Objective To explore the clinical value of 13C-methacetin breath test for the assessment of liver disorder and to analyze its predictive value to the severity of liver function injury in children.Methods Eighteen healthy children served as healthy control group,and 40 patients with different etiology and severity served as experimental group,and then the latter were divided into 2 subgroups,28 patients in Child-Pugh classification A,and 12 cases in below B(11 cases in B and 1 case in C).An oral dose of 2 mg/kg tracer 13C-methacetin was administered to each subject for the 13 C-methacetin breath test.At the same time,serum liver function markers including serum transaminase,bilirubin,albumin and prothrombin time were measured.The acquired data were analyzed by SPSS 17.0 software.Results (1) Metabolisation velocity (MV) max30 and cumulated dose (CUM) 120 in experimental group (46.64 ± 27.93,59.29 ± 30.73) were much lower than those of the healthy control group(73.56 ± 26.03,102.97 ± 41.80) (t =2.450,3.165,all P ＜0.05);(2) MVmax30 and CUM120 were closely correlated with the liver function markers of albumin,total bilirubin,direct bilirubin,prothrombin time (P ＜ 0.05);(3) MVmax30 and CUM120 could predict liver diseases in children,especially the CUM120.With CUM120 =85.80 as a cut-off value to predict liver diseases,the Youden index was 0.578 at its maximum,and the sensitivity and specificity were 77.8％ and 80.0％;(4) Compared with the Child-Pugh classification A,the CUM120 in Child-Pugh classification B and lower B was significantly lower(P ＜ 0.001);(5) CUM120 could predict the severity of liver diseases.With CUM120 =56.15 as a cut off value to predict the severity of liver diseases,the Youden index was 0.857 at its maximum,and the sensitivity and specificity were 85.7％ and 100.0％.Conclusion 13C-methacetin breath test index of CUM120 could predict liver diseases in children and the severity of liver function.

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Radiation Dosage ; Radiosurgery ; Treatment Outcome

Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.

Objective To compare the clinical efficacy of acupuncture and medicine for the treatment of chronic pharyngitis. Methods Sixty chronic pharyngitis patients were randomized into treatment group and control group, 30 cases in each group. The treatment group was treated with acupuncture mainly on acupoints of Zhaohai(KI6), Lieque(L7), Tiantu(CV22) , Lianquan(CV23), Tianrong(SI17) , Hegu(LI), Yuji (LU10) for nourishing yin to reduce fire and clearing throat. The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was performed once a day and 6 times a week. The control group received western medical therapy including pharyngeal application with 1% iodine glycerin preparation and oral use of Cydiodine tablets, 3 times per day. Four weeks constituted one treatment course and the treatment for the two groups covered 2 courses. After treatment, the therapeutic effect was evaluated. The scores of the signs and s ymptoms as well as scores of chronic pharyngitis syndrome discomfort rating questionnaire(CPSDQ) evaluated by visual anal og scale(VAS) were observed. Results (1) The overall effective rate of the treatment group was 93.3%, higher than that of the control group(73.3%), and the inter-group difference was statistically significant (P<0.05). (2) After treatment, scores of the signs and symptoms and VAS for CPSDQ scores in the two groups were reduced as compared with those before treatment(all P<0.05 or P<0.01 ) .The improvement of the scores in the treatment group was superior to that in the control group(all P<0.05 or P<0.01).(3) During the treatment , needling-induced mild pain and bleeding occurred in the treatment group. No acupuncture syncope, stuck needles or allergic and toxic-side effect was shown in the two groups. Conclusion Acupuncture therapy can obviously relieve the symptoms, signs and discomfort in the patients with chronic pharyngitis, and the curative effect is superior to the drugs.

Objective To explore the treatment experience and surgical strategy in papillary thyroid carcinoma (PTC) patients with parapharyngeal lymph node metastasis. Methods A retrospective review was performed on ten patients with PTC metastasis to parapharyngeal lymph node from January 2005 to August 2014. The treatment experience and surgical strategy were analyzed. Results Three patients accepted initial treatment and 7 patients had a history of surgical treatment prior to PTC. Parapharyngeal lymph node metastasis was diagnosed by imaging examination or fine needle aspiration cytology. Resection of lymph node metastasis was performed via transcervical approach and transmandibular approach. Total thyroidectomy and neck dissection were performed synchronously. All patients received 131I therapy after surgery and did not have recurrence in neck or parapharyngeal space. During follow-up, 3 patients died in 5 years because of lung metastasis, 3 patients survived with tumor , and 4 patients survived without recurrence. The 5-year overall survival rate was 7/10 and the 5-year disease-free was 4/10. Conclusions Parapharyngeal lymph node metastasis from PTC may occur in patients with previous neck dissection or widespread cervical metastases. CT and MRI is helpful for establishing the diagnosis. Surgical resection remains the mainstay of treatment for this disease. PTC patients with parapharyngeal lymph node metastasis have a poor prognosis.

Objective To investigate the effect of resveratrol on miRNA-106b in Alzheimer′s disease ( AD ) animal model.Methods Fifty Kunming male mice were divided into five groups by completely randomized block sampling.The five groups included three dosage resveratrol groups , an AD model group and a control group.The AD models were established in one month prior to treatments. Subsequently, from the 31st day various doses of resveratrol were provided intragastricly for 60 days.Then the memory function was observed by the step-down test.Meanwhile, the varying expressions of APP , P62, ApoA1, miRNA-106b, ABCA1 were tested in each group to determine whether there is the binding site for miRNA-106b in APP 3′UTR sequence.Results Compared with the control group by step-down test, the memory function of the AD model group mice decreased in different degree , which in the drug treatment group was higher than that in the model group (P<0.05).Compared with the AD group, the expression of APP (1.131 ±0.035) in the drug treatment group was higher than that in the model group (0.652 ± 0.026), while the P62 (0.412 ±0.022) and ApoA1 (0.534 ±0.032) were lower than the model group ( all P<0.05 ).High and medium dose groups of resveratrol treatment reduced varying degrees of APP (0.733 ±0.018,0.929 ±0.019,F=177.733) levels, and increased P62(0.954 ±0.035,0.633 ±0.015, F=434.5 ) and ApoA1 ( 1.042 ±0.051, 0.824 ±0.034, F=286.582 ) levels ( all P<0.05 ).The expression of miRNA-106b (0.464 ±0.313) and ABCA1(0.293 ±0.042) in the model group was lower than that in the control group (miRNA-106b 1.064 ±0.032, F=238.159; ABCA1 0.781 ±0.027,F=341.61;both P<0.05).The miRNA-106b (0.843 ±0.034, 0.601 ±0.012) and ABCA1 (0.882 ± 0.025, 0.624 ±0.036) levels in the high, medium dose resveratrol treatment groups increased to different extent ( both P<0.05 ).After the drug treatment , luciferase reporter vector experiments showed that the APP 3′UTR sequence contains the binding site of miRNA-106b.Conclusions APP is one of the target genes of miRNA-106b.Resveratrol is capable of improving AD by enhancing the expression of miRNA-106b and down-regulating the target genes including APP , P62 and ApoA1.This provides a new theoretical basis for the clinical treatment of AD.

PURPOSE: The aim of this study was to understand and describe difficulties and needs experienced by head nurses in the clinical practice education of nursing students. METHODS: A qualitative descriptive method was employed. A convenience sampling method was used to recruit participants from four hospitals in South Korea. Twenty-one head nurses participated in the first interview and 17 of them participated in the second interview. Data were collected through two in-depth interviews and field notes were written. Qualitative content analysis method was utilized for data analysis using ATLAS.ti 6.2 software. RESULTS: Thirty-one codes and twelve categories were identified. Four themes emerged from data analysis, which included ‘too many tasks’, ‘limitations of student education’, ‘many differences’, and ‘lack of support and resources.’ CONCLUSION: This qualitative study described head nurses' many difficulties and needs in the clinical practice education of nursing students. The results of this study provide valuable understanding and knowledge of head nurses' experiences in students' clinical education, which leads to improvement of the quality of clinical education for nursing students.
Education* ; Head* ; Humans ; Korea ; Methods ; Nursing* ; Nursing, Supervisory ; Qualitative Research* ; Statistics as Topic ; Students, Nursing*

OBJECTIVETo determine whether the ingestion of a herbal supplement called Rhodiola-Gingko Capsule (RGC) would enhance the endurance performance of healthy volunteers and change relevant hormones in a favorable manner.

METHODSSeventy healthy male volunteers (age ranges from 18 to 22 years old) were randomly assigned to RGC group (35 cases, each capsule containing 270 mg herbal extracts, 4 capsules per day) or placebo group (35 cases, equivalent placebo preparation) for 7 weeks using computer produced digital random method. The endurance performance, serum testosterone and cortisol levels were measured at the baseline and the endpoint.

RESULTSSixty-seven subjects (34 in the RGC group and 33 in the placebo group) completed a 7-week treatment. The RGC group displayed a significantly greater baseline-to endpoint increase in maximal oxygen uptake (VO(2max)) than placebo group in both absolute (P=0.020) and relative values (P=0.023). At the endpoint, the serum cortisol level was unchanged in the RGC group compared with the baseline, but it was significantly elevated in the placebo group (P<0.05). The endpoint ratio of testosterone to cortisol, a surrogate for overtraining and fatigue in endurance exercises, was also indifferent compared with the baseline in the RGC group, but significantly decreased in the placebo group (P<0.05).

CONCLUSIONThe combined herbal supplement of Rhodiola and Gingko could improve the endurance performance by increasing oxygen consumption and protecting against fatigue.

Adolescent ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Fatigue ; drug therapy ; Ginkgo biloba ; Humans ; Hydrocortisone ; blood ; Integrative Medicine ; Male ; Oxygen Consumption ; drug effects ; Physical Endurance ; drug effects ; Placebos ; Rhodiola ; Testosterone ; blood ; Young Adult

Chinese patent orthopedic medicines feature complex components, mainly including desperate and toxic herbal pieces, narrow safety window, more clinical contraindications and frequent adverse drug reaction/events (ADR/ADE). To study the general safe medication regularity of Chinese patent orthopedic medicines, define key points in the medication education and ensure rational clinical medication, the authors took 80 types of commonly used Chinese patent orthopedic medicines as the study objects, collect 237 cases from 164 ADR/ADE documents through a system retrieval strategy, make a multidimensional literature analysis to determine the common risk factors for safe and rational medication of Chinese patent orthopedic medicines and establish an ADR/ADE prevention regularity. First, in the aspect of clinical symptoms, skin allergy is the most common ADR/ADE and closely related to the toxic ingredients, particularly accumulated liver or kidney damage caused by some drugs. Second, there are three time nodes in the ADR/ADE occurrence; The ADR/ADE occurred in 30 minutes is closely related to the idiosyncrasy; the ADR/ADE occurred between several months and half a year is related to the drug-induced liver and kidney damages; The most common ADR/ADE was observed within 7 days and predictable according to the pharmacological actions; Third, toxicity is an important factor in the occurrence of ADR/ADE of Chinese patent orthopedic medicines. Fourth, emphasis shall be given to the special medication factors, such as the combination with western medicines and Chinese herbal decoctions, overdose and long-course medication and self-medical therapy. In conclusion, the general ADR/ADE prevention regularity for Chinese patent orthopedic medicines was summarized to provide supports for clinicians in safe and rational medication and give the guidance for pharmacist in medication education.
Adult ; Aged ; Bone Diseases ; drug therapy ; Drug-Related Side Effects and Adverse Reactions ; etiology ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nonprescription Drugs ; Orthopedics ; legislation & jurisprudence ; Young Adult

The taxonomy of Acanthamoeba spp., an amphizoic amoeba which causes granulomatous amoebic encephalitis and chronic amoebic keratitis, has been revised many times. The taxonomic validity of some species has yet to be assessed. In this paper, we analyzed the morphological characteristics, nuclear 18s rDNA and mitochondrial 16s rDNA sequences and the Mt DNA RFLP of the type strains of four Acanthamoeba species, which had been previously designated as A. divionensis, A. parasidionensis, A. mauritaniensis, and A. rhysodes. The four isolates revealed characteristic group II morphology. They exhibited 18S rDNA sequence differences of 0.2-1.1% with each other, but more than 2% difference from the other compared reference strains. Four isolates formed a different clade from that of A. castellanii Castellani and the other strains in morphological group II on the phylogenetic tree. In light of these results, A. paradivionensis, A. divionensis, and A. mauritaniensis should be regarded as synonyms for A. rhysodes.
Acanthamoeba/*classification/*genetics ; Animals ; DNA, Mitochondrial/genetics ; DNA, Ribosomal/genetics ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 18S/genetics