Objective To study the clinical evaluation of Shenqi Fugan granule for chronic Hepatitis C and its effect on WBC and neutrophil count.Methods 135 patients with chronic hepatitis C from October 2014 to September 2016 were randomly divided into control group(n=68)and control group(n=68).The patients in control group were treated with reserpine.The patients in the observation group were treated with Shenqi Fugan Granule,and then the numbers of leukocytes and neutrophils were measured before and after treatment at 2,4 and 8 weeks after treatment.Meanwhile,the patients in both groups were treated before and after treatment.Liver function recovery,and to make a comprehensive evaluation of its clinical effect.Results There were significant differences between the two groups before and after treatment(P<0.05).The difference between the two groups was statistically significant(P<0.05),and the difference between the two groups was statistically significant(P<0.05).After treatment,the liver function(alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL))in the observation group was significantly better than that in the control group,and the total effective rate(91.18％)in the observation group was significantly greater than that in the control group Total effective rate(85.07％),the difference between the two groups was statistically significant(P<0.05).Conclusion The clinical effect of Shenqi Fugan Granule on chronic hepatitis C is significant,which can effectively inhibit the decrease of peripheral white blood cell count and middle cell count,and the safety is higher.

Objective To explore the effect of weightlessness simulation on processing speed of mental rotation of males in 72 h head-down tilt,in order to further reveal human performance changes caused by weightlessness.Methods During 72 h weightlessness simulation (9 am day 1 to 9 pm day 4,head-down tilt started from 9 pm day 1),16 male subjects were processed speed of rotation data byhand picture mental rotation (test 8 times),using self cross-references design,and the variation of processing speed of mental rotation by duration was analyzed.Results The linear regression analysis showed,the reaction time of each time point for each subject as the independent variable,the angle of rotation as the dependent variable,with the extension of simulated weightlessness time.The intercept(constant term of the regression equation),indicating the processing speed of non-rotation,were gradually increased with HDT time,but didn(t) reached significantly difference (F(3,14) =0.551,P =0.650) ;the slope(Regression coefficient of the regression equation),indicating the processing speed of rotation.were gradually increased with HDT time,and reached the significantly difference (F(3,14) =4.338,P =0.009).The value of intercept and slope was like upside-down U in three days,and reached the highest value at day 2.Conclusion Weightlessness simulation have affection on the speed of mental rotation,especially on the rotation speed.

Objectives:To investigate the nutritional status of the maintenance hemodialysis(MHD) patients. Methods:The dietary investigation, anthropometry and biochemical tests were conducted in 46 MHD patients,including weight,triceps skinfold(TSF), arm muscle circumference(AMC), serum total protein(TP), albumin(Alb), prealbumin(PA), transferrin(TF) and ideal weight rate(IBW%).Then nutritional status was evaluated. Results:①The energy intake of most MHD patients was lower than 125.4 kJ/(kg?d) and the mean protein intake was nearly 1.0 g/(kg?d).②According to each single index,the incidence of malnutrition was:39.13% by IBW%, 71.74% by TSF, 58.70% by AMC, 30.43 % by Alb and 82.61% by TF respectively.Only 6.52% patients had all normal paremeters. Conclusions:Malnutrition incidence of MHD patients was as high as 93.48% in our study. The regular nutritional assessment and the nutritional advice are very important for the better clinical outcome in the MHD patients.

BACKGROUND: Decrease of regional cerebral blood flow (rCBF) perfusion of different degree exists in depressive patients, but the decreased ranges were different, different cerebral cortical and subcortical regions are involved.OBJECTIVE: To observe the types of abnormal rCBF perfusion in patients with depressive disorder.DESIGN: A diagnosis-based case-control analysis.SETTINGS: Department of Nuclear Medicine, Ruijin Hospital Affiliated to the Medical College of Shanghai Jiaotong University; Staff Room of Biomedical Engineering, Medical College of Shanghai Jiaotong University;Putuo District Mental Health of Shanghai City.PARTICIPANTS: The patients with depressive disorder were selected from the Putuo District Mental Health Center from January 1999 to December 2000, and 19 normal subjects matched by age were selected from the medical staff of the hospital as normal controls.METHODS: The patients with depressive disorder and healthy subjects were examined by single photon emission computerized tomography (SPECT), ethyl cysteinate dimmer (99Tcm-ECD) was performed, and the images were analyzed with the statistical parametric mapping (SPM). All the SPECT images were converted into DICOM format or ANALYZE-7 format at first, and then the images were standardized by taking MRI template as the template and smoothed, and the significantly different regions were evaluated by the statistical analysis and inferences with the Gaussian random theory.MAIN OUTCOME MEASURES: The differences of the cerebral blood flow perfusion in specific region and the changes of average rCBF images were mainly observed in the depressive disorder group and normal control group.RESULTS: All the 12 patients with depressive disorder and 19 normal healthy subjects entered the analysis of results. The SPM showed that the blood flow perfusion was decreased in bilateral frontal lobes, left superior temporal gyrus, left Brodmann area 20, left mamillary body of thalamus,right cingulated gyrus and right putamen in the patients with depressive disorder. The blood flow perfusion was increased in the right central frontal gyrus, right superior temporal gyrus, right occipital lobe and left central frontal gyrus.CONCLUSION: The rCBF is obviously changed in the frontal lobe, temporal lobe and limbic system of patients with depressive disorder.

[Objective] To investigate the clinical value of using prospective ECG-gating Helical protocol in whole aorta and coronary arteries CT angiography combined with low tube voltage,low contrast medium injection rate and dose technology.[Methods]A total of 60 patients (heart rate≤ 75 bpm and normal heart rhythm) with suspected aortic disease or post-operation were randomly divided into 2 groups:G1 (n =30;tube voltage:80 kV;contrast medium injection rate:3 mL/s;contrast medium dose:0.65 mL/kg)and G2 (n =30;tube voltage:120 kV;contrast medium injection rate:4 mL/s;contrast medium dose:1.2 mL/kg).The two groups underwent aorta angiography with prospective ECG-gating Helical protocol by using 320-detector CT.The mean CT values and standard deviation of aorta,coronaries and adjacent adipose tissue were measured,signal to noise ratio (signal-to-noise ratio,SNR)and contrast to noise ratio (contrast-to-noise ratio,CNR) were calculated.The subjective quality scoring of 3-d post-processing images were evaluated independently by 2 senior radiologists.The mean CT values and standard deviation of aorta,coronaries and adipose tissue,SNR,CNR,subjective quality scoring,contrast medium dose and radiation dose were compared and analyzed.[Results] The abnormal and normal rate of aorta in two groups were 83.33％ (25/30),16.67％ (5/30) and 86.67％ (26/30),13.33％(4/30);while the abnormal and normal rate of coronary arteries in two groups were 43.33％ (13/30),56.67％ (17/30) and 53.33％(16/30),46.67％ (14/30).SNR values of ascending aorta,descending aorta,abdominal aorta,superior mesenteric artery,bilateral renal artery,left main coronary artery,left anterior descending branch,left circumflex branch,right coronary artery and CNR values of abdominal aorta,superior mesenteric artery,bilateral renal artery,left anterior descending branch,left circumflex branch had no statistical significance,while the other indicators were significant differences between the two groups.The radiation dose and the contrast medium dose of G1 was significantly lower than G2 (P ＜ 0.05).There was no difference in the subjective image quality of 3D post-processing images between the two groups (P ＞ 0.05).[Conclusions] Using prospective ECG-gating Helical protocol in whole aorta and coronary arteries CT angiography combined with low tube voltage,low contrast medium injection rate and low contrast medium dose technology can help to reduce radiation and contrast medium dose without impacting on the imaging quality satisfactorily.

Objective To analyze the clinicopathological characteristics and the prognostic survival factors of young patients who have undergone hepatectomy for primary hepatic carcinoma.Methods Clinicopathological da-ta and treatment outcomes in 79 young (≤40 years old)and 67 elderly (≥65 years old)patients who underwent hep-atectomy for primary hepatic carcinoma between 2008 and 2012 were retrospectively collected and compared using various parameters.Then the survival rate and prognostic factors of the younger patients were analyzed using Kap-lan-Meier and COX multivariate proportional hazards model.Results The positive rate of HBs-antigen and alpha-fetoprotein level were significantly higher in the younger patients than in the elderly patients (P<0.05).However, the positive rate of Anti-HCV-Ab was markedly lower in the younger patients (P<0 .0 5 ).The two groups did not significantly differ in gender,clinical symptoms,intraoperative parameters or pathological features (P>0.05).The overall survival rate was similar between the two groups.COX multivariate proportional hazards model analysis showed that the independent prognostic factors of overall survival were pre-operative albumin level <3 5 g/L and maximum tumor diameter ≥5 cm.Conclusion Hepatectomy is a safe and feasible treatment for young and elderly patients with primary hepatic carcinoma.The independent prognostic factors of survival for young patients are pre-operative albumin level <3 5 g/L and the maximum tumor diameter ≥5 cm.

The term,cerebral small vessel disease (CSVD),describes a syndrome of neuroimaging,pathological,and associated clinical features caused by small intracranial vascular lesions.Recent studies have found different MRI features of CSVD in patients with ischemic strokes caused by large artery atherosclerosis (LAA),significantly influencing the stroke outcomes.This paper reviews the effects of CSVD on clinical outcomes of cerebral infarction patients caused by LAA and their mechanisms.

Objective Based on the Kabat-Zinn's mindfulness decompression therapy and Teasdale's mindfulness cognitive therapy,and using the solution-focused approach as the frame structure,we establish comprehensive,standard mindfulness interventions scheme of domiciliary patients with chronic obstructive pulmonary disease,which can provide the basis for the development of the community and residential care.Methods Twenty-six experts were selected as the target of the study and two rounds of correspondence were used to establish the final mindfulness intervention plan of the domiciliary patients with chronic obstructive pulmonary disease.Meanwhile,the reliability and representativeness of the consultation are tested by using the coordination degree,positive coefficient and authoritative coefficient of expert opinions.Results The positive coefficient of the two round correspondence experts were 88.46%(23/26)and 100.00%(23/23),and the expert authority coefficient was 0.90 and 0.91.The variation coefficient of the indicators after two rounds of expert consultation was 0.04-0.14,the coordination coefficient of experts was 0.32(P＜0.01)and 0.59(P＜0.01)respectively.The final construct of domiciliary patients of chronic obstructive pulmonary disease with the intervention programme consists of 5 steps,25 entries,which was suitable for the positive reading intervention scheme.Conclusions The results show that experts enquiry for representative and high credibility,and the mindfulness intervention plan of domiciliary patients with chronic obstructive pulmonary disease is scientific and practical.

OBJECTIVE: To study the genetic variants of a child with Autism Spectrum Disorder (ASD) combined with epilepsy, and explore its possible pathogenic mechanism. METHODS: Clinical data of the child were collected and evaluated, whole-exome sequencing (WES) technology was used to explore the genetic variants sites of the child and his parents and candidate genes were filtered out. Sanger sequencing were performed to verify the variants identified by WES and PolyPhen2 was utilized to predict the function of these variants. qPCR was carry out to determine the expression of the variant gene. RESULTS: The proband carried a compound heterozygous mutation in the SIK3 gene (Chr11 q23.3, NM_025164.6), which contains a missense mutation c.1295A>G (p.N432S) inherited from the father and a deletion [c.2389_2391del(p.797del)] inherited from the mother. Both mutation sites are highly conservative, and PolyPhen2 predicted (c.1295A>G [p.N432S]) to be harmful. Compared to the mother, expression of SIK3in mRNA level in the peripheral blood of the proband and his father were both significantly decreased; compared to normal child, SIK3 expression in the peripheral blood of the proband and two other children with ASD were all decreased significantly too. In addition, studies on mice found that Sik3 gene has a marked higher level of expression in the brain. CONCLUSION The SIK3 gene variants may probably be associated with ASD. The detailed mechanism needs to be studied further, which may involve lipid metabolism dysfunction in the brain.
Animals ; Autism Spectrum Disorder/genetics* ; Epilepsy/genetics* ; Male ; Mice ; Mutation ; Mutation, Missense ; Protein Kinases ; Protein Serine-Threonine Kinases/genetics* ; Whole Exome Sequencing

Objective:To study the effects of different fluid balance strategies on severe pneumonia patients and explore the possible influence path in order to optimize fluid treatment for severe pneumonia patients.Methods:A total of 89 adult patients with severe pneumonia admitted to EICU and RICU of Jiangsu Provincial Hospital from January 2017 to August 2019 were retrospectively analyzed . The differences of clinical data between the death group ( n=35) and the survival group ( n=54) were analyzed. Multivariate logistic regression analysis was used to identify predictors of 30-day mortality after entering ICU of severe pneumonia patients. Patients were divided into a positive fluid balance (PFB) group ( n=48) and a negative fluid balance (NFB) group ( n=41). Kaplan-Meier survival curve was used to analyze the difference of 30-day survival rate between the PFB and NFB groups. Results:Age ( OR=1.060, 95% CI: 1.018-1.104, P=0.005), ventilator dependency ( OR=6.679, 95% CI: 1.218-36.620, P=0.029), vasoactive agents ( OR=21.068, 95% CI: 4.654-95.376, P<0.001), and new hyperchloremia occurred within 24 h after admission to the ICU ( OR=21.714, 95% CI: 1.059-445.008, P=0.046) were the risk factors for severe pneumonia patients' 30-day mortality after entering ICU. The concentrations of creatinine, urea nitrogen, sodium and chlorine of the NFB patients were lower than those of the PFB patients within 5 days after admission to ICU (day 1-day 5) ( P<0.05). The serum calcium concentrations of the NFB patients were higher than those of the PFB patients on day 3-5 ( P<0.05). The 30-day survival rate was significantly higher in the NFB patients than in the PFB patients ( P<0.001). Conclusions:The strategy of negative fluid balance can reduce serum chlorine concentration, improve renal function and reduce mortality in patients with severe pneumonia.