survival rate were observed. Liver tissues were researched at 24 h after operation under the light microscope. Results This model was easy to be perfused, the operative time was (48±3.0) min and the survival rate was 96.7% (29/30). The structure of hepatic tissue was basically normal with a little hydropic degeneration under the light microscope. Few erythrocytes residual occurred in the interlobular arteries under the light microscope. Conclusion The orthotopic liver autotransplantation model via portal vein perfusion has an exclusively blockage pattern which possesses a higher survival rate. It prevents the injury of immunological rejection and purely reflects the hepatic ischemia-reperfusion. But it is better to be applied in the non-hepatic artery anastomosis or the research nothing to do with the hepatic artery because the hepatic artery does not have sufficient perfusion.
Objective To investigate the protection on the intrahepatic cholangiocyte mediated by hypoxic preconditioning (HP) after liver transplantation and the role of vascular endothelial growth factor (VEGF). Methods The model of autologous liver transplantation was established, and the rats were divided into 3 groups: autologous liver transplantation group, hypoxic preconditioning before operation group (HP group) and sham operation group. At 6, 12, 24, 48 h after operation, blood samples were collected for examination of the serum total bilirubin (TBIL), direct bilirubin (DBIL) and alkaline phosphatase (ALP), and the expression of VEGF was detected by immunohistochemical method. The pathological changes of cholangiocytes were observed by light microscope. Results As compared with autologous liver transplantation group, the levels of seurm TBIL, DBIL and ALP in HP group were lower (P＜0.05), while the expression of VEGF in HP group was higher at the whole process (P＜0.05). The degrees of billiary epithelium damage and inflammatory infiltration in autologous liver transplantation group were more severe than those in HP group. Conclusion HP has protective effect on cholangiocytes after liver transplantation, in which VEGF may play an important role.
ObjectiveTo explore the association between frailty and in-hospital mortality in older patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Elderly patients who were hospitalized with AECOPD from June 2022 to December 2022 at a large tertiary hospital were selected. The independent prognostic factors including frailty status were determined by multivariate logistic regression analysis. Mediation effect analysis was used to evaluate the mediating relationships between C-reactive protein (CRP) and albumin and in-hospital death. ResultsThe training set included 1 356 patients (aged 86.7±6.6), 25.0% of whom were diagnosed with frailty. The multiple logistic regression analysis showed that frailty, mean arterial pressure, Charlson comorbidity index, neutrophil–lymphocyte ratio, interleukin-6, CRP, albumin, and troponin T were associated with in-hospital mortality. Furthermore, CRP and albumin mediated the associations between frailty and in-hospital mortality. ConclusionFrailty may be an adverse prognostic factor for older patients admitted with an AECOPD. CRP and albumin may be parts of mechanism between frailty and in-hospital death.
Objective To explore the clinical effect of ventricular septal defect repair and lung allograft (simply as "heart repair and lung transplant") in the treatment of ventricular septal defect complicated with severe pulmonary hypertension. Methods A 21-year-old female patient with ventricular septal defect and severe pulmonary hypertension was treated with cardiopulmonary bypass (CPB) under general anesthesia, and then right lung transplantation was performed, and then left lung transplantation was performed after changing body position. Results The operation was conducted successively. The intraoperative CPB support time was 90 minutes, and the blood loss was 2000 mL. Extracorporeal membrane oxygenation was removed on the second day after operation, the ventilator was evacuated on the third day, and the patient recovered and discharged on the 38th day. Postoperative echocardiography showed significant improvement in pulmonary artery pressure. Conclusion For patients with simple congenital heart disease complicated with severe pulmonary hypertension, "heart repair and lung transplant" can improve their quality of life.