Objective To investigate the expression and significance of Peripheral blood of Toll-like receptor-4 and cytotoxic T lymphocyte-associated antigen-4 in patients with essential hypertension. Methods We selected 35 patients with hypertension and 20 healthy people.We used flow cytometry to investigate TLR4 expression levels, and ELISA to detect the expression of CTLA-4. Results TLR4 expression in peripheral blood of patients with hypertension was (8.63 ±1.16)%, significantly higher (5.27 ± 1.25)%.The difference was statistically significant (t = 6.16,P < 0.05); CTLA-4 expression in peripheral blood of patients with hypertension was significantly higher (P<0.05); Hypertensive patients with CTLA-4 positive rate and TC, LDL-C was positively correlated (P<0.05); TLR4 and CTLA-4 was positive correlation (r = 0.886,P < 0.05). Conclusions TLR4 and CTLA-4 were high expression in hypertensive patients with hypertension,and related to hypertension.

Abstract:Chronic hepatitis C (CHC) is a global health problem, which is prevalent all over the world. China is a low epidemic area. Hepatitis C virus (HCV) is mainly transmitted through blood, and nowadays, intravenous drug addicts are the key population for the prevention and treatment of hepatitis C. HCV has multiple genotypes and gene subtypes, and the distribution of these genotypes and gene subtypes varies significantly among the regions of the world. Nowadays, the treatment of hepatitis C has entered the era of direct-acting antiviral agents, which have high efficacy and safety in the general population. However, when special populations use direct-acting antiviral agents to treatment hepatitis C, we don't know how its efficacy and safety will be. The special populations include children, adolescents, drug users, HCV/HBV co-infected patients, HCV/HIV co-infected patients, and patients who have comorbidity of HCV and chronic kidney disease. This review will discuss the efficacy and safety of using direct-acting antiviral agents to treat hepatitis C in these special populations.

AlM: To study an approach to visual acuity correction after intracapsular cataract extraction by phase - ll intraocular lens implantation through the individualized arcuate keratotomy.
METHODS: For demonstration, 48 postoperative patients ( 50 eyes ) receiving the intracapsular cataract extraction were gathered up. Each patient received a scleral tunnel major incision along the radial line of the maximum corneal refractive power determined by a cornea curvimeter, and a arcuate keratotomy was made opposite to the major one; through the major incision an iris-claw intraocular lens is implanted. Each patient was measured for their corneal astigmatism and uncorrected visual acuity before and after the surgery.
RESULTS: The results suggested the average corneal astigmatism before the surgery and that 3d, 1, 3, 6 and 12mo after the surgery as+3. 18±0. 68,-1. 56±0. 73,+0. 87± 0. 51, + 1. 21 ± 0. 70, + 1. 33 ± 0. 68 and + 1. 48 ± 0. 48 respectively. The uncorrected visual acuities 3d, 1, 3, 6 and 12mo after the surgery are 0. 5±0. 38, 0. 56±0. 23, 0. 55± 0. 24, 0. 52±0. 28 and 0. 51±0. 25 respectively.
CONCLUSlON: Phase-ll intraocular lens implantation witharcuate keratotomy is helpful to improve the postoperative visual acuity and reduce preoperative corneal astigmatism after the intracapsular cataract extraction aphakic eyes, lt is also a low-cost surgery, and easy to perform, with minor surgical injuries, particularly available for surgical visual acuity correction of the aphakic eye receiving intracapsular cataract extraction.

Objective To guide the fluid resuscitation in patients with severe sepsis and septic shock by monitoring the central venous oxygen saturation(ScvO2),and to improve the rescue success rate and prognosis of patients with sepsis.Methods Based on the standard of ScvO2 of 6h,45 patients with severe sepsis and septic shock were divided into two groups:observation group(n=28) and control group(n=17).The ScvO2,mean arterial pressure(MAP) and central venous pressure(CVP) levels were measured in the two groups after fluid resuscitation,and then the mortality,MAP compliance rate and CVP compliance rate were compared between the two groups.Results Compared with mortality in the control group(52.94%),the mortality in the observation group(14.29%) was significantly lower,the difference was significant (x2=5.927,P=0.015),but after 6h's fluid resuscitation,the MAP and CVP standard number in the two groups did not exist significant difference(x2=1.182,P>0.05).Conclusion ScvO2 with or without reaching the standard level(more than 65%) was positively correlated with the severity of the disease after fluid resuscitation in patients with severe sepsis and septic shock.Therefore,the monitoring of ScvO2 plays an important role in guiding the treatment of fluid resuscitation and judging the prognosis.

Adult ; Female ; Humans ; Kartagener Syndrome

AIM: To study the quality of life in patients with thyroid associated ophthalmopathy in China, to analyze the factors related to the decline of quality of life and to provide evidence for the clinical diagnosis and treatment.

METHODS: Totally 125 patients diagnosed with thyroid associated ophthalmopathy from January 2015 to January 2016 at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were included. Clinical data including gender, age, eyelid, conjunctival hyperemia and edema, lacrimal caruncle swelling, degree of proptosis, eyelid retraction volume, vision, diplopia were recorded. TAO-QOL questionnaire were investigated. The content was divided into two dimensions: visual function and appearance. Each dimension contains eight related questions. Final indicators for each dimension was the score. Independent t test, ANOVA and multiple regression analysis were performed using SPSS tactics 22.0 software.

RESULTS: Eighty-eight valid questionnaires were included. The average score of visual function was 72.6±28.3 and that of appearance was 66.8±26.0; 28 cases(28/88)were in active phase while 60 cases(60/88)were in inactive phase. Visual function and appearance scores were 59.4±28.8 and 56.1±26.0 in active group; 78.8±26.1 and 71.8±24.6 in inactive group. Active group has decreased score for both visual function sore and appearance score(P=0.002 and P=0.008). The score of patients with mild TAO(26/88 )was 86.2±17.1 and 82.1±17.8; 70.3±28.3 and 63.3±25.5 for moderate-severe patients(55/88), 41.1±34.6 and 37.6±22.7 for extremely severe patients(7/88). The score of both visual function and appearance in severe group were significantly lower than those in the moderate-severe group(P=0.006 and P=0.007).Compared to mild group, those of moderate-severe group were significantly lower(P=0.012, P=0.001).The visual function score of patients in constant diplopia group were significantly lower than the no diplopia group, horizontal or vertical gaze diplopia and inconstant diplopia group(P<0.001, <0.001, =0.002). By multivariate regression analysis, we found the factors that influence visual function score were visual acuity and diplopia(R²=0.470), and those correlated to appearance score were exophthalmos, retraction and diplopia(R²=0.375).

CONCLUSION: TAO-QoL can be used as a simple and effective tool to evaluate the quality of life in TAO patients. The QoL score is related to disease staging and grading. Thus, shortening the course of active phase, decreasing the degree of diplopia and improving visual acuity are critical ways to improve the quality of life in TAO patients.

To develop a LC-MS/MS method for the determination of five kinds of trace ginkgolic acids in diterpene ginkgolides meglumine injection materials, the column was Agilent ZORBAX Eclipse plus C18 (3.0 mm x 50 mm, 1.8 µm), and the mobile phase consisted of methanol-water (containing 0.2% formic acid) (95:5) at a flow rate of 0.5 mL · min(-1). The multiple reaction ion monitoring (MRM) with an ESI interface in the negative ion mode was selected. The results showed that the linear ranges of five kinds of ginkgolic acids were in the range of 0.2-36.0 µg · L(-1) (r ≥ 0.999 5). The lowest limit of quantification (LOQ) of ginkgo acid C13: 0, C15:1, C17:2, C15:0 and C17:1 were 0.18, 0.18, 0.21, 0.10 and 0.20 µg · L(-1), respectively. The average recovery was between 73.28% and 87.56%, and the average content of total ginkgolic acids in three batches of samples was in the range of 0.023-0.028 µg · g(-1), which was much lower than 2 µg · g(-1) prescribed in drug registration standards. This method is simple and rapid with high sensitivity, which can be used for the determination of five kinds of trace ginkgolic acids in diterpene ginkgolides meglumine injection materials.
Chromatography, Liquid ; methods ; Ginkgolides ; analysis ; Injections ; Limit of Detection ; Salicylates ; analysis ; Tandem Mass Spectrometry ; methods

Biological Products ; analysis ; pharmacology ; Chromatography, Liquid ; methods ; Drug Evaluation, Preclinical ; methods ; Gas Chromatography-Mass Spectrometry ; methods ; Magnetic Resonance Spectroscopy ; Plants, Medicinal ; chemistry

Objective To evaluate the myocardial blood supply in patients with metabolic syndrome (MS) using 99Tcm-MIBI SPECT MPI. Methods A total of 342 patients were divided into four groups according to the number of abnormal metabolic indices: no abnormal metabolic index (Group 1), one abnormal index (Group 2), two abnormal indices (Group 3), three or more abnormal indices (Group 4). Each patient underwent two-day protocol of gated stress and rest 99Tcm-MIBI MPI. One hundred and three of the 342 patients were clinically diagnosed as MS and underwent CAG within 1 month after MPI. χ2test was used to evaluate the difference among the four groups and Kappa test to analyze the correlation between MPI and CAG. Results Compared with CAG, the diagnostic sensitivity, specificity, positive and negative predictive values by 99Tcm-MIBI SPECT MPI for coronary artery diseases (CAD) in 103 MS patients were 80.5% (33/41), 85.5% (53/62), 78.6% (33/42) and 86.9% (53/61), respectively. The correlation coefficient between MPI and CAG was 0.657 (P<0.001). The abnormal MPI rates in group 1, 2, 3 and 4 were 23.3% (10/43), 32.9% (26/79), 54.4% (56/103), and 57.3% (67/117), respectively (χ2=23.22, P<0.001). Conclusions In MS patients,99Tcm-MIBI SPECT MPI can be useful for evaluating myocardial blood supply and the myocardial ischemia rates may correlate positively with the number of abnormal metabolic indices.

ObjectiveTo investigate the role of reducing the door-to-needle time for patients with acute ischemic stroke based on the quality improvement program of PDCA cycle.MethodsConsecutive patients with acute ischemic stroke admitted to hospital were registered prospectively from January 1, 2016 to September 30, 2016.Questionnaires and time tracking method were used to investigate the door-to-needle (DNT) and its influencing factors.PDCA cycle method was used to improve the stroke channel workflow and the changing trend of DNT was analyzed.ResultsA total of 71 patients with acute ischemic stroke were enrolled.After 3 PDCA cycles, DNT (median, interquartile range) from 100.0 min (65.5-127.0 min) reduced to58.0 min (45.5-80.0 min) (Z=11.689, P<0.001), the proportion of the patients with DNT ≤60 min increased from 19.05% to 60.00% (χ2=7.893, P=0.019).Conclusions The quality improvement program of PDCA cycle may effectively reduce the time of DNT in patients with acute ischemic stroke.