Humans ; Microsurgery ; methods ; Vocal Cords ; Voice Disorders ; surgery

Bosentan is a non-selective endothelin receptor antagonist,which plays an important role in the treatment of children with pulmonary arterial hypertension.Bosentan has shown to improve exercise capacity,hemodynamics and reduce pulmonary vascular resistance in pediatric patients.The main adverse effect is less severely comparing with the adult.The combination of bosentan with other drugs can improve the life quality furtherly.Further study of large-scale trials needs focus on the long-effects of bosentan,the ideal period of therapy and the effects of combination therapy in children.

Abstract To further standardize the procurement management of reagents and consumables in disease control and prevention institutions in Zhejiang Province and facilitate incorruptible health building, the procurement management for reagents and consumables in Zhejiang disease control and prevention institutions was created by Zhejiang Provincial Center for Disease Control and Prevention in 2019. Based on three-layer architecture of SaaS, PaaS and IaaS, this platform, which is easy to perform, safe and practical, provides modular portal website services, and its main functions include procurement budget management, procurement plan management, order management, bidding management, contract management, execution-of-contract and acceptance, and payment management. This platform, which was initiated to be run on early 2020, was found to be improve the procurement efficiency, safe management costs, reduce the internal control risk, and facilitate the containment of COVID-19, which may provide the support to improving procurement management and laboratory capability in disease control and prevention institutions.

In order to assess the effect of long-term versus short-term intravesical chemotherapy in preventing the recurrence of patients with non-muscle-invasive bladder cancer, we searched several databases with words as mesh terms and free text words to find all eligible randomized clinical trials (RCTs) for the comparison of the two strategies of instillation durations. "Observed-Expected events research (O-E)" and "Variance (V)" for calculating hazard ratio (HR) were used in Revman 5.2 software recommended by Cochrane Collabration for data analysis. Sensitivity and subgroup analysis were selected to minish heterogeneity. GRADEpro 3.6 profile recommended by Cochrane Collabration was employed for quality assessment of analyses. Finally, 13 eligible RCTs with 4216 patients were included in this review and 16 comparisons from 13 trials were involved for analysis. The pooled analysis revealed no significant difference between long-term and short-term duration [HR=0.99, 95% CI (0.89, 1.11), P=0.89]. Within the subgroup analysis, patients benefited from long-term instillations with a start regimen of one immediate instillation [HR=0.83, 95% CI (0.69, 1.00), P=0.05]. But patients were not suitable to receive long-term instillations with epirubicin (EPI) [HR=1.01, 95% CI (0.91, 1.13), P=0.78]. The progression rate was not reduced after long-term instillations [HR=0.96, 95% CI (0.66, 1.39), P=0.82]. From our results, patients should not receive introvesical chemotherapy more than half a year. In contrast, patients with one immediate instillation are preferred to have a long-term duration at least one year. Long-term instillations can not reduce the progression rate.

Objective To study the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with biliary and pancreatic diseases under the concept of enhanced recovery after surgery (ERAS). Methods 320 patients were enrolled in ERCP operation. Both ERAS elderly group (experimental group A, n = 58, above 75 years) and young and middle-aged group (control group B, n=202,below 60 years)underwent enhanced recovery after surgery,meanwhile traditional elderly group(control group C, n = 60, above 75 years) received traditional perioperative management. It had compared multiple clinical indexes between group A with B and group A with C during the preoperative, intraoperative, and postoperative period. Results The incidence rate of cholangiocarcinoma, multiple complications, nutrition screening ≥ 3 points, ASA scored III degree and Child-Pugh scored A-level in preoperative ERAS elderly patients were higher than that of the young and middle-aged group (P < 0.05); And its incidence rate of nausea and vomiting and abdominal pain,nutritional screening < 3 points and ASA scored I degree were lower than that of the middle-aged group (P < 0.05);the fasting and water- deprivation time of the ERAS elderly group was shorter than that of the traditional elderly group (P < 0.05). The intraoperative operation time of the elderly ERAS group was slightly longer than that of the traditional elderly group (P < 0.05). The duration of electrocardiographic monitoring and the first aerofluxus time of the elderly patients with ERAS were longer than that of the young and middle-aged group (P < 0.05). The success, failure rate, and complication rate of the elderly patients with ERAS were 91.38% (53/58) and 8.62% (5 /58), 3.45% (2/58), meanwhile the young and middle-aged group were 96.53% (195/202), 3.47% (7/202), and 4.95% (10/202), and with no statistical difference (P > 0.05). The mild pain in ERAS elderly group was more than that of in traditional elderly group, while the moderate, and severe pain was less than that of traditional elderly group (P < 0.05); The opioid use rate, endoscopic nasobiliary indwelling, first-time ambulation and aerofluxus, total hospitalization, and postoperative hospitalization time of ERAS elderly group was less than the traditional elderly group (P < 0.05). Conclusions With ERAS, the treatment effect of ERCP in elderly patients is similar to that in young and middle-aged people, and it has good safety and effectiveness.

OBJECTIVE To discuss the characteristics and risk factors of nosocomial infection inpatients with chronic kidney disease.METHODS The data from chronic kidney disease(CKD) patients retrospectively analyzed.RESULTS The nosocomial infection rate of CKD patients was 14.73%,urinary tract was the most comun site,The main-pathogens were Gram-negative bacteria,and then Gram-positive bacteria and fungii.The patients with diabetic nephropathy,lupus nephritis,aging,lower glomerular filtration rate,hypoproteinemia,anemia,and long time duration were easy to get nosocomial infection.CONCLUSIONS Nosocomial infection in CKD patients is related to underlying diseases,age,kidney function,serum albumin level,hemoglobin level,duration time in the hospital.

OBJECTIVE To discuss the clinical traits,pathogenesis and TCM stepwise treatments of fungal urinary tract infection.METHODS According to the risk factors and clinical character of fungal urinary tract infection,we clarified the mechanism of the disease.The principal aspect was spleen-kidney vacuity detriment and the secondary incidental was accumulated damp-heat and static blood in the lower burner,viz weaken healthy qi and excessive pathogenic factor.Hence during the clinical treatment we should regulate faculty condition.In the acute infection period we should give priority to dispel evils supplemented by the recovery of right qi.In the convalescence we should pay more attention to support right supplemented by dispelling.RESULTS The most common pathogen of fungal urinary tract infection was Candida albicans.The TCM stepwise treatments of fungal urinary tract infection together with regulatiy entire faculty condition had the characteristics of high efficacy and few side effects.CONCLUSIONS The TCM stepwise treatments of fungal urinary tract infection has more potentiality which deserves further study.

It is a common understanding that turbidity and precipitation of traditional Chinese medicine are easy to occur in the process of decocting. At present, our research group found that the cause of "multi-phase of traditional Chinese medicine decoction" mainly came from the interaction between the effective components of traditional Chinese medicine, especially the interaction of acid and base components. For example, the Liquorice and Rhizoma chinensis was a supramolecular system formed by a large number of active components in the decoction (>30%), and could stably exist in the decoction system. In this study, the supramolecular part was extracted, and the morphology of the supramolecular part was characterized by scanning electron microscopy and dynamic light scattering. It was observed that the supramolecular particles were uniform in size and regular in shape. The main components of supramolecular sites were identified by liquid mass spectrometry (LC-MSⁿ). The results of UV and IR spectra showed that the chemical components of Liquorice and Rhizoma chinensis in the co-decocting process collided with each other, and weak bonds were formed between the functional groups of the molecules, which then induced the aggregation to form supramolecules. Thereafter, Through the diarrhea model of mice, sensory evaluation and antibacterial activity evaluation found that Liquorice and Rhizoma chinensis decocted together enhanced the antibacterial activity of Rhizoma, and compatibility "reconcile" Rhizoma "big bitter cold" property compared with single decoction group and interval administration group. All animal experiments were approved by the Animal Ethics Committee of Beijing University of Chinese Medicine, and the relevant regulations of Beijing University of Chinese Medicine on experimental animals were strictly followed. In this study, supramolecular chemistry method was used to preliminarily discuss the scientific connotation of "increasing efficiency and decreasing toxicity" of Liquorice and Rhizoma chinensis combined decoction from three perspectives of "property, efficacy and taste", and provide new ideas for the basic research of "reconcile" compatibility of Liquorice.

OBJECTIVETo assess the relationship between fractional esterification rate of high density lipoprotein cholesterol (FER(HDL)) and coronary artery disease.

METHODSA total of 131 hospitalized patients underwent coronary angiography due to chest pain were included in the study and patients were divided into CAD group (n = 76) and non CAD group (n = 55) according to coronary angiogram. Clinical and laboratory data including biochemical laboratory, FER(HDL) and lipid subclasses were analyzed.

RESULTSThe FER(HDL) value of CAD group was significantly higher than that of the non CAD group (21.70 ± 8.73 vs. 18.65 ± 6.26, P < 0.05). There was an increased trend of FER(HDL) with numbers of diseased coronary arteries, significant difference was evidenced between non CAD group and 3-vessel group (18.65 ± 6.26 vs. 24.00 ± 9.22, P < 0.05). FER(HDL) was positively correlated with TG (r = 0.647, P < 0.001), LDLb-C(r = 0.441, P < 0.001) and negatively correlated with HDL-C (r = -0.708, P < 0.001) and HDL(2)-C (r = -0.748, P < 0.001).

CONCLUSIONOur data showed that the values of FER(HDL) were significantly increased in CAD patients and correlated with the severity of the CAD.

Adult ; Aged ; Aged, 80 and over ; Cholesterol, HDL ; metabolism ; Cholesterol, LDL ; metabolism ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; metabolism ; Esterification ; Female ; Humans ; Lipoproteins, HDL ; metabolism ; Lipoproteins, LDL ; metabolism ; Male ; Middle Aged

Objective To discuss the clinical effects of laparoscopic therapy and duodenoscopic therapy in the treatment of biliary severe acute pancreatitis.Methods A total of 140 patients with biliary severe acute pancreatitis(BSAP) in our hospital was assigned into laparoscopic therapy group(60 cases) and duodenoscopic therapy group(80 cases) according to the treatment plan,and indicators in both groups were compared,including acute physiology and chronic health evaluation(APACHE Ⅱ score),WBC,CRP,the operation time,intraoperative blood loss,hospitalization time,hospitalization fee,complication rate,cure rate,mortality rate,abdominal pain disappearing time,body temperature recovered to normal time,blood amylase recovered to normal time,amino acid transaminase(ALT) recovered to normal time,total bilirubin(TBIL) recovered to normal time,alkaline phosphatase(ALP) recovered to normal time.Results APACHE Ⅱ scores and the levels of WBC,TBIL,ALT and CRP in both groups were significantly decreased after surgery(P＜0.05),but there were no statistical differences between the two groups at the same time point after treatment(P＞0.05).The operative time and the intraoperative blood loss in the duodenoscopic therapy group were significantly less than those in laparoscopic therapy group(P＜0.05).There were no statistical differences between the two groups of hospitalization time,complication rate,cure rate,mortality rate,abdominal pain disappearing time,temperature returned to normal time,blood amylase recovered to normal time,ALT recovered to normal time,TBIL recovered to normal time,ALP recovered to normal time(P＞0.05).Conclusion In early stage,both laparoscopic therapy and duodenoscopic therapy can treat BSAP effectively,and their therapeutic effects are nearly similar.