Objective The purposes of the present study are to investigate the effects and mechanisms of Bu Shen Ning Xin Yi Jing Pill on premature ovarian failure (POF) through a clinical study. Methods Sixty women with POF were administered and randomized into the treatment group and the control group. Every group had thirty cases. Patients in the treatment and control groups were requested to have the Bu Shen Ning Xin Yi Jing Pill and the Liu Wei Di Huang Pill, respectively. Six-month duration was considered as a therapeutic course. The serum levels of follicle stimulating hormone (FSH) and estradiol (E2) were determined by the chemistry luminescence method. Differences between the treatment and control groups were investigated.Results Improved menstruation were revealed in both groups and the treatment group showed significant improvement than the control group (P<0.01). In the treatment group, serum FSH levels sharply dropped after treatment, while the serum E2 levels significantly elevated compared with those of prior-treatment (P<0.01) . The total effective rate in the treatment group was 70% (21 cases), whereas 40% in the control group (12 cases). The difference had statistical significance (P<0.01) .Conclusion The BuShen NingXin YiJing Pill is effective in the treatment of premature ovarian failure via significant improvements in the clinical symptoms and balance of the endocrine hormones.

Objective To investigate the changes of clinical and laboratory manifestations of rheumatic fever (RF) in recent ten years by reviewing the medical data of 315 patients with RF. Methods Three hundred and fifteen in-patients and out-patients with RF during 1985-1995 (group A) and 1997-2007(group B) were selected. Their manifestations were compared. Results Male/female ratio was about 1:2. Carditis and polyarthritis were common manifestations. Compared with group A, the rate of low-grade fever and carditis increased and the rate of heart failure, positive rate of C reaction protein and antistreptolysin O decreased in group B. In group B, 61.4% patients fulfilled the updated Jones diagnostic criteria. 76.2% fulfilled the 2002-2003 WHO criteria. The sensitivity and specificity of peripheral blood lymphocyte procoagulant activity (PCA) for the diagnosis of rheumatic carditis was 79.1% and 71.4% respectively. That of the anti-streptococcal group A polysaccharide (ASP) antibodies was 70.3% and 70% respectively. Five to ten years follow-up clinical data were available for 35 cases since Dec. 1997. The recurrent rate of RF was 62.8%. Only 1/3 cases received regular secondary prevention. Recurrence rate of patients with regular secondary prevention was significantly lower than that of patients without regular secondary prevention. Conclusion Mild earditis has been increasing during last ten years. PCA and ASP are valuable tests for diagnosing rheumatic carditis. More emphasis should be paid to atypical cases, early diagnosis and regular secondary prevention in order to improve prognosis.

Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area.MethodsA total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Ji′nan University,Guangzhou Eighth People′s Hospital and the Second People′s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed.The patients were divided into two groups based on the findings of the chest X-rays (with or without radiographic abnormalities).Furthermore,the clinical characteristics and prognosis in two groups were compared.The statistical analysis was done using t test,chi-square test or Fisher′s exact test.ResultsChest X-rays showed abnormalities in 66 (44.6％) cases,and the chest X-ray features were diverse.The incidences of cough,severe thrombocytopenia,hypoalbuminemia,shock,acute respiratory failure,jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities (χ2 =18.193,6.872,17.138,5.608,4.318,7.982 and 7.932,respectively; all P＜0.05).The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities,but there was no statistical difference [(11.7±7.1)d vs (9.9±5.0)d,t=1.717; P=0.088)],while the mortality was higher(6.1 ％ vs 0; Fisher′s exact test,P =0.038).Conclusions The clinical manifestations of the patients with scrub typhus are diverse,and the presence of abnormal chest X-rays is shown to be associated with the disease severity.Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.

Objective:To explore the feasibility of high-flow nasal cannula(HFNC)therapy for respiratory failure in elderly patients.Methods:A total of 300 patients with respiratory failure admitted to Peking University Shougang Hospital from December 2016 to March 2019 were enrolled in this prospective study.Patients were divided into three groups: the HFNC group, the conventional oxygen therapy(COT)group and the non-invasive positive pressure ventilation(NPPV)group(n=100 in each group). Arterial oxygen saturation(SPO 2), oxygen index(OI), heart rate(HR), respiratory rate(RR), mean arterial pressure(MAP), comfort level, discharge rate, tracheal intubation rate, rate of referral to ICU, mortality and rate of referral to another group after therapy were compared between the HFNC and COT groups and between the HFNC and NPPV groups. Results:SPO 2 after oxygen therapy for 30 minutes( t=-2.992, P=0.003), 1 hour( t=-2.884, P=0.005)and 6 hours( t=-3.196, P=0.002)and OI before discharge( t=-2.060, P=0.048)were higher in the HFNC group than in the COT group.The HR in the above two groups was lower before discharge than before therapy, and the HR in the COT group was even lower(73.1±25.1 beat per minute vs.75.1±25.9 beat per minute), but both were within the normal range.The discharge rate was higher( χ2=-1.969, P=0.049), while the rate of referral to another group was lower in the HFNC group than in the COT group( χ2=-3.115, P=0.002). There was no significant difference in the tracheal intubation rate, ICU transfer rate and mortality between the HFNC and COT groups.SPO 2 after oxygen therapy for 30 minutes( t=-2.026, P=0.046)and 6 hours( t=-2.101, P=0.040)were higher in the HFNC group than in the NPPV group, but there was no significant difference in OI and SPO 2 between the two groups before discharge.The HR in both HFNC and NPPV groups was lower before discharge than before therapy, and there was no statistical difference between the two groups.The mortality, discharge rate, tracheal intubation rate, ICU transfer rate and rate of referral to another group had no significant difference between the HFNC and NPPV groups.The comfort level was higher in the HFNC group than in the COT and NPPV groups( t=-3.758 and -19.180, both P=0.000). Conclusions:HFNC is a new type of oxygen therapy equipment introduced after COT and NPPV, and possesses more advantages for elderly patients with respiratory failure.

Objective:To retrieve, assess and summarize the best evidence for prevention and management of totally implantable venous access port blockage in malignant tumor patients.Methods:Literatures related to the prevention and management of infusion port blockage were searched by computer on BMJ Best Practice, UpToDate, Australian Joanna Briggs Institute Evidence-Based Health Care Centre Database, Guidelines International Network, National Guideline Clearinghouse, Cochrane Library, Ovid, PubMed, CNKI, Wanfang Database, VIP, Medlive, China Biomedical Medline Disc and other Chinese and English databases. The search period was from January 2013 to January 2023. Two researchers evaluated the quality of the literatures respectively, and the literatures that met the criteria were extracted, integrated and graded.Results:A total of 18 literatures were included, including 2 guidelines, 9 evidence summaries, 5 expert consensus articles and 2 systematic reviews. A total of 34 pieces of evidence were summarized from 6 aspects, including personnel training, nursing evaluation, catheter implantation, catheter maintenance, blockage management and health education.Conclusions:Summary of the best evidence for prevention and management of totally implantable venous access port blockage is comprehensive. Clinical medical staff should apply the evidence according to the medical situation to reduce the occurrence of blockage of infusion port.

Objective:To develop a risk assessment scale for infusion port occlusion in patients with malignant tumors and to test its reliability and validity.Methods:An initial item pool was constructed based on literature review. Through purposive sampling, two rounds of Delphi consultations with 20 experts were conducted from March to May 2023. Weights were assigned to the indicators using the analytic hierarchy process (AHP), and the risk assessment scale was finalized. From June to September 2023, a convenience sample of 278 malignant tumor patients with infusion ports from four Class Ⅲ Grade A hospitals in Shanxi Province was selected for item analysis and reliability and validity testing.Results:The risk assessment scale for infusion port occlusion in malignant tumor patients includes five dimensions, 16 primary indicators, and 35 secondary indicators. The content validity index at the scale level was 0.925, and at the item level ranged from 0.818 to 1.000. A total of five factors were extracted by exploratory factor analysis, with a cumulative contribution rate of 57.081% to the variance. The area under the receiver operating characteristic curve was 0.815, with a cutoff score of 24.50. The overall Cronbach's α coefficient was 0.910, and the split-half reliability coefficient was 0.762.Conclusions:The risk assessment scale for infusion port occlusion in malignant tumor patients demonstrates good reliability and validity, and has high predictive power, which provides a scientific basis for identifying high-risk populations in clinical settings.

Objective:Exploring the effect of radiofrequency ablation treatment to restore sinus rhythm on the improvement of functional mitral regurgitation (FMR) and cardiac structure in patients with atrial fibrillation combined with moderate or severe FMR, compared with drug therapy alone.Methods:This retrospective cohort study consecutively enrolled patients diagnosed with persistent atrial fibrillation and moderate or severe FMR who were admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2021. Forty-eight patients who were treated with radiofrequency ablation and maintained sinus rhythm were enrolled in the ablation group, and 63 patients who were treated with medication alone during the same period were in the medicine group. Patients in the ablation group and medicine group were matched in a 1∶1 ratio using a propensity score, and 41 patients were finally included in each of the 2 groups. All patients reexamined echocardiography after 3-month of treatment. The proportion of patients with FMR improvement and the differences in changes of cardiac structural and functional parameters were compared between groups.Results:After propensity score matching, the ablation group was aged (69.3±7.1) years with 21 males (51.2%) and the medicine group was aged (71.3±9.4) years with 21 males (51.2%). The echocardiography after 3-month of treatment showed the rate of FMR improvement was significantly higher in the ablation group than in the medicine group (19 (46.3%) vs. 33 (80.5%), P<0.001), and patients in the ablation group showed a significant decrease in FMR extent (Δmitral regurgitation area: (-1.30±2.64) cm 2 vs. (-3.55±2.50) cm 2, P<0.001), left atrial size (Δleft atrial diameter: (-0.17±3.78) mm vs. (-2.46±4.01) mm, P=0.009) and E/e′ (ΔE/e′:-2.54±7.34 vs.-6.34±7.08, P=0.021) compared with the medicine group. There was also a significant decrease in left ventricular size (Δleft ventricular end diastolic diameter: (-3.12±6.62) mm vs. (-0.73±3.62) mm, P=0.046) and significant increase in left ventricular ejection fraction (Δleft ventricular ejection fraction: (2.73±9.69) % vs. (-0.93±5.41) %, P=0.038) in ablation group. Conclusion:Performing radiofrequency ablation to restore sinus rhythm can effectively reduce the severity of mitral regurgitation and improve left atrial and left ventricular remodeling and cardiac function in patients with atrial fibrillation and FMR.

OBJECTIVETo explore the impact of maternal hepatitis B surface antigen (HBsAg) carrier status on the occurrence of preterm birth.

METHODSWe analyzed pregnancy-related complications, outcomes and fetal growth index in 188 HBsAg positive singleton pregnant women during the period of May 2009 to July 2011, with 265 HBsAg-negative women with singleton pregnancies in the same period serving as controls.

RESULTSThe HBsAg-positive pregnant women showed a significantly higher incidence of placenta praevia than the control group (2.66% vs 0%, P=0.03), and the incidence of preterm delivery (<37 weeks) was also significantly higher in HBsAg-positive group (12.23% vs 6.04%, P=0.02). The incidences of gestational hypertension, preeclampsia, gestational diabetes mellitus, abnormal glucose tolerance, premature rupture of membranes, cesarean delivery, and postpartum hemorrhage showed no significant differences between the two groups (P>0.05), nor did the fetal birth weight, height, head circumference or Apgar scores at 1, 5, and 10 min (P>0.05). Logistic regression identified HBsAg positivity, abnormal ALT, placenta praevia, and severe preeclampsia as the risk factors for preterm delivery.

CONCLUSIONHBsAg carrier status can increase the risk of preterm delivery in pregnancy, but it does not seem to affect the fetal growth.

Adult ; Carrier State ; Case-Control Studies ; Female ; Hepatitis B Surface Antigens ; blood ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; Premature Birth ; etiology ; Risk Factors ; Young Adult

OBJECTIVETo investigate the cytogenetic differences between children and adults with acute lymphoblastic leukemia (ALL) using eight-probe fluorescence in situ hybridization and karyotype analysis.

METHODSEight-probe (MYC, P16, E2A, TEL/AML1, BCR/ABL , MLL , IGH, and hyperdiploidy) fluorescence in situ hybridization and karyotype analysis were performed for 86 adults and 39 children with acute lymphoblastic leukemia.

RESULTSEight-probe fluorescence in situ hybridization showed significant differences in the positivity rate of TEL/AML1, BCR/ABL, and hyperdiploidy between adult patients and children with ALL. By karyotype analysis, the positivity rate of t(9;22) and hyperdiploidy differed significantly between the children and adult patients (P<0.05).

CONCLUSIONAdults and children with ALL have different expression profiles of the fusion genes. Eight-probe fluorescence in situ hybridization is time-saving, accurate and efficient in detecting common genetic abnormalities in ALL patients, and can be well complementary to karyotype analysis in clinical diagnosis of ALL.

Adolescent ; Adult ; Child ; Child, Preschool ; Cytogenetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Infant ; Karyotype ; Karyotyping ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; Young Adult

OBJECTIVETo investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province.

METHODS44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March, 2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't.

RESULTS33.8% (69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16% (702/865) of the records were with accurate information. 74.36% (522/702) of the patients received normative services. Blood pressure was well controlled in 86.92% (299/344) of the hyperpietics, and FPG was well controlled in 85.46% (288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69% (677/686), but of which had not was just 40.38% (21/52) (χ² = 320.52, P < 0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ² = 2.92, P = 0.087).

CONCLUSIONThe quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Blood Glucose ; China ; Community Health Services ; Cross-Sectional Studies ; Diabetes Mellitus ; Disease Management ; Humans ; Hypertension ; United States