OBJECTIVETo observe the effect of Qinggan Jiangtang tablet (QJT) in improving the insulin resistance (IR) in patients with multiple metabolic syndrome (MMS).

METHODSAdopting randomized controlled double-blinded method, 60 patients with MMS were divided equally into two groups. The treated group was treated by oral taking of QJT 3 tabs, twice a day and the control group treated by oral taking of Glucophage 3 tabs, twice a day, the therapeutic course for both groups was 1 month, and the observation lasted for 2 successive courses.

RESULTSAfter treatment, levels of blood glucose, fasting and postprandial blood glucose, C-peptide and IR were significantly reduced with markedly improvement of beta-cell function in both groups, the difference between the two groups showed no significance. Change of plasma level of free fatty acids before and after treatment in both groups was insignificant.

CONCLUSIONQJT has the effects on reducing blood glucose, blood lipids, blood pressure and IR and improving function of beta cells.

Adult ; Aged ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypoglycemic Agents ; therapeutic use ; Insulin Resistance ; Male ; Metabolic Syndrome ; drug therapy ; Metformin ; therapeutic use ; Middle Aged ; Phytotherapy ; Tablets

OBJECTIVETo explore the etiology, clinical aspects, diagnosis and therapeutic strategies of acute low-tone sensorineural hearing loss (ALHL).

METHODSThirty patients (31 ears) with ALHL were selected for this study. Detailed history collection, otological examination and systematic audiological evaluations were conducted. The hearing tests included pure tone audiometry, acoustic immittance, auditory brainstem response (ABR) and otoacoustic emissions (OAE). All cases received therapeutic trial of corticosteroid for 15 days with 6 to 14 months' following-up.

RESULTSALHL mainly affected young people. Low-tone tinnitus, a sensation of ear fullness and hearing impairment were the frequent complains. Otological examinations showed normal results. Mild to moderate sensorineural hearing loss at low frequencies and type "A" tympanograms were found in all patients. Acoustic stapedial reflexes were elicited in 26 of 31 affected ears, and 14 of them had positive results on the Metz test. ABR responses were normal in all 20 tested ears. In 14 out of 20 ears, TEOAEs were absent and DPOAE grams at low frequencies (0.5, 0.75 kHz) were abnormal on the first visit. After steroid therapy, 24 ears demonstrated complete recovery, but 4 ears showed partial recovery and 3 ears unchanged. The total improvement rate was 90.3%.

CONCLUSIONSALHL patients are clinically characterized by low-tone tinnitus, aural fullness and hearing loss, which mainly involved unilateral ear. Audiological findings indicate a cochlear impairment, which only invades low frequency region. The basic pathological feature may be endolymphatic hydrops involves immune response. Conflicting data exist on whether ALHL is an independent disorder or a subtype of Meniere's disease. Ideal therapeutic strategy has not been established by now and corticosteroid is probably an effective agent.

Acute Disease ; Adrenal Cortex Hormones ; therapeutic use ; Adult ; Audiometry, Evoked Response ; Endolymphatic Hydrops ; etiology ; Female ; Hearing Loss, Sensorineural ; diagnosis ; drug therapy ; physiopathology ; Humans ; Male ; Meniere Disease ; diagnosis ; drug therapy ; physiopathology ; Middle Aged ; Otoacoustic Emissions, Spontaneous

OBJECTIVETo investigate the proportions of functional dyspepsia (FD) and structural diseases within the dyspeptic outpatients in hospitals of different ranking in central area Shaanxi province, and to explore the safety in adopting "symptom and treatment" algorithm used in Western countries.

METHODSA clinical epidemiology survey was carried out by means of a stratified sample of 3 019 dyspeptic outpatients through standardized questionnaire. All of the patients were followed for 4 - 24 weeks, and finally received their diagnoses through a consistent criteria.

RESULTSProportionally, FD in all the outpatients took up 44.8% with 44.7% benign organic causes and 10.5% malignant diseases. In the patients who had marked alarm symptoms, the proportion of benign and malignant diseases rose to 52.1% and 29.2%, respectively. They were significantly higher than those without alarm symptoms (39.2%, 2.9%) (P < 0.01). All of the dyspeptic patients were divided into 7 groups according to different ages. 64.5% of FD patients were younger than 25 years and the rate of FD declined with age. It was found that only four patients below 35 years old had malignance. The number of cases increased significantly in age 35 - 45 group and reached 30.8% in 65 - 74 group.

CONCLUSIONThere were some differences noticed within dyspeptic patterns between local area in China and Western countries, and the "symptom and treatment" approach was not entirely suitable to the local area in China.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; China ; epidemiology ; Dyspepsia ; diagnosis ; epidemiology ; etiology ; Esophageal Motility Disorders ; complications ; diagnosis ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prevalence ; Stomach Diseases ; complications ; diagnosis ; epidemiology

This study was to determine the protective effect of ω-3 polyunsaturated fatty acids (ω-3PUFAs) on MK-801-induced cognitive impairment in schizophrenia (SZ) rats and the underlying mechanism.A rat model of schizophrenia was induced by MK-801.The cognitive function of rats was assessed using a Morris water maze.The number of hippocampal neurons was measured by Nissl staining.The expression of CREB,p-CREB,BDNF,TrkB,p-TrkB,AKT,p-AKT,ERK,and p-ERK in the hippocampus of rats was detected by Western blotting.The results showed that ω-3PUFAs attenuated MK-801-induced cognitive,impairment and hippocampal neurons loss,reversed the injury of the CREB/BDNF/TrtB pathway induced by MK-801,and antagonized MK-801-induced down-regulation of p-AKT and p-ERK in the hippocampus of rats.In conclusion,ω-3PUFAs enhances the CREB/BDNF/TrkB pathway by activating ERK and AKT,thereby increasing the synaptic plasticity and decreashng neuron loss,and antagonizing MK-801-induced cognitive impairment in schizophrenic rats.

OBJECTIVETo investigate the genotypes of mitochondrial DNA mutations of a large nonsyndromic inherited hearing impairment pedigree.

METHODSThe diagnosis was validated by hearing test. Blood samples from the branch pedigree (33 members) and 6 sporadic patients were obtained. DNA was extracted from the leukocytes. The mitochondrial DNA target fragments were amplified by polymerase chain reaction(PCR). The 1555G, 3243G and 7445G mutations were detected by BsmA I, Apa I and Xba I restriction endonuclease digestion respectively. Some PCR products were analyzed by sequencing.

RESULTSRestriction endonuclease digestion identified that 17 patients from the pedigree carried 1555G mutation. All pedigree members, including patients and sporadic patients, did not have 3243G and 7445G mutation. In 6 patients of the pedigree DNA sequence analysis revealed double mutations, an A>G transition at position 1555 and a C insertion at position 961, whereas the unaffected relatives of the pedigree and sporadic patients did not have such mutations. None of them carried 3243G and 7445G mutation.

CONCLUSIONDouble mutations of A1555G and 961 insC in mitochondrial DNA 12S rRNA gene region may play a pivotal role in the pathogenesis of hearing loss in the large nonsyndromic inherited hearing impairment pedigree.

Base Sequence ; DNA Mutational Analysis ; DNA, Mitochondrial ; genetics ; Female ; Genetic Predisposition to Disease ; Hearing Loss ; genetics ; Hearing Loss, Sensorineural ; genetics ; Humans ; Male ; Mutagenesis, Insertional ; Pedigree ; Point Mutation

OBJECTIVETo explore the mechanism of continuous traction in treating unstable distal radius fracture.

METHODSThirty patients with unstable distal radius fractures were treated by diaplastic external fixator including 4 males and 26 females with an average age of 61 years ranging from 18 to 85 years. According to AO classification, 12 cases were type A3, 3 were type B2, 8 were type C1, 4 were type C2, 3 were type C3. The distance of the processus radial malleolus and ulnar articularis were measured through X-ray examination.

RESULTSThirty patients were followed-up for 6 to 15 months with an average of 11.2 months. The results of distance before treatment measuring in X-ray was (0.55+/-0.22) cm, and the distance after treatment was (1.07+/-0.23) cm. The distance after treatment was higher than the distance before treatment, there were significant difference between them (P<0.01).

CONCLUSIONContinuous traction by diaplastic external fixator can explain by the theory of tendon reinforced bone and ligament restoration, or distraction osteogenesis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; External Fixators ; utilization ; Female ; Fracture Fixation, Internal ; Fracture Healing ; physiology ; Humans ; Male ; Middle Aged ; Radiography ; Radius Fractures ; diagnostic imaging ; surgery ; Range of Motion, Articular ; physiology ; Recovery of Function ; Traction ; methods ; Treatment Outcome ; X-Rays ; Young Adult

OBJECTIVETo investigate the prevalence of hearing impairment and ear diseases in old people and provide scientific data for drawing up the prevention and treatment strategies.

METHODSUsing the probability proportion to size (PPS) method, 1261 people over 60 years were investigated in 40 clusters in Jiangsu Province with the WHO protocol.

RESULTSThe prevalence of hearing impairment was 58.1% (the standardized rate: 59.5% in the whole country, 60.9% in Jiangsu province). Degrees of hearing impairment were mild (33.1%), moderate (17.8%), severe (5.9%) and profound (1.3%). The prevalence of hearing disability was 25.0% (the standardized rate: 26.6% in the whole country, 28.1% in Jiangsu province). There were significant difference of the prevalence between male and female, as well as urban and rural, and different ages. The prevalence of the ear diseases was auricle malformation (0.2%), wax (1.7%), otitis externa (0.1%), fungi (0.5%), serous otitis media (1.2%), chronic suppurative otitis media (1.6%), dry perforation of tympanic membrance (2.3%). The causes of hearing impairment were ear diseases (2.9%), non-infectious condition (92.6%), genetic condition (0.3%) and undetermined causes (4.2%). Of which, 31.1% of persons needed hearing aids while 2.3% of persons needed medicine treatment, but 0.9% of persons needed non-urgent surgery and 1.0% of persons needed other treatment.

CONCLUSIONSThe prevalence of hearing impairment and disability in the old rised obviously than the last investigation in 1987. It was a heavy burden for social development in China. The government and the whole society should take more concern about the problem. The scientific strategies of prevention and treatment were urgently needed and implemented.

Aged ; Aged, 80 and over ; Audiometry, Pure-Tone ; China ; epidemiology ; Ear Diseases ; epidemiology ; Female ; Hearing Loss ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence

Objective:To investigate the safety and short-term efficacy of laparoscopic pro-ximal gastrectomy (LPG) for proximal gastric cancer and adenocarcinoma of esophagogastric junction.Methods:The retrospective cohort study was conducted. The clinicopathological data of 385 patients with proximal gastric cancer and adenocarcinoma of esophagogastric junction who underwent LPG in the 15 medical centers, including the First Affiliated Hospital of Xiamen University et al, from January 2014 to March 2022 were collected. There were 304 males and 81 females, aged (63±9)years. Of the 385 patients, 335 cases undergoing LPG were divided into the laparoscopic group and 50 cases undergoing open proximal gastrectomy were divided into the open group. Observation indicators: (1) intraoperative and postoperative situations; (2) follow-up; (3) stratified analysis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed using the repeated ANOVA. Results:(1) Intraoperative and postoperative situations. The operation time, cases with reconstruction of digestive tract as esophagogastric anastomosis and esophageal-jejunal anastomosis, cases with postoperative pathological staging as stage 0?Ⅰ and stage Ⅱ?Ⅲ, duration of postoperative hospital stay, cases with postoperative early complications were (212±96)minutes, 270, 65, 177, 107, 10(range, 8?14)days, 40 in patients of the laparoscopic group, with 51 cases missing the data of postoperative pathological staging. The above indicators were (174±90)minutes, 39, 11, 22, 28, 10(range, 8?18)days, 10 in patients of the open group. There were significant differences in the opera-tion time and postoperative pathological staging between the two groups ( t=2.62, χ2=5.93, P<0.05), and there was no significant difference in the reconstruction of digestive tract, duration of post-operative hospital stay, postoperative early complications between the two groups ( χ2=0.19, Z=0.40, χ2=2.50, P>0.05). (2) Follow-up. Of the 385 patients,202 cases were followed up during the post-operative 12 months, including 187 cases in the laparoscopic group and 15 cases in the open group. Cases with reflux esophagitis, cases with esophageal anastomotic stenosis were 48, 11 in patients of the laparoscopic group, versus 5, 2 in patients of the open group, showing no significant difference in the above indicators between the two groups ( P>0.05). The body mass index (BMI), hemoglobin (Hb), albumin (Alb) at postoperative 6 months and 12 months were (21±3)kg/m 2, (130±15)g/L, (40±4)g/L and (21±3)kg/m 2, (132±14)g/L, (41±4)g/L in patients of the laparoscopic group, versus (21±3)kg/m 2, (121±19)g/L, (37±5)g/L and (21±3)kg/m 2, (125±21)g/L, (43±6)g/L in patients of the open group. There were significant differences in postoperative Hb between the two groups ( Fgroup=5.88, Ftime=5.49, Finteraction=19.95, P<0.05) and there were significant differences in time effect of postopera-tive BMI and Alb between the two groups ( Ftime=9.53, 49.88, P<0.05). (3) Stratified analysis. ① Incidence of postoperative of reflux esophagitis and esophageal anastomotic stenosis in patients with different reconstruction of digestive tract. Of the 202 patients, cases with reconstruction of digestive tract as esophagogastric anastomosis and esophageal-jejunal anastomosis were 168 and 34, respectively. The incidence rates of postoperative of reflux esophagitis were 26.79%(45/168)and 23.53%(8/34)in cases with reconstruction of digestive tract as esophagogastric anastomosis and esophageal-jejunal anastomosis, showing no significant difference between them ( χ2=0.16, P>0.05). Cases undergoing esophageal anastomotic stenosis were 13 in patients with reconstruction of diges-tive tract as esophagogastric anastomosis. ② The BMI, Hb, Alb in patients with different reconstruc-tion of digestive tract. The BMI, Hb, Alb were (24±3)kg/m 2, (135±20)g/L, (41±5)g/L in the 168 patients with reconstruction of digestive tract as esophagogastric anastomosis before the operation, versus (23±3)kg/m 2, (130±19)g/L, (40±4)g/L in the 34 patients with reconstruction of digestive tract as esophageal-jejunal anastomosis before the operation, showing no significant difference between them ( t=1.44, 1.77, 1.33, P>0.05). The BMI, Hb, Alb at postoperative 6 months and 12 months were (21±3)kg/m 2, (128±16)g/L, (39±4)g/L and (21±3)kg/m 2, (131±16)g/L, (41±4)g/L in the 168 patients with reconstruction of digestive tract as esophagogastric anastomosis, versus (20±4)kg/m 2, (133±13)g/L, (43±3)g/L and (21±3)kg/m 2, (135±12)g/L, (44±3)g/L in the 34 patients with reconstruction of digestive tract as esophageal-jejunal anastomosis. There were significant differences in the group effect and time effect of postoperative Alb between patients with different reconstruction of diges-tive tract ( Fgroup=15.82, Ftime=5.43, P<0.05), and there was also a significant difference in the time effect of postoperative BMI between them ( Ftime=4.22 , P<0.05). Conclusion:LPG can be used to the treatment of proximal gastric cancer and adenocarcinoma of esophagogastric junction, with a good safety and short-term efficacy.

OBJECTIVES: To analyze the causes of perinatal death and related factors from the perspective of forensic medicine, and to provide references for reducing perinatal mortality and guidance for forensic identification. METHODS: A retrospective analysis was performed on 102 cases of perinatal autopsy with clinical data from the Department of Forensic Medicine of Chongqing Medical University in 2004-2016. RESULTS: Of the 102 cases of perinatal deaths, 66 （64.71%） were neonatal deaths, 24 （23.53%） were stillborn foetuses, and 12 （11.76%） were stillbirths. Among the 66 neonatal death cases, 39 （59.09%） died within 1 d, 19 （28.79%） died within 1-3 d, and 8 （12.12%） died within >3-7 d of birth. The top 3 causes of neonatal death were pulmonary diseases, congenital malformation, umbilical cord and placental abnormalities. The causes of stillborn foetus and stillbirth were mainly umbilical cord and placental abnormalities, and intrauterine asphyxia. CONCLUSIONS Pulmonary diseases, umbilical cord and placental abnormalities, and congenital malformations are the main causes of perinatal death. In order to reduce the perinatal mortality, pre-pregnancy examination and prenatal care should be strengthened, and the knowledge of pregnancy care should be popularized.
Autopsy ; Cause of Death ; Female ; Humans ; Infant ; Infant Mortality ; Pregnancy ; Retrospective Studies ; Stillbirth

Adenoviridae ; genetics ; Ebolavirus ; genetics ; pathogenicity ; Gene Transfer Techniques ; Genetic Vectors ; therapeutic use ; Glycoproteins ; genetics ; HEK293 Cells ; Hemorrhagic Fever, Ebola ; genetics ; pathology ; virology ; Humans ; Inflammation ; genetics ; pathology ; virology ; Mucins ; genetics ; Transfection ; Viral Envelope Proteins ; genetics