Child ; Evidence-Based Medicine ; Humans ; Lupus Nephritis ; diagnosis ; therapy ; Practice Guidelines as Topic

Thyroid hormones and the related antibodies have some function in the natural process of breast cancer development.The possible mechanisms include:iodine complex can inhibit breast cell proliferation and can induce apoptosis; thyroid hormone can affect breast cancer cell proliferation and apoptosis; the imbalance of thyroid hormone and estrogen hormone promotes breast cells cancerous; hypothyroidism may affect the proliferation and invasiveness of breast tumors; lymphocytic infiltration or abnormal local immune response in thyroid disease.

Objective To compare the efficacy of different doses of esomeprazole based quadruple therapy on Helicobacter pylori(H.pylori) eradication in Uygur population, and to study the relationship between H.pylori eradication and dyspepsia symptoms in H.pylori caused gastritis.Methods From August 2015 to May 2016, Uygur patients diagnosed with H.pylori positive superficial gastritis in Xinjiang Uygur Autonomous Region Kashgar Prefecture were recruited.According to random number table, patients were divided into single-dose group, standard-dose group and high-dose group.In single-dose group patients received esomeprazole 40 mg, once per day;in standard-dose group patients received esomeprazole 20 mg, twice per day;and in high-dose group patients received esomeprazole 40 mg, twice per day;besides esomeprazole the treatment of three groups were all combination of amoxicillin, clarithromycin and bismuth, magnesium compound granules.The treatment course of all three groups was 14 days.The H.pylori eradication rate, clinical efficacy, symptom score and adverse drug reaction were compared.The H.pylori eradication rate was evaluated with intention to treat analysis (ITT) and per-protocol sets (PP).Chi square test, t test and one-way analysis of vaiance were used for statistical comparison.Results A total of 248 patients were enrolled,82 cases in single-dose group, 83 cases in standard-dose group and 83 cases in high-dose group.There were five, five and six cases lose to follow-up or dropped out respectively in single-dose, standard-dose and high-dose group.The results of ITT analysis showed that the eradication rates of H.pylori in single-dose group, standard-dose group and high-dose group were 62.2%(51/82),77.1%(64/83) and 89.2%(74/83),respectively;the differences between each two groups were statistically significant (x2=4.34,16.33 and 4.30, all P<0.05).The results of PP analysis showed that H.pylori eradication rates of single-dose group, standard-dose group and high dose group were 66.2%(51/77),82.1%(64/78) and 96.1%(74/77),respectively;the differences between each two groups were statistically significant (x2=5.06, 22.47 and 7.84, all P<0.05).After four weeks of eradication therapy, the total dyspepsia symptom scores of single-dose group, standard-dose group and high dose group were all significantly lower than those before treatment (52.3±27.1 vs 99.4±44.1, 38.2±25.4 vs 101.0±48.9 and 28.8±16.1 vs 99.9±46.6), and the differences were statistically significant(t=5.88, 8.79 and 9.11, all P<0.01).After treatment, the total dyspepsia symptom scores of standard-dose group and high-dose group were both lower than that of single-dose group, and the differences were statistically significant (t=2.78 and 2.91, both P<0.01).The score of upper abdominal pain, epigastric burning, abdominal distention and symptom total score of high-dose group were all lower than those of standard dose group (4.8±3.9 vs 8.1±3.5, 3.1±2.5 vs 5.8±4.1, 7.9±6.8 vs 10.5±9.6 and 28.8±16.1 vs 38.2±25.4), and the differences were statistically significant (t=1.52,1.08,1.23 and 1.96, all P<0.01).After four weeks of treatment, the total efficacy rates of single-dose, standard-dose and high-dose group were 45.5%(35/77), 74.4%(58/78) and 87.0%(67/77),respectively.There were statistically significant differences between each two groups of three groups (x2=13.49, 29.73 and 3.98, all P<0.05).The incidences of adverse drug reaction of single-dose, standard-dose and high-dose group were 6.5%(5/77), 7.7%(6/78) and 7.8%(6/77),respectively;there was no statistically significant difference among the three groups (all P>0.05).Conclusions High dose of esomeprazole based quadruple therapy can increase the eradication rate of H.pylori in Uygur population, and H.pylori eradication therapy can significantly improve the dyspepsia symptoms of H.pylori caused gastritis in Uygur.High dose of esomeprazole may improve the clinical efficacy of H.pylori caused gastritis with dyspeptic symptoms in Uygur with safety.

A Review The elastin has been investigated since the 1950 s, and it has been found that elastin relates to the vascular diseases in recent years. In this review, the elastin gene structure, distribution and its role in the pathogenesis of vascular diseases and aging are summarized.

Objective:To observe the clinical effect of liver-regulating and blood-tonifying acupuncture in the treatment of cervical spondylosis of vertebral artery type. Methods:A total of 60 cases meeting the inclusion criteria were randomized into an observation group and a control group, 30 cases in each group. Cases in the observation group received liver-regulating and blood-tonifying acupuncture, in which Jiaji (EX-B 2) points of C3-C7, Ganshu (BL 18) and Geshu (BL 17) were used; cases in the control group received routine acupuncture treatment in which jiaji (EX-B2) points of C3-C7 were used. Both groups received 5 times of treatment in a week with a 2-day rest, symptoms evaluation was done after 4 weeks of treatment, and then therapeutical effect was evaluated. Results:The total effective rate was 90.0% in the observation group, 73.3% in the control group, and inter-group comparison showed a statistical significance (P<0.05). After treatment, the symptoms and signs scores in both groups all substantially dropped, showing statistical significances (both P<0.05); inter-group comparison showed that the improvements in subscales of dizziness, pressing pain along vertebrae and revolve-cervix test in the observation group were superior than those in the control group, showing statistical significances (all P<0.05), while the inter-group comparisons of subscales of headache and vomiting and nause didn't show any statistical significances after treatment (both P>0.05). Conclusion: Liver-regulating and blood-tonifying acupuncture is effective in treating cervical spondylosis of vertebral artery type, and it can significantly improve patients' symptoms and signs.

BACKGROUND:α-zearalanol, a natural phytoestrogen has the effect of anti- atherosclerosis like the estrogen but with less side effect. Therefore, it has a potential for more application in the future. OBJECTIVE: To investigate the effect of 17β-estradiol (E2) and α-zearalanol (ZAL) on coagulation and fibrinolysis in ovariectomized rats and to compare and analyze their effects. DESIGN: An observational and controlled experiment. SETTING:Department of Pathophysiology of the Capital University of Medical Sciences and the Department of Pathophsiology of the Institute of Basic Medical Sciences of Chinese Academy of Medical Sciences and Peking Union Medical College. MATERIALS: The experiment was completed at the Science Department of Experiment Animals from July to September 2003. Thirty-six healthy female Wistar rats aged 12-week old , weighing (250±10)g, clean grade were involved. The animals were divided into 4 groups, namely sham-operation control group, ovariectomy (OVX) group, OVX +E2 group, OVX+ZAL group with 9 rats in each group. METHODS: For the rats in the sham-operation control group, operation was performed without removing the ovary. For the rats in the OVX group,ovariectomy was performed and the rat models were made at the sterile condition. 1 mg/kg 17β-estradiol and 1mg/kg α-zearalanol were respectively injected intramuscularly into the rats in the OVX +E2 group and OVX+ZAL group 14 days after the operation, once every three days for 35days altogether. After the administration of 17β-estradiol or α-zearalanol for 5 weeks, rats were killed, and blood was collected through the common carotid artery and plasma was collected from it. The prothrombin time (PT)and the activated partial thromboplastin time (APTT) were determined with coagulation method. The level of fibrinogen (FG) was measured with an automatic biochemistry analyzer. Tissue factor(TF)level was determined with ELISA method, the activity of tissue plasminogen activator(t-PA)and plasminogen activator inhibitor type 1 (PAI-1)were determined with chromogenic substrate assay. At the same time, the uteri were cut off and weighed by an electronic scale to work out the uteri weight/body weight (g/kg). MAIN OUTCOME MEASURES: ① PT, APTT, FG,TF, t-PA, PAI-1; ②uteri mass/body mass RESULTS: All the 36 rats entered the stage of the result analysis. ①change of PT: it was shorter in the OVX group than that in the sham-operation control group (P ＜ 0.01 ), but it was longer than that in the OVX group after supplementation of E2 and ZAL (P ＜ 0.05-0.01 ). ② Change of FG and TF: they were significantly higher than those in the sham-operation control group (P ＜ 0.05-0.01 ). But, they were lower than those in the OVX group after supplementation of E2 and ZAL (P＜ 0.05-0.01 ). ③Change of tPA: It was significantly lower in the OVX group than that in the sham-operation control group [(0.33±0.33) μkat/L,(4.00±1.50) μkat/L,(q=9.43, P ＜ 0.01 )]. However, it was significantly higher than that in the OVX group after supplementation of E2 and ZAL [(1.83 ±0.67)μkat/L,(1.17±0.83) μkat/L, (q=13.50, P ＜ 0.01; q=5.00, P ＜ 0.05). ④ Change of PAI-1: It was significantly higher than that in the sham-operation control group [(2.33±0.67) μkat/L,(1.17±0.33) μkat/L,(q=10.5, P ＜ 0.01 )]. ⑤Uteri mass/body mass: It was significantly lower in the OYX +ZAL group than that in the OVX+ E2 group [0.66,1.96, (q=14.67, P ＜ 0.01)]. CONCLUSION: Both 17β-estradiol and α-zearalanol can resume the balance of coagulation-fibrinolysis of ovariectomized rats, suggesting that αzearalanol has a similar protective effect similar to that of 17β-estradiol on cardiovascular system. As α-zearalanol has less adverse effect on uteri enlarging than 17β-estradiol, it has a better prospect for substitution of estrogens as a natural phytoestrogen.

Objective To assessthe association of polymorphism in angiotensin converting enzyme insertion/deletion (ACE I/D) gene with curative effect of hypotensive drugs.Methods The studies concerning association of ACE I/D with curative effect of hypotensive drugs were retrieved by searching data base,and then screened according to inclusive and exclusive criteria.Meta-analysis was performed by review manager 5.3 software.WMD and OR were used to assess difference of levels or effective rate of blood pressure degression among DD,DI and Ⅱ gcnotype.Results Totally 12 articles with 2 528 patients were included in this study.For all patients,WMD (95％ CI) with DD:Ⅱ genotype reflecting degression level of systolic pressure (SP) and diastolic pressure (DP) were respectively 5.92(4.09～7.75) and 1.70(1.03～ 2.38),and OR (95％CI) reflecting effective rate of blood pressure degression was 2.49 (1.44～ 4.31),with statistical significance (P＜ 0.05).For subgroup analysis according to hypotensive drugs,using angiotensin Ⅱ receptor blocker (ARB),WMD (95 ％CI) of SP and DP were respectively 9.16(6.51～11.82) and 1.84(0.10～3.57) in DD:Ⅱ,or 6.75(4.21～9.28) and 3.38(0.16～6.61) in DI ∶ Ⅱ genotype,all with P＜0.05.There were no statistical significance for diuretic in DD ∶ Ⅱ,DD ∶ DI and DI ∶ Ⅱ.Using angiotensin converting enzyme inhibitor (ACEI),OR (95％CI) were respectively 3.79(1.80～8.01) and 2.97(1.34～6.55) in DD:Ⅱ and DD:DI,with P＜0.05.Conclusion Compared with I allele in patient,ACEI and ARB were more effective for D allele,while there were no difference for curative effect of diuretic between I allele and D allele.

Background:Serum levels of pepsinogen( PG),gastrin-17( G-17)and Helicobacter pylori( Hp)infection are closely associated with gastric cancer. Studies on relationship of serum levels of PG and G-17 with Hp infection in Uygur and Han population with gastric cancer in Xinjiang area are rare. Aims:To investigate serum levels of PG and G-17 and their relationships with Hp infection in Uygur and Han population with gastric cancer in Xinjiang area. Methods:A total of 198 Uygur and 50 Han gastric cancer patients were enrolled,and healthy people with the same race were served as normal controls. Serum levels of PGⅠ,PGⅡ,G-17 were determined by ELISA,PGⅠ/ PGⅡ ratio(PGR)was calculated. Urea breath test and stool Hp antigen test were used to detect Hp infection. Results:Serum PGⅠ level and PGR in Uygur and Han patients with gastric cancer were significantly decreased than those in corresponding control groups(P < 0. 05),and serum levels of PGⅡ and G-17 were significantly increased(P < 0. 05). Serum PGⅠ level and PGR in Uygur gastric cancer patients were significantly decreased than those in Han gastric cancer patients(P < 0. 05),and serum G-17 level was significantly increased(P < 0. 05). Hp infection rate in Uygur and Han patients with gastric cancer were significantly increased than those in corresponding control groups( P < 0. 05). Serum level of PG Ⅰ and PGR were significantly decreased in Han gastric cancer patients with Hp-positive than in Hp-negative patients,and serum levels of PGⅡ and G-17 were significantly increased(P < 0. 05). Serum levels of PGⅠ,PGⅡ and G-17 were significantly increased in Uygur gastric cancer patients with Hp-positive than in Hp-negative patients,PGR was significantly decreased(P < 0. 05). Serum levels of PGⅠ,PGⅡ and PGR were significantly increased in Uygur gastric antral cancer patients than in gastric corpus cancer and proximal gastric cancer patients(P < 0. 05). Conclusions:Decreased serum PGⅠ level,PGR and increased serum level of G-17 can be used as biomarkers to screen gastric cancer in Uygur and Han population in Xinjiang area. Hp infection in Uygur and Han patients with gastric cancer is related to the changes of serum level of PGⅠ,PGR and G-17.