Objective To compare the diagnostic value of the Standardized Bedside Swallowing Assessment (SSA)and the Scottish Intercollegiate Guidelines(SIC)for bedside dysphagia screening of patients after acute cerebral infarction(ACI). Methods Eighty-six ACI patients within 24 h of stroke onset were enrolled in the study.Within 48 h after hospitalization,swallowing function assessments and dysphagia screenings were carried out with the SSA and SIG,as well as video fluroseopic swallowing studies(VFSSs).The SSA and SIG assessments generated sensitivities,specificities,positive predict values(PPVs),negative predict values(NPVs),positive likelihood ratios (PLRs)and negative likelihood ratios(NLRs).These were compared with the VFSS results. Results The SSA showed a sensitivity of 89.1%,specificity of 75%,PPV of 0.804,NPV of 0.833,PLR of 3.56,NLR of 0.15,and Kappa of 0.648 compared to the VFSS results.The SIG showed a sensitivity of 60.9%,specificity of 82.5%,PPV of 0.800,NPV of 0.647,PLR of 3.44,NLR of 0.47 and Kappa of 0.425 compared to the VFSS.The sensitivity of of the SIG.Both assessments correlated well with the VFSS results. Conclusions Both the SSA and the SIG are elfective in dysphagia screening.The SSA is more sensitive than the SIG and is more suitable for early screening.The SIG is helpful in guiding dysphagia management and evaluating curative effects.

Adolescent ; Adult ; Female ; Humans ; Male ; Methanol ; poisoning ; Occupational Diseases ; chemically induced ; diagnosis ; therapy ; Poisoning ; diagnosis ; therapy

OBJECTIVE: To establish a quality standard for Jieyinling lotion. METHODS: Cortex Phellodendri and Epimedium Herb were identified by TLC, and the content of Icariin was determined by HPLC. RESULTS: The TLC spots were fairly clear and a good reproducibility was obtained. The linear range of Icariin was 2.0 ～10.0?g(r=0.999 6),with average recovery at 100.1%,RSD =1.92%. CONCLUSION: The established method is reliable and accurate, and suitable for the quality control of Jieyinling lotion.

al aberrations in MM.

Objective To study the clinical value of heart‐type fatty acid binding protein(H‐FABP) ,high‐sensitive cTnI(hs‐cT‐nI),homocysteine(Hcy)andcystatinc(Cys‐C)intheearlydiagnosisofacutemyocardialinfarction(AMI).Methods 150casesof AMI patients with coronary arteriography (AMI group) were selected from the cardiovascular department admitted within the first 6hours of chest pain attack .An additional 30 case for control group .The level of four novel cardiac marker were measured in each group of serum .Results The level of serum H‐FABP ,hs‐cTnI ,Hcy and Cys‐C in AMI group were markedly higher than control group(P<0 .05) ,and rose with the increase of coronary artery lesions with statistical difference (P<0 .05) .Each cardiac markers showed high specificity in the diagnosis of AMI ,amongst which H‐FABP and hs‐cTnI ,stood out with sensitivity of 97 .34% and 89 .98% respectively .With Youden index ,positive likelihood ration ,negative likelihood ration ,positive predictive value and negative predictive value ,H‐FABP and hs‐cTnI appeared to have higher diagnostic value than Hcy and Cys‐C in AMI .Conclusion H‐FABP and hs‐cTnI displayed significant clinical value as a most sensitive indicator in the early diagnosis of AMI (within 6 hours of attack) . The level of H‐FABP ,hs‐cTnI ,Hcy and Cys‐C elevated as coronary artery lesions increase .

Objective To study the diagnostic value of computed tomographic virtual endoscopy versus electronic colonoscopy for colon cancer in elderly patients.Methods The 69 cases of elderly patients with colon cancer received CTVE and electronic colonoscopy before surgery to compare achievement rates,sensitivities,and endoscopy coincidence rate with pathologic classification between the two methods.Results For a definite diagnosis of colon cancer in elderly patients,achievement ratio was 98.6％ (68/69) in CTVE and 62.3％ (43/69) in electronic colonoscopy(x2 =14.72,P＜ 0.05);sensitivity was 95.6％ (65/68) in CTVE and 97.7％ (42/43) in electronic eolonoscopy(x2=0.003,P ＞ 0.05);endoscopy coincidence rate with pathologic classification was 95.4％ (62/65) in C-TVE and 95.2％(40/42) in electronic colonoscopy.Conclusions CT virtual endoscopy may be one of examination methods in elderly patients with colon cancer.

In our previous study, we found that Si Miao Formula (SMF) had the effect of improving the disorder of glucose metabolism caused by high fat and high sucrose diet, and significantly altered the composition of gut microbiota, especially increasing the level of Akkermansia muciniphila (A. muciniphila). However, it is unclear that the role of intestinal flora and A. muciniphila play in SMF improving blood glucose homeostasis, and the mechanism of how SMF increases the level of A. muciniphila. Therefore, this study will explore the correlation between SMF improving the insulin resistance and increasing the level of A. muciniphila, as well as the mechanism of SMF-induced growth of A. muciniphila using the in vitro and in vivo experiments. We explored the effect of intestinal flora and A. muciniphila on SMF-improved insulin resistance through fecal microbiota transplantation (FMT) and antibiotic intervention. In order to study the mechanisms underlying SMF on elevating A. muciniphila, we disassembled SMF to find the key component which can particularly elevate the number of A. muciniphila. Using the in vitro anaerobic culture system combined with cell and animal experiments, we explored the mechanism of the key component in elevating A. muciniphila. The research was approved by the Animal Ethical and Welfare Committee of Shanghai University of Traditional Chinese Medicine. Our results showed that the gut microbiota altered by SMF can improve high fat and sucrose diet induced insulin resistance in recipient mice, and the improvement was closely related to the abundance of A. muciniphila. Cortex Phellodendri played the most important role in regulating the composition of intestinal flora and increasing the number of A. muciniphila, of which, berberine was the key component of Cortex Phellodendri which up regulated A. muciniphila. We have found that berberine cannot directly promote the growth of A. muciniphila in vitro, but it can stimulate the expression of mucin, which, in turn, promote the growth of A. muciniphila. The above results show that the improved insulin sensitiviy by SMF depends on the increased level of A. muciniphila. The effect of SMF on elevating the amount of A. muciniphila might be correlated with the increased expression of mucin stimulated by berberine.

Objective To investigate the effects of chronic high glucose on α-cells glucagon releasing in relation to insulin resistance induced by high glucose. Methods TC1-6 cells, an α-cell line, were incubated separately in DMEM containing high (25.0 mmol/L), medium (11.1 mmol/L) and low (5.5 mmol/L) concentrations of glucose for 1 to 5 days. The secretion and gene expression of glueagon were measured. When TC1-6 cells had been cultured for 5 days, three different concentrations of insulin were added for 6 h and then glucagon secretion was detected. Western blot was used for 1 and 3 days to confirm the effect of high glucose on phosphorylation of Akt in TC1-6 cells. Results (1) Exposure of TC1-6 cells to 11.1 and 25.0 mmol/L glucose resulted in a slight increase of glucagon secretion compared with those incubated with 5.5 mmol/L. However, after 5 days in media containing 25.0 mmol/L glucose, glucagan secretion was significantly increased as compared to cells treated with low glucose [(136.80±10.94 vs 78.62±4.72 ) ng/106 cells, P<0.05]; moreover, in TC1-6 cell cultured with high glucose glucagon mRNA expression was increased significantly. (2) 10-7 mol/L insulin reduced significantly glucagon secretion of TC1-6 ceils exposed to low glucose [(21.59±1.30 vs 55.12±3.86) ng/106 cells], but just scarcely inhibited glucagon secretion of cells incubated with high glucose [(106.58±8.53 vs 117.18±10.55) ng/106 cells]. When insulin concentration was increased to 10-5 mol/L, glucagon secretion of TC1-6 cells in high glucose was also reduced [(46.55±3.72 vs 118.61±10.68 )ng/106 cells]. (3) After treated with 10-5 mol/L insulin for 2h, the levels of Akt phosphorylation in both groups of TC1-6 cells were increased by 180% and 70%, while the level in high glucose group was significantly lower than that in low glucose group. In the presence of phosphoinositide 3 kinase inhibitor, the levels of Akt phosphorylation were both lowered, but the inhibition in low glucose group was more significant than in high glucose group. Conclusion High glucose induces hypersecretion of glucagon, which may be due to the a-cell insulin resistance.

Objective With awareness, attitudes, and rice-intake behavior of Kaschin-Beck disease (KBD) and the analysis of the factors that influence KBD related rice-intake behaviors among resident's in Aba,this research could provide evidences for KBD-Control, and benefit the policy development related to KBD-Control.Methods Villages were chosen by proportional stratified random sampling from KBD monitoring villages among agriculture areas, pastoral areas, and farming & pastoral areas in Aba, Sichuan, in July 2009. Interview questionnaire of household survey, designed by research associates of this project, was used in this research for residents in endemic area of KBD in Aba. The questionnaire covered demographic and socio-economic characteristics, KBD knowledge and diet habits. Multi-level Variance Component Analysis was used to explore factors which would influence the KBD related rice-intake behaviors. Results A total of 1029 permanent residents were recruited in this research, among which the detection rate of KBD was 48.01％ (482/1004). Most of the patients lived in farming & pastoral areas(84.44％, 407/482). Pastoral residents had the least knowledge of KashinBeck disease, and the composition ratios ofGeneral andGood were 15.87％ (33/208)and 3.36％ (7/208),respectively. Still, people who were willing to have rice as staple food were 93.13％(935/1004). It indicated that only (50.40 ± 23.68)％ on average, of research subjects had the life style of rice intake. Ethnic, work status,language situation and attitudes to rice intake were influencing factors for rice-intake behavior. Conclusions The percentage of rice intake in Aba KBD epidemic areas is low. And to prevent KBD, the advocacy actions should be targeted at ethnic, work status, language situation, and attitudes to rice intake.

Objective To evaluate the iodine nutritional status and thyroid function of pregnant women in different periods of pregnancy,analyze the relationship between iodine nutritional status and thyroid function and provide a basis for scientific supplementation of iodine to pregnant women.Methods In 2013 and 2014,using stratified random sampling method,six counties were selected in the city;around 30 early,middle and late pregnant women each in every county were selected;a total of 545 (173 early,203 middle and 169 late) pregnant women were investigated in the 6 counties;instant random urine samples of 25 ml were collected and urinary iodine was tested.A total of 151 (52 early,55 middle and 44 late) pregnant women were selected to collect 3 ml venous blood samples for determination of thyroid hormone and thyroid autoantibodies.Results Median urinary iodine levels of early,middle and late pregnant women were 132.2,128.9 and 113.5 μg/L,respectively,under the condition of iodine deficiency.Prevalence rates of low frce thyroxine FT4,subclinical hypothyroidism,hypothyroidism and hyperthyroidism in pregnant women were 0.66％ (1/151),15.23％ (23/151),0.66％ (1/151) and 0.66％ (1/151),respectively.The positive rate of TgAb and TPOAb was 15.23％ (23/151) and 11.92％ (18/151),respectively.There were significant differences in the levels of free three iodine thyroid (FT3) in different periods of pregnancy (F =7.723,P ＜ 0.05);FT3 in late pregnancy was lower than that in early and middle pregnancy (P ＜ 0.05).There were significant differences in the levels of FT4 in different periods of pregnancy (F =3.762,P ＜ 0.05);FT4 in late pregnancy was lower than that in early and middle pregnancy (P ＜ 0.05).There were significant differences in the levels of thyroid stimulating hormone (TSH) in different periods of pregnancy (F =13.199,P ＜ 0.05);TSH in early pregnancy was higher than that in middle and late pregnancy (P ＜ 0.05).Subclinical hypothyroidism prevalence rate in late pregnancy was higher than that in middle pregnancy (x2 =3.912,P ＜ 0.05).The positive rate of TgAb in early and middle pregnancy was higher than that in late pregnancy (x2 =9.883,3.906,all P ＜ 0.05).Urinary iodine ≥250 μg/L was a risk factor for subclinical hypothyroidism in pregnant woman [odds ratio (OR) =5.076,P ＜ 0.05].Conclusions The iodine nutrition of pregnant women in Tianjin is insufficient.Excessive urinary iodine is an increased risk of subclinical hypothyroidism.We should monitor the urinary iodine and thyroid function in pregnant women.