OBJECTIVEThis study aimed to observe the postoperative pain rate and degree of pain in preschool children with cleft lip and palate, and investigate the effect of nursing intervention on pain relief.

METHODSA total of 120 hospitalized cases of three- to seven-year-old preschool children with cleft lip and palate were selected from May to October 2011. The subjects were randomly divided into the control group and experimental groups 1, 2, and 3. The control group used conventional nursing methods, experimental group 1 used analgesic drug treatment, experimental group 2 used psychological nursing interventions, and experimental group 3 used both psychological nursing intervention and analgesic drug treatment. After 6, 12, 24, and 48 h, pain self-assessment, pain parent-assessment, and pain nurse-assessment were calculated for the four groups using the pain assessment forms, and their ratings were compared.

RESULTSThe postoperative pain rates of the four groups ranged from 50.0% to 73.3%. The difference among the four groups was statistically significant (P < 0.001). The differences among the control group and experimental groups 1 and 2 were not statistically significant (P = 0.871), whereas the differences among experimental group 3 and the other groups were statistically significant (P < 0.001).

CONCLUSIONPostoperative pain in preschool children with cleft lip and palate is common. Psychological nursing intervention with analgesic treatment is effective in relieving postoperative pain.

Child, Preschool ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Humans ; Pain, Postoperative

Objective: To evaluate the intestinal trophic effects and adverse reactions of nasojejunal and jejunostomy tube im-plants on patients with total gastrectomy. Methods:A total of 86 patients with advanced gastric cancer were randomly and equally di-vided into two groups. Groups A and B received enteral nutrition therapies through nasojejunal and jejunostomy feeding tube implants, respectively. The therapeutic efficacy of the two methods of enteral nutrition therapy and the corresponding adverse reactions observed in the two groups were compared. Results:Group B patients demonstrated shorter anal evacuation and defecation times than group A patients, the difference is statistically significant (P<0.05). Moreover, the bodyweight, total protein, and albumin levels of the patients significantly decreased in both groups after enteral nutrition therapy was administered (P<0.05). Postoperative nutritive indexes were higher in group B than in group A;however, no significant difference was obtained between the two groups (P>0.05). Nonetheless, the patients in group B tolerated the treatment well compared with those in group A (P<0.05). The complication rates of groups A and B were 18.6%and 23.3%, respectively, but this difference was not significant (P>0.05). Conclusion:Patients subjected to total gastrecto-my showed higher tolerance to jejunal tube implants for enteral nutrition than to nasojejunal tube implants, indicating that jejunal tube implants can be used to improve the nutritional status of patients.

Objective:To evaluate the efficacy and safety of dienogest (DNG) in the treatment of refractory endometriosis-associated pain (REAP).Methods:In this study, REAP was defined according to the following criteria: (1) the pain duration was ≥12 months and visual analogue scale (VAS)≥60 mm; (2) the previous treatments with over two medicines like oral contraceptives and levonorgestrel-releasing intrauterine system failed to achieve satisfactory relief of pain, with VAS reduction less than 50%; with gonadotropin-releasing hormone agonist or mifepristone, the pain could be controlled temporarily, but it recurred after discontinuation of medicines; (3) the pain could not be relieved by surgery or even repeated surgeries. In the present study, 48 patients with REAP were treated with DNG 2 mg/day orally and the clinical outcomes were retrospectively analyzed. The VAS scores, levels of CA 125, estradiol, FSH, LH and changes in the size of endometriotic lesions before and after treatment were compared respectively. The side effects were also analyzed. Results:The average duration of DNG treatment was (20.1±12.8) months. After 3 months of medication, the VAS score was significantly reduced from (77.9±15.8) mm to (20.8±10.7) mm ( P<0.01), and CA 125 level was significantly reduced from (95±139) kU/L to (38±45) kU/L ( P<0.05). The effects were maintained with continuation of DNG treatment. Endometriotic lesions tended to shrink, after 12 months of DNG treatment, the size of ovarian endometriomas was reduced significantly from (3.1±1.0) cm to (1.9±1.2) cm ( P<0.05). The mean level of estradiol was maintained at 124.82-221.04 pmol/L and levels of FSH and LH did not change significantly during the treatment. The major side effect was irregular bleeding (75%, 36/48). Conclusions:DNG could effectively relieve REAP and is a well-tolerated therapy. It may supply an alternative option for patients with REAP.

OBJECTIVE: To study the clinical effect of carvedilol in the treatment of children with severe hand-foot-mouth disease (HFMD) caused by enterovirus 71 (EV71) infection. METHODS: A retrospective analysis was performed for the clinical data of 86 children with severe HFMD caused by EV71 infection who were admitted to the hospital from April 2016 to August 2017. According to whether carvedilol was used, the children were divided into conventional treatment group with 51 children and carvedilol treatment group with 35 children. A total of 56 healthy children who underwent physical examination at the outpatient service during the same period were enrolled as the control group. The two treatment groups were compared in terms of clinical features and levels of catecholamines (norepinephrine, adrenaline and dopamine), and the levels of catecholamines were compared between these two treatment groups and the control group. RESULTS: Before treatment, the conventional treatment group and the carvedilol treatment group had significantly higher levels of norepinephrine and adrenaline than the control group (P<0.05). After treatment, both the conventional treatment group and the carvedilol treatment group had significant reductions in norepinephrine, adrenaline, blood glucose, systolic pressure, diastolic pressure, heart rate, body temperature and leukocyte count (P<0.05). Compared with the conventional treatment group, the carvedilol treatment group had significantly lower dopamine level, blood glucose, heart rate and respiratory rate after treatment (P<0.05). CONCLUSIONS Changes in norepinephrine and adrenaline might be involved in the pathogenesis of severe HFMD caused by EV71 infection. Carvedilol, in addition to the conventional treatment, can improve respiration, heart rate and blood glucose in children with severe HFMD caused by EV71 infection.
Carvedilol ; therapeutic use ; Child ; China ; Enterovirus A, Human ; Enterovirus Infections ; complications ; Hand, Foot and Mouth Disease ; drug therapy ; etiology ; Humans ; Retrospective Studies

Objective By analyzing the surveillance result of Brucellosis in human being of Guizhou province from 2005 to 2008,to understand the current situation of relevant population with brucella infection,and then to provide the basis for the development of prevention and control measures.Methods According to the Brucella Disease Monitoring Standards (GB 16885-1997),in Guizhou province,Huaxi,Wudang,Xingyi,Dushan,Ceheng,Long Lane,Xifeng,Carey,Ziyun and so on other areas(city,county) were selected as monitoring points,and occupational groups of animal husbandry in agricultural areas,as well as farmers and students contacted with livestock were selected as monitoring subjects.Rose bengal plate agglutination test(RBPT) and tube agglutination test (SAT) were used to detect Brucellosis antibody.Results From 2005 to 2008,Brucellosis antibody detection rate was 0.63％(37/5904) in target groups of Guizhou province,specifically,the rates in Huaxi,Wudang,Xingyi and Ceheng counties(towns or districts) were 2.28％(19/832),0.16％(2/1274),1.84％(15/815) and 0.14％ (1/735),respectively; the rates in livestock workers,peasants and students contacted with livestock in rural areas were 1.29％ (36/2800),0.04％ ( 1/2814) and 0.00％ (0/290),respectively.In all antibody positive carriers,most were dairy cattle raisers which accounted for 83.78％ (31/37) in the total infected persons.Conclusions Dairy cattle and goat raisers in some counties(towns or districts) of Guizhou province have infected Brucellosis,and direct contacts with brucella-carrying cattle is the major route of Brucellosis transmission in human being.Strengthen livestock quarantine and dispose infected livestock timely are the key of Brucellosis control.

OBJECTIVETo study the DNA methylation of human telomerase reverse transcriptase (hTERT) promoter in ameloblastoma (AB) and investigate its clinical biological significance.

METHODSDNA methylation of hTERT promoter in 12 cases of AB and 11 cases of normal oral mucosa were detected by methylation-specific PCR.

RESULTSThe positive cases of unmethylated hTERT promoter region in AB and normal oral mucosa were 4 (4/12) and 6 (6/11), respectively (P < 0.001). The positive cases of methylated hTERT promoter region in AB and normal oral mucosa were 11 (11/12) and 3 (3/11), respectively. Four cases of AB and 1 case of normal oral mucosa showed both DNA methylation and unmethylation of hTERT promoter region in the same time.

CONCLUSIONSDNA methylation of of hTERT promoter region in AB was more common than that in normal oral mucosa. The DNA methylation in hTERT promoter maybe regulate hTERT gene expression.

Adolescent ; Adult ; Aged ; Ameloblastoma ; genetics ; DNA Methylation ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Jaw Neoplasms ; genetics ; Male ; Middle Aged ; Promoter Regions, Genetic ; genetics ; Telomerase ; genetics ; Young Adult

OBJECTIVEThe aim of this study was to evaluate the effects of XRCCl gene polymorphisms and its haplotype on the susceptibility of pancreatic carcinoma.

METHODSPeripheral blood DNA was extracted from 210 pancreatic carcinoma patients and 213 control subjects. SNaPshot technique was used for genotyping seven SNP sites of the XRCCl gene (rs3213403, rs25487, rs1799782, rs731420, rs1001581, rs12611088, and rs3213282). Logistic regression model was performed to analyze the relationship of different genotypes or haplotype and the susceptibility of pancreatic carcinoma.

RESULTSThe frequency for allele A at site rs25487 in the case group was significantly higher than that in the control group (P < 0.05). The frequency of GG, GA and AA genotype between the case group and control group had statistically significant differences (P < 0.05). Compared with GG genotype, the risk of pancreatic carcinoma in the subjects carrying mutated allele A (GA+AA) was increased by 0.648 times (P < 0.05). Among them the pancreatic carcinoma risk of individuals carrying A allele was increased by 0.552 times compared with the individuals carrying G allele. The frequency of allele and genotype at site rs1799782 in the case group and control group had a significant difference (P < 0.05). Compared with the CC genotype, the risk of pancreatic carcinoma in the subjects carrying mutated allele T (CT+TT) was increased by 0.683 times. Among them the pancreatic carcinoma risk of individuals carrying T allele was increased by 0.549 times compared with the individuals carrying C allele. Significant differences were observed in linkage disequilibrium between any two of the seven SNPs (P < 0.05), the frequency of H4-AGCCCGC, H6-GGCCCGG or H7-AGCCTAG haplotypes was significantly lower in the case group than that in the control group (P < 0.05).

CONCLUSIONSThe single nucleotide polymorphisms of rs25487 and rs1799782 for XRCC1 gene may be correlated with the occurrence of pancreatic carcinoma. The haplotypes of H4-AGCCCGC, H6-GGCCCGG and H7-AGCCTAG might be a potential genetic protective factor for the occurrence of pancreatic carcinoma.

Alleles ; DNA-Binding Proteins ; genetics ; metabolism ; Genetic Predisposition to Disease ; epidemiology ; Genotype ; Haplotypes ; Humans ; Pancreatic Neoplasms ; epidemiology ; Polymorphism, Single Nucleotide ; X-Rays ; X-ray Repair Cross Complementing Protein 1

OBJECTIVEHigh-sensitivity C-reactive protein (hs-CRP) may predict the development of type 2 diabetes mellitus (T2DM), metabolic syndrome (MS) and cardiovascular diseases (CVD) in adult, but few reports on relevant studies in children are available. The present study aimed to understand possible correlation between serum hs-CRP levels and some factors of obese children and adolescents with or without impaired glycometabolism.

METHODSSeventy obese children and adolescents (age 8 - 17 years) and 30 non-obese healthy controls (group 1, 20 boys and 10 girls, mean age 12.6 years) were enrolled into this study. The obese individuals were subdivided into two groups according to the results of oral glucose tolerance test: the obese subjects without IGR (group 2, 54 cases, 43 boys and 11 girls, mean age 11.3 years) and the obese subjects with impaired glycometabolism (group 3, 16 cases, 8 boys and 8 girls, mean age 12.8 years). The levels of serum parameters including hs-CRP, glucose, lipid, insulin, C-peptide and whole blood HbA1c were determined. SPSS 10.0 was used for statistical analysis.

RESULTS(1) There was significant increase of serum hs-CRP level in obese children and adolescents, the median was 2.44 (0.01 - 14.6) mg/L; the level of control group was 0.1 (0.01 - 2.1) mg/L. (2) Some of the following parameters, such as fasting plasma glucose (FPG), triglyceride (TG), fasting insulin (FINS), C-peptide (Cp) and insulin resistance index (IRI), were found increased in group 2 and 3 as compared to group 1. When FPG and TG were still in normal range in group 2, the levels of hs-CRP and IRI were significantly higher than those in group 1, the level of hs-CRP was 2.4 (0.01 - 9.0) mg/L. While FPG and TG were abnormal in group 3, the level of hs-CRP was 2.6 (0.1 - 14.6) mg/L, but the difference had no statistical significance. (3) Pearson correlation analysis showed that there was a moderate correlation between serum hs-CRP and BMI (r = 0.414, P = 0.000). There was a low correlation between hs-CRP and waist circumference, hip circumference and waist to hip ratio (WHR). The correlation of serum hs-CRP with blood pressure, TG, cholesterol, high density lipoprotein-cholesterol (HDL-C), HbA1c, FPG, FINS and Cp had no significant deviation. (4) Multiple linear regression analysis showed that body mass index (BMI) was the only indicator which had correlation with hs-CRP.

CONCLUSION(1) There may be a chronic low-grade inflammation and insulin resistance in obese children. (2) The level of hs-CRP might be independently correlated with BMI in children. (3) Hs-CRP and IRI elevated before FPG and TG did, which may suggest that the low-grade inflammation and insulin resistance may be a pathogenic base of DM rather than the outcome of it. (4) The elevation of hs-CRP may help predict impaired glucose and lipid metabolism.

Adolescent ; Blood Glucose ; analysis ; Body Mass Index ; C-Reactive Protein ; analysis ; Case-Control Studies ; Child ; Female ; Glucose Tolerance Test ; Humans ; Insulin Resistance ; Lipoproteins, HDL ; blood ; Male ; Obesity ; blood ; metabolism ; Triglycerides ; blood ; Waist Circumference ; Waist-Hip Ratio

Objective To investigate the effect of cyclosporine blood level at first year after kidney transplantation on patients with a survival time over 10 years. Methods 380 patients with functional allograft, a survival time over 10 years and long-term administration of cyclosporine A (CsA) were studied, and received CsA-based treatments. According to the blood CsA level at the first year after kidney transplantation, patients were divided into five groups: group 1, blood CsA level was above 0. 208 μmol/L (1 μmol/L = 1201.9 μg/L), group 2, blood CsA level between 0. 166-0. 208μmol/L; group 3, blood CsA blood level between 0. 125-0. 166 μmol/L; group 4, blood CsA blood level between 0. 083-0. 125 μmol/L; group 5, blood CsA level less than 0. 083 μmol/L. Systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine(SCr), uric acid (UA), cholesterol (CH), triglyceride (TG), alanine aminotransferase (ALT), direct bilirubin (DBil) and total bilibubin (TBil), albumin (Alb), hemoglobin (Hb), count of white blood cells and positive rate of proteinuria in 5 groups at the 1st, 5th and 10th year after kidney transplantation were analyzed. Results At the 5th year SBP in groups 1 and 2 was higher than in groups 3, 4 and 5. UA level in group 5 was lower than other groups, and Alb level in group 5 was higher than other 4 groups. Proteinuria positive rate in groups 4 and group was lower than other groups. At the 10th year after kidney transplantation,indexes among 5 groups had no statistically significant difference, except for SBP, DBP, DBil and CH in some groups. There was also no significant difference in SCr level among 5 groups at the 5th or 10th year after transplantation. Conclusion Blood CsA levels at the first year after kidney transplantation has no significant effect on long-term allograft function. But higher level of CsA (＞0. 166μmol/L) at the first year maybe predict high rate of hypertension, high blood UA and proteinuria at the 5th and 10th year after transplantation.