Animals ; Blood Gas Analysis ; Brain Ischemia ; complications ; metabolism ; physiopathology ; Lung Injury ; etiology ; metabolism ; physiopathology ; Male ; Pyrazines ; pharmacology ; Rats ; Rats, Wistar ; Reperfusion Injury ; complications ; metabolism ; physiopathology

OBJECTIVE: To systematically evaluate the economics of saxagliptin for treatment of type 2 diabetes mellitus. METHODS: PubMed, Embase, Cochrane Library, NHS EED, CNKI, Wanfang and CBM were systematically searched. Literatures were screened according to pre-defined inclusion criteria. The quality of included studies were evaluated by CHEERS statement and the economic results were systematically analyzed. RESULTS: Eight cost-effectiveness analyses were included, one of which was conducted in China. Patients among the studies all had blood glucose non-adeguately controlled by monotherapy. When added on to metformin, saxagliptin was cost-effective compared with sulfonylureas (glipizide and glimepiride) and thiazolidinediones (pioglitazone and rosiglitazone). When added on to metformin or sulfonylureas, saxagliptin was cost-effective compared with NPH insulin. CONCLUSION: Saxagliptin represents a cost-effective option in treatment of type 2 diabetes mellitus patients with non-adequately controlled blood glucose after monotherapy.

Objective To explore the effects of L-carnitine on the plasma lipid profile and liver function in elderly patients receiving total parenteral nutrition after abdominal operations.Methods In this prospective blinded randomized controlled trial,24 eligible elderly patients were given 6-day total parenteral nutrition.They were further equally divided into L-carnitine group(administered with L-carnitine 50 mg/kg)and control group(without L-carnitine).The changes of lipid profile and liver function and the clinical outcomes were recorded and compared.Results The plasma triglyeride levels were lower in L-carnitine group than in control group on the 4th and 7th post-operative day,but there were not significant difference(P>0.05);There was a significant difference between the two groups in the change of the 4th post-operative day and pre-operative day(P<0.05).However,the liver function indicators were not significantly different between these two groups.Conclusion Administration of L-carnitine during total parenteral nutrition can improve the triglyeride metabolism in elderly patients after abdominal operations and may benefit the recovery of liver function.

Objective To evaluate the postoperative pain induced by various therapeutic catheters after abdominal surgery.Methods A prospective study was conducted in patients selected based on the inclusion criteria.The general condition of the patients was recorded,and nutritional risk screening was performed.The indwelling of therapeutic catheters after abdominal surgery were recorded,including urinary catheter,nasogastric tube,peritoneal drainage tube,common bile duct drainage tube,wound drainage tube,central venous catheter and peripherally inserted central catheter.The pain caused by each type of catheters was evaluated using visual analog scale at 24,48 and 72 hours after tube/catheter insertion.Results A total of 157 patients were selected,including 70 males and 87 females,aged (60.5 ± 12.5) years,with a body mass index of (23.8 ± 3.2) kg/m2,and a total nutritional risk rate of 42％.According to visual analog scale scores,the degrees of pain due to the therapeutic catheters,in descending order,were as follows:4.9 ± 1.7 for nasogastric tube,3.6 ± 0.9 for wound drainage tube,3.0 ±0.9 for urinary catheter,2.6 ±0.9 for central venous catheter,2.4 ± 1.0 for peritoneal drainage tube,1.9 ± 0.7 for common bile duct drainage tube,and 1.8 ± 0.8 for peripherally inserted central catheter.The catheter-induced pain accounted for (44.9 ± 14.1)％ of the total pain during the hospital stay.Conclusions Nasogastric tube,wound drainage tube and urinary catheter can increase the pain of patients.It is therefore recommended to remove the indwelling tubes as early as possible if only the removal does not harm the outcome of the patient.

Objective To explore the factors related to the severity of disease symptoms in patients with acute leukemia (AL). Methods 198 AL patients with symptoms of disease (anemia, bleeding, infection, fever, etc.) from September 2013 to July 2016, were evaluated by the questionnaires of self-rating anxiety scale (SAS), self-rating depression scale (SDS), eysenck personality questionnaire (EPQA), Toronto alexithymia scale (TAS), family environment scale (FES), self-rating scale of illness conception and health seeking behavior (ICHSB). The results were compared with 198 healthy volunteers. Results The scores of SDS, SAS, factorⅠin FES, factor Ⅲ in FES, factor Ⅳ in FES, nervous and the total scores of EPQA, factor Ⅱ in TAS, factor Ⅱ in ICHSB were significantly higher in AL patients than those in healthy subjects [(41.09 ±6.85) scores vs. (36.74±6.99) scores, t=2.150, P=0.031; (38.64±7.51) scores vs. (31.79±7.57) scores, t= 3.327,P=0.001;(2.38±1.54) scores vs. (5.18±1.33) scores, t=3.319, P=0.001;(3.31±1.82) scores vs. (2.23±1.99) scores, t= 3.325, P= 0.001; (2.41±1.62) scores vs. (5.75±1.51) scores, t= 3.332, P= 0.001; (14.14±5.37) scores vs. (11.01±5.51) scores, t= 5.179, P= 0.000; (42.97±7.10) scores vs. (40.41±6.51) scores, t= 2.930, P=0.004;(22.97±4.57) scores vs. (21.54±4.13) scores, t=2.926, P=0.004; (16.37±3.89) scores vs. (15.92± 3.93) scores, t= 2.104, P= 0.034]. The difference was statistically significant (P< 0.05). The risk factors of AL were SAS (95 %CI= 1.064-1.210, P= 0.001), factor Ⅲ in FES (95 %CI= 1.104-1.694, P= 0.004), age (95 %CI= 1.027-1.094, P= 0.001), factor Ⅱ in TAS (95 %CI= 1.046-1.352, P= 0.005), besides, education level (95 %CI= 0.708-0.866, P= 0.001) acted as the protective role. Conclusions AL patients tend to the psychological problems such as depression, anxiety. Those will show much severer symptoms as a consequence of lacking of family warmth and concern, low expression of emotion, lacking of organization, low economic capacity, tension, and lacking of the ability to distinguish between emotion and physical feelings.

Objective To investigate the clinical features and TCD-detected microembolic signals in patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, and to explore the possi?ble underlying mechanisms. Methods A retrospective review was conducted on all clinical, laboratory, radiological and TCD monitoring records from patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, who admitted to the neurology department in our hospital. Results The data from twenty-two cases were finally included in this study. All patients presented with acute-onset localized neurological dysfunction, e.g. hemi?paresis, aphasia, hemiparesthesia, dysarthria, hemianopsia and cortical blindness. Their hypercoagulability related diseas?es included 10 cases of systemic malignancy, 5 moderate to severe hyperhomocystynemia (HCY>50μmol/L), 2 nephrot?ic syndrome, 2 antiphospholipid syndrome, 1 ulcerative colitis, 1 polycythemia vera,1 paroxysmal nocturnal hemoglobin?uria. In 18 cases, the hypercoagulability related diseases were diagnosed after their initial stroke onset. DWI showed mul?tiple disseminated acute cerebral infarcts in non-single arterial territories involving bilateral anterior or anterior plus pos?terior cerebral circulation simultaneously. Foci involved lobar cortex/subcortex of cerebral hemisphere in 22 cases, deep cerebral hemisphere in 12 cases, cerebellum foci in 10 cases,brainstem foci in 2 cases. TCD revealed microembolic sig? nals in ten of 22 patients monitored. Conclusions Patients with multiple acute cerebral infarcts involving non-single arte?rial territories, should be screened for hypercoagulability as in that hypercoagulability and microembolism might be in?volved in the etiology of cerebral infarction.

Objective To characterize the clinical manifestations, laboratory findings of patients with occult sys?temic malignant neoplasms, whose initial manifestation presented as multiple acute cerebral infarcts including coagula?tion function,radiological imaging and microembolic signals (MES) detection by transcranial Doppler sonography (TCD) and to explore the possible underlying mechanisms. Methods All clinical records, laboratory hematological tests includ?ing hypercoagulable states measured by D-dimer levels, brain MRI including DWI, and TCD monitoring MES, the treat?ment and prognosis were retrospectively reviewed in 12 patients with multiple acute cerebral infarcts as the first manifes?tation of occult systemic malignancy. Results The clinical manifestations presented as localized neurological dysfunction, e.g. hemiparesis, aphasia, hemiparesthesia, dysarthria, vertigo and seizures, etc. DWI revealed multiple disseminated acute cerebral infarcts in multiple arterial territories such as the bilateral anterior or anterior plus posterior cerebral circu?lation in all patients. Eleven of 12 patients tested had elevated D-dimer. TCD detected MES in 5 of 7 patients. There were 12 patients diagnosed with occult systemic malignancy including 5 lung cancer, 3 pancreatic cancer, 1 gastric can?cer, 1 colon cancer, 1 endometrial adenocarcinoma and 1 metastatic poorly differentiated mucinous adenocarcinoma with unknown primary. Ten patients already had remote metastasis at diagnosis. The prognosis was usually poor and there were 7 cases with ischemic stroke recurrence, 4 cases with acute myocardial infarction, 3 cases died during hospitaliza?tion. Conclusions When patients present with multiple disseminated acute cerebral infarcts involving multiple arterial territories as initial manifestation, the underlying occult systemic malignancy should be considered. Hypercoagulopathy and MES might provide the clues to the diagnosis.

Objective To evaluate the association between vancomycin trough concentrations and incidence of nephrotoxicity . Methods Pubmed, EMbase, Cochrane Library, China National Knowledge Infra-structure ( CNKI ) , WanFang Data and Chinese Bio Medical Literature Database ( CBM) were systematically searched from inception to February 2014.Specificity, sensitivity and predictive odds ratios with 95% confi-dence intervals were calculated.Results Seventeen observational stu-dies and 2802 patients were included in the Meta-analysis.While cut-offs of trough concentrations were 10 , 15 or 20 mg? L-1 , pooled sensi-tivity were 0.83, 0.69 or 0.43, pooled specificity were 0.35, 0.61 or 0.83 , pooled predictive odds ratios were 2.65 , 3.60 or 3.85. Conclusion There is definitive association between vancomycin trough concentrations ( ascending from 10 to 20 mg? L-1 ) and incidence of nephrotoxicity.Trough concentration is an appropriate parameter of thera-peutic drug monitoring of vancomycin.

Objective To assess the laparoscopic technique combined with open surgical technique in pyeloplasty.Methods Overall,45 patients with ureteropelvic junction obstruction underwent laparo- scopic dissection of the renal pelvis and upper ureter transperitoneally,and pyeloplasty was performed through a expanded trocar-incision(extension of 1-2 cm)as open surgery was performed.Results The opera- tion was successful in all 45 patients.The mean operative time was 58 min(range,40-85 min),and the mean blood loss was 22 ml(range,15-30 ml).No complication was observed during and after operation. Follow-up for 3-36 months was available in 34 patients.Intravenous urography(IVU)showed no obstruc- tion of the anastomotic stoma,and B-ultrasound indicated relief of hydronephrosis.Conclusions Laparo- scopic approach combined with open surgery in pyeloplasty is an effective way to treat ureteropelvic junction obstruction.This technique can simplify the operative manipulation and shorten the operative time without more trauma to the patients.It is worth general application in clinical practice.

The present paper is to investigate the relationship between height and stress-bearing area of mandibular alveolar ridge, their influence on retention of complete denture, and the effectiveness of denture adhesive (DA). Five mandibular edentulous models of different heights and a rabbit palate model were prepared in Die-Stone. Measurements were made on the heights and stress-bearing areas of mandibular alveolar ridge, the retention force of mandibular models 15 min after DA administration, and the retention force on the rabbit palate before and after adhering. All available data were analyzed statistically. Linear regression relationship was demonstrated between ridge height and bearing area, ridge height and retention force, and bearing area and retention force (P<0.01), separately. Retention force per unit area was positively related to the height and area. Retention force increased to 2.87 times postadhesive-treating. Height and stress-bearing area of mandibular alveolar ridge directly correlate with the retention of complete denture, and DA significantly improves the retention ability of complete denture.
Alveolar Process ; anatomy & histology ; Animals ; Dental Cements ; chemistry ; Denture Retention ; Denture, Complete ; Humans ; Jaw, Edentulous ; Mandible ; Rabbits