Objective To evaluate the feasibility and clinical efficacy of selective mini-incision procedure for superficial varicose veins of lower extremities. Methods A total of 89 patients with local superficial varicose veins (101 veins) treated in this hospital from January 1998 to July 2003 entered the study.Stetho-Doppler and finger pressure examination were performed preoperatively in all the patients to locate the malfunctioned venous valves.Ligation of communicating veins combined with saphenectomy was carried out by way of mini-incision under local anesthesia. Results The sutured wounds in all the patients healed by first intention.Out of 36 limbs with swelling and heaviness,symptoms disappeared in 29 limbs and relieved in 7 limbs.Localized subcutaneous hematoma beneath the incision occurred in 3 patients,but no skin numbness or other complications took place.Follow-up ranged from 1 month to 5 years [(30 2?18 8)months] and 65 patients were followed for more than 1 year.No recurrence of superficial varicosis of lower limbs was seen. Conclusions Selective mini-incision procedure for the treatment of varicose vein of lower extremities is feasible,simple,safe and effective.

Objective To study the effect and safety of intra-arterial thrombolysis combined with mechanical ad-juvant in the treatment of acute large artery occlusive infarction of anterior circulation and posterior circulation. Methods Fourty-tow patients were divided into anterior circulation group (24 cases) and posterior circulation group(18 cases). The recanalization rate, NIHSS score (National Institute of Health stroke scale), GCS score ( Glasgow coma score,GCS), BI ( Barthel Index) excellent rate, symptomatic intracranial hemorrhage rate and mortality was analyzed after intra-arterial thrombolysis combined with mechanical aids therapy. Results The anterior circulation group was mainly caused by car-diogenic embolism (15/24, 62.5%) and posterior circulation group was mainly caused by atherosclerosis thrombosis (5/18, 72.2%). The NIHSS score was significantly lower after treatment (8.3±4.9 vs. 8.1±5.7) than before treatment(15.1±5.3 vs. 16.8±7.8)(P=0.001 vs. P=0.001), the GCS score was significantly higher after treatment(13.9±4.4 vs. 12.8±4.2)than be-fore treatment(9.5 ± 3.8 vs. 9.6 ± 3.7)(P=0.001 vs. P=0.021). The symptomatic intracranial hemorrhage rate was signifi-cant higher in anterior circulation group (5/24, 20.8%) than in posterior circulation group (0,0%) (P<0.05). Compared with the anterior circulation group, the recanalization rate trended to increase in posterior circulation group (P=0.830).The symptomatic intracranial hemorrhage rate in anterior circulation group (5/24,20.8%) was significant higher than in pos-terior circulation group (0,0%) (P<0.05), the mortality was similar between these two groups. Conclusions Intra-arterial thrombolysis combined with mechanical adjuvant therapy can improve neurological deficit in acute large artery occlusive infarction and increase the recanalization rate,which is more suitable for the treatment of posterior circulation infarction.

Objective:To study the clinical efficacy of levosimendan combined with naoxintong capsule in the treatment of acute heart failure and effects on the serum amino terminal B type natriuretic peptide precursor (NT-proBNP),Galectin-3,endothelin 1 (ET-1),Cystatin C levels.Methods:90 patients with acute heart failure from March 2015 to June 2016 in our hospital were selected and divided into observation group (n=45) and control group (n=45) by lottery method.Patients in the control group were treated by levosimendan alone.Patients in the observation group were treated by Naoxintong capsule combined with levosimendan.The clinical effect,changes of serum NT-proBNP,galectin-3,ET-1,cystatin C levels before and after treatment and the incidence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate was 93.33％ in the observation group,which was higher than that in the control group (77.78％) (P＜0.05);the left ventricular fractional shortening,left ventricular ejection fraction,stroke volume of both groups were higher than those before treatment,the blood pressure,heart rate and serum NT-proBNP,galectin-3,ET-1,cystatin C levels were lower than before treatment,and LVFS,LVEF,SV levels of the patients in the observation group were significantly higer than those of the control group (P＜0.05),the blood pressure,heart rate and serum NT-proBNP,galectin-3,ET-1,cystatin C levels were lower than those of the control group (P＜0.05).Conclusion:Levosimendan combined with Naoxintong Capsule could improve the therapeutic effect of acute heart failure with higher safety and reduce the levels of serum NT-proBNP,Galectin-3,ET-1 and Cystatin C.

Objective To evaluate the effect and safety of intravenous (IV) thrombolysis, intra-arterial (IA) thrombolysis and mechanical adjuvant intra- arterial thrombolysis (IA + MA) in treating cardiogenic cerebral embolism. Methods A total of 66 patients with cardiogenic cerebral embolism were randomly divided into IV group (n = 25), IA group (n = 18), IA + MA group (n = 23). The artery recanalization rate, NIHSS score, GCS score, BI excellent rate, symptomatic intracranial hemorrhage rate and mortality after different thrombolytic therapies were determined. The results were compared between each other among the three groups. Results In all three groups both the post-treatment NIHSS score and GCS score were significantly improved when compared with pre-treatment ones (P < 0.05). In IA + MA group the artery recanalization rate was 78.3%(18/23) and the BI excellent rate was 40%(10/25), which were significantly higher than those in IV group (P < 0.05). The symptomatic intracranial hemorrhage rate in IA group was 5.6%(1/18), which was strikingly lower than that in IV group (32%, 8/25). Analysis of the causes showed that the artery recanalization rate in patients with valvular heart disease or cardiac myxoma was rather lower, but the intracranial hemorrhage rate and mortality in these patients were much higher. Conclusion Thrombolytic therapy can improve neurological deficit in cardiogenic cerebral embolism, and the therapeutic effect of mechanical adjuvant intra- arterial thrombolysis is definitely better.

Fourteen neonatal diabetes mellitus(NDM)patients were recruited. 9 patients were treated with glyburide and the other 5 with insulin. ABCC8, KCNJ11, and INS genes were sequenced in 6 of them. Gene mutations were found in 2, 1, and 1 cases in these genes, respectively. One case with 6q24 hypomethylation and another without known mutation were also found. 8 out of 9 patients treated with glyburide reached euglycemia(88.9%). The other 5 patients with insulin therapy either died or lost contact. The results suggest that glyburide therapy is effective in neonatal diabetes mellitus, while insulin therapy may contribute to poor compliance.

Objective To study the impacts of pre-pregnancy maternal BMI and gestational weight gain(GWG)on pregnancy outcomes. Methods We adopted a prospective cohort study with cluster sampling in single pregnant women,who were not with hypertension,diabetes,hyperlipidemia or other diseases in the previous history,neither did they have diseases of heart,liver,kidney,thyroid etc. related to current pregnancy. Those pregnant women who visited the prenatal nutrition clinic under‘informed consent’were surveyed with questionnaire to track their peri-natal complications,delivery mode and neonate birth outcomes etc. Pearson and partial correlations,chi-square test and binary logistic regression were used to study the association between pre-pregnancy maternal BMI,GWG and pregnancy outcomes. Results A total of 623 pregnant women were recruited in the cohort,with 592(95%)of them eligible for analysis. Results from the Multivariate Logistic Regression analysis indicated that,after controlling the potential confounding factors,when compared to women with pre-pregnancy BMI between 18.5 and 24.0,the odds ratios(ORs)for low birth ponderal index(PI) were 2.34[95%confidence interval(CI),1.24-4.42)]among those with BMI<18.5,respectively,while 2.73(1.12-6.68)for high birth PI among those with BMI>24.0. Similarly,when compared to pregnant women with normal GWG(defined as weight gain range from P15 to P85 by stratification of pre-pregnancy BMI),low GWG(P85)appeared the risk factor for high birth weight,high birth PI,and gestational diabetes mellitus,with ORs as 3.83(1.74-8.44),2.39(1.14-5.01) and 2.21(1.07-4.55),respectively. Conclusion Low or high pre-pregnancy maternal BMI and GWG were associated with adverse pregnancy outcomes.

OBJECTIVE： To study the phylogenetic relationships of 3 basic plants of Tibetan medicine “Dida”， such as Swertia puricea， Wertia mileensis， Halenia elliptica. METHODS： ISSR technology was used for PCR amplification of 9 samples of S. puricea （ZT-1 to ZT-5 from Gantongsi in Dali Cangshan， ZC-1 to ZC-4 from Binchuan county of Dali）， 2 samples of W. mileensis （QYD-1 to QYD-2） and 2 samples of H. elliptica （HM-1 to HM-2）. Using DNA genome of S. puricea as template， 8 primers were screened and used for PCR reaction. The PCR amplification products were read by hand， the original data matrix was established， and the polymorphic band ratio was calculated. At the same time， genetic similarity coefficient was calculated by using NTSYS 2.1 software， and UPGMA method was used to draw cluster diagram. RESULTS： A total of 113 clear and identifiable amplification product bands were obtained by 8 ISSR primers. The rate of polymorphic site was 100％. The genetic similarity coefficients for totally 13 samples of S. puricea， W. mileensis and H. elliptica ranged 0.301-0.500. Intraspecific genetic similarity coefficients for 9 samples of S. puricea ranged from 0.752 to 0.929. The cluster analysis showed， when the range line was 0.410， 13 samples could be divided into three groups， i.e. S. puricea， W. mileensis， H. elliptica； when the range line was 0.780， 9 samples of S. purpurea could be divided into 2 subgroups， one of which was only sample ZT-1 collected from Gantongsi in Cangshan， and the other contained the remaining 8 samples. CONCLUSIONS： ISSR technology can be used to identify S. punicea， S. glabra and H. elliptica at the molecular level. S. punicea has some genetic relationship with S. glabra and H. elliptica， but the genetic relationship is relatively distant and the genetic difference is large. S. punicea from two different locations in Dali area has little genetic difference and close relationship， but it shows abundant genetic diversity.

OBJECTIVETo study the impacts of pre-pregnancy maternal BMI and gestational weight gain(GWG) on pregnancy outcomes.

METHODSWe adopted a prospective cohort study with cluster sampling in single pregnant women, who were not with hypertension, diabetes, hyperlipidemia or other diseases in the previous history, neither did they have diseases of heart, liver, kidney, thyroid etc. related to current pregnancy. Those pregnant women who visited the prenatal nutrition clinic under 'informed consent' were surveyed with questionnaire to track their peri-natal complications, delivery mode and neonate birth outcomes etc. Pearson and partial correlations, chi-square test and binary logistic regression were used to study the association between pre-pregnancy maternal BMI, GWG and pregnancy outcomes.

RESULTSA total of 623 pregnant women were recruited in the cohort, with 592 (95%) of them eligible for analysis. Results from the Multivariate Logistic Regression analysis indicated that, after controlling the potential confounding factors, when compared to women with pre-pregnancy BMI between 18.5 and 24.0, the odds ratios (ORs) for low birth ponderal index (PI) were 2.34 [95% confidence interval (CI), 1.24-4.42)]among those with BMI<18.5, respectively, while 2.73 (1.12-6.68) for high birth PI among those with BMI > 24.0. Similarly, when compared to pregnant women with normal GWG(defined as weight gain range from P15 to P85 by stratification of pre-pregnancy BMI), low GWG (P 85)appeared the risk factor for high birth weight, high birth PI, and gestational diabetes mellitus, with ORs as 3.83(1.74-8.44), 2.39(1.14-5.01)and 2.21(1.07-4.55), respectively.

CONCLUSIONLow or high pre-pregnancy maternal BMI and GWG were associated with adverse pregnancy outcomes.

Adolescent ; Adult ; Birth Weight ; Body Weight ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Risk Factors ; Weight Gain ; Young Adult

Objective To investigate the application value of tenofovir alafenamide fumarate (TAF) in elderly patients with chronic hepatitis B (CHB) and its influence on bones and kidneys. Methods A total of 36 CHB patients, aged ≥60 years, who received TAF antiviral therapy in Qingdao Municipal Hospital, The Affiliated Hospital of Qingdao University, Qingdao Sixth People's Hospital, Chengyang People's Hospital, and Jimo People's Hospital from June 2021 to October 2022 were enrolled in this study, and all patients received TAF (25 mg/d) antiviral therapy. Related data were collected at baseline and weeks 24 and 48 of treatment, including virological indicators, biochemical parameters, urinary protein electrophoresis indices, transient elastography (FibroScan), and bone mineral density. Virological indicators included high-sensitivity HBV DNA quantification; biochemical parameters included total bilirubin, direct bilirubin (DBil), indirect bilirubin (IBil), alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bile acid (TBA), glucose, blood urea nitrogen, creatinine, estimated glomerular filtration rate, and cystatin C (Cys C); urinary protein electrophoresis indices included urinary β2 microglobulin (β2-MG), urinary retinol (URBP), and urinary α1 microspherin (α1-MG). The paired t -test was used for comparison of normally distributed continuous data before and after treatment, and the Wilcoxon signed-rank test was used for comparison of non-normally distributed continuous data before and after treatment; the chi-square test or the Fisher's exact test was used for comparison of categorical data. Results A total of 36 CHB patients completed 24 weeks of follow-up. The complete virological response rate after 24 weeks of treatment was higher than that at baseline [83.3% (30/36) vs 77.8% (28/36), χ 2 =0.36, P =0.55], and there were significant reductions in DBil ( t =-2.42, P =0.02) and Cys C ( t =-4.34, P < 0.001) from baseline to week 24. A total of 18 CHB patients completed 48 weeks of follow-up. The complete virological response rate after 48 weeks of treatment was higher than that at baseline (94.4% vs 77.8%, χ 2 =2.22, P =0.34), and there were significant increases in IBil ( t =2.43, P =0.03), TBA ( Z =-2.24, P =0.03), and bone mineral density T score of lumbar vertebra ( t =2.92, P = 0.01) and femoral neck ( t =2.42, P =0.03) and a significant reduction in liver stiffness measurement ( t =-2.31, P =0.03). There were no significant changes in β2-MG, URBP, and α1-MG after treatment (all P > 0.05). Conclusion TAF has a good antiviral effect in CHB patients aged ≥60 years and can help more CHB patients achieve complete virological response, without causing damage to the kidney, and it can also improve bone mineral density and liver fibrosis degree.