Objective To study the association between metabolic syndrome (MS) and prognosis of endometrioid carcinoma.Methods A total of 256 patients with endometrioid carcinoma at,Zhejiang Cancer Hospital between January,2001 and December,2008 were chosen.The deadline for follow up was December 2008.The general conditions(including age and body mass index),whether coupled with MS and it's risk factors(including waist circumference,fasting plasma glucose,triglycerides,high-densitylipoprotein,systolic and diastolic blood pressure) were analyzed.The outcome of 256 patients whether coupled with MS were analyzed using Kaplan-Meier curve.Relative risks were estimated using Cox proportional hazards regression model.Results A total of 256 cases were followed-up successfully.Sixtyfour (33.0％) cases coupled with MS among the 194 patients survived,while thirty-two (51.6％)coupled with MS from 62 cases died,there was significant difference between them (x2=6.953,P=0.008).The total fiveyear survival rate was 75.8％,the survival time was (78.0±3.4) months.The rate and the survival time of patients coupled with MS [66.7％,(67.0±2.4) months] were significatly lower than those coupled with no MS [81.3％,(85.0±4.0) months;P＜0.05].The Cox proportional hazards regression results showed that coupled with MS,body mass index ≥25 kg/m2,waist circumference＞80 cm,abnormol systolic and diastolic blood pressure,abnormal fasting plasma glucose and more than two components of definitions of MS were related to bad prognosis of endometrioid carcinoma(P＜0.05).Conclusion Metabolic syndrome may be lead to a bad prognosis of endometrioid carcinoma.

OBJECTIVETo explore the better therapy in the treatment of ganglion.

METHODSNinety cases of ganglion were randomized into a two-way quintuple puncture group, a common quintuple puncture group and a fire needling group, 30 cases in each one. In the two-way quintuple puncture group, the "9-in-1" multiple penetrating needling technique was used. In the common quintuple puncture group, the traditional "5-in-1" multiple penetrating needling technique was applied. In the fire needling group, the traditional multiple fire needling technique was adopted. The treatment was given once a day, 3 treatments made one session and the efficacy was analyzed statistically after 1 session treatment in the three groups.

RESULTSAll of the three therapeutic methods achieved the efficacy on ganglion. The curative rate was 96. 7% (29/30) in the two-way quintuple puncture group, which was better obviously than 66.7% (20/30) in the common quintuple puncture group and 60. 0% (18/30) in the fire needling group (both P<0. 01).

CONCLUSIONThe two-way quintuple puncture technique achieves the remarkably superior efficacy on ganglion as compared with the common quintuple puncture technique and fire needling technique.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Ganglion Cysts ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo analysis the genetic mode of Rh DEL phenotype and RHD 1227A allele in Zhejiang Han population through family investigations.

METHODSRh DEL phenotypes were identified by a serologic adsorption-elution method. Two polymerase chain reaction-sequence specific prime (PCR-SSP) methods which detectED RHD 1227A allele and Rhesus hybrid box, respectively, and a nucleotide sequencing method focused on the exon 9 of RHD 1227A allele were employed to determine the zygosity of RHD allele.

RESULTSAll five probands with Rh DEL phenotype harbored a RHD 1227A allele and had a RHD allele deletion, and they were RHD 1227A/RHd heterozygote. One of the parent members was found to contain a RHD 1227A allele and a normal RHD allele in pedigree 1, 2 and 3, respectively. Thus, they were RHD 1227A/RHD heterozygotes and presented normal D positive phenotype. The son of proband No 1. inherited the RHD 1227A allele and presented a normal D positive phenotype due to a RHD 1227A/RHD heterozygote; The offsprings of proband No. 2, No. 4, and No. 5 did not inherit RHD 1227A allele and presented a normal D positive phenotype.

CONCLUSIONRHD 1227A allele is an important genetic marker of Rh DEL phenotype; RHD 1227A is recessive to normal RHD allele and dominant to RHd allele; RHD 1227A allele is an ancestral, but not a spontaneously mutated allele.

Alleles ; China ; Female ; Genotype ; Humans ; Male ; Pedigree ; Phenotype ; Polymerase Chain Reaction ; methods ; Rh-Hr Blood-Group System ; genetics

The purpose of this study is to investigate the basic situation of self-regulated learning among clinical medical undergraduates in the stage of professional courses and construct a structural model suitable for them to carry out self-regulated learning . Zimmerman's self-regulated learning concept framework was determined as the theoretical basis of this study. A questionnaire survey was performed to identify five main dimensions affecting self-regulated learning including expression of learning intention, self-efficacy, adjustment of learning behavior, management of curriculum strategies, and adaption of learning environment, and then, Amos 24.0 software was used to construct the structural model and draw the conclusion that self-regulated learning in this group centers on the regulation of learning behavior, with learning intention and self-efficacy as sub-centers.

Objective To compare antitussive and expectorant effects between endophytes from Glycyrrhiza uralensis and decoction,and filtrate effective strains.Methods A total of 84 Kunming mice were randomly divided into blank group,positive control group,Glycyrrhiza decoction group,3 groups of endophytes (JTYB006 group,JTYB029 group,JTYF023 group).There are two batches of mice altogether.Blank group was given the injection of 0.9％ NaCl.Positive control group was given 30 mg · kg-1 codeine phosphate tablets.Glycyrrhiza decoction group was given 1.3 g · kg-1 wild Glycyrrhiza decoction.Three groups of endophytes were respectively given 1.3 g · kg-1 powder of endophytes.Six groups were given the corresponding dose by intragastric administration once a day,for 7 days.1 hour after the last medication,the mice cough models were respectively induced by ammonia and SO2.The antitussive effects were evaluated by median effective dose time (EDT50),R-value,the incubation period of cough,the times of cough within 2 minutes,inhibition ratio of cough and extension ratio of cough.70 Wistar rats were randomly divided into 7 groups,these were blank group,model group,positive control group,Glycyrrhiza decoction group,3 groups of endophytes(JTYB006,JTYB029,JTYF023).The rat model of phlegm blocking in lung was established by inhaleing SO2 and clod wind for 10 days.10 days later,the blank group was given the injection of 0.9％ NaCl,positive control group was given 0.08 mg · kg-1 compound bulbus fritilillariae cirr hosate and ammonium chloride tablets,Glycyrrhiza decoction group was given 0.95 g · kg-1 wild Glycyrrhiza decoction,3 groups of endophytes were respectively given 0.95 g · kg-1 powder of endophytes.Seven groups were given the corresponding dose by intragastric administration once a day for 7 days.The general activities,the amount of phlegm and pathological of lung tissues were measured.In addition,the levels of nitric oxide (NO),tumor necrosis factor (TNF-α),interleukin-17 (IL-17) and IL-23 were measured by enzyme-linked immunosorbent (ELISA) method.Results The EDT50 in blank group was 13.00 s,which in positive control,Glycyrrhiza decoction,JTYB006,JTYB029,JTYF023 groups were 30.09,20.32,18.45,25.03,16.52 s,the EDT50 of all drug intervention groups extended.Positive control,Glycyrrhiza decoction and JTYB029 groups had the obvious effect (R ＞ 150),JTYB006 had the effect of relieving cough (130 ＜ R ＜ 150),JTYF023 was invalidity(R ＜ 130).For cough caused by SO2,the incubation period of cough in blank group was (14.67 ± 7.20) s and positive control,Glycyrrhiza decoction,JTYB006,JTYB029 groups (28.00 ± 8.15),(25.83 ±9.35),(20.58 ±6.52),(26.50 ±5.32)s with statistically significant difference (P ＜0.01 or P ＜0.05).The times of cough within 2 minutes in blank group was(78.92 ± 19.06) and positive control,Glycyrrhiza decoction,JTYB006,JTYB029 groups were (47.42 ± 19.96),(57.67 ± 19.04),(63.15 ± 15.30),(44.25 ± 16.87) with statistically significant difference (P ＜ 0.01 or P ＜ 0.05).Compared with Glycyrrhiza decoction,JTYB006 and JTYF023 had remarkable short on the incubation period of cough,JTYB029 had remarkable reduction on the times of cough within 2 minutes(P ＜0.01 or P ＜0.05).In model,positive control,Glycyrrhiza decoction and JTYB029 groups,the amount of phlegm were (14.47 ± 3.30),(7.26 ± 4.55),(8.45 ± 3.78),(8.23 ± 1.19) mm,the levels of NO were (51.57±8.33),(30.02 ±2.65),(39.10 ±9.63),(39.25 ± 10.20)μmol · L-1,the levels of TNF-α were (654.80±56.40),(282.56 ±70.81),(400.24 ±78.03),(410.86 ±68.74) ng· mL-1,the levels of IL-17 were (66.28 ±9.34),(39.10 ±6.27),(50.20 ±9.05),(48.70 ± 10.28)pg · mL-1,the levels of IL-23 were (29.04 ±3.55),(16.02 ±3.60),(20.11 ±2.96),(21.25 ±3.40)pg · mL-1 Compared with the model group,Glycyrrhiza decoction and JTYB029 had remarkable decreasions in the terms of the amount of phlegm and the levels of NO,TNF-o,IL-17 and IL-23 (P ＜ 0.01 or P ＜ 0.05).Conclusion By filtrating,2 endophytes from Glycyrrhiza uralensis (JTYB006,JTYB029) have antitussive effects,and 1 endophytes from Glycyrrhiza uralensis (JTYB029) has expectorant effects.The antitussive and expectorant effects have no significant difference between wild Glycyrrhiza'decoction and JTYB029.

Objective To explore the effect of family-centered nursing on family function and family burden of schizophrenic patients.Methods A total of 108 schizophrenic patients with the whole course less than 5 years were randomly divided into study group(n =53)and control group(n =55).The two groups received the routine antipsychotic drugs maintenance therapy and the general psychological education.In addition,the study group received the family-centered nursing intervention,and the total following-up course was 1 year.To evaluate the family situation and psychotic symptoms of patients,all the participants were assessed by using Family Assessment Device (FAD),Family Burden Scale of Disease (FBS) and Brief Psychiatric Rating Scale (BPRS) at entry and 1 year after discharged.Results There was no statistically significant difference between the two groups in scores of BPRS,FAD and FBS at baseline (P ＞ 0.05).After 1 year,the scores of BPRS (24.60 ± 7.87),total function of FAD (26.8 ± 3.7) and FBS (20.60 ± 9.91) in the study group were lower than those in the control group:BPRS (28.91 ± 8.72),FAD (30.1 ± 3.4) and FBS (30.76 ± 12.27),and the difference was statistically significant (t =2.61,4.67,4.57,respectively; P ＜0.05).The scores of each factor of FAD and four domains of FBS (such as family economic burden,family daily activities,familyent ertainment and mental health of family member) of the study group were lower than those of the control group (P ＜ 0.05).Conclusions The family-centered nursing model is helpful to improve family function,the prognosis of the disease and to decrease family burden of schizophrenia.

Objective:To construct a medical equipment management system based on improved evidence theory,and to analyze its application effect in the equipment management of geriatric gastroenterology department in hospitals.Methods:With the help of improved evidence theory,the risk of medical equipment management in geriatric gastroenterology department was identified,dynamic weights and static weights were introduced,and a medical equipment management system based on improved evidence theory was constructed by combining the game idea with the portfolio empowerment approach.A total of 60 medical devices in clinical use in the department of geriatric gastroentero1ogy of Xi'an No.1 Hospital from 2021 to 2023 were selected,and the medical devices used from 2021 to 2022 were managed by conventional methods,and the medical devices used from 2022 to 2023 were managed by using the improved evidence theory(improved evidence theory management).The equipment management quality,equipment data integrity score and comprehensive assessment score of equipment management team were compared between the two management methods.Results:The average failure rate and scrap rate of equipment managed by the improved evidence theory method were(12.36±3.65)％and(2.65±0.54)％,respectively,which were lower than those of the conventional management method(t=9.897,15.877,P＜0.05),the average self-maintenance rate and upgrade rate of faults were(90.69±6.25)％and(91.25±5.25)％,respectively,which were higher than those of the conventional management method,the difference was statistically significant(t=13.191,14.828,P＜0.05).The average scores of equipment data management,diagnosis and treatment data analysis and clinical application data integrity using the improved evidence theory method were(92.36±2.36)points,(93.69±2.36)points and(94.39±3.26)points,respectively,which were higher than those of the conventional management method,the difference was statistically significant(t=13.044,13.893,15.036,P＜0.05).The average comprehensive assessment scores of technical support team,technical development team,technical practice team and auxiliary management team members adopting the improved evidence theory method were(91.36±3.26)points,(94.26±3.59)points,(95.36±4.36)points and(96.36±3.26)points,respectively,which were higher than those of the conventional management method,the difference was statistically significant(t=8.224,14.796,14.129,19.005,P＜0.05).Conclusion:The medical equipment management system based on the improved evidence theory can evaluate the risks in the application of equipment,improve the quality of equipment management,enhance the level of equipment management team,and provide decision-making assistance for the equipment management in geriatric gastroenterology department.

OBJECTIVETo compare the differences in the efficacy on traumatic spinal cord injury(SCI) in the thoracic and lumbar vertebra between the paraplegia-triple-needling method and the conventional acupuncture therapy.

METHODSThe perspectively randomized controlled trial was adopted. Forty-eight cases of traumatic SCI in the thoracic and lumbar vertebra were randomized into an observation group and a control group, 24 cases in each one. The conventional rehabilitation training was applied in both groups. In addition, the paraplegia-triple-needling method was used in the observation group. In the treatment, acupuncture was applied to the points of the Governor Vessel and the Back-shu which, located two segments above and below the spinal injury plane separately. Acupuncture with the electric pulsing stimulation was applied to the motor points of the key muscles of the lower extremities. In the control group, the conventional acupuncture was applied to Huantiao (GB 30), Zusanli (ST 36), Xuanzhong (GB 39) and Sanyinjiao (SP 6). In each group, the treatment was given once a day, one month treatment made 1 session. Totally, 3 sessions of treatment were required. Before and after treatment, as well as in 1-month follow-up visit after treatment, the modified Barthel index (MBI) and the function comprehensive assessment (FCA) were adopted to assess the activities of daily life (ADL) and the comprehensive function of the patients. The score of MBI and FCA were taken as the double response variables to imitate the multilevel model. The changing tendency of MBI and FCA along with the time was observed in two groups.

RESULTSIn the follow-up visit, MBI and FCA score were all improved as compared with those before treatment in two groups (all P < 0.05). There were no statistically significant differences in MBI and FCA score at any time point between two groups (all P > 0.05). In 4-month observation, there was a rising tendency with time in MBI and FAC scoe in both groups, which was roughly linear. As time went on, the increasing amplitude in the observation group was much bigger. It was explained that there was no difference in the short-term efficacy between two groups. However, the long-term efficacy in the observation group was much better.

CONCLUSIONBoth the paraplegia-triple-needling method and the conventional acupuncture therapy can improve the ADL and the comprehensive function of the patients with traumatic SCI of the thoracic and lumbar vertebra. Concerning the long-term efficacy, the paraplegia-triple-needling combined with the rehabilitation training achieves better result. This therapeutic program is safe and effective.

Activities of Daily Living ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Needles ; Spinal Cord Injuries ; rehabilitation ; therapy ; Young Adult

Background:Chronic kidney disease (CKD) with moderate-to-severe renal dysfunction usually exhibits an irreversible course,and available treatments for delaying the progression to end-stage renal disease are limited.This study aimed to assess the efficacy and safety of the traditional Chinese medicine,Niaoduqing particles,for delaying renal dysfunction in patients with stage 3b-4 CKD.Methods:The present study was a prospective,randomized,double-blind,placebo-controlled,multicenter clinical trial.From May 2013 to December 2013,300 CKD patients with an estimated glomerular filtration rate (eGFR) between 20 and 45 ml,min-1· 1.73 m-2,aged 18-70 years were recruited from 22 hospitals in 11 Chinese provinces.Patients were randomized in a 1∶1 ratio to either a test group,which was administered Niaoduqing particles 5 g thrice daily and 10 g before bedtime for 24 weeks,or a control group,which was administered a placebo using the same methods.The primary endpoints were changes in baseline serum creatinine (Scr) and eGFR after completion of treatment.The primary endpoints were analyzed using Student's t-test or Wilcoxon's rank-sum test.The present study reported results based on an intention-to-treat (ITT) analysis.Results:A total of 292 participants underwent the ITT analysis.At 24 weeks,the median (interquartile range) change in Scr was 1.1 (-13.0-24.1) and 11.7 (-2.6-42.9) μmol/L for the test and control groups,respectively (Z =2.642,P =0.008),and the median change in eGFR was-0.2 (-4.3-2.7) and-2.2 (-5.7-0.8) ml·min-1.1.73 m-2,respectively (Z =-2.408,P =0.016).There were no significant differences in adverse events between the groups.Conclusions:Niaoduqing particles safely and effectively delayed CKD progression in patients with stage 3b-4 CKD.This traditional Chinese medicine may be a promising alternative medication for patients with moderate-to-severe renal dysfunction.

BACKGROUNDEndostatin is a potent inhibitor of tumor angiogenesis. In the preliminary studies, we developed a mutant endostatin containing Arg-Gly-Asp-Arg-Gly-Asp (RGDRGD) sequences. In this study, we compared the antitumor effects of mutant endostatin and Bcl-2 antisense oligonucleotides both in combination and individually.

METHODSThe artificially synthesized Bcl-2 ASODN (antisense oligonucleotides) included a translation-initiation site and was transfected into the bladder cancer cells by Lipofectamine. Cell growth was investigated by the tumor cell growth chart, MTT assay, caspase-3 activity detection assay, AO/EB fluorescein stain, and the annexin V-FITC apoptosis detection assay. In the in vivo study, UM-UC-3 bladder cancer cells were subcutaneously implanted into nude mice and the growth of tumor was examined. The ultrastructure of the tumor tissues in the treated and control groups were observed.

RESULTSThe cell growth chart showed that the cell population of the treated combination group decreased by 52.04% compared to the control group. The inhibition rate of the treated combination group was (79.66 ± 6.79)%, whereas those of the individual ASODN and ES groups were (53.39 ± 3.22)% and (50.22 ± 5.46)% respectively. In the caspase-3 activity detection using AO/EB fluorescein stain and annexin V-FITC apoptosis detection assay, the co-inhibitory effect was higher than the individual inhibitory effects (P < 0.05). There were significant differences in the inhibition of the solid tumor growth in the in vivo study.

CONCLUSIONSOur findings indicated that Bcl-2 antisense oligonucleotides enhance the antitumor effects of mutant endostatin both in vitro and in vivo. We noted the synergistic effects of Bcl-2 antisense oligonucleotides combined with mutant endostatin.

Angiogenesis Inhibitors ; administration & dosage ; Animals ; Cell Line, Tumor ; Drug Synergism ; Endostatins ; administration & dosage ; Mice ; Thionucleotides ; administration & dosage ; Urinary Bladder Neoplasms ; pathology