Objective To investigate the effects of Qiliqiangxin capsule on serum concentration of adiponectin (APN) and heart function in patients with uremia combined with heart failure. Methods Uremia patients combined with heart failure were randomly divided into treatment group and control group , both of which were given anti-failure routine therapy. The patients in treatment group were treated with Qiliqiangxin capsule for 8 weeks and those in control group with placebo. The New York Heart Association (NYHA) heart function classi-fication, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction(LVEF), and the levels of APN were observed before and after treatment. Results The level of APN in uremic patients combined with heart failure was significantly higher than that in normal subjects. With the increase in the class of NYHA heart function, the serum concentrations of APN increased, but the difference was not significant(P > 0.05). After 8 weeks′ treatment, the effective rate in treatment group was higher than that in control group (P < 0.05). LVEDD and LVESD in both groups decreased significantly. LVEF in both groups increased, but serum concentration of APN decreased significantly. More obvious effects were observed in treatment group (P < 0.05). Conclution Qiliqiangxin capsule could significantly reduce the level of APN and improve heart function in patients with uremia combined with heart failure.

Objective To test the reliability and validity of Chinese version of Stressful Life Events Questionnaire and the influence of preinjury stressful life events on the life quality and mood symptoms of the patents following cerebral concussion.Methods 285 patients with cerebral concussion were assessed by Stressful Life Events Questionnaire(SLESQ),PTSD Checklist civilian version(PCL-C),Thirty-Six-Item Short-Form Health Survey (SF-36),Hamilton Depression Rating Scale(HDRS),Hamilton Anxiety Scale(HAMA) at baseline.The patients had been reassessed with the HDRS,HAMA,SF-36 at 3 months after cerebral concussion.The hierarchical regression analyses were used to determine the influence of Stressful Life Events for the life quality and mood symptoms of the patient with cerebral concussion.Results The incidence of stressful life events was 42.8％.The multiple regression analysis showed the experience of stressful life events were the influence factor of scores on the SF-36,HDRS,HAMA after adjusted by the age,gender,education,income,social support,the scores of anxiety and depression before injury and the R 2 value of SLESQ to SF-36 physical health factor,mental health factor,HDRS,HAMA was 0.064,0.111,0.145,0.028,respectively.Conclusion The history of stressful events is the influence factor of the patient with cerebral concussion to have poor life quality and mood disorder.

Cochlear Implantation ; Cochlear Implants ; Humans

Adult ; Carcinoma, Papillary ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Thyroid Gland ; pathology ; surgery ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; methods ; Video-Assisted Surgery ; methods ; Young Adult

Background and purpose:Radiotherapy and endocrine therapy are both important parts of adjuvant therapy for breast cancer, yet few studies have been conducted focusing on the interaction between radiation and endocrine therapy. Up to now, no conclusion has been drawn on the timing sequence of adjuvant radiation and endocrine therapy, which is indeed crucial in clinical practice. This study intended primarily to investigate the effect of concurrent or sequential exemestane combined with radiation on radiosensitivity of MCF-7 cells and its possible mechanism,and further to provide rationale for optimal clinical treatment modality.Methods:MCF-7 cells were arranged into three trial groups: the radiation group, exemestane sequenced with radiation group and exemestane followed radiation group. Radiosensitivity was evaluated by clonogenic assay, cell proliferation was measured by MTT assay, the ability to induce cell apoptosis was evaluated by DAPI staining assay, the changes of Bcl-2 and Bax were detected by Western blot.Results:Sensitive enhancement ratios (SER) were 1.51 and 1.37 in the exemestane sequenced with radiation group and exemestane followed radiation group, respectively. Compared with the radiation group, the percentage of cellular proliferation inhibition and apoptosis increased obviously in the exemestane sequenced with radiation group and exemestane followed radiation group. Exemestane combined with radiation made the Bax protein increase obviously and the Bcl-2 protein lowered significantly.Conclusion:Exemestane can enhance the radiosensitivity of MCF-7 cells, whose mechanism might be relevant to the promotion of cellular apoptosis. However,the treatment sequence does not affect the outcome.

Objective To discuss the effect of melatonin on sleep and agitation in patients who had undergone tracheotomy in ICU.Methods Sixty-six tracheotomisd patients of ASA Ⅱ or Ⅲ in ICU were included,age 18-60 years,weaning from mechanical ventilation not receiving continuous sedation.We conducted a double-blind, placebo-controlled randomized pilot study comparing melatonin with placebo in such patients.They were allocated into two groups by compute randomiza-tion-melatonin group(n =32)and control group(n = 34).We administered either oral melatonin (3 mg)or placebo at 20∶00 for 7 days.We collected pre-and post-dosage blood samples on days 1 and 3 to confirm drug delivery.The hours of sleep at day and night were assessed by the bedside nurse as the primary outcome.And the secondary outcome included comparison of the incidence of agitation, assessed by score on the Riker Sedation Agitation Scale,and requirement for sedatives or haloperidol to settle agitation.Results Pre-treatment melatonin levels in the two groups were similarly low.Post-treatment,melatonin levels increased significantly in the melatonin group compared with the placebo group (3 233±1 961 )pg/ml versus (3.8 ± 2.2 )pg/ml(P < 0.05 ).And subsequently the observed sleep time in the two groups was (1 1.9±2.0)hours for melatonin vs (7.8±1.6)hours for placebo, respectively (P < 0.01 ).The incidence of agitation was significantly lower in the melatonin group (0% vs 8.8%).Conclusion Melatonin is well absorbed,and a standard dose increases blood levels approximately 1000-fold.Furthermore it would help the tracheotomisd patients sleep and ease agitation in ICU.

Objective To analyze plasma vitamin E and CoQ10 levels in patients with autosomal recessive cerebellar ataxia for finding the evidence of the related pathogenesis research and therapeutic strategies.Methods The plasma vitamin E and CoQ10 levels were detected by high performance liquid chromatography (HPLC) with diode array detector in 123 probands of autosomal recessive cerebellar ataxia pedigrees.Quantitation was performed using vitamin E and CoQ10 external standard and two 5-point calibration curve;clinical manifestations were analyzed simuhaneously.Results Vitamin E and CoQ10 levels of healthy subjects in the plasma were (8.77 ± 2.28) μg/ml and (1.31 ± 0.38) μg/ml,respectively;the plasma vitamin E and CoQ10 levels of patients were (5.61 ± 2.04) μg/ml and (0.79 ± 0.26) μg/ml,respectively,which were significantly lower than those in healthy controls (t =11.87,13.15;all P＜ 0.01).Clinical manifestations were characterized by cerebellar symptoms,and gait instability was usually the first recognized abnormality.Most of early onset occurred before the age of 25 years (111/123);dysarthria and abnormal eye movement were observed,with cerebellar atrophy on MRI;concomitant symptoms were also present.Conclusions HPLC analysis shows that the plasma vitamin E and CoQ10 levels of patients with autosomal recessive cerebellar ataxia are generally lower than those in the healthy controls.Several patients with significant reductions in these two levels have genetic defects.The combination of clinical phenotypes,biochemical indexes and genetic analyses will be helpful for the establishment of diagnosis and specific treatment.

Objective To investigate the value of urine L-type fatty acid-binding protein (uL-FABP) and uric neutrophil gelatinase-associated lipocalin (uNGAL), and predict the value of poor outcomes (injury progression,dialysis,or death within 7 days ) in critically ill patients with early acute kidney injury (AKI) at time of nephropathy consultation. Methods One hundred and twenty-five patients with evidence of the AKIN criteria stage1 AKI were enrolled in this study. At time of nephropathy consultation , urinary samples were collected. The levels of uL-FABP and uNGAL were measured. Each marker was assessed for its predictive value using an area under the receiver operator characteristic curves (ROC-AUC) to predict AKI prognosis. Results Twenty-eight patients developed poor outcome. It was 0.81 in ROC-AUC in uL-FABP , in,which it could be improved to 0.83 when combined with APACHEⅡscore (0.75 in ROC-AUC). The ROC-AUC of uNGAL was 0.66, in which it could not impove its predictive power significantly when combined with APACHEⅡscore. Conclusion Among critically ill patients with early AKI , uL-FABP provided an independent and prognostic power when combined with APACHEⅡscore and the level of uL-FABP at time of nephropathy consultation helps to predict clinical outcome in critically ill patients with early AKI.

ObjectiveTo investigate the value of CEUS in differential diagnosis of benign and malignant thyroid solid lesions.MethodsTotally 45 patients with thyroid solid lesions underwent CEUS examination.The enhancement mode and blood perfusion characteristics of malignant and benign lesions were analyzed,and the results were compared with pathology.ResultsCEUS diagnosed 31 benign lesions and 14 malignant masses.The diagnostic accordance rate of CEUS was 93.75％ (30/32) and 92.31％ (12/13) for benign and malignant lesions respectively.In 31 benign lesions,27 (27/31,87.10 ％) showed entire homogeneous enhancement,4 (4/31,12.90％) presented inhomogeneous enhancement.In 14 malignant masses,1 (1/14,7.14 ％) showed homogeneous hypoechoic enhancement,12 (12/14,85.71％) presented inhomogeneous hyperechoic enhancement and 1 (1/14,7.14％) presented non-enhancement.ConclusionCombined with two-dimensional grey scale ultrasound and CDFI,CEUS enables dynamic observation of the microvascular perfusion of thyroid lesions,therefore helps to differentiate benign and malignant thyroid lesions.