Objective To observe the effect of Shenfu injection on fluid intake volume of resuscitation therapy for patients with septic shock. Methods The clinic data of 36 patients with septic shock admitted to Department of Critical Care Medicine of the Affiliated Hospital of Hangzhou Normal University from June 2010 to June 2013 were retrospectively analyzed. All the patients were treated with western conventional medicine. Twenty cases treated with western medicine combined with Shenfu injection (intravenous drip 100 mL once daily, half of a month was a therapeutic course) were defined as Shenfu group; the rest 16 cases treated with western medicine only were assigned as control group. The following data after treatment for 6, 24, and 72 hours in the two groups were compared:liquid intake and urine volumes, system vascular resistance index (SVRI), mean arterial pressure (MAP), cardiac index (CI), and case fatality rate in 28 days. Results There were no significant differences in the liquid intake volume in 6 hours after treatment (mL:3 101±219 vs. 3 329±295, P>0.05), the urine volumes in 6, 24 and 72 hours after treatment (mL, 6 hours:701±229 vs. 651±292, 24 hours:1 870±566 vs. 1 697±618, 72 hours:7 396±2 546 vs. 5 987±2 497), and the levels of SVRI in 24 hours after treatment between Shenfu group and control group (kPa·s·L-1·m-2:802±158 vs. 741±106, all P>0.05). The total liquid intake volumes (mL) in 24 hours and 72 hours after treatment in Shenfu group were significantly less than those in the control group (24 hours:4 544±425 vs. 4 996±396, 72 hours:10 985±891 vs. 11 612±807, both P<0.05). The SVRI, MAP, and CI in 72 hours of Shenfu group were significantly higher than those of control group [SVRI (kPa·s·L-1·m-2): 1 361±182 vs. 1 163±183, MAP (mmHg, 1 mmHg = 0.133 kPa): 76.2±6.1 vs. 71.8±6.3, CI (mL·s-1·m-2):76.2±7.5 vs. 70.8±7.2, all P<0.05], and the 28-day mortality rate in Shenfu group was significantly lower than that of control group [25.0%(5/20) vs. 62.5%(10/16), P<0.05]. Conclusion The application of Shenfu injection was favorable to the reduction of liquid intake volume in 72 hours after treatment that may be beneficial to the fluid limitation management in the course of treatment for septic shock.

Aim To study the effects of total saponins of Panax japonicus(TSPJ) on liver inflammation of natural aging rats.Methods The experimental rats were allocated into seven groups (twelve rats in each group): three months group, nine months group, fifteen months group, twenty-four months group, and TSPJ low-, mid-and high-dose groups(10, 30, 60 mg·kg-1).When the rats were eighteen months old, the TSPJ low-, mid-and high-dose groups of rats were given lavage treatments with TSPJ 10,30, 60 mg·kg-1 respectively until twenty-four months.During lavage, we stopped a day every week for six consecutive months.HE staining was used to observe the pathological morphological changes.Western blot was utilized to test IL-1β and TNF-α protein expressions.RT-PCR method was adopted to test IL-1β, IL-6, IL-12, IL-17α, TNF-α, IFN-γ mRNA expressions.Results HE staining observation showed that as the rats grew older the hepatic cord and sinusoid were arranged in more severe disorder, and the fat vacuole and inflammatory cells were increased significantly.While every dose group of TSPJ could improve these pathological changes distinctly.The IL-1β, TNF-α protein and IL-1β, IL-6, IL-12, IL-17α, TNF-α, IFN-γ mRNA expressions were increased gradually as the rats grew older, and every dose group of TSPJ could reduce their expressions to some extent.Conclusion TSPJ could protect the aging rat liver to some extent by inhibiting the liver inflammation.

Objective To evaluate the clinical efficacy and adverse reactions of alizarin combined with anti-tuberculosis therapy for multidrug resistant pulmonary tuberculosis (MDR-PTB).Methods A total of 200 confirmed MDR-PTB patients admitted in the Affiliated Hospital of Hangzhou Normal University during June 2013 and June 2015 were enrolled in the study.Patients were randomly divided into study group and control group (100 in each).Both groups were given standard anti -tuberculosis treatment for 8 months, and additional alizarin was given to study group .Chi-square test was used to assess the differences in clinical efficacy, sputum negative conversion rate, cavity closure and lesion absorption rate , as well as the incidence of adverse reactions between two groups ( including patients categorized according to TCM syndrome ). Results There were 39 markedly effective cases, 51 improved cases, 10 ineffective cases in study group, and 22 markedly effective cases, 35 improved cases, 43 ineffective cases in the control group.The total effective rate in study group was significantly higher than that in control group (90% vs.57%, χ2 =28.262, P <0.01).For patients with TCM syndrome differentiation as phlegm -heat stagnating lung and those with qi-stagnation induced blood-stasis, alizarin combination therapy had significantly higher total effective rate than standard anti -tuberculosis treatment (78.78% vs.63.33%, χ2 =7.187, P <0.05;95.74% vs.42.31%, χ2 =73.997, P <0.01), but the difference was not observed in patients with TCM syndrome differentiation as deficiency of qi and blood (95.00% vs.88.89%, χ2 =5.025, P >0.05). There was no significant difference in sputum negative conversion rate between two groups (76% vs.55%,χ2 =2.190, P >0.05).The cavity closure and lesion absorption rate in study group ( 91%) was significantly higher than that in the control group (54%,χ2 =38.294, P <0.01).The adverse reaction rate in study group was 27%, which was significantly lower than that in control group (66%, χ2 =30.570, P <0.01).Conclusion Alizarin in combination with standard anti -tuberculosis therapy can improve the clinical efficacy and reduce adverse reactions in treatment of MDR -PTB.

OBJECTIVETo investigate the distribution of H. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythensis and T. denticola in the subgingival plaque in the patients with chronic periodontitis.

METHODS27 patients with chronic periodontitis were included. Two of the deepest pockets of each patient were selected as the study sites. Semi-quantification of subgingival microorganism samples was analyzed by multiplex polymerase chain reaction and reverse hybridization assay.

RESULTSP. gingivalis, P. intermedia, T. forsythensis and T. denticola were detected in a high proportion of examined sites(corresponding values were 98.15%, 92.59%, 100% and 98.15%), however, the proportion of H. actinomycetemcomitans was low (20.37%). The levels of P. gingivalis and T. forsythensis were higher than the other three microorganisms with statistical significance.

CONCLUSIONThe simultaneous infection of P. gingivalis, T. forsythensis, P. intermedia and T. denticola is found in the patients with chronic periodontitis, in which the levels of P. gingivalis and T. forsythensis are higher than the other two microorganisms.

Aggregatibacter actinomycetemcomitans ; Bacteroides ; Chronic Periodontitis ; Dental Plaque ; Humans ; Male ; Porphyromonas gingivalis

Objective To compare the differences of the development of mathematical cognitive characteristics between ADHD children and normal children aged from 7 to 12 years old with event?related potentials ( ERP ) in the mathematical tasks, and to explore the neural mechanisms and characteristics. Methods ERP and behavioral data of 72 ADHD children and 88 normal children in three groups( 7?8 years old,9?10 years old,11?12 years old) were recorded,and analyzed N1,P2 and N2 components'amplitude and latency of Fz by judging the answers to simple calculation within 20. Results ( 1) Vertical comparative a?nalysis( the three age groups were compared):the differences of N1,P2 and N2 amplitudes in normal groups were considered to be statistically significant (right answer:N1(-3.8±2.1)μV,(-4.3±3.4)μV,(-2.2± 2.4)μV;P2(10.6±4.3)μV,(12.6±5.1)μV,(8.5±2.4)μV;N2(-6.5±3.1)μV,(-10.2±4.2)μV,(-6.8± 3.4)μV;error answer:N1(-2.8±2.7)μV,(-4.5±3.0)μV,(-2.9±2.5)μV;P2(9.3±5.9)μV,(12.1±5.0)μV,(8.2±3.6)μV;N2(-7.4±3.7)μV,(-11.4±5.5)μV,(-7.7±3.7)μV;all P<0.05),while was not sig?nificant in ADHD group(all P>0.05). (2)Horizontal comparative analysis(ADHD group and normal group were compared):N1 amplitude of ADHD group aged from 7 to 8 years old was higher than normal group’ s while judging the right answer((-5.3±2.4)μV,(-3.8±2.1)μV, P<0.05).P2 and N2 components’ ampli?tude of ADHD group aged from 9 to 10 years old were lower than of that normal group.(right answer:P2(9.6 ±4.4)μV,(12.6±5.1)μV;N2(-8.0±4.3)μV,(-10.2±4.2)μV;error answer:P2(9.6±4.4)μV,(12.1± 5.0)μV;N2(-7.9±4.6)μV,(-11.4±5.5)μV;all P<0.05).(3)Comparison of different tasks(the judge?ment of right and wrong answer):There was no statistically significant difference between ADHD and normal group in amplitude( P>0.05) . The latent period of the wrong answers was longer than that of the right ones among normal groups aged from 11?12 while the difference of ADHD group had no statistical significance ((312.9±42.3)ms,(292.2±21.2)ms, P<0.05). Conclusion The development trend of mathematical ERP component in ADHD children is different from normal ones,and it is closely related to the maldevelopment of frontal lobe.The characteristics of cognitive deficit differ from ages.ADHD children in low and intermediate level were damaged primarily with inhibition function,while the senior were damaged mainly in collision de?tection function.

OBJECTIVETo conduct a meta-analysis on the effects of testosterone on the related factors of metabolic syndrome in hypogonadal males.

METHODSBased on the principles and methods of Cochrane systematic reviews, we searched the PubMed (1980 to August 2009), Embase (1980 to August 2009), the Cochrane Central Register of Controlled Trials and CNKI (1995 to August 2009) , and handsearched some relevant journals and conference proceedings as well. We also identified randomized controlled trials addressing the use of testosterone for the treatment of hypogonadism, screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of the included studies, and performed a meta-analysis on the results of homogeneous studies using the Cochrane Collaboration's RevMan 5.0 software.

RESULTSSix randomized controlled trials were included. The results of analysis indicated that testosterone substitution could significantly ameliorate fasting blood glucose, total cholesterol and insulin resistance in hypogonadism patients, and it could also reduce LDL, HDL, triglyceride and systolic blood pressure, though with no significant difference from the controls. However, there was insufficient evidence to show the effects of testosterone on waist circumference, waist-hip ratio and diastolic blood pressure.

CONCLUSIONExisting clinical evidence has demonstrated the positive effects of testosterone substitution on the improvement of insulin resistance, blood glucose and lipids, but due to the heterogeneity and high risk of bias in the included studies, the evidence might be insufficient to give full support to the demonstration. Further large-scale trials are required to define the metabolic effects of testosterone in the treatment of hypogonadism.

Humans ; Hypogonadism ; complications ; drug therapy ; Male ; Metabolic Syndrome ; complications ; Randomized Controlled Trials as Topic ; Testosterone ; therapeutic use ; Treatment Outcome

Introduction:The 2010 targets of the China Hepatitis B Prevention Programme were a prevalence of hepatitis B surface antigen (HBsAg) less than 1.0% for children less than five years old and less than 6.0% for the total population. This survey assessed the prevalence of Hepatitis B infection in Lianyungang, Jiangsu province, China in 2009–2010.Methods:Multistage sampling was used with 2372 subjects among 17 selected villages. Blood specimen collection and testing by enzyme-linked immunosorbnet assay (ELISA) were completed using the following markers for hepatitis infection: HBsAg and antibody to HBsAg (anti-HBs); hepatitis B e antigen (HBeAg) and antibody to HBeAg (anti-HBe); and hepatitis B core antibody (total anti-HBc). The data were analysed with Epi Info, version 3.3.2.Results:The prevalence of HBsAg was 2.4% (95% Confidence Interval [CI]: 1.8–3.0; Adjusted Prevalence [AP] 2.9%); anti-HBs prevalence was 51.1% (95% CI: 49.1–53.1; AP 49.2%) and total anti-HBc prevalence was 41.7% (95% CI: 39.8–43.7; AP 45.5%). The prevalence of HBsAg and total anti-HBc positivity increased from young to older age groups, yet the prevalence of anti-HBs positivity decreased from young to older age groups (P< 0.001 for all). There was no difference in the prevalences of HBsAg and anti-HBs among females and males (P= 0.108 and 0.089), but females had a higher prevalence than males for total anti-HBc positivity (P< 0.001). Discussion: This survey showed that in 2010 the prevalence of HBsAg among children aged less than five years was lower than the national target of 1.0% and that the prevalence of HBsAg for the total population was lower than the national target of 6.0%.

BACKGROUNDSymptoms, endoscopy, and pH monitoring form the basis of diagnosis of gastroesophageal reflux disease (GERD). Their relationship was meaningful for primary care physicians, but still unclear. Our research aimed to compare questionnaire, endoscopy, and pH monitoring and to analyze their correlations.

METHODSThree hundred patients who underwent the Reflux Disease Questionnaire (RDQ), endoscopy, and esophageal 24-hour pH monitoring from March 2007 to December 2010 in Peking University People's Hospital were enrolled. We analyzed the characteristics of different investigations and their relationships.

RESULTSMale (OR for mild reflux esophagitis (RE) = 2.433, severe RE = 8.386), body mass index (BMI) (OR for mild RE = 1.222, severe RE = 1.297), and hernia (OR for mild RE = 6.059, severe RE = 17.547), were found to be the risk factors for RE; age (OR = 1.074) was correlated with severe RE. The consistency of questionnaire, endoscopy, and pH monitoring was poor: RDQ did not agree well with pH monitoring (κ = 0.061), nor with endoscopy (κ = 0.044); pH monitoring did not agree well with endoscopy (κ = 0.316). However, the severity of mucosa injury in RE was associated with pathological acid exposure (PAE): reflux episodes of >5 minutes (P = 0.035), the percentage time pH <4 (P = 0.017), and the DeMeester score (P = 0.016) increased significantly in patients with severe RE. Chest pain had poor relationship with RE or PAE.

CONCLUSIONSMale, age, BMI, and hernia were probably risk factors for esophagitis. RDQ, endoscopy, and pH monitoring have their own focus and reinforce each other in diagnosis. Of the GERD symptoms, chest pain had negative correlation with RE or PAE.

Adult ; Aged ; Body Mass Index ; Esophageal pH Monitoring ; Esophagitis ; etiology ; pathology ; physiopathology ; Female ; Gastroesophageal Reflux ; complications ; pathology ; physiopathology ; Hernia ; complications ; pathology ; physiopathology ; Humans ; Male ; Middle Aged ; Risk Factors

Adolescent ; Adult ; Ambulatory Surgical Procedures ; instrumentation ; methods ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Radio Waves ; Tonsillectomy ; instrumentation ; methods ; Young Adult

OBJECTIVETo evaluate the diagnostic value of full-field digital mammography for breast cancer.

METHODSThe clinical data and mammograms of 230 patients with breast diseases between January 2008 and July 2008 were collected and reviewed. Craniocaudal (CC) and mediolateral oblique (MLO) view mammograms were performed in all patients before surgery. Three experienced radiologists in breast imaging assessment analyzed and classified all the mammograms according to breast imaging reporting and data system (BI-RADS). The sensitivity, specificity and accuracy were evaluated according to their pathological diagnosis. The reasons resulting in false-negative and false-positive diagnosis were also analyzed.

RESULTSOf the 238 samples, 130 had a malignant breast tumors and 108 cases of benign breast lesions. One hundred and nine of the 130 malignant breast tumors were invasive ductal carcinoma. Fifty-seven of the 108 benign breast lesions were breast adenosis. Masses or masses with microcalcification were the most frequently seen signs of the malignant tumors, accounting for 40.8% and 20.8%, respectively. The sensitivity, specificity and accuracy of FFDM in detecting breast carcinoma were 90.8%, 87.0% and 89.1%, respectively. The false-negative signs including negative X-ray finding (5 cases) and focal asymmetric densities (4 cases). The false-positive signs were masses with spiculate, indistinctive or lobulated margin leading to misdiagnosing the lesions as malignant tumors.

CONCLUSIONFull-field digital mammography (FFDM) is helpful in detection of breast cancers in women, with a higher sensitivity, specificity and accuracy, and has an important clinical application value.

Adult ; Aged ; Aged, 80 and over ; Breast Diseases ; diagnosis ; diagnostic imaging ; Breast Neoplasms ; diagnosis ; diagnostic imaging ; Calcinosis ; diagnosis ; diagnostic imaging ; Carcinoma, Ductal, Breast ; diagnosis ; diagnostic imaging ; Diagnostic Errors ; Female ; Fibrocystic Breast Disease ; diagnosis ; diagnostic imaging ; Humans ; Mammography ; methods ; Middle Aged ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies