Adult ; Anti-Inflammatory Agents ; therapeutic use ; Arthritis, Reactive ; diagnosis ; drug therapy ; etiology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Phytotherapy ; Treatment Outcome ; Urethritis ; complications

Objective The aim of the present study was to assess the changes of IGF-1,IGF-2,IGFBP-1 and IGFBP-3 in diabetes nephropathy,the relationships between IGFs,IGFBPs and ?_1-,?_2- microglobulin.Methods A total of 130 type-2 diabetic participants(male:52,female:78)aged 37~75 yeares in Guangdong Provincial People's Hospital were enrolled from Feb.2000 to May 2003.Serum IGF-1,IGF-2,IGF binding protein 1(IGFBP-1),IGFBP-3,creatinine(Cr),cholesterol,triglycerides,HDL,LDL,apolipoprotein B100(apoB100),apoA,HbA_1c,fasting and postprandial C-peptide,serum and urine ?_1-MG and ?_2-MG were measured.Patients were divided into clinical albuminuria(DN,n=24),microalbuminuria(MA,n=40),and normal(NOR,n=66)groups according sCr and urine Alb/Cr ratio.Results In multiple linear regression analysis,determinants of S ?_1-MG were IGF-2 、TC and age(r=0.492,P=0.0001);U ?_1-MG were IGF-2、age(r=0.307,P=0.007); S ?_2-MG were IGFBP-1、HDL and age(r=0.528,P=0.0001);U ?_2-MG were IGFBP-1、CP120 and age(r=0.407,P=0.0001);s-Cr were IGFBP-1、CP0 and age(r=0.499,P=0.0001)。Serum IGF-2 and IGFBP-1 were significantly increased in DN group[IGF-2:(889.48?65.94)?g/L vs (711.57?28.73)?g/L,P=0.03;IGFBP-1:(94.91?17.48)?g/L vs(54.81?5.04)?g/L,P=0.009].Conclusion Serum IGFBP-1 and IGF-2 are significantly increased in type 2 diabetes with nephropathy.The disorders of IGFs and lipid metabolism may contribute to the development of diabetic nephropathy.

AIM: To observe the targeting thrombolytic effect of a monoclonal antibody specific for cross-linked fibrin connected with liposomal urokinase(UK) in the model of rabbit artery thrombosis.METHODS: Preparation of thrombolytic solutions: with the method of controllable dialysis eradicator in liposomat, empty liposomes, liposomally entrapped urokinase and liposomally entrapped urokinase linked with D-dimer antibody were made. Experiment in vivo: a rabbit thrombosis model of abdominal aorta was induced by ferric chloride. When the blood pressure fall to the lowest, 5 different solutions were separately imported (PBS, maximal-level UK, Ab/Lip/UK, Ab/UK-Lip, Ab-UK-Lip) and observed for 40 min continuously. RESULTS: The varieties of 5 groups blood pressures were analyzed with q-test. Significant differences were observed among Ab-UK-Lip group, maximal-level UK group and others (P

Objective To explore the prenatal ultrasonographic features of fetuses diagnosed as echogenic bowel and chromosomal abnormalities. Methods From September 2009 to June 2013, eighty cases diagnosed as echogenic bowel by prenatal ultrasound screening in our hospitals underwent chromosomal karyotype analysis and were followed up till fetal birth. The prenatal ultrasonographic features were carefully correlated with the postnatal findings. Results Prenatal ultrasoundand chromosomal findings of the 80 cases were:(1) Fifty-eight cases of fetuses with echogenic bowel alone (72.5%, 58/80, without chromosomal karyotype abnormalities). (2) Eleven cases of fetuses with additional ultrasound soft markers (13.8%, 11/80, without chromosomal karyotype abnormalities). The ultrasound examination revealed 8 cases of choroid plexus cysts, 1 case of single umbilical artery, 1 case of shorter nasal bone, and 1 case of echogenic intracardiac focus. (3) Five cases of fetuses with severe functional abnormalities or complex structural malformations and normal chromosomal karyotype. The ultrasound examination revealed 3 cases of structural cardiac malformations, 1 case of heart failure and 2 cases of central nervous system malformations. Of them,one case showed complex malformations (right ventricular dysplasia syndrome, cerebellar dysplasia and single umbilical artery), whereas the remaining 4 cases only involve single malformation. (4)Six cases had chromosomal abnormalities (7.5%, 6/80), including 3 cases of abnormal chromosome microdeletions, and 3 cases of abnormal chromosome numbers (1 21-trisomy syndrome, 1 18-trisomy syndrome, and 1 triploid syndrome). All of them had severe structural malformations and abnormal soft markers. The ultrasound examination revealed 2 cases of severe cardiac malformations, 2 cases of central nervous system malformations, 1 case of pericardial/peritoneal effusion, and 1 case of placental chorionic multiple hemangioma. One case of holoprosencephaly (donor of the twins) ended with intrauterine death. The associated abnormal soft markers include nuchal fold (NF) thickening, choroid plexus cysts, umbilical cord cysts, single umbilical artery, and placental chorionic hemangioma. Conclusions The fetuses with echogenic bowelaloneusualyhaveagoodprognosis.Insomecases,echogenicbowelmaydisappearduringvfolow-up.The fetuses complicated with severe structural malformations and chromosomal abnormalities have poor prognosis. For the fetuses diagnosed of echogenic bowel by prenatal ultrasound screening, systematic ultrasound examination should be carried out and clinical chromosomal karyotype analysis was suggested.

Abstract: Objective To analyze the changes of coagulation indicators in patients with hepatitis B complicated with Clonorchis sinensis (C. Sinensis), and provide reference value for diagnosis, drug using and prognosis monitoring. Methods　The patient samples were collected from the Third Affiliated Hospital of Sun Yat-sen University from June 2018 to February 2022 and divided into six groups. They were 40 healthy patients, 47 patients with simple chronic hepatitis B, 47 patients with post-hepatitis B liver cirrhosis, 40 patients with C. Sinensis mono-infection, 30 patients with chronic hepatitis B patients co-infected with C. Sinensis and 27 patients with post-hepatitis B liver cirrhosis patients coinfected with C. Sinensis. Four coagulation indexes, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB), were detected and compared among the groups. Results Compared with the healthy group, C. Sinensis mono-infection group had higher level of FIB and delayed PT, APTT; chronic hepatitis B group and chronic hepatitis B patients co-infected with C. Sinensis group had delayed PT, APTT, TT and significant lower FIB, these differences were statistically significant (all P<0.05). Compared with simple chronic hepatitis B group, post-hepatitis B liver cirrhosis and chronic hepatitis B patients co-infected with C. Sinensis had significant delayed PT, APTT, TT and lower FIB (all P<0.05). Compared with the post-hepatitis B liver cirrhosis and chronic hepatitis B patients co-infected with C. Sinensis, post-hepatitis B liver cirrhosis patients coinfected with C. Sinensis group had significant delayed PT, APTT, TT and lower FIB (all P<0.05). Conclusions The coinfection of C. Sinensis will further aggravate the coagulation dysfunction of HBV patients, leading to poor treatment and prognosis. HBV patients will have worse coagulation function in the process to post-hepatitis B liver cirrhosis; Therefore, it is important to pay attention to C. Sinensis co-infection when treating HBV patients, so that further guidance on clinical use and monitoring of prognosis can be provided.

With the increase of the incidence and the refinement of clinical treatment,the clear preoperative staging and the assessment of tumor recurrence and metastasis of cervical cancer is particular important.Different results may be explained in the same tumor applied different methods of imaging examination,which influences the clinical diagnosis and treatment.So imaging examination plays a more and more important role in the assessment of preoperative staging and tumor recurrence.

Objective To summarize the clinical features,diagnostic and treatment experience of severe hand,foot and mouth disease(HFMD) cases receiving mechanical ventilation from Jan 1 to Sep 6,2009 in our hospital and provide reference for reducing the occurrence of neurogenic pulmonary edema(NPE) and mortality. Methods 147 severe HFMD who received mechanical ventilation were analyzed by a retrospective investigation. Results 85.0% children were less than 3 years old and 100% patients had a fever. The mechanical ventilation occurred within 1 to 4 days after fever (3.06 ± 1. 02) d. Neurological complications presented as bad spirit,easy surprised, involuntary movement of the extremities and lethargy. Respiratory system complication presented as polypnea, hypepnea and irregular rhythm. Circulatory system complication presented as heart rate increase or decrease, hypertension or hypotension, piebald skin and low limb temperature.Some of the children had high white blood cell counting,glucose and lactic acid of the blood. The EV71-PCR positive rate was 34. 7% for throat swabs,and 42. 2% for anal swabs. Chest X-ray presented as increased broncho vascular shadows, exudation or nonapparent abnormality. Only three children were dead, fatality rate was 2. 0%. Conclusion The HFMD cases in this outbreak are relatively more serious,and change rapidly. It's difficult to treat as soon as NPE appeared,and it has high fatality rate. Early recognition of critical patients,timely giving mechanical ventilation,and the comprehensive treatment can reduce NPE incidence and the mortality.

The hepatocellular carcinoma (HCC) is one of the most common malignant tumors.Patients with hepatobiliary cancer suffer from multiple symptoms,such as physical symptoms and psychology symptoms.In recent years,along with the further research of symptoms,the concept of symptom clusters occurred.Those two issues have always been the hot topics in recent years.Through the efforts of experts at home and abroad,there has been a part of progress in this area.However,the results are not the same.There are lots of disputes in the numbers、sequence、incidences of the symptom clusters.The paper will discuss this issue from symptom experience and symptom clusters in order to provide the reference and basis for symptom management.

Objective To assess whether dynamic arterial elastance (Eadyn)can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock.Methods A prospective observational cohort study was conducted.Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University.Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO) monitoring technology before and after decreasing norepinephrine dosage.Eadyn was defined as the ratio of pulse pressure variation (PPV) to stroke volume variation (SVV).Mean arterial pressure (MAP) variation was calculated after decreasing the dose of NE.Response was defined as a ≥ 15％decrease of MAP.AUC was plotted to assess the value of Eadyn in predicting MAP response.Results A total of 32 patients were enrolled in our study,with 13 responding to NE dose decrease where as the other 19 did not.Eadyn was lower in responders than in nonresponders (0.77 ± 0.13 vs 1.09 ± 0.31,P ＜ 0.05).Baseline Eadyn was positively correlated with systolic blood pressure variation,diastolic blood pressure variation,systemic vascular resistance variation and MAP variation (r =0.621,P =0.000;r =0.735,P =0.000;r =0.756,P =0.000;r =0.568,P =0.000 respectively).However,stoke volume variation,baseline level of systemic vascular resistance and NE baseline dose were not correlated with Eadyn baseline value (r =0.264,P =0.076;r =0.078,P =0.545;r =0.002,P =0.987 respectively).Eadyn ≤ 0.97 predicted a decrease of MAP when decreasing NE dose,with an area under the receiver-operating characteristic curve of 0.85.The sensitivity was 100.0％ and specificity was 73.7％.Conclusions In septic shock patients treated with NE,Eadyn is an index to predict the decrease of arterial pressure in response to NE dose reduction.

Objective To study dexamethasone and higher C-reactive protein(CRP) on effects of platelets concentrates(PC) transfusion for bleeding patients with thrombocytopenia.Methods To investigate peripheral blood platelets count,clinical bleeding before(CRP test simultaneously) and 12～16 hours after PC transfusion for 45 non-fever,non-splenomegaly and non-DIC(disseminated intravascular coagulation,DIC) patients with leukemia,aplastic anemia,or solid tumor chemotherapy,which had bleeding and needed PC transfusion.All cases were divided into two groups:CRP normal and CRP higher one according to their CRP results.Each group were also classified as non-dexamethasone and dexamethasone division(10mg dexamethasone intravenous injection before transfusions) respectively,in order to analyze the relationships between effects of PC transfusion and serum levels of CRP or dexamethasone.Results The peripheral blood platelets counts (33.2?9.2)?109/L after PC transfusions in CRP normal group were more than that (25.4?10.4)?109/L,in CRP higher group,with significant differences(t=4.42,P