China ; Evidence-Based Medicine ; Health Policy ; Humans ; Public Health

Objective:To examine whether the thyroxine treatment can affect the serum lipid levels in patients with subclinical hypothyroidism by Meta analysis.Methods:Pubmed and China National Knowledge Infrastructure(CNKI)were searched for randomized controlled trials reporting the effectiveness of thyroxine treatment on serum lipid levels in subclinical hypothyroidism patients from January 1980 to September 2006;hand-search was also performed.The included trails were analyzed by RevMan4.2 software.Results:Six studies were finally included and five of them found thyroxine to be significantly more effective than placebo in improving the serum lipid disorders;one of them found thyroxine had no obvious effect.The pooled effect sizes(95%CI)of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apoprotein A(ApoA),apoprotein B(ApoB)and lipoprotein a(Lp(a))were -0.39(-0.71, -0.07),-0.02(-0.07,0.04),-0.02(-0.06,0.03),-0.22(-0.31,-0.12),-0.08(-0.11,-0.06),-0.05(-0.08, -0.02),and -0.38(-2.41,1.64),respectively.The analysis results showed that thyroxine treatment was significantly effective on serum levels of TC,LDL-C,ApoA,and ApoB,but not on TG,HDL-C,or Lp(a).Conclusion:This Meta-analysis demonstrates that thyroxine treatment can improve thyroid function and lipid metabolism in patients with subclinical hypothyroidism,reducing the prevalence of artherosclerosis and coronary heart disease.

Objective To assess the value of serum N terminal pro-brain natriuretic peptide(NT-Pro-BNP) in the diagnosis of congestive heart failure(CHF) and evaluation of cardiac function in children with ventricular septal defect (VSD).Methods Fifty one children were enrolled from March 2004 to March 2005.NT-Pro-BNP was measured by enzyme immunoassay technique.At the same time,left ventricular ejection fraction(LVEF) and left ventricular shortening fraction(LVFS) were detected with echocardiography.Results The data of NT-Pro-BNP were showed but the logarithms of which were normal distribution.The values of NT-Pro-BNP were developed successively along with the severity of cardiac function.But there was no difference between the group of no heart failure and mild heart failure.But the values of LVEF and LVFS had no differences in the control,the mild and the moderate heart failure and the same time all of which beyond the standard of diagnosing heart failure.NT-Pro-BNP could reflect the degree of heart failure or cardiac function (r=0.826).But LVEF and LVFS can not reflect the degree of the cardiac function.Conclusions NT-Pro-BNP can reflect the degree of the cardiac function in VSD,and the degree of the heart failure can be classed by the levels of serum NT-Pro-BNP.But the value of LVEF and LVFS can not reflect the degree of the heart failure in the same disease.

OBJECTIVETo study clinical results of the manual reduction in treatment.

METHODSFrom October 2010 to April 2013,39 children with Monteggia fracture associated with anterior interosseous nerve injury were treated by manual reduction and fixation on buckling rotation backward,including 17 females and 22 males with an average age of 6.3 years old ranging from 3.2 to 11 years old. Among them, 15 cases were on the right side and 24 cases on the left. The course of disease was 40 minutes to 8 days (averaged 1.5 days). There were 7 cases with skateboard injured, 13 cases with stumble injured, 11 cases with falling injured,8 cases with air bed injured. According to Bado classification, 13 cases were type II, 22 cases were type III, 4 cases were type IV.

RESULTSThe distal forefinger showed exercise normally in 34 cases at 3 weeks after treatment, and the patients restored normal activities at 6 weeks after treatment. All patients were follow-up from 54 days to 6 months (averaged 67 days. According to Mayo elbow functional evaluation standard,the scoring result was 19.62±1.35 in activity, 45.00 ± 0.00 in pain, 9.87 ± 0.80 in stability, 25.00±0.00 in strength, 99.49 ±1.92 in total. The outcome of all patients was excellent and good evaluation results.

CONCLUSIONIf the anterior interosseous nerve injury could be identified early and treated timely, patients could gradually restore reasonable function and recover with satisfactory results. Raising understanding of anterior interosseous nerve injury can effectively reduce misdiagnosis.

Arm Bones ; injuries ; innervation ; surgery ; Child ; Child, Preschool ; Female ; Forearm Injuries ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Median Nerve ; injuries ; Monteggia's Fracture ; surgery

The mitogen-actived protein kinase(MAPK)is one of important ways in eukaryote signal transmission network,and plays the key role in the gene expression regulation and the cytoplasm function activity.In the mammal organism,five kinds of different MAPK signal transduction passage.ERK1/2 signal transduction passage regulates cell growth and differentiation,JNK and p38 MAPK signal transduction passages play the vital role in the stress of inflammation and apoptosis etc.The activation of signal transduction passage is the typical characteristic of RA chronic synovitis,through this way to induct synoviocytes cytoplasm protein phosphorylation,then causes transcription factor and nucleoprotein c-Fos,c-Jun,AP-1 and NF-kappa B and so on phosphorylation,thus promotes cell proliferation and activation.It has the vital significance of the above-mentioned mechanism research to understand deeply and researche new medicine to RA.

Objective To investigate therapeutic effects of muscle sliding operation treating Volkmann ischemic contracture of the forearm. Methods 32 cases Volkmann ischemic contracture were classified two types: the single type and the complex type. Three approaches were employed to treat different types which were single muscle sliding operation, muscle sliding plus skeletal operation, muscle sliding operation plus neurolysis.Results 29 cases were followed up, which excellent and good was 93.7 percent.Conclusions Muscle sliding operation was effective management for Volkmann ischemic contracture, and the skeletal operation or neurolysis could managed for the complex type in the meantime.

OBJECTIVE E-cadherin is a major component of tubular adherent proteins which maintain intercellular contacts and cell polarity in epithelial tissue, it is involved in the pathological process of renal cell carcinoma and fibrotic diseases via epithelial- mesenchymal transition. Although we and others found that expression of E-cadherin was significantly down-regulated in kidney suffered acute kidney injury (AKI), its function in AKI was still unknown, which was explored in the current study. METHODS We disrupted E-cadherin or restored E-cadherin with compound 8J in cisplatin-stimulated tubular epithelial cell lines, the cell damage and inflammation were evaluated, additionally, the thera?peutic potential of E-cadherin restoration was also determined in vivo. RESULTS We found that cisplatin reduced E-cadherin expression both in mouse kidney and tubular epithelial cell lines (mTECs). Adminis?tration of compound 8J restored the level of E-cadherin, thereby increased cell viability while attenuating programmed cell death, which may be mediated by deactivation of RIPK/MLKL axis, reduced membrane translocation of phosphor-MLKL and decreased cleavage of caspase 3. Compound 8J also suppressed inflammatory response in cisplatin- treated mTECs, which was correlated with suppressed NF- κB phorsphorylation and promoter activity. In contrast, disruption of E-cadherin enhanced cell damage and inflammation. Treatment of compound 8J failed to further attenuate kidney damage in E- cadherin knockdown cells, indicating compound 8J protected against mTECs mainly through restoring E-cadherin. We also found that peritoneal injection of compound 8J protected against renal function and tubular damage by preventing NF-κB-driven renal inflammation and RIPK/MLKL-regulated programmed cell death, which was led by restoration of E-cadherin in cisplatin nephropathy. CONCLUSION More than a victim degraded after kidney injury, E-cadherin also has functional role in controlling tubule integrity, programmed cell death and renal inflammation. In this regard, restoration of E-cadherin by compound 8J should be considered as a novel therapeutic strategy for acute kidney injury.

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

Objective To investigate the effects of intervention of information literacy education on the feeling of uncertainty of patients with percutaneous coronary intervention.Methods A total of 228 cases of patients with percutaneous coronary intervention who were hospitalized during July 2010 to June 2012 were selected.The patients were divided into two groups by means of random numbers table:the experimental group (including 119 cases) and the control group (including 109 cases).The patients of the control group received traditional nursing intervention,while the patients of the experimental group received additional information literacy education intervention besides the traditional nursing.The change of feeling of uncertainty and state anxiety level of patients under two kinds of nursing interventions was analyzed and compared.Results The patients of the experimental group had high uncertainty level on the day of admission,(99.17-4.46) points.It was obviously higher than the total score (80) by 50％.Compared with that on the day of admission,the uncertainty level on the night before surgery and on the day of patient discharge significantly declined.The state anxiety level of the patients of the experimental group was (52.97±5.91) points,higher than the normative level of Chinese normal people.Compared with that on the day of admission,the state anxiety level on the night before surgery and on the day of patient discharge significantly declined,and it was lower than the normative level.Compared with those of the control group,the MUIS and SAI assessment of the experimental group on the night before surgery and the day of patient discharge obviously declined.Conclusions The information literacy education intervention was able to reduce the uncertainty level and state anxiety level of patients with percutaneous coronary intervention.Therefore,the nursing quality of patients was enhanced.

Acute Disease ; Autonomic Nervous System Diseases ; Child ; Humans ; Male