Objective:To analyze the anti-hypertension drugs used by elderly patients with essential hypertension and target organ injury in the inpatient department of the hospital.Method:A statistical and review analysis of anti-hyper- tension therapy planned for 208 patients aged 60 years and over with essential hypertension of 3rd grade,extreme high risk group and target organ injury.Result:The most common combinative treatment plan and drug option frequency(%)were as follows:cerebral infarction group:angiotensin-converting enzyme inhibitor (ACEI) (87.77%)+long-acting calcium channel blocker (CCB) (79.58%)+diuretic (77.55%),diabetes mellitus group:CCB(86.26%)+ACEI (68.18%)+diuretic(56.82%),renal insufficiency group:CCB(87.67%)+ACEI(45.45%) or angiotensinⅡre- ceptor blocker (ARB)(45.45%)+diuretic(60.61%),heart failure group:ACEI (86.67%)+diuretic(96.67%) +?-blocker(66.67%) and coronary heart disease group:CCB(84.73%)+ACEI(86.53%)+?-blocker(77.12%). Conclusion:The essential hypertension of 3rd grade,extreme high risk group of the aged should adopt a combinative treat- ment plan and concise indication drugs in term of the target organ injury of patients.

Objective To observe the clinical efficacy and the economic effectiveness of different therapeutic schemes for Chronic hepatitis UB.Methods Patients with Chronic Hepatitis B were treated by using different drugs:Interferon ?1b(group A),Lamivudine(group B),Interferon ?1b combination with Lamivudine(group C),Interferon ?1b combination with thymotentin(group D),Interferon ?1b combination with thymosin alphal(group E).Evaluation was carried out with pharmacoeconomic cost-effectiveness.Results At the end of therapy,the clearance rate of serum HbeAg was lowest in group B(10 94%),the other groups were more than 50%.The clearance rate of serum HBV-DNA was higher in group B and C than in the other groups,it was 85 94%,87 93% respectively.Normalizing ALT values was higher in group C,group D and group E than in group A and group B.The costs of several therapeutic schemes were RMB 8156 7(group A),6935(group B),15091 7(group C),26033 4(group D) and 89978 4(group E) yuans,respectively.Conclusions According to the evaluation with pharmacoeconomic cost-effectiveness analysis,the therapeutic scheme of Interferon ?1b,Lamivudine and Interferon ?1b combination with Lamivudine is best one for treating chronic hepatitsi B,in this groups,Interferon ?1b combination with Lamivudine was better than the other two groups.

Objective To investigate inhibitory effects of matrine (Ma) combined with vincristine (VCR), cytosine arabinoside (Ara-c), harringtonine (HRT), adriamycin (ADM), and daunorubicin (DNR) on proliferation of K562 cells. Methods MTT colorimetric assay was used to detect the inhibition rate of Ma combined with antineoplastic on K562 cells. Results The proliferation of K562 cells was inhibited by Ma at the concentration of 160 ?g/ml to 400 ?g/ml. The inhibitory rates of Ma combined respectively with VCR, Ara-c, HRT, ADM, and DNR were significantly higher than those of VCR, Ara-c, or HRT alone (P0.05). Conclusion Ma can inhibit the proliferation of K562 cells in a dose-dependent manner. The anti-proliferation effect of VCR, Ara-c, and HRT on K562 cells could be enhanced by Ma.

Ataxins ; Humans ; Male ; Middle Aged ; Nerve Tissue Proteins ; genetics ; Spinocerebellar Ataxias ; genetics ; Trinucleotide Repeats

Objective To evaluate the correlation of hemodynamic parameters and blood pressure with cerebral infarction in elderly patients with stenosis.Methods 216 elderly patients with transient ischemic attack(TIA)caused by cerebral stenosis were collected and divided into the cerebral infarction group and the control group.Differences in hemodynamic parameters and blood pressure between the two groups and the correlation between the parameters and cerebral infarction were analyzed.Receiver operating characteristic(ROC)curves were used to analyze the specificity,sensitivity and threshold of each parameter under different degrees of stenosis.Results After adjusting for the well-known associated factors,the occurrence of cerebral infarction was negatively correlated with systolic peak velocity(Vs),end diastolic velocity(Vd) and mean blood flow velocity(Vm),and positively correlated with diastolic blood pressure(r=-0.445 、-0.420 、-0.459、0.292,P＜ 0.01).In addition,the risk thresholds for cerebral infarction under mild,moderate and severe vascular stenosis were Vs≤97.1,Vd≤43.4,Vm≤59.9 cm/s,and diastolic blood pressure ＞92.3 mmHg(1 mmHg=0.133 kPa);Vs≤ 185.8,Vd≤ 83.6,Vm≤ 123.7 cm/s,and diastolic blood pressure ＞ 104.5 mmHg;Vs≤ 198.6,Vd≤ 121.1,Vm ≤ 137.5 cm/s,and diastolic blood pressure ＞ 109.6 mmHg,respectively.Conclusions There is a correlation between the blood flow parameters and elderly cerebral infarction.Based on the degree of cerebral arterial stenosis,the risk of cerebral infarction occurrence is greater with decreased blood flow velocity and increased diastolic blood pressure.

Objective:To explore the clinical and imaging features and prognoses of myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD).Methods:Thirty-nine MOGAD patients, admitted to our hospital from January 2018 to April 2021, were chosen in our study. The clinical and imaging data and follow-up results of these patients at acute attack period (first-onset or relapse) were collected and their features were analyzed.Results:In these 39 patients with MOGAD, 20 patients (51.3%) had non-reversing course, and 19 patients (48.7%) had relapsing course. The clinical and imaging data of 55 episodes of these 39 patients were collected. In these 55 episodes, optic neuritis was noted in 27 episodes (49.1%), encephalitis was noted in 10 episodes (18.2%), brainstem encephalitis was noted in 8 episodes (14.5%), meningoencephalitis in 2 episodes (14.5%), myelitis in 3 episodes (5.5%), encephalomyelitis in 1 episode (1.8%), optic neuromyelitis in 1 episode(1.8%), optic neuritis+meningoencephalitis in 2 episodes (3.6%), and optic neuritis+encephalitis in 1 episode (1.8%). The positive rate of antinuclear antibody (ANA) was 11.1% (4/36); the cerebrospinal fluid results of 28 samples were collected from 22 patients, and CSF pleocytosis occurred in 67.9% of the samples with value of 54.89±67.70×10 6/L. Twenty-seven brain MRIs of 19 patients at the acute episode were collected; one completely normal MRI was recorded; among the remaining 26 MRIs, 6 were with one single lesion, 5 were with 2 lesions, and 15 were with 3 or more lesions; in terms of distribution, lesions involving brainstem and its adjacent structures were found in 9 MRIs, lesions involving diencephalon and deep gray matter were found in 7 MRIs, supratentorial white matter lesions were found in 13 MRIs, and cortical lesions were found in 13 MRIs. Meningeal enhancement were found in 4 contrast-enhanced brain MRIs (4/20). Long or short segmental myelitis in the spinal MRIs was noted in spinal lesions, involving cervical spinal cord, thoracic spinal cord and conus, and the "H" sign could be seen in the cross section. All patients received steroids therapy at the acute phase and the doses of steroids were tapered down gradually. Thirty-eight patients (97.4%) had good prognosis after 3 months of treatment. Conclusions:MOGAD is a disease entity widely involving the white matter, gray matter and meninges of the central nervous system with various clinical manifestations such as optic neuritis, encephalitis, brainstem encephalitis, meningoencephalitis and myelitis or a combination of the above. Immunotherapy is effective in most patients, but the recurrence rate is high, and some patients require long-term immunotherapy.

Objective:To investigate the occupational health status of electric welding workers and explore the effects of electric welding on hearing loss and respiratory damage.Methods:From August to December 2021, the cluster sampling method was used to select workers from an automobile manufacturer in Guangzhou City as research subjects: 636 welding workers in the welding workshop as the welding group, 757 assembly workers in the engine workshop and the final assembly workshop exposed to pure noise as the assembly group. Occupational disease hazard factors were detected for welding positions and assembly positions, and occupational health examination was carried out for research subjects. The occupational health status, the trends of hearing loss and respiratory abnormalities with working age were compared and analyzed between the two groups. Binary logistic regression was used to analyze the association between hearing loss and respiratory abnormalities in welding workers.Results:The excess rates of welding fumes, manganese and its compounds in the welding position were both 9.68% (3/31). Its noise exposure intensity [ (85.36±2.68) dB (A) ] and excess rate [48.39% (15/31) ] were not significantly different from those in the assembly position [ (84.86±3.28) dB (A) and 43.24% (16/37) ] ( P>0.05). The results of the occupational health examination showed that the detection rates of hearing loss, digital radiography (DR) chest X-ray abnormality, alanine aminotransferase abnormality, deazelaic aminotransferase abnormality and white blood cell count abnormality of workers in the welding group were higher than those in the assembly group ( P<0.05). The detection rates of hearing loss, DR chest X-ray abnormality, pulmonary ventilation abnormality in the welding group and the detection rate of hearing loss in the assembly group increased with the working age of the workers ( P<0.05). The hearing loss detection rate and DR chest X-ray abnormality detection rate of the workers with ≥9 years working age in the welding group were both higher than those in the assembly group workers with same working age ( P<0.05). The binary logistic regression analysis showed that abnormal pulmonary ventilation and abnormal DR chest X-ray were the risk factors for hearing loss in welding workers ( OR=10.83, 95% CI: 7.31-16.06; OR=16.59, 95% CI: 5.72-48.10; P<0.05) . Conclusion:Hearing loss and respiratory damage are prominent problems among welding workers, and the detection rates of abnormality increase with the working age of the workers. Hearing loss in welding workers is associated with abnormal pulmonary ventilation and abnormal DR chest X-ray.

Objective:To explore the clinical characteristics of neurological syndrome associated with anti-glutamic acid decarboxylase (GAD) antibodies (Abs).Methods:Six patients with neurological syndrome associated with anti-GAD-Abs admitted to Department of Neurology, Henan Provincial People's Hospital from January 2019 to October 2022 were chosen. The clinical manifestations, imaging and laboratory results, therapeutic schedules, and follow-up prognoses of these patients were collected and summarized.Results:Three females and 3 males were included, with onset age of (54.3±17.7) years. Three patients had stiff-person syndrome (SPS), 1 had limbic encephalitis+generalized epilepsy, 1 had extralimbic encephalitis+occipital epilepsy, and 1 had cerebellar ataxia who was diagnosed with paraneoplastic syndrome associated with small cell lung cancer. Four patients had elevated level of thyroid peroxidase antibodies, and 1 patient was positive for overlapping anti-gamma aminobutyric acid B receptor antibodies and Amphiphysin antibodies. Two patients with SPS had failed lumbar puncture; 1 had slightly increased white blood cells and proteins in cerebrospinal fluid (CSF); the remaining 3 patients were basically normal. Specific oligoclonal bands in CSF were observed in 2 patients. Brain MRI showed abnormal signals in the bilateral occipital lobes in 1 patient, and no specific inflammatory lesions in other patients. All patients accepted corticosteroids and intravenous immunoglobulin/plasma exchange therapies; except for the one with paraneoplastic syndrome associated with small cell lung cancer, the remaining 5 patients had improved modified Rankin scale (mRs) scores at discharge and received long-term immunotherapy. Two patients with SPS had gradually aggravated symptoms, and mRs scores reached 5 at the last follow-up (one for 3 years and the other one for 2 years).Conclusions:The clinical manifestations of patients with neurological syndrome associated with anti-GAD-Abs include SPS, limbic encephalitis, extralimbic encephalitis, epilepsy and cerebellar ataxia; some of these patients have paraneoplastic syndromes. Immunotherapies are effective except for these patients with paraneoplastic syndromes. Some patients with SPS tend to have a chronic course and a poor prognosis.

Objective:To investigate the occupational health status of electric welding workers and explore the effects of electric welding on hearing loss and respiratory damage.Methods:From August to December 2021, the cluster sampling method was used to select workers from an automobile manufacturer in Guangzhou City as research subjects: 636 welding workers in the welding workshop as the welding group, 757 assembly workers in the engine workshop and the final assembly workshop exposed to pure noise as the assembly group. Occupational disease hazard factors were detected for welding positions and assembly positions, and occupational health examination was carried out for research subjects. The occupational health status, the trends of hearing loss and respiratory abnormalities with working age were compared and analyzed between the two groups. Binary logistic regression was used to analyze the association between hearing loss and respiratory abnormalities in welding workers.Results:The excess rates of welding fumes, manganese and its compounds in the welding position were both 9.68% (3/31). Its noise exposure intensity [ (85.36±2.68) dB (A) ] and excess rate [48.39% (15/31) ] were not significantly different from those in the assembly position [ (84.86±3.28) dB (A) and 43.24% (16/37) ] ( P>0.05). The results of the occupational health examination showed that the detection rates of hearing loss, digital radiography (DR) chest X-ray abnormality, alanine aminotransferase abnormality, deazelaic aminotransferase abnormality and white blood cell count abnormality of workers in the welding group were higher than those in the assembly group ( P<0.05). The detection rates of hearing loss, DR chest X-ray abnormality, pulmonary ventilation abnormality in the welding group and the detection rate of hearing loss in the assembly group increased with the working age of the workers ( P<0.05). The hearing loss detection rate and DR chest X-ray abnormality detection rate of the workers with ≥9 years working age in the welding group were both higher than those in the assembly group workers with same working age ( P<0.05). The binary logistic regression analysis showed that abnormal pulmonary ventilation and abnormal DR chest X-ray were the risk factors for hearing loss in welding workers ( OR=10.83, 95% CI: 7.31-16.06; OR=16.59, 95% CI: 5.72-48.10; P<0.05) . Conclusion:Hearing loss and respiratory damage are prominent problems among welding workers, and the detection rates of abnormality increase with the working age of the workers. Hearing loss in welding workers is associated with abnormal pulmonary ventilation and abnormal DR chest X-ray.

Objective To observe the influences on prognoses and airway acid and base levels while using anti-inflammatory and anti-reflux therapies combined with "Hezhong Fuzheng massage" for treatment of infants with gastric volvulus (GV) and gastroesophageal reflux (GER)-induced pneumonia in order to provide evidence for clinical diagnosis and treatment of such infant disease. Methods Sixty infants 1-6 months old admitted to the Department of Integrated Traditional Chinese and Western Medicine of Wuhan Children's Hospital from January 2013 to December 2015 were diagnosed as pneumonia combined with GV and GER by the chest radiograph and radiography of upper gastrointestinal tract (UGT) with iodine, and according to difference in diagnostic methods, they were divided into an observation 1 group (30 cases) and an observation 2 group (30 cases). In observation 1 group, 24-hour pH value in upper digestive tract especially the distal esophagus was dynamically monitored, while in observation 2 group, 24-hour multichannel intraluminal impedance (MII) combined with pH monitoring of esophagus was carried out. Furthermore, two control groups were set up, each 30 cases; after radiography of the UGT with iodine, the control 1 group was diagnosed as GV and GER without pneumonia and control 2 group was diagnosed as only simple GV. Treatment of infant pneumonia was carried out in accordance with the guidelines for the management of community-acquired pneumonia in children; the treatment of GV and GER included postural, dietary, prokinetic and Hezhong Fuzheng massage [acupoint selection and massage was undertaken in 5 steps: push from the palmar crease to Banmen (rectilinear pushing manipulation) 300 times, push abdominal Yin and Yang (finger-pushing massage) 200 times, palpate the abdomen (clockwise) 100 times, poking of Tianshu 100 times, poke alternately bilateral Zusanli 100 times. Once-daily massage, (15±2) minutes each time, for consecutive 7 days]. The results of pH monitoring of the distal esophagus in observation 1 group was recorded; All GER data concerning pH monitoring of observation 2 group and the results of esophagus multi-channel intra-luminal impedance combined with pH monitoring in control group were compared. After 7 days of continuous treatment, the clinical efficacy of pneumonia and GV, hospitalization time, prognosis and the changes of sputum pH before and after treatment in the two observation groups were compared. Results In two observation groups, the main type of 60 cases with GV was organoaxial volvulus, accounting for 91.67% (55 cases), and more than 60% patients exhibited sputum pH <7.0. The distal esophagus 24-hour pH dynamic monitoring in observation 1 group showed that there were 26 cases with acid reflux (86.67%), 4 cases with GER negative (13.33%), the proportion of pH < 4 in GER negative patients was significantly lower than that in moderate acid reflux patients [3.35% (0.77% - 8.08%) vs. 26.23% (15.19% - 42.87%), P < 0.05], the number of long reflux (> 5 minutes) in GER negative patients was significantly reduced than that in mild acid reflux patients [times: 2 (0-5) vs. 7 (2-15), P < 0.05], the longest time of reflux in GER negative patients was significantly shorter than that in either mild or moderate acid reflux patients [minutes: 5.9 (2.5-10.0) vs. 19.2 (5.9-51.0), 41.6 (16.9-121.0), both P < 0.05]. The 24-hour MII-pH monitoring of esophagus in observation 2 group showed that there were 30 cases with pathological reflux, mainly mild acid reflux accounting for 90%, in which the percentage of proximal reflux events was 46.07% in the total reflux events. The numbers of acid reflux and proximal reflux in the observation 2 group were significantly higher than those in the control 1 and 2 groups [1 305 (37.72%) vs. 795 (25.69%) and 136 (18.89%), 1 594 (46.07%) vs. 687 (22.20%) and 154 (21.39%), both P < 0.05]; there were no significant differences in total effective rate (100% vs. 100%, P > 0.05) and hospitalization time (days: 7.58±1.09 vs. 7.67±1.12, P > 0.05) between the two observation groups. Conclusions For the diagnosis of infant pneumonia combined with GV and GER, the first selection of chest radiograph and radiography of the UGT with iodine can identify the severity of pneumonia, whether it is complicated with GV and its classification, and whether GER exists at the same time. The estimation of 24-hour pH dynamic monitoring of the acid reflux in the upper digestive tract especially the distal esophagus is consistent with that of the 24-hour MII-PH monitoring of esophagus. Moreover, 24-hour MII-PH monitoring of esophagus can also identify non-acid reflux, resulting in the GER diagnosis more accurate. Since the proximal reflux ratio of infants with GV combined with GER and pneumonia is relatively high and easy to cause cough and aspiration. attention should be paid on early diagnosis and timely intervention to such patients. The sputum acidity test can reflect the airway acid-base level and its manipulation is simple, so by that the real time disease situation can be estimated, and aspiration of sputum also can help the treatment. The therapeutic schedule formulated by our group can elevate the therapeutic effect, improve the airway acid-base environment and benefit prognosis.