[Objective]The paper was designed to introduce the Professor YE Jin's personal clinical experience which can provide an effective means for other pediatrician.[Method]By introducing the Professor YE Jin's personal clinical experience,we summarize the effective therapies about the infantile recurrent abdominal pain(RAP). [Result]According to the Professor YE Jin, the pathomechanism of RAP includes mainly cold stagnation, the indigestion, parasite and Qi stagnancy. RAP caused bycoldcan be treated from warming the middle-energizer and fending off the cold,RAP resulting from retention of food can be cured by removing the retention and invigorating the stomach, RAP incurred by ascaris can be cured by relieving ascariasis,expelling parasite and purgation simultaneously,and RAP resulting from Qi stagnation can be cured by soothing liver, regulating qi activity, rather than relieving pain merely. Based on the above-mentioned theory,she tends to use Liquorice and prefers Paeonia a lot in curing the disease, that is always effective in clinic as a result.The recurrence rate is also lower.One case was provided for verification.[Conclusion]Professor YE Jin thinks that warming the middle-energizer and fending off the cold, removing the retention and invigorating the stomach, the RAP can be improved the curative effect,and that can provide another idea for other clinicians.

Objective To survey the prevalence of hypertension in population of Keshan disease endemic areas, in order to provide a scientific basis for prevention and control of hypertension in rural areas of our country.Methods One hundred and twenty villages were selected as the survey places based on case-finding from 15 provinces including Gansu, Hebei, Henan, Heilongjiang, Jilin, Liaoning, Shaanxi, Shandong, Shanxi, Hubei, Yunnan,Sichuan, Guizhou, Chongqing and Mongolia in 2009.The subjects were permanent residents in the survey places.Basic situation of all subjects was collected through the questionnaire survey and blood pressure was measured by a clinician.Diagnostic criterion for hypertension was based on the Chinese Guidelines for the Management of Hypertension.Results Totally 33 558 subjects aged 18 and over were surveyed, including 8 699 hypertension patients.The positive rate of hypertension was 25.9％ (8 699/33 558), among that 26.3％ (3 532/13 408) were males,and 25.6％ (5 167/20 150) were females.The positive rate of hypertension increased with age (x2 =3 348.325, P ＜0.05).In the classification of hypertension, the proportion of stage 1, 2 and 3 hypertension and isolated systolic hypertension was 31.8％ (2 770/8 699), 26.1％ (2 273/8 699), 17.2％ (1 492/8 699) and 24.9％ (2 164/8 699),respectively.Conclusions The positive rates of hypertension in Keshan disease endemic areas are higher than those of the national average (18.8％).Hypertension is a serious public health problem in Keshan disease endemic areas.The strategy of hypertension prevention and control should be formulated for remote rural areas.

Objective:To observe the effect of hemp seed oil on the blood lipid and its hepatoprotective efficacy in hyperlipidemic rats. Methods:High fat diet was used to make the hyperlipidemia model in SD rats,and the rats were randomly divided into 6 groups:the normal control group,high fat model group,high dose group(1. 5 g·kg-1 ),medium dose group(1. 0 g·kg-1 ),low dose group (0. 5 g·kg-1 )and Xuezhikang group(0. 5 g·kg-1 ). After 35-day treatment,serum TC,TG,HDL-C,LDL-C,SOD,MDA,ALT, AST and liver SOD were detected. Results:Compared with the model group,hemp seed oil at different dosages could significantly de-crease the contents of serum TC,TG,ALT and the atherogenic index(AI)( P<0. 05 or P<0. 01),and significantly increase the SOD activity in serum and liver(P<0. 01). The contents of serum MDA and AST in the medium and high dose groups were signifi-cantly decreased(P<0. 01),and the content of LDL-C in serum and the content of MDA in liver in the high dose group were signifi-cantly reduced(P<0. 01). Conclusion:Hemp seed oil shows promising blood lipid reducing ability and liver protective effect in hy-perlipidemic rats,and the mechanism may be related with liver lipid metabolism improvement and antioxidant function enhancement.

PURPOSE: The purpose of this study was to explore the potential early diagnostic value of serum microRNA-381(miRNA-381) in patients with gastric cancer (GC). MATERIALS AND METHODS: Patients with advanced gastric cancer (AGC) and early gastric cancer (EGC), as well as healthy individuals, were enrolled in this study. Expression of miRNA-381 in serum was detected using real-time quantitative PCR. Electrochemiluminescence analysis was used to investigate the expression of classic tumor markers, including carbohydrate antigen (CA) 199, CA724, and carcinoembryonic antigen. Finally, receiver operating characteristic curve and Kaplan-Meier analysis were used to determine the value of miRNA-381 in clinical diagnosis of GC. RESULTS: miRNA-381 was differentially expressed among the study groups. AUC analysis showed that the sensitivity and specificity of serum miRNA-381 in the diagnosis of GC were superior to those of other tumor markers. Furthermore, low levels of miRNA-381 expression were positively correlated with lymph node metastasis and AGC. Finally, Kaplan-Meier survival analysis showed that down-regulation of miRNA-381 was associated with lymph node metastasis and the development of GC. CONCLUSION: miRNA381, which was down-regulated in GC, might be a novel early diagnosis marker for patients with GC.
Area Under Curve ; Biomarkers, Tumor ; Carcinoembryonic Antigen ; Diagnosis ; Down-Regulation ; Early Diagnosis ; Humans ; Kaplan-Meier Estimate ; Lymph Nodes ; Neoplasm Metastasis ; Polymerase Chain Reaction ; ROC Curve ; Sensitivity and Specificity ; Stomach Neoplasms

Adenocarcinoma ; pathology ; Adult ; Female ; Humans ; Kidney Neoplasms ; pathology ; Male ; Middle Aged

Objective:To analyze the delivery room disaster vulnerabilities of 7 tertiary hospitals in Liaoning Province, evaluate the nursing management disasters vulneratility, and provid support for emergency management of delivery room nursing.Methods:The Kaiser model analysis was used to design a disaster vulnerability assessment form for the delivery room, combined with the actual risk prevention and control in the delivery room. The survey was conducted from March 18 to 27, 2020 by paper questionnaire among 200 nursing staff in the delivery room, and the risk values for emergencies were calculated and the matrix distribution was analyzed and evaluated.Results:Totally 190 valid questionnaires were collected. The top 10 risk events faced by the delivery room were epidemic outbreaks, failure to adequately protective equipment for emergency admission to the delivery room, maternal poor protection awareness, nursing staff were contaminated with amniotic fluid and body fluids, poor maternal compliance with midwife orders, shortage of supplies of medical care protective equipment, nursing staff suffered needlestick injuries, high fever in patients, masks and gloves were worn or removed incorrectly, and doctor-patient tension due to poor compliance.Conclusion:Kaiser model-based hazard vulnerability analysis of delivery rooms can provide an important basis for risk identification and early warning and emergency plan improvement and formulation, which should be applied flexibly with the actual and specific characteristics of delivery rooms and dynamic changes of risks.

OBJECTIVETo analyze early hematopoietic response and long-term survival of very severe aplastic anemia (VSAA) patients with different absolute neutrophil counts (ANC) after frontline immnunosuppressive therapy (IST).

METHODSClinical data and outcome of 145 VSAA patients treated with rabbit antithymocyte globulin combined with cyclosporine were retrospectively analyzed. Hematopoietic responses to IST and long-term survival were statistically analyzed for VSAA patients in different ANC subgroups.

RESULTSPre-IST ANC=0.05×10(9)/L acted as the best cutoff level to predict IST response at 3, 6 months. For 145 VSAA patients, early death rate was 13.4% (11/82) vs 1.6% (1/63), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group (P<0.05). Hematopoietic response rates to IST was 22.0% vs 54.0% (P=0.000) at 3 months, 34.1% vs 63.5% (P=0.000) at 6 months; the overall five-year survival rate was only (62.5±5.4) % vs (91.4±3.7) % (P=0.000) and five-year event-free survival rate was (42.3±5.5) % vs (63.1±6.5) % (P=0.003), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group.

CONCLUSIONVSAA patients with extremely low ANC (≤0.05×10(9)/L) had high early death rate and with very low response rate to frontline IST and poor survival, so it is urgent to seek for the alternative frontline therapy that will bring faster and better outcome for these patients.

Anemia, Aplastic ; blood ; drug therapy ; Animals ; Antilymphocyte Serum ; therapeutic use ; Cyclosporine ; therapeutic use ; Disease-Free Survival ; Humans ; Immunosuppressive Agents ; therapeutic use ; Leukocyte Count ; Neutrophils ; cytology ; Rabbits ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo explore the effects of serum ferritin (SF) and iron overload (IO) pre-immunosupressive treatment (IST) on hematologic response of severe aplastic anemia (SAA/VSAA) patients treated with IST.

METHODS257 SAA/VSAA patients who underwent first-line IST from Feb, 2003 to Dec, 2011 in Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital were retrospectively analyzed, the status of SF before IST and the IO-affected factors were studied. The effects of IO on hematologic response of SAA/VSAA patients were evaluated as well.

RESULTSThe median level of SF of 257 patients was 387 (6-2 004) μg/L. 36 patients (14%) had IO, including 20 SAA and 16 VSAA patients. According to univariate logistical regression analyses, IO was influenced by age>14 years (P=0.010) and blood transfusion (P<0.001). The multivariate logistic regression analysis showed that blood transfusion [P=0.001, OR=0.218 (95% CI 0.092-0.520)] was the only independent prognostic factor. SAA (but not for VSAA) patients with IO had much lower hematologic response rate in 6 month after IST (P=0.037). Absolute reticulocyte count and IO correlated with response at 6 month by univariate logistical regression analysis (P=0.014, 0.037). The multivariate logistic regression analysis showed that IO [P=0.021, OR=4.092 (95% CI 1.235-13.563)], ARC ≥20×10(9)/L [P=0.040, OR=2.743 (95% CI 1.049-7.175)] were independent prognostic factors.

CONCLUSION84.8% patients had high serum ferritin before IST, and 14.0% reached IO. Adult and more blood transfusion caused IO more likely. IO correlated with response at 6 month, and was independent prognostic factor.

Adult ; Anemia, Aplastic ; drug therapy ; physiopathology ; Blood Transfusion ; Ferritins ; blood ; Humans ; Immunosuppressive Agents ; therapeutic use ; Iron Overload ; physiopathology ; Logistic Models ; Reticulocyte Count ; Retrospective Studies

Objective: To explore the life span of red blood cells (RBC) in patients with severe/very severe aplastic anemia (SAA/VSAA). Methods: Clinical data of 128 SAA/VSAA patients from November 2016 to April 2017 were retrospectively analyzed, and 13 healthy volunteers in the same period was used as normal control. The endogenous Breath Carbon Monoxide (CO) test was used to detect the life span of RBC in SAA/VSAA patients, and the effect of immunosuppressive therapy (IST) on the life span of RBC in these patients was explored. Results: The mean life span of RBC in 51 untreated SAA/VSAA patients was (50.69±21.43) d, which was significantly shorter than that in normal controls[(111.85±31.55) d](t=-6.611, P<0.001). The mean life span of RBC in 77 patients treated with IST was (87.14±39.28) d. The mean life span of RBC in complete responses (CR), hematologic response (HR) and non-response (NR) patients were (106.15±32.12) d, (92.00±38.60) d and (50.44±21.56) d, respectively. The life span of RBC in patients with HR was significantly longer than that in newly diagnosed and NR patients (t=7.430, P<0.001; t=4.846, P=0.002), which was similar to that in the normal controls (t=-1.743,P=0.085). There was no statistical significance between CR patients and the normal controls in the mean life span of RBC (t=-0.558, P=0.579). No factor affecting the RBC life span was found in univariate logistical regression analyses in the newly diagnosed SAA/VSAA patients. The serum levels of IL-2R and IL-6 were much lower in HR patients than NR patients[IL-2R: 4.3×10⁵ U/L vs 6.5×10⁵ U/L, z=-2.733, P=0.006; IL-6: 2.6 (2.0-17.7) ng/L vs 6.1 (2.0-14.4) ng/L, z=-2.968, P=0.003]. Of the 51 newly diagnosed patients, 38 received IST and their 3-month curative effect was evaluated. Receiver operator characteristics (ROC) curve was used to analyze the predictive effect of RBC life span of untreated patients on the efficacy of IST before treatment. The cut-off point was 60 days with sensitivity of 37.5% and specificity of 86.4%. In 9 cases with life span of RBC>60 d before IST, 6 cases acquired HR, while in 29 cases with life span of RBC ≤ 60 d before IST, 10 cases acquired HR, the difference was not statistically significant (P=0.128). Conclusion The life span of RBC in SAA/VSAA patients was shortened, which can be improved even recovered to the normal after IST. Elevated cytokines might play a role in the pathophysiology of the shortened RBC life span in SAA/VSAA.

Objective:To establish a nomogram based on features under endoscopic ultrasonography (EUS) for predicting the diagnosis of small gastric stromal tumors.Methods:The clinicopathological data of 189 patients with gastric submucosal tumors (diameter less than 2 cm) who underwent endoscopic resection at the Department of Gastroenterology, Tongji Hospital of Tongji University from June 2015 to August 2021 were retrospectively collected. All patients were divided into the modeling group ( n=126) and the validation group ( n=63) at 2∶1 by random function of software R. Independent influencing factors for the diagnosis of small gastric stromal tumors under EUS screened by univariable and multivariable logistic regression analysis were used to establish the diagnostic prediction nomogram. The receiver operator characteristic (ROC) curves were drawn to evaluate the discrimination of the model both in the modeling group and the validation group. Hosmer-Lemeshow test and calibration curve were used to evaluate the calibration of the model in both groups. Results:The age of patients >60 years ( OR=2.815, 95% CI:1.148-6.900, P=0.024), the lesions located in cardia/fundus ( OR=5.210, 95% CI:1.225-22.165, P=0.025), originated in muscularis propria ( OR=6.404, 95% CI:2.262-18.135, P<0.001) and of external growth ( OR=6.024, 95% CI:1.252-28.971, P=0.025) were independent influencing factors for the diagnosis of small gastric stromal tumors under EUS. The diagnostic prediction nomogram was established based on the four factors above. The areas under ROC curve of the modeling group and validation group were 0.834 (95% CI:0.765-0.903) and 0.780 (95% CI:0.667-0.893). Hosmer-Lemeshow test indicated that this model fit the data well ( χ2=10.23, P=0.176 in the modeling group; χ2=2.62, P=0.918 in the validation group). Calibration charts of the model drawn by Bootstrap method showed that the calibration curves fit well with the standard curves in both groups. Conclusion:The nomogram based on features under EUS for predicting the diagnosis of small gastric stromal tumors provides a visual reference for endoscopists to diagnose small gastric stromal tumors under EUS with good discrimination and calibration.