Objective To compare the predictive power of model for end-stage liver disease(MELD) and Child-Turcotte-Pugh(CTP) on the cirrhotic patients who underwent transjugular intrahepatic portosystemic shunt(TIPS).Methods A total of 110 patients(98 males and 12 females) undergoing TIPS from January 2004 to March 2008 in our hospital were analyzed.Data of all patients were analyzed retrospectively.The main statistical tests included: Kaplan-Merier analysis to compare survival respectively,and the area of receiver operating characteristics(ROC) to compare the performance of the 2 models for predicting 3-month,1-year,and 2-year mortality.Results The survival rate rate of the patients whose MELD score under 15 showed significantly higher than the patients above MELD score 15.The area of ROC that predicting survival was 0.866 and 0.863 at 3 months,0.755 and 0.739 at 1-year,0.729 and 0.750 at 2-years respectively for the MELD and the CTP score.Conclusion Both MELD and CTP score can predict short-term survival accuracy,but poor in long-term.However,the MELD has overcome the shortcomings of CTP,and may be worth using in clinical.

Objective To evaluate the effect of C-type natriuretic peptide (CNP) on paraquat-induced pulmonary fibrosis in mice.Methods Fifty-four male Kunming mice,aged 8-10 weeks,weighing 30-35 g,were randomly divided into 3 groups (n=18 each) using a random number table:control group (C group),pulmonary fibrosis group (PF group) and CNP group.Paraquat 10 mg/kg (in 0.1 ml of normal saline) was injected intraperitoneally once every 3 days for 5 times in total in PF and CNP groups,and in addition CNP 3 μg/kg (in 0.1 ml of normal saline) was simultaneously injected via the tail vein once every 2 days for 14 times in total in group CNP.The equal volume of normal saline was given instead of paraquat in group C.On days 1,8 and 15 after the end of administation of paraquat,6 mice were sacrificed,and lungs were removed for determination of wet to dry weight ratio (W/D ratio),hydroxyproline (HYP) content (using alkaline hydrolysis),and transforming growth factor-beta 1 (TGF-β1) content (using enzymelinked immunosorbent assay) in lung tissues.Results Compared with group C,the W/D ratio and contents of HYP and TGF-β1 in lung tissues were significantly increased at each time point after the end of administation of paraquat (P＜0.05),and the pulmonary fibrosis was obvious in group PF.Compared with group PF,the W/D ratio and contents of HYP and TGF-β1 in lung tissues were significantly decreased at each time point after the end of administation of paraquat (P＜0.05),and the pulmonary fibrosis was significantly attenuated in group CNP.Conclusion CNP can reduce paraquat-induced pulmonary fibrosis in mice.

Objective To evaluate the value of multislice spiral CTA in diagnosis of intracranial aneurysm.Methods CTA data in 32 patients with intracranial aneurysms proved by operation and DSA were retrospectively analysed in comparison with the results of DSA.Results 38 aneurysms in 32 patients were detected by DSA and operation.Six cases of 32 had two aneurysms.36 and 34 aneurysms were detected by DSA and CTA respectively.4 aneurysms located at anterior communicating artery,7 at middle cerebral artery,9 at posterior communicating artery,14 at internal carotid artery and 4 at basilar artery.Conclusion MSCTA can be used as the method in screening intracranial aneurysms for surgery and interventional therapy.

Objective:To describe health service use and trend of treatment and rehabilitation rates among people with psychiatric disability from 2007 to 2013.Methods:Data collected by the 2006 Second China National Sample Survey and the 2007-2013 National Disability Monitoring Survey were utilized and analyzed.The 2006 National Sample Survey on Disabilities investigated 2 526 145 non-institutionalized representative civilians in 734 counties across mainland China.Psychiatric disability was diagnosed by clinical psychiatrists according to ICD-10 and WHO DAS Ⅱ criteria.The 2007 to 2013 National Disability Monitoring Survey selected 1 to 2 study sites among each of the 734 study counties that had been investigated by the Second China National Sample Survey.Information on living conditions,health service use,education and employment were recorded.Results:The data showed that treatment and rehabilitation rates for people with psychiatric disability had largely increased from 2007 to 2013 among adults aged 18 years or older,with the treatment and rehabilitation rates from 49.52％ and 21.8％ to 66.9％ and 58.7％ respectively,and the rates among those with 17 years or younger from 23.5％ to 43.9％.However,with regard to the effect of the treatment and rehabilitation services,a much larger proportion of people with psychiatric disability reported that the effect was soso instead of good or very good.In addition,among those who received rehabilitation service,most received day care or psychotherapy service,only less than 8％ participated work therapy,farming therapy or working skill trainings.Conclusion:The results suggest treatment and rehabilitation rates among people with psychiatric disability are largely increased from 2007 to 2013,while the quality of the service needs further attention.

ObjectiveTo investigate the misdiagnostic reason and treatment of the syndrom of splenic flexure of colon(SSFC). MethodsThe clonical data of 21 patients with SSFC admitted from May 1993 to May 2001 were retrospectively analysed. ResultsThese patients aged from 51 to 88 years old with a median age of 67.8years.Clinical manifestalion was repetitive stomach pain, abdominal distension, constipation, etc. Double contrast radiology of colon demonstrated that too high fixation site of colon of splenic flexure, volvulus of colon of splenic flexure, and displacement of colon usually occurred together with transverse or sigmoid colon redundant.All of them were cured by cololysis of colon of splenic flexure, redundant partial colectomy and managing other companying diseases.Postoperative pathological diagnoses were chronic colitis.Followed up was done for 6 months to 6 years, all of them released from primary symptoms. ConclusionsThe main misdiagnostic reason of SSFC is less understanding of SSFC and did not take double contrast radiology of colon. By way of cololysis of splenic flexure, redundant colon resection and managment other companying abdominal diseases, most patients with SSFC may expect satisfactory treatment effects.

Objective:To evaluate the effect of modified Shengjiang Powder acupoint application on hypertension patients with phlegm-heat syndrome. Methods:A total of 61 patients in Shijiazhuang hospital of traditional chinese medicine (TCM) meeting the inclusion criteria from September 2018 to September 2019 were randomly divided into two groups, the treatment group was 30 cases, the control group was 31 cases. The control group was given Amlodipine Besylate Tablets orally, and the treatment group added modified Shengjiang Powder acupoint application, and both groups were treated for 4 weeks. TCM syndrome scores were performed before and after treatment, and 24 h ambulatory blood pressure were measured with an ambulatory blood pressure monitor, including daytime mean systolic blood pressure (dMSBP), daytime mean diastolic blood pressure (dMDBP), night time mean systolic blood pressure (nMSBP), and night time mean diastolic blood pressure (nMDBP), 24-hour mean systolic blood pressure (24 hMSBP), 24-hour mean diastolic blood pressure (24 hMDSBP) and blood pressure circadian rhythm detection. Results:After treatment, the nMSBP and 24 hMSBP in the treatment group were significantly lower than those control group ( t values were -2.331,-1.511, P values were 0.045, 0.033), the blood pressure circadian rhythm [(8.87 ± 8.33)% vs. (6.94 ± 6.12)%, t=1.034] of the treatment group was significantly higher than those of the control group ( P<0.05); mdizziness, headache, head wraps, vomiting, sputum salivation, upset, mouth pain, insomnia scores of the treatment group after treatment were significantly lower than those in the control group ( P<0.05). Conclusion:The modified Shengjiang Powder acupoint application can reduce the blood pressure level of hypertension patients with phlegm-heat syndrome, especially for the improvement of night blood pressure, and improve the clinical symptoms.

Objective To isolate and identify exosomes from serum samples of the patients with polymyositis / dermatomyositis (PM/ DM),and analyze their protein composition preliminarily.Methods Exosomes from serum samples of the patients with PM/DM were isolated and purified by the ExoQuickTM kit.The morphological characteristics and particle size of exosomes were determined by transmission electron microscope (TEM) and NanoSight analyzer,respectively.The surface markers of exosomes such as CD9,CD81 and Flotillin-2 were identified by western blot.The concentration and composition of exosome protein were determined by the BCA method and SDS-PAGE,respectively.Results The exosomes from serum samples of PM/DM patients displayed round or oval vesicles with membrane structure under TEM,and their diameter range was about (92 ± 67) nm.western blot showed that these exosomes expressed CD9,CD81 and Flotillin-2.The total protein concentrations of exosomes in the patients with PM/DM and healthy controls were 14.68 (6.00,32.55) μg/μL and 14.09 (8.00,23.28) μg/μL,respectively.SDS-PAGE showed that high-abundance proteins enriched in 55-70 kD in both PM/DM patients and healthy controls,and that there were different bands in 40-55 kD between them.Conclusion Exosomes are isolated from serum samples of the patients with PM/DM successfully,and their protein concentration and composition are analyzed preliminarily,which provides the experimental evidences for further finding differential proteins.

Objective To investigate status of macrolide resistance and determine molecular mechanisms in Mycoplasma pneumoniae.Nethods All of 370 throat swab specimens were cultured to isolate Mycoplasma pneumoniae.Mycoplasma pneumoniae isolates were identified by nested PCR for specific 16SrRNA gene.Antibiotic susceptibility test was done to identify acrolide resistant strains.23SrRNA gene wag amplified by nested PCR followed by direct automatic sequencing method.The DNA sequences were compared to the sequence of Mycoplasma pneumoniae M129(accession no.X68422)to find molecular mechanisms of drug resistance.Results Fifty clinical strains were isolated from 370 specimens.Of 50 strains.4 strains were susceptible to macrulide,46 strains were macrolide resistant with the percentage of 92%.MICs of resistant strains to erythromycin.Azithromycin and josamycin were elevated.The sequence of 23SrRNA gene in 4 Susceptible strains and the reference strain FH was identical to Mycoplagma pneumoniae gene in GenBank.46 resistant strains arbored a point mutation respectively,among them,40 strains had all A to G transition at position 2063.1 strain had an A to C transition at position 2063,the other five strains showed an A to G transition at position 2064.Conclusions Macrolide resistance in Mycoplasma pneumoniae iS very serious health conceru.The point mutation in 23SrRNA.Xpecailly predominant position 2063 mutation contributed to the macrolide resistance in Mycoplagma pneumoniae.The MICs of resistant strains to erythromycin,azithromycin and iosamycin are much higher than Mycoplasma pneumoniae reference strain FH.

Objective To investigate the relations between psychiatric disability and co-morbid disability caused by injury,severity of the disabilities,as well as the unmet health care need among people living with both disabilities.Methods Data collected through both the Second China National Sample Survey on Disabilities in 2006 and the Follow-up Studies in 2009,were utilized.Sampling weights were considered to appropriately estimate situations in the total Chinese population.Results Among people with psychiatric disability,2.7％ of them were affected by other injurycaused disabilities as visual,hearing,speech,psychical and intellectual disabilities.Among people with disability that caused by injuries,1.8％ of them were living with psychiatric disability as well.The prevalence rates of psychiatric disability and injury caused disability were as 0.94％ and 0.63％,respectively.More than half of the co-morbid people were living with profound disabilities while 46.32％ of the people living with both disabilities developed co-morbid disabilities in the same year.Data from the follow-up program showed that 56.25％ of the people living with co-morbid disabilities did not receive any psychiatric treatment which were in need.Conclusion There seemed a close but bidirectional relationship existed between the mental disorders and injuries that calling for better mental health services provided for people with psychiatric disabilities.

OBJECTIVE: To introduce peratrial device closure of secundum atrial septal defects (ASD) under the guidance of transesophageal echocardiography (TEE) without cardiopulmonary bypass (CPB) in children, and to summarize the clinical experiences. METHODS: A total of 115 children with secundum ASD (the occlusion group) underwent peratrial device closure of atrial septal defects through a small sternotomy under TEE guidance without cardiopulmonary bypass. Children were followed up closely for 1-13 months. Another 59 children (the bypass group) had closed atrial septal defects under cardiopulmonary bypass during the same period. The differences in the operation duration, convalescence and complication between the 2 groups were compared. RESULTS: Except 1 patient was operated under the CPB, the rest 114 patients in the occlusion group were successfully closed by the occluders. The duration of the operation, mechanical ventilation, intensive care and hospitalization, and the rate of blood-transfusion in the occlusion group were significantly lower than those in the bypass group (P<0.01), with no difference in complications in the 2 groups (P>0.05). CONCLUSION Minimally invasive peratrial device closure of ASD without CPB is a relatively simple, safe and effective operation under the guidance of TEE for children. The short and mid-term clinical outcomes are promising. Long-term follow-up is indispensable.
Child ; Child, Preschool ; Echocardiography, Transesophageal ; methods ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial ; diagnostic imaging ; surgery ; Humans ; Infant ; Male ; Minimally Invasive Surgical Procedures ; methods ; Septal Occluder Device ; Ultrasonography, Interventional