Objective To assess the therapeutic effect of esomerphrazole in treating patients with gastroesophageal reflux disease (GRED) between Han and Inner Mongolia populations.Methods Those who underwent endoscopic examination and had reflux disease questionnaire (RDQ) >12 from March 2006 to March 2008 were selected. The patients were divided into Han group and Inner Mongolia group with 120 each. All patients were received esomerphrazole 20 mg daily for 6 weeks. The patients were evaluated by RDQ questionnaire at 2nd, 4th and 6th week, and were reexamined by gastroscopy at 6th week. Results After two weeks, effective rate of 50% was achieved in both groups, but it was higher in Han group than in Inner Mongolia group at 4th and 6th week. After 6 weeks, the curative rate of RE was higher in Han group than in Inner Mongolia group. Conclusion The different nations ancl habits result in the different efficacy of esomerphrazole, which may be improved by prolonging time of medication and changing habits.

Objective:To study the expression of human Era.Methods:The encoding region of human Era gene was inserted into pUC19 plasmid and sequenced,the gene fragment was then cloned into the prokaryotic fusion expression vector pRSET B to contruct recombinant expression plasmid pRSET B hEra.The recombinant protein was expressed in E.coli BL21DE3(plys S).Results:6His hEra was expressed after induced by IPTG and took 51.2% of the total cell lysate and mainly existed in the inclusion body.Conclusion:High level of human Era was established and this result may shed light on the further study on function of human Era.

Aim To express h-ERA and h-ERA C-terminal domain in E.coli and prepare antiserum against human ERA. Methods Human era(h-era) cDNA and h-ERA C-terminal domain gene were amplified by PCR and ligated with prokaryotic expression vector pRSET-C and pDH respectively. E.coli TAP106 transformed with the recombinant plasmid pDH-h-era-C was induced at 42℃ to express h-ERA C-terminal domain protein. Antiserum against h-ERA was prepared by immunizing rabbit with h-ERA C-terminal domain protein purified by SDS-PAGE. E.coli BL21(DE3) transformed with the recombinant plasmid pRSET-C-h-era was induced with IPTG to express (His)6-h-ERA fusion protein for Western-blot analysis.Results The expressed h-ERA C-terminal domain and (His)6-h-ERA fusion protein occupied about 40％ and 80％ of total bacterial protein respectively. The(His)6-h-ERA fusion protein expressed in E.coli can be detected with the rabbit antiserum. Conclusion The h-ERA C-terminal domain protein and (His)6-h-ERA fusion protein were expressed with high efficiency in E.coli, and the rabbit antiserum against h-ERA was prepared successfully.

Based on the review of Medical Device Risk Management both at home and abroad, this article analyses the problems existing in the process of medical device risk management and gives some suggestion, aiming to provide some references to systematic medical device risk management in China.
Equipment and Supplies ; Organization and Administration ; Risk Management

BACKGROUND: The efficacy of bisphosphonates for osteoporotic fracture has been consistently reported in recent randomized controlled trials (RCTs) enrolling hundreds of patients. The objective of this study was to update knowledge on the efficacy of available bisphosphonates in the prevention of vertebral and non-vertebral fractures. METHODS: An approach “using systematic reviews” on PubMed and Cochrane Library was taken. Twenty-four RCTs investigating the effects of bisphosphonates for the prevention of osteoporotic fracture were included in final analysis. A pairwise meta-analysis was conducted with a random effects model. Subgroup analysis was performed according to the type of bisphosphonate. RESULTS: The use of bisphosphonate decrease the risk of overall osteoporotic fracture (odds ratio [OR] 0.62; P<0.001), vertebral fracture (OR 0.55; P<0.001) and non-vertebral fracture (OR 0.73; P<0.001). Subgroup analysis indicated that zoledronic acid showed the lowest risk reduction (OR 0.61; P<0.001) for overall osteoporotic fractures but no significance was observed for etidronate (OR 0.34; P=0.127). CONCLUSIONS: This update meta-analysis re-confirmed that bisphosphonate use can effectively reduce the risk of osteoporotic fracture. However, there is a lack of evidence regarding etidronate for the prevention of osteoporotic fracture.
Diphosphonates* ; Etidronic Acid ; Humans ; Meta-Analysis as Topic ; Osteoporosis ; Osteoporotic Fractures* ; Risk Reduction Behavior

OBJECTIVE: This study aimed to compare perioperative and postoperative morbidity of older and younger women undergoing sacrocolpopexy (SCP). METHODS: A retrospective study included 271 patients who underwent laparotomic SCP for symptomatic pelvic organ prolapse from November 2008 to June 2013 at our institution. By the review of medical records, perioperative and postoperative data including the length of the surgery, estimated blood loss, blood transfusion, the length of hospital stay, wound complications and febrile morbidity were collected. In addition, cardiovascular, pulmonary, gastrointestinal, genitourinary, or neurological adverse events were retrieved. The need for an indwelling urinary catheter or performance of clean intermittent self-catheterization, mesh erosion rate and the number of days required for each were included in the postoperative outcomes. For the outcome variable analyzed in this study, the patients was dichomotized into women aged 65 and older and those younger than 65. RESULTS: One hundred and thirty-five (49.8%) patients were younger than 65 and 136 (50.2%) were aged 65 and older. Older women had higher body mass index, vaginal parity and prior surgery for hysterectomy than younger women (P<0.05). And older women had higher baseline comorbidities, such as hypertension, diabetes, cardiac disease (P<0.05), and their American society of Anesthesiologist class was higher (P<0.001). In the perioperative and postoperative complication, older group showed no differences in most of the operation-related complication rates, but gastrointestinal complication rate. Also, mesh erosion rate was not found to be significantly different between the two groups at the last visit. CONCLUSION: Older women undergoing laparotomic SCP have similar perioperative and postoperative morbidities as younger women, suggesting surgeons can counsel older and younger women similarly in terms of operative risks.
Blood Transfusion ; Body Mass Index ; Comorbidity ; Female ; Heart Diseases ; Humans ; Hypertension ; Hysterectomy ; Length of Stay ; Medical Records ; Parity ; Pelvic Organ Prolapse ; Postoperative Complications ; Retrospective Studies ; Urinary Catheters ; Wounds and Injuries

Background: Quantitation of urine protein is important in dogs with chronic kidney disease.Various analyzers are used to measure urine protein-to-creatinine ratios (UPCR). Objectives: This study aimed to compare the UPCR obtained by three types of analyzers (automated wet chemistry analyzer, in-house dry chemistry analyzer, and dipstick reading device) and investigate whether the differences could affect clinical decision process. Methods: Urine samples were collected from 115 dogs. UPCR values were obtained using three analyzers. Bland-Altman and Passing Bablok tests were used to analyze agreement between the UPCR values. Urine samples were classified as normal or proteinuria based on the UPCR values obtained by each analyzer and concordance in the classification evaluated with Cohen's kappa coefficient. Results: Passing and Bablok regression showed that there were proportional as well as constant difference between UPCR values obtained by a dipstick reading device and those obtained by the other analyzers. The concordance in the classification of proteinuria was very high (κ = 0.82) between the automated wet chemistry analyzer and in-house dry chemistry analyzer, while the dipstick reading device showed moderate concordance with the automated wet chemistry analyzer (κ = 0.52) and in-house dry chemistry analyzer (κ = 0.53). Conclusions Although the urine dipstick test is simple and a widely used point-of-care test, our results indicate that UPCR values obtained by the dipstick test are not appropriate for clinical use. Inter-instrumental variability may affect clinical decision process based on UPCR values and should be emphasized in veterinary practice.

Background: Rapid revascularization is the key to better patient outcomes in ST-elevation myocardial infarction (STEMI). Direct activation of cardiac catheterization laboratory (CCL) using artificial intelligence (AI) interpretation of initial electrocardiography (ECG) might help reduce door-to-balloon (D2B) time. To prove that this approach is feasible and beneficial, we assessed the non-inferiority of such a process over conventional evaluation and estimated its clinical benefits, including a reduction in D2B time, medical cost, and 1-year mortality. Methods: This is a single-center retrospective study of emergency department (ED) patients suspected of having STEMI from January 2021 to June 2021. Quantitative ECG (QCG™), a comprehensive cardiovascular evaluation system, was used for screening. The non-inferiority of the AI-driven CCL activation over joint clinical evaluation by emergency physicians and cardiologists was tested using a 5% non-inferiority margin. Results: Eighty patients (STEMI, 54 patients [67.5%]) were analyzed. The area under the curve of QCG score was 0.947. Binned at 50 (binary QCG), the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 98.1% (95% confidence interval [CI], 94.6%, 100.0%), 76.9% (95% CI, 60.7%, 93.1%), 89.8% (95% CI, 82.1%, 97.5%) and 95.2% (95% CI, 86.1%, 100.0%), respectively. The difference in sensitivity and specificity between binary QCG and the joint clinical decision was 3.7% (95% CI, −3.5%, 10.9%) and 19.2% (95% CI, −4.7%, 43.1%), respectively, confirming the non-inferiority. The estimated median reduction in D2B time, evaluation cost, and the relative risk of 1-year mortality were 11.0 minutes (interquartile range [IQR], 7.3–20.0 minutes), 26,902.2 KRW (22.78 USD) per STEMI patient, and 12.39% (IQR, 7.51–22.54%), respectively. Conclusion AI-assisted CCL activation using initial ECG is feasible. If such a policy is implemented, it would be reasonable to expect some reduction in D2B time, medical cost, and 1-year mortality.

To reduce swine production costs, a slaughter check system has been developed in countries with an advanced swine industry. Evaluation of lung lesions in carcasses is a critical part of the slaughter check system. This study was performed to collect background information for use in developing a slaughter check system in Korea. Lung tissues and their gross images were collected from slaughterhouses in Gyeonggi-do, Korea. Scoring of the gross lung lesions was performed on the lung images. Histopathologic examination was conducted to classify the pulmonary lesions as bronchopneumonia or interstitial pneumonia. Scores of the gross lung lesions were significantly different between bronchopneumonia and interstitial pneumonia groups (p < 0.001). A 90% confidence interval of gross lung lesion scores was established for the bronchopneumonia group, and the lesion scoring had a sensitivity of 100% and specificity of 77.3%. The gross lung lesion scoring test was subjected to a diagnostic distinction evaluation by examining the receiver operating characteristic curve and was appraised as having good discrimination for bronchopneumonia. Establishment of a gross lung lesion scoring test for the diagnosis of bronchopneumonia could be valuable as a screening test of macroscopic bronchopneumonia in swine slaughter check system.
Abattoirs* ; Bronchopneumonia ; Diagnosis* ; Discrimination (Psychology) ; Gyeonggi-do ; Korea ; Lung Diseases, Interstitial ; Lung* ; Mass Screening ; Pathology ; Pneumonia* ; ROC Curve ; Sensitivity and Specificity ; Swine*

Baclofen, a gamma-aminobutyric acid B agonist, is frequently used in the treatment of various neurologic diseases including spasticity, dystonia and trigeminal neuralgia. This drug usually acts at the presynaptic motor neuron to induce an antispastic response. Oral baclofen toxicity is extremely rare, but is often reported to affect patients with renal disease. Here, we report a patient with chronic kidney disease who was treated with relatively low doses of baclofen (5 mg twice per day) and experienced nonconvulsive status epilepticus.