ObjectiveTo investigate the mechanism and prevention of invisible injury of recurrent laryngeal nerve (RLN) system in thyroid surgery, with the application of intraoperative neuromonitoring ( IONM ) system. MethodsThe type of invisible RLN injury and its protection with the application of IONM system were analyzed. ResultsThe causes of invisible RLN injury mainly included stretching of Berry ligament or the tumor,contusion, thermal injury, cutting of silk and suction injury. RLN invisible injury was recoverable through neurotrophic and symptomatic treatment. No permanent vocal cord paralysis occurred. ConclusionsWith the application of IONM system, some invisible type of RLN injuries can be found. The risk of RLN injury can be reduced if the surgical techniques are improved with the development of study on mechanism of IONM system.

Objective To observe whether the expression of interferon-regulatory factor genes are re- lated to systemic lupus erythematosus (SLE).Methods The clinical data of 45 SLE patients and 37 normal controls were collected.Total RNA of peripheral blood was extracted and transcripted into cDNA.Sybr green dye based real-time quantitative PCR method was used to compare the expression (indicated as-??Ct value) of IRFI,IRF4,IRF8 in patients with SLE and those in the controls.Results The levels of IRF1,IRF4 and IRF8 mRNA were-3.90?0.19,-8.04?0.25 and 3.60?0.15 respectively in normal controls.In SLE patients, IRF4 mRNA expression was -8.82?0.18,higher than that in normal (P=0.011).But IRF8 mRNA expression was 3.09?0.13,lower than that in normal (P=0.012).Conclusion Abnormal IRF mRNA expression is found in the peripheral blood of SLE patients.IRFs may play roles in the pathogenesis of SLE by affecting the differen- tiation of Th cells.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Cost of Illness ; Echinococcosis ; economics ; epidemiology ; Female ; Humans ; Inpatients ; Male ; Middle Aged ; Young Adult

Objective The aim of this study was to analyze the status and influencing factors of public health service utilization in rural patients with severe mental illness in Yunnan province. Methods The main caregivers of patients with severe mental illness in Yunnan province were selected by stratified cluster sampling method. Multivariate logistic regression was used to analyze the influencing factors of public health service utilization. Results A total of 284 cases of rural patients with severe mental illness were investigated, including 144 males (50.7％) and 140 females (49.3％) . The rate of medical file filing, follow-up rate of village doctor, participation rate of free physical examination and health education acceptance rate among patients with severe mental illness were 89.8％, 84.9％, 73.2％and 56.7％respectively (<0.05) . Female patients had higher participation rate of free physical examination than male patients, and patients having work and patients with controlled disease condition and their caregivers had higher rates of health education acceptance rate than their counterparts ( <0.05) . Conclusion Measures should be taken to strengthen the work of medical examination for male patients, and to expand health education activities for patients having no work and patients with uncontrolled disease condition, so as to improve the public health service utilization in rural areas of Yunnan province.

Objective To explore the relationship between the incidence of hypoglycemia in infants of diabetic mothers and brain injury.Methods The incidence of 86 infants of diabetic mothers combined with hypoglycemia as well as the relationship time of persistent hypoglycemia of infants were studied.And the association of the incidence and degree of brain injury with the time of persistent hypoglycemia,complication of other diseases and symptomatic hypoglycemia was also investigated.Results Seventy-five cases of temporary hypoglycemia(87.2%),and 11 cases of frequent hypolycemia(12.8%)were observed in the study.In the group of unsatisfactory maternal blood glucose control cases,the incidence of frequent hypoglycemia was 19.4%;in the group of satisfactory maternal blood glucose control cases,the incidence of frequent hypoglycemia was 8%.The overall incidence of the brain injury and the incidence of severe brain injury in the group of frequent hypoglycemic cases were higher than those in the group of temporary hypoglycemic cases.The incidence of brain injury in cases complicated with other diseases(77.4%) and in those with clinical symptoms(81.2%) were significantly higher than those in without other diseases(48.5%) and clinical symptoms(57.4%)(Pa

Objective : To explore the positive rates and influencing factors of depression and anxiety among managed diabetic patients in community and to provide evidence for the future mental health intervention. Methods: Random sampling method was used to select the diabetic patients from the local health information platform in Ningbo. The anxiety and depression symptoms of the diabetic patients were evaluated by 9-Item Patient Health Questionnaire（PHQ-9）and 7-Item Generalized Anxiety Disorder Scale（GAD-7）. Logistic regression model was applied to analyzing the influencing factors for anxiety and depression in diabetic patients. Results: A total of 1 032 diabetic patients were enrolled,with a response rate of 91.98%. The positive rate of depression was 9.01% and the positive rate of anxiety was 3.78%. The results of multivariate logistic regression analysis showed that divorced/widowed（OR=3.046,95%CI：1.522-6.100）,having two comorbidities or more（OR=6.723,95%CI：2.495-18.120）and suffering diabetes for more than ten years（OR=2.668,95%CI：1.406-5.062）were the risk factors for depression in diabetic patients,while having a college education or above（OR=0.288,95%CI：0.093-0.893）was the protective factor for depression in diabetic patients;unmarried（OR=13.244,95%CI：1.268-138.377）,having two comorbidities or more（OR=6.979,95%CI：2.164-22.503） and suffering diabetes for more than ten years（OR=3.109,95%CI：1.241-7.787）were the risk factors for anxiety in diabetic patients. Conclusion Marital status,the number of comorbidity,course of diabetes and education level could affect the occurrence of depression in diabetic patients;marital status,the number of comorbidity and course of diabetes could affect the occurrence of anxiety in diabetic patients.

Objective: To investigate the association of Internet gaming disorder (IGD) and sleep quality in adolescents of Xi an, thereby providing theoretical evidence for prevention of IGD and improvement of sleep quality of adolescents. Methods: A total of 1 181 adolescents from 3 middle schools of Xi an were randomly selected between August, 2019 and February, 2020. These adolescents were assessed by a series of questionnaires, including basic information questionnaire, IGD and Insomnia Severity Index (ISI). Univariate analysis and multivariate Logistic regression model were used to evaluate the association between IGD and insomnia. Results: Among 929 junior middle school students who participated in online games and the IGD Diagnostic Questionnaire was filled out in the past 12 months, the prevalence of IGD was 20.0%(186). Univariate analyses indicated that gender,whether single family, whether they living with their parents, whether they were addicted to online games, whether they could control the time of online games, and the severity of insomnia influenced IGD ( χ 2=17.11, 8.33, 202.92, 91.23, 29.06, P <0.05). The multivariate Logistic regression of the total population showed that participating in online games was not associated with the severity of insomnia ( OR = 1.62 , 95% CI =0.92-0.85, P >0.05). The people who participated in online games in the past 12 monthsthe severity of insomnia was positively correlated with the risk of IGD ( OR =3.56，95% CI =1.92-6.61, P <0.01). Conclusion Internet gaming disorder become a severe situation in the middle school students. The severity of insomnia might become the risk factor of IGD, so social should pay more attention to the prevention of internet addiction.

OBJECTIVETo explore the value of the POSSUM scoring system in predicting postoperative morbidity and mortality of pancreatoduodenectomy (PD).

METHODSTwo hundreds and sixty-five consecutive PDs were performed between January 2005 and December 2007. POSSUM scores which relied on 12 physiologic and 6 operative variables were prospectively calculated for each case. Expected morbidity and mortality were estimated based on POSSUM scores and were compared with observed morbidity, which were diagnosed according to the Clavien complication scheme and domestic reference criteria respectively, and mortality.

RESULTSPhysiologic scores of 265 cases ranged from 12 to 24,the mean was 15. Operative scores ranged from 14 to 24, the mean was 17. The overall POSSUM scores ranged from 0.24 to 0.88. Average expected morbidity was 43.8%, expected cases were 116. Observed morbidity rate was 39.6% (105/265). The expected and observed morbidities and cases had no significantly differences. All patients were classified to 1 of 4 strata based on their individual POSSUM scores and subsequent risk of morbidity. Predictive value was the highest when scores ranged from 0.4 to 0.8. POSSUM exhibited less predictive value for mortality, but if POSSUM was more than 0.5, it was useful for mortality predicting.

CONCLUSIONSPOSSUM scoring system has high value for predicting the risk of morbidity in PD and can be helpful in guiding surgery and postoperative management decisions.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; mortality ; Postoperative Complications ; Prospective Studies ; Risk Assessment

OBJECTIVETo study the serum proteome of rat endotoxemia treated by figwort root (FR).

METHODThe differences of serum proteome among rats treated with lipopolysaccharide (LPS), FR, LPS + FR and saline respectively were analyzed by two-dimensional electrophoresis (2DE) assay.

RESULTThe volumes of sixteen serum proteins (xPr) in LPS induced-endotoxemia group were greatly changed compared with those of the control group. Among them, the volumes of xPr 16, 19 were significantly decreased, and the volumes of xPr 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 14, 18, 23 were significantly increased. When treated with FR, the volumes of xPr 1, 6, 7, 8, 9, 11, 12, 14, 18, 23 were significantly decreased, and the volumes of xPr 8, 9, 11, 12, 23, 14 were back to normal level. Two factors statistic analysis showed that FR had interaction with LPS for xPr 1, 5, 8, 10, 11, 12, 18, 19, 20, 21, 22, and FR might be the functional antagonist of LPS. We also observed that the volumes of xPr 10, 13, 15, 20, 21, 22 were found to change significantly only in FR treated group but not in LPS treated group or control group. Interestingly, the volume of xPr 13, 20, 21, 22 were increased and the volume of xPr 10, 15 were decreased.

CONCLUSIONThe molecular basis of therapeutic effect of FR on endotoxemia might be through the regulation of xPr 1, 6, 7, 8, 9, 11, 12, 14, 18, 23. We can use proteomic techniques to study the molecular mechanisms of diseases treated by functional Chinese herbs and the combination of different herbs is necessary for the treatment of endotoxemia, as FR can not regulated all the changed proteins induced by LPS.

Animals ; Blood Proteins ; metabolism ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Endotoxemia ; blood ; chemically induced ; Injections, Intravenous ; Lipopolysaccharides ; administration & dosage ; Male ; Plants, Medicinal ; chemistry ; Proteome ; analysis ; Rats ; Rats, Sprague-Dawley ; Scrophularia ; chemistry

Objective To investigate the infection of Cryptosporidium and its epidemiologicul characteristics in AIDS patients of Southern China. Methods Stool samples eolleted from AIDS cinfirmed patients. The samples were detected for ooeyst of Cryptesporidium by acid fast bacteria stain and indirect fluorescent antibody stain respectively, CD4 eount was detected by Flow Cytometry. Results 212 samples of fresh stool obtained from the AIDS patients who live in Guangdong and Yunnan province. The total infection rate of Cryptesporidium in AIDS patients was 4.25% (9/212), the infectious rate of ooeyst in the group of 50-59 yeats old was signifieantly higher than those in 30-39 (P ＜ 0.01); the infectious rate of oocyst in patients with antiretrovind therapy(ART) was also significantly lower (P = 0.0000);we found the patients coinfected with Cryptosporidium with CD4 count all below 100 cells/μl. However, there were no any difference between the infectious rate to the patient's gender, areas and stool shape. Conclusion AIDS patients infected by Cryptesporidium are not rare in southern China, and the infectious rate was lower than western country. Patients reeeived ART could decrease the infectious rate of Cryptesporidium, Cryptosporidium always happen in patient whose CD4 count was very low(＜ 100 cells/μl).