Antigens, CD ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Killer Cells, Natural ; pathology ; Leg ; Lymphoma, T-Cell, Cutaneous ; immunology ; pathology ; Middle Aged ; Skin Neoplasms ; immunology ; pathology

Objective To compare the efficacy and cost of surgical clipping and endovascular embolization in the treatment of anterior and posterior communicating artery aneurysm and to conduct cost-effectiveness analysis. Methods The data of treatment outcomes and costs in patients with anterior or posterior communicating artery aneurysms admitted to Huashan hospital from 2002 to 2006 were analyzed using a retrospective cohort study. Results A total of 302 patients were included in the study. They were divided into surgical clipping group (n = 150; 65 males, age [48. 11 ±9. 94] years), interventional treatment group (n = 152;75 males, age [52. 56 ± 11. 09] year). The age of the former was lower than that of the latter (t = -3. 670, P =0. 000). There was no significant difference in preoperative clinical conditions (such as location of aneurysms and Hunt-Hess grade) between the two groups. The good outcome rate in the interventional treatment group was significantly higher than that in the surgical clipping group (84. 87% vs. 74. 67%, χ2 = 4. 875, P = 0. 027). There was no significant difference in hospital mortality (5. 33% vs. 3. 94%,χ2 =0. 328, P =0. 567) and complication rate (26.67% vs. 19. 74% , χ2 =2.036, P =0.154) between the surgical clipping group and the interventional treatment group, but the intraoperative aneurysm rupture (10. 67% vs. 3. 95%, χ2 =5.047, P =0.028) and the incidence of postoperative intracranial infection (6/144 vs. 0/152, χ2 = 6.203, P =0.014) in the surgical clipping group were higher than those in the interventional treatment group. The length of hospital stay in the interventional treatment group was significantly shorter than that in the surgical clipping group ([10. 0 ± 7. 0] dvs. [23.0 ± 11. 0] d, Z = -10. 35, P ＜0.001). The median cost of treatment was 95 327.63 %,yuan in the interventional treatment group, and the interquartile range (IQR) was 26 312. 98 yuan; it was significantly higher than the surgical clipping group (median 30 072. 01 yuan, IQR 11 178. 54 yuan) (Z = -14.449, P＜0.001). Compared with the surgical clipping group, while the mRS score improved in the interventional treatment group 0. 10, the cost was about 66 438 yuan, so that the surgical clipping was more cost-effective. Conclusions The efficacy of the intervention treatment of anterior and posterior communicating artery aneurysms is better than that of the surgical clipping The mortality and total complication rate are almost the same with the surgical clipping Thehospital stay is shorter, but the cost of treatment is higher. From an economic point of view, the surgical clipping is more cost-effective.

Given the myriad of choices available on the market, selecting the appropriate wound dressing remains a challenge for most healthcare workers. It is important to exercise discretion and adopt a systematic approach in dressing selection following wound assessment, as this will directly impact on rates of wound healing, which in turns affects the patient’s quality of life and overall healthcare costs. This paper provides an overview of the common types of wound dressings in use currently and gives a brief synopsis of some of the latest advances in wound care technology and their applications in management of complex wounds. The consensus to date is for the use of hydrogels in the debridement stage, foams and low-adherence dressings in the granulation stage and hydrocolloids and low-adherence dressings for the epithelialization stage. Additional studies and research need to be undertaken to further evaluate the application of advanced wound technology in clinical practice.

Accommodation of the human eye ian extremely complex and dynamiprocess,which iaccomplished by the interaction between the central nervousystem and variouoculastructurethaare relevanto accommodation.Varioumechanismof accommodation have been puforward since the beginning of the 19th century,among which Helmhohz'theory ithe mosfamous.However,iistill challenged by othetheories.So far,the mechanism of accommodation hanobeen fully understood.The mosdirecmethod to study accommodation ito observe changein the biometry of the oculastructureduring accommodation,which ialso the mosobjective interpretation of accommodative mechanisms.The rapid developmenof imaging technologiein regardto ophthalmology makethipossible.Thiarticle aimto describe the use of variouimaging technologiein oculaaccommodative studiein vivo from the perspective of morphology.

Objective To explore the effect of community comprehensive rehabilitation on quality of life in patients with stroke sequelae under the family medical service mode. Methods From October, 2013 to October, 2014, 51 patients with stroke sequelae received compre-hensive rehabilitation intervention for three months, including rehabilitation training, rehabilitation guidance, health education and psycho-logical counseling. They were assessed with modified Barthel index (MBI), WHO-Disability Assessment Schedule (WHO-DASⅡ), Short Form 36 Health Survey Questionnaire (SF-36), Brain Injury Community Rehabilitation Outcome Scales (BICRO-39), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) before and after intervention. Results The scores of physical functionning, role physical, general health, mental health, social functioning and the total score in SF-36 increased after intervention (t>2.072, P<0.05). The scores of so-cial contact, locomotivity, self handling transaction ability and the total score in BICRO-39 decreased after intervention (t>2.434, P<0.05), as well as the scores of getting along with people, housework and society and participation in WHO-DAS II (t>2.507, P<0.05). Conclusion In the community health service, comprehensive rehabilitation guided by multidisciplinary rehabilitation team can facilitate to improve the quality of life in patients with stroke sequela.

Objective To investigate the correlation between spot albuminuria to creatinine ratio (ACR) and 24 h urinary protein excretion in women with preeclampsia and determine the optimal cut-off values of spot ACR in mild preeclampsia and severe preeclampsia.Methods Twenty-eight women with mild preeclampsia and 22 with severe preeclampsia at Nanfang Hospital,Southern Medical University between October 2010 and June 2011 were recruited.Maternal serum cystatin,uric acid,mea nitrogen,creatinine and albumin levels were collected and analyzed.Twenty-four hours urinary protein excretion was measured with immunoturbidimetric assay and ACR with automatic analyzer DCA2000.The correlation between ACR and 24 hours urinary protein excretion was explored.And the optimal cut-off values of the spot ACR for mild and severe preeclampsia were determined with receiver operating characteristic curve.Results ( 1 )Maternal serum biochemical parameters:uric acid levels in mild and severe preeclampsia were (359 ± 114)μmol/L and (450 ± 132) μmol/L,while cystatin levels were ( 1.3 ±0.3) mg/L and ( 1.6 ±0.5) mg/L respectively.The differences were statistically significant ( P ＜ 0.05 ).Serum urea nitrogen,creatinine and albumin in mild preeclampsia were(3.6 ± 1.6) mmol/L,(52 ± 38 ) μmol/L and ( 33 ± 3 ) g/L,while in severe preeclampsia were( 6.2 ± 3.1 ) mmol/L,( 78 ± 59 ) μmol/L and ( 29 ± 6 ) g/L respectively.There were no statistical significant differences ( P ＞ 0.05 ).(2) Twenty-four hours urinary protein excretion and ACR:24 hours urinary protein levels in mild and severe preeclampsia was (700 ± 160) mg and (4800 ±2200) mg (P＜0.05).ACR in mild and severe preeclampsia was (72.7 ± 12.4) mg/mmol and (401 ±245) mg/mmol respectively (P ＜ 0.05 ).(3) There was a strong correlation between the spot ACR and 24hours urine protein excretion ( r =0.938 ; P ＜ 0.05 ).( 4 ) The optimal spot ACR cut-off point for the diagnosis of preeclampsia:the optimal spot ACR cut-off point was 22.8 mg/mmol for 300 mg/24 hours of protein excretion in mild preeclampsia,the area under curve was 0.956,with a sensitivity,specificity of 82.4％,99.4％ respectively.And the optimal spot ACR cut-off point was 155.6 mol for 2000 mg/24 hours of protein excretion in severe preeclampsia,the area under curve was 0.956,with a sensitivity,specificity of 88.6％,91.3％ respectively.Conclusions Compared with 24 hours urinary protein excretion,the spot ACR may be a simple,convenient and accurate indicator of early diagnosis of preeclampsia.Spot ACR may be used as a replacement for 24 hours urine protein excretion in assessment of preeclampsia.The optimal spot ACR cut off points were 22.8 mg/mmol for mild preeclampsia and 155.6 mg/mmol for severe preeclampsia.

Erythrocytes ; metabolism ; Fatty Liver ; blood ; Female ; Hepatitis ; blood ; Humans ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Male ; Middle Aged ; Receptors, Complement 3b ; blood ; Thymosin ; therapeutic use ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo explore the intervention of Huayu Qutan Recipe (HQR) on liver SREBP-2 signal pathway of hyperlipidemia rats of Pi deficiency syndrome (PDS).

METHODSTotally 100 SPF grade SD rats were randomly divided into the blank control group, the hyperlipidemia group, the hyperlipidemia treatment group, the PDS hyperlipidemia group, and the PDS hyperlipidemia treatment group, 20 in each group. Common granular forage was fed to rats in the blank control group. High fat forage was fed to rats in the hyperlipidemia group and the hyperlipidemia treatment group. Rats in the PDS hyperlipidemia group and the PDS hyperlipidemia treatment group were treated with excessive labor and improper diet for modeling. They were administered refined lard by gastrogavage (3 mL each time, twice per day) and fed with high fat forage on the odd days, and fed with wild cabbage freely on even days. The modeling lasted for 30 days. Rats in the hyperlipidemia treatment group and PDS hyperlipidemia treatment group were administered with Huayu Qutan Recipe (20 mL/kg) by gastrogavage, once a day, for 30 successive days. Levels of serum cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and serum amylase (AMY) were detected by automatic biochemical analyzer. D-xylose excretion rate was determined using phloroglucinol method. Morphological changes of liver and the lipid deposition in liver were observed using HE stain and oil red O stain respectively, mRNA and protein expression levels of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), cholesterol 7α-hydroxylase 1 (CYP7A1), LDL-R, and sterol regulatory element binding protein-2 (SREBP-2) were detected using real time RT-PCR and Western blotting.

RESULTSCompared with the blank control group, serum levels of TC (1.84 ± 0.19 mmol/L, 2.23 ± 0.43 mmol/L) and LDL-C (0.99 ± 0.24 mmol/L, 1.13 ± 0.56 mmol/L) were higher in the hyperlipidemia group and the PDS hyperlipidemia group, serum levels of HDL-C (0.41 ± 0.66 mmol/L, 0.41 ± 0.11 mmol/L) and AMY activities (351 ± 45 mmol/L, 153 ± 30 mmol/L) were lower, and urinary D-xylose excretion rates were lower (26.9 ± 2.1 ng/mL, 15.0 ± 1.7 ng/mL) (all P < 0.05). Lipid deposition occurred in liver cells. Much fat vacuoles occurred in the cytoplasm. Expression levels of HMGCR, CYP7A1, LDL-R, and SREBP-2 mRNA and proteins in liver significantly decreased (P < 0.01). Compared with the hyperlipidemia group, serum levels of TC and LDL-C significantly increased (P < 0. 05), AMY activities and urinary D-xylose excre- tion rates significantly decreased in the PDS hyperlipidemia group (P < 0.01). A large amount of lipid deposition occurred in liver. The atrophy of liver cells was obviously seen. Expression levels of CYP7A1, LDL-R, and SREBP-2 mRNA and proteins in liver were significantly lower (P < 0.01, P < 0.05). Serum levels of TC and LDL-C significantly decreased (P < 0.05), AMY activities and urinary D-xylose excretion rates significantly increased in the hyperlipidemia treatment group (P < 0.01). Expression levels of CYP7A1, LDL-R, and SREBP-2 mRNA and proteins in liver were significantly increased (P < 0.01, P < 0.05). Compared with the PDS hyperlipidemia group, serum level of TC significantly decreased (P < 0.05), HDL-C levels, AMY activities and urinary D-xylose excretion rates significantly increased in the PDS hyperlipidemia treatment group (P < 0.01),expression levels of CYP7A1, LDL-R, and SREBP-2 mRNA and proteins in liver were significantly increased (P < 0.01). Similar changes occurred in the two treatment groups.

CONCLUSIONSPi deficiency exacerbates abnormal serum TC level and the lipid deposition in liver. These might be related to regulating expression levels of LDL-R, HMGCR, and CYP7A1 genes in the SREBP-2 signal pathway. HQR could regulate this pathway to intervene abnormal metabolism of TC.

Animals ; Cholesterol, HDL ; Cholesterol, LDL ; Drugs, Chinese Herbal ; therapeutic use ; Hyperlipidemias ; drug therapy ; Liver ; Male ; Medicine, Chinese Traditional ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Sterol Regulatory Element Binding Protein 2 ; metabolism ; Triglycerides

Objective To study the relationship of early postoperative CRP and PCT with pancreatic fistula after pancreaticoduodenectomy (PD);to study whether the combination of CRP and PCT can be used as an early predictor of pancreatic fistula;and to determine the optimal cut-off values of CRP and PCT for early diagnosis of pancreatic fistula after PD.Methods Postoperative pancreatic fistula and other complications were recorded in 82 patients after PD carried out at the Anshan Iron and Steel Group General Hospital from January 2013 to May 2017.PCT and CRP were measured on the 1st to the 5th postoperative day (POD).CRP and PCT were compared between the pancreatic fistula group and the non-complication group on pancreatic fistula prediction.The sensitivity,specificity,and combined sensitivity,combined specificity,negative predictive value,positive predictive value and optimal cut-off value were calculated.Results 56 patients developed postoperative complications,including 17 patients with pancreatic fistula,and 39 patients with non-pancreatic fistula.The postoperative CRP and PCT were correlated with postoperative pancreatic fistula and with other complications.The higher the CRP and PCT,the higher the risk of postoperative pancreatic fistula.The ROC curves suggested that CRP and PCT had a high predictive value for pancreatic fistula,especially on POD 2.The optimal cut-off value of CRP was 189.05 mg/L,the sensitivity was 94.1％,the specificity was 81.5％,the positive predictive value was 94.7％,and the negative predictive value was 24.4％.The optimal cut-off value of PCT was 0.89 mg/dl,the sensitivity was 88.2％,the specificity was 84.6％,the positive predictive value was 91.3％,and the negative predictive value was 20.5％.The sensitivity and specificity of combined CRP with PCT on POD 2 in predicting pancreatic fistula after operations were 100％ and 69.1％,respectively.Conclusion Combined CRP and PCT had a high early predictive rate in the identification of pancreatic fistula after PD.