Objective To assess the evolution of gastric epithelial dysplasia (GED). Methods We reviewed the history of 239 of patients with gastric dysplasia diagnosed by endoscopic biopsy, and 195 were followed up for 61. 37 months. Results Among 239 cases of dysplasia (261 lesions) , there were 119, with mild dysplasia, 77 with moderate dysplasia, and 43 with severe dysplasia. The gastric dysplasia lesions are mainly in lesser curvature, and its endoscopic appearance mostly is localized erosion. In the follow - up group, regression of dysplasia was demonstrated in 86. 36% , 81. 25% , and 47. 62% of mild, moderate and severe dysplasia respectively. Progression to gastric cancer was detected in 8. 18% , 15. 63% , and 72. 09% of mild, moderate, and severe dysplasia, respectively. The relative risk (RR) of mild, moderate, severe dysplasia was 1. 96, 3. 74, and 17. 25 respectively. Conclusion Carcinomatous evolution of GED increases proportionally with its histological grade. Gastroscopy biopsy follow-up should be held up for all grades of GED, especially, in high grade GED, gastroscopy and biopsy should be taken as soon as possible.

Nowadays, various voice disorders are sprung out towards teachers of primary and secondary school, affecting their personal life and social work. Through literature review, the author aims at clearing up series of assessments and methods of voice training which are suitable for the teachers of primary and secondary school, such as establishing a right way of respiratory, phonation and resonance, avoiding occupational risk factors such as vocal abuse or misuse to regain healthy voice. Review of the several relevant literature and commentary about voice disorders of the teachers in primary and secondary school. Although various methods of voice training were reported from time to time to guide us SLP to carry out voice therapy, however, deviations of the clinical data from scholars' different points of view are waiting for our further support through case-control study.
Faculty ; Humans ; Schools ; Voice Disorders ; diagnosis ; rehabilitation

Objective To report the clinical, myopathological and genetic features of a patient with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS)/Leigh syndrome (LS) overlap syndrome who carried m.10158 T>C mutation. Methods The patient′s clinical and imaging materials were collected. An open biopsy of right biceps brachii was performed. DNA samples were prepared from the patient and her mother′s blood. Direct sequencing of the complete mitochondrial genome was performed to detect the mtDNA mutation.Western blotting was used to estimate the content of respiratory complexes in the patient′s muscle. Results The patient was a 40-year-old female. She had seizures and lost consciousness for 9 months. Brain MRI findings consisted of asymmetrical lesions in the cerebral cortex of the frontal and temporal lobes, as well as symmetrical lesions bilaterally in the basal ganglia. Muscle biopsy showed typical ragged red fibers. Direct sequencing of the complete mitochondrial genome from blood and muscle of the patient revealed the T-to-C transition at nucleotide position 10158 in the MT-ND3 gene.The mutation rate was 9.31% and 70.0%, respectively.Western blotting demonstrated that the contents of complexes Ⅰ and Ⅳ were significantly lower in the patient′s muscle mitochondria compared with the normal controls (53.1%±1.2% vs 88.6%±1.7%, t=4.08, P<0.05;57.3%±2.4% vs 80.1%±2.1%, t=3.39,P<0.05).Conclusion We reported a case of MELAS/LS overlap syndrome who carried m.10158 T>C mutation in MT-ND3 gene and DNA test is very important for the diagnosis of the disease.

Objective To analyze the monitoring data of iodine deficiency disorders in Jiangxi Province and to provide a basis for adjusting iodized salt concentration.Methods Thirty primary schools were selected in 30 counties and 40 pupils' goiters were examined with B ultrasound in every school.At the same time,salt iodine level was tested at their home.Twelve pupils urinary iodine in selected schools,15 pregnant urinary samples,15 lactating women urinary samples in 3 towns around the schools and water samples in the counties with the schools were collected.Results The goiter rate of children aged 8 to 10 was 1.25％ (15/1 200); the median salt iodine was 30.80 mg/kg and the consumption rate of qualified iodized salt was 96.92％ ; the median urinary iodine level of children,pregnant and lactating women was 308.73,206.95 and 206.75 μg/L,respectively.The proportion of urinary iodine level of children above 300 μg/L was 52.25％(186/356),while the proportion of urinary iodine level of pregnant women below 150 μg/L was 34.81％(157/451).The water iodine median was 4.62 μg/L and the per capita daily salt intake was 13.20 g in Jiangxi Province.Conclusions The status of iodine deficiency in Jiangxi has been significantly improved.According to the monitoring results,it's necessary to adjust salt iodization standards appropriately.

Objective To establish a HPLC method for the determination of gastrodine in Tianma Formula Granule.Methods A HPLC was performed on Shim-pack VP-ODS(4.6mm? 150mm,5? m).The mobile phase consisted of acetonitrile and 0.1 % H3PO4(3∶ 97).Detected wavelength was at 220 nm,the flow r ate was 0.5 mL? min-1,column temperature was at 25 ℃,and the injection volume was 5 ? L.Results The linearity was good in the range of 0.1020～0. 6120 ? g for gastrodine(r=0.9999).The average recovery rate was 100.5 %, and RSD was 1.01 %(n=5).Conclusion The established HPLC method is simple,accurate,and suitable for the determination of gastrodine in Tianma Formula Granule.

Objective To explore the diagnosis and treatment of hypopara thyroidism-deafness-renal dysplasia(HDR) syndrome in children.Methods According to the symptoms,signs,laboratory examination and the previous published papers of other authors,the disease of the child was diagnosed and treated,and some related literatures were reviewed.Results The 12-years-old boy presented with tetany and deafness and Chvostek's and Trousseau's signs were positive.The initial laboratory studies showed that the serum concentration of calcium was lower,parathormone was in the low limit of normal range and alkalin phosphatase was normal.An audiography revealed the pattern of sensorineural deafness in all frequencies.Abdominal CT revealed that his right kidney was not observed and creatinine clearance rate was low.After treated with calcium carbonate and vitamin D,the symptoms and the signs were improved.Conclusion HDR syndrome is a rare disorder and less recognized in children,and therefore more attention should be paid to avoid missing diagnosis.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hemopneumothorax ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Paracentesis ; Thoracoscopy

Abstract: Objective　To investigate the fundus arteriosclerosis and its influencing factors in HIV/AIDS patients after long-term highly active antiretroviral therapy (HAART). Methods　The clinical basic data and fundus examination data of 203 HIV/AIDS patients before and after HAART in the Fourth People 's Hospital of Nanning from January 2020 to June 2022 were collected to evaluate the occurrence of fundus arteriosclerosis and analyze its influencing factors. Results　Of the 203 HIV/AIDS patients, 159 patients developed fundus arteriosclerosis, with an incidence of 78.33%, including 33 patients with grade Ⅰ(20.75%), 87 patients with grade Ⅱ (54.72%), 28 patients with grade Ⅲ(17.61%), and 11 patients (6.92%) with Grade Ⅳ. Before HAART, there was no significant difference in CD4+T lymphocyte count, CD8+T lymphocyte count, viral load, white blood cell count, platelet count, hemoglobin, serum creatinine, blood urea nitrogen, triacylglycerol, total cholesterol, fasting blood glucose, alanine aminotransferase, aspartate aminotransferase and serum total bilirubin between the atherosclerosis group and normal group (P>0.05). After 6 months of HAART, CD8+T lymphocyte count, triacylglycerol and fasting blood glucose in atherosclerosis group were significantly higher than those in normal group (P<0.05). In the stratified comparison of CD4+ and CD8+ lymphocyte counts after 6 months of HAART, the proportion of patients with CD4+ lymphocyte count (CD4+)<200 (cells/μL) in the atherosclerosis group was significantly higher than that in the normal group; the proportion of patients with CD4+ lymphocyte count (CD4+)≥500 (cells/μL) was significantly lower than that in the normal group; the proportion of patients with CD8+ lymphocyte count CD8+≥ 800/μL was significantly higher than that in the normal group (all P<0.05). Binary logistic regression analysis showed that opportunistic infection, HIV course, CD4+T, CD8+T lymphocyte count after HAART and triglyceride were independent risk factors for ocular fundus atherosclerosis in HIV/AIDS patients (all P<0.05). Conclusions　The incidence of ocular fundus arteriosclerosis is high in HIV/AIDS patients. More than 4 years of HIV course, combined opportunistic infection, Low CD4+T lymphocyte count after 6 months of HAART, high CD8+T lymphocyte count and high triglyceride level are independent risk factors for ocular fundus arteriosclerosis in HIV/AIDS patients. Fundus screening should be performed before and after HAART in such population, HAART program should be formulated for the risk of cardiovascular disease, and risk management of cardiovascular disease should be strengthened during treatment to improve patient outcomes.

Objective To observe the therapeutic effect of traditional Chinese medicine(TCM)granules made by the formula of Shegan Mahuang decoction for treatment of patients with asthma. Methods A prospective study was conducted,51 cases of light to moderate asthma(cold type)patients were randomly divided into treatment group (25 cases)and control group(26 cases). Conventional symptomatic treatments were of the same in two groups. The patients in control group were given salbutamol aerosol inhalation,100μg each time,4 times per day;based on the treatment of the control group,additionally the above mentioned TCM granules dissolved in water was administered orally 1 dose/day taken twice once in the morning and another once in the evening in treatment group. The therapeutic course was 12 weeks in both groups. Before and after treatment,the asthma control test(ACT)score,forced expiratory volume in 1 second(FEV1)and peak expiratory flow(PEF)were observed. The therapeutic effect,adverse reaction and compliance were evaluated. Results The number of patients with asthma completely controlled in the treatment group was significantly higher than that in the control group(16 cases vs. 9 cases,χ2=4.82,P=0.028). In the patients of two groups,FEV1,PEF and ACT scores were significantly improved after treatment,and in the treatment group,they were obviously higher than those in control group〔FEV1(L):2.67±0.46 vs. 2.32±0.47,PEF(L/min):327.6±49.4 vs. 273.1±42.8,ACT score:22.8±2.0 vs. 21.1±2.6,all P<0.05〕. After treatment,FEV1%predicted value was increased in the treatment group but decreased in control group,there was significantly statistical difference〔(0.68±0.07)% vs.(0.80±0.11)%,P<0.05〕,no significant adverse reaction was found,compliance was good. Conclusion TCM granules made by formula of Shegan Mahuang decoction can improve the clinical symptoms, pulmonary function and control level in patients with asthma,so it is an effective medicine for the control of asthma.

Objective To evaluate the effect of Diver CE aspiration thrombus catheter used in patients during the recovery of acute myocardial infarction (AMI) with percutaneous coronary intervention (PCI). Methods A total of 50 AMI patients were enrolled from January 2010 to December 2011. Twenty-ifve patients received PCI and used the Diver CE aspiration thrombus catheter (aspiration group);and the other 25 patients received routine PCI (routine PCI group). The basic characteristics, PCI characteristics, myocardial perfusion indexes and clinical data were compared and analyzed. Results There was no statistically difference between two groups in basic characteristics. Compared with the routine PCI group, higher rate of myocardial blush grade 3 but lower thrombus scores were found in the aspiration group. The incidence of no-lfow or slow-lfow were also lower in aspiration group (all P<0.05). The LVEF after 6 and 12 months were higher in the aspiration group (both P<0.05), no difference in MACE between the two groups. Conclusions Using the Diver CE thrombus aspiration in PCI is a simple and safe by method for treatment of acute myocardial infarction with high thrombosis burden. It can improve reperfusion decrease the rates of no-relfow on slow-relfow and can improve the long-term left ventricular function.