Educational Measurement ; Humans ; Inservice Training ; Pneumoconiosis ; diagnosis ; Reference Standards

OBJECTIVETo evaluate the efficacy and safety of high dose dexamethasone combined with recombinant human thrombopoietin (rhTPO) in adults with severe newly diagnosed immune thrombocytopenia (ITP).

METHODSForty-eight adult patients with severe ITP were randomized into two groups, experimental group and control group. The patients in experimental group were given high-dose dexamethasone combined with rhTPO treatment, the patients in control group were given single high-dose dexamethasone treatment. Platelet count, platelet increase, as well as the overall response rate were strictly observed in the process. At the same time, the patient's drug tolerance and any adverse drug reactions were observed.

RESULTSThe platelet counts and platelet increase of the patients in experimental group were significantly higher than that in control group (P<0.05) at day 3, 7, 14, 30. There was no significant difference in overall response rates between the two groups (34.8% vs 36.0%, 56.5% vs 48.0%, P>0.05) at day 3, 7. The overall response rates of experimental group at day 14, 30 were significantly higher than that of control group (91.3% vs 68.0%, 82.6% vs 52.0%, P<0.05). The muscle aches occurred in one patient in experimental group which was self-recovery without special treatment.

CONCLUSIONrhTPO combined with high-dose dexamethasone could rapidly increase the platelet count, reduce the risk of bleeding, and prolonge the effect with a low incidence of tolerable adverse events compared to single high-dose dexamethasone. rhTPO combined with high-dose dexamethasone could be a new therapeutic choice for severe primary ITP.

Adult ; Blood Platelets ; Dexamethasone ; administration & dosage ; therapeutic use ; Humans ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Thrombopoietin ; administration & dosage ; therapeutic use ; Treatment Outcome

Administration, Rectal ; Adolescent ; Adult ; Drugs, Chinese Herbal ; administration & dosage ; Endometriosis ; drug therapy ; Female ; Humans ; Middle Aged ; Phytotherapy

HIV Infections ; immunology ; HIV-1 ; genetics ; immunology ; Humans ; Mutation ; T-Lymphocytes ; immunology

Background Corneal parameters (such as curvature,thickness,etc) are essential to the diagnosis of corneal related diseases,contact lenses fitting and corneal refractive surgery.Objective The aim of this study was to assess the repeatability and accuracy of corneal parameters obtained by RTVue Fourier-domain optical coherence topography (FD-OCT).Methods In this prospective study,77 eyes of 43 subjects with the refraction from-1.25 D to-10.00 D and astigmatism ＜2 D were enrolled in keratorefractive surgery center,Eye Hospital of Wenzhou Medical College.The anterior and posterior corneal curvature in 3 mm central zone (Ranterior and Rposterior),the ratio of posterior and anterior curvature (Rposterior/Ranterior),corneal central thickness (CCT),total corneal power(Knet),the simulated corneal power (Sim K),the anterior and posterior corneal power (Kanterior,Kposterior)were measured by FD-OCT.Corneal power (Km) was obtained by Topolyzer topography based on Placido ring.Three consecutive scans were acquired in every tested eye.Repeatability of FD-OCT measurement was assessed using the coefficient of variation CV),Cronbach Alpha and intra-class correlation coefficient (ICC).Repeated measure ANOVA was used to analyze the differences among SimK,Knet and Km.Pearson correlation analysis was used to analysis the correlation between SimK and K Knet and Km,SimK and Km.The agreement between Sim K and K Knet and Km,SimK and Km was assessed by Bland-Altman plots analysis.All the subjects understood the purpose of this investigation and written informed consent was obtained prior to the medical examination.Results The Ranterior,Rposterior,Rposterior/Ranterior,Kanterior,Kposterior,Sim K,Knet and CCT were (7.691 ±0.302) mm,(6.532±0.276) mm,0.849±0.014,(48.97±1.92)D,(-6.13±0.26)D,(43.95±1.72) D,(42.95±1.68) D and (545.20± 35.04) μm,respectively.The CV of all parameters was less than 1％.The Cronbach Alpha and ICC were both more than 0.9 except 0.802(ICC)of the Rposterior/Ranterior.SimK was (0.27±0.34) D higher than Km,and Knet was (0.73±0.37) D lower than Km.SimK was (1.01 ±0.11) D higher than K and all the differences showed a statistical significance (P＜0.001).There were close positive correlations between SimK and Km,Knet and Km,SimK and Knet(all r ≥ 0.976,P＜0.001).The Bland-Altman analysis showed a poor agreement between SimK and Km,Knet and Km,SimK and Knet.Conclusions The RTVue FD-OCT measuring corneal curvature and CCT performes good repeatability.The Sim K obtained by RTVue FD-OCT is slightly greater than that obtained by corneal topography,and the Rposterior/Ranterior obtained by RTVue FD-OCT is slightly lower than that from Gullstrand model eye.These results offer a basis for establishing a more accurate standardized model eye.

Objective:To explore the effect on sex hormone functional of extracts of Herba Epimedii /Fructus Ligustri Lucidi in osteoporosis rats.Methods:50 cases of 3 months Wistar rats were rando mly divided into normal group ,model group,extract low dose group(extract-L),extract middle dose group(extract-M),extract high dose group(extract-H),10 cases in each group,in addition to the normal group,other 4 groups were bulided OP model by filling and feeding retinoic acid for 15 d,then normal group and model group were filling physiological saline;extract-L,extract-M,extract-H were respectively feeding extracts of Herba Epimedii /Fructus Ligustri Lucidi at 50 mg/kg,100 mg/kg,200 mg/kg,both for 3 weeks.Measured the bone mineral density (BMD),observed the femoral pathology change of left femur with hematoxylin and eosin ( HE ) staining, measured trabecular bone tissue morphology related parameters ,analyzed the hormone receptor protein expression with immunohistochemistry .Results:The BMD of the whole femur ,femur head,and femur neck in normal group were all significantly higher than that of model group ,the BMD of the whole femur ,femur head, and femur neck in extract-M and extract-H group were all significantly higher than that of model group ,the BMD of the whole femur in extract-L group was significantly higher than that of model group ,the differences were statistically significant (P<0.05 or P<0.01).The bone trabecular number had significantly increased ,integrity,continuity improved significantly ,bone histomorphometry such as Tb.Ar, Tb.Th,and Tb.N in model group were decreased ,and Tb.Sp was increased,extract-M and extract-H group had remarkable effect on each index ,while extract-L group only had a remarkable effect on Tb .Ar and Tb.Th ( P<0.05 or P<0.01 ) , compared with model group.The expression of AR , ER in normal groups were significantly higher than that of model group , the expression of AR , ER in extract-H group was significantly higher than that of model group , the differences were statistically significant ( P<0.05 or P<0.01 ) . Conclusion:This study demonstrated that the combination with TFE and TIFL had potential protective effects on osteoporosis rats induced by retinoic acid .The combination with TFE and TIFL is able to increase BMD ,reverse pathological changes of bone tissue ,co-ordinate hormones of the hypothalamic-pituitary-gonadal axis ,and upregulate the expression of sex hormone receptors .

Objective:To analyze the change of bone mineral density (BMD) in postmenopausal women,and to study the relationship between BMD and the estrogen,cytokines,and serum levels of bone metabolism.Methods: 135 postmenopausal women were divided into the OP group (n=54),Osteopenia group (n=43) and normal group (n=38) according to the results of lumbar spine bone mineral density (BMD) scan.To detected the concentration of serum estradiol (E2),bone alkaline phosphatase (BALP) and osteocalcin (BGP),tartrate resistant acid phosphatase-5b (TRAP-5b),interleukin-6 (IL-6),tumor necrosis factor alpha (TNF-α),transforming growth factor beta (TGF-β1) and IL-10 of research objects in the three groups.And to analyze the relationship between BMD and the levels of E2,BALP,BGP,TRAP-5b,IL-6,TNF-α,TGF-β1 and IL-10.Results: In the OP group and the Osteopenia group,BMD and the levels of E2,TGF-β1 and IL-10 were obviously lower than that in the normal group (P<0.05),and the levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were obviously higher than that in the normal group (P<0.05).When compared with the Osteopenia group,the BMD and E2 level in the OP group was more lower (P<0.05),and the levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were more higher (P<0.05).E2 and TGF-β1 showed the significant positive correction with BMD (P<0.05),and the BALP,BGP,TRAP-5b,IL-6 and TNF-α were all negatively corrected with BMD (P<0.05).However,no significant difference of relevance was seen between IL-10 and BMD (P>0.05).The low serum E2 levels and high serum levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were the independent factors affecting the reduction of BMD (P<0.05).Conclusion: The E2 level in patients with PMOP decreased obviously,which caused the imbalance of bone remodeling and inflammatory reaction,and which was related to the decrease of BMD.

Objective: To investigate the incidence of adverse events following immunization (AEFI) with inactivated influenza vaccine among the elderly in Huzhou City, Zhejiang Province, so as to provide insights into safety monitoring and evaluation of inactivated influenza vaccines. Methods: Data pertaining to surveillance on AEFI with inactivated influenza vaccines among the elderly at ages of 60 years and older in Huzhou City from 2020 to 2022 were collected from the AEFI Monitoring Information Management System of the Immunization Planning System of Chinese Disease Control and Prevention Information System, including demographics, time of AEFI occurrence, classification of AEFI and clinical syndromes, and the reported incidence and epidemiological features of AEFI with inactivated influenza vaccines were analyzed using a descriptive epidemiological method. Results: Totally 84 elderly cases at ages of 60 years and older were reported with AEFI with inactivated influenza vaccines in Huzhou City from 2020 to 2022, with a reported incidence rate of 9.83/105 doses, and the reported incidence rates of AEFI with trivalent and quadrivalent inactivated influenza vaccines were 9.74/105 doses and 48.71/105 doses, respectively. The reported incidence rates of general, abnormal, coincidence and psychogenic reactions were 7.96/105 doses, 1.52/105 doses, 0.23/105 doses and 0.12/105 doses, respectively, and no vaccine quality accidents or wrong vaccine administered were reported. The cases with AEFI included 52 women and 32 men, and most cases were aged from 60 to 69 years (44 cases, 52.38%). The highest incidence of AEFI was reported in Nanxun District (17.94/105 doses), and there were 79 cases (94.05%) with AEFI within 24 hours following vaccination. The clinical symptoms mainly included fever, local redness and swelling, and local induration, with reported incidence rates of 2.22/105 doses, 3.74/105 doses, and 1.99/105 doses, respectively. Conclusions The reported incidence of AEFI with inactivated influenza vaccines is low among the elderly at ages of 60 years and older in Huzhou City, with general reactions as predominant AEFI, and most AEFI occurs within 24 hours following vaccination.

OBJECTIVETo characterize the genetic background of multidrug-resistant Acinetobacter baumannii (A. baumannii) from China, and the population structure of this pathogen.

METHODSA previously reported MLST scheme was applied to a collection of 33 multidrug-resistant strains of A. baumannii from China, and the data of all the strains in the A. baumannii MLST database were downloaded for the population structure analysis. The sequence types and clonal complexes were identified, the presence or absence of recombination was analyzed for each MLST locus, and the values of I(A)(S), and recombination/mutation ratio were calculated for the whole strain collection. A phylogenetic tree was constructed using all the allelic profiles in the database.

RESULTSA total of six sequence types were identified from the 33 Chinese strains tested, and 29 of these strains belonged to the CC92 clonal complex. Three (gdhB, gpi, and rpoD) of the seven MLST loci (gltA, gyrB, recA, cpn60, gdhB, gpi, rpoD) had undergone recombination with statistical evidence. For all allele profiles in the MLST database, the I(A)(S) value was 0.155 and the recombination/mutation ratio was 6.083. Sequence types from each clonal complex were grouped closely in the phylogenetic tree, which gave an overview of the microevolution of this pathogen.

CONCLUSIONThe spread of multidrug-resistant A. baumannii in China was closely related to the CC92 clonal complex. A. baumannii had an 'epidemic' population structure, i.e., a superficially clonal structure with high levels of recombination, in which successful epidemic clones arise especially including worldwide dissemination of the CC92 clonal complex to cause a widespread occurrence of multidrug-resistant infections.

Acinetobacter baumannii ; classification ; genetics ; isolation & purification ; Bacterial Typing Techniques ; China ; Cluster Analysis ; DNA, Bacterial ; genetics ; Drug Resistance, Multiple, Bacterial ; Genetic Variation ; Genetics, Population ; Molecular Epidemiology ; Molecular Sequence Data ; Multilocus Sequence Typing ; Phylogeny

OBJECTIVETo observe clinical curative effect of cake-separated moxibustion on impaired glucose regulation (IGR) and explore its action mechanism.

METHODSSixty cases were randomly divided into a simple lifestyle intervention group (control group) and a cake-separated moxibustion combined with lifestyle intervention group (observation group), 30 cases in each one. The control group was treated with lifestyle intervention. Based on lifestyle intervention, cake-separated moxibustion at Pishu (BL 20), Weishu (BL 21) and Yishu (EX-B 3) was applied to the observation group. Fast plasma glucose (FPG), two hours plasma glucose after oral glucose tolerance test (OGTT2hPG), fasting insulin (FINS), homa insulin resistance index (HOMA-IR), blood lipid, body mass index (BMI) and waist circumference (WC) were observed in the two groups before and after treatment.

RESULTSAfter treatment, the OGTT2hPG and FPG were both decreased significantly (both P<0.05) in the two groups, compared between the two groups, the differences of FPG [(0.41 +/- 0.42) mmol/L vs (0.05 +/- 0.08)mmol/L] and OGTT2hPG [(0.85 +/- 0.53)mmol/L vs (0.17 +/- 0.19)mmol/L] were both statistically significant. There were no significant changes in FINS, HOMA-IR, blood lipid, BMI and WC in the control group before and after treatment (all P>0.05), but FINS, HOMA-IR levels, triglycerides (TG), total cholest-erol (TC), low density lipoprotein (LDL-C), BMI and WC in the observation group were decreased obviously after treatment (all P<0.05), which had statistical differences between the two groups (all P<0.05).

CONCLUSIONThe cake-separated moxibustion combined with lifestyle intervention can obviously control blood glucose levels, improve insulin resistance and blood lipid levels, decrease BMI and WC.

Adult ; Aged ; Female ; Glucose ; metabolism ; Glucose Intolerance ; metabolism ; physiopathology ; therapy ; Humans ; Insulin ; Male ; Middle Aged ; Moxibustion ; Waist Circumference