Animals ; Behavior, Animal ; Reproduction ; physiology ; Social Behavior ; Tupaiidae ; physiology

Objective To investigate the clinical value of dynamic glucose monitoring in the middle and late pregnant women with diabetes mellitus,and the related clinical and nursing measures.Methods One hundred admitting cases of the middle and late pregnant women with diabetes mellitus were grouped according to the random number table,50 cases of the control group were treated with finger tip blood glucose monitoring and conventional treatment,50 cases of dynamic blood glucose monitoring and comprehensive clinical and nursing intervention for the observation group.The blood glucose control situation with different time,the incidence of hypoglycemia,the actual control range of the glycosylated hemoglobinblood and the length of hospital stay and so on were evaluated in two groups.Results The incidence of hypoglycemia in the observation group was 6.0％ (3/50),the control group was 24.0％ (12/50),the difference was statistically significant (P ＜ 0.05).In the early morning,after breakfast 2 h,before and after lunch 2 h,before and after dinner 2 h and before bed and other different time,the blood glucose level with the observation group was lower than that in the control group (P ＜ 0.05).At the same time,in the blood glucose effective controlling time,hospitalization time,the observation group was better than the control group (P ＜ 0.05).The blood glucose level and the detection range of the glycosylated hemoglobin were also detected in the safe state for outpatient follow-up after hospital discharge.Conclusions The intervention of dynamic blood glucose monitoring and comprehensive clinical and nursing measures in middle and late pregnant women with diabetes mellitus is conducive to control blood glucose level timely and accurately and to improve their prognosis.It is the key to the success of the future obstetric prevention and diagnosis and treatment of the disease,and is recommended clinical popularization.

Objective To assess the efficacy and safety of intrapleural instillation of Yadanzi (Brucea Javan-ica)oil emulsion injection and cisplatin for malignant pleural effusion by literature searching and meta -analysis. Methods Databases were searched for random controlled trails (RCTs)including Pubmed,the Cochrane Library, CNKI,VIP,Wanfang Database and CBM.The quality of included RCTs was evaluated and the data were collected by 2 evaluators independently.Meta -analysis was performed using RevMan 5.2.Results 18 RCTs involving 1 322 par-ticipants was included.The results of meta -analysis indicated that intrapleural instillation of Yadanzi oil emulsion injection and cisplatin could improve the treatment efficiency of malignant pleural effusion (OR =3.82,95%CI 2.94 ~4.96,P <0.01)and improve the quality of life of patients(OR =4.07,95%CI 2.87 ~5.79,P <0.01),and reduce the gastrointestinal tract reaction (OR =0.55,95%CI 0.38 ~0.78,P <0.01)and white blood cell reduction occurs (OR =0.34,95%CI 0.25 ~0.46,P <0.01).Conclusion Intrapleural instillation of Yadanzi oil emulsion injection and cisplatin was effective and safe in the treatment of malignant pleural effusion,while the further studies should make efforts in improving research quality.

Objective: To observe the clinical efficacy of acupuncture plus medicine in treating laryngopharyngeal reflux due to liver-qi stagnation and spleen deficiency. Methods: A total of 70 patients were divided into a control group and an observation group by the random number table method, with 35 cases in each group. Both groups were treated with conventional medications, and the observation group was treated with additional acupuncture therapy. The reflux symptom index (RSI) and reflux finding score (RFS) were evaluated. Esophageal motility indicators such as lower esophageal sphincter pressure (LESP) and upper esophageal sphincter pressure (UESP), and salivary pepsin level were measured. The clinical efficacy was also compared. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, the RSI and RFS scores in both groups decreased significantly (all P<0.05), and the RSI and RFS scores in the observation group were significantly lower than those in the control group (both P<0.05). There were no significant changes in the LESP and UESP in the control group (both P>0.05), while LESP and UESP in the observation group increased significantly (both P<0.05), and higher than those in the control group (both P<0.05). The salivary pepsin levels in both groups decreased (both P<0.05), and the salivary pepsin level in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Acupuncture plus medicine can improve symptoms and signs in patients with laryngopharyngeal reflux due to liver-qi stagnation and spleen deficiency, and regulate esophageal motility and salivary pepsin level. Its efficacy is more significant compared with medicine alone.

Objective To discuss the safety and the application of the self-designed multifunctional inflatable pelvis and hip-joint fixator (MIPHF) in damage control in pelvic fracture patients.Methods The MIPHF was subjected to pressure test and quality inspection.From September 2016 to June 2017,61 pelvic-fracture patients were treated with our self-designed MIPHF as pre-hospital first-aid care according to the concept of damage control orthopedics (DCO) (MIPHF group).The control group consisted of 69 pelvic-fracture patients who had not received pre-hospital first-aid care with the self-designed MIPHF from December 2015 to August 2016.There were no statistically significant differences between the two groups in gender,age,types of pelvic fracture,and preoperative injure severity score (ISS).The study compared the two groups for the case fatality rate,volume of blood transfused during surgeries,early complication rates,fracture reduction (Matta standards),and long-term efficacy (Cole scores).Results The pressure test showed that the MIPHF had a good fixation effect on the pelvis.And the quality inspection showed that the material used for the MIPHF was in line with national standards and the safety was guaranteed.The MIPHF group had 1 death (1.6％) and the control group had 8 deaths (11.6％),which was a significant difference (x2=4.979,P=0.026).All survival patients in both groups were followed up.The MIPHF group (61 cases) received 3.0 to 18.0 months follow-up,with an average of 9.0 months.And the control group (69 cases) had 18.0 to 30.0 months follow-up,with an average of 21.9 months.In the MIPHF group,23 cases were treated conservatively,and 37 cases were treated with surgery.Among them,3 cases were fixed with external fixator,20 cases with anterior open reduction and internal fixation,9 cases with posterior open reduction and internal fixation,and 5 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 20 days after injury,with an average of 4.1 days.The volume of blood transfused in the MIPHF group during surgery was 200 to 1500 ml,with an average of 628.6 ml.In the control group,27 patients were treated conservatively,and 42 patients were treated with surgery.Among them,2 cases were fixed with external fixator,24 cases with anterior open reduction and internal fixation,10 cases with posterior open reduction and internal fixation,and 6 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 15 days after injury,with an average of 3.l days.The volume of blood transfused in the control group during surgery was 200 to 4000 ml,with an average of 1 707.1 ml.There was a significant difference between the two groups in intraoperative blood transfusion(Z=-2.330,P=0.020).The MIPHF group had 10 (16.4％) cases of early serious complications and the control group had 22 (31.9％) cases,which had a significant difference (x2=4.187,P=0.041).According to the criteria proposed by Matta et al.,the good rate of results for treating fractures was 82.0％ in the MIPHF group and 60.9％ in the control group,which got a significant difference (x2=6.967,P=0.008).The MIPHF group and the control group also differed significantly in their mean long-term Cole scores (27.2±4.0 versus 25.1 ±5.6,t=2.457,P=0.015).Conclusion MIPHF,which reflects the DCO concept,may be recommended as pre-hospital first-aid care for patients with pelvic fracture because it can lessen bleeding and prevent secondary pelvic injury,thus reduce case fatality rate and the incidence of complications.It can also improve the success rate of treating pelvic fracture,which will positively affect long-term outcomes.

OBJECTIVECigarette smoke extract (CSE) can induce injuries of pulmonary II epithelial cells, activate nuclear factor-kappaB and increase tumor necrosis factor-alpha(TNF-alpha) secretion. This study aimed to investigate whether azithromycin can protect pulmonary II epithelial cells from injuries induced by CSE and relevant mechanisms.

METHODSPulmonary II epithelial cells (A549 cells) were cultured in vitro. After 48 hrs of culture the cells were randomly treated with serum-free DMEM only (blank control group), azithromycin + serum-free DMEM, CSE+ serum-free DMEM or CSE+azithromycin. Eight hours later the morphology of A549 cells, the activity of NF-kappaB and the levels of TNF-alpha were measured by inverted microscope, immunohistochemistry and ELISA.

RESULTSThe morphology and structure of A549 cells were changed, NF-kappaB activity increased (dark brown staining ) and TNF-alpha levels (0.307 +/- 0.036 pg/mL vs 0.234 +/- 0.028 pg/mL)increased in the CSE+ serum-free DMEM group compared with the blank control group (P < 0.01). CSE together with azithromycin treatment recovered partly the morphological injuries of A549 cells. It also attenuated NF-kappaB staining and decreased TNF-alpha levels from 0.307 +/- 0.036 pg/mL (CSE+serum-free DMEM group) to 0.269 +/- 0.009 pg/mL (P < 0.05).

CONCLUSIONSAzithromycin may inhibit NF-kappaB activity, decrease TNF-alpha secretion and thus lessen cytotoxicity of CSE to A549 cells.

Anti-Bacterial Agents ; pharmacology ; Azithromycin ; pharmacology ; Cells, Cultured ; Epithelial Cells ; drug effects ; Humans ; Immunohistochemistry ; Lung ; drug effects ; metabolism ; pathology ; NF-kappa B ; analysis ; Smoke ; adverse effects ; Tobacco ; adverse effects ; Tumor Necrosis Factor-alpha ; analysis

OBJECTIVETo discuss the significance of testing hepatitis B virus (HBV) from saliva in HBV patients.

METHODSHBV DNA content in serum and saliva of 200 HBV patients and 20 healthy subjects were detected by fluorescence quantitative polymerase chain reaction. According to the serum level of HBV content, four groups were divided: control group A, group B negative, low virus C (1 x 10(3) - 1 x 10(5) copies/ml) and high-group D ( > 1 x 10(5) copies/ml). The relationship of serum and virus content in saliva was analysed.

RESULTSOf 200 HBV cases, 180 were found HBV DNA in serum with positive rate of 90.0%; while 145 were found HBV DNA in saliva with positive rate of 72.5%, and there was no significant difference (chi2 = 1.35, P > 0.05). The significant difference was observed in testing serum and saliva in Group C (100.0% vs. 38.5%; Z = 14.11, P < 0.01). In group D, there was no significant difference found either (100.0% vs. 83.8%; chi2 = 1.05, P > 0.05). Group D virus serum had a high average level of (6.63 +/- 1.55) log copies/ml virus and in the saliva had an average level of (5.21 +/- 1.85) log copies/ml; saliva had serum viral load lower than an order of magnitude average. No HBV DNA was found in serum or saliva from 20 health subjects.

CONCLUSIONWhen the serum contains a high content of HBV DNA virus, the content of saliva HBV DNA virus should be likely high, which might pose a threat of source of infection. A precise quantitative detection of HBV DNA in saliva might be used as evaluation of the level of virus in the body copy for judgment of infection.

Case-Control Studies ; DNA, Viral ; analysis ; blood ; Female ; Hepatitis B ; diagnosis ; transmission ; Hepatitis B virus ; genetics ; Humans ; Male ; Saliva ; virology

OBJECTIVETo investigate the reasonable proposal of prophylactic antibiotics use in selective colorectal operation.

METHODSOne hundred and sixty-five patients underwent colorectal surgery were randomized to Treatment 1 (55 cases), Treatment 2 (50 cases) and Control (60 cases) group. The Treatment 1 group was given oral MgSO4 solution at the night before operation, and Cefradine 2.0 g (I.V.) during the induction of anesthesia, continued with tow times of intravenous Cefradine 2.0 g and 0.5% Metronidazole 100 ml at an interval of 12 hours in 24 hours after the operation. The Treatment 2 group was given the same treatment as Treatment 1, but the antibiotics would not be withdrawn until 3-5 d after operation. On the basis of the treatment of Treatment 2 group, the Control group was given oral antibiotics 2-3 days before operation. Postoperative complications including surgical site infection, stoma leakage, dysbacteriosis, and WBC, body temperature, days of hospitalization and antibiotic expenses in the three groups were observed and compared.

RESULTSThere was no significant differences in surgical site infection, stoma leakage, WBC counting and its change, body temperature and hospital stay among the three groups (P > 0.05). The incidence rate of dysbacteriosis in Control group was significantly higher than that in Treatment 1 group (P < 0.05). The antibiotic expenses in the Treatment 1 group was significantly lower than those of the other two groups (P < 0.05).

CONCLUSIONSProphylactic antibiotic use during the induction of anesthesia and 24 hours after operation was reasonable in selective colorectal operation, it can prevent the surgical site infection effectively with good social-economic effects and fewer side effects.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; adverse effects ; Antibiotic Prophylaxis ; adverse effects ; methods ; Colorectal Surgery ; Female ; Humans ; Male ; Middle Aged ; Surgical Wound Infection ; prevention & control

OBJECTIVETo explore the effective skills of reconstruction and balance of soft tissue in hemi-shoulder replacement for patients with four-part fracture of the proximal humerus in order to avoid postoperative complications of joint instability and great tubercle displacement.

METHODSFrom June 2002 to June 2006, 25 patients with Neer four-part fracture of the proximal humerus were adopted in the study which included 15 females and 10 males, with the mean age of 66 years (ranged from 56 years to 80 years). They were treated with humeral head replacement and should joint reparation simultaneously by modified operation approach and reconstruction and balance skills of soft tissue.

RESULTSThe mean duration of follow-up was 2.3 years (ranged from 1 to 4.5 years). No infection, nerve damage and prosthesis loosing were found in all cases. Two cases of infra-forward dislocation or subluxation occurred due to affected limb placed on abduction splint postoperatively. One case occurred prosthesis upward displacement due to early active abduction exercise but no complains. Neither joint instability nor displacement and malunion of great tubercle were found in other patients. According to Neer scoring system, 6 cases were rated as excellent, 15 as good and 5 as fair. The good and excellent rate was 84%.

CONCLUSIONIn hemi-shoulder replacement for patients with Neer four-part fracture the modified operation approach and reconstruction and balance of soft tissue skills combined with rational rehabilitation exercise can prevent postoperative shoulder joint instability and displacement and malunion of great tubercle.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement ; methods ; Connective Tissue ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Shoulder Fractures ; surgery ; Shoulder Joint ; surgery

AIMTo study the effect of XW630 on expression of pro-oncogene c-myc in the long bones of fetal mice in vitro for postulating the mechanism by which XW630 exerts its effect on bone.

METHODSThe fetuses of pregnant mice were removed on day 16 of gestation, the long bones of the forelimbs of female fetal mice were freed of muscle and soft tissue and cultured in a specific device for 48 h in BGJb medium treated with 1 x 10(-7), 1 x 10(-8) and 1 x 10(-9) mol.L-1 XW630 in the final medium. After cultured for 48 h, the long bones were harvested and immunohistochemical analysis was performed for determination of c-Myc protein expression in epiphyseal plates. The areas of positive cells in the resting zone, proliferative zone and hypertrophic zone in epiphyseal plate were determined under image analytic system.

RESULTSWhen the concentration of XW630 in the medium was 1 x 10(-9) mol.L-1, the area of c-Myc positive cells increased in the proliferative zone compared with 1 x 10(-9) mol.L-1 in the estrone group, significant increase was also observed in the resting zone compared with the control group. When the concentration of XW630 in medium was 1 x 10(-8) or 1 x 10(-7) mol.L-1, stronger expression than that in the control group and the estrone group at the same concentration was observed in each of the three zones.

CONCLUSIONThe estrogenic effect of XW630 on bone was stronger than that of estrone. XW630 may promote proliferation and differentiation of chondroncytes by promoting c-Myc protein expression in chondroncytes. Thus, endochondral bone formation was enhanced.

Animals ; Chondrocytes ; metabolism ; Culture Techniques ; Estrone ; pharmacology ; Female ; Fetus ; Mice ; Piperazines ; pharmacology ; Pregnancy ; Proto-Oncogene Proteins c-myc ; metabolism ; Tetracyclines ; pharmacology ; Ulna ; drug effects ; metabolism ; Up-Regulation ; drug effects