Female ; Humans ; Hyperkeratosis, Epidermolytic ; pathology ; Infant, Newborn

Child ; Evidence-Based Medicine ; Humans ; Nephrotic Syndrome ; diagnosis ; etiology ; therapy ; Practice Guidelines as Topic ; Recurrence

Objective To observe the change of the sera lipid profiles in patients with chronic hepatitis B Virus (HBV)infec-tion.Methods Sera from 254 patients suffered from liver disease were collected and divided into four groups according to the severity of the disease (71 of Cirrhosis;80,46,51 of Light,Moderate and Highly severity of the chronic HBV infection, respectively).Sera of 59 healthy patients were collected as control.The concentrations of their sera lipids (CHOL and TG), lipoprotein (HDL and LDL)and apolipoproteins (ApoA-I and ApoB)were determined and compared.Results Compared to the control group,the levels of the CHOL,TG,HDL,LDL,ApoA-I and ApoB were varied in degree in the chronic HBV in-fection group and the cirrhosis group.For the highly severity group and the cirrhosis group,statistics analysis showed de-creased and significantly different lipid and apolipoprotein results when compared to the control group.For the light and moderate severity group,when compared to the control group,levels of TG,HDL and ApoA-I were decreased with remarka-ble difference.The ApoB/ApoA-I ratio of the chronic HBV infection (Highly severity group)was 2.10±1.44,which was significantly higher than that of any other group (P<0.05).Conclusion The ApoB/ApoA-I ratio can be a potential marker for the evaluation of the severity of the chronic HBV infection.

Objective To investigate the characteristics and risk factors of hospital infection in elderly patients with acute leukemia and provide basis for its prevention and treatment. Methods The hospital infection rate,infection sites,pathogenic bacteria and infectious factors of 116 elderly patients with acute leukemia between January 1999 and January 2008 were analyzed retrospectively,and compared with groups of non-elderly patients in the corresponding period. Results The incidence of hospital infection [62.9 %(73/116)]and death[52.1 %(38/116)]in elderly patients were higher than that of non-elderly ones (P <0.01). The most commonly infective sites were oral cavity and respiratory system. The multiple and serious infection in elderly patients was more than that of non-elderly noes. The common pathogenic bacteria were mainly grant-negative one. The results of multivariate aralysis showed that the absolute neutrophil count in peripheral blood,cycles of chemotherapy,latest infections,stages of treatment,length of hospitalization and seasons on hospitalization were found as independent risk factors for hospital infection in elderly patients with acute leukemia. Conclusion The incidence of hospital infection and death in elderly patients was high. The absolute neutrophil count in peripheral blood,cycles of chemotherapy,latest infections,stages of treatment,length of hospitalization and seasons on hospitalization are independent risk factors for elderly patients with acute leukemia.

Objective To investigate various factors influencing long-term survival of the patients with APL. Methods The clinical data of 62 cases with APL were analyzed retrospectively. Univariate and multivariate analysis of the potential factors influencing survival and prognosis were carried out with Log-Rank and Cox regression method, including sex, age, initial WBC count, initial Plt count, the level of LDH,first induction regimen, length from induction therapy to CR, and post-remission therapy. Results 62 cases were followed up for 6 to 102 months. 5-year OS and relapse-free survival (RFS) were (77.1±6.2)% and (71.4± 3.68)%, respectively.Univariate analysis revealed that initial WBC count, first induction regimen, length from induction therapy to CR and post-remission therapy were important prognostic factors for long-term survival. Multivariate analysis demonstrated that initial WBC count and post-remission therapy were associated with RFS and OS. Conclusion The post-remission therapy combining ATRA, As2O3 and chemotherapy would significantly improve the long-term survival of APL patients entering CR.

Objective: To explore the mediating effects of activities of daily living (ADL) and social interaction on the relationship between intergenerational support and depressive symptoms in the elderly. Methods: Basic information, ADL, social interaction and intergenerational support from children of the elderly aged 60 years and above were collected through the 2020 database of China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated using the Short Version of Center for Epidemiological Studies Depression Scales, and the mediating effects of ADL and social interaction on intergenerational support and depressive symptoms in the elderly was analyzed using Process program. Results: A total of 3 174 individuals were enrolled, including 1 638 males (51.61%) and 1 536 females (48.39%), and 2 264 individuals were aged 60 to <70 years (71.33%). The median score of depressive symptoms was 8 (interquartile range, 13), with 1 346 individuals (42.41%) identified as having depressive symptoms. The median scores of intergenerational support from children, ADL, and social interaction were 2 (interquartile range, 3), 0 (interquartile range, 1) and 3 (interquartile range, 6), respectively. Intergenerational support negatively affected depressive symptoms through the independent mediating effects of ADL (effect value=-0.224, 95%CI: -0.288 to -0.161) and social interaction (effect value=-0.516, 95%CI: -0.807 to -0.228), and negatively affected depressive symptoms via the chain mediating role of ADL and social interaction (effect value=-0.184, 95%CI: -0.237 to -0.134). The total mediating effect value was -0.924, accounting for 46.67% of the total effect. Conclusion Intergenerational support has a negative indirect impact on depressive symptoms in the elderly, mediated through ADL and social interaction.

Objective:To evaluate the role of esophagogastric junction contractile index (EGJ-CI) in distinguishing patients with refractory gastroesophageal reflux disease (RGERD) from functional heartburn (FH).Methods:From March 2014 to January 2018, 82 patients with proton pump inhibitor (PPI) refractory heartburn and/or regurgitation, who visited the Outpatient Department of Gastroenterology at The First Affiliated Hospital with Nanjing Medical University were enrolled, among them 50 patients with RGERD (RGERD group) and 32 patients with FH (FH group). EGJ-CI of RGERD group and FH group were compared. The sensitivity and specificity of EGJ-CI to distinguish RGERD from FH patients. The correlation between EGJ-CI and high resolution esophageal manometry parameters, baseline impedance level and 24 h impedance-pH monitoring parameters were analyzed. Mann-Whitney U test, receiver operator characteristic curve analysis and Spearman correlation analysis were used for statistical analysis. Results:The EGJ-CI of RGERD group was lower than that of FH group (25.8 mmHg·cm (14.1 mmHg·cm, 35.9 mmHg·cm)(1 mmHg=0.133 kPa) vs. 39.2 mmHg·cm (23.0 mmHg·cm, 60.8 mmHg·cm)), and the difference was statistically significant ( Z=-2.833, P=0.005). When the cut-off value of EGJ-CI was 35.8 mmHg·cm, the sensitivity and specificity to distinguish RGERD from FH were 76.0% and 62.5%, respectively; area under the curve was 0.69 (95% CI 0.57 to 0.81). EGJ-CI was positively correlated with lower sphincter resting pressure, integrated relaxation pressure, distal contractile integral, distal esophageal pressure, and mean nocturnal baseline impedance ( r=0.812, 0.631, 0.451, 0.490 and 0.401, all P<0.01). EGJ-CI was negatively correlated with DeMeester score, acid exposure time, total reflux episodes, acid reflux episodes, long reflux episodes and longest reflux time ( r=-0.363, -0.372, -0.346, -0.318, -0.300 and -0.291, all P<0.01). Conclusions:EGJ-CI can help to distinguish patients with FH from RGERD.

OBJECTIVE: To explore the clinical application of gastric pharyngeal anastomosis assisted by laparoscope. METHOD: Apply laparoscope in the gastric pharyngeal anastomosis for 4 cases of advanced hypopharyngeal carcinoma and cervical esophageal carcinoma patients. RESULT: Gastric pharyngeal anastomosis assisted by laparoscope were successfully completed in all 4 patients, all patients avoided thoracotomy or laparotomy, one patient occurred pharyngeal fistula, and died six months later. One patient had cervical lymph node metastasis a year and a half later, without treatment again because of economicissue. The remaining two patients were still alive, one patient had survived 3 years and a half after operation, the other had survived 2 years and a half after operation. CONCLUSION Gastric pharyngeal anastomosis assisted by laparoscope is feasible. It can reduce the operation wound, improve the safety of operation and patients' life quality.
Anastomosis, Surgical ; Esophageal Neoplasms ; surgery ; Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laparoscopy ; Lymphatic Metastasis ; Neck ; Pharynx ; pathology ; surgery ; Survival Rate

Objective To estimate the prevalence and associated factors of adult female urinary incontinence in Hebei province. Methods Stratified and multistage sampling method was used, between January 2016 to May 2016, to investigate the target population in Hebei province. While, logistic regression was used to analyse datas. Results A population-based survey was conducted in 2 450 women in Hebei province, there were 2 408 effective questionnaires after deleting 48 invalid questionnaires. According to the results, the average age of subjects was (56±15) years old, and the urinary incontinence prevalence of adult female in Hebei province was 27.70%(667/2 408). Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 23.13%(557/2 408), 1.58%(38/2 408) and 2.99%(72/2 408), respectively. There were only 2.85% (19/667) urinary incontinence patients seeking medical help. The results of logistic regression analysis showed that age, daily water intake, pulmonary diseases, urinary tract infection, hypertension, chronic low back pain, dysmenorrhea, vaginitis, abortion, mode of delivery, postpartum infection were statistically significant (all P≤0.05). Among these factors, cesarean section was the protective factor for urinary incontinence (OR=0.365, 95%CI: 0.195-0.685, P<0.01). Conclusions The prevalence of urinary incontinence in adult female in Hebei province is high, and there are few patients seeking medical help. It is a common disorder in women and is associated with many factors;among these factors, cesarean section is the protective factor for urinary incontinence.

Objective To investigate the correlation between the level of serum cortisol and alexithymia in depressive patients with somatic symptoms.Methods The morning level of serum cortisol was measured with radioimmunoassay in 30 depressive patients with somatic symptoms (somatization group) and 30 depressive patients without somatic symptoms (non-somatization group).The severity of alexithymia was evaluated with Toronto alexithymia Scale(TAS-20).Results (1) The level of serum cortisol in somatization group was significantly higher than that in non-somatization group((533.88±144.10) μmol/L vs (458.27±82.87) μmol/L,P＜0.01).(2) The total TAS score and the factor score of Difficulty in identifying feelings and Difficulty in describing feelings in somatization group were obviously higher than those in non-somatization group,respectively ((67.13 ± 6.96) vs (62.03±7.14),(24.50±3.78) vs (21.63±3.63),(15.30±2.69) vs (13.57±2.03),all P＜0.01).(3) The level of serum cortisol in somatization group was positively correlated with the total score of alexithymia (r=0.596,P＜0.01) and the factor score of Difficulty in identifying feelings, Difficulty in describing feelings, externally oriented thinking,respectively (r=0.391,0.435,0.452,all P＜0.05).(4) The level of serum cortisol in non-somatization group was positively related to the total TAS score (r=0.418,P＜0.05) and the factor score of externally oriented thinking(r=0.489,P＜0.01).Conclusions Compared with depressive patients without somatic symptoms,depressive patients with somatic symptoms had more severe alexithymia,especially in Difficulty in identifying feelings and Difficulty in describing feelings.The severity of alexithymia was positively correlated with the level of serum cortisol.