Objective:To investigate the compliance with early Warfarin anticoagulation therapy after cardiac mechanical valve replacement(MHVR)and its related factors in elderly patients.Methods:The convenience sampling method was used to prospectively recruit 210 patients undergone MHVR at the Ningbo Medical Center of Lihuili Hospital from January 2017 to October 2019.Six months after discharge, face-to-face interviews or telephone follow-ups were conducted to assess general information, warfarin anticoagulation knowledge, anticoagulant treatment compliance and social support.Results:The overall compliance of early Warfarin anticoagulation therapy was excellent, with 99.5% of patients compliant with medication and 99.0% compliant with INR monitoring, both higher than the rate of compliance with advised lifestyle adjustment(92.1%). Anticoagulation knowledge and age were the main influencing factors for compliance in elderly patients after MHVR.Conclusions:The compliance with early Warfarin anticoagulation therapy after MHVR is good in elderly patients in the Ningbo area.The correlation analysis suggests that medical professionals need to promote education on anticoagulation knowledge and pay more attention to anticoagulation compliance in elderly people.

OBJECTIVE To study the in virto interaction of allicin combined with cefoperazone against clinical isolates of Pseudomonas aeruginosa.METHODS The protocol was designed by checkerboard method and the MICs of allicin combined with cefoperazone against the 17 strains of sensitive and 14 strains of drug-resistant P.aeruginosa were determined by broth dilution method,the FIC index was calculated according to MIC results.The combined effects were confirmed by FIC index.RESULTS The percentage of the FIC index less than 0.5,from 0.5 to 1,from 1 to 2,and more than 2 was 41.2-64.3% 35.7-41.2% 0-17.6%,and 0%,respectively.CONCLUSIONS Synergism and additivity of allicin combined with cefoperazone against P.aeruginosa are their main action,there are little autonomy and no antagonism.Allicin can significantly improve the antibacterial activity of cefoperazone against drug-resistant P.aeruginosa.

Objective:To evaluate 1,8-cineol as vaccine adjuvants to enhance influenza vaccine immune efficacy.Methods:80 BALB/c mice were divided into blank control group,1,8-cineol group,HA group and HA+ 1,8-cineol group,each group of 20.Blank control group normal breeding,HA group accepted HA protein 0.2 μg,the HA+1,8-cineol group was given 0.2 μg HA+ 100 mg/kg 1,8-cineol,1,8-cineol group was given 100 mg/kg 1,8-cineol.Except the blank group,other groups of mice intranasal immunized for three times interval of one week.At the fourth weeks each mice was infected with 10LD50 influenza virus FM1.On the 6 days after the infected,10 mice in each group were collected serum,using enzyme-linked immunoassay(ELISA)to detect serum IgG,IgG1b,IgG2a, IgG2b in 450 nm absorbance values(OD).Removed the lung tissue and measured the lung index and pathological.Remaining mice continue to observe 15 days and record the deaths,calculating the infected mice survival rate.Results:Compared with the HA group, HA + 1,8-cineol group can reduce the lung index,alleviate the pulmonary lesions,improve the serum IgG,IgG1b,IgG2a,and increases the survival rate of infected mice.Conclusion:1,8-cineol as vaccine adjuvants,can strengthen the immune effect of influenza vaccine.

Bariatric Surgery ; methods ; Embolization, Therapeutic ; methods ; Ghrelin ; blood ; Humans ; Obesity ; blood ; surgery ; therapy

Objective The present study was conducted to identify the Vibrio cholera type and to analyze its antibiotic resistance in an epidemic of cholera in Haiyan County in 2018, which would provide the references for prevention and control of cholera. Methods Stool samples of the patient and his close contacts as well as the food and environmental samples were collected for identification of the type of Vibrio cholerae and the toxin gene. The resistance of identified Vibrio cholerae to 20 different common antibiotics were tested. Results A total of 176 samples were collected, including 101 stool samples from the case and his close contacts, 35 environmental samples and 40 food samples. Among those samples, only one strain of V. cholerae, O139, was isolated from the patient's first feces sample. It was detected as a toxin gene of ctxA positive by real-time fluorescence PCR. Antibiotic resistance test showed that the strain was sensitive to norfloxacin, levofloxacin, ciprofloxacin, cefotaxime, cephalothin, ampicillin, and amoxicillin. It was 100% resistant to tetracycline, doxycycline, neomycin, kanamycin, streptomycin, and rifampicin. Conclusion V. cholerae O139 strain with ctxA is detected in an epidemic of cholera. Norfloxacin, levofluoxacin and some other antibiotics could be used for clinical treatment and prevention. It should pay attention to this strain of V. cholera regarding the multiple drug resistance and the change of antibiotic resistance.

AIM To explore the clinical effects of Shiyan Prescription on patients with ulcerative colitis due to Bowel Dampness-Heat Stagnation.METHODS Eighty-two patients were randomly assigned into control group(41 cases)for 8-week administration of Mesalazin Enteric-coated Tablets,and observation group(41 cases)for 8-week administration of both Shiyan Prescription and Enteric-coated Tablets.The changes in clinical effects,TCM syndrome scores,serum inflammatory factors(interleukin-6,interleukin-22,interleukin-33),intestinal mucosal barrier function indices(diamine oxidase,D-lactic acid,endotoxin),intestinal flora(Escherichia coli,Enterococcus,Bifidobacterium,Lactobacillus)and GQOLI-74 scores were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,serum inflammatory factors,intestinal mucosal barrier function indices(P＜0.05),increased GQOLI-74 scores(P＜0.05),reduced Enterococcus(P＜0.05),and enhanced Bifidobacterium,Lactobacillus(P＜0.05),especially for the observation group(P＜0.05).CONCLUSION For the patients with ulcerative colitis due to Bowel Dampness-Heat Stagnation,Shiyan Prescription can enhance life quality with obvious clinical effects.

Objective: To evaluate the efficiency and safety of low intensity conditional regimen for children with Fanconi anemia (FA) receiving allogenic hematopoietic stem cells transplantation (allo-HSCT). Methods: Four patients diagnosed as Fanconi anemia were enrolled in this study. One patient received HLA-identical sibling donor hematopoietic stem cell transplantation, two patients underwent unrelated donor matched (UD) HSCT, and one patient received unrelated cord blood transplantation. The conditional regimen consisted of Busulfan with low dose of cyclophosphamide. Results: All 4 cases succeeded in allo-HSCT. The median time for neutrophils engraftment was 11(9-15) day, median time to platelets (PLT) engraftment was 12 (8-28) day. One case occurred with grade I of aGVHD, 1 case with hemorrhagic cystitis. No patient happened with hepatic veno-occlusive disease (VOD). Conclusion: Low intensity of conditional regimen is efficient and safe which should be recommended for FA patients with HSCT.
Busulfan ; Fanconi Anemia ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Transplantation Conditioning

Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Blotting, Western ; Bridged Bicyclo Compounds, Heterocyclic ; pharmacology ; Carcinoma, Hepatocellular ; enzymology ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Flow Cytometry ; Humans ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Liver Neoplasms ; enzymology ; pathology ; Signal Transduction ; physiology ; Time Factors

OBJECTIVETo investigate the clinical features and prognostic factors in children with fulminant myocarditis.

METHODSThe clinical data of 24 children with fulminant myocarditis were retrospectively analyzed. According to the prognosis, these children were classified into two groups: survival (n=12) and death (n=12). The risk factors influencing prognosis in children with fulminant myocarditis were identified by logistic regression analysis.

RESULTSAmong the 24 cases of fulminant myocarditis, gastrointestinal symptoms were found as initial symptoms in 14 cases, neurological symptoms in 12 cases, respiratory symptoms in 1 case, and cardiac symptoms in 2 cases. On admission, serum levels of creatine kinase MB, troponin I, and brain natriuretic peptide (BNP) were all increased. Besides, left ventricular ejection fraction (LVEF) decreased in 22 cases (92%), cardiothoracic ratio increased in 10 cases, third-degree atrioventricular block was observed in 8 cases, ST-segment changes were found in 11 cases and ventricular tachycardia was identified in 2 cases. LVEF in the death group was lower than in the survival group (P<0.05), while the peak level of serum BNP during hospitalization in the death group was higher than in the survival group (P<0.05). The multivariate logistic regression analysis revealed that LVEF was the risk factor influencing prognosis (OR=7.418; P<0.05).

CONCLUSIONSFulminant myocarditis has no specific clinical features in children. A decreased LVEF is a risk factor for poor prognosis in children with fulminant myocarditis.

Adolescent ; Child ; Creatine Kinase, MB Form ; Electrocardiography ; Female ; Humans ; Infant ; Logistic Models ; Male ; Myocarditis ; physiopathology ; Natriuretic Peptide, Brain ; blood ; Prognosis ; Ventricular Function, Left

OBJECTIVETo study the effects of low level manganese (Mn) exposure on the serum neuroendocrine hormones levels of the welders.

METHODSThe exposure group consisted of 41 male welders, 40 male workers without exposing to harmful agents served as controls. The serum contents of prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (TST) and thyroid stimulating hormone (TSH) of 81 subjects were detected by chemiluminescence immunoassay.

RESULTSThe geometric mean value of airborne Mn concentrations was 0.03 mg/m(3) (0.003 - 0.519 mg/m(3)) in the welding circumstances. The levels of Mn in red blood cells (RBCs) and urinary Mn of the exposure group were significantly higher than those of control group (P < 0.01). The contents of serum LH and TSH of the exposure group were 2.89 ± 0.69 mIU/ml and 1.45 ± 0.56 uIU/ml, which were significantly lower than those (3.82 ± 1.61 mIU/ml and 2.19 ± 1.28 µIU/ml) of control group (P < 0.01). The serum contents of LH, FSH and TSH of the group exposed to Mn for < 5 years were significantly lower than those of the control group, The serum TST level of the group exposed to Mn for < 5 years was significantly higher than those of the control group and group exposed to Mn for 5 ∼ years, the serum FSH level of the group exposed to Mn for < 5 years was significantly lower than that of the group exposed to Mn for 10 years (P < 0.05 or P < 0.01). The serum contents of LH and TSH of the group exposed to Mn for 5 ∼ years were significantly lower than those of the control group (P < 0.05 or P < 0.01). The serum contents of PRL, LH and TSH of the group exposed to Mn for 10 years were significantly lower than those of the control group (P < 0.05). There was negative correlation between blood (RBC) Mn and urinary Mn (r = -0.310, P < 0.05), also there was negative correlation between serum PRL and serum TST (r = -0.409, P < 0.01), the positive correlation between serum LH and serum FSH was observed (r = 0.361, P < 0.05).

CONCLUSIONThe results of present study showed that the long exposure to low level of Mn may decrease the levels of serum PRL, LH and TSH in workers occupationally exposed to Mn, which can influence the metabolism of neuroendocrine hormones to certain extent.

Adult ; Air Pollutants, Occupational ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Manganese ; Occupational Exposure ; Prolactin ; blood ; Testosterone ; blood ; Thyrotropin ; blood ; Welding