No abstract available.
Fetal Blood* ; Humans ; Infant, Newborn* ; Phenotype

Abstract： Objective　To investigate and analyze the factors influencing the direct medical costs of tuberculosis patients in Hainan Province, so as to provide scientific reference for reducing the medical burden of patients and adjusting the medical insurance reimbursement policies in the local area. Methods　Using the total health expenditure accounting data of Hainan Province in 2020, including the outpatient and inpatient data of 14 provincial medical institutions, 235 city and county level medical institutions, and other relevant data from the 2020 Hainan Statistical Yearbook and Health Financial Yearbook, the direct medical costs of tuberculosis patients in the province in that year were calculated, and the influencing factors were explored using single factor analysis and multivariate generalized linear model. Results　The final number of cases included in this study was 11 979, including 7 526 males (62.83%) and 4 453 females (37.17%). The total direct medical costs of patients were 43.207 3 million yuan, of which the total outpatient costs were 2.733 9 million yuan (6.32%) and the total inpatient costs were 40.473 4 million yuan (93.67%). In the cost composition analysis, the drug cost was 17.971 million yuan (41.44%), the examination cost was 8.854 7 million yuan (20.49%), other costs were 16.445 5 million yuan (38.06%), and the median (quartile) M(P25,P75) direct medical cost of each patient was 177.50 (66.73,764.89) yuan. The multivariate generalized linear model analysis showed that hospitalization, new rural cooperative medical insurance (NRCMI) and urban employee medical insurance were the influencing factors of the increase in direct medical costs of tuberculosis patients the median (quartile) M(P25,P75) of direct medical costs are 10 425.04 (6 560.87,17 374.9), 10 246.5 (5 871.28,17 220.33), 3 177.2 (293.09,7 730.23) yuan respectively; the OR(95%CI) values were -3.505 (-3.499- -3.517), 1.559 (1.551-1.569) and 2.191 (2.188-2.207) respectively. Conclusions　The direct medical costs of tuberculosis patients in Hainan Province are high. Hospitalization, the new rural cooperative medical insurance and the medical insurance for urban workers are the influencing factors of the increase in costs.

ObjectiveTo evaluate the efficacy of PEEP set according to pressure-volume (P-V) curve for one lung ventilation (OLV) in patients undergoing thoracic surgery.MethodsOne hundred and twenty ASA Ⅱ or Ⅲ patients of both sexes aged 20-60 yr weighing 40-80 kg undergoing lobectomy under general anesthesia were enrolled in this study.Double lumen tube was inserted.Correct positioning was verified by fiberoptic bronchoscopy.The patients were mechanically ventilated.P-V curve was determined at 3 min of two-lung ventilation (TLV).Lower inflection point (LIP) was measured and the pressure at LIP (PLIP) was recorded.The patients were randomly divided into 5 groups (n ＝ 24 each):control group (group C) and 4 lung protective ventilation regimen groups ( groups P1-4 ).PEEP was set at 0 and VT was set at 10 ml/kg in group C.PEEP was set at 0 and VT was set at 6 ml/kg in group P1.PEEP was set at PLIP- 2 cm H2O and VT was set at 6 ml/kg in group P2.PEEP was set at PLIP and VT was set at 6 ml/kg in group P3.PEEP was set at PLIP + 2 cm H2O and VT was set at 6 ml/kg in group P4.Peak airway pressure (Ppeak),plateau airway pressure (Pplat),airway resistance (Raw) and lung compliance (CL ) were measured and recorded during OLV and TLV after a period of stabilization.Arterial blood samples were taken before induction of anesthesia and at 20 min of TLV and 20 min of OLV for blood gas analysis.Qs/Qt was calculated.Arterial blood samples were collected at the beginning and end of OLV for determination of plasma concentrations of IL-6 and TNF-α(by ELISA).ResultsCompared with group C,Ppeak and Pplat were significantly increased while Raw was decreased and plasma IL-6 concentration was significantly decreased at the end of OLV in group P4.PaCO2 was significantly higher during TLV and OLV in groups P1-4 than in group C.There was no significant difference in the parameters of respiratory mechanics,blood gases and plasma IL-6 and TNF-α concentrations among groups P1,2.3.Compared with groups P1,2,3,Ppeak and Pplat were significantly increased while plasma IL-6 concentration was decreased at the end of OLV in group P4.ConclusionMechanical ventilation with VT set at 6ml/kg and PEEP at PLIP + 2 cm H2 O provides best venfilatory efficacy for OLV in terms of oxygenation and inhibition of inflammatory response.

PURPOSE:To report the change of corneal asphericity and the relationship between asphericity and visual acuity after wearing the reverse-geometry lens. METHODS: The authors reviewed out-patient records of 37 consecutive patients wearing reverse-geometry lenses. The patients were followed up from July 2004 to December 2007. The unaided visual acuity (VA), spherical equivalent (SE) and asphericity before and after wearing the lens were compared. The relationship of SE and final VA, initial astigmatism and final VA, and asphericity and final VA was also analyzed. In addition, the relationship between the increment of VA and asphericity was determined. RESULTS: VA and SE improved and the asphericity decreased after wearing the lens (p<0.05). There was high correlation between the spherical equivalent and final visual acuity (p<0.001), and no correlation between asphericity and final visual acuity (p=0.358) was observed. However, the lower the initial asphericity, the greater the increment of visual acuity observed (p=0.048). CONCLUSIONS: Initial corneal asphericity can be a predictor of increment of VA after wearing reverse-geometry lenses.
Astigmatism ; Humans ; Outpatients ; Visual Acuity

The role of acetylcholine as an excitatory neurotransmitter is well established, and cholinergic neurons appear to play an important role in the mammalian retinae. Though it has been reported that certain conventional and displaced amacrine cells are consistently labeled with anti-choline acetyltransferase antiserum in the mammalian retinae, little has been studied on the synaptic circuitry of cholinergic neurons to clarify mechanism of its action in the visual processing of the mammalian retinae. This study was conducted to localize cholinergic neurons and to define their synaptic circuitry in the rat retina by immunocytochemical method using anti-choline acetyltransferase antiserum. The results were as follows: 1. Cholinergic neurons of the rat retina were conventional amacrine cells located in the inner nuclear layer and displaced amacrine cells in the ganglion cell layer. 2. Cholinergic amacrine cells were branched in the middle of the sublamina a of the inner plexiform layer, and cholinergic displaced amacrine cells branched in the sublamina b, forming one prominent band, respectively. 3. Presynaptic processes to cholinergic amacrine cell processes were axon terminals of invaginating and flat cone bipolar cells, and unlabelled amacrine cell processes in the inner plexiform layer. Postsynaptic dyads at the ribbon synapses of axon terminals of cone bipolar cells were cholinergic amacrine cell process and dendrite of ganglion cell, cholinergic amacrine cell process and unlabelled amacrine cell process and cholinergic amacrine cell process and cholinergic amacrine cell process. In addition, cholinergic amacrine cell process formed postsynaptic monoad at the ribbon synapse. 4. Cholinergic amacrine cell processes made output conventional chemical synapses onto the dendrites of ganglion cells, unlabelled amacrine cell processes and cholinergic amacrine cell processes in the inner plexiform layer. These results demonstrate that (1) cholinergic neurons are conventional amacrine cells and displaced amacrine cells of which somata are located in the inner nuclear layer and ganglion cell layer, respectively, (2) cholinergic conventional amacrine cells are involved in OFF pathway, and cholinergic displaced amacrine cells play an important role in ON pathway in visual processing of lightness, and (3) acetylcholine released from cholinergic neurons by light excites directly ON and OFF ganglion cells or indirectly ON and OFF ganglion cells via non-cholinergic amacrine cells.
Acetylcholine ; Amacrine Cells ; Animals ; Choline O-Acetyltransferase ; Cholinergic Neurons* ; Dendrites ; Ganglion Cysts ; Neurotransmitter Agents ; Presynaptic Terminals ; Rats* ; Retina* ; Synapses

BACKGROUNDTo evaluate the safety of intracytoplasmic sperm injection (ICSI) with epididymal or testicular sperm, this study compared children born after ICSI treatment with epididymal or testicular sperm with children conceived after ICSI with ejaculated sperm.

METHODSThis retrospective study included 317 children born after ICSI with percutaneous epididymal sperm aspiration (PESA), 103 children born after ICSI with testicular sperm aspiration (TESA), and a control group of 1008 children born after ICSI with ejaculated sperm. All of the patients received their assisted reproductive treatment in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2004 to December 2011. Data, such as the rate of stillbirths, perinatal mortality, gestational age, birth weight, and the rate of congenital malformations of the three groups, were compared.

RESULTSPESA and TESA children were not different from ICSI children in the rate of stillbirths, perinatal mortality, infant mortality rate, gestational age, the rate of prematurity, and the rate of malformations (P > 0.05). A slight increase in birth defects was reported in the TESA group compared with those in the control group, but there was no significant difference between the groups (P > 0.05).

CONCLUSIONICSI with epididymal or testicular sperm does not lead to more stillbirths or congenital malformations compared with ICSI using ejaculated sperm.

Adult ; Congenital Abnormalities ; epidemiology ; Epididymis ; Female ; Fetal Death ; epidemiology ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

OBJECTIVETo study the stereoselective glucuronidation of carvedilol (CARV) by three Chinese liver microsomes.

METHODSThe metabolites of CARV were identified by a hydrolysis reaction with beta-glucuronidase and HPLC-MS/MS. The enzyme kinetics for CARV enantiomers glucuronidation was determined by a reversed phase-high pressure liquid chromatography (RP-HPLC) assay using (S)-propafenone as internal standard after precolumn derivatization with 2,3,4,6-tetra-O-acetyl-beta-D-glucopyranosylisothiocyanate.

RESULTSTwo CARV glucuronides were found in three Chinese liver microsomes incubated with CARV. The non-linear regression analysis showed that the values of K(m) and V(max) for (S)-CARV and (R)-CARV enantiomers were (118+/-44) micromol/L, (2 500+/-833) pmol/(min.mg protein) and (24+/-7) micromol/L, (953+/-399) pmol/(min.mg protein), respectively.

CONCLUSIONThese results suggested that there was a significant (P<0.05) stereoselective glucuronidation of CARV enantiomers in three Chinese liver microsomes, which might partly explain the enantioselective pharmacokinetics of CARV.

Carbazoles ; metabolism ; China ; Glucuronic Acid ; metabolism ; Glucuronides ; metabolism ; Microsomes, Liver ; metabolism ; Propanolamines ; metabolism ; Stereoisomerism

Renal cell carcinoma (RCC) is likely to metastasize to other organs, and is often resistant to conventional chemotherapies. Thymoquinone (TQ), a phytochemical derived from the seeds of Nigella sativa, has been shown to inhibit migration and metastasis in various cancers. In this study, we assessed the effect of TQ on the migratory activity of human RCC Caki-1 cells. We found that treatment with TQ reduced the proteolytic activity of matrix metalloproteinase-9 (MMP-9) in Caki-1 cells. TQ significantly repressed prostaglandin E2(PGE2) production, its EP2 receptor expression as well as the activation of Akt and p38, the wellknown upstream signal proteins of MMP-9. In addition, treatment with butaprost, a PGE2 agonist, also induced MMP-9 activity and migration/invasion in Caki-1 cells. Moreover, pharmacological inhibitors of PI3K/Akt and p38 remarkably attenuated butaprostinduced Caki-1 cell migration and invasion, implying that activation of PI3K/Akt and p38 is a bridge between the PGE2-EP2 axis and MMP-9-dependent migration and invasion. Taken together, these data suggest that TQ is a promising anti-metastatic drug to treat advanced and metastatic RCC.

This study was aimed to investigate the occurrence and clinical significance of the SET-NUP214 fusion gene in patients with T-cell acute lymphoblastic leukemia (T-ALL), analyse clinical and biological characteristics in this disease. RT-PCR was used to detect the expression of SET-NUP214 fusion gene in 58 T-ALL cases. Interphase FISH and Array-CGH were used to detect the deletion of 9q34. Direct sequencing was applied to detect mutations of PHF6 and NOTCH1. The results showed that 6 out of 58 T-ALL cases (10.3%) were detected to have the SET-NUP214 fusion gene by RT-PCR. Besides T-lineage antigens, expression of CD13 and(or) CD33 were detected in all the 6 cases. Deletions of 9q34 were detected in 4 out of the 6 patients by FISH. Array-CGH results of 3 SET-NUP214 positive T-ALL patients confirmed that this fusion gene was resulted from a cryptic deletion of 9q34.11q34.13. PHF6 and NOTCH1 gene mutations were found in 4 and 5 out of 6 SET-NUP214 positive T-ALL patients, respectively. It is concluded that SET-NUP214 fusion gene is often resulted from del(9)(q34). PHF6 and NOTCH1 mutations may be potential leukemogenic event in SET-NUP214 fusion gene.
Carrier Proteins ; genetics ; Chromosome Deletion ; Chromosomes, Human, Pair 9 ; genetics ; Gene Expression ; Histone Chaperones ; genetics ; Humans ; Mutation ; Nuclear Pore Complex Proteins ; genetics ; Oncogene Proteins, Fusion ; genetics ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Receptor, Notch1 ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors ; genetics

In partial thickness burn injuries, silver sulfadiazine cream 1%(SSD, Silvadene(R)) is the most commonly used topical agent worldwide. But silver sulfadiazine cream 1% has no exudate absorption property. Usually after escar is removed from wound surface, Silvadene(R) is changed to saline wet gauze dressing to promote epithelization. Aquacel(R)(ConvaTec, UK) is a 100% sodium carboxymethylcellulose Hydrofiber material. It absorbs exudates directly into the hydrofibers by vertical wicking which allows rapid uptake of liquid into the fibers. The absorbed exudate fluid can be distributed to the entire dressing rather than just over the wound surface, which results in larger fluid absorption capacity. From April, 2003 to July, 2004 a study was done with 40 patients who had variable partial thickness burns. Aquacel(R) dressing was compared in 21 cases to silver sulfadiazine cream 1% and saline wet gauze dressings in 19 cases. In the Aquacel(R) cases, the average healing time on the face was 5.36+/-1.69 a day; on the hands was 8.46+/-2.15 a day; and, on the neck was 6.0+/-2.0 a day. With the Silvadene(R) and Saline wet gauze dressing, the average healing time on the face was 6.44+/-1.74 a day; on the hands was 13.79+/-5.35 a day; and, on the neck was 11.17+/-3.31 a day. As a result, the Aquacel(R) group showed a shorter healing time compared to the Silvadene(R) and saline wet gauze dressing group and patients were satisfied because of less pain and improved comfort. In conclusion, Aquacel(R) is a better choice for partial thickness burn injuries because of shorter healing time, less pain and more confortable dressing.
Absorption ; Bandages* ; Burns* ; Capillary Action ; Carboxymethylcellulose Sodium ; Exudates and Transudates ; Hand ; Humans ; Neck ; Silver Sulfadiazine ; Wounds and Injuries