Objective To explore influence of valsartan on MAU of patients with DN at early stage.Methods 163 patients with DN at early stage were randomly divided into experimental group and control group.Two groups were given routine therapy, and experimental group were added the therapy of valsartan.Period of treatment was 24 weeks, and compared the UAER, Cr, BUN of two groups.Results After treatment of 24 weeks, UAER, Cr, BUN of experimental groups was (142.4 ± 15.6) μg/min, ( 68.7 ±9.4) μmol/L, (3.5 ± 1.2 ) mmol/L, compared with (195.8±23.7)(μg/min,(93.8 ± 13.6) μmol/L, (6.3 ±1.5) mmol/L before treatment, had significant difference (t = 13.675,11.287,2.469,all P<0.05).Compared with( 199.6 ±24.7)μg/min,(87.7 ±11.3)μmol/L、(6.2 ± 1.3)mmol/L of control group after treatment, declined more significantly (t = 13.246,10.312,2.518,all P<0.05).There was no serious complications occurred in two groups.Conclusion Valsartan used in patients with DN at early stage,can significantly improve the function of kidney and enhance clinical effect,decline the side reaction.

BACKGROUND: Bronchial asthma is one of those diseases that are significantly affected by meteorological factors. There is close relationship between asthma attack and meteorological factor. There have been some studies on the relationship between asthma and meteorological factors at home and abroad, but the results are various due to different area conditions.OBJECTIVE: To analyze the relationship between asthmatic attack and meteorological factors in children in Qingdao city.DESIGN: Observational experiment.SETTING: The Affiliated Hospital of Qingdao University Medical College.PARTICIPANTS: Altogether 445 inpatient children, 307 males, 138 females, aged ＜ 14 years, who were diagnosed of asthma attack definitely, of the Affiliated Hospital of Qingdao University Medical University, Qingdao Haici Hospital,Qingdao Children Hospital between January 1st 2000 and December 31st 2004 were retrieved.METHODS: The asthmatic attack time of 445 children patients with asthmatic attack of Qingdao city and concurrent month mean temperature, air pressure, relative humidity, wind speed and other meteorologic al data were collected.Seasonal rhythm of asthmatic attack in children and the relationship between asthmatic attack and meteorological factors were analyzed with circular distribution analysis and linear regression analysis, respectively.MAIN OUTCOME MEASURES: ①Month attack information of 445 asthma patients. ② Circular distribution analysis results of asthmatic attack time. ③ Linear regression analysis results about the relationship between asthma attack and meteorological factors.RESULTS: ① Data revealed that asthmatic attack in Qingdao city focused on November, December, January and February, which took up 47.9% of total amount in that year. There were 307 male patients (incidence 3.12%)in a year,female patients only 138 cases (incidence 1.51%), which revealed that boys have a higher incidence of asthma attack than girls. ②The peak season of incidence of asthmatic attack was found in winter and peak season for male and female patients was in January and December, respectively (P ＜ 0.05). ③ Higher incidence of asthmatic attack of children was related with higher air pressure, lower temperature, lower relative humidity(r =0.435, -0.320, -0.296, all P ＜ 0.05).CONCLUSION: The incidence of asthma attack presents seasonal rhythm in Qingdao city and it is influenced by climate conditions. Therefore, enough consideration of meteorological factors should be paid on preventive works for asthma.

Objective To investigate how gene silence of CD40 by small interfering RNA(siRNA)influences the balance between Th1 / Th2 and Th17 / Treg in rats with experimental autoimmune myocarditis(EAM). Methods Lewis rats were divided into a normal - control group,EAM group,CD40 siRNA - therapy group and siRNA - control group by using random number table. EAM,CD40 siRNA - therapy and siRNA - control groups were immunized on day 0 and day 7 with purified porcine cardiac myosin to establish EAM,and CD40 siRNA was administered intravenously on day 7. The basic data of each group were observed,and the rats were executed on day 21 to study the pathology of myo-cardial tissues and the myocardial histopathology scores were calculated,and than the changes in electrocardiograms (ECG)and echocardiogram were recorded. Enzyme - linked immunosorbent assay(ELISA)was used to determine the levels of interferon(IFN) - γ,interleukin(IL) - 10,IL - 17 and transforming growth factor(TGF)- β in peripheral blood. Results (1)The overall incidence of EAM,CD40 siRNA - therapy and siRNA - control group was 100% ,and no rats died from day 0 to day 21.(2)There were only 2 premature rats in EAM and siRNA - control groups,and the ECGs of normal - control group and CD40 siRNA - therapy group were normal.(3)The echocardiogram of EAM,CD40 siRNA - therapy and siRNA - control group,displayed the left ventricular dilatation,hypertrophy of the left ventricle, the weakening of the left ventricular wall motion,and heart failure,and pericardial effusion was discovered. The left ven-tricular fractional shortening(LVFS)and the left ventricular ejection fraction(LVEF)of rats treated by CD40 siRNA were higher than those of rats in the EAM group[(46. 70 ± 8. 25)% vs(34. 28 ± 11. 81)% ,(80. 92 ± 11. 76)% vs (64. 03 ± 12. 60)% ,F = 0. 652,0. 234,all P ﹤ 0. 05].(4)Pathologic examination of the EAM group,CD40 siRNA therapy group and siRNA control groups,showed myocardial fiber fracture,myocardial tissue necrosis and inflammatory cell infiltration. But myocardial tissue pathological scores of the cardiac tissue of CD40 siRNA therapy group was lower than those of the EAM group(2. 10 ± 1. 07 vs 3. 40 ± 0. 72,F = 1. 290,P ﹤ 0. 05).(5)ELISA method examination re-vealed that the levels of IFN - γ,IL - 4,IL - 17 and TGF - β in EAM group were increased compared with those of nor-mal control group[(1 245. 55 ± 244. 56)ng/ L vs(501. 53 ± 18. 93)ng/ L,(78. 03 ± 10. 47)ng/ L vs(30. 77 ± 1. 74)ng/ L,(80. 82 ± 13. 33)ng/ L vs(27. 98 ± 3. 01)ng/ L,(156. 27 ± 12. 11)ng/ L vs(4. 33 ± 0. 79)ng/ L,t =7. 408,10. 764,9. 250,30. 608,all P ﹤ 0. 05]. However,the levels of IFN - γ and IL - 17 in CD40 siRNA therapy group were lower than those in the EAM group[(940. 62 ± 128. 40)ng/ L vs(1 245. 55 ± 244. 56)ng/ L,(60. 42 ± 12. 40) ng/ L vs(80. 82 ± 13. 33)ng/ L,t = 2. 704,2. 745,all P ﹤ 0. 05],while the levels of IL - 4 and TGF - β were higher [(97. 91 ± 13. 62)ng/ L vs(78. 03 ± 10. 47)ng/ L,(178. 84 ± 12. 10)ng/ L vs(156. 27 ± 12. 11)ng/ L,t = 2. 835, 3. 229,all P ﹤ 0. 05]. Conclusions The administration of CD40 siRNA markedly reduces myocardial inflammation of EAM rats and improves their cardiac function,which can be explained by Th1 - type and Th17 - type cytokines inhibi-ted,Th2 - type and Treg - type cytokines increased,and so then the imbalance of Th1 / Th2 and Th17 / Treg corrected.

Objective To explore the effect of CD40 small interfering RNA(siRNA)on the expressions of pe-ripheral blood interleukin(IL)-21 and IL -35 in rats with experimental autoimmune myocarditis (EAM)and its sig-nificance.Methods Twenty 6 -8 week male Lewis rats were divided into normal group,EAMgroup,CD40 siRNA group and siRNA group by using random number table,with 5 rats in each group.The normal rats were induced with phos-phate buffer saline in double foot pads on day 0 and day 7,while the rest 3 groups were induced with cardiac myosin protein to establish EAMmodels.The rats in CD40 siRNA group and siRNA group were respectively injected with CD40 siRNA and siRNA slow virus expression vector through the tail vein of rats on day 7.The rats were executed on 21 day after echocardiogram examination was made.The histopathologic changes were observed by using light microscope and the myocardial histopathology scores were calculated.Enzyme -linked immunosorbent assay was used to determine the levels of IL -21 and IL -35 in peripheral blood.Results (1)Except the normal group,the total incidence rate of rats of each group was 100%,and there was no rat death.(2)Compared with EAM group,the heart mass/body ratio and myocardial histopathology scores were lower in CD40 siRNA group,and the differences were significant (3.13 ±0.21 vs 3.80 ±0.29,2.22 ±0.43 vs 3.32 ±0.51,F =0.332,0.456,all P <0.05).(3)The echocardiogram showed that there was only 1 rat in EAM group with massive pericardial effusion,and there was no pericardial effusion in CD40 siRNA group.EAMgroup,CD40 siRNA group and siRNA group displayed hypertrophy of the ventricular septum and left ventricular wall,narrow heart cavity and weakening of ventricular wall motion.The left ventricular shortening rate in CD40 siRNA group was significantly higher than that in the EAMgroup[(63.34 ±11.06)% vs (38.56 ±6.98)%,F =16.080,P <0.05].(4)The peripheral blood level of IL -21 in CD40 siRNA group was lower than that in EAM group [(141.19 ±17.46)ng/L vs (157.81 ±17.58)ng/L,F =57.008,P <0.05],while its level of IL -35 was signifi-cantly higher than that in the EAMgroup [(195.96 ±18.26)ng/L vs (174.78 ±13.91 )ng/L,F =31.727,P <0.05].(5)The level of IL -21 in peripheral blood was positively correlated with myocardial histopathology scores in EAM group (r = 0.69,P < 0.05 ),but IL -35 was negatively correlated with myocardial histopathology scores (r =-0.64,P <0.05).Conclusions CD40 siRNA might relieve the myocardial inflammation and reduce the myocar-dial injury of EAMrats.The levels of IL -21 and IL -35 can partly reflect the degree of myocardial injury.The mecha-nism may be related to down -regulating the expression IL -21 and up -regulating the expression of IL -35.

OBJECTIVE: Explore the model of universal NICU newborns' hearing screening in high-risk neonates, preliminary understanding factor of hearing damage. METHOD: Transient evoked otoacoustic emissions (TEOAE) and automatic auditory brainstem response (AABR) were used to detect newborns' hearing in 13 315 objects, that is newborns' hearing screening in NICU with TEOAE test who not pass, 42 days after will use AABR rescreening. Children's Hearing Center of Guangxi Child Health Hospital will diagnose the newborns that did not pass in 3 months. RESULT: In these 13 315 newborns, 5 151 subjects who did not pass the initial screening, 1910 subjects who also did not pass after 42 days, 1167 subjects cannot pass the rescreening after 3 months, 642 subjects were diagnosed congenital hearing impairment by Brainstem Auditory Evoked Potential Test, the rate is 4.82%. CONCLUSION TEOAE and AABR are the suitable model of universal newborns' hearing screening in high-risk neonates.
Evoked Potentials, Auditory, Brain Stem ; Female ; Follow-Up Studies ; Hearing Tests ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Male ; Neonatal Screening

Objective: To investigate the effect of lung rehabilitation exercise on cancer-related fatigue and quality of life in patients with non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods: From October 2016 to October 2018, 82 patients with NSCLC treated in Zhejiang Rongjun Hospital were randomly divided into control group (41 cases) and observation group (41 cases) according to random number table method.The control group was given routine intervention, while the observation group was given lung rehabilitation exercise on the basis of the control group.Both two groups were evaluated after 8 weeks of intervention.The changes of lung function, cancer-related fatigue and quality of life before and after intervention were compared between the two groups. Results: After intervention, the FEV₁% and FEV₁/FVC in the two groups were higher than those before intervention (observation group: t=18.565, 11.207; control group: t=9.363, 6.028, all P<0.05). After intervention, the FEV₁% [(64.38±3.79)%] and FEV₁/FVC (69.47±6.54) in the observation group were higher than those in the control group [(56.74±2.85)% and (60.10±4.25)] (t=10.316, 7.692, all P<0.05). After intervention, the scores of body, cognition, behavior and emotion in the two groups were higher than those before intervention (observation group: t=17.663, 15.167, 12.304, 14.750; control group: t=9.869, 6.617, 7.566, 9.553, all P<0.05). After intervention, the scores of body [(6.57±0.31)points], cognition[(6.15±0.42)points], behavior[(6.32±0.31)points] and emotion [(6.28±0.21)points] in the observation group were higher than those in the control group [(5.78±0.28)points, (5.41±0.48)points, (5.78±0.27)points and (5.82±0.25)points] (t=12.109, 7.429, 8.411, 9.021, all P<0.05). After intervention, the scores of social function, cognitive function, emotional function, role function, physical function and general health in the two groups were higher than those before intervention (observation group: t=14.487, 17.845, 22.025, 16.393, 11.665, 14.533; control group: t=9.880, 9.777, 10.797, 6.231, 6.838, 6.512, all P<0.05). After intervention, the scores of social function[(75.48±8.19)points], cognitive function[(72.43±6.32)points], emotional function [(71.93±5.74)points], role function[(63.25±7.86)points], physical function[(69.45±8.97)points] and general health[(68.39±7.54)points] in the observation group were higher than those in the control group [(67.31±6.74)points, (60.38±5.75)points, (59.64±6.56)points, (51.47±10.29)points, (58.83±7.09)points and (56.82±7.38)points] (t=4.932, 9.030, 9.028, 5.825, 5.947, 7.022, all P<0.05). Conclusion Lung rehabilitation exercise has good clinical effect on patients with NSCLC undergoing chemotherapy.It can alleviate cancer-related fatigue and improve the quality of life of patients.It is worthy of clinical reference.

OBJECTIVETo evaluate the combination of drop in canales sacralis with acupotomy dissolution in the treatment of lumbocrural pain caused by slipped discs.

METHODSOne hundred and thirty-nine patients with lumbocrural pain caused by slipped discs were randomly divided into 3 groups: cases in Group A were treated by the drop in canales sacralis, in Group B by acupotomy dissolution and in Group C by the combination of canales sacralis drop with acupotomy dissolution. MacNab score and VAS score were assayed before treatment and 1 week, 3 and 6 months after treatment.

RESULTThe effective rates in Groups A, B and C at 1 week, 3 and 6 months after treatment were 71.4%, 75.5%, 79.6%; 75.0%, 79.6%, 81.8% and 89.1%, 91.3%, 93.5%, respectively (P < 0.01). The pain intensity in Group C was reduced more markedly at different time points after treatment than that in Group A and Group B (P < 0.01).

CONCLUSIONThe combination of canales sacralis drop with acupotomy dissolution is superior to each method used alone in treatment of lumbocrural pain caused by slipped discs in the short-and long-term.

Acupuncture Therapy ; Female ; Humans ; Instillation, Drug ; Intervertebral Disc Displacement ; complications ; therapy ; Low Back Pain ; drug therapy ; etiology ; therapy ; Lumbar Vertebrae ; Male ; Treatment Outcome

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.