China ; Gastroesophageal Reflux ; therapy ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; methods

Objective: To overview the experience of postoperative nutritional management in live transplant patients. Methods: Postoperative nutritional therapy and nutritional status assessment in 18 liver transplantation (2 patients undergone retransplantation) were retrospectively analyzed. During the first 3 days after operation, patients were supported with total parenteral nutrition (TPN) and supplied with human albumin. On the 4th and 5th days after operation, patients were provided with parenteral nutrition (PN) and enteral nutrition (EN). And on days 6～10 after operation, patients were gradually transferred to total enteral nutrition and they restored the oral intake completely on days 12～18 after operation. Recombinant human growth hormone was postoperatively injected for 4～7 days. Results: Despite 3 cases who died from brain hemorrhage, respiratory failure and acute rejection respectively, other 13 cases recovered fluently. Conclusions: Appropriate postoperative nutritional therapy facilitated the recovery of liver transplant patient.

Objective To verify BMP-2 and VEGF gene activated nanobone paste can effectively enhance the vertebral bone of ovariectomized goat.Methods From January,2011 to May,2016,the goats had been neutered by ovariectomy 6 months earlier to induceosteoporosis.Then surgery to established the model of vertebral bone defected with nanobone implanting,and the operation vertebrae divided randomly into 3 groups:control group,nanobone group and double gene activated nanobone group.Three months after operation the goats were sacrificed and removed the vertebrae.Micro CT analysis of micro three-dimensional structure of trabecular bone,scanning electron microscope (SEM) analysis of the two-dimensional structure of the vertebrae,the structure of trabecular bone was evaluated by movat pentachrome staining.Results The dual gene activated nanobone group compared with the nanobone group,the bone volume fraction (BV/TV) significantly increased (85％ at 1.2 mm vs 43％ at 1.2 mm,P ＜ 0.05);the dual gene activated nanobone group compared with nanobone group,in the largest ROI (1.2 mm),TbTh increased 10.9％ (374 ± 26.2 μm vs 337 ± 22.3 μm,P ＜ 0.05);Trabecular distribution coefficient (TbPf) was significantly decreased (7.519 ± 0.184 mm-1 vs 7.529 ± 0.261 mm-1,P ＜ 0.05);In the largest ROI (0.8 mm),trabecular distribution coefficient (TbPf) was significantly decreased (283 ± 36.4 μm vs 327 ± 31.2 μm,P ＜ 0.05),In the largest ROI (0.8 mm),the trabecular bone volume (Tbn) was increased 20％(1.404 ± 0.283 mm-1 vs 1.173 ± 0.224 mm-1,P ＜ 0.05);Cortical thickness over the implantation area showed asignificant increase of 43％ in vertebrae(P ＜ 0.05);The histological analysis revealed a more extensive osseointegration of the dual gene activated nanobone group,with the presence of anabundant osteoid tissue and an osteoblastic celllining.Conclusion BMP-2 and VEGF gene activated nano bone paste can effectively enhance the vertebral bone of ovariectomized goat.

objective To observe the distribution of vitamin D receptor(VDR)gene polymorphisms in children of Han nationality and investigate the relationship between VDR gene polymorphisms and the susceptibility to children's dental fluorosis of Han nationality.Methods From October of 2008 to March of 2009,a case-control study was conducted among children between 8 and 12 years old with(n=101)and without(n=102)dental fluorosis using Dean method in Guandian countyside of Fengtai county in Anhui province.DNA was extracted from blood samples ofthese children.The Apa I,Bsm I,Fok I and raq I polymorphisms in the VDR gene were genotyped using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The distribution of the genotypes in patients and the control group were analyzed. Results Different genotypes of the VDR gene existed in children of Han nationality with the highest distribution frequency of Aa, bb, Ff, TT, which respectively was 51.7% ( 105/203 ), 89.7% (182/203), 52.7% (107/203), 93.1% (189/203), followed by genotype distribution frequency of aa, Bb, FF, Tt, being 39.9% (81/203),7.9% (16/203),31.5% (64/203) ,6.9% (14/203), respectively. AA,BB, ff, tt distribution frequency was the lowest as follows, 8.4% ( 17/203 ), 2.4% (5/203), 15.8% (32/203),0 (0/203). The frequency distribution of VDR Apa I genotype was AA 7.9% (8/101), Aa 55.4% (56/101), aa 36.7%(37/101) in children with fluorosis, and AA 8.8% (9/102), Aa 48.0% (49/102), aa 43.3% (44/102) in children without fluorosis, respectively. There were no significant differences in the two groups(χ2= 1.13, P > 0.05).The frequency distribution of VDR Bsm I genotype was BB 3.0%(3/101), Bb 5.9%(6/101 ), bb 91.1% (92/101) in children with fluorosis, and BB 2.0% (2/102), Bb 9.8% (10/102), bb 88.2% (90/102) in children without fluorosis, respectively. There were no significant differences in the two groups(χ2 = 0.55, P > 0.05). The frequency distribution of VDR Fok I genotype was FF 28.7%(29/101), Ff 56.4% (57/101), ff 14.9%(15/101) in children with fluorosis, and FF 34.3% (35/102), Ff 49.0% (50/102), ff 16.7% (17/102) in children without fluorosis,respectively. There were no significant differences in the two groups(χ2 = 1.14, P > 0.05). The frequency distribution of VDR Taq I genotype was TT 93.1%(94/101), Tt 6.9%(7/101) in children with fluorosis, and TT 93.1% (95/102), Tt 6.9%(7/102) in children without fluorosis, respectively. The tt genotype was not found. There were no significant differences in the two groups (χ2 = 0.00, P > 0.05 ). Conclusions Different genotypes of the VDR gene existed in children of Han nationality. There were no correlation between VDR Apa I , Bsm I , Fok I , Taq I gene polymorphisms and children's dental fluorosis of Han nationality in this area.

Objective To investigate the effects and the mechanism of tirofiban administration in myocardial ischemical reperfusion injury(MIRI) in patients with acute myocardial infarction(AMI) undergoing primary percutaneous coronary intervention(PCI). Method The study included 158 STEMI Patients who accepted primary PCI therapy and were randomly (random number) divided into two groups: tirofiban administration group and control group. Incidence of MIRI during PCI, Correct TIMI frame count(CTFC), ST segment resolution(STR), peak value and peak time of MB isoenzyme of creatine kinase( CK-MB), and incidence of major adverse cardiac events (MACE) during 30 days postoperation in both groups were measured. Results Tirofiban administration group was superior to control group in terms of incidence of MIRI, CTFC, STR, peak value and peak time of CK-MB, and incidence of MACE during 30 days postoperation (P < 0.05). Multiple factor logistic regression analysis indicated that intravenous tirofiban administration before primary PCI was the independently protective factor for MIRI. Conclusions Intravenous tirofiban administration in patients with STEMI before primary PCI can significantly decrease the incidence of MIRI,reduce myocardial damage and improve the prognosis.

Humans ; Kidney ; pathology ; Kidney Neoplasms ; pathology ; Neuroectodermal Tumors, Primitive ; pathology

Objective To investigate the effect of stress-induced hyperglycemia (SHG) on myocardial perfusion and clinical prognosis in elderly patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI).Methods 348 elderly patients with first-time occurrence of acute ST-elevation myocardial infarction (STEMI) who underwent primary PCI within 12 hours from June 2008 to June 2010 were enrolled and followed up.All patients were divided into three groups according to serum glucose (SG) on admission:normal group (SG＜ 7.0 mmol/L,n=112);SG elevation group (7.0 mmol/L≤SG≤11.1 mmol/L,n=128) and (steady high blood glucose) SHG group (SG＞11.1 mmol/L,n=108).Myocardial perfusion indexes,including ST segment resolution (STR),TIMI myocardial perfusion grade (TMPG),peak value of creatine kinase CK-MB,left ventricular ejection (LVEF),and major adverse cardiac events (MACE) of patients in three groups,were measured and compared after emergency PCI.Results The blood glucose levels were increased,ST-elevation 2 h after PCI were well declined,the percentages of patients with TMPG 2-3 were decreased and peak values of CK-MB were increased in the three groups (all P＜0.01).After 12 months of follow-up,Kaplan-Meier survival analysis showed that patients of three groups had significantly different cumulative non-events survival rates [89.3％ (100/112) vs.85.9％ (110/128),76.3％ (83/108),P＜0.05].Multivariate Cox regression analysis showed that steady high blood glucose were the independent predictor for the occurrence of MACE in patients undergoing PCI after adjusting for age and gender,and the risk of MACE was increased by 5.811 folds in SHG group as compared with normal group (P＜0.01).Conclusions Stress induced hyperglycemia in elderly patients with STEMI can decrease myocardial perfusion level after primary PCI,which will lead to high incidence of MACE.

Objective To investigate the relationship between absent or hypoplastic fetal nasal bone and chromosome abnormalities.Methods From January 2010 to April 2014,187 fetuses were found to have absent or hypoplastic nasal bone by prenatal ultrasound scanning in Guangzhou Maternal and Children's Hospital.All the pregnant women should undergo interventional prenatal diagnosis for fetal chromosome abnormalities,and should be followed up for three months after the expected delivery date.The correlation between absent or hypoplastic fetal nasal bone and chromosome abnormalities,and the effects of complicating structural defects were analyzed by descriptive analysis and the Chi-square test.Results Of the 187 pregnant women,126 underwent interventional prenatal diagnostic tests,and fetal chromosome abnormalities were detected in 36 cases (28.6％),including 26 cases (20.6％) of trisomy 21,6 cases (4.8％) of trisomy 18,three cases (2.4％) of trisomy 13 and one sex chromosome chimerism.In the 126 cases received prenatal diagnosis,the incidence of chromosome abnormalities in fetuses without other structural defects was significantly lower than that with structural defects [12.7％ (8/63) vs 44.4％ (28/63),x2=15.556,P=0.000].Among 63 cases without other structural defects,seven fetuses were confirmed to have chromosome abnormalities in 14 women with high risk by Down syndrome screening,no chromosome abnormalities were found in 39 pregnant women with low risk by Down syndrome screening,and one sex chromosome chimerism was found in the other ten women who did not undergo Down syndrome screening.Absent or hypoplastic nasal bone detected in the first trimester resulted in a higher risk of chromosome abnormalities than that detected in the second and the third trimester [25.5％ (28/110) vs 10.4％ (8/77),x2=6.613,P=0.007].Conclusions When a fetus is found to have absent or hypoplastic nasal bone,it is necessary to perform Down syndrome screening and a detailed morphology scan.Women shown to have fetuses with absent or hypoplastic nasal bone with other structural defects or high risk by Down syndrome screening should undergo prenatal diagnostic tests to exclude fetal chromosome abnormalities.

Objective To study the clinical curative effect of Tongqiao Huoxue decoction combined with edaravone and hyperbaric oxygen for treatment of delayed encephalopathy after carbon monoxide poisoning (DEACMP). Methods A prospective study was conducted. Forty-six patients with DEACMP admitted into Yidu Central Hospital of Weifang Medical College from January 2012 to January 2014 were randomly divided into observation group (23 cases) and control group (23 cases). The basic treatments of two groups were identical. Based on the basic treatments including hyperbaric oxygen and citicoline sodium injection etc, the observation group was treated with our-self made Tongqiao Huoxue decoction which could be modified in accord to the individual differentiation of syndromes in traditional Chinese medicine (the composition of decoction included Paeoniae Radix Rubra 15 g, Chuanxiong Rhizoma 15 g, Persicae Semen 15 g, Carthami Flos 15 g, Zingiberis Rhizoma Recens 3 pieces, Jujubae Fructus 2 pieces, Moschus 0.5 g, Allium Fistulosum 1 segment). The decoction was administered orally or by nasogastric gavage, one dosage everyday for 1 month, and in the mean time, edaravone intravenously drip 30 mg was given to the observation group twice a day for 14 days. The control group was given hyperbaric oxygen and other conventional treatment for 30 days. The clinical therapeutic effect and adverse reaction were observed after treatment for 30 days. The changes of intelligent level were detected by Hasegawa dementia scale (HDS), and the changes of latency of P300 were measured by electromyologram/evoked potential instrument in two groups before and after treatment. Results The total effective rate in observation group was significantly higher than that in control group [91.3% (21/23) vs. 65.2% (15/23), P < 0.01]. Elevation of creatinine occurred in 1 case, moderate increase in alanine aminotransferase (ALT) appeared in 1 case, and both of them were reduced to normal after treatment in observation group; no adverse reaction occurred in control group. The HDS scores were significantly higher 30 days after treatment than those before treatment in the two groups [control group:13.4±2.8 vs. 6.8±2.3, observation group:20.8±3.4 vs. 6.6±2.5, both P<0.05]. The latency of P300 after treatment was significantly lower in two groups than that before treatment [control group (ms): 355.7±25.7 vs. 385.5±27.8, observation group (ms): 337.3±24.6 vs. 386.8±25.4, both P < 0.05], the change in observation group being more significant [the HDS score: 20.8±3.4 vs. 13.4±2.8, the latency of P300 (ms): 337.3±24.6 vs. 355.7±25.7, both P<0.05]. Conclusion Tongqiao Huoxue decoction combined with edaravone and hyperbaric oxygen has favorable cognitive effect on patients with DEACMP, thus, it can be used extensively in clinic.

[Objective] To assess the changes in bone marrow microenvironment in patients with psoriasis by determining the level of transforming growth factor β1 (TGF-β1),stem cell factor (SCF),keratinocyte growth factor (KGF) and tumor necrosis factor-α (TNF-α) secreted by bone marrow stromal cells(BMSCs).[Methods] This study recruited 20 healthy controls with normal bone marrow picture and 20 patients with psoriasis vulgaris,including 10 at progressive stage and 10 at resting stage.The psoriasis area and severity index (PASI) score varied from 0.6 to 22.8 and averaged 10.97 in these patients.Bone marrow mononuclear cells were isolated by density-gradient centrifugation from bone marrow of these subjects,and BMSCs were cultured with adherent method.After three passages,the BMSCs were subjected to a 72-hour culture followed by the identification of cell phenotypes via flow cytometry and determination of TGF-β1,SCF,KGF and TNF-α levels in the culture supernatant via enzyme linked immunosorbent assay (ELISA).The parameters were compared by two independent samples t test between the two groups,and the correlation of eytokines with PASI was assessed by Pearson correlation analysis.[Results] Inverted microscopy revealed no obvious difference in the morphology of BMSCs between the patients and controls.CD29 was expressed by more than 90％ of the BMSCs,but no expression of CD45,CD34 or HLA-DR was observed in them.The BMSCs from patients showed a significantly lower level of supematant TNF-α ((22.93 ± 10.1 1 ) μg/L vs.(35.73 ± 15.15) μg/L,t =3.14,P ＜ 0.05),a higher level of supernatant SCF ((76.80 + 16.19) μg/L vs.(59.86 + 22.41) μg/L,t =2.74,P＜ 0.05),and asimilar level of supernatant KGF and TGF-β1 (both P＞ 0.05) compared with those from the controls.The PASI score was uncorrelated with the levels of SCF,TNF-α,KGF or TGF-β1 secreted by BMSCs in patients with psoriasis (all P＞ 0.05).[Conclusion]s The levels of SCF and TNF-α secreted by BMSCs are aberrant in patients with psoriasis,hinting an abnormal bone marrow microenvironment in these patients.