Objective To observe the clinical efficacy of comprehensive acupuncture therapy in treating tinnitus in elderly neurosensory deafness. Method Eighty elderly neurosensory deafness patients were randomized into a treatment group and a control group, 40 cases in each group. The control group was intervened by oral administration of Mecobalamin tablets, and the treatment group was intervened by acupuncture plus acupoint injection plus auricular point sticking. The changes of tinnitus intensity after the treatment in the two groups were observed, the clinical efficacies were compared between the two groups, and the correlation between disease duration and therapeutic efficacy was also observed. Result The tinnitus degree was significantly changed after the treatment in both groups (P<0.01). The total effective rate was 83.3% in the treatment group, versus 57.1% in the control group. There was a significant difference in comparing the clinical efficacy between the two groups (P<0.05). In both groups, the clinical efficacy of the patients with a disease duration ≤3 years was significantly different from that of the patients with a disease duration > 3 years in the same groups (P <0.05). Conclusion Comprehensive acupuncture therapy is an effective method in improving tinnitus in elderly neurosensory deafness.

Objective:To investigate the relationship between clinical effects of acupuncture for elderly patients with sensorineural deafness and ear distending sensation.Methods:A total of 120 elderly patients with sensorineural deafness were randomly divided into a comprehensive treatment group,an acupuncture group and a Western medicine group,with 40 cases in each group.The acupuncture group received acupuncture treatment,the Western medicine group received oral mecobalamin tablets and the comprehensive treatment group received acupuncture plus acupoint injection and auricular acupoint sticking.The values of pure tone hearing threshold test of the three groups were observed before and after treatment,and the relationship between clinical effects and ear distending sensation was compared.Results:The total effective rate of the comprehensive treatment group was 82.5％ versus 67.0％ in the acupuncture group and 62.5％ in the Western medicine group.The inter-group comparisons showed statistically significant differences in the comprehensive treatment group versus the Western medicine group (P＜0.01) and the acupuncture group (P＜0.05).In the comprehensive treatment group,there were 23 cases (57.5％) with ear distending sensation,the clinical total effective rate was 86.9％;there were 17 cases (42.5％) without the sensation,the clinical total effective rate was 76.5％.In the acupuncture group,there were 24 cases (60.0％) with ear distending sensation,the clinical total effective rate was 71.0％;there were 16 cases (40.0％) without the sensation,the clinical total effective rate was 63.0％.In the Western medicine group,there were 21 cases (52.5％) with ear distending sensation,the clinical total effective rate was 66.7％;there were 19 cases (47.5％) without the sensation,the clinical total effective rate was 57.9％.The total effective rate of patients with ear distending sensation were higher than the rates of those without ear distending sensation in the three groups,but the differences were insignificant (all P＞0.05).Conclusion:The comprehensive therapy is one of the effective methods to treat elderly patients with sensorineural deafness.In the three groups of elderly patients with sensorineural deafness,the relief of ear distending sensation and the hearing loss were basically simultaneous,and the hearing recovery in the patients with ear distending sensation may be slightly better than that in those without ear distending sensation.Nevertheless,further research is needed.

Objective To investigate the effect of low molecular weight heparin combined with active immunization on patients with recurrent spontaneous abortion and its influences of hemodynamics.Methods A total of 92 cases of recurrent spontaneous abortion patients were randomly divided into treatment group (46 cases) and control group (46 cases).In control group,the lymphocytes of the patients' husbands were actively immunized.After pregnancy confirmed with blood β-human chorionic gonadotropin (β-HCG),the patients were administered of progesterone 40 mg,intramuscularly once a day until 14 weeks of gestation.The treatment group was treated with low molecular heparin calcium 5000 U,twice a day on the basis of control group until 24 h before termination of pregnancy.The clinical efficacy,the levels of β-HCG,progesterone and hemodynamics and the incidence of adverse drug reactions were observed before and after treatment.Results The clinical effective rate in treatment group was 95.65％ (44 cases/46 cases),had significant difference with that in control group,which was 76.09％ (35 cases/46 cases,P ＜0.05).After treatment,the levels of β-HCG in treatment group and control group were (6535.05 ± 54.34),(9845.50 ± 86.91) mU · mL-1,progesterone were (123.45 ±3.79),(93.24 ±5.18) nmol · L-1 (all P ＜0.05).After treatment,the blood viscosity,whole blood low shear viscosity and plasma viscosity in treatment group were (5.98 ± 0.52),(7.68 ± 0.51),(1.90 ± 0.34) mPa · s,had significant difference with those in control group,which were (7.78 ± 0.76),(9.18 ± 0.71),(2.30 ± 0.29) mPa · s (all P ＜ 0.05).In treatment group,there were 3 cases of erythema and itching in the injection site,2 cases of temporary vaginal bleeding,the incidence of adverse drug reactions was 10.87％ (5 cases/46 cases).There were 4 cases of erythema and itching in the injection site in control group,with incidence of 8.70％ (4cases/46 cases,P ＞ 0.05).Conclusion Low molecular weight heparin combined with active immunization has a significant effect on recurrent spontaneous abortion,and can improve the blood rheology.

OBJECTIVETo investigate the effect of the different immunosuppression therapy on CD4(+)Foxp3(+)regulatory T cells (CD4(+)Foxp3(+)Treg cells) in the peripheral blood monocytes of kidney transplantation recipients.

METHODSA Closed Cohort study was conducted in 50 primary living kidney transplant recipients between January 2006 and January 2008, who had been followed up for 1 year. The recipients divided into calcineurin inhibitors group (CNI + MMF + Pred) (19 recipients, including cyclosporin group 10 recipients and tacrolimus group 9 recipients), rapamycin group (RAPA + MMF + Pred) (31 recipients). Twenty end-stage renal disease patients were in control group. The frequency of CD4(+)Foxp3(+)Treg cells in total CD4(+)T cells was analyzed by flow cytometry in peripheral blood from three groups, results were compared.

RESULTSThe clinical variables of recipients such as age, sex, cold ischemia time, human leucocyte antigen mismatch, panel reaction antibody, rejection episode were no significant difference. The percentage of CD4(+)Foxp3(+)Treg cells in total CD4(+) cells was significantly higher in rapamycin group and end-stage renal disease group than calcineurin inhibitors group (P < 0.01). The level of CD4(+)Foxp3(+)Treg cells between cyclosporin group and tacrolimus group was no significant difference (P > 0.05).

CONCLUSIONThe level of CD4(+)Foxp3(+)Treg was significantly higher in patients receiving RAPA + MMF + Pred than the patients receiving CNI + MMF + Pred, which suggested that RAPA may be play a more important role in immune tolerance induction.

Adult ; Female ; Follow-Up Studies ; Forkhead Transcription Factors ; Humans ; Immunosuppression ; methods ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; immunology ; Male ; Middle Aged ; Sirolimus ; therapeutic use ; T-Lymphocytes, Regulatory ; drug effects ; immunology

Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with high local invasiveness. To date, there is no consensus on the imaging characteristics of NACC. To address this, we retrospectively reviewed 10 cases of NACC and summarized the magnetic resonance imaging (MRI) features. MR images of 10 patients with histologically validated NACC were reviewed by two experienced radiologists. The location, shape, margin, signal intensity, lesion texture, contrast enhancement patterns, local invasion, and cervical lymphadenopathy of all tumors were evaluated. Clinical and pathologic records were also reviewed. No patients were positive for antibodies against Epstein-Barr virus (EBV). The imaging patterns of primary tumors were classified into two types as determined by location, shape, and margin. Of all patients, 7 had tumors with a type 1 imaging pattern and 3 had tumors with a type 2 imaging pattern. The 4 tubular NACCs were all homogeneous tumors, whereas 3 (60%) of 5 cribriform NACCs and the sole solid NACC were heterogeneous tumors with separations or central necrosis on MR images. Five patients had perineural infiltration and intracranial involvement, and only 2 had cervical lymphadenopathy. Based on these results, we conclude that NACC is a local, aggressive neoplasm that is often negative for EBV infection and associated with a low incidence of cervical lymphadenopathy. Furthermore, MRI features of NACC vary in locations and histological subtypes.
Adult ; Aged ; Carcinoma, Adenoid Cystic ; diagnosis ; pathology ; surgery ; Female ; Humans ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies

Objective:To explore the risk factors of paralytic ileus (PI) after simultaneous pancreas-kidney (SPK) transplantation.Methods:From January 2017 to December 2019, clinical data were reviewed retrospectively for 115 cases of SPK transplantation. The risk factors of PI after SPK were analyzed. According to the occurrence of PI, they were divided into two groups of occurrence and non-occurrence. One-way analysis of variance was utilized for analyzing such influencing factors as gender, age, body mass index (BMI), diabetic type, duration of diabetes, mode of dialysis, duration of dialysis, diabetic gastroenterology, history of open surgery, bowel preparation, operative duration, hemorrhagic volume, immunosuppressant and hypoproteinemia. Multivariate Logistic regression analysis was performed for screening the suspected risk factors.Results:Among them, 19 patients (16.5%) had PI. Univariate analysis showed that PI was associated with diabetic gastroenterology, operative duration, history of open surgery, no bowel preparation and hypoproteinemia ( P<0.05). Multivariate Logistic regression analysis revealed that the risk factors of PI after SPK included diabetic gastroenterology, operative duration time, history of open surgery and no bowel preparation ( P<0.05). Conclusions:Diabetic gastroenterology, operative duration, history of open surgery and no bowel preparation are risk factors for PI after SPK. Clinical interventions for the above factors are necessary.

OBJECTIVEA retrospective analysis of 160 pre-menopausal breast cancer patients was carried out to elucidate the the menstrual outcome in those cases who had undergone adjuvant chemotherapy after surgery, and evaluate the relationship between chemotherapy-induced amenorrhea (CIA) and recurrence of the disease.

METHODS160 pre-menopausal breast cancer patients were collected, 62/159 (39.0%) of them were node positive, 91/158 (57.6%) were ER positive, and 95/155 (61.3%) were PR positive. 111 cases had infiltrative ductal carcinoma, 26 cases had infiltrative lobular carcinoma, and 22 cases with others. In 152 cases data were collected by face-to-face interview and 8 cases by phone conversation. Types and cycles of chemotherapy regimen as well as menstrual abnormalities were recorded before, during, and after chemotherapy completion. Follow up duration was 12-72 months after chemotherapy completion for all patients.

RESULTS107 (66.9%) developed CIA, 24 cases returned to normal menses (22.4%), 83 cases continued CIA during more than 12-month follow up (77.6%). The rate of CIA increased with age (P < 0.01). During the follow up, disease free survival (DFS) rate was 85.9% in CIA group and 79.2% in non-CIA group, with no statistically significant difference. But in hormonal receptor positive patients, DFS was 80.0% in non-CIA and 90.1% in CIA, respectively (P = 0.04), showing a significant difference. Because of the small number of died cases, no analysis of the overall outcome was carried out.

CONCLUSIONAdjuvant chemotherapy causes ovarian function suppression, and may further leading to amenorrhoea. Women who experienced amenorrhoea after chemotherapy had a significantly better disease-free survival (DFS) rate showed by univariate analysis than women who continued normal menstruation. Chemotherapy is insufficient therapy for very young patients who are in high risk with hormone responsive disease, particularly when chemotherapy fails to induce amenorrhea. Further research is needed to evaluate interventional chemotherapy to improve the quality of life in women with early stage breast cancer who experienced ovarian toxicity. The post-chemotherapy menstruation status is a clinically valuable, objective and salient marker for sufficient endocrine effect of chemotherapy in ER/PR-positive premenopausal patients.

Adult ; Age Factors ; Amenorrhea ; blood ; chemically induced ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Breast Neoplasms ; drug therapy ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; surgery ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Follow-Up Studies ; Humans ; Middle Aged ; Premenopause ; Retrospective Studies

Objective To explore the association between quality of sleep and quality of life among residents of Suzhou city.Methods A total of 3225 residents at the age of 18-55 years old in Suzhou city were selected through a clustered sampling method.All the participants were comprehensively evaluated on their quality of sleep by Pittsburgh Sleep Quality Index (PSQI) and on their quality of life (QOL) by SF-36 quality of life scale.Partial canonical correlation analysis was performed.Results Negative relationships were noticed between all the dimensions of sleep quality white all the QOL domains remained significant when the confounding effect of age,gender,marital status,occupation and cultural level were adjusted.The first pair of canonical correlation variances showed statistically significant differences,with 0.7978 of canonical correlation coefficient,1.7505 of eigenvalue,and 92.43％ of proportion.Data on daytime dysfunction,sleep disturbances and subjective sleep quality were inversely associated with factors as vitality,general health perceptions and mental health,respectively,after controlling for covariates.The inverse relationship between the quality of sleep and the quality of life mainly manifested the following aspects:the association between the status of daytime dysfunction,sleep disturbances,subjective quality of sleep and vitality,general health perceptions and mental health.Conclusion Quality of sleep had influenced the quality of life,overall health and mental health.Daytime dysfunction,sleep disturbances and subjective sleep quality seemed the main factors in Suzhou city.Intervention programs related to improving the sleep need to be popularized among the residents,so as to make the quality of life better.

Objective To explore the relationship between the concentration of serum magnesium and the short-term outcome of patients with acute ischemic stroke,in order to provide evidence for improving the outcomes.Methods Patients with acute ischemic stroke under study,were from four hospitals in Shandong province.Data on demographic characteristics,life style related risk factors,history of cardiovascular disease,blood pressure at admission and other clinical characteristics were collected for all the participants.The outcomes were defined as National Institutes of Health Stroke Scale (NIHSS) ≥ 10 or death.According to NIHSS,the subjects were divided into two groups:death/NIHSS≥ 10 and NIHSS＜ 10.Concentrations of Mg2+ were categorized into four levels according to the quartiles of serum magnesium.Cox proportion hazard regression analysis was used to evaluate the association between serum magnesium concentrations and the short-term outcome of acute ischemic stroke.Results In the death/NIHSS≥10 group,concentrations of serum magnesium and the time from onset to admission were lower than that in the NIHSS＜ 10 group while the systolic blood pressure on admission,the proportion of low density lipoprotein abnormal,impaired fasting glucose and history of auricular fibrillation were all higher than that in the NIHSS＜ 10 group.Without the adjustment of multiple factors,when comparing to the lowest quartile of serum magnesium level,the fourth quartile (highest) seemed to have had a tendency of reducing the risk of death/NIHSS ≥ 10 (RR=0.47,P＜ 0.05).When multiple factors were adjusted (adjust serum calcium,potassium level and other factors),the fourth and the third quartiles could both reduce the risk of death/ NIHSS≥10 (RR values were 0.39 and 0.54,P＜0.05,respectively).With or without the adjustment of multiple factors,there appeared a dose-response relationship between serum magnesium concentrations and the risk to death/ NIHSS≥10 (trend P＜0.05).Conclusion Higher serum magnesium concentrations could reduce the risk to death/NIHSS ≥ 10,suggesting that there was a dose-response relationship between magnesium and the risk to death/NIHSS ≥ 10.

BACKGROUNDHuman epidermal growth factor 2 (HER2) is one of the most important prediction factors, but only 25% - 30% of breast cancer patients HER2 are positive. It is unknown whether there are other molecular markers that could be used to predict prognosis and recurrence in HER2 negative patients. This study investigated correlations of cyclin A2 and HER2 levels with clinical outcomes in 281 patients with invasive breast cancer in order to identify whether cyclin A2 can serve as a prognostic factor in HER2 negative patients.

METHODSImmunohistochemical staining was used to detect cyclin A2 and HER2 expression in 281 patients. Cyclin A2 and HER2 gene amplifications were analyzed using gene analysis and RT-PCR in 12 patients. Risk and survival estimates were analyzed using Log-rank, Kaplan-Meier, and Cox regression analysis; cyclin A2 and HER2 consistency with survival were analyzed using Kappa analysis.

RESULTSPatients with higher cyclin A2 and HER2 expressions had significantly shorter disease-free survival periods (P = 0.047 and P = 0.05, respectively). Kappa analysis performed that cyclin A2 and HER2 showed a low Kappa index (kappa = 0.37), allowing us to conclude that cyclin A2 and HER2 detect different pathologies. Gene analysis and RT-PCR showed that cyclin A2 was upregulated in patients with early relapse; the average increase was 3.69 - 2.74 fold.

CONCLUSIONSCyclin A2 and HER2 are associated with proliferation and high recurrence, particularly when combined. Cyclin A2 is easily detected by nuclear staining and might be a useful biomarker for recurrence risk in HER2 negative patients.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; genetics ; metabolism ; Cyclin A2 ; genetics ; metabolism ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Multivariate Analysis ; Receptor, ErbB-2 ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction