Objective To explore the efficacy, safety,time of drug taking effect and therapeutic dosage of sertraline in treatment of child emotional disorder. Method One hundred and forty-seven patientswith child emotional disorder were treated by sertraline and the efficacy rate, therapeutic dosage, the time of drug taking effect and adverse reaction was analyzed retrospectively. Results One hundred and thirty-seven patients were regular visited under supervision of a physician. Two months after treatment, the efficacy rate was 80.3%(110/137) and the rate of adverse reaction was 5.8%(8/137). The therapeutic dosage of sertraline was (47.9 + 19.0) mg/d. The time of drug taking effect was (20.4±13.2) d. The therapeutic dosage of sertraline in obsessive-compulsive disorder [(58.7±26.2) mg/d] was significantly higher than that in depression[(43.6±14.0) mg/d],anxiety disorder[(44.4±10.6) mg/d] and phobia[(43.5±15.5) mg/d](P < 0.01 ). The time of drug taking effect in depression[( 14.0±6.1 ) d] was significantly shorter than that in obsessive-compulsive disorder[(26.6±16.3) d,anxiety disorder [(22.3±13.9) d] and phobia [(21.4±12.8) d] (P <0.01). Conclusions Sertraline is an efficient and safe medicine in treatment of child emotional disorder. Its adverse reaction is slight and most patients can tolerate. But it takes higher therapeutic dosage in obsessive-compulsive disorder and the time of drug taking effect is earlier in depression than in other disorder.

Objective To explore the clinical effect of transjugular intrahepatic portosystemic shunt (TIPS) and percutaneous transhepatic variceal embolization (PTVE) on the treatment of cirrhosis with esophageal gastric varices bleeding. Methods The data of 61 patients of liver cirrhosis combined with esophageal gastric varices bleeding who underwent the interventional treatment were included in the retrospective analysis. Patients were divided into two groups, PTVE treatment group (n=42), and TIPS treatment group (n=19). The success rate of clinical treatment, the rebleeding rate, the alleviation of varicose veins, the incidence of hepatic encephalopathy, survival rate and liver function parameters were compared between two groups. Results Two groups of surgery were successful. The portal vein pressure decreased obviously in TIPS group. The rebleeding rate was higher in PTVE group (78.6%) than that in TIPS group (63.2%). The total alleviation rate of esophageal gastric varices was significantly lower in PTVE group (50.0%) than that in TIPS group (89.5%, P<0.05). The incidence rates of hepatic encephalopathy were 14.3% and 26.3% for PTVE group and TIPS group respectively. The two-year cumulative survival rates of PTVE group and TIPS group were 95.2% and 89.5% respectively, and there was no statistically significant difference between two groups. After surgery, the liver function parameters were not significantly different from those determined before the treatment in PTVE group. At 1 month and 3 months after TIPS, the liver functions were declined obviously. At 6 and 12 months after the treatment, the liver functions were not significantly different from those determined before the treatment in PTVE group. Conclusion The surgery of TIPS is safe and ideal interventional treatment for cirrhosis with esophageal gastric varices bleeding, which has the lower rebleeding rate, better esophageal gastric varices alleviation rate and long term less influence in liver function.

Objective To investigate the effect of stress dose glucocorticoid on patients with acute respiratory distress syndrome (ARDS) combined with critical illness-related corticosteroid insufficiency (CIRCI).Methods All early ARDS patients combined with CIRCI were screened by an adrenal corticotrophic hormone (ACTH) test and randomly divided into treatment group (hydrocortisone 100 mg intravenous,3 times/day,consecutively for 7 days,n =12 ) and control group (equivalent normal saline,n =14 ).General clinical data,changes of arterial blood gas,hemodynamics and respiratory mechanics were observed and recorded at admission and at 7 days after treatment.Ventilator-free and shock-free days,ICU stay within 28 days after admission were recorded and 28-day mortality was used as judge prognosis index.Results CIRCI rate in 45 early ARDS patients was 57.8％ ( 26 patients),and the shock rate was markedly higher in ARDS patients with CIRCI than patients without CIRCI (46.2％ vs 5/19 ).There were no significant differences in baseline parameters,oxygenation and illness severity between the treatment and control groups,except for markedly lower lactic level in the treatment group [ 2.7 ( 1.2,3.9 ) mmol/L vs 4.6 ( 2.5,6.3 ) mmol/L,P ＜ O.05].After 7 days of treatment,PaO2/FiO2 markedly increased,while heart rate obviously decreased in the both groups.Compared with the control group,survival time of patients was significantly longer and shock rate of the patients was markedly lower in treatment group within 28 days (5/12 vs 10/14,P ＜ 0.05).The 28-day mortality,which were adjusted by baseline arterial lactic,was lower in the treatment group (2.6/12 ) than in the control group (5.8/14) while with no significant difference ( P ＞ 0.05 ).There was no significant difference in complication incidence between the two groups.Conclusion Stress dose glucocorticoid could reduce shock incidence and prolong survival time,and has a tendency of lower 28-day mortality in early ARDS patients combined with CIRCI.

Quality variation and ecotype classification of Chinese herbal medicine are important scientific problems in Daodi herbal medicine research. The diversity of natural environmental conditions has led to form unique multi-Daodi, multi-product areas that produce particular Chinese herbal medicine. China is one of three big American ginseng (Panax quinquefolium L.) producing areas worldwide, with over 300 years of application and 40 years of cultivation history. Long-term production practice has led to the formation of three big advocate produce areas in China: Northeast province, Beijing and Shandong. P. quinquefolium L. grown under certain environmental conditions will develop long-term adaptations that will lead to more stable strains (different ecotypes). P. quinquefolium L., can vary greatly in quality; however, the ecological mechanisms causing this variation are still unclear. Root samples were collected from four-year-old cultivated P. quinquefolium L. plants in the three major genuine (Daodi) American ginseng-producing areas of Northeast province, Beijing and Shandong province, China. Ultra-performance liquid chromatography was used to analyze the contents of eight ginsenosides (Rg1, Re, Rb1, Rb2, Rb3, Rc, Rd, Rg2). Data for nine ecological factors, including temperature, moisture and sunlight, were obtained from the ecological database of Geographic Information System for Traditional Chinese Medicine. Soil samples from the sampling sites were collected. Effective boron and iron, available nitrogen and potassium, as well as other trace elements and soil nutrients, were determined by conventional soil physicochemical property assay methods. Analytical methods of biostatistics and numerical taxonomy were used to divide ecotypes of the three main Panax quinquefolium L. producing areas in China based on ginsenoside content, climate, soil and other ecological factors. To our knowledge, this is the first time that ecological division of P. quinquefolium L. producing areas in China has ever been conducted. The results show that there are two chemoecotypes of P. quinquefolium L. in China: ginsenoside Rb1-Re from outside Shanhaiguan, and ginsenoside Rg2-Rd from inside Shanhaiguan. Similarly, there are two types of climatic characteristics: inside Shanhaiguan (Beijing, Shandong) and outside Shanhaiguan (Northeast). This suggests that the formation and differentiation of chemoecotypes of P. quinquefolium L. is closely related to variability of the climatic and geographical environment. Additionally, ecological variation of the three main producing areas, characteristics of two climatic ecotypes, and soil characteristics are also discussed and summarized. These results provide experimental scientific evidence of the quality variation and ecological adaptation of P. quinquefolium L. from different producing areas. They also deepen our understanding of the biological nature of Daodi P. quinquefolium L. formation, and offer novel research models for other multi-origin, multi-Daodi Chinese herbal medicines ecotypes. In addition, the results demonstrate the critical need for improving quality, appropriate ecological regionalization and promoting industrialized development of P. quinquefolium L.

OBJECTIVE: Chengde is a city with many corneal blindness patients In north China. Lacking of corneas donation is the main reason which prevents corneal transplantation. Survey was made by questionnaire in Chengde to evaluate the current situation and the influential factors of corneal donation.METHODS: Survey was made in 3 200 Chengde residents aged 18 years or older, includes outpatients and inpatients of ophthalmology, some undergraduate students and people met accidentally in park, supermarket, station and centre for elders.48.6% are male and 51.4% are female. Self-made questionnaire includes general state, questions about cornea donation and factors influencing cornea donation.RESULTS: Among 3 200 questionnaires, 2 971 were valid. The effective rate was 92.84%. Over 50% people support donating cornea. More than 40% people intend to donate their corneas and support their relatives to donate. Among the factors for not intending to donate cornea, lacking knowledge of cornea donation was the main reason accounting for 42.81%, and worrying about the misusage of donating cornea without corresponding law became the second factor, which accounting for 21.07%. It has no influence on the consciousness of cornea donation by the difference of sex and location between city and countryside.Whereasfession and level of education indeed influence the consciousness of cornea donation, which of the people from 18 to 40 years old was greater than those of over 40, medical workers was greater than those from other fields, the people graduating from secondary specialized school or higher was greater than those graduating under secondary specialized school.CONCLUSION: People in Chengde have a positive attitude towards cornea donation. It is very necessary to enhance the education of cornea donation, establish an easy and smooth way for donation may promote cornea donating. Consummate legislation is also needed for cornea donation.

Objective To compare the clinical efficacy and postoperative liver function in patients with primary hepatic carcinoma treated by transcatheter arterial chemoembolization(TACE) or TACE combined with portal vein chemoembolization.Methods 48 patients with primary hepatic carcinoma, randomly divided into 2 groups (hepatic artery group in 25 cases and dual interventional group in 23 cases),underwent interventional treatment.The hepatic artery group underwent conventional hepatic artery interventional therapy, while the dual interventional group underwent hepatic artery and portal vein interventional treatment.The postoperative clinical efficiency, liver volume and liver function between the two groups'' patients were compared.Results To the endpoint of observation,the clinical efficacy and tumor reduction degree of dual interventional group were better than that of hepatic artery group.Compared with hepatic artery group, the postoperative ALT, AST and TBIL of dual interventional group were higher on the first and third days.On the seventh and fourteenth days, the statistical difference was not significant.The volume of non-embolization part in dual interventional group was larger than that in preoperative volume to different degrees.The most obvious change of liver volume happened in the 4th weeks after treatment.There was no treatment-related death or severe adverse reaction in two groups.Conclusion The treatment of TACE combined with portal vein chemoembolization is a safe and effective method, which may effectively inhibit the growth and reduce the volume of tumor, and result in compensatory hypertrophy of non-embolization part.

OBJECTIVETo describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis.

METHODSData from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System. Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites. Anthropometric and hemoglobin measurements for children under 5 were conducted. Nutritional status was determined according to WHO child growth standards.

RESULTSPrevalence of underweight and stunting in children under 5 had a downward trend. Underweight prevalence was close to normal (less than 5%), with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas. Prevalence of stunting in infants under 6 months and 6-12 months old in poorer rural areas increased from 5.7%-9.1% and 6.7%-12.5%, respectively, in 2008-2009. This trend also continued post-crisis in 2010. Prevalence of stunting in children left behind by mothers was 20%-30% higher than in children the same age in general and poorer rural areas. Prevalence of anemia in children did not change in rural areas, but prevalence of anemia in all age groups increased in poorer rural areas, especially in children under 24 months old. Level reached 30%-40% in 2009, and fluctuated in 2010.

CONCLUSIONThe nutritional status of children under 5 was comparatively stable during and after the global economic crisis, attributable to the Chinese government's policy response. The nutritional status in poorer rural areas fluctuated in response to the economic crisis and, thus, relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas. A proper national nutritional strategy for children under 2 years old, including nutrition supplementation for pregnant women and in-home fortification for complementary feeding, should be initiated.

Aging ; Anemia ; economics ; epidemiology ; Child Development ; physiology ; Child Nutrition Disorders ; economics ; epidemiology ; Child, Preschool ; China ; epidemiology ; Economic Recession ; Female ; Humans ; Infant ; Infant Nutrition Disorders ; economics ; epidemiology ; Male ; Nutritional Status ; physiology ; Population Surveillance ; Poverty ; Pregnancy ; Prevalence ; Rural Population ; Thinness ; Time Factors

OBJECTIVETo probe the significance of specific IgG4 in sera of patients with cerebral cysticercosis for diagnosis and therapeutic evaluation.

METHODSSpecific IgG4 in sera of patients with cerebral cysticercosis was assessed using colloidal gold-labeled mouse-anti-human IgG4 McAb as probe. The results were compared with the CT image manifestation.

RESULTSThe specific IgG4 positive rate in sera of patients with cerebral cysticercosis was 97.8%, whereas sera from patients with other kinds of parasitosis or central nerve system disease and the control group were all negative, except for a weak cross-reaction of sera from patients with hepatic echinococoosis. The determination of specific IgG4 in sera of patients with cerebral cysticercosis during different times of treatment showed that along with an increase in treatment time and improvement of clinical symptoms, specific IgG4 level gradually decreased. The positive rate and intensity of specific IgG4 in sera from patients with cerebral cysticercosis were consistent with the number of cysticercus parasites in the brain and pathologic changes, such as survival, disintegration, death and calcification. Survival of cysticercus in the brain was objectively evaluated using this technique.

CONCLUSIONSThe determination of specific IgG4 in sera is a practical method for diagnosis and therapeutic evaluation of cerebral cysticercosis.

Animals ; Antibodies, Monoclonal ; immunology ; Antibody Specificity ; Humans ; Immunoglobulin G ; blood ; immunology ; Mice ; Mice, Inbred BALB C ; Neurocysticercosis ; blood ; diagnosis ; therapy ; Predictive Value of Tests ; Tomography, X-Ray Computed

OBJECTIVETo compare the efficacies ofentecavir and adefovir in patients with chronic hepatitis B (CHB) and cirrhosis when administered as monotherapies using a 240-week course.

METHODSNinety patients diagnosed with CHB and cirrhosis (compensated or decompensated) were randomly divided into two treatment groups for administration of either entecavir (0.5 mg/day, oral; n =38) or adefovir (10 mg/day, oral; n =52) for 240 weeks. All participants underwent B-ultrasound and were tested for levels of HBV-DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen, creatinine, alpha-fetoprotein (AFP) and various serological markers of the hepatitis B virus at baseline and at treatment weeks 24, 48, 96, 144, 192, and 240. Instances of drug-related complications and adverse reactions were recorded. Patients who did not achieve complete virological response by treatment week 48 or who experienced virological breakthrough at any time during the study course were recorded and started on an appropriate combination therapy regimen. Statistical analyses were carried out using the t-test, chi-square test, and Cox regression modeling.

RESULTSThe dropout rate in the entecavir group was 2.6% and in the adefovir group was 13.5%. At treatment week 240, significantly more patients in the entecavir group had undetectable serum HBV-DNA (91.9% vs. adefovir group: 57.8%; x2=10.362, P=0.001), a negative conversion rate of hepatitis B e antigen (HBeAg) (46.2% vs. adefovir group: 24%; x2=5.055, P=0.025), and rate of HBeAg seroconversion (23.1% vs. adefovir group: 8%, P=0.047).The entecavir group and the adefovir group showed no significant differences upon per-protocol analysis and intention-to-treat analysis, nor in the rates of hepatocellular carcinoma development (entecavir group: 8.1% vs. adefovir group: 6.7%; x2=0.000, P=1.000) or mortality (entecavir group: 8.1% vs. adefovir group: 4.4%; x2=0.051, P=0.821). The possibility of achieving undetectable serum HBV-DNA was 2.761 times higher in the entecavir group than in the adefovir group (95.0% CI: 1.630 to 4.679). The possibility of HBeAg seroconversion was 0.192 times higher for males than for females (95.0% CI: 0.046 to 0.806).

CONCLUSIONCompared to adefovir, entecavir provides high efficiency and rapid viral suppression as a monotherapy for CHB patients when administered in a 240-week course.

Adenine ; analogs & derivatives ; Aged ; Alanine Transaminase ; Antiviral Agents ; Aspartate Aminotransferases ; Biomarkers ; Carcinoma, Hepatocellular ; Female ; Guanine ; analogs & derivatives ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Liver Neoplasms ; Male ; Organophosphonates ; Time Factors ; alpha-Fetoproteins

Objective: To investigate the average dietary nutrients intake status among Chinese residents between 2010-2012, and to compare the difference between rural and urban areas. Methods: Data were collected from Chinese Nutrition and Health Surveillance between 2010-2012. Based on regional features and economic development levels, China's county-level divisions were classified into four types: big city, medium and small city, ordinary rural area and poor rural area. A total of 62 857 valid subjects, including 14 017, 16 539, 19 910 and 12 391 respondents in each group separately, were enrolled by Multi-stage stratified proportion to the population cluster random sampling method. The dietary survey was conducted by recalling the 24 h diet in 3 consecutive days and weighting condiment. The daily dietary intake of energy, macronutrient, dietary fiber, vitamin, and mineral substance per resident were calculated based on China Food Composition. Results: The average energy intake per resident in Mainland China was 9 047.1 kJ, with highest (9 719.3 kJ) in poor rural area and lowest (8 490.4 kJ) in medium and small city. The average dietary protein intake was 64.2 g, with highest (73.9 g) in big city and lowest (60.7 g) in poor rural area. The average dietary fat intake was 79.7 g, with highest (89.4 g) in big city and lowest (70.6 g) in poor rural area. The average intake of micronutrients of vitamin A, vitamin B₂, vitamin C, calcium, iron, phosphorus, zinc was separately 441.9 μg, 0.8 mg, 80.1 mg, 364.3 mg, and 21.4 mg; which were lower than Chinese Dietary Reference Intakes. The percentage of population whose average intake of vitamin A, vitamin B₂, vitamin C, calcium were lower than estimated average requirement was separately 77.0%, 90.2%, 67.7%, and 96.6%. Conclusion The supply of 3 macronutrient was sufficient in mainland China. However, it was a common issue that there was excessive intake of fat but deficient intake of micronutrients such as vitamin, calcium, iron and zinc. There were differences in nutrition intake among big city, medium and small city, ordinary rural area and poor rural area.