OBJECTIVETo observe metabolomic changes in urine of chronic superficial gastritis (CSG) patients with Pi-qi deficiency syndrome (PQDS) or Pi-Wei dampness-heat syndrome (PWDHS), thereby providing scientific evidence for syndrome typing of them.

METHODSUrine samples were collected from CSG patients with PQDS/PWDHS and healthy volunteers, 10 in each group. Proton nuclear magnetic resonance spectroscopy (1H-NMR) based metabonomic analysis was performed on urine samples. Contents of related biomarkers were analyzed by principal component analysis (PCA), partial least square discriminant analysis (PLS-DA), and urivariate statistical analysis.

RESULTSPLS-DA analysis showed that metabolites among CSG patients with PQDS/PWDHS and healthy volunteers could be mutually distinguished. Seven differentially identified metabolites were screened from urines of CSG patients with PQDS and healthy volunteers included glutamate, methionine, α-oxoglutarate, dimethylglycine, creatinine, taurine, and glucose. Four differentially identified metabolites were screened from urines of CSG patients with PWDHS and healthy volunteers included 2-hydroxybutyric acid, trimethylamine oxide, taurine, and hippuric acid. Eleven differentially identified metabolites were screened from urines of CSG patients with PQDS and PWDHS included fucose, β-hydroxybutyric acid, alanine, glutamate, methionine, succinic acid, citric acid, creatinine, glucose, hippuric acid, and lactic acid.

CONCLUSIONThe metabolic differences of CSG patients PQDS and PWDHS mainly manifested in glycometabolism, lipid metabolism, and amino acids catabolism, and 1H-NMR based metabonomics may be used in classified study of Chinese medical syndrome typing.

Biomarkers ; urine ; Discriminant Analysis ; Gastritis ; urine ; Hot Temperature ; Humans ; Hydroxybutyrates ; Ketoglutaric Acids ; Least-Squares Analysis ; Medicine, Chinese Traditional ; Metabolome ; physiology ; Metabolomics ; Principal Component Analysis ; Proton Magnetic Resonance Spectroscopy ; Qi ; Syndrome

Objective To explore the causes,clinical manifestation and therapy of frontal sinusitis after transfrontal craniotomy.Methods Thirty-three patients with frontal sinusitis after transfrontal craniotomy were included in the study.Among them,7 cases had frontal sinus abscess and 4 cases had frontal sinus fistula.Twenty-three patients were treated with traditional frontal sinus surgery with facial incision.The nasofrontal dilatation tube was positioned for more than 3 months.Nine patients were treated with endoscopic frontal sinus surgery,and 1 patient was treated with combined endoscopic and traditional frontal sinus surgery,with nasofrontal dilatation tube positioned for less then 1 month.In the revision surgery,the bone wax and phlogistic acestoma were cleaned out in both operational methods.The causes of frontal sinusitis after transfrontal craniotomy were discussed by studying the frontal sinus CT image,and prior surgical data.Results All patients were followed up for more than 6 months after the nasofrontal dilatational tube was removed.Among 33 patients,two cases with traditional frontal sinus surgery were operated twice due to nasofrontal dilatation tube fall off in 1 month.In all 33 patients,30 cases cured and 3 cases got better.There were no curative difference between two operational methods.Conclusions The causes of frontal sinusitis after transfrontal craniotomy were inadequate sinus management in craniotomy and bone wax tamping in frontal sinus.There was more frontal sinus abscess and fistula occurring in frontal sinusitis after transffontal craniotomy than that in ordinary frontal sinusitis.The therapy included cleaning out bone wax and phlogistic acestoma,and expanding the frontal sinus ostium.The satisfying curative effect was obtained in both operational methods,but endoscopic frontal sinus surgery Was better because it is minimally invasive,no facial incision and quick recovery with less nasofrontal dilatational tube posting time.

AIM: To analysis of cataract prevalence and operation status in people aged 65 years old in the eastern Fengxian of Shanghai.?METHODS:In the period of January to December 2015, random stratified sampling in the whole group was taken in 3050 people over 65 years, in Situan and Fengcheng, two towns at the Eastern District of Fengxian Town. Ophthalmologic examination and questionnaire survey were given to those people, including slit lamp microscopy and visual acuity ( LogMAR ) and the conditions on cataract surgery.?RESULTS: Totally 1244 cases of cataract were found in 3050 subjects, the prevalence rate was 40. 79％. The prevalence rates in the subjects of different ages were different, as the age increases, the prevalence rate was rising. The difference of prevalence rate in different age groups was statistically significant (x2=558. 6, P<0. 001);the prevalence rate of male and female were 31. 06％ and 49. 94％, the difference was statistically significant ( x2 =112. 4, P<0. 001 ); the rate of illiterate and literate was 52. 04％ and 38. 76％ respectively with significantly difference (x2 = 28. 78, P<0. 001). Cataract surgery was taken in 765 cases, surgical coverage rate was 61. 25％;difference on age, gender was not statistically significant;the degree of education: the rate in literate was significantly far higher than in the illiterate, the difference was statistically significant ( x2 = 39. 72, P < 0. 001 ). Postoperative corrected visual acuity ≥ 0. 3 was considered as removing from disable and postoperative corrected visual acuity≥0. 05 as removing from the blind. The rate removing from disable was 71. 50％, the rate removing from the blind was 95. 29％. In 765 eyes receiving surgery, postoperative complications occurred in 29 eyes, 3. 79％ of the total eye receiving surgery.?CONCLUSION: Cataract is the common blind causing disease in the elderly, and the prevalence rate of cataract in eastern Fengxian of Shanghai is high. Although in recent years, the Restoring Vision Project has been developed, the surgical coverage has been improved, and the prevention and control of cataract is still the primary task of blind prevention.

OBJECTIVETo explore the relationship ol lingual region upper airway stricture and lingua-palate position type in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.

METHODSOne hundred patients with OSAHS were included in the study and divided into 4 groups by lingua-palate age, AHI, BMI and lowest SaO2, the dimensions and area of lingual region airway, the thickness of retropharyngeal and lateral pharyngeal tissue, the tongue width, tongue length and tongue area were compared among four groups. The multinomial step regression process was performed with SPSS software to explore the effects of lingua-palate position type on lingual region upper airway stricture.

RESULTSThere were no statistical difference of age, BMI, AHI and lowest pulse oxygen among four groups OSAHS patients (P > 0.05). And the CT results showed: starting from type I to type IV, the area, coronal and arrowe diameter of lingual region upper airways were decreasing, tongue length, tongue area and the percentage of lingual region airway stricture were increasing, the percentage of lingual region airway stricture were 0/25, 3/39, 7/22, 14/14, respectively (P < 0.05). The multinomial step regression analysis showed that the area of lingual airway was the most important factor of lingua-palate position type, the unstandardized coefficient was -0.39, and standardized coefficient was -0.545.

CONCLUSIONSThe study suggests that there is evident correlation between lingual region airway stricture and lingua-palate position type, and lingual region airway stricture can be roughly determined by lingua-palate position type.

Adult ; Aged ; Airway Obstruction ; diagnosis ; Humans ; Male ; Middle Aged ; Palate ; diagnostic imaging ; Pharynx ; diagnostic imaging ; Radiography ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tongue ; diagnostic imaging ; Young Adult

OBJECTIVETo investigate the feasibility, safety and efficacy of Cypher drug-eluting stent implanted after the emergency percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).

METHODSFrom Nov. 2002 to Dec. 2004, 186 patients with STEMI treated by emergency PCI were included into this study. The incidence of major adverse cardiovascular event (MACE), stent thrombosis and restenosis were evaluated during 6 months follow-up after PCI.

RESULTSOne hundred and sixty-eight patients were successfully treated by emergency PCI and there were no complication during the procedure. The rates of successful treatment were 100%. One hundred and seventy-five Cypher drug-eluting stents were successfully implanted into 171 target lesions. There was one case with acute stent thrombosis among 186 patients, and the MACE and mortality were 2.4% and 1.8%, respectively, during the first one month follow up. Six months later, the MACE was 4.2% and the mortality was 2.4%. The in-stent thrombosis and restenosis rates were 1.2% and 1.8%, respectively, when evaluated by angiography and clinic follow up at six months after PCI.

CONCLUSIONImplanting a Cypher drug-eluting stent in STEMI patients during emergency PCI is as safe and effective as a conventional bare stent. Cypher drug-eluting stent can reduce restenosis rate and MACE in STEMI patients treated with emergency PCI.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; instrumentation ; methods ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Sirolimus ; administration & dosage

This study aims to investigate the regulatory effects of Astragalus polysaccharide(APS) and APS combined with 5-fluorouracil(5-FU) on indoleamine-2,3-dioxygenase(IDO1) in the colon tumor microenvironment. Sixty Balb/c mice were randomized into a blank group, a model group, an APS group, an APS + 5-FU group, an APS + low-dose 5-FU group, and a 5-FU group. A tumor model was established by subcutaneous transplantation with CT-26 mouse colon cancer cells in other groups except the blank group. After successful modeling, each group was treated with corresponding drugs for 7 days. The general condition, body weight, and tumor volume of the mice were observed and measured daily during the treatment period. The mice were sacrificed at the end of treatment, and the tumor suppression rate and spleen index of the mice were calculated. Western blot and fluorescence quantitative PCR were employed to determine the protein and mRNA levels, respectively, of IDO1 in the tumor tissue of mice. High performance liquid chromatography was employed to measure the levels of tryptophan(Trp) and kynurenine(Kyn) in the tumor tissue of mice. Hematoxylin-eosin(HE) staining was performed to observe the histological changes of the tumor tissue, and immunohistochemistry to detect the changes of CD4 and CD8 expression in the tumor tissue. Compared with that in the model group, the tumor volume of mice in each treatment group significantly reduced. The body weights of mice in APS + 5-FU group and 5-FU group significantly reduced from day 4 to day 7 of treatment. In addition, the APS + 5-FU group and 5-FU group showed significantly decreased spleen index. The protein and mRNA levels of IDO1 were significantly down-regulated in the APS, APS + 5-FU, and APS + low-dose 5-FU groups. The drug interventions significantly increased the Trp content and decreased the Kyn content. The APS + 5-FU group showed significantly reduced infiltration of CD4~+ T lymphocytes and increased infiltration of CD8~+ T lymphocytes. APS inhibited the expression of IDO1 in the colon tumor microenvironment to increase CD8~+ T lymphocyte infiltration, and the combination of APS with 5-FU demonstrated better effect.
Mice ; Animals ; Tumor Microenvironment ; Colonic Neoplasms/genetics* ; Fluorouracil/pharmacology* ; Polysaccharides/pharmacology* ; CD8-Positive T-Lymphocytes/metabolism* ; RNA, Messenger/metabolism*

Background:Clinical outcomes of undifferentiated arthritis (UA) are diverse,and only 40 ％ of patients with UA develop rheumatoid arthritis (RA) after 3 years.Discovering predictive markers at disease onset for further intervention is critical.Therefore,our objective was to analyze the clinical outcomes of UA and ascertain the predictors for RA development.Methods:We performed a prospective,multi-center study from January 2013 to October 2016 among Chinese patients diagnosed with UA in 22 tertiary-care hospitals.Clinical and serological parameters were obtained at recruitment.Follow-up was undertaken in all patients every 12 weeks for 2 years.Predictive factors of disease progression were identified using multivariate Cox proportional hazards regression.Results:A total of 234 patients were recruited in this study,and 17 (7.3％) patients failed to follow up during the study.Among the 217 patients who completed the study,83 (38.2％) patients went into remission.UA patients who developed RA had a higher rheumatoid factor (RF)-positivity (42.9％ vs.16.8％,x2=8.228,P=0.008),anti-cyclic citrullinated peptide (CCP) antibodypositivity (66.7％ vs.10.7％,x2 =43.897,P ＜ 0.001),and double-positivity rate of RF and anti-CCP antibody (38.1％ vs.4.1％,x2 =32.131,P ＜ 0.001) than those who did not.Anti-CCP antibody but not RF was an independent predictor for RA development (hazard ratio 18.017,95％ confidence interval:5.803-55.938;P ＜ 0.001).Conclusion:As an independent predictor of RA,anti-CCP antibody should be tested at disease onset in all patients with UA.

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.