ObjectiveTo investigate the clinical features of patients with primary biliary cirrhosis (PBC) in China. MethodsThe reported articles about clinical analysis of patients with PBC in China were searched. The quality of included studies was critically evaluated. Meta-analysis was performed using RevMan 4.2 software about controlled trials. Results① Ninety-one literatures including 2315 patients wuth PBC were included. ②The common symptoms in PBC were fatigue (54.54％). AMA was found in 74.1％～100％ of patients with PBC, as well as the prevalence rate of anti-M2 range from 45％ to 83％. ANA antibodies present in 20％～83.78％ of patients, the most common antinuclear patterns were nuclear-envelope(38.65％).Increased levels of IgM [(2.8±0.7)～(7.3±5.1) g/L], IgG [(16.5±4.9)～(20.5±5.9) g/L] were found in these patients, and the most common liver histologic classification was type Ⅱ (36.6％). Sjogren's syndrome occured significantly more frequently in PBC (1.96％～34.61％). To the end of follow-up period (five months to nintysix months ), 3.80％ of patients were dead. ③ Meta-analysis performed in several case control studies, showed no significant differences was found in liver tests including of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotrans ferase (AST), total bilirubin (TBil), or gamma-glutamyltransferase (GGT), IgG levels between AMA positive groups and AMA negative groups. However, lower levels of IgM presented in the latter. While it also showed that levels of ALP decreased after ursodeoxycholic acid (UDCA)therapy. The levels of TBil were lower in the elderly than in younger group, but the mortality ratio for liver diseases was higher in the former. ConclusionThe clinical characteristics of the present series in China are mostly similar to those reported in other countries. Because of the low quality and the small number of included studies, larger sample-size, randomized, double-blinded controlled trials are needed.

OBJECTIVETo observe the therapeutic effect of a drug pair of Radix Astragali and Rehmanniae Radix combined with glucocorticoid (GC) in treating lupus nephritis (LN) patients and its influence on some experimental indices.

METHODSTotally 52 LN patients were randomly assigned to the treatment group (treated by routine Western medicine and a drug pair of Radix Astragali and Rehmanniae Radix, 25 cases) and the control group (treated by Western medicine, mainly by GC and cyclophosphamide, 27 cases). All patients received 6-month therapy. The GC dosage, the withdrawal and reduction dosage of GC, clinical efficacy, systemic lupus erythematosus disease activity index (SLEDAI) score, adverse reactions, and laboratory indicators were recorded.

RESULTS(1) All patients got relieved to some degree with the dosage of GC reduced. The total withdrawal and reduction dosage of GC was slightly higher in the treatment group than in the control group [(50.23 +/- 12.43) mg vs (48.76 +/- 13.61) mg, P > 0.05]. Besides, the prednisone dosage in the treatment group was lower than that in the control group, but without statistical difference (P > 0.05). The ratio of patients in need of adding prednisone for aggravating disease was 24.0%, significantly lower than that in the control group (44.44%, P < 0.05). (2) There was no statistical difference in the SLEDAI score, inflammatory indicators, liver and renal functions, blood electrolytes, blood glucose, blood and urine routines between the two groups (P > 0.05). The 24-h urinary protein count was (1.06 +/- 0.22) g/L in the treatment group, obviously lower than that in the control group (1.43 +/- 0.55 g/L, P < 0.05). (3) There was no statistical difference in the incidence rate of infection, gastrointestinal hemorrhage, psychoneuroses, Cushing's syndrome, cardiovascular anomalies, and femoral head necrosis between the two groups (P > 0.05). But the incidence of adverse reactions such as insomnia, tidal fever, spontaneous sweat, and obesity was less in the treatment group than in the control group (P < 0.05).

CONCLUSIONSUsing a drug pair of Radix Astragali and Rehmanniae Radix combined with GC in treating LN could withdraw the dosage of GC and relieve symptoms it induced. It was advantageous in reducing the dosage of GC and stabilizing patients' conditions.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Lupus Nephritis ; drug therapy ; Treatment Outcome ; Young Adult

Background and purpose: Preemptive analgesia is one of the strategies to treat postoperative pain by preventing the establishment of central sensitization. This study was designed to explore whether the method of flurbiprofen axetil injection combined with bilateral cervical plexus nerve block in thyroid carcinoma surgery as multimodal preemptive analgesia can serve as a better analgesia. Methods: Sixty patients with thyroid carcinoma were randomly divided into three groups. Patients in Group A were treated with flurbiprofen axetil injection combined with bilateral cervical plexus nerve block as multimodal preemptive analgesia. Patients in Group B were anesthetized with bilateral cervical plexus nerve block. General anesthesia alone was used in patients of Group C. The onset time of nerve block, operation time, extubation time and dosage of fentanyl were recorded. The VAS (visual analogue scale) was used to evaluate the pain level, the side effects of drugs were also analyzed. Results: The onset time of nerve block in Group A, Group B were (7.47±1.04) min and (8.75±1.36) min, repectively (P<0.05). The dosage of fentanyl n Group A, B and C were (0.36±0.04) mg, (0.40±0.06) mg and (0.45±0.07) mg, respectively (Group A vs Group B P<0.05; Group A vs Group C, P<0.01).VAS scores of patients in Group C were higher than both Group A and B at 4,8 h after operation. Moreover, patients in Group B got higher VAS scores than that of Group A at 8 h. The side effects of both Group A and B were much less serious than that of Group C. Conclusion: Flurbiprofen axetil injection combined with bilateral cervical plexus nerve block as multimodal preemptive analgesia during thyroid carcinoma surgery can supply better analgesia and opioid-sparing effects, with less side effects.

Wild birds (mainly Anseriformes and Charadriiformes) are recognized as the natural reservoir of avian influenza viruses (AIVs). The long-term surveillance of AIVs in wild birds has been conducted in North America and Europe since 1970s. More and more surveillance data revealed that all the HA and NA subtypes of AIVs were identified in the wild ducks, shorebirds, and gulls, and the AIVs circulating in wild birds were implicated in the outbreaks of AIVs in poultry and humans. Therefore, the AIVs in wild birds pose huge threat to poultry industry and human health. To gain a better understanding of the ecology and epidemiology of AIVs in wild birds, we summarize the transmission of AIVs between wild birds, poultry, and humans, the main results of surveillance of AIVs in wild birds worldwide and methods for surveillance, and the types of samples and detection methods for AIVs in wild birds, which would be vital for the effective control of avian influenza and response to possible influenza pandemic.
Animals ; Animals, Wild ; virology ; Birds ; virology ; Humans ; Influenza A virus ; genetics ; isolation & purification ; physiology ; Influenza in Birds ; epidemiology ; transmission ; virology ; Influenza, Human ; epidemiology ; transmission ; virology ; Sentinel Surveillance ; veterinary

Objective To explore the possibility of non-discarding blood after cisplatin hyperther-mic antiblastic perfusion(HAP)in treating the patients with malignant bone tumor of lower extremity.Methods Forty patients consisted of 31osteosarcomas and9malignant fibrous histiocytomas of bone.The clinical stages were wholly classified intoⅡB stage according to Ennekings surgical staging system for muscu-loskeletal tumors.The patients were divided into three groups:group1:discarding blood group(10cases),in whom200ml of the400ml blood remaining in heart-lung machine was discarded after HAP;group2:Non-discarding blood group(25cases),the blood remaining in heart-lung machine was not discarded after HAP and re-infused into systemic circulation;group3:systemic chemotherapy group(5cases),cisplatin was infused intravenously.The regional and the systemic blood cisplatin concentrations were determined at3,30and60minutes during HAP,and the systemic blood cisplatin concentrations were determined at0,0.5,1,2,4,8,12,24,48and72hours after HAP in the group1and group2.While1h after cisplatin infusion in-tra venously in the group3,the blood cisplatin concentration were also measured.Results The regional blood cis platin concen tra tions were high er than that in systemic blood at the time during HAP.The systemic blood cisplatin concen trations after HAP,ex cept at0minute in the group2were higher than that in the group1,there were sig nificant statistic differences between the two groups.The systemic blood cisplatin con-cen trations after HAP in the group2were simi lar to that after systemic chemotherapy.No severe adverse ef-fects in the group1were found.The Ennek ings surgical stagings for the tumors were turned fromⅡB intoⅡA in all the patients.Conclusion The method of non-discarding blood after HAP is available,it is not only local treatment ,but also systemic chemotherapy in the patients with malignant bone tumor of lower ex-tremi ty for limb-salvage surgery.

Objective To discuss the protective effect of doxofylline on radical surgery for esophageal cancer.Methods Under elective general anesthesia, 60 cases, 35 males and 25 females, aged 45-70 years, BMI 20-30 kg/m2, ASA physical status Ⅰ or Ⅱ, FEV1%>50%, underwent radical surgery for esophageal cancer at middle and distal parts.Random number table was employed to divide these patients into two groups: doxofylline group (group D) and control group (group C) with 30 cases in each.After a routing intravenous induction in the two groups, mechanical ventilation was conducted after bronchial intubation with double channel catheter on the right side.The intravenous injection of doxofylline 4 mg/kg in group D was administrated 30 min after bronchial intubation with double channel catheter.Equal normal saline was instilled to the patients in group C.Blood samples were taken from radial artery to detect the levels of TNF-α, IL-6, IL-10, MDA and SOD at four time points: 10 min (T0) before the one-lung ventilation, 60 min after OLV (T1), after two-lung ventilation (T2) and the end of the operation (T3).Meanwhile, the blood and breath at these time points were tested.The occurrence of OLV, blood loss volumes, fluid input quantities, urine volumes, postoperative hyoxemia and pulmonary inflammation were observed.Results Compared with T0, the activity of SOD in serum and PaO2 in the two groups at T1-T3 decreased (P＜0.05).The concentrations of TNF-α, IL-6, IL-10 and MDA increased significantly (P＜0.05).Compared with group C, the activity of SOD activities and PaO2 in group D at T1-T3 increased while concentrations of TNF-α, IL-6, IL-10 and MDA decreased significantly (P＜0.05).The occurrence rates of postoperative hyoxemia and pulmonary inflammation in group D were obviously lower than those in group C (P＜0.05).Conclusion Doxofylline can suppress patients' inflammatory response and oxidative stress response after OLV and reduce the incidence rates of postoperative hyoxemia and pulmonary inflammation as well as alleviate lung injury triggered by radical surgery for esophageal cancer.

Objective To establish a rapid and specific method for identifying megkaryocytes under the light microscope and to provide a new method and new idea for diagnosis and differential diagnosis of blood diseases.Methods Unfixed smears of blood or born marrow were exposed firstly to an alcoholic solution of Basic Royol Blue for 5 min.Next, an equal amount neutral HEPES buffered solution of the same dye was added to the first stain solution.The two solutions were mixed by adding the second stain.After 10 min, the smears were washed for 2 min with flooding water and drained dry.Meanwhile, the stain was compared with traditional histochemistic stains and flow cytophotometer.Results Megakaryocytes showed purple red cytoplasm and bright blue nuclei.Platelet displayed purple red. Other blood cells(such as granulocytes、monocytes、lymphocytes、plasmacytes and ucleated erythrocytes) had no such stainning character. Compared with traditional histochemistic stains and flow cytophotometer, the stain of two steps by using Basic Royole Blue for megkaroblasts、promegkaryocytes and megkarocytes was credible and distinctive.Conclusion Basic Royol Blue for megkaryocytes stain was worth to contribute to the diagnosis and differential diagnosis of blood diseases.This technique can be used in clinical laboratory.

Objective To investigate the effect of one-time anti reflux multi-function drainage bag in clinical application.Methods A total of 125 cases of benign prostate hyperplasis (BPH) were treated with transurethral resection of prostate (TURP) from October 2012 to March 2013 at our hospital of uropoiesis surgical department.All the cases were randomly divided into the control group (63 cases) and the experimental group(62 cases).The three cavities balloon catheter was connected with common drainage bag in the control group,and with one-time anti-reflux multi-function drainage bag in the experimental group.The urine in catheters and drainage bag of 3,5,7 days postoperatively in two groups was sampled for urine culture.The cases of daily urine tube plugging and daily drainage bag reflux in two groups were observed respectively.Results The cases of bacilluria significantly reduced in catheters of the experimental group compared with the control group and the drainage bag of the experimental group,respectively.The cases of bacilluria was significantly reduced in drainage bag compared with the control group.The cases of drainage bag reflux was significantly reduced compared with the control group.The cases of bacilluria in catheter and drainage bag had no significant difference in the control group.The cases of catheter plugging had no significant difference between two groups.Conclusions One-time anti reflux multi-function urine drainage bag can effectively prevent bacteria and reflux,and make the drainage system in a closed state.It has obvious advantage to prevent the happening of the retrograde infection compared with the common drainage bag.

OBJECTIVETo observe the expression of Ginkgo biloba Tablet (GbT) on scavenger receptor A (SRA) of the aortic wall and changes of serum inflammatory factors in atherosclerotic rats, and to explore its new mechanism for fighting against atherosclerosis (AS).

METHODSTotally 45 male Wistar rats were randomly divided into the control group, the model group, the GbT group, 15 rats in each group. Levels of blood glucose, blood lipids, blood calcium, serum C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (slCAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured in all rats. The expression of SRA in the aortic wall of atherosclerotic rats was observed by immunohistochemical assay. The correlation between the expression of SRA and levels of in-flammatory factors was also observed.

RESULTSCompared with the control group, blood glucose and blood calcium obviously increased (P < 0.05); levels of TG, TC, and LDL-C were significantly elevated (P < 0.01); neointimal areas were significantly thickened, increased intima percentage was significantly enlarged, narrowed lumen index was significantly reduced; levels of CRP, sICAM-1, and sVCAM-1 were significantly elevated in the model group (all P < 0.01). Compared with the model group, blood glucose and blood calcium obviously decreased (P < 0.05); levels of TG, TC, and LDL-C significantly decreased (P < 0.01) in the GbT group. Aortic lumens were obviously narrower in the model group than in the GbT group (P < 0.05). SRA expressed at the aortic wall. The aforesaid 3 indices were significantly improved in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were significantly decreased in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were positively correlated with the percentage of SRA positive expression area (r = 0.701, 0.604, 0.581, all P < 0.01).

CONCLUSIONSSerum levels of inflammatory factors in atherosclerotic rats were elevated, and the expression of SRA in the aortic wall was enhanced. The expression of SRA was closely correlated with serum levels of inflammatory factors. GbT could decrease serum levels of inflammatory factors and inhibit the expression of SRA.

Animals ; Aorta ; drug effects ; metabolism ; Atherosclerosis ; drug therapy ; Blood Glucose ; analysis ; C-Reactive Protein ; analysis ; Calcium ; blood ; Drugs, Chinese Herbal ; pharmacology ; Ginkgo biloba ; chemistry ; Intercellular Adhesion Molecule-1 ; blood ; Lipids ; blood ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Scavenger Receptors, Class A ; metabolism ; Tablets ; Vascular Cell Adhesion Molecule-1 ; blood

Objective To investigate the characteristics of central cord syndrome without fracture or dislocation and assess the effect of surgical management.Methods Twenty-one cases of central cord syndrome without fracture or dislocation were diagnosed with X-ray radiography,CT and MRI and treated surgically.Spinal cord dysfunction and its recovery rate were evaluated using American Spinal Injury Association (ASIA) system.Radiological and clinical evaluation was performed for all cases.Pre-and postoperative ASIA scale and score were statistically analyzed.Results All cases sustained cervical spinal cord compression resulting from cervical disc herniation in 18 cases,of which five were accompanied by ligamentum flavum hypertrophy and reductus,developmental cervical spinal canal stenosis in two cases and posterior longitudinal ligament ossification in one case.Neurological dysfunction involved in the upper extremity in 15 cases and upper and lower extremity in six cases.Mean period of follow-up was 13.5months.ASIA scale was improved from C (n =9) and D (n =12) before operation to C (n =1),D (n =6) and E (n =14) in the last follow-up.ASIA score of motor and sensory dysfunction revealed a (84.3 ±12.5)％ and (62.7 ± 14.6)％ improvements,with significant difference as compared with the preoperative one (P ＜ 0.05).Conclusions Cervical disc herniation is the major factor of spinal cord compression in central cord syndrome without fracture and dislocation.Neurological dysfunction occurs mostly in the upper extremity.Surgery is an effective method to release spinal cord compression and restore neurological function.