A 56-year-old male had presented with left nasal bleeding repeatedly for 4 days. The pathological examination after resection showed pyogenic granuloma. Its etiology and pathogenesis, clinical features, pathological features and treatments were reviewed.
Epistaxis ; etiology ; Granuloma, Pyogenic ; complications ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Nasal Septum ; pathology

Objective To explore the effect of hyperglycemia on the survival time, duration of disease remission and complications during induction chemotherapy for acute lymphocytic leukemia(ALL). Methods The treatment-related complications in 98 adult ALL patients with or without hyperglycemia were retrospectively analyzed. Survival time and complete remission duration(CRD) were evaluated using Kaplan-Meier method. Cox regression analysis was used to examine whether hyperglycemia was an independent predictor of disease recurrence and death. Results ALL patients with hyperglycemia were found to be older, and more likely to occur thrombocytopenia. ALL patients with hyperglycemia had a shorter CRD and survival time, and were more likely to develop infection and neuropathy. Conclusion Hyperglycemia during induction chemotherapy for ALL increased the frequency of infection and the risk of disease recurrence and death.

Objective To investigate the effect of transplantation of islet allograft with Bcl-2 gene transfection on diabetic rats. Methods Among 26 Wistar rats, 22 were built as model of diabetes, and were divided in to 3 groups. Islet cells expressing Bcl-2 by adenovirus-mediated Bcl-2 gene transfection were transplanted through the portal vein of streptozotocin-induced diabetic rats. The function and rejection of the transplanted islet allograft were evaluated by analysis of blood glucose level and histological examination after transplantation. Results 48h after transplantation, the level of blood glucose was significantly decreased in both transfected and untransfected islets transplantation groups. The euglycemia period of transfected islet cells transplantation group was longer than that of the untransfected islet cells transplantation group (16.4?4.3d vs 6.8?2.2d, P

Objective To investigate the present situation of quality of life in the elderly residents aged more than 60 years in Zhanjiang city and to analyze its influence factors .Methods 418 elderly residents over 60 years sampled by the random sampling in Zhanjiang city were performed the questionnaire survey by using the Chinese Scale of World Health Organization QOL (WHOQOL-BREF) .Results The quality of life in the physical ,psychological and environmental fields in male residents was higher than that in the female residents ;which in the psychological and environmental fields in the high cultural level residents was higher than that in the low cultural level residents ;which in the social relations field in the high income residents was higher than that in the low in-come residents ;there were no statistical differences in the quality of life among the elderly residents with different occupations be-fore retirement and marital status ;the Logistic regression analysis showed that gender and occupation were the influence factors of quality of life self evaluation in elderly residents .Conclusion Gender ,occupation ,educational level and income level are the influ-ence factors of quality of life in elderly residents .

BACKGROUND: Infection following kidney transplantation has become one of the main reasons for graft failure and death of allograft recipients. However, there is not a standard therapeutic scheme for infection following kidney transplantation. OBJECTIVE: To investigate the clinical features and treatment measures of infection, additionally, to increase the cure rate of infection following kidney transplantation.DESIGN, TIME AND SETTING: A retrospectively analysis was performed at the Organ Transplantation Center, the First Affiliated Hospital of Kunming Medical College from February 2006 to February 2008.PARTClPANTS: Eighteen cases of infections in 84 kidney allograft recipients.METHODS: All cases were checked by chest X-ray. Patients who had no significant lung infection symptoms or obvious signs received lung CT scan. Pathogen detection was performed, including hemoculture, urine culture, sputum culture, nose swabs culture, throat swab culture, checking clinically important cytomegalovirus (CMV), EB-DNA and mycoplasma in blood, acid-fast bacilli and eumycete culture in sputum. All cases of pulmonary infection underwent a comprehensive treatment-antiviral drugs, antibiotics and antifungal. Depending on the individual condition and absolute values of lymphocytes and CD4+T cells, the immunosuppressant was adjusted individually. The occurrence time, clinical symptom, auxiliary examination and treatment strategies were analyzed.MAIN OUTCOME MEASURES: The occurrence time of infection and clinical symptoms; imaging manifestation and results of pathogenic detection; selection of antibiotics and immunosuppressant adjustment.RESULTS: Among 18 cases, 11 cases (61.2%) were deceased-donor kidney transplant recipients. Inflection following kidney transplantation occurred in 12 cases (66.7%) within 3 months, and increased to 15 cases (83.3%) within 3-6 months. Of the 18 infection cases, 14 cases (77.8%) had a main symptom of fever. There were 15 cases (83.3%) of respiratory tract infection, including 13 cases (72.2%) of pulmonary infection. Fungal cultivation, especially Monilia, was positive in 6 cases. Three out of the 18 cases (16.7%) died, two of whom had CMV infection. Mixed infection occurred in all cases.CONCLUSION: Infected patients following kidney transplantation present with diversity pathogens, which are dominated by bacteria, fungus and virus. Severe pneumonia combined with CMV infection demonstrates that poor prognosis, fungal and virus infection following kidney transplantation should be given more attention. Combined de-escalation therapy is the main method, and timely adjustment and even discontinuance of immunosupprassive agents is one of the key points in the treatment of infection following kidney transplantation

Objective To investigate the toxic effect of immunosuppressive drugs on apoptosis of rat pancreatic islet cells in vitro and the protective action of Bcl-2.Methods Islet cells expressing Bcl-2 and the control islet cells were cultured at different concentrations of tacrolimus and the apoptosis rate of islet cells and insulin accumulation in the culture medium were detected after 48h.Results Low and high concentrations of tacrolimus induced the apoptosis of islet cells and decreased insulin secretion.The Bcl-2 inhibited the apoptosis of islet cells induced by tacrolimus and improved the insulin secretion.Conclusion Tacrolimus may directly damage to isolated rat islet cells and the expression of Bcl-2 can protect the cells from the damage of immunosuppressive drugs.

Objective To investigate the effects of antithyroid drug(ATD) on oxidative stress in Graves disease patients with and without infiltrative ophthalmopathy.Method The levels of superoxide dismutase(SOD),glutathione peroxidase(GPx) and catalase(CAT) in erythrocytes of Graves disease patients(18 with and 20 without infiltrative ophthalmopathy) were measured before and after treatment with ATD.Results Compared with the normal control group,the levels of SOD,GPx and CAT were significantly higher in Graves disease patients with and without infiltrative ophthalmopathy.After euthyroidism was achieved with the treatment of ATD,the levels of SOD,GPx and CAT were normalized in the patients without infiltrative ophthalmopathy,but oxidative stress was still present in the patients with infiltrative ophthalmopathy.Conclusion The oxidative stress is obvious in patients with Graves ophthalmopathy,which suggests that oxidative stress is involved in orbital inflammation.

Objective To observe the occurrence and risk factors of arrhythmia in chronic kidney disease (CKD) patients in different stages of renal function. Methods A total of 405 CKD patients were enrolled in this study and none of them received renal replacement therapy.The 24 h dynamic electrocardiogram (DCG) was performed,and baseline characteristics were compared.Multivariable Logistic regression analysis was used to examine the relationship between the severe arrhythmia and the potential risk factors,such as age,gender,CKD stage,diabetes,hypertension,hyperpotassaemia,left ventricular hypertrophy (LVH),etc. Results There were 69 patients (17.04％),79 patients (19.51％),82 patients (20.25％),88 patients (21.73 ％) and 87 patients (21.48％) in CKD stage 1,2,3,4 and 5,respectively.As high as 45.68％ of all the patients had severe arrhythmia,represented by 27.54％,29.11％,42.68％,57.95％ and 65.52％ in CKD stages 1-5 respectively.The occurrence of severe arrhythmia increased as the eGFR decreased in CKD stages 2,3,4 (p＜0.05).On multivariable Logistic regression analysis,the occurrence of severe arrhythmia was related to LVH,CKD stage,diaberes hyertension and hyperpotassaemia are signidicantly assoxiated with severe arrhythmia.

: To assess the relationship between high blood pressure (HBP) and body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR) among children and adolescents in Suzhou. Methods: A total of 3 150 children and adolescents aged 7-17 years were enrolled through stratified cluster sampling from September to October, 2019. Questionnaire survey was conducted, and height, weight, WC and BP were measured to calculate BMI and WHtR, relationship of HBP and adiposity indicators were evaluated. Results: The prevalence of HBP was 11.3%, overweight/obesity rate was 28.5%, and centrality obesity based on WC and WHtR was 20.6% and 23.7%, respectively. There were significant relationships between HBP and BMI, WC, and WHtR (χ2=157.80,105.87,124.17,P<0.01). As Logistic regression showed, compared to normal weight group, overweight/obesity based on BMI had positive relation with HBP (OR=3.89, 95%CI=3.09-4.90); compared to normal WC/WHtR, centrality obesity showed positive association with HBP (WC: OR=3.05, 95%CI=2.41-3.86; WHtR: OR=3.35, 95%CI=2.67-4.21). Meanwhile, BMI had joint effects on HBP with WC/WHtR. Specifically subjects with overweight/obesity and center obesity had higher risk of HBP, compared to normal BMI and WC subjects(OR=4.28, 95%CI=3.31-5.53). Conclusion Significant relationships between HBP and BMI, WC, and WHtR were found. BMI had joint effects on HBP with WC/WHtR. Keeping normal body weight and WC/ WHtR would have significant effects on HBP.

Objective: The current study aimed to determine the prevalence of high blood pressure (HBP) among children and adolescents aged 7-17 years in Suzhou by using different references, and to provide a reference for the application of standard of blood pressure among children. Methods: Data of 6 972 children and adolescents aged 7 to 17 years were collected by stratified cluster random sampling method to determine the prevalence of HBP based on 2017 AAP Guidelines for Childhood Hygertension(America 2017), National Blood Pressure Reference for Chinese Han Children based on Chinese National Survey on Students’ Constitution and Health in 2010 (Ma 2017), blood pressure guidelines based on their investigation in mainland children and adolescents (Mi 2017) and blood pressure guidelines based on data from the China Health and Nutrition Survey during the year of 1999-2009 (CHNS 2013). Results: Referred to Ma 2017 reference, the prevalence of HBP was highest with 12.7%, followed by America 2017 with 16.3%, Mi 2017 with 17.4%, and CHNS2013 with 25.5%. In boys, HBP prevalence based on America 2017 was close to that using Mi 2017 among children younger than 13 years old, and was close to that using Ma 2017 among those≥14 years old. In girls, HBP prevalence based on America 2017 was close to that using Mi 2017 among those≤12 years old, and was close to that using Ma 2017 among those ≥13 years old. Compared with America 2017 reference, kappa value based on Mi 2017 was better than Ma 2017 in boys(0.81, 0.77), opposite result was found in girls(0.86, 0.85). Kappa value were the lowest based on CHNS 2013. Conclusion The prevalence of HBP among children in Suzhou achieve a high level. Ma 2017, Mi 2017, and CHNS2013 references show different advantages among various gender and age groups.