Humans ; Purpura, Thrombocytopenic, Idiopathic

Hemorrhage ; pathology ; Humans ; Thrombocytopenia ; pathology

Adult ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; therapy

Objective To assess the clinical effects of Shenfu injection which consists mainly of panaxoside and water-solubility alkaloied on chronic pulmonary heart disease complicated with heart failure.Methods Ninetysix patients were randomly divided into two groups ,40 patients underwent regular treatment (control group) and 56 patients were treated with Shenfu injection additionally to regular treatment (treatment group ).There were 2 treatment durations,with 15 days in one duration.The symptoms,left ventricular ejection fraction (LVEF) and B type UNa peptide (BNP) were measured before and after treatment.Results The total effective rate in the treatment group was 91.1% (51/56) ,which was significantly higher than that in the control group (72.5% ,29/40) (P ＜0.05 ).After treatment,the treatment group has significantly higher LVEF than the control group(53.27% ±7.45%vs.49.12% ± 5.89% ) ( P ＜ 0.05 ),and significantly lower BNP ( ( 209.1 ± 18.7 ) ng/L vs.( 261.2 ± 19.3 ) ng/L ( P ＜ 0.05).Conclusions Shenfu injection could strengthen the contractility and increase LVEF,therefore improve the function of left ventricle,as well as decrease BNP and repair heart failure.

Objective:To explore the perioperative safety management of patients with severe limb dysplasia, to select appropriate methods to monitor vital signs, and to prevent intraoperative acquired pressure sore, nosocomial infection and other related complications.Methods:A case of severe developmental disorder of extremities caused by acroscleroderma in November 2019 in Peking University Shenzhen Hospital needed to be amputated. By organizing multidisciplinary consultation to discuss the operation plan, repeatedly selecting appropriate tools, and multiple scenario simulation exercises, continuous transcutaneous oxygen saturation and noninvasive blood pressure monitoring could be realized for the patients with acromegaly deficiency of the extremities. Under the monitoring of color ultrasound, the arterial blocking pressure of the extremities was determined as the tourniquet pressure during the operation value, take appropriate measures to prevent intraoperative acquired pressure sore, nosocomial infection and other related complications.Results:With the cooperation of multidisciplinary team, amputation was successfully carried out for the patients. The position was comfortable during the operation, the operation process was smooth, the residual limbs healed well after the operation, and there was no intraoperative acquired pressure sore, nosocomial infection and other related complications.Conclusions:To establish a multidisciplinary cooperation mechanism, strengthen the construction of the operating room special group, and use evidence-based nursing methods and actual scenario simulation exercise can ensure the perioperative safety of patients with severe developmental disorder of extremities and similar patients with special body shape or very low weight.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Boronic Acids ; administration & dosage ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; therapeutic use

Cofactor engineering, a vital part of metabolism engineering, changes the redox cofactor regeneration approach. Its main goal is to rebuild the components of metabolic products. The bioconversion of xylose for the production of ethanol is being studied intensively because ethanol is an alternative energy source and a potential liquid fuel. Saccharomyces cerevisiae has been traditionally used in producing ethanol from fermentable sugars but it cannot utilize xylose, only its isomer xylulose. Introduction of the xylose fermentation pathway from Pichia stipitis into S. cerevisiae enables xylose utilization in recombinant S. cerevisiae, but the ethanol yields of xylose fermentation with recombinant S. cerevisiae has been low and large amounts of the byproduct xylitol are produced. The major reason is that the catabolism of xylose with the fungal pathway leads an imbalance of redox cofactor. The process of the catabolism of xylose requires NADPH and NAD~+, both of which have to be regenerated in separated processes. More and more attention has therefore focused on the redox cofactor balance in S. cerevisia. The research progress of cofactor engineering to solve the imbalance of redox cofactor in xylose metabolism recombinant S. cerevisiae was introduced. This included expression of transhydrogenase, increasing the utilization of NADPH, and achieving the anaerobic reoxidation of NADH. Reversing the cofactor specificity of enzymes is another effective way.

Objective To address the standard first-line management under the new diagnostic criteria in adult immune thrombocytopenia (ITP). Methods A retrospective analysis was conducted involving 178 adult ITP patients treated with high-dose dexamethasone or prednisone in Qilu Hospital from March 2004 to November 2009 using new diagnostic criteria. Results The median age was 41 years with a male/female ratio of 0. 73: 1. Among the 178 ITP patients, 87 were newly diagnosed, 30 persistent ITP, 58 chronic ITP, and 3 unable to follow up. The efficacy rates among 167 patients able to assess in the three groups were 77.4% ( 65/84 ), 64. 0% ( 16/25 ) and 62. 1% ( 36/58 ) respectively, and their complete remission (CR) rates were 57. 1% (48/84), 36. 0% (9/25) and 32. 8% (19/58). The efficacy rate and CR rate of the newly diagnosed ITP category were significantly higher than those of the chronic ITP category (x2 = 3. 917, P ＜ 0. 05 ;x2 = 8. 186, P ＜ 0. 01 ). The patients treated with high-dose dexamethasone or prednisone therapy had no significant differences in sex, age or blood platelet count before treatment.Moreover, the short or long term response rates and the CR rates between the two therapies had no statistically significant differences while the former had a shorter onset time ( F = 10. 34, P ＜ 0. 01 ).Conclusions The study sets up a basis for the application of the recommended new definition and outcome criteria for adult ITP. Dexamethasone therapy is favored as first-line therapy.

Objective To evaluate the results of the Secuplate anterior cervical osteosynthesis plate (SACOP) for the treatment of patient with cervical spondylotic myelopathy (CSM). Methods Twenty six patients with CSM underwent anterior decompression fusion and internal fixation with SACOP were reviewed. All patients were followed up for 6 to 12 months (mean, 8 months). Results Neurological deficits improved in 23 of 26 patients after operation. A stable bony fusion according to radiological criteria was achieved in all cases 6 months postoperatively. There was no implants breakage and loosening. Conclusion Intervertebral fusion and internal fixation with SACOP after anterior decompression can offer immediate stability, prevent graft dislodgement, avoid cast immobilization and give a high rate of successful bony fusion for the patient with CSM.

Objective To review and analyze the sexual function of patients with spinal fractures complicated by incomplete paraparesis. Methods A total of 73 patients with incomplete paraparesis resulted from spinal fractures were retrospectively analyzed. Frankel Grade was used to determine the neurologic function and international index of ecrectile function (IIEF) to evaluate patients' sexual function. The patients with sexual dysfunction also were examined for reflex erection and psychogenic erection function. Results There were 21 patients with sexual dysfunction. Through ?2 test, significant difference was found between Frankel grade B and grade C as well as between grade D and grade E (P