Child ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Pneumonia, Mycoplasma ; diagnosis ; drug therapy

Objective:To investigate the association of surrogate indexes of insulin resistance with the risk of nonalcoholic fatty liver disease(NAFLD)and advanced liver fibrosis in newly diagnosed patients with type 2 mellitus.Methods:A total of 429 newly diagnosed type 2 diabetic patients hospitalized in the Department of Endocrinology and Metabolism, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from June 2018 to June 2020 were included. The patients were divided into NAFLD group( n=263)and non-NAFLD group( n=166)according to the results of abdominal ultrasound, NAFLD patients were divided into advanced liver fibrosis group( n=33)and non-advanced liver fibrosis group( n=230)according to the NAFLD fibrosis score(NFS). The correlation of the triglyceride/high density lipoprotein-cholesterol ratio(TG/HDL-C), triglyceride glucose index(TyG), visceral adiposity index(VAI), triglyceride glucose-body mass index(TyG-BMI), homeostasis model assessment of insulin resistance index(HOMA-IR)with NAFLD and the occurrence of advanced liver fibrosis were analyzed. Results:The prevalence of NAFLD in newly diagnosed type 2 diabetic patients was 61.3%, and the prevalence of advanced liver fibrosis was 12.5%. After adjusting the potential confounders, multivariate logistic regression analysis showed that TG/HDL-C, TyG, VAI, TyG-BMI, and HOMA-IR were independently and positively correlated with NAFLD, and only TyG-BMI was independently and positively correlated with advanced liver fibrosis( OR=1.021, 95% CI 1.009-1.034, P<0.01). The receiver operating characteristic analysis showed that the area under the curue of TyG-BMI was more than those of TG/HDL-C, TyG, VAI and HOMA-IR for predicting the occurrence of NAFLD in newly diagnosed type 2 diabetic patients(0.83 vs 0.73, 0.74, 0.73, 0.67, P<0.01), but had no predictive value for advanced liver fibrosis. Conclusion:TyG-BMI is superior to TG/HDL-C, TyG, VAI and HOMA-IR for predicting the occurrence of NAFLD in newly diagnosed type 2 diabetic patients, and it is also an independent risk factor for advanced liver fibrosis.

Agricultural Workers' Diseases ; Agriculture ; Humans

Objective To investigate the effect of cognitive intervention on language function and quality of life (QOL) in elderly patients with post-stroke aphasia.Methods Fifty-five elderly patients with post-stroke aphasia were randomly divided into the control group (n =27) and the experimental group (n=28).The control group received comprehensive treatment including speech-language therapy (SLT),while the experimental group was subjected to additional cognitive intervention.All patients were enrolled in an eight-week rehabilitation program.The mini-mental state examination (MMSE) was used to assess cognitive function,a device for diagnosis and treatment of language disorders,ZM 2.1,was used to evaluate language function,and the 36-item short-form health survey (SF-36) (Chinese version) was used to assess quality of life (QOL),before and after treatment.Results After treatment,MMSE scores,language function scores in all categories and QOL scores in all dimensions improved in both groups (P＜0.05 for both).Furthermore,after treatment,there were significant differences between the two groups in MMSE scores of orientation,recall,attention and calculation,and in scores of overall language ability and the individual categories (P＜0.05 for all).Scores of the experimental group vs.the control group for the individual categories of language function were as follows:simple instructions (76.6 ± 14.1 vs.67.4± 19.3),complex instructions (66.1±12.8 vs.58.2±14.9),yes or no (72.5±12.1 vs.63.0±14.1),naming (55.0 19.5 vs.43.3±22.2),simple comprehension (67.5±21.4 vs.55.620.6),complex comprehension (44.8±17.0 vs.35.0±18.9),listening and reading words (65.4±16.7 vs.53.7±19.3),calculation (39.3±25.8 vs.25.9±19.2),memory (36.4±18.7 vs.26.3±17.8),matching (75.9±18.6 vs.65.3±17.1),simple general knowledge (68.3±18.2 vs.58.0±19.5),complex general knowledge (58.7±17.4 vs.50.0±13.3),orientation (70.7±19.6 vs.60.5±17.2) and comparison (59.9± 14.6 vs.50.2±17.5) (P＜0.05 for all).There were significant differences between the two groups in emotional function (66.7±18.2 vs.53.1±21.2),general health (67.2±12.6 vs.60.7±9.8),mental health (71.0±5.6 vs.63.1±4.2),social functioning (64.7±9.0 vs.59.3±10.2) and vitality (55.4±14.8 vs.46.9±15.6) (P＜0.05 for all).Conclusions Cognitive intervention combined with SLT can contribute to the recovery of language function and the improvement of QOL in elderly patients with post-stroke aphasia.

Objective To investigate the effects of the rat serum with chronic renal failure (CRF) on ubiquitin-proteasome pathway,histone acetyltransferase p300 and activation of activating transcription factor 4(ATF4) of rat arterial vascular smooth muscle cells(VSMCs) cultured in vitro,and explore the possible mechanism.Methods To establish the rat model of CRF by 5/6 nephrectomy,VSMCs were incubated in the media with the 10％ of CRF serum or control serum in vitro.The mRNA expressions of ubiquitin(Ub),ubiquitin activating enzyme(E1),ubiquitin ligases enzymes (β-transducin repeat containing protein 1,β-TrCP1),p300 and ATF4 in the rat VSMCs were examined by using realtime PCR.Expressions of E1,β-TrCP1,p300 and ATF4 proteins in response to the CRF serum in VSMCs were determined by Western blotting analysis.The enzyme activities of 20S proteasomes in the total protein were examined by using three special fluorogenic peptide substrates.Results The CRF serum significantly promoted the mRNA expressions of Ub,E1,β-TrCP1,p300 and ATF4 in VSMCs in a time dependent manner.Compared with that in control serum group,the mRNA levels of Ub,E1,β-TrCP1,p300 and ATF4 in CRF serum group increased significantly (P ＜ 0.01).The CRF serum also increased the protein expressions of E1,β-TrCP1 and p300 in a time dependent manner.The expression of ATF4 was decreased,but the difference was not significant (P ＞ 0.05).Compared with that in control serum group,the protein expressions of E1,β-TrCP1,p300 and ATF4 in CRF serum group increased significantly (P ＜ 0.01).The activities of 20S proteasomes in the CRF serum group were significantly increased in a time dependent manner.Compared with that in control serum group,the activities of 20S proteasomes in the CRF serum group increased significantly (P ＜ 0.01).Conclusions The serum of CRF rat can effectively active the ubiquitin-proteasome pathway,but ATF4 ubiquitinylated degradation is blocked.The latter may be associated with increased expression of p300.

Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Severe Acute Respiratory Syndrome ; drug therapy ; prevention & control

Objective The purpose of this study was to compare gadolinium-enhanced multiphase dynamic MR imaging and multirow-detector helical CT (MDCT) multiphase scanning for detection of small hepatocellular carcinoma. Methods Multirow-detector helical CT multiphase scanning and MRI with SE sequence combined with FMPSPGR sequence were performed in 37 patients with 43 small HCCs. ROC curves were established to analyze the results for each modality. Results There was no statistical difference between MDCT and MRI in the areas below the receive operating characteristic curve (Az). The detection of small HCC on MDCT showed lesser false-positive lesions than that on MRI, however the difference was not statistically different. Sensitivity of detecting small HCC on MDCT with multiphase scanning was higher than that on dynamic MRI. The sensitivity of detection for small HCC (≤1 cm) was 90.0%, 95.0% on MDCT and 70.0%, 85.0% on MRI, respectively. The positive predictive values for small HCC were higher on dynamic MDCT (97.5%, 97.6%) than on dynamic MRI (90.7%, 94.7%), respectively. Conclusion For early detection of small HCC, multiphase hepatic CT scan using MDCT is highly recommended for the patients with chronic hepatitis and cirrhosis.

Objective To study the clinical characteristics, diagnosis, treatment and prognosis of primary pulmonary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods Two cases of primary pulmonary PTCL-NOS were studied and relevant literature were reviewed. Results Case 1 diagnosed as primary pulmonary PTCL-NOS was a 44 years old woman and disease progressed after GLD (Gem+L-OHP+DXM) chemotherapy regimen. At last, the patient died of respiratory failure after one month. Case 2 diagnosed as primary pulmonary PTCL-NOS was a 46 years old man and reach partial response after CHOP regimen, and still alive now.Conclusion Primary pulmonary PTCL-NOS is very rare. It is easy to be misdiagnosed due to non-specific clinical and imaging manifestations. Acquiring enough tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no standard chemotherapy regimen for these patients, the prognosis is relatively poor.

Objective To study the recombination type of B/C genotype in hepatitis B virus.Methods The PCR was applied to amplifed the whole genes of HBV through the serums of four chronic HBV carriers who come from Jinghong distict,Yunnan province.The whole HBV genomes were ligated with pMD18-T vector and trasformed to E.coli JM109.After the positive colones were picked up,the HBV genotypes and recombinated sites were discoved through sequenced the acquired positive colones.Results All the acquired sixteen HBV sequences from the four HBV carriers were genotype B which were combinated with genotype C in some region.There are two ways of the combinations.For the first one,a 496 bp fragment from genotype C taked place the genotype B at the place of nt1825 to nt2320 of precore C/C region.For the second way,a 695 bp fragment of genotype B taked place at the both sites of nt822 to nt1020 of P gene region and nt1825 to nt2320 of precore C/C region.Conclusion A new recombination type of B/C genotype in hepatitis B virus was reported for the first time.The new Bj subgenotype was combinated with genotype C not only at the region of precore C/C but also at the place of P gene region.

Objective To apply robotic surgery of early ovarian malignancy tumors clinically and evaluate its feasibility in management for early ovarian cancer. Methods Using the da Vinci robotic surgical system, seven patients with early ovarian malignancy tumors (stage Ⅰ) underwent robotic surgery from April 2012 to September 2013. The average age was 45.7 years. Robotic surgeries approaches contained salpingo-oophorectomy,para-aortic lymphadenectomy, pelvic lymphadenectomy, omentectomy and appendectomy. Perioperative and follow-up clinical data were recorded. Results All robotic surgeries were successfully completed without the conversion to laparotomy. The mean operative time was 225 minutes (100-330 minutes). The average estimated blood loss was 171 ml (20-600 ml). No patients received blood transfusions. No intraoperative and postoperative complications were observed. The average number of pelvic lymph node dissected were 18.3 (11-34). The average number of para-aortic lymph node dissected were 3.7 (3-4). The mean follow-up time was 26.0 months after surgery (20-36 months). Currently, all patients had no tumor recurrence and survived. Conclusion Robotic surgery is feasible as a novel alternative approach in the treatment of early ovarian malignancy tumors.